 All right, so our webinar has started. And attendees are going to be coming in and I see them their names and we're going to move over Nancy Gilbert hopefully. So I don't see Nancy there. So everyone we're just waiting for our chair. And she should be joining us. And I'm just going to give her a call. Oh, there we are. Okay. Okay, so. Going as panelists. Okay, Nancy. We have you as a panelist. Are you there. We could hear you a minute ago. I don't know if you're muted. Okay, now you're muted. Start. Okay. We can hear you. Okay, now can you see me? Yes. So Nancy, we've started the webinar. And we're recording. So if you want to. Perfect. I'll start. All these hiccups pursuant to chapter 20 of the acts of 2021 and renewed by. Governor more healing. This meeting of the board of health will be conducted via remote means. Members of the public who wish to access the meeting may do so by following the instruction on board on the board of health's posted agenda. Via zoom. No in-person attendance of members of the public will be permitted, but every effort will be made to ensure that the public and adequately access proceedings in real time via technological means. We will post on the board of health website a recording of the proceedings as soon as it's technologically possible after this meeting. All approved board of health meetings are posted on our website once they are approved by the board. So I will now open the June. Eight nine. June eight. Board of health meeting at five 33 with the roll call. So I see Tim. Yeah. Lauren. Lauren, can you unmute? Oops. Lauren's muted. Well, I'll do premises. Here. I think Maureen Maureen sent an email that she didn't know if she would have internet connection where she was. So I think she's absent. But Lauren. Can you hear Lauren? I can't hear her. I see her. No, Lauren's gone. Lauren. Are you there, Lauren? Yes, I am. Can you hear me? Thank you. Welcome. So the first thing we will do is review. And vote on the. The minutes of our May 11th meeting. I have. One correction. Two corrections under topics not anticipated by the chair. Number three. I wrote a letter to the town council in support of the zero waste Amherst proposal. And number four would be that I had. Asked the board of health to consider writing an LGBTQ plus equity statement. So those were the only changes I had. Did anyone else see anything? Hello, can you hear me? Yes. I'm feeling a little feisty today. I went to the dentist. Probably my last meeting. No. I was marked absent because of technical difficulty on a couple of votes. I think one of the votes was I entered into the chat. I think it was the tobacco license. The new recollection. What, what happens if it's internet. Difficulty that makes you miss the vote. So we can add. We could say board. Technological problems and not have apps. Do you think that would be adequate Jennifer? I think that would be accurate. From apps into technological difficulty. And how do you, does that seem okay, Lauren? Okay. Great. She gave a thumbs up. Thank you. Thank you very much. Pamela, do you have any other. Comments corrections. For the minutes. I do not. Tim. I do not. Would someone like to make a motion to accept them as amended. Motion to accept as amended. I can second it. Second Tim and I second it. All in favor, Tim. Hi. Hi. And Nancy. Okay. Thank you. Now we will open to public comment. And the chair or I will recognize members of the public to express their views. For up to two minutes. And when called on, please identify yourself by stating your full name, preferred pronouns and your address. At this point, the board of health will not engage in dialogue or comment on a matter raised during this public comment. So do we have any. No hands are up. No hands are up. Okay. Oh, there is, there is. You can. Okay. All right. Jill Sherman, if you can say your name and where you live and where you're from. I'm going to unmute yourself. Your hand is up. So I'm going to lower your hand. Am I allowed to make a comment? Yes, please. Yes, you are. Please. I don't know if I'm, if you want me to make a comment on last month's meeting. All I want to say is I think you're all doing a good job. I exercise shop and visit friends and Amherst. So I'm going to give more publicity about the necessity of having the booster to the COVID vaccine. And the fact that the COVID is still around. That's all I'd like to see the health department. Give more publicity and also have more clinics. But I know the state may not allow you to get more vaccines for more clinics. Thank you, Jill. Okay. Any other. I think that's it. Okay. So next, right on time for old business. So all business. I am so pleased. And I cannot say more than enough for Jen supporting this. And. Students from the school of public health. I've been working on a community health needs assessment for the town. And Emily Connors has been on this program since day one. She was in. Four plus one undergrad. And she just graduated and she's been the leader on this project with Kylo Conner. Who was. So impressive and had time. He's now an employee. Of the health department. And he's going to be in his, the last final year of his masters. Catherine gorilla is in the last. A semester of her masters. James De Silva is. I think he's going into a senior year. And. Kyle joined us in the fall. Catherine a little later. James a little later. And this past semester. Neha. Red hall car. Man. Raw. Raw. Car. Joined us in February. And has been a great asset. So I'm going to turn it over to this wonderful team. Who's worked so hard. With. Minimal resources to conduct this community health assessment. So I'm going to turn it over to Amy. I promote everyone correctly. Kyle. Can you take a look at the attendees? Did I need to. Move anyone else over. I'm just moving James over. Oh, I apologize. James. Okay. Oh, there. All right. Are we good to start? Yes, you are. Emily. Right. Can everyone see that? I don't know if everyone's going to see that. I don't know if everyone just wants to show their face and just say their name again. So people know who you are because you're also wonderful. Yeah, that's a good idea. I'm Emily. I'm Kyle. I'm Catherine. I'm James. Neha, are you there? Yes. I may have. All right. Awesome. So I'm going to turn it over to Amy. I'm going to turn it over to Amy. Okay. All right. Awesome. So I guess we can start our presentation now. Thank you everyone for giving us the time to present this. This will be the 2022 2023 Amherst community health needs assessment. So for a little background, community assessment is the process of identifying key health needs. Assets and challenges of a community through systematic, quantitative data collection and analysis. So the specific aims for our project were to identify needs, prioritize decisions, identify ways to reach at-risk disenfranchised populations, address systemic health problems and concerns of our community members, promote equity and guide advocacy efforts and policy development. So our project was broken down into three main phases. We started about a year and a half ago in February of 2022, as Nancy said. This included a report and a presentation on descriptive, quantitative data. That included a description of Amherst and its history, demographics and general health status and population vital statistics. We got these from the US. And from the CDC. Then we had phase two, which was in summer of 2022, which included descriptive, quantitative and qualitative data, including determinants of health, government and policymaking. And then the final phase, phase three started in fall of 2022. And it's finishing up now. And in this phase, we gathered community members views through qualitative data regarding key health concerns. We mainly did this through key informant interviews and listening sessions. So our framework for the project as a whole is the social determinants of health. The social determinants of health are non medical factors that influence health outcomes. So we can think of them as the conditions in which people are born, grow, work, live in age, and the wider set of forces and systems shaping the conditions of our daily lives. So these forces can include, can include economic policies and systems, development agendas, social norms and policies, racism, climate change and political systems. And through a broader awareness of how to better incorporate the social determinants of health throughout many aspects of public health work, we can transform and strengthen our community's capacity to advance health equity. So here is an image that breaks down the five categories included in the social determinants of health. We have education access and quality, healthcare quality, neighborhood and built environment, social and community context and economic stability. So we have a little more background on the social determinants of health for those of you who are not as familiar. It might seem weird that we're talking about education or neighborhood environments, social context, all of that in relation to health, but we do know that it all is very connected and very important. So education access and quality shapes opportunities for learning, skill development, social integration and future socioeconomic prospects, which influence overall well-being and health equity. Next we have healthcare access and quality. So we think about things like insurance coverage, the ability to treat chronic illnesses, health literacy, access to mental health services, the ability to treat chronic illnesses, the ability to treat chronic illnesses. Specialists and PCPs are all super important. Then we have neighborhood and built environment. So human-made surroundings and environments in a town that influence overall community health. So things like parks, recreational spaces, roads and infrastructure, gathering spaces, as well as proximity to grocery stores and transportation. So we have a strong social support and a sense of belonging and contribute to the emotional well-being and resilience of individuals and communities. It can reduce the risk of mental health issues, can enhance physical health outcomes and can provide opportunities for health education, awareness and behavior changes. And lastly, we have economic stability, which can lead to higher employment rates, greater income levels for individuals and families. And when people have access to these more stable jobs and sufficient incomes, they're better able to afford essential goods and services. So things like healthy and nutritious food, housing, transportation and healthcare. And before we jump into the sections, we did just want to note that this presentation is a very broad overview of our final report. We go into a lot more detail in that document. So for more details on our findings and recommendations, we'll refer people to that document. So I'll start us off with economic stability as a determinant of health. So some quick statistics. In 2021, about 10% of people aged 16 years or older that were in the workforce were unemployed, which is fairly high for Massachusetts. It's about three times the state average. And then about, well, more than half of renters in Amherst were paying over 35% of their household income on rent. And the national average there is around 30%, maybe 29. And if you're higher than that, then you're considered cost burden. And then Amherst spends about a quarter of what North Hampton spends on health department staff and less than half of what East Hampton spends. And so some questions that we were asking when we're doing this were, how do college students affect the economic functionality of our town? How are the non-student community members affected by that? How is access to affordable and subsidized housing changed in Amherst? And then how does Amherst spending on health affect its citizens? So some findings. The biggest thing that we found was due to the overcrowding on the college campuses, the colleges will sort of make students find rent or find places to live off campus. And students are very easy targets for landlords to raise the prices of rent. So then prices of rent would skyrocket, which would make vulnerable populations that can't usually afford housing, have an even harder time affording it. And then on top of that, it makes it harder to get quality food, good healthcare, access to transportation, et cetera. And a quote that kind of embodies that is that rents are getting raised at proportions that you know regular people can't really keep up with. Landlords have all this power to raise as much rent as they want to. That really puts vulnerable populations in a real crisis mode. Another thing we found was that the health spending in Amherst was a lot lower than in neighboring towns. And that means that there's fewer staff and resources, and it prohibits lower income groups from receiving adequate care. And then we also found that spending in Amherst downtown, the business improvement district, is only really a few people and they all own multiple businesses in the downtown area. So spending decisions are decided without a lot of input from the general public. Someone mentioned that it's going towards these pet projects that aren't contributing to the upliftment of people. And then sort of a last thing we found was that there's classism in the town, especially in the school system, which causes a lot of stress, anxiety, and depression for the kids. And then a quote for that is in a place like Amherst, that divide is going to lay on someone's emotional and mental health. When you don't have much and you're constantly around people who have so much, it's hard. So some recommendations. The biggest thing we can recommend for this is creating additional affordable and subsidized housing, or trying to influence the school to create more dorms. That gives citizens more money to spend on other things other than rent, such as transportation, healthy food, frequent health care, stuff like that. And then another thing we can recommend is supporting business development outside of Amherst downtown, because that sparks sort of new business in new areas, like the middle district and South Amherst, these commercial pockets that aren't, that could live up to more. And then inviting residents of the town to participate in what Amherst downtown does spend its money on instead of just solely these districts, property owners, creates a more accommodating and lively downtown. Okay, so next we're going to get into the neighborhood and built environment. So just as a bit of background, Amherst is built with a lot of natural green space and other areas for recreation. And we found in our analysis that a lot of residents actually consider these parks and green spaces to be one of the most beneficial assets Amherst has to offer. So this is a really big positive in the built environment that we found. As I said though, there are some negatives definitely to note. One of the most important ones being that 97% of Amherst residents live in a USDA designated food desert. This means that they have few or no convenient options to securing both affordable and healthy food. And that food for them is not easily accessible by foot or bus. So I wanted to note on the right, there's a graph by the US census tract and it shows the percentage of households without a vehicle that are more than a half mile away from a supermarket. So you can see that UMass does have the most, but even central Amherst and Amherst center, those percentages are still high. So it's something we need to look at. And then from there, we wanted to consider different interventions. So interventions towards helping residents to get access to nutritious food in Amherst. And then we also wanted to look at the public transportation system. We wanted to see if there were shortcomings or gaps in that service. And then if there were gaps that we evaluated, we wanted to see how this could be improved for residents. So what we found was that as expected with the food desert, food is very hard for many residents to access comfortably. And there are a lot of transportation improvements that are also needed. And then we also wanted to look at the public transportation system. And then we also wanted to look at the public transportation system. A lot of residents noted also issues with the bad limit on the PVTA. There are dangerous road conditions and some gave personal anecdotes of injuries from potholes or other. Road conditions at night, such as poor lighting for adults that are getting older and can't see as well. So those are all things to consider with the built environment. And so I wanted to look at the public transportation system. I wanted to see if there are any additional resources and support that they need to live their healthiest lives. So I put two quotes up here from some interviews that we did. One is on transportation and one is on food access, which are two of the most important issues we saw come up and built environment. So I'm just going to read them here. I think making transportation more available would be helpful. Okay. Thank you. You know, when UMass is on break buses are running once an hour. It's just ludicrous. And the second on food insecurity, my first and number one answer is that the public health crisis of food insecurity is a really enormous one. And it's impacting a lot of Amherst residents. So for recommendations, the first one is that individuals just go out and see it firsthand. And then listen and observe, but more importantly, take action from this for transportation map out a plan to fix the dangerous roads. Take a closer look at the bag limit that exists on the PVT. I as this limits a lot of families from getting a weak supply of groceries home in one trip. And then, you know, I'm going to go ahead and take a closer look at the bag limit that exists on the PVT I as this limits a lot of families from getting a weak supply of groceries home in one trip. And then continue to provide stable and consistent bus access for residents in town, even when students are out of town. For food access, look into initiatives to reduce food loss and food waste and see if some of that food loss or food waste to go to those that are food insecure and may need it more. Consider the existing benefits of nutrition assistance programs and what their available food options are. And then build more areas where individuals in the town can get food together. So maybe considering a community garden or farmers markets that run year round. Some residents stated that they had a bit of issues with the fact that the market ran in the fall and in the summer, but having something that runs year round could get individuals that live closer to maybe the downtown more easy food access. And then finally, our last recommendation was for homeless support. So just reevaluate and make improvements to homeless support, increase the resources for the homeless, and then forms and bikes that may only be available online. This is something that we saw come up. Some homeless individuals said that their forms that they needed to fill out were only accessible through a smartphone or a tablet. So not having those really hindered their ability to complete these. And then the bikes that are rentable in the downtown, I think those you also need a credit card and a phone to access. So just making those available to all would also be really awesome. Okay. Next, we're going to talk about social and community context. So our focus areas going into phase three where how can we make the social services available in town easier to coordinate and access for those in need? Why are there so few recreational options for children and adults in town? And how do community members feel about the range of activities available? And how can we better perceive social engagement and belongingness for all residents, as well as what improvements can be made to be more consistent in communication and outreach to reach more community members. So as I said before, this is a very broad overview of the results. And I just want to emphasize that there are a lot more findings and recommendations in the final report, but these are the three main findings we wanted to highlight. So Amherst does have many valuable social services available. We have the survival center, Craig stores, all of these places, but the services are fragmented and difficult to coordinate. We heard from a lot of people that if you're struggling, you may need to go to three or four different places to meet all of your basic needs. So a place for food, a place for clothes, a place to take a shower, they may all be different. So if you're already struggling, this can be a lot to manage and navigate. Also how individuals relate and interact with the town. Resources is affected by race, ethnicity, socio-economic status, age, et cetera. So social engagement and community support is really affected by racial experiences in town, especially in Amherst, which can cause individuals to experience the available services and community outreach differently. We heard from one participant that they felt there was something missing in Amherst that makes you really feel the disparities. Another person was talking about the local government and the lack of diversity on boards and committees. They felt as though everyone is coming with their own agendas and people are representing themselves, not the community. And lastly, there are major holes in the recreation programs for children and adults. There's a handful of sports available, but if your child isn't interested in those or has different abilities, they might need to turn to private entities, which can be much more expensive and just not feasible for many families. So for our recommendations, like I said, Amherst has a lot of valuable resources. They're just fragmented. So putting in a town liaison or point person to help direct and connect individuals with the right resources could take a little bit of the burden off the individual's shoulders in terms of coordination and help them get back on their feet a little bit easier. Also support and expand the Crest Department and the Senior Center. This would help promote health and well-being for all town residents. Supporting the creation of a more diverse town government, looking into having more diverse council members in terms of race, age, socioeconomic status, et cetera, could help better reflect the town population and highlight what the town can do better to address existing disparities. And then lastly, we would suggest continuing the community health needs assessment to listen to more voices. We tried to talk to as many people as possible, but due to limitations on resources and time, we couldn't talk to everyone, obviously. So continuing to get out there and get feedback from the community will help us kind of ensure interventions and policies are responsive to the diverse needs of this community and are actually what they want. Okay, moving on to education. The Amherst School District is split into some of the Amherst schools. Oh, wait. Sorry. The Amherst School District is split into some of the Amherst schools, which encompass the three elementary schools and the Amherst Pellum schools, which encompass the middle and the high school. So this equates to about 2,280 students combined. In regards to special populations, 32.8% of Amherst students are low income and 8% are registered as English language learners. In the high school specifically, 43.5% of students qualify as high needs. As mentioned in the introduction, education is a key social determinant of help in which it impacts lifelong well-being and opportunities. So to try to really understand and shed light on this background, we came up with focus areas to address in the third phase of the project. These focus areas are more specifically alluded to in the final document, but to really sum it up for the education section. We sought to evaluate the accessibility of educational institutions, the capacity to meet community needs, and analyze factors affecting school dropout rates, while also assessing support services for diverse student populations. Next slide. So heavily summarized on this slide are key findings through these interviews and listening sessions. Essentially a breakdown of what we found is that teachers and education staff in the Amherst schools are very highly talked about and are consistently cited for going above and beyond if we're caring for students. However, teachers and staff may not feel supported by school and town administrators. Low income students, students of color, LGBTQIA students and English language learners may face additional barriers in accessing the same resources and educational opportunities as their peers. Students who are not pursuing a college track may feel under supported and budget cuts may be impacting educational opportunities. And finally, COVID-19 has really heavily impacted student learning. These are quotes that we thought really encompass these points. Yeah. Did you want to read those? Sorry. No, it's okay. They encompass these points specifically regarding the barriers that those marginalized communities may face. And it's important to emphasize that there are many more in the final report. Liz, these aren't the only ones. Okay. So our overarching recommendation is that more outreach be done to address the gaps to quality and access in education, specifically in regards to marginalized communities and the Board of Health can support the implementation of these. So more specific recommendations are below and are illustrative in our final report. These include creating culturally responsive school programming, creating more opportunities for career exploration, which essentially includes broadening access to vocational opportunities for non-college bound students, increasing family engagement and support, which is extending the timings of extracurriculars. As Emily said, adjusting barriers in communication between the schools on families and engaging marginalized communities. The next recommendation is in continuing to develop and implement plans to mitigate the impact of COVID-19 on student learning. And finally, we recommend an increase in mental health support for students and staff. So the final pillar of the social determinants of health is healthcare access and quality. For this section, we focused on the many different healthcare services provided in the town, including primary care services, mental health services, dentistry, senior care and more. The Misante Health Center and Tapestry Health are just some examples of programs that help increase access to healthcare services within the town, especially for underserved populations. Through this community health assessment, we wanted to understand how accessible these services are, where are their shortcomings, and how improvements can be made to better serve the community. In our findings, one of the biggest concerns of the community was the lack of access to primary care providers and dentists. There was also a large general lack of knowledge and understanding of the Misante Health Center. There was also a need for a more diverse language representation, especially for the social services of the town. And there is a general concern over environmental issues, infectious diseases and extreme weather brought upon by climate change. And there was also a concern over rising substance abuse in Amherst. Below are some quotes from a community member and a Misante Health employee that reflects some of these findings. One quote was, getting a doctor's appointment is so hard. And the other is from a Misante Health employee who said, people don't know that we're here. People don't understand what an FQHC is, and we are not in urgent care. So based on these findings, the first major recommendation is looking how the Amherst Public Health Department compares to its neighboring towns. It doesn't have the access to staff and resources it needs to go above and beyond the projects that are already managing. Adding a community outreach worker position would allow them to be more accessible in communal spaces, to educate and provide free tools to keep Amherst residents healthy, especially the underserved populations. It would also be beneficial of the health department or to bring awareness to mental health concerns of the town and implement programs to its residents. The community health assessment also found that expanding the sharps program would allow residents who are struggling to deposit the sharps safely at no extra cost and to address the rising problem of substance abuse. So our second recommendation is to address the lack of access to primary care providers and to dentists for Amherst residents. To close this gap, it's important to promote, support and expand the Musante Health Center who provides both clinical and dental care. It's also important to educate the Musante Health employees about the town's culture and its residents so they can better understand the needs of the community. And lastly, it's important to ensure the underserved communities, like the elderly, have access to transportation to get to needed services that helps them maintain a healthy lifestyle. All right, to conclude the community health assessment, we have a summary of our key findings. These are just some of the recommendations that we mentioned previously that fit nicely into the social determinants of health framework, which we used as a lens to do this assessment. But like we all said, there's more findings and recommendations on the full report. There are some limitations as there are with any assessment. Due to constraints in time, resources and available data, this community health assessment was not able to investigate every health and concern of the community. While we did a sample, what we did sample from a variety of data sources and the community members, we recognize that there is more research to be done in order to get a comprehensive understanding of all the challenges and opportunities needed to address diverse health concerns of the community. And to wrap up, the assessment identified recommendations that the community can work together for in creating a healthier and more equitable amherst. The recommendations aim to provide a roadmap for key stakeholders, community groups and the town government to collaborate and prioritize efforts that will have a positive impact on the overall health of Amherst community. We also want to reiterate the health and well-being of the town as a responsibility of all town departments, organizations and businesses, not just the public health department and the Board of Health. Thank you so much for listening to our presentation. Thank you to Nancy and Anita for their support throughout the assessment and to all of the participants. A full finalized report with more context, quotes and recommendations will be available to the public very soon. And we are looking forward to seeing how this assessment can be used as a guide to improve the health and well-being of Amherst residents. And we will now open the floor for some questions if there are any. But our contact info is on the screen for any further questions. Kyle, thank you for saying Anita's name after I finished the introductions, I forgot to thank Anita Sara who is a community member who's been very supportive and helpful to the students and myself during this whole process. She volunteered to be a team member in thinking once again. And let me open up to the Board members if they have any questions for you. Let's see. Board members, do you have any questions? Any comments? I want to first ask to maybe not share. Can you stop? Yeah, so we can see that. I just want to say as the health director, thank you so much. I know the work you've done and just how smart and organized you all have been. And I'm really inspired. And I'm happy to hear that we'll get a completed report because I'm always interested in how we can research translations. We have this good information, but how can we implement it? And I'd love to get my hands on that and let the community see it. And then I loved hearing, I think maybe it was Catherine, that we don't have to repeat this every three years, but we can continue on in key points. I think that's what you said someone said. And so I'd be interested in finding out about that. So it doesn't just end now. We can continue this. Is that what I heard? Yes, absolutely. Yeah, very cool. So Lauren, Pramila, Tim, do you have any questions or comments? I wanted to thank the student team and they did an incredible job. We know that it's not easy filling all the data and compiling them, analyzing and putting them into nice recommendations. And so I applaud all your efforts. Thank you. It's very nice when you get to report they have data in census tracks. We will be able to see a lot of the demographic data. Lauren, do you have a question or comments? Sure, I was just going to say something quick. I have a question. Yeah, I've heard a lot of this and have lived a lot of this. Of what was said. I just wish that public health campaign or information to share it in the future. I hope that somebody can do that. Lauren, can you say that again? I miss that. I don't know if other people got it. I said I wish there was a way to enliven the information through a public campaign through video or something that could be shared with the public. That's a good idea. I was wondering how you see some of the recommendations or all of the recommendations that you made translate into action for the town. Would you make a presentation to the town council, for instance, as you have to us or I'm just wondering how you see that happening possibly. I think that's a good question and we don't totally have the answer yet. I know Kyle is continuing to work in Amherst next year and he's planning on implementing a lot of the recommendations through his I think he'll be doing a practicum, I think. That's one way I think continuing to talk about it and present it like you said to maybe the town council would be helpful and it's something that definitely some future students can look into. I know Neha and I are graduating so we won't be on the project anymore but there's always public health students at UMass who are looking for opportunities and they could possibly take over and start presenting this to wider audiences which would be great. If I could just add to that I think one of the great things about doing a needs assessment like this is you hear you're not just getting data on paper on the computer that people talk about their problems and some of those problems are really big systemic things but then some of them are just like let's add a sharps box. I guess some of it is easier to implement than other things so I think for the smaller things maybe that'd be one town meeting and it's one and done just put some money into it but other things are a lot harder to do and that's why continuing this kind of community assessment would be a really good idea. I'm glad you brought up the New Santee Health Center it just seems to me like this is a tremendous resource for the town to have a federally qualified health center in our midst and it seems to me that it's very underutilized and I really would like to see some awareness being raised in terms of what's available specifically in terms of people having difficulties finding primary care providers because they do have primary care providers and dental services where those are sorely lacking for the uninsured so it would be really good to see something come out of that specifically in relation to the health center. I can just add that I think they have recognized that or maybe you guys have sparked their talking about this but they have a new diversity equity inclusion director I think Kyle you may have met her or Olivia has so I see this as a great thing that you've identified and I know that they want to improve their engagement with the community but I see more foot traffic I can see their office so I think things are picking up I don't know other comments I think one thing that the students came across and talked about and I used it when I was talking to the housing board our vulnerable population have had students and people go and talk to them repeatedly but our vulnerable populations and this is what the students told me are not seeing action and they're tired of telling their stories they're weary and they need action so I hope that this process which is a beginning of something that can be wonderful is not just another wonderful academic piece that doesn't get used and implemented by the town and as the students pointed out the health of the town and the public health issues is not just the health department and the board of health it encompasses all of the government entities and members of the community so I think that was one of their concluding remarks that we have to really emphasize that it's not just the little health department and the board of health which is really focused on regulations and I want to thank the students once again for getting these voices and getting this data and getting this document which I hope we can post the document on the on our website and I know Kyle did a wonderful job inviting people and boards and town council members all come and hear this and people weren't able to attend I know there was some other town council subgroup meeting tonight because one of the town councillors reached out to me and said she really wanted to be here but she's at this other meeting so hopefully people will go online and listen to it but thank you thank you, thank you, thank you students once again it's been a wonderful experience for me to work with you and see you grow become leaders and really contribute beyond academics to our town it's been a wonderful process for me and I hope a wonderful learning process for you to take to your future careers I know Kyle's with us and Emily just got an assistant director position at the Milton health department so these students are moving on to great places great Emily thank you and Kyle we're fortunate to have you and I hope Catherine and James can continue to be with us and Nika I wish you the best of luck when you come back to your community to work are there any other comments or questions a quick question if there is any way to develop an executive summary of this document just a one pager key items and that somebody could be shared with the town council and different like broadcast much more broadly so that you can see the key recommendations you know instead of reading the whole report this is just a suggestion great idea and assessment team we should probably have one final meeting to just wrap everything up and for me to tell you how wonderful you are again so Emily maybe we could schedule that I'll email you yeah that works for me we'll do that out later and I think that's excellent Tim and Anita and I were talking about that and Anita can help work on that also anything else well thank you once again and I wish you all the best going forward in public health and you're going to be an asset to public health no matter where you all go because you've been a big asset to our town thank you thank you thank you for having us oh yeah okay take care everybody and we'll meet one more time quickly okay thanks and we'll go on to the rest of the old business so the LGBTQ plus equity statement I know I brought it up at the end of the last meeting and then I quickly put one together so that it could be moved forward right before I left for a wedding so I don't know I saw a type error with one word repeated twice I don't know what people's thoughts are on this document and if you had a chance to read it comments do we want to make a motion on anything I heard the beginning I mean to my computer to try and hear yes I said I looked over and it seemed that the information presented was very thorough I didn't see anything that should be added thank you I also agree that it's very thorough well written sorry yes I agree it is very thorough and I wonder what you meant in terms of passing a resolution or proposing a resolution so two years ago we made a statement on racism just a statement and at our last meeting I felt and now it's been really exposed what has been going on in the schools and I thought because what's going on in the schools and also what's going on nationally because we are concerned about the health of people it would be beneficial for us just to have a statement it's not a resolution it's not an action it's not a regulation but to show what the board stands for and supports in relationship to LGBTQ plus community members large in the region and statewide nationally so that was the only reason why I brought it up and when I brought it up it was sort of like the tip of the iceberg of what was happening in the schools since then there have been numerous meetings with the school committee in the schools and a lot has happened but this is separate from the schools in the school committee this is just a statement like our racism statement I don't know if people I obviously feel it was important that's why I brought it up that's why I drafted it I don't know if other people on the board feel that it's important for us to make this statement and have it posted on the Board of Health website I think that would be worthwhile Tim So do we vote on this statement? Yeah well this is a discussion and then we should decide if we want to vote on it Yeah I don't know how other people feel but this is my last board meeting I thought it was an important public health issue that's why I raised it that's why I wrote it and that's why it's here today we can act on it today you can take it on to another meeting it's just a I used it as a starting point I think the statement is good and it's written well you have done a really good job and I think we should act on this today it's my Thank you Ramila, Lauren do you feel the same way? Yes I hope I'm sorry I was just going to say because my phone is acting up again that there seems to be like a disconnect between what the Board of Health does and what the town council does and I think we're starting to get some other departments involved in health services and what needs to happen but just a resolution I'm not against it but I just want to comment and say that just state it without action steps and again like a campaign it doesn't really move the community forward so it would be good to either work with other departments or work with the town council to create some action steps That's a good point Lauren this could be used for the Board to take action in the future and the Board and the health department can use it in the future as they see fit At minimum it seems that it would be worthwhile to have a statement about where we stand on this issue and yes hopefully it would lead to something more in the future Thank you for putting it together Nancy You're welcome If there's any other statements otherwise if we have a motion to accept this I'll correct the one type of error and I'll put our names and the dates as we have on our racism statement and it can get out for signatures in the next month I can make a motion that we accept the LGBTQ plus equity statement as drafted by Nancy Gilbert and also the modification proposed and that's my motion I'll second that So it's been moved and seconded to accept the LGBTQ plus equity statement with the few changes I'm going to ask for your vote Tim Hi Remela Hi Lauren Hi and Nancy Thank you Thank you all The agenda is the Board of Health Succession We are unfortunately losing the Board of Health the Board of Health the Health Department but we're losing the chair and we have two vacancies but we're also losing the Director of the Health Department which comes up later which is big changes So I know Maureen said she would chair the July meeting but to move forward one needs to decide on who's going to be the chair or how that position is going to be filled and also the vacancies and I talked with Jennifer earlier the town does not start interviewing people for the vacant positions on the Board until they're vacated which means there's this huge gap with just three of you being on the Board through the summer because it seems to take a while for the process to go through to get little pointees Jen, do you want to add anything to this? I don't have much more to add than what you said I know when I spoke to Paul Bachman he said there were a few candidates so hopefully we can get those going soon and appoint people but if anyone is interested in applying you can contact the health department or the town hall Okay, so I wish the Board would as it moves forward after this meeting New business the geothermal well application for the 39 Bowen dry and Ed sent us material on that and the drillers registration is up to date I don't know if people have any comments or concerns about this well and if not we can just move forward to have it accepted Does anyone have any concerns about it? Can I have a motion to accept the geothermal well for 39 Bowen dry? I'll make the motion a second I can second it it's been moved and seconded all in favor of the geothermal well on 39 Bowen dry Premola I Lauren I didn't see the information so I'm just going to abstain Nancy I had three votes in favor of the geothermal well then next is Market Hill Road is a drinking water well application and Ed sent the materials he visited the site and he supports the well Does anyone have any concerns or about the well and if not can I have a motion to accept it I make a motion to accept the well drinking water well application in Market Hill Road 3 3C so we have it okay a second I'll second all in favor Premola I just wanted to ask a clarifying point is this did I understand correctly that the well is served by town water yes but they want to create a drinking water well yes and we've had that in the past sometimes people prefer that than to hooking up I don't because of the length of the from the public source to the house people have different reasons why they want their own well I okay Tim I Lauren Lauren's muted I'll vote I okay so we we don't have Lauren's vote but we have three votes and one thing I want to make sure we we note that after the well is drilled that there is water testing after it's completion because that's the regulations and I want to make sure that that gets done and report gets to the Board of Health so accept it with and to make sure that there's follow-up water testing okay so that is all the well all all business and now and that's the new business and we're going to move on to the Amherst Regional public school vaccine requirement which Tim was on September 27th 2021 when we voted for it Jen do you want I've done a little research and Jen I know you wanted to make a statement about the the vaccine that we had voted on in September yeah so not so much like a statement but just sort of getting everyone sort of a summary but in the packet that the Board of Health members received and also posted on the Board of Health web page you can pull up the package that I put there and it's the meeting minutes from September 27th 2021 and the Board voted to add vaccines against COVID using vaccines with full FDA approval as a requirement for students who attend public schools and Amherst so the question today is should this requirement continue and if you want it to be continued it does need to be rewarded at least that's my opinion this this requirement was done obviously during the early phases of the pandemic and the vaccine rollout and a lot of extreme measures that we were going through to save lives and prevent the collapse of the public health you know the healthcare system and the thought was at the time to interrupt transmission on a population level so now we're two years out people are more vaccinated I don't know if we have herd immunity but the declared public health emergency is over and now what I alluded to earlier is the vaccine we use now the bivalent is emergency use authorizations EUA so it's not fully approved by the FDA so that's something that if you wanted it to continue you'd have to say that we just any emergency use of the vaccine should be used but also I want to say that it also affects summer camps because summer camps follow the school recommendations some of them so it's not just the school it's summer camps also this is not been required by the state by desi the department of early education so the state recommends certain vaccines for children but not the flu vaccine and not the COVID vaccine so that's what I just wanted to say and sort of get us up to speed and I went into the CDC and in the end of February they made a statement that 57% of children 6 months to 17 years have not received their first dose of the COVID vaccine so it makes enforcing mandates logistically and politically difficult and because other precautions have been rolled back I think that we should lift this mandate and strongly recommend in the immunizations but lift the mandate I don't know what other people feel about it but that was my thought I would like to see it sorry Tim go ahead I just wanted to say I would like to see it strongly recommended but I agree in terms of enforcement it doesn't make sense so I do think we should remove the requirement I also agree lifting the mandate and strongly recommending the vaccination Warren if I understand what you're saying correctly you said that to continue the mandate would have to be through emergency situations and is that correct no it's it's just the way that they've designated these vaccines when they rolled out they were all emergency use authorization and then one or two got federally approved and but now this bivalent is emergency use authorization so it's just a title to it I don't sure if I explained that very well I'm sorry Lauren but I'm asking if the bivalent if it were to be used in emergency situation would there have to be a mandate well we're giving the bivalent now to adults so you know with doctor's orders it's just you know it's being given across the country but not mandated for the students at the school at the public school no one nationally mandates that California that mandated at the same time we did have everybody's walked it back and lifted the mandate as I said strongly recommend it. Does that clarify it Lauren? Sorry Lauren I'm sorry if I didn't explain myself my question is if it were to be administered to a student or a camper would it have to be under an emergency situation that's what I'm asking if it were to be administered people could still opt to get it but we're not going to amend the data I think Lauren is asking it has to be I mean people if they are going to take a vaccine should it be an emergency situation it's not I think it's primarily anyone can opt in to take the vaccine is that correct? Yes so even if it's emergency it was originally emergency use authorized even though the emergency is technically over you can still opt to get the vaccine correct? Right it's just this title that it has and now we don't even acknowledge it as much as we did before I had to really look it up and see if it was federally approved or not because they're really used the same manner does that clarify it for you Lauren? Yes okay good so it's I believe it was the motion is to lift the mandate for COVID vaccine so lift let's see what was our exact yeah the required it is to lift that the Board of Health adds vaccine against COVID-19 using vaccines that have been received full FDA approval to the list of vaccinations that are required except for medical and religious exemptions for students to attend public schools in Amherst so we are lifting that mandate and we're just strongly recommending that COVID-19 vaccines are used along with other vaccines for children does that still it Jennifer? Yeah I think that's right you know I'm looking at it it's like we added it to the list and we could remove it so now we're removing it so TDAP, polio, MMR, HEPI and Varicella are still there and COVID is off to go to school and then we're going to go to school and then we're going to go to the online camp in Amherst so that's the motion they have a second I can second it okay thank you any further discussion okay Tim I Premola Lauren and Nancy I Holly so again this is in the packet that I mailed to the Board of Health members and it's also available on the web page but what I posted up there is the Pioneer Valley mosquito control district information report from 2022 so it's a surveillance report last year we were partial members and we received their services and going into this summer we're now full members of the PVMCD so I'm really excited about this I think everyone will really benefit from all the information that we're going to get from this group you can go on and see the report that they sent but one thing just sort of as an example is that they do weekly trapping and testing they have five sites around Amherst and they've put the approximate sites down in the report so if you go down to Station Road you're not just an approximate position but they really outline the different traps they put out and what mosquitoes that they might be targeting and then if we get samples or pools that are positive as the season progresses it's really going to inform us how to educate and let the public know what's going on so I think it's a great tool very excited about it and I suggest people check it out I was very impressed having been on multiple votes to get it in I was very impressed where they have all the locations of the testing sites yeah it's really something like South the Station Road they're getting the mosquitoes that transmit triple E but back at Village Park Drive around there there's more that are West Nile virus so it's really interesting yeah so that's sort of a big deal because we've been looking to join for a while and that's a real accomplishment thank you the next thing I want to talk about just briefly is the opioid settlement money so I don't know what people know about this I can just tell you briefly what I'm aware of I think it was like 2018 let me just look at my notes then Attorney General Healy coming involved with other states about lawsuits looking at different aspects of the opioid epidemic how did we get here so they started some lawsuits and they looked at opioid manufacturers opioid distributors and pharmacies and they really over the course of the years how they really have fueled the opioid epidemic so there's a huge amount of money that every US state is going to be receiving I don't know exactly what Massachusetts is receiving but I have a list again published of what Amherst is going to be receiving and if you look at that number it's about and it's spelled out per year 25,000 to 30,000 per year up until 2038 so that's 20 years we're going to be getting this money and it should be earmarked for looking at different ways to increase working with disorders overdose deaths encouraging strengthening different prevention harm reduction treatments and recovery and they're encouraging people to pool resources so the town is going to be working with partners to figure out how we can use this money jointly together and then also for the town of Amherst Jen do you know where the money is being deposited and how it's going to be followed does it go to general funds or does it go to the health department or not the health department so I don't know the specific grant money but you know I think really open access it's going to be very you know very transparent about where funds are going and the other part of it is but I don't want to over speak but part of it is that we need to have the money so I secured a room if I'm the one that's going to be doing that and we'll have people in to discuss the money and decide where or to talk about where it should be allocated okay thank you anybody else have any questions or comments on that a lot of money over a lot of time I hope it's used wisely I know then the next thing I wanted to do is this is not on the agenda come up in the last two days is air quality so I know with COVID we've been talking about indoor air quality now we're talking about outdoor air quality and on the town web the town web page there's a banner up across that we have that will give updates on the latest particulate matter and what the quality is and where we are daily and then they're also on the Amherst health department web page there's some other websites that you can go to so the ones that I've been following posting is air now that's the EPA and then also the department Massachusetts department of environmental protection has really good web pages so if you go to that I'm going to click on it now and you can see that our our numbers are on a scale I think it's a scale of 0 to 500 earlier today we were 160 now it's 111 so we're lowering our group to unhealthy for sensitive groups so you know it's a designation but also if you go to these websites you can see some guidance and how it impacts different people so I think that's really important for us to follow now while it's happening and just in the future I think we're going to see this more more frequently and fortunately but unhealthy here and fortunately we have a lot of masks available all over from COVID so people can be urged to use it use them outdoors the particular numbers are up that's right and the right mask at N95 there are also some other monitors low cost monitors called purple air that are around town that you can log into and see what's going on but they're not always greatly accurate they're not greatly accurate I think it's another piece of information some of them are very similar to what we see like the ones that are monitored by the EPA I think there's one in where and I sent a link out to board members for a good resource from a faculty member at UMass this is his area of expertise so it's really important health matters that's going on right now I know people with asthma are using their inhalers you worry about children but it's just individual organizations are making their decisions now so nothing from MIMA or FEMA at this point and then the last thing on the agenda is the director's resignation so I think most people know that I've had I resigned May 19th I'll be leaving at the end of July and I've left working here I live in Amherst I believe in the power of all the people that have participated in the local government and the excellent employees here and the things I'm going to miss very much but I've said this before the public health scene in Pioneer Valley is pretty small so I'll be around Lauren it's been a pleasure working with you this is your last last month last meeting you just added so much to this town I was going to say for three years but it was two years but thank you so much for everything I just personally am going to really miss you I thank you Nancy you've been the voice for public health so long I just admire you you've been a mentor very welcome and you've been such an asset to the town my pleasure we do have public comment on the agendas so but there are only two attendees and I don't know if anyone wants to make a comment before okay no but topics not anticipated by the chair so this is my final meeting I've been on the Board of Health for about 20 years I want to thank you Jennifer you started as a board member you became the public health nurse you saw us through difficult times of COVID you never gave up even though there were so many challenges and I know it would have been easy to give up but you stayed with us you became the interim director twice and then you became the director I admire you because someone always said follow the money and so I followed the money we have this wonderful report I've also I want to give people a teeny bit of history I have worked with the Amherst Health Department since the 1970s when they had home care and they had school nursing all in the health department I was the first continuing care coordinator at Cooley Dickinson in the mid-70s and I made referrals over to the Amherst Board of Health I've seen I've worked with six directors since the 70s I was on the community advisory board for the health department in the late 80s until the early 90s and I've been on the board of health I believe it's since 2002 except for 18 months given that I think that Jen has done an amazing amount of work given the staff she has and the limited budget she has and this may be difficult for the town to hear but I don't think the town values the health department and what Jennifer and other directors have done the community assessment sort of alluded to it and if you follow the money North Hampton that has a population of 29,311 if you take out the grant money and you take out the inspectors they spend about $900,000 a year East Hampton with a population of $16,211 and if you take out the inspector they spend $32,200 per year that's this year's budget Amherst with $39,263 residents has a budget is this correct $184,561 so I think the town government has to look at how much they want to put in and how much they value the health department I've spoken to Jennifer I've spoken to Paul the blueprint for public health put out by the state we need to regionalize and I think this is a huge opportunity for Amherst to regionalize I see Hampshire County as a health department Amherst as the lead for east of the Connecticut River and North Hampton as the lead west of the Connecticut River and I think we need a community advisory board as you talked about the money for this opioid that would be a perfect place for a community advisory board so those are my comments I want to wish all the board members who have been so helpful supportive and have worked so hard during my time as chair and I wish you all well and hope you can continue all this work and I just wanted to go on record saying that I think the town powers to be really need to have to step up and support the health department and public health in the town of Amherst because I think you've done I think the board has done extremely well and I think Jennifer you have done extremely well given our limited resources and I think the town does need to put more into the resources for the health of the town so with that big topic not anticipated thank you all once again I wish you well if you want any of my input or my comments you can contact me and I'm off the record after June 30th so I can say whatever but I wish you all well and I thank you all for members for all that they have done working on the regulations looking at things researching things commenting I just thank you all from the bottom of my heart for supporting public health in the town of Amherst so thank you all and thank you for your dedication and your hard work you're most welcome and so I need a motion to adjourn our meeting my last chair meeting and Lauren thank you for coming on and bringing up a lot of points you'd be great on the advisory board if the health department ever gets that would be the perfect place so a motion to adjourn I want to thank you Nancy for the leadership and also for Lauren for bringing you wise to this board it's so amazing to be on the board we'll be missing you thank you thank you I make a motion to adjourn someone to second it's moved and seconded to adjourn Lauren you okay I wish you well and keep up a little work you've done Cremola and I Tim Nancy I so thank you all good night and I hope you get new board members ASAP