 preamble. Yeah we're recording now so you can. All right. Pursuant to chapter 20 of the acts of 2021 and renewed by Governor Mora Haley, 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 instructions on the Board of Health 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 will 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 by the Board. I will now open the Board of Meeting for April 11th at 5.33 p.m. with a roll call. Pramila, I think you're muted. Oh god I was muted. I'm so sorry. Here. Lauren. Yes sir. And Tim Rendir here. So the Board of Health meeting has started. Hello Kiko. Hello. Good evening. So we will start our agenda with a review and receive a session which is primarily meetings from the March 14th minutes. Are there any comments, questions or changes proposed for this meeting, meeting minutes? Neither Lauren nor I were present last month I think. Yeah, Lauren and Pramila are absent. I'm the only one here present I think last I don't have any edits or comments. So can we make a motion just by just one person or Risha is not here. Yeah, I'm just texting Risha because I didn't get a message from her that she wasn't attending. So I'm not sure what's happening. But I think technically we have to have a quorum in order to make motions. Isn't that correct? So for the minutes word I think I'm the only one here who was present last month. So we can actually wait until Risha shows up. Yeah, I don't know what I don't know it's not like her not to be in touch. So I'm not sure what's going on. And then Pramila you also need to jump off in about 25 minutes, correct? Right, right. So when that happens if Risha doesn't show we won't we will no longer have a quorum. Yeah, my video is going in and out as well. So I'm trying to be as present as I can. Yeah, we mostly hear you but you are cutting in and out a little bit. Yeah, my zoom keeps going out and in. So can we put the approval of the minutes on hold and continue on? Sure. Yeah, let's let's decide on the approval of the minutes for March 14th on hold right now. So our next agenda is the public comment. There are anyone in the public who would like to speak? We don't have any attendance at the moment. So no. All right. So now we are at the old business which is Tobacco Regulations. Just continuing the discussions from last month. I think we could start up the discussions and hopefully Prisha can join us. If not, we cannot make any final decisions because of the lack of quorum. Are there what are some of the questions we had which was still pending or at least continuing into this into this meeting from this Board of Health draft? Yeah, so here's the other thing, Tim, that's a little complicated is that Risha, since Maureen is away and Risha and Maureen were the two people who were kind of driving this Tobacco Regulations revision, Risha had agreed to facilitate this section as you know, Tim, of the meeting and she's not here. So yeah, I think I can try. I have some notes here so I can try to kind of remind everyone of the things that I think are still pending so we can start to have a discussion and for the 30 minutes or I guess it's now 22 minutes that we have Premola with us, we're still a quorum and so that discussion can count but once Premola leaves, if Risha hasn't joined, then since I haven't encountered this situation before, but I don't know that we can have a productive meeting without a quorum. Isn't that what happens? We have to just adjourn, isn't that right? Not adjourn. I think we cannot make any decisions. Make any decisions. Okay. Like say, we can't vote on certain things. So we still can because it's recorded, we can still have the director's report and everything and then we can adjourn after that. Okay. And I think the goal all along with these tobacco discussions has not so much to make, has not been to make decisions in this meeting just yet, but to talk through all of the issues and sort of reach consensus and then have a list of the things that we want to change, have them written into the regulations and then vote as a group on the revised regulations. So I think we can get around the voting issue anyway on this particular topic anyhow, because we're not there yet. Yeah. Yeah. Okay. So the decision, I have a question. I'm sorry. So the things that are marked decision decisions are not yet voted on. Is that correct? That's right. I mean, the idea was we got clarity on these things. And so Risha and Maureen were sort of tasked with writing that up into a final document, which would then be reviewed in detail with everyone and voted on as a board. Yeah. So should we just get to a discussion on number two or? Yeah. I think the main thing that we wanted to discuss today is about the violations. So we had decided in the last meeting to stick with the, let me see, where are my notes? For the penalty structure for violations. So we did decide, we discussed the penalties for state regulation violations at the last meeting and we agreed to drop the suspension for first violations that didn't involve sales to a minor. So if there was a sale to a minor, there was the $1000 fee and the seven-day suspension as is currently written in the regulations. But if it wasn't a sale to a minor, we agreed, you all agreed to drop the seven-day suspension in light of that brain tree, the Cumberland Farms lawsuit, I think. Was it in brain tree? Am I remembering that correctly? Where that particular item came under scrutiny. So the idea was let's keep it in sync with the state regulations. So that you all decide or there was consensus on. But then the question was about the penalty structure for the town regulations, which has lower fines. But then there was also an automatic suspension of 714 and 30 days, which seemed, I think, to the group maybe out of step or a bit harsh. So I think that was the conversation that Risha was going to lead the group in is what about the penalty structure for the town regulations? Violation of the town regulations versus violation of the state regulations. So as of now the town violations, first violation is $100 and seven-day suspension. So we thought of the seven-day suspension is some sort of a harsh. So just keep the $100 fine, is that right? Right. That's I think what we, I don't remember exactly that we talked about that as a group, but that is definitely the recommendation that Maureen and Risha were making, just what you said, Tim. Okay. And this was for the second violation. We again retained the fine of $200 and not do the suspension of 14 business days. Correct. I think the recommendation that Maureen and Risha had made was to keep the fine of $200, but to make the suspension seven days instead of 14 because it was going to be zero for the first violation and then seven days for the second instead of 14 days. Okay. And for the third violation it would be 14 days. Correct. I think that's the recommendation that they were making. So I don't know if there's some discussion folks want to have about that, if it seems reasonable. Sarah. Sorry. Go ahead. Go ahead, Lauren. Is there a fine on the third? That was my question. Is there a fine on the third suspension? For the third violation currently there is a fine of $300 and a suspension of 30 days. So what we're proposing is keeping the fine of 300, but changing the suspension to 14 days. For the third violation of town regulations. Pramila, what were you going to say? Well, I just was curious about you know what the discussion was in terms of uniformity with the state. It just just listening quickly. It seems like we're lowering fines and suspensions and therefore not violations, you know, will be less, I can't think of the word, but there's less disincentive is what I need to say. And so I was, was the general consensus that $1,000 was just too high? Well, that's for the state. Yeah. Fine. We are talking about the town fine. No, no, I know that. But you know, I don't know if $1,000 was even considered or if, you know, so I just wondered, I'm not advocating $1,000 fine, but it does seem overall like we're making the restrictions more lenient or, you know. Yeah. I mean, so I guess my question would be, since I wasn't, I haven't been around for a long time, when these fines were set for the fines for the first, second, and third violation of town regulations, their lower fines, like you're saying, Pramila, for the state, it's $1,000 for the town, it's only $100 for first violation. So there must have been, it's been like that for some time. So there must have been some discussion about that, right? Is that true for other towns as well? Do you know? I don't know. I imagine that when these were set or developed, that it was to be in sync with what other towns are doing. But I wasn't around. I don't, Tim, do you recall? I don't recall, but I, you know, you guys, you talked about it last time and made some kind of a decision as well. So I wasn't present. I don't need to belabor the point. I was just asking for more information. Whatever you decided at the last visit is reasonable, unless you want to have more discussion about it. I would just add, because I do kind of agree with Pramila. I know that, as I said before, you know, math is, and numbers is not my best strength, but I know that the town has, you know, state college issues. And I know with cannabis stores that they're supposed to have like certain treatments, community impact treatments, that's gorgeous. To wonder what is the intention now, let's see if I'm like, working on the policy, you know, if it's possible to gain some, some other that could be useful for the things that the town needs or, you know, programs at the town needs. So I don't know. I hope it's for me. Oh, I was just going to say, Lauren, you were breaking up a bit. I mean, I caught some of that. I don't know if others were able to catch the gist. Yeah. I was not able to. Yeah. I always, Lauren, I think I heard you saying something about, you know, the importance of fees maybe being available to pay for certain town services. And so questioning whether they should be higher in order to generate more revenue for things, I think that's what you were saying. Yeah. Okay. Yes. That's a good point. I was looking at Northampton tobacco regulations. They don't have anything for the town violations. They have for the state violations exactly the same numbers, but violations related to the town, I don't think, or city, they don't have anything listed there. Oh, okay. So does that mean? Go ahead. Go ahead. They would just follow the state. I mean, is that what's implied or not that they don't have any fees at all for violations, right? So the town has some specific regulations, I think. I think, for example, the number of tobacco sale permits, prohibition of smoking bars, and that is very specific to our town. And those are the ones I think we have this fine structure, different from the state regulations, which are state, primarily defined by the state, you know, regulations and penalties. So these are same, you know, $1,000, $2,000, and $5,000 for three violations in incrementally. But I don't see one in Northampton, but I'm not sure other towns have that for town violations. Can I ask a question? So if someone is found to be in violation, do they only pay the town violation fee or do they have to pay the state one too? When does the state one get levied? I'll try to answer that. Primarily, I think the state doesn't have penalties for town laws. For example, there are laws about the number of tobacco sales permits, that type of things. So whenever there is a violation of the state, it's automatically those numbers like $1,000 comes in. But when it comes into prohibition of smoking bars, enamors, minimum pricing of sale of cigars, which is a town type of a by-law. And so, town regulations are usually coming under town penalties. So when would the state regulations apply, do you know? Like most towns have governing bodies that decide these things, right? Yeah. So the state regulations are governed by the MGL, the Master's General Law, within the public health. That's where state laws comes in. Yeah. So the state regulations are things like you can't sell to a minor. That's set at the state level. So we have that in our local regulations, but it's a state law. So if people violate that state law, then they get the penalties that go with violating a state regulation. But then Amherst has decided to put in a couple other things that are just specific to the town that other towns don't have. So if people violate those things, then they get penalized according to the town fine structure. Okay. I understand now. Thank you. Sure. I think Lauren's point is really well taken in terms of revenues generated by any type of penalties and how we could use it for other related programs. And $100 for the first violation is not that much, given the... Yeah. I mean, certainly the other fines are hefty. The $1,000 is a decent fine, and we've levied that for a number of times over the last several years when people have violated it and sold to a minor. So that has generated some revenue. But to your point, Lauren, I don't actually know where that revenue goes. What happens when... It's a good question for me to follow up on in terms of thinking about how those fines are used to pay for programs, because I don't know the answer to that question. But I think... So I will follow up on that just for my own information as well as everybody else's. But I don't know... So then it sounds like... I think Amherst might be somewhat exceptional in having some town regulations that we are charging people money for violating. I don't know how often that happens. I looked back through my records and I saw violations of state regulations over the last several years, but I didn't know any violations of our town regulations. So we haven't, as I could see recently, recouped any of these smaller fines for anything. And it sounds like other towns may not even have regulations that are town specific that they find people for. So it would be good to understand how these fees were set initially when this regulation was written, you know, last written, and what information that was based on. Okay. So if we can take a look at the specific regulations of the town of Amherst, which are listed under seven violations, and then B five, there's a whole bunch of lists of what violations constitute for the town laws. So it includes Tobacco Handlers' Quiz. And we had discussion about Tobacco Handlers' Quiz last time, but I don't know if he decided on that. But it also has violations of any type of exceedance of permits or prohibition of smoking bars that's exclusively town oriented or town relevant. So if we can take a look at it and see if they are still relevant, if so, I think we should, we can reduce the list. And since we are getting rid of the suspension, I could make a recommendation that we should increase the penalty of the fine, you know, because so we need some sort of a disincentive, as Pramila was saying, to follow the violating the rules. So do we want to look at that right now? The list, as you just pointed out, that's on page 11 under section seven, bullet number five, A through J, those tobacco town specific regulations, are any of those no longer relevant? Well, so we talked about the Tobacco Handlers' Quiz, as you said, Tim. But I think we've now kind of, I think Maureen is rethinking it like, oh, maybe we should talk about that some more. Because, you know, it might be something to talk through with Cheryl, Sabara, if we decide to invite her to our next meeting, I think it would be good to have a list of questions to ask her. Because Meredith O'Leary did sort of say that she thought it was a good thing, and there are some folks that are doing it with good effect. I think Risha sort of on the fence, I think it would be good to have all of us here to talk about that again. But are there other things in this list that folks think maybe we should dispense with? I'm looking at the first one, the maximum number of tobacco sales permits. That's actually decided by the permitting authorities, right? Why will that become a violation? Yeah, I think it's a good point. I thought the same thing. And same thing with the prohibition of smoking bars, you know. How would one violate establishing a smoking bar without permit? Yes, yes. It's a mismatch. The set of violations to these things are these are this is huge. If you actually set up a smoking bar without license, and we only charge you $100 for doing that, that none of that makes sense, right? Yeah. That becomes illegal, you know. So violating some of the laws existing laws. Yeah. And minimum pricing on the sale of cigars. That is some sort of a giving discounts, is that right? I'm not sure what that means, you know. Well, didn't we talk about that last time? About the, oh, Risha's here. Oh, Risha's here. I'm so sorry. I'm completely lost track of time. No worries. We're glad to see you. Thank you for, you joined just in the nick of time, because Pramila has to drop off and now we'll still have a quorum since you're here. So that's great. Anyway, so, Tim, do you want to catch Risha up on what we've talked about so far? Yes. We had been in the violations section. Couple of things we had been discussing is if we get rid of the suspension period for the town violations. I think we talked about this last time, I think last meeting, which is $100 for the first violation and then having along with that seven consecutive days of business days of suspension. So I think we thought that suspension is a much more harsher penalty and one proposal, this just for discussion is to, if you are getting rid of the suspensions, we probably need to increase the penalty, which is the fine for each one of those from $100 in a little bit more because there's no sufficient disincentive for violation. So that is one of the things. And then we are also right now discussing about the list of violations which were mentioned in that same subsection B5 and which includes Tobacco Handlers' Quiz as one of the town violations. And I think we discussed about whether we need to have it or not, but that is something we can discuss. But I was also saying the other specific things which were listed, which might be redundant. For example, the maximum number of tobacco sale permit allowed in Amherst, that is decided by the licensing authority. Primarily, the person will not illegally open a tobacco sales permit or start a store because we have to permit it. Someone is permitting. So it becomes very redundant to have that as a violation. The second is also the prohibition of smoking bars. So violation of establishing a smoking bar illegally, that is something usually with smoking licenses or anything is actually controlled by the licensing authority. So it may not be listed as a violation. And so those are three things we discussed. And I don't know what you think about those listed. And I just say I have to leave now. My apologies. I will see you next month. Okay. Thank you, Pramila. Bye. Take care. Bye. Yeah. Sorry, Lauren. No, it's okay. I just wanted to ask a question. Is there more talking about like the illegal like an informal kind of smoking bar? Not illegal, but like informal? Do we even have a definition of smoking bar in here? Let's see. Yes, we do. So an establishment that exclusively occupies an enclosed indoor space derives revenue from food, alcohol, or other that is incidental to the sale of tobacco. Yeah. Cigar bars, hookah bars are included in that definition. So it's a pretty formal definition of a smoking bar. Okay. Yeah. And so we should just also to say that Maureen had suggested or you both had suggested that we adjust the suspensions from instead of from 714 and 30 days for first, second, and third violation of town regulation to 07 and 14, which folks generally felt was reasonable. But as Tim said, you know, maybe we want to think about increasing the fines because it's not very punitive. But then the whole question was, what are the actual things that people would be fined for in that category? And this is the list. And it's not really a good match, as Tim was saying. You know, obviously someone wouldn't be able to, the maximum number of tobacco sales permits is set by the licensing. They control that somebody couldn't violate that and be fined $100. It doesn't make sense unless I'm missing something. It seems like an odd list of things for which you would find people these small amounts of money. Does that make sense to you? Yeah. And you know, I don't think that we'd consider or discuss that. So I think these are all really good points. I think on its face, the difference was solely what's in the state and what comes under the state mandates and then what's unique and sort of more municipality run and nobody really thought about whether the crime matches the punishment as it were. So I think it's a really good conversation to have and to consider. And Kiko was mentioning that the historically the violations were more focused on the state violations. And we didn't have much of these town violations in the historically, you know, people being penalized for some of those lists in the list. So and also Northampton had, I was just looking at Northampton's tobacco regulations. They don't have any city violations or anything section. Mostly they were all state regulations. I don't know if I'm reading the right one, you know, Risha, you can correct me. I thought they did, but I don't have it open right now. And it's probably not a great use of time for me to try to figure out which is the right one, but I can look at that. Yeah, I mean, I didn't do a comprehensive review, but I did look back because Meredith, since she's the coordinator of the Pioneer Valley Tobacco Coalition, occasionally checks in, you know, wanting me to verify her records with what she has as a list of violations. And so over the last two and a half years, there have been several violations and to the state regulations, sales to minors, all of them were sales to minors. And there were fines that were collected and all that stuff, but I didn't see, unless the data work was in a different folder that I didn't look at. Again, not a comprehensive review, but nothing stood out to me in terms of any fees that were levied along the violation of town regulations, you know, those hundred or $200 fines. I didn't see anything like that. So I don't know that those, that we're actually levying those fines for violations of the town regulations much. So I think, as you said, Risha, it's something to consider. The other thing I'm just going to add to this conversation while we're all here is that I did get a report at the end of March from the PVTC again, that the a representative went out to conduct education, merchant education and pricing checks in Amherst among our tobacco retailers. And six of the 14 retailers did have, I guess you would call them, technically, their minor violations in that they didn't have their DOR permits posted, they didn't have their BOH permits posted, they didn't have no smoking signs, you know, those kinds of things that they're supposed to have, I guess per the state regulations that here's where I'd have to, right? You're nodding your head. I'm not as familiar as you are. So then the question would be, should we be finding them for these kinds of things? Because I don't think we have traditionally, we've only levied those more substantial fines for the sales to minors. And what are those fines? Would it be, I guess it would be, I don't know, state level and that's $1,000, right? Required retailer signage is one of the specific penalties for state enforcement. So yeah. So we don't have control over what's listed or what the fines are, if I've understood everything correctly, I guess that, and I don't know what are, what we're allowed to do in terms of not levying a fine. Should be. Right. I mean, so Meredith is on vacation this week. I was on vacation when I got this email, now she's on vacation, so we haven't had a chance to connect because my question would be, should we be levying fines? Are other municipalities doing that? Because that's pretty significant. It's almost half of our retailers that are not in compliance. And as you said, it feels like a fairly, it's a piece of paper that's not up versus, I don't know, a vending machine, a cigarette vending machine, which feels like a much more blatant disregard for the regulations. And that's $1,000 for the signage and right now it's $100. For the vending machine, right? Yeah. So is there no prohibition against cigarette vending machines in the state regulations? No. I mean, to me it feels like a maybe too specific, right, that self-serve, because there's also, I mean, that's still a municipality, but those are sort of the same things. And then there's this weird, and I have to look if there's more of them, but like sales of rolling papers to minors is a $25 fee. There's a whole different set of fines for that. Yeah, I know. So yeah, it feels like there's some leveling that needs to be done here in terms of making sure we've got the right, we can't do anything about the state ones as I understand it, but that ours are the right things. And to be honest, if we felt like we had two categories within local regulations, if we thought that we had minor and major, we could set different fine schemes to address that. So if we felt like, I don't know, are any of ours minor? Not really. Pricing on the sale of cigars. If we felt like that was a minor infraction and $100 felt right on that versus, you know, sales products in educational institutions, I don't know. Right. Yeah. So how do we move this forward? Would you guys like for a small group of us again, sort of, you know, Maureen and myself to go and put our heads together and come up with some suggestions or options and come back next meeting or what would be the best way to, because it feels like there's a bunch here that we really haven't thought through. I think it's kind of hard for me to follow that way. And I have to be honest that I have a lot of, you know, from our conversations in students, that we need to be like, who would follow and go to these places of business and make sure that we don't follow it and it's like we didn't have I thought that's why we were kind of being more lenient in some ways. But I would we're going to be in suspense on what she'd like to have. I was looking forward to hearing it. I'm not able to follow. Maureen, is it possible to call with your phone for the audio? I try. Good suggestion. So I would suggest that we make a comment about this list today. And then Risha and Maureen can actually work a little bit more on making some suggestions on which we could delete, because it looks like some of them are redundant, but some of them are important. So we can actually have those things which you are proposing to have it in the list. You can, we can discuss in our next meeting. Yeah. And just FYI, now that I have everything in front of me and deepest apologies that I was late, we had removed the educational materials, the quiz list in the latest draft, which I think, I think we haven't shared just because it's still a work in progress, but I see it in front of me and it's not there. So I think the question now is on these redundant ones and doesn't make any sense to have them in the list. And then maybe some thoughts with some pros and cons on sort of how much below state or equal to state fines we would want to be. Lauren, are you back? Yeah, it's still cutting out a lot. It's okay. I'll just listen. Oh no, but I think you were talking about how we enforce the local regulations, right? And how we even check. Is that what? Yes, but I don't want to say too much because you probably won't be able to hear me. We can hear you really well now. Yeah, I was just saying before we were saying that there's not enough staff to follow up with these infringements. And so I didn't know if that was one of the reasons why we were trying to be a little more lenient. And so I'm kind of getting lost in what our intention, like where are we going to be because I'm really, it's not clear to me. And I have to do more studying before the meeting. Yeah, so Kiko or anyone jump in if I'm off base because I'm learning as we all go, but my understanding is that the state has the inspectors for this or there's that come in, but they will take our local regulations and check for those as well. And so I don't think the reason we're considering changing the fines is because we don't have people who can check the fines. That was an issue with the tobacco quiz in particular, whether that was sort of enforceable. But I think there are people who go out, as Kiko just mentioned, she got a report that check for this. Right, Kiko Amai? Yeah, yeah, that's correct. They are affiliated with the PVTC, the tobacco compliance officers, and they do these checks, you know, not that frequently. It's maybe a couple times a year. I think in other municipalities like in Northampton, their inspectors do also do some inspections of tobacco retailers in addition to what the PVTC provides. So they're out there a little bit more. We don't really have that capacity so much here. Our inspectors don't do that level of work, but I don't know that it's needed necessarily. I think what we should definitely focus on is as long as the tobacco compliance officers are out there and finding violations, we should be acting on those. And I don't think we have. Again, I should probably go back and really review to make sure, but it doesn't seem like we have in the past. Sorry, Kiko, you're going to go and check whether that's happened, and then whether it's a mandatory thing that we need to make sure happens, right? Yes, right. Yeah, because this is all for fun if we don't actually think so. So I think we just discussed until the minimum pricing of the sale of cigars. What do you think of the other items, you know, maybe a quick overview so that Risha can take notes and on others, you know, what, for example, the sale of blunt wraps. Is that something constantly violated or is it something prohibition of the sale of products, tobacco products and educational institution? That makes sense to keep it, you know. These are schools and universities, colleges like that. Do college, do the universities have separate enforcement mechanisms? Do we? They have a Board of Health at UMass, right? I mean, the health officials. Yeah, they have an Environmental Health Department and they have, you know, University Health Services. So if they're communicable diseases and whatnot among UMass folks, we don't track those as a health department. They track it themselves. And if there's a building inspection that needs to happen, it's environmental health at UMass that does it, not our inspectors. So I would think that this would fall under the Environmental Health umbrella regulation of this sort of thing. Okay. I mean, I think it's still useful to be there because it would school. However, it does. That's not a, that we would find that out in different ways than the inspections, right? Because it's not in a tobacco premise. Right, right. It would get reported or something. That seems fine. I mean, I think we should check over this whole list and make sure that A, it still aligns with everything that's been mentioned as a local regulation and that we haven't missed any or have something there that's no longer in the rest of the document. But I think the second then question is, are breaking of these regulations minor as we are sort of insinuating they are by their fines or are they closer to the level of the state ones? And there's also other others in the list which says prohibition of tobacco product vending machines versus prohibition of self-service tobacco product displays. I don't know. They look like very similar display versus vending. Or is that something people do in terms of violations? I'm not sure. I mean, I get so self-service, both vending machines and self-service displays have definitions in the earlier section and they are separate. I mean, it's just automated versus like having them out on a counter and you take them and leave money. There's certainly ways to streamline this, which is you could just define self-service as also including automated, not have to list things doubly, but it holds up in terms of they are mentioned and they are defined. I'm sure there's still an old cigarette vending machine somewhere in town, hopefully not being used, but I'm sure it exists. And E and H, like for example, tobacco sales in educational institutions and healthcare institutions, we can always combine them in saying educational and healthcare institutions. I think it's just about, so I think the ones in the fines are just perfectly aligned to how we've defined the prohibitions and so we can combine them in both the prohibitions and the fines, but if we keep them separate in the prohibitions, probably makes sense to call them out separately in the fines. I have strong opinions on this. If we feel like it's fine to combine them, that sounds reasonable. I'm thinking more on the implementation side. There are so many in the list and everything is equally weighted in terms of penalties right now. So you're essentially suggesting kind of a rewrite of this section in terms of what are the regulations that we list here and then what are the corresponding fines for violating those regulations? Yes, but that also will become little complicated. So now who will decide, you know, whether it's going to be $100 versus $200 for the first violation and what is the severity of those, you know, that becomes little more complicated. It seems like it's worth some research. So I mean, what I hear you saying is opportunities to streamline this and I'm sure enforcement people would appreciate that, right? It's a little clearer what they have to do and certainly the store owners and workers also, the easier it is for someone to remember, the easier it is for them to adhere to them. So we can definitely look those over and if you see more, we can, we'll keep looking at those. The fines to me feel like this is a really good space for us to do a little research and see what other municipalities are doing and if there's any sort of trends in that that make sense, that give us a sense of a pro or a con of, you know, the kinds of levels of fines that they're doing because I just don't know I haven't done that research. So some of the fines are written, I would say decade old or maybe so there is inflation. You know, when we account for it, it's nothing, you know, dollars is nothing based on the profits and stuff like that. So I think we have to revisit that type of a change in value of that, you know, money. But I'm not sure if other towns have updated their penalties. But yeah, if he could just review what others are doing, and maybe we can come back and read just ours. All right, looks like we have a plan for that for next meeting. Yeah. So we'll say there is a marine get together and update it himself. We'll make suggestions or bring arguments, you know, the why you might want to go one way or the other the next meeting. Okay. Okay. Next in our agenda is director's update. Okay. Oh, let me ask one question first, which is that in terms of inviting Cheryl Sabara back to the meeting, are we maybe we're not ready to do that for this next meeting in May? Because there's a little more research and whatnot that you want to do. I'm just wondering, because we talked earlier about maybe we do want to have her come to the next meeting, or maybe that's premature. The only thing for me that feels like it would be really useful to have her is this Delta, whatever conversation where I feel like I just don't have anything to, you know, be useful to have her context. I think at this level, she might just be able to review what were, you know, our suggested draft and give feedback. And then also if we come away from the sort of final conversation on where we're landed with a few things we can't quite, you know, agree on that maybe that's a place to bring her back in. But I'm not sure we have anything specific to ask her at this point. Okay. Unless it's this question, and maybe we'll find that out as we research that we need to ask her. Right. And as you said, that could be something that you and Maureen could just call her about or email her about, she might be able to answer. So then do we just thinking about our next meeting, do we want to, because the Delta A conversation I think is heating up, I think absolutely it would be good to get the rundown from her because she's so knowledgeable. Do we want to try to do that in May, as we're also working on this tobacco regulations or is that too much to do in one meeting? I don't know what else is on those two things don't feel too overwhelming. I guess it sort of depends on what else pops up and needs to be addressed at a timely manner. Yeah. Yeah. I mean, I said, I feel like the Delta A conversation is a little bit time sensitive. So unless we have, you know, a million geothermal wells that we need to approve at the next board meeting, I would vote to, I mean, I would suggest that we try to include that on our agenda for next time, if it doesn't feel overwhelming. Yeah. And if you feel like that's time sensitive, I mean, we can pause on these regulations too, if there's too much else, right? I mean, it isn't a deadline for this, so. Right. That's a good point. Okay. That's a very good point. And it also depends, I think, on the time that you and Maureen have to do research and work on this in between now and the May meeting. So we can, you know, keep in touch about that. Yeah. I feel like we're getting really close on these tobacco regulations on having it be something to review in writing, that people see a draft, see the changes, remind themselves of, oh yeah, this sounds right. We agreed on this, or like, ooh, we didn't talk about this. I have questions versus long conversations. I think we've hit almost all the points except this last one, which we'll bring back. Okay. All right. Sounds good. Thanks. Go ahead, Tim. Well, it's a director's update. Okay. So just the usual sort of standing item things for the director's update. In terms of respiratory illness, I think we're finally exiting the winter respiratory illness season. COVID wastewater levels are definitely on a downward trend and staying low. So we haven't seen any spikes recently. You know, anecdotal reports are that there are lots of colds going around still, but a flu and COVID are decreasing definitely. So we did exhaust our supply of COVID tests. We had so many of them. We gave them all away to people coming here or to community-based organizations. And they've all expired by now. So if people still have a cache of them, they technically can't be used any longer. We don't have a huge budget to buy more. The CDC is essentially treating, you know, the new, the revised guidance is to treat COVID as any other respiratory illness. And the Mass Department of Public Health has also reinforced that guidance and given that to the local health jurisdictions to, you know, work with. But there is some value, I think, according at least to mass DPH and people knowing whether they have COVID or flu. So being able to have a provider test someone for COVID or flu, because in some cases there would be treatment indicated for those things in a way that there wouldn't if you just had a common cold. So there could be some value in us having COVID tests in the future. We're going to kind of see what happens and what, if the state provides more free ones, or if we have some budget spending or leftover money we need to spend by the end of the year, that might be a good budget item. But at this point we don't have any. And people still come by, right, Kyle? Still come by the office asking for them because they are definitely very popular. So that's sort of the update there. The kindness campaign, this is the last month of the campaign, although we're really thinking about trying to keep the spirit alive. On that note, Lauren, who I guess really has dropped off, which is too bad, maybe she'll pop back on before the end of the meeting. But she has been communicating or working, collaborating with me and Becky from the recreation department, on setting up some more mental wellness sessions specifically for adolescents in the month of May. So May is actually Mental Wellness Awareness Month, I think, or Mental Health Awareness Month. And we're really excited we're collaborating with the Youth Mental Health Collaborative. I think it's called Out of Springfield. They have some great trainers to do two sessions in May for high school students. I can definitely get those flyers out to you all. I haven't shared those with you yet, Kyle. But because they're sort of outside of the kindness campaign, which is supposed to end at the end of April, but we're, you know, it's still this theme that we're kind of working on. And one of them is a spoken word workshop. It's called, I said what I said, I meant what I wrote and really kind of encouraging young people to express themselves and their emotions through the written word or spoken word. So that's, we're really excited about hoping to get a lot of young people to come to those. The other mental wellness workshops that we've done through the kindness campaign have not been that well attended. I had a feeling this might happen. It's just some of them have focused specifically on suicide prevention, which we know is an issue in our community and nationally that suicide rates are going up. But it's a hard thing for people to talk about. And what we learned at the session last night, which was attended by only one person other than our staff from the trainer was that oftentimes when she does these sessions, it's in response to something that's happened. A young person has, you know, died by suicide or some family member has had a relative who died by suicide and wants to learn more, wants to spread the word. And that's when you get people to show up for these things. Just out of the blue, it's not meeting people's needs. So we did have more attendees at the mindfulness session that Shalini Milne conducted. That was at the end of March. And there were more people who came for that. And Heather, or Hala Heather Lord is doing one in April, which is for families. And I think we might get some more attendance there. But we're learning a lot about this, how to do this, and still trying to just spread the word about how being kind and reduces stress and stress is a big public health concern. So how can we keep spreading the word about that? We had a successful hepatitis A vaccine clinic at Craig's Doors. We vaccinated 11 guests and three staff. And at first, we didn't know that we would have much interest at all. But people kind of talked to each other at the shelter. And there was a lot of peer-to-peer encouragement. Even that evening, people were kind of convincing each other to get vaccinated. So it was actually a really lovely, fun, feel good kind of event. So that felt great. And we want to be able to do more hepatitis A vaccine with that population in other ways. So continuing to collaborate with Craig's Doors on that. I don't really have much to say about National Public Health Week, which was the first week in April. It's sometimes hard to come up with things to do to celebrate that. I think North Hampton had a lot of events like car safety, education evenings and vaccine clinics. But we just kind of put the word out about it and tried to remind people that we're still here in public health and we're still doing our work. So maybe next year we could plan something. I think it's something we have to think about more ahead of time. And maybe that would be a good Board of Health Public Health Department collaborative activity to plan something for National Public Health Week to again kind of raise our visibility as public health. People do forget the important work that we do when there's not a pandemic raging. So it's always good to remind people about why we're here. And on that note, our public health nurse Olivia has been doing office hours at the bangs. She's the second Wednesday of the month. So we actually had a lot of interest before officially got going. Some people were knocking on her door last month and was really supposed to start this month. But so she has seen a couple of people and it's just nice for her to be able to offer blood pressure screenings and health education. She's in the bubble room, which is on the ground floor of the bank center and has had a couple of not huge volume, but I think it will, it'll take off with time. It's great for people to have time with the public health nurse just to talk about whatever is a concern to them. So we're happy about that. Those are the main things that were on my list. I did want to mention that we get these infectious disease reports every month through the MAVEN database and also through our collaboration with the public health excellence grant that's run by the city of Northampton. So I could add this as a standing agenda item, you know, our infectious disease reports. I think it's probably not that interesting to drill through the whole list of things. How many TB cases this month? Probably not that interesting, but if there's something that's kind of standing out, I might bring it up. And one thing that is standing out is that we are already seeing cases of tick-borne disease, some Lyme and anaplasmosis, and it's really early in the season. So we're gearing up for what is going to be probably a prolific tick and mosquito season with all this lovely rain that we've had. And if it starts to get hot at some point, it's just the perfect prescription for lots of bugs reproducing. So yeah, we're just going to keep an eye on that. I think you've also heard about avian flu kind of being out there and some cases that it has, there was one human case in Texas. So Mass Department of Health is just kind of on the alert, nothing is happening, we don't have any, it was avian flu was found in dairy cows in Texas and that the person who got infected got it from a cow. No cases of dairy cows in Massachusetts with avian flu. So we're just unaware of it, but nothing, we're not doing anything right now except just keeping an eye out and listening to whatever the Mass Department of Public Health has to say about it. So also no measles cases in Massachusetts right now, thankfully. Hopefully it stays that way. I don't think I have anything else. Any questions, comments? The conversation around the infectious disease report, is there anything akin to that for non-infectious? I mean, is there sort of a morbidity, immortality? We don't have a lot of deaths. So we aren't going to have like a death report of injuries, harm, things that detract from life quality. Is there anything that sort of combines infectious and non-infectious? Gives us a sense of where the trends are or where the greatest need is? Yeah, I think we don't have those kind of data at the hyper local level. I mean, because we are charged with tracking infectious disease at the local municipal level, we get all the, all the reportable diseases we have in our town-wide database. But for some of those other things, it would be more like the state puts out reports that are maybe county-wide or statewide. So we can look at trends that are more general, but not so specific to AMR so much that I'm aware of. And then the, is there a Hampshire County public health that then is mandated to look at that? Well, there are county health departments. So there isn't a county entity. I mean, I think the public health excellent grant does try to, because they have the town-wide reports, you know, for infectious disease for 16 communities in Hampshire County, they can kind of look at a county-wide trend for those infectious diseases. But in terms of these other things, I don't know who's collecting those data and how, I mean, I think the state probably has some that, like for example, hospitalization data, I go on the mass DPH site and I can see in Hampshire County how many hospitalizations there have been. But other sorts of data, I'm not really tracking that closely. Do you have a specific thing that you're thinking about, just general? No, I was just thinking, you know, if we, if we're doing, if we're trying to think of where to invest and we're talking about, you know, these various things, like how does, how does the harm or potential harm from a HAPA compare to road accidents or, you know, completely other things? And I don't have any sense of that. So I was wondering if there's a place to look. Yeah. Yeah. I mean, those, if we had county health departments, those kind of data would be tracked at the county health department level. And because the locals are often so small, like maybe in Boston, they can track that stuff better. But I don't think we have an infrastructure here to do that. For things like overdose deaths, those kinds of data are collected by the state at the zip code level. So we know kind of roughly what's happening with that in Amherst, but we don't collect it ourselves. So for some of these other things, if there's not a state mechanism in place to collect them, then we don't really have access to that info. Yeah. Okay. Makes sense. Yeah. Just still learning the... No, it's a good question. I'm also still learning. So my answer might not be 100% accurate, but I'll also keep this in mind as something to think about too, because it helps in terms of understanding what our public health issues are in the town and how we should be addressing them. We need to know what they are before we can address them. Thanks for that question. One thing I thought about though, before we adjourn, which is, Premela made me aware that this meeting was... Meeting time was changed to 5.30 from 5 o'clock to accommodate her schedule. And today was an anomaly for her, but she normally does not have to work on Thursday nights. So she said the meeting could go back to 5 o'clock, if that's something that people want. Now we only have two folks, two board members on the call right now, but I just wanted to put that out there as something that would that work for you both, Risha and Tim, to start at 5 instead of 5.30. Yeah, it's fine with me. Yeah, me too. 5 o'clock, yeah. Okay. Okay. So maybe we can chat with Maureen about that when she gets back, see if we want to change the time. And Lauren. Yeah, exactly. Yeah. Thank you. One more thing is, is there a way to arrange a hotspot or something for Lauren, you know, for sort of a borrow for that month? No, each month, you know, for during the meeting, I think it will help communications, you know, really well. So, because I think the signal is being lost, you know, and we want everyone to participate. That's the main thing. I know. I so appreciate you saying that. Do you know, Tim, is that something that had been suggested before? It sounds like it may have been suggested before. I suggested a couple of times before. Okay. And did Jen, did Jen try to make that happen or do you know? No, no, it was not. I think it's not that expensive. I think if even the Board of Health can get one, you know, take it. Right. To use for various things, right? Exactly. And. Okay. Thank you. Good suggestion. Thanks. I feel like, does the library have them? I feel like I've seen some place that gives them out or has them. And I wonder if we could be a facilitator of getting, yeah, getting back for, because I think expanding access is really important, right? It might be Lauren now, but it could be anybody that we want to participate in the future. So. That's a great point. Yeah. Yeah. I don't know. But I was just remembering that I've seen them somewhere. Yeah. Yeah. We can look into that for sure. Yeah. I remember. I know libraries is one option. Schools might also lend hotspots enough. They lend laptops, but I'm not sure about hotspots. Yeah. And there may be resources. And I also like the idea of it being something that we, that we have for ourselves for the Board of Health for Public Health, because I think we could use it for a number of reasons. Exactly. Especially when we are having clinics or anything wherever you want to have a Wi-Fi connection, you know, it'll be wonderful to have one. Yeah. Okay. Awesome. One question related to Director's Update. I know we are potentially going to have a larger tick and mosquito type of a season. I'm just curious. I think we've subscribed to Pioneer Valley Mosquito Control, I think, surveys. District. Yes. District. And I'm just curious, you know, I think if they will be actually more providing us more frequent information on the, you know, any potential cases or what is the risk involved in this, you know, I'm just curious about that. Yeah. No, I'm glad you asked that. So they will be doing, they did fairly comprehensive surveillance starting last year. And they'll start doing that in early summer. They're also going to do, we've had some, I've made a budget request to pay for some treatment as well. So there, because there was a West Nile positive pool in September in North Amherst last year. And so they know that there was West Nile in that area of town. So the plan is to begin treating that pool with briquettes, you know, that kill the larvae in early summer in that area. So we knew that there was West Nile there last year. Let's get ahead of the game by treating it early in the season. So that's plan number one. And then the surveillance will continue throughout the summer. And if there is more prevalence, then there could be possibilities of more intervention down the road if needed. But yes, we're doing treatment for the first time this year, based on what happened last year. Would there be an interest, and I say this for myself personally, I would be interested in learning more about what we can do at the household level to prevent or and more treat in ways that is, you know, both approved and safe and all of this thing. Yeah, I know. I mean, Kyle, we've certainly done a lot of education about mosquito-borne illness as the season ramps up. And there's, you know, all the traditional things like make sure you have screens in your windows, no standing water, we're repellent, long sleeves, you know, all that sort of stuff. But if there are in terms of treatment, it might be actually good to give education to some people because there are those companies out there that do mosquito spraying. And some people feel like maybe that's the way to go. I think there's mixed feelings about whether that is the way to go. It can be expensive. How toxic is it? These are all questions that people probably have. And I don't know if we've had developed education material about that sort of thing. It might be worthwhile to do that. Yeah, that could be something maybe we take on as a as a one pager that we put on the website. And when I say we, I don't know who I'm talking about necessarily. But you know, whether that's the board or the department or, but it feels like, you know, maybe we don't need to do big sessions. But that is kind of what I was talking about is there's always these signs for different sprayers or treatments. And, you know, as a resident, I don't really know what is in those things or what is the latest recommendation. So maybe just the personal, I agree, has gotten out pretty well. Yeah. But more at the household level or the Yeah. So John Briggs, who is the sort of director of the Pioneer Valley Mosquito Control District, he's super knowledgeable. And when I first met him, he did talk to me somewhat about these companies. And I think he we could pick his brain and come up with do develop a really nice one pager about this that we could put on the website along with the general, you know, education about what to do. Because like those signs are very compelling. I remember when I first moved here, I saw them everywhere. So yeah. Yeah. And they probably have one, right? I mean, this is a different town to town. So right. Exactly. Yeah. Yeah. Okay. Awesome. We don't have any topics not anticipated recently. So it's time to adjourn. So I will make a motion to adjourn the April meeting of the Board of Health. I think I'm the only one who can second it. All in favor. Aye. Aye. All right. Meeting adjourned. Thanks all. Thank you, everyone. Have a good evening. Bye. Bye.