##VIDEO ID:pcMLLgdUNfw## all right we're starting and we're recording thank you so much um so welcome everyone I'm going to be facilitating this meeting since we don't technically have a chair yet we will by the end of the meeting because it's one of our agenda items um but good evening I'm Kiko I'm the public health director for the town um I'm officially opening the meeting of the board of healths August 8th 2024 I'm realizing that I don't have the preamble that Moren used to read as the chair which is this um you know Legal Information that says that it's okay for governor Healey for us to hold these meetings virtually it's a provision that happened during covid and I remember that a couple times we had to send it to Meen Kyle do you have that handy I am looking in the share drive for it now these are the details that sometimes Escape us until we're in the hot seat so on whether we have to do that because the other Town boards I have been part of do not is that right okay um so worth I can make a note to see if I can figure out if that's an actual requirement or not Kiko I'm sending it to you via teams right now in case you wanted to okay thank you Kyle right it's making me log into teams again okay so I'll just read it but we will get clarity on this thank you Risha for offering that uh pursuant to chapter 20 of the acts of 2021 and renewed by Governor Mary this meeting of the Board of Health would be conducted via remote means members of the public who wish to access the meeting May do so by following the instruction on the board of health posted agenda via Zoom no inperson attendance of members of the public will be permitted but every effort will be made to ensure that the public can adequately access proceedings as soon as it is technologically possible after this meeting all approved Board of Health minutes are posted on our website once they are approved by the board I will now open the August 8th Board of Health meeting at 5 o'cl with the roll call so I'm going to start with you Risha yes present I forget what we say that works Prema mayor present uh Betsy Brooks present and Jack Jon present thank you um so our first order of business is to review the minutes from the last meeting July 11th which two of our new board members were not at because they were not board members at that time um but we have ran Prema here not a quorum um but it's what we have in terms of approving those minutes um so did folks get a chance to look at them there was a it was literally a 10-minute meeting that we had in July which was simply held to approved minutes from the past meeting in June yeah they look fine to meet okay me too great so a motion to approve I can motion if we don't have a core I don't know that it matters but I can motion to approve thanks and I can second all right great so and and all in favor thanks you as well okay great hi I think that's I think that's fine it was not there was nothing really substantial in there so it feels okay not to have an official Quorum hope that's all right okay so now the next item on the agenda is public comment do we have anybody I don't see any attendees so I think attendees okay okay great so we will move along um I thought it would be great so initially we had thought to do this meeting in person um it's pouring rain outside so it's kind of nice that we didn't end up doing it in person and also because Prema wasn't able to join and we don't really have our full compliment of board members we're still missing one person who has yet to be identified so then we pivoted to just to do this meeting virtually um but would be great just to uh have you Jack and have everyone introduce themselves just briefly name you know what you do and why you're here on the board um just so we can get to know each other a little bit that would be great um so I'm bety I'm looking at you because you're the first person I see on my screen so I'm gonna start with you okay my name is uh Betsy Brooks I'm a retired pediatrician I retired uh actually last November i' had been uh previous ly at Holio Pediatrics for 35 plus years and then the regional medical director at the um uh Primary Care Network associated with Children's Hospital that a lot of the I think most of the regional pedi pediatric offices are part of and I've lived uh in amorist and actually the house that I still live in for 40 years now um and uh I live next door Teresa connection yep who was not the person who um who solicited me to join um right so and that that was actually Moren who you know well right who suggested you I've known Moren for almost 40 years and um both Moren and Diane Amsterdam are two close friends of mine who have served on the board yes well thank you Betsy welcome we're so happy to have you so happy to be here so keeping along the theme of new folks Jack I'm gonna turn it to you yeah oh is this being recorded it is oh okay all right I got to keep it um official then uh professional not official but yeah I'm a hydrogeologist in the area I've been a consultant for again that 35 number sounds about right for me too um and I have been an amoris resident since 2000 and previous to this I started doing some Community Service uh probably eight years ago on the planning board I served two terms on the planning board and six years total and then I've just been on some other uh boards one being oh I'm currently on the water supply protection uh uh committee so um but yeah other things I was involved with the dog park and the solar bylaw working group uh so and I was and and then Paul bamman knows me and I guess the person that was previous to me had some groundwater experience or or kind of engineering so I'm kind of filling that role I guess so I'm pleased to be on here and W hello everybody can I ask you a question yes are the beautiful sunflowers real or virtual though well uh they're real from 10 years ago but I got another crop coming in so we'll see if I can do as well that's our backyard yeah oh it's beautiful that is beautiful they look like they're they're taller than you yeah well I have a I'm in a in a basement office so I kind of need some more attractive than uh yeah you know what I mean yeah well and it's nice for all of us too we enjoy seeing that so thank you it's great thank you so much Jack really happy to have you as part of the board thanks um Risha sure um and it's great to have you guys I'm really excited about the the next phase of this board um so I'm Risha I grew up here as a child um and then returned in 2020 in between I was um working in international Public Health uh mostly maternal and reproductive Health HIV Family Planning abortion maternity Etc um I am also on um the survival center board and uh was previously on the affordable housing trust um I'm on the Roger E Wallace teachers uh in Excellence board and uh the Ethiopian ultimate Club board oddly enough um so yeah that's me I'm I'm a consultant now in in international Health thanks Risha that's quite the diverse board experience it's fantastic great R are you an MD no I am not I am I come from a business background I'm more about uh running the programs than actually doing any of the work okay thanks Risha we you know how much we appreciate you having you on the board so thanks a lot um and Prema would you like to introduce yourself sure Risha did you say Ethiopian ultimate yeah that's where I was living before here so uh oh okay they need a board so I'm on it yeah that's very unusual um so I'm Prema ner uh Betsy you and I have actually met at the um I think at the house of Diane Amsterdam when she had the meeting about um abortion providers oh H yes okay yeah um so anyway and and Jack actually you and I have met um yes I I I told Bobby yet that you're you're on the board so that's my wife yeah I'm friends with Jack's wife Bobby yes um anyway so I'm a nurse practitioner I currently work at UH Smith the health services at Smith college um prior to that I worked at UMass and then uh at a community health center in Springfield um I worked overseas with refugees um for many years um since 1979 and I've lived in amoris for 33 years um or born and raised in Singapore originally that's it wonderful thanks Prema and it's nice to see all these connections it really is a a small community people do kind of tend to you know cross paths with each other so it's great that you've met folks in other settings um okay so in terms of um orientation um and Jack you both received um a a a manual about what it means to participate in General on boards and committees for the town I mean Jack you obviously have some experience um and you were both sworn in you told us so you've gotten that sort of official onboarding and then we are putting together an orientation manual it's almost completed it is in PDF form so Jack we definitely wanted to we took your advice and it's a virtual um manual electronic manual that um Kyle's been working really hard on it's almost finished so we'll send that out to you it has you know most of the background just about the charge of the Board of Health uh you know the establishment of boards of Health through Mass General law um some other kind of legal stuff open meeting law which might be somewhat redundant to some things that you've already received and also the minutes from the last year and sort of summary of the work that the board has done over the last couple of years um and contact information for everyone on the board as well as the public health department staff and as I'm talking I'm wondering so Risha you started when I started and I don't know whether you got an orientation manual you did not so we'll send it to you as well um and Prema I'm not sure if you I'm assuming you got one because you had been on the board for years so you did okay um so the only thing that would be different I mean we can email this to you so you have it it's slightly updated if you'd like and it has the updated contact information for everybody too so okay great any questions about orientation about the charge of the board um yeah I'm on um Kiko how about you and Kyle because I I think I remember most but a little brief background would be good oh yeah of course yeah thanks for asking um Kyle do you want to go first yes I had to make sure I was off mute um so I'm Kyle I'm the public health program assistant here at the health Department uh I graduated from UMass in 2023 with a bachelor's in public health and then in 2024 with a masters in health policy and management um and right now I just kind of assist in this role with the board and kind of organizing things doing some preliminary research and just compiling things for you guys so I hope to have that orientation out pretty soon um and I'm going to try to make it pretty user friendly so fingers crossed on that thanks Kyle thank you um and so I'm I'm Kiko M and I've been in this job only since last October so it hasn't even been a full year yet um my public health experience has mostly been on the west coast in Oregon and California I grew up in the eastern part of Massachusetts so I am a New Englander by birth but I moved out to the West Coast in the mid 80s thinking I would never come back um it was just sort of important for me to stret my you know wings and do something different and I really enjoyed what I learned on the west coast I was working mostly in Maternal Child Health reproductive Health most of my career and ended up um in Oakland California where I lived for almost 25 years I was the Family Health Services Division director for the Alam County Public Health Department in Oakland for 12 years and that was a job I really enjoyed you know big Health Department big Division I had 200 staff in my division that were doing all kinds of things ranging from home visiting for young families with kids under the age of five to services for children with special Health Care needs to policy work we had lots of funding from various sources Federal and otherwise so it was a big job in a very diverse and sort of busy city um which I enjoyed doing for many years but then I decided to move back to Massachusetts mostly to be closer to family um my mom is aging and having some health problems and she's been the primary care caregiver for my sister who's been disabled since she was 12 years old and she's now 53 so my mom's no longer able to serve in that caregiving role for my sister and it was really so difficult to manage all of this from 3,000 miles away during a pandemic eventually I thought I just have to be closer so I decided to move back to Massachusetts I came back two years ago I worked in Northampton at the Department of Health and Human Services for a year as their substance use prevention team director and then came over here to ammer to be the public health director and I've landed in such a good spot I'm very very happy to be here love the folks that I work with really enjoy working with the board and the other um staff in the town so it's a great great thing for me very different job I used to be Super Hyper focused on a very specific area and now it's everything that comes across my desk that could be potentially related to The public's Health in Amor that I that I need to manage so it's been a learn steep learning curve but it's been really fun so thank you yeah yeah thank you for asking um I also want to mention mentioned that you know our health department is small so we have Kyle who's been full-time this summer but was part-time when he was in school and sadly probably won't be here won't be with us forever is going to be moving you know he graduated so he'll be moving away soon and we're going to try to keep him on for as long as we can but eventually he won't be working for us anymore and we'll be looking for another public health program assistant hopefully it's really helpful to have someone in that job um we also have a full-time public health nurse Olivia Lara kahoun who's been with the department for two and a half years and she does all of our vaccines and vaccine for children program and a lot of health education and just supporting people in the community so she's a super important staff person and then we also have a uh Nancy Schroeder who is retired from the Housing Authority for many many years is a longtime amoris resident knows everybody and everything that's going on in the town and is sort of our sort of Resident historian for public health and for the town she works part-time just 12 hours a week but she's a terrific person to have on board and she does the minutes for these meetings so she'll be listening to this recording and transcribing it into meeting minutes that we'll review next time so that's the public health department small But Mighty um then uh but you have inspectors but that's I wrot that down to say something about it and promptly forgot so thank you for asking yes so there are three inspectors there are two Health Inspectors Susan Malone and Sasha clap and then Ed Smith is the lead um code enforcement in insector and he is the supervisor and then does is sort of the most senior person who does all the higher level stuff but they don't report to me as the health director they're part of the planning department here in the town there was a separation that happened I think more than 10 years ago where the inspectors got moved to planning from public health and I work very closely with them we have a twice a month meeting there's also a big meeting of the inspect all the inspections group including the plumers the electricians folks who do all those kinds of inspections and I try to sit in on those meeting so I'm just aware of what's going on in the community so definitely very well connected Sasha and Susan we work with closely you know a lot of times people if they have a complaint about a restaurant they call us first Kyle Fields the call to Susan or Sasha and they get on it right away and they let us know what they're discovering when they go out to do a restaurant inspection um and if there is something that's going on with a restaurant to the point that it needs to come before the board the inspectors will attend this meeting they are agents of the Board of Health and so they they are connected to this meeting for those kind of issues for um well applications geothermal well applications are also handled handled by them so they make occasional appearances at this meeting and so that's how we're set up here in town anything else other questions okay so I think we can move on then to our next agenda item which is old business um and these are our tobacco regulations that we have had in place for some time they were revised I guess back in 2020 it was a major revision um and we've gone back to look at them in the last year I think we started looking at them as a board in January and it's taken us some time to kind of adjust and tweak we wanted them to be in alignment with the changes that are being made to the state template for regulations you know local regulations can be stricter than the state but they have to follow what the state says and can do more if they like so it's been an ongoing conversation and um with that I'm GNA hunt it to Risha because she's really been holding this um with Moren and now that moren's gone she's our chief person on Tobacco regulations so go ahead Risha yeah thank you um so we're not gonna we're not aiming to make any decisions or even really dive into details today um what I wanted to do is just catch particularly the the two new members up on where we are and then let you know what the next step is for the next meeting um so in late breaking attachments you should have received a summary of decisions as well as a cleaned up draft of the regulations as they stand now so what we did since January and it was quite a slow process um was have a series of discussions both um there are some edits that are not optional we have to adhere to the states and therefore incorporate them and then have discussions about the optional pieces and some of them were quite small and then some of them were substantive um I tried to summarize all of those in that summary document so you can see we didn't vote on any of those those are not done deal decisions we just sort of understood that the consensus seemed to be leaning in One Direction or another and so I wanted to highlight those so that you know you can voice another opinion on them if you think we we headed in the wrong direction um but these are the substantive changes that we have made that are now in the new draft it we change so much um editorially sort of the outline and the the way it is that it doesn't make sense to have a track changes it just is gobbly G so you're getting a clean version but I'm trying to highlight what changed um and I think there was just the one um yeah so on number nine on the summary document I share your screen with with that um can I share my screen I didn't print these out and I think that's okay to do yeah go ahead and share your screen if that's helpful to folks okay I think this is the right one does this have a bunch of dates over here are you see so um so these are sort of administrative these were conversations we had one through five I'm not going to go over them you can read them after this meeting uh these were three edits that we made that we did not discuss and so when Moren and I and the the state person were sort of going back and forth it seemed like these were fairly straightforward but again we can be totally overrode on that um and then nine I I will update um we decided that it didn't make sense for Town inspectors to go to non-tobacco outlets to check for regulated products in the tobacco regulations right so if if we want them to go to non-tobacco um so there could be tobacco products in stores that are not licensed to sell tobacco products right and we could check that they that those don't exist um we decided it wouldn't make sense to put that in these iions that that would be um part of what they could check when they are going to other stores under other directives um so I can update that that I I couldn't remember what our decision was but uh I was reminded and then there's three questions here that we haven't landed um that remain to be decided uh again they they're fairly small but everything small always ends up with long conversations because it's never small um so what I would like to do is have everybody before the next meeting both review The Tobacco regulations as they stand in the current draft check the list here of what we've decided and needs to be decided and come prepared to say I think we're going the wrong way on this or I have questions about this or um and then we'll vote ideally uh to approve uh with maybe a few changes um those regulations they then have to go to public comment Pico am I right on the process there so need to do a public hearing an official public hearing where we make an advertisement in the newspaper that we're holding a hearing to solicit feedback or you know get comment from the public about the regulations before they're approved by the board y anything Prema or Kiko to add to what I said okay and any then any questions I I did I scan it and I just I was thinking wow is some of this stuff you know dated you know given the marijuana laws and and things like that and so it was definitely new to me that you know we were strict toward tobacco so this is my my lack of experience being on the board of L so it was interesting but the one thing that caught my eye was like if a establishment was uh had their license revoked that that license wasn't made available to someone another uh store in town I think I read that right and I thought that was odd but yeah that struck me as well uh it was a decision made long ago that we were uh phasing out tobacco licenses as a town and so every time one closes you have one less um and I the the theory is it goes to zero at some point in the future that was that was not a decision made in in this revision or in the 2020 I don't think I don't know when that was made yeah I think it predates both of those I I think it's you know Public Health has long really been a watchdog about to about tobacco related issues and there has been so much reform with respect to Tobacco as a result of advocacy that's been done by public health you know sort of spearheaded by public health and in amoris there really was a quite deliberate decision made to be very strict on Tobacco especially on the ability of young people to get access to it when it's really not legal for folks under the age of 21 so I understand it feels a bit restricted Ive you know to say that we are eventually trying to dwindle our the number of available tobacco permits in the town but that was a deliberate decision that was made by a very sort of tobacco concerned Public Health Board um at the time and it was in sync with what was really going on I think nationally about tobacco and in Massachusetts as a state where we have quite quite strict laws about tobacco here compared to some other places Massachusetts and California do yeah well anyway I guess I have to get on board with that um it it's it just seems restrictive to me but um and I you know I'm not a a health uh professional but I you know I know some people are more susceptible to it than others and so we're kind of protecting the most sensitive you know Among Us I guess so and that's that's with cancer and things like that some uh but that I'm digressing there in terms of people you know living to 100 you know that are smokers sort of thing but um all right know appreciate you expressing your point of view um I I do think what you were saying earlier um Risha about the public hearing so um I think when the tobacco regulations were revised in 2020 there were some additional restrictions that were introduced and there was a hearing that was quite well attended and I understand there was some Lively debate uh I wasn't there um I don't think this iteration of the of the regulations is going to have that kind of response because there aren't as many big changes that are happening but there are some things that are significant um some of the things that you've mentioned but and also that it's been very clearly spelled out in this version of the regulations again flowing from the state that flavored wraps so you know not made out of tobacco but things that are made out of hemp and have flavors in them and are designed to roll either tobacco or potentially marijuana those are clearly band and that was sort of a gray area for a while and I think that I've gone into some stores where those things are being sold and was not of the mind to say those have to come off the shelf because it wasn't crystal clear and our regulations and that has been spelled out and that will be a change for some of these places and that may cause some some stir um so I just think it's and there so there may be a few things that are different um we'll just see what happens when it comes time to hold the hearing uh but I just wanted to say that go ahead Betsy so I had two questions that are sort of big picture let me know where the conflicts are so what what's changed between um vaping and and cigarettes like the you know are there any U differences on where you're allowed to vape versus where you're allowed to smoke or are these you know were there any big changes in those and then are tobacco and vape products that again I only looked at this very quickly are those uh that are sold in uh Cannabis shops not covered by these regulations um how what's what's the politics and the history of these things so the first thing I'll say is that these regulations don't touch on where people can smoke it's only where they can buy products um and and where you can sell them um and so I don't know the answer on where you where you can Vape versus Smoke um I'm going to assume it's the same places but I don't know that for sure I can jump in quickly on that so uh Betsy if you go to our website um specifically under the Board of Health Website and click regulations there is a section for tobacco products and smoking and there's a specific regulation about prohibiting smoking and vaping in workplaces and public places so that might answer some of your first questions yeah and and these again are Statewide laws so my understanding of it is you you can't smoke or you can't Vape some places and smoke others you can't do any of it in the same kinds of places like within 200 feet of a doorway in workplaces smoking vaping they're equivalent things and and similarly the the regulations that you've discussed they're they're they're pretty much the same for smoking and and vaping the the license requirements the yeah and then in terms of the marijuana Outlets to sell tobacco you need a tobacco seller's license and so whether you're also a marijuana I think um I think we actually have banned the two of those things being one right that I'm thinking about I know you can't be an adult only venue and also a non-adult only so right I don't know if it is C I'd have to go back and look if there's Clarity on that but if anywhere you sell tobacco you need to have a tobacco license um and then the marijuana licensing is separate it certainly has overlaps because of the wraps because of the various paraphernalia but and the vape pens whatever are are good for one and the other and so is that a gray area I don't think we've talked about that yeah um it it I have to say the landscape has changed so much like there are always new products that are coming in so it is complicated to keep keep up with all this um but um any of those electronic nicotine delivery devices those are all covered under these regulations so if there are other if there is paraphernalia that doesn't have a nicotine product associated with it that can be sold you know like pipes and P other kinds of things can be sold in non-tobacco places um but all the nicotine has to be in a place that has a permit to sell it um the other thing I just wanted to mention is that you know Jack to your earlier Point uh there was a piece of legislation that was introduced and passed I'm forgetting which town now Brookline maybe somewhere in the sort of greater Boston metropolitan area um that was has been labeled the nicotine free Generation Um legislation which essentially says that anybody after older younger born after a certain year cannot buy nicotine products forever in perpetuity so it's not like once you reach a certain age you can buy them in this particular town I'm forgetting which one once you're if you're born after a certain year you are never going to be able to buy nicotine products so in terms of this idea of being very restrictive like trying to sort of eradicate tobacco or nicotine from you know retail establishments because of its demonstrated health hazards gateway drug lots of different things that are concerning about it there are there are much more restrictive policies that are in place than our limiting you know to 14 permits here in the town of ammer that are out there and there's a movement to kind of really push this so I think that Amis is kind of in the middle of being we really want to be careful we want to make sure that we're monitoring this I'm not I don't think this nicotine free generation is something that we've ever talked about here or that is something we would consider um but we the the previous board was quite clear about being rather strict about limiting access to this very highly addictive substance and at the same time we do really try to be business friendly to the degree possible when things happen so example for example if somebody sells to an underage you know we do have there are tobacco compliance officers that go out every twice a year to do basically sting operations they send a young person into these retailers to try to buy tobacco and if the person in the store sells to the young person without asking for an ID and them tobacco then we get informed about that and we we site them we find them and we suspend their license but you know we work with them on it we say okay you got to pay this fine and when would you like to suspend the license would it be what's the best time for you you know we really try to they are businesses in our community they're part of our economy we want to support them and we also want to hold them accountable for complying with the laws that are trying to keep people as safe and healthy as possible so just to give you a little bit more background since it's a new area for you jack I thought I'd throw that out there and we can certainly talk about this more as this topic is going to come up on our agenda again next month and perhaps the month after yeah I mean just from a health perspective I'm again I'm just trying to remember you know nicotine and there's there's tars and I think is the tars that that are cancer causing and the N nicotine is more like you know the drug part of it um yeah um I'm I used to smoke a little bit so trying to remember yeah so I I may not have these facts exactly correct but I think the you know the Pediatric literature says among the people who become addicted you know starting to smoke at age 12 um makes it much much more likely than you're that you're going to be a lifelong smoker and um there are really are um you know even with the VAP well maybe even especially with the Vape devices because they you know they can go under the radar for parents and others that um you know the that nicotine addiction has not been decreasing you know there's sort of been an upswing um and that you know the new landscape has been um you know had some real risk to it it's it's not like this was all solved and no one's smoking anymore or using nicotine products yeah and there are compelling public health reasons to try and um keep the youngest people from becoming smokers users yeah and as you said I'll just say one more thing on this and then and then I can move us along unless there's a burning issue that people want to keep talking about but there's a there's a rich literature here Jack as as Betsy is alluding to um and I think it's true you know it used to be just cigarettes and now there are all these other products and how young people have taken to vaping and the way that vaping has been marketed aggressively by these companies to young people using social media to the point where some of them are not you know able to function very well in school because of this vaping it's a huge concern in the schools um and then just the whole point about how this is a big corporate these are Big corporations that are making lots of money they disproportionately Market in communities of color there's a whole Equity argument about this that's very concerning from a public health standpoint so there are many reasons to to restrict or worry about access um to tobacco products ntin products for for young people and for people in general just from a health standpoint an equity standpoint so anyway yeah go ah one point um as you review it um also know that this is a very litigious area um and so other towns Departments of Health are getting sued by particularly Cumberland Farms um which is local so could happen here too um so if you catch anything that seems you know that it's it's vague or it might be hard to defend I think it's useful to highlight that in your review such a great point Thank you for for flagging that so so then we have a little homework right everyone has a little homework to go to read over what um we've sent to you most recently and come to the next board meeting prepared to you know answer those questions that you've outlined Risha in your document that are still outstanding and then hopefully be able to move towards a final version of these regulations fairly quickly does that sound accurate I just wanted to compliment whoever put that document together it seemed very clear again I just browsed it but it seemed like it was very well done I I was quite impressed with the professionalism the quality of that document a lot of hands that predate everyone here on this meeting but uh but yes there's a lot of work done thank you and yes Kiko I think that sounded right okay thanks yeah it's definitely been a labor of love a lot of hands and I really want to compliment Risha for being able to summarize it so succinctly and help us to move us along to getting this finished so thank you okay so I'll move us to our next item which is new business um which is to nominate and vote on a new chair so I'm wondering I mean uh if anybody here would like to self-nominate um to be chair so I'll just speak Frank Risha and I have had some conversations Prema and I have had some conversations Risha is interested in being chair Prema has said it's not something that's really in the cards for her right now Betsy you and Jack being new I wouldn't expect you to step into that role so through our conversations Risha I think it's self to sa safe to say that you have self-nominated for this position would you concur um I I am willing to self-nominate I do want to say that I am not dying to do this job and I'm not petitioning for it so if there is anyone else that would like to raise their hand I'm more than willing to support anyone else in doing this um but if there isn't I'm happy to self-nominate I'm happy to nominate you so you don't have to self all right so no one wants to do it is what I'm here okay thank you so I think Risha has now been offic officially nominated to serve as chair I did want to say that um it's just it's a year commitment the Board of Health member term is a three-year commitment but the chair is just a year and that's because both because we recognize it's a lot of work I think it's good to sort of keep that role moving among people um it's wonderful Risha that you're able to do it I know it's not your first choice but very much appreciate that and the support of your colleagues here so unless there's any discussion I think we'll move forward then to say that Risha has been nominated to serve as chair of the Board of Health for one calendar year or until the membership changes significantly and there's a need to revisit it and I would want I would ask then if somebody would I guess we just move to a vote then if we can vote to elect Risha Hess as chair of the Board of Health for the calar for until next year this time so Betsy says I I yeah pra yes with much thanks to Risha when we get together for a potluck you don't have to bring [Music] anything yes thank you Jack and I'm the last one so yes I mean there is also theoretically a position of a vice right yeah we did at some point um during the time that I've been the health director we had a board meeting where we did decide to have co-chairs I think we called them not Vice chairs or I don't recall now I'd have to go back and look at the minutes but the idea that there would be another person who would step in should the chair not be available or you know need to step back for some reason so we did codify that through a meeting of the board so I guess we could elect a co-chair although I would propose that maybe we want to wait till we have our full board before doing that yeah and I I I think I had spoken against co-chairs when that conversation happened only because we had co-chairs um on the affordable housing trust and I found it very difficult to mesh that with open meeting laws because you're only allowed to have um two people talking outside of a meeting about meeting business before it becomes a violation and so if two co-chairs and a third person are talking even if they're not talking at the same time that's a violation um and so I I found that very difficult so I would not recommend having co-chairs um but someone that could step up if I miss a meeting or you know can't do something I think would be very useful if we it officially then we just ask for someone to step in but it's nice to have it official and do you recall because I think we did actually vote on this in a meeting so and I remember you raising this concern before so I think we must have used the wording Vice chair versus co-chair to address this concern since we did vote it in as a board yes I'm pretty sure we we uh agreed on Vice chair okay that Tim was going to be Vice chair thank you thank you Prema um so so given that that I mean certainly this board could change could vote to change that um you've made a strong argument Risha for why that makes sense it's currently what's happening so unless anyone has strong objection I would sounds like we want to go ahead with that um but to wait until uh we have our full comp of board members to elect a vice chair great does that sound right okay great all right um okay thank you um so I guess the next item then is for the is the director's update I I did just want to say that these meetings so the the Board of Health if you looked at um well I guess we haven't sent this to you yet because it's part of the orientation manual that we're putting together but really the charge of the of health is focused around regulations writing new regulations you know amending existing ones ensuring that we're in alignment as a m local municipality with state regulations related to Public Health it's really about that's the work that's the meat and potatoes of the board um not so much program planning or other kinds of things but really around regulations um but there's also a section of the meeting and we've come to it right now where I as the Director or other Pro public health staff we'll just give you an update on what we're doing programmatically I think it's important for the board to be aware and also for us to take questions and for you to you know have some role in kind of participating in providing feedback about the programming that we're engaged in so that's this section of the meeting so just a couple of things um the first item is to talk about Board of Health membership so we still have one um seat that's vacant and we have a couple of applications that have come in there're also a couple of people that have expressed some interest that Paul and I have been talking to so I'm hoping um by the end of August that we will have um the the fifth member identified so that that person would come to the September meeting which we can hopefully do in person um since we'll have everybody um you know identified to serve on the board so that would be that's the plan there that's what's happening with that final seat any questions about that um when we meet and person um were we in the the town hall there what what room do we would oh no there's the downstairs one too yeah yeah it's it's kind of at this point it's it's anybody's guess we have met and the last time we met in person it was in the Town Hall in the town room on the second floor yeah but we would actually prefer to meet here at the bang Center because that's where the public health department is it's where our community services Hub you know where our community services are located so Kyla is working on getting a room that we can use here on a monthly basis so that people will be coming to the same place every time when we have an inperson meeting so we'll have more information about that soon I believe I requested the bangs room um through the rest of the calendar year but I will double check that and we'll let you all know uh before the next meeting and do we continue to have a a zoom option available so if we're try if we're in London for instance yeah I think I think what works best is to either do it virtually or do it in person the hybrid meetings can be a little tricky because we don't always have a big screen that someone can join virtually through um So based on member availability weather things like that we will decide ahead of time will this be an in-person meeting will this be a virtual meeting and I think we'll try to sort of do a blend of the two as the year unfolds okay um okay so what else mosquito surveillance so I sent you so for for those of you who are new just a quick overview is that um town of amrest has a contract with the Pioneer Valley mosquito control district um which does a really good job with M mosquito surveillance so we work it's really a oneman show a man named John bricks who is like the most dedicated public servant I've ever met he's out there every day in the trenches um treating mosquito pools you know catch Basin storm drains other things where mosquito larvi could be growing and surveilling mosquitoes so he was telling me how he had a whole Lab Set up in his dining room where he's you know looking at mosquitoes and testing them and seeing if there are any that are testing positive for for West Nile or Triple E um so he does that Weekly he's out there surveilling in amorist and in other communities that are part of the pvm CD and um at the at the very end of last year he found a westnile positive mosquito in a pool in North ammer so it's the very end of the season really like late September we didn't have any cases of westnile virus that we were aware of in ammer but there was this one mosquito that was identified at the end of the season and as I think you all are well aware we're it's it's the mosquitoes are worse because of climate change more humidity more wet rain heat all of those lovely things are combining to increase our mosquito population so we um carved out some funds to be able to do some treatment so he did he's treating some of those areas North amorist he did this first in late June with briquettes these bti Prett so it's not spray they're you know much much less toxic these are little briquettes you can get them at Home Depot for your own use at home that are put into the storm drains and they kill the larae versus the adulticide which is what the spraying does that you might see around town um so he's treated a couple areas and he did an additional treatment today because he found quite increased mosquito growth in some pools in that area of North am so he's continuing to kind of keep an eyee on that there there was a westnile v virus positive mosquito identified in hoio and a couple in West Springfield or East Long Meadow within the last month but nothing in our town so far um the state really keeps a close eye on this we get an email every week we get a phone call every time there's a westn virus positive mosquito someplace so it's a very closely monitored situation um and the state did just announce this week that there was a westn positive human case um in hamen County and the first Triple E eoin case in Plymouth which is kind of what happens around this time of year um we haven't had any Triple E in our area in some time but we are definitely keeping an eye on that and you know aware of that caution cautious about that since it's a much more fatal concerning disease than West n so I sent you the report it's fascinating more information than you'd ever want about arbo virus and miss um if you feel like looking at it it's pretty interesting so you have that in the email that Kyle sent and it's also posted to the web um any questions about that yes um is there also any surveillance of tick for lime um there isn't the equivalent surveillance of tick for lime that we are able to contract with I think UMass does some surveillance um and they have they certainly have their lab where you can bring ticks for testing although that's not really clinically indicated but it is sort of from a surveillance standpoint sort of interesting but we don't get those data from that not that I know do you have something anything to add there Kyle I believe UMass is no longer doing tick testing after covid um there's a company called tick report in Amherst um that sometimes people send their text to to get tested there is a couple schools have thought of the efficiency of testing ticks um so it's not something that we really you know refer people to but it's just something to be aware of no I I think I meant something different like just knowing how you know what the prevalence of um of of Lyme disease in the tix in our community do we are we following that or we're just assuming that all the deer ticks carry lme I've definitely seen some statistics you know that X percentage of deer ticks are expected to carry lime and I don't know what that's based on so so I don't know if there's as far as I know well the town certainly doesn't participate in any equivalent tick surveillance as we do mosquito surveillance and I and I think there's some efforts out there I'm just not aware as aware of them but I will look into this now because I think it's a good question yeah I think it's so much more common that I mean people yeah it's a there's so many more cases that the prevalence is usually tracked through human cases not through the tick percentage Yeah I'm not an expert in this either so I I don't claim to but um I mean we you you shared the the data around Lyme disease cases that were identified I did yeah right so I mean it's true that Lyme disease is much more prevalent than West Nile so we know we have a lot of that and you're you've articulated it really well but that's kind of maybe more how the surveillance is done and I think the state probably on their website has some estimates of the prevalence of Lyme disease in the community just based on human cases um but I don't but it's still another question like what percentage of ticks carry lime these days I don't know the answer to that it's a good question and whether it's different in ammer than it is in Lime Connecticut or in or in Maine or someplace else yeah yep because originally it was all in Connecticut you know Conneticut rather than local so you worried about being exposed to a tick elsewhere interesting so yeah full disclosure here I I've learned more about Lyme disease than I uh care to uh discuss it is it is uh it's makes my head turn thinking all the thing all the uh pathogens in in in a person's body that doesn't affect some people and affects others and it's but anyway I I was diagnosed last year but so yeah when I saw that it was like oh boy this is got a tiger by the tail there yeah the line right because because public policy is is terrible and our healthc care is terrible when it comes to to Lime yeah yeah I I did so you know this is a good segue then to the um infectious disease report which you just alluded to Betsy so yeah there were you know good number of cases for the month of June of Lyme disease as well as some others um I always forget how to pronounce it that bosis bosis bosis bosis yeah and then anaplasmosis we and we actually don't case those are other tickborne diseases for people who don't yes thank those are other tickborne diseases and here at the health department we don't manage the we do a lot of case management for infectious disease you know so if there's a case of TB obviously we manage that um and we do follow up on the anaplasmosis and the bosis cases but the Lyme disease Lyme disease cases are managed through the state it's just is lime disease still uh reportable it is yeah yeah that's how we get these numbers they're all reported into the Infectious Disease tracking system so but I I would add that this these numbers are under reported because the the Western blot whatever that they're triggered is is a very poor indicator of when someone has has lime or not so that's part of the problem yeah and also people might not access treatment so it could be an undercount for that reason too you know they don't never get tested possibly they may Beed before before um they have they may be treated preventatively and therefore not not get it and right never have a positive test right yeah so um so I would say you know it's still a significant concern in our community it's not like the numbers have skyrocketed this summer I mean they're sort of around the place that they normally are maybe slightly higher um but I am interested in this question about tick surveillance so I'll follow up on that see what I can find out um so moving on to the next item um changing subjects a bit we are already beginning to plan some vaccine clinics for the fall so we've traditionally worked really closely with the Northampton Department of Health and Human Services because they have a public health Excellence Grant which is part of this whole system of building a regional Public Health infrastructure for the Commonwealth of Massachusetts there will be in your orientation manual um a really nice document explaining that whole project it's called the blueprint for public health Excellence which you may or may not be familiar with um so they have funding to have staff to do Regional work and to organize Regional clinics we are only getting vaccine here for uninsured or underinsured people we don't get vaccine any longer for people who don't fall into those categories because everything's changed and those vaccines are now available iny or through primary care physicians but we still try or Prov providers so we do still try to do the vaccine clinics because sometimes people really like to get the vaccine that way so we'll probably do between I'd say three and six clinics here at the bangs and then we'll also be going out to the community we actually have an intern working with us right now A UMass student Public Health Masters in public health student who's doing a summer project with us analyzing our current data to understand if there are pockets of the community that are less likely to be vaccinated or certain population certain groups age groups racial ethnic groups that might be less likely to be vaccinated so we could kind of do more strategic promotion or go to those communities versus having them come to us so we really want to try to increase our vaccination rate only 25% of people in ammer got the booster last fall um we would love to see that number increase and also flu so we're offering both covid and flu vaccine at these clinics so we'll be keeping you informed about that and also looking at the flu vaccination rates yep she's looking at both of those things it's great to have her she's looking through all the data she's going to do a visualization little PowerPoint presentation so that's something we can also share with the board when she's finished with it and I know that's something you have a particular interest in Betsy so I'm definitely excited to have your support with this work we'll keep you posted about it all um I also wanted to mention this is something I'd forgotten to put on my list but I'm just going to add it now that we did have a sale to a minor a tobacco retailer did sell to a minor uh back in June and so one of these these tobacco compliance checks that happened uh so we that was a big guy liquers um out on in north ammer on montue road as you're headed out of town just before the turn off to M River um so we um they they were fined and they um had their license suspended for seven days and they were very compliant and no problems um so they've had violations in the past not recently but in the past so this is the kind of thing that we track and if somebody has continuous violations they would come before the Board of Health for a potential suspension of their license that's not anything that happened recently but that is something that could happen if somebody breaks the law repeatedly um two upcoming events that are happening there's a community safety day at M River Recreation on August 17th it's a Saturday all day so police and fire are there it's kind of an interactive fun Safe Community safety day for the community for young people kids and public health will be there we're going to have the bite lab there which is an interactive tick mosquito display to help educate people about those insects and the diseases that they carry so we'll be there Staffing that booth and you're welcome all of you to come out that sounds like a fun way to spend your Saturday August 17th and then the other thing that we're excited about is on September 18th and we sent you these flyers via email September 17th sorry we're doing an open house here at the bangs and we really kind of find that people don't often know what goes on in this building and what kind of services Public Health provides where Crest is you know what does the senior center do where's the musante clinic these are all questions that we get and we're we've really developed a nice relationship with the clinic um working closely with their Chief uh people and Equity officer to be more in alignment and to be more kind of arm in-arm because we refer people there all the time we've done lots of events together we do vaccine campaigns that could be relevant to people who go to their Clinic if they're not getting vaccinations there so this is an opportunity for people to come to the banks and really tour the whole Center understand where everything is how it all fits together and who the people are who work here so we're inviting community members but also legislators and you know Town Council Members board members um you all are we'd love to have you if you can stop by I think it'll be fun there'll be music and food and kind of a raffle and games and things and also just opportunities to let people know what we do here so that's upcoming in September I guess that's I I think the two more things I wanted to mention um is that there is the board does have responsibility well how shall I say this public health has responsibility for emergency preparedness if there were a natural disaster and the need to set up a shelter or something like that there's obviously a role for public health in that whole situation and when there are emergencies the Board of Health or at least one or two members of the Board of Health has been listed as as contacts for the emergency alert system um so that's it's currently Meen who's still listed as our chair and as our contact for um any kind of emergency alerts and that's something that we have to change in the next little while so I think I want to sort of follow up with her and try to remember is it maybe just one person from the board or two people from the board one person in a backup that we do and then there's a web process that you have to get oriented to so that's just a preview of coming attract actions for maybe one or two of you as board members to be listed as the contact for that whole Emergency Operations procedure so just putting that out there something that we'll talk about more and also as a reminder to myself to make sure to follow up on that and the last thing I'll tell you is about puffer's Pond just because it has come up so much for us here in the health department and just to make sure that the Board of Health is aware of what's happening at puffers and how we manage the situation there so puffer Pond is Technic under the jurisdiction or managed by the conservation department and so it is conservation department staff that go out and do weekly testing they take water samples and they are tested in our lab here and the results are posted to the website so we're testing for eoli bacteria we're testing for exceedances the standards are all set by the state of Massachusetts very clear standards if it's over a certain amount either single sample or a geometric mean that's taken over the course of of 5 days then the recommendation is to close the pond to swimming there are two beaches we take samples from each beach sometimes one of the beach will pass the other one will fail but if one of them fails we make the decision to close the whole Pond to swimming it's a small pond people swim across it if one beach is failing it doesn't seem like it's safe to say it's okay to swim now this isn't enforced by the police people go swimming they go swimming really at their own risk we're not going to yell at them or pull amount of the water but it is technically signage says that it's closed to swimming if the ecoli levels are over these exceedent standards so um yeah I mean obviously the the standards are set by the uh code for Massachusetts regulations and the Board of Health is involved in you know managing all that but it is the conservation department who does the testing and has traditionally been the point person for questions I think their contact information is listed on the all the signs but we do get a lot of calls here um and I think people understand that the Board of Health is somehow involved so yes I'm aware I'm involved I'm supporting that the pond is closed because it's not safe to swim um but it is the conservation department that's doing most of the on the ground work so that's that go ahead do you think there's a need to educate people for why that that closes it you know what the risks are uh it's obvious well you know that we do get a lot of questions I think mostly people don't really ask so much why I think folks mostly understand if there's ecoli in the water that's not good to ingest it can make you really sick but we have put a whole frequently asked I mean Kyle worked really hard on a FAQ document that's now up on the website that we're driving people towards that does address why it's not good to swim obviously ingestion of contaminated water is the highest risk but you can also get have rashes skin rashes or if it can get gets in your eyes or nose that can be a potential infection source so we do have that listed and we also explain why how the testing works and why we are doing this and we also try to explain why this is happening you know I think climate change plays a role aging sewage infrastructure plays a role we know that it's Downstream from some things you know bird feces dog feces these things can wash into the pond the heavy rains stir up the sediment there's a lot that's contrib in to it testing positive and unfortunately it tends to be closed most of the summer these days it was open maybe for a couple weeks in June for swimming and then we had to close it and I don't Envision that it will clear up before the end of summer that seems unlikely especially with this weather that we're having it doesn't help so so that's the story about puffers I was actually interviewed by Western Mass news today about this because it is so much on people's minds and it's it's a beloved place and everyone really wants to swim there and it's we don't want to close it but we also don't want people to get sick so we have to do what the right thing is for the health of the community and what is stipulated by the state of Massachusetts in terms of standards for Beach water quality Pico is this a situation where if there were money there's something we could do about it um it's it's a complicated situation I think nobody knows for sure what will fix it I think there because there are so many contributing factors one thing we've talked about is dredging the pond which would be a big operation would be very expensive would mean that the pond would essentially be closed for as much as long as a year and my understanding is that may or may not take care of the problem because I think some of the issue is that it is Downstream from some of our you know from a aging sewage infrastructure we have sometimes sewage overflows pipes are old people put gr grease and wipes down the pipes and that doesn't help them to function well you know these are all things that can kind of contribute along with climate change so I think there are some things we can do and there's some studies that are happening to try to pinpoint what the contaminants are that are really driving these exceedances um but any way you slice it it's going to be quite expensive and I know that we don't have money in the current budget but we are pursuing grants to try to think about how we can restore puffers to be a place that people can still come and swim in because it's a beautiful place and you want to be able to cool off in the summer so so it will be expensive and I think we we really I think we need to understand more about exactly what will be the best thing to do to fix it so we don't spend money on something that isn't going to help right yeah how do how do items get added to the agenda is there a process to this agenda to this agenda yeah I mean I think certainly if you have something that you're thinking of right now it would be great to suggest that some it' be something that we talk about so the one thing that that um one of our neighbors had a an adolescent who died at a track meet because of um she went into vac and had an AR an arhythmia and died and I know that there's been a lot of things about training you know the real thing that you need is defibrillators and I wonder whether we've looked at placement of defibrillators and training so in public P places there's someone you know when you put a a defibrillator to to know that people know how to use it uh and whether there are any guidelines on that whether that's been addressed by the state because that seems like something where the um the the medical literature is actually really moved on that and you know I just wonder whether that's a public health issue that we should be addressing yeah I think with that um what it's good that you've brought it up I think as public health staff we can look into this to see if there you know what what does the state say about it are there are there current regulations what what is the status of this do we have I know we have aeds in some places I don't know who makes decisions about what goes where we could do a little research and if it's something that lends itself to a regulation that the Board of Health would want to develop then that would be that could be a decision that the board would make based on some of the background research that we can do as staff yeah is are there any state guidelines how many how many are there what training Etc yeah good question yeah P I don't know if this is the right time but I did have a question um on h5n1 and if there's discussion about dealing with the Farms locally um and getting them prepared and PPE and all the things that are being talked about in relation to that um yeah well I think this would be the time I think um we've moved through my update and so we can sort of talk about any other topics that weren't anticipated 48 hours prior to the meeting so um yeah let's think we have you want make sure that everyone knows that you're talking about bird flu yeah yeah Avan flu thanks Betsy you're so good about making sure that we're translating everything for people who may not have all that medical background um so uh I I haven't gotten what what we had been told maybe six weeks ago was that um if you have dairy farms you needed to make sure that people that your Animal control officer was going out to ensure that staff in the dairy farms know about the symptoms and are um you know monitoring their cows for any symptoms that was back when there were some cow that had tested positive and they were concerned about exposure to milk and that sort of thing um we don't actually have any dairy farms in amest any longer um there are certainly some cows in amest but not dairy cows so I haven't we haven't received specific direction from the state about any other followup around Aven flu at this point um but I'm feeling like maybe there should be more clarity around what we need to be doing locally because I haven't heard anything specific yeah I mean the things that I've heard are not from the state either um but would apply to both and I wonder if it's cattle Farms Beyond dairy uh but also chickens yeah and it is about sort of getting PPE to to folks who handle I wonder I don't even know what to do with home chicken farm you know I know the non-industrial versions of that but um but certainly with the formal Farms of both of those I would want to be thinking about what preventative measures can be taken as the cases rise yeah and already about the ice cream places where there are large crowds and children and cows right yep yeah but there's not an aurc proper right yeah so that I mean I can look into whether that's for all cows or just dairy cows um but the chickens leads me to believe it's probably just all of them yeah for chickens yeah no this is a good point um I think we need to if you if you hear of anything or you whatever sources you're hearing from that aren't State sources but there's information I'd love to see whatever it is you've consulted and then I think Kyle and I can also do a little bit of research on this to see whether we should be at least at a minimum putting some information on our website or going out to Farms to do some education about PP or whatnot if that's indicated that seems to be the you know the the stages that people are recommending right now is really about prevention and education and just making sure that Farm Workers in particular have what they need to be protected okay yes share okay thank you okay um anything else and I I guess just to answer Betsy's original question how to get something on the agenda if anyone wants to I think it's emailing me now and we have to share everything um you said now 48 hours before yeah otherwise it's unanticipated right exactly yeah our general practice is to so normally what I do is get in touch with the chair you know maybe a week and a half before the meeting and talk about what what did we talk about the last meeting what needs what's come up since then what do we need to put on the agenda but certainly as reisha said if you have items other than what we've just talked about email those terisha and me um and then Kyle usually sends out all the materials the Thursday or Friday the week before so they go out a little bit earlier but they have to go out per open meeting L 48 hours ahead of time and they have to be posted on the website 48 hours ahead of time at a minimum um so Risha since you're now the chair can I turn it to you to adjourn our meeting if there isn't anything else that people would like to oh this is very exciting I motion to journ approved seconded seconded okay yeah I think technically you're supposed to take a vote right so you you you moved and you second in and all in favor all in favor say I I I it's 11:17 pm here so I think I am done thanks for hanging in there Prema appreciate it okay take care all right bye bye everyone thank you thank you everybody take care bye bye bye bye