 Okay. The webinar has started and it's being recorded. I'm going to read the preamble to open up the Board of Health meeting of November 9, 2023 pursuant to chapter 20 of the Acts of 2021 and renewed by Governor Mora Healy. 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 can adequately access proceedings as soon as it is technologically possible. After this meeting, all approved Board of Health minutes are posted on our website once they are approved by the Board. I will now open the November 9, 2023 Board of Health meeting at 6 o'clock with a roll call. Tim? Here. Risha? Here. Pramila? Here. Maureen? Here. So now. So we need to review. And receive the minutes of the October 12 meeting. Are there any comments on that? No. Okay. Do we have a motion to accept the meeting, the minutes as written? Can't hear you. I'll make the motion to accept the minutes as recorded. In a second. I'll second. So the minutes of the October 12, 2023 meeting are accepted. I guess we have public comment on items that are on the agenda. Is there anyone who wishes to make a comment? Maureen, we need to make individual votes, I think. Oh, sorry. We have to call in individuals. I don't know. I don't know. I don't know. I don't know. I don't know myself. Okay. So let's go back and vote on the minutes. Maureen. I, Tim. Hi. Risha. Hi. And Pramila. Hi. Pramila. Hi. Sorry. All right. Deep breath. Until now, if there's anyone for public comment on this. I don't know. I don't know. I don't know. I don't know. The. The. Items on this agenda. We do have two participants. If either of you want to make a comment, please do raise your hand. Your zoom hand. I don't see any hands. Okay. Oh, wait. I see the hand. Sorry. Okay. Steven Lambert. Would like to speak. I'm going to unmute you. And it's again, three minutes. Is that right? You should be able to make your comment now. Awesome. Are we going over the, like the new regulations right now? Is that what. What's. Well, we will be the board will be deliberating it won't be a question and answer session. It'll just be the board deliberating when we get to the old business. Okay. All right. Yeah. No problem then. I was just seeing what was going on. With that. Okay. I'm sorry. Just to clarify, just to make sure that it's clear. So this is the, the only opportunity that folks get to from the public to make comment. So, and then once public comment happens about anything, whether it's related to the agenda or something else, then we move into the next item, which will be deliberating the body art regulations. Okay. So this is the only opportunity for you to sort of participate in that conversation or weigh in or ask further questions. Is that right? Maureen. Yes. Yeah. Clear on the process. All right. So then my comments from earlier, just, just stand with like the stuff I talked about with like different hit the violations. With like asking about het fee. And all the stuff I said earlier. So I would probably just go over that. That's all. Okay. Okay. Thank you. Yeah. All right. So no other comments. From the public. I guess we can move on that to old business. Which is the body out regulation final review. Deliberation and vote if we feel like we're ready to do that. I. I thought. It was helpful to hear from Steven again. We did talk here from him early in the process. It's been quite a number of months. He actually was the person who got this started because he was interested in having a. Possible guest artists come and want to formalize that. It was hard for me to hear all of this. I mean, I could hear them, but do I remember each point that he made? I don't think so. But I can say that. Our. Our changes were really based on very local. Regulations that that were. From North Hampton and East Hampton and some from Boston. And maybe even some other towns were primarily from. Comparable towns in the valley. So things that. Were. And our, our, our regulations, as Steven mentioned, were quite. Restricted, especially regarding piercing. He mentioned that some things were legal in other towns than that maybe so, but. Those are limitations were the same. As North Hampton and East Hampton. According to my. Reckoning. So. And some of the other comments. I. I certainly heard. And also things that about communicable disease is, is common in, in these regulations throughout the Commonwealth. I have one comment I'll come back to about that. And even things like a respiratory illness, I think. Common sense means you want to take precautions to keep. You want to take precautions. You want to take precautions from getting other people. Like with COVID or RSD or all of those others. And that even the apprenticeship. Also the questions of apprenticeship length. They're exactly the same as North Hampton and. And East Hampton, I believe. It's a three year apprentice, but. In the third year, the person. In the fourth year. In the fourth year. Can allow them to practice under their auspices and be paid. So it. It's. Again. We didn't draw these up out of thin air and we wanted to be more similar to the local communities and have a fair. Fair game for people who are coming to this area to be successful. And so we had to take the time to ask them. To be honest, I think prior to this, they, they were too restrictive. And didn't allow for that. And I echo. You know, that was my sense from reading all of the different regulations. Does anyone else have comments or have concerns about the regulations? Sorry. Relatively new to the. To the board. And so I don't have all the background on what was going on. But I was struck by the comment around the criminal record. And wondering if, you know, I see that. It's a declaration about prior. It does. I don't know what that means in terms of, are you allowed to hire people with criminal records? Is it relevant in this context to be. Requiring that as part of, of licensure. I don't know the background on that, but. I would be interested in understanding it better. Yeah, that hadn't been in our. Prior. Regulations. It is a common declaration in other areas. Again, I guess it seems a little bit big as what you do with that. I know in some, some. Places like I think province town. It was. You also had to make a declaration of whether you were on a sexual predator list. And that was an annual. A check of the, of those. Both a quarry and a sexual predator list. So there, there are concerns, I guess, with the proximity and vulnerability of, of clients. In a, in a setting that's so intimate. Although I, again, I'm not quite sure how. How that plays out. I don't have any background of, or knowledge of having. That come up in any town or. Or city, you know, that, that I've. That I came across when I did a lot of research on this topic. And I think that if we don't want to put it that in, we can decide not to, we could decide to eliminate that. It hasn't. Come up as a problem. I had, you can see issues about that. But it is something. That we could consider. I think, you know, many of the information. Even if it's negative, I don't, I don't think it's precludes. Any type of a. Rejection of the permit. So this information is some sort of a background information. You know, so you have. Variety of information here on, on types of. Pre-apprentice training. Inform constant. So my, my observation is, you know, this does not result in a rejection. But it might be some information might be useful. If some violation happens in the future, you know, after the license and she should. I couldn't agree. I mean. How often have you had a Corey check because. You were going to volunteer for an organization. Going to start the first one I had, I was going to be at a. A book sale at the, at the middle school, just dealing with children in a public area, you know. Helping them pick out books. So I think it's a low bar in a lot of ways. I think it doesn't. Again, it. An old violation that settled and unrelated to anything of concern to the board. Would not prevent. A license or a permit for, but if there's something that's more relevant to the practice of body art or, you know, other kind of like, you know, for every two years I go sign that for my medical license. I think it's part of partly. On that basis, I think that would be something that if something came up that would be reviewed in more detail. I don't know that we need to define what the threshold is for being concerned. I think we can. We can get help on that if we need to in the future. I wanted to say in relation to HIPAA violations. Correct me if I'm wrong, but I don't think that asking. Information such as happy status and, and so on for licensure of. Body art establishment would constitute HIPAA violation. You know, the community. Sorry, go ahead. Yeah. There's a lot of, there's a lot of health information on the forms that the clients fill out. And, and I don't think there's, there isn't really, we don't have a place where we ask. The practitioners about their status is it's more. In educate it's education and universal precautions. And it doesn't. It says if you're infectious, you shouldn't be, be treating people, you know, be practicing body arts on people or having body arts practiced on them should also not be healthy. And, and that emphasizes universal precautions. I do think we did put in, I know we had this conversation premula under the definition of communicable disease or condition. Most of those things were acute infectious diseases like meningitis and months and whooping cough and it's kind of like we said a kind of a couch podge of things, but it wasn't limited to those and we added hepatitis and HIV. My thought today is we might want to take that out because that is actually covered under the universal precautions. I dug into the site, the, the, the article cited at the MMWR. I forget what that stands for right now, but it's the CDC's publication. And they specify issues of what constitutes a high risk situation for HIV and hepatitis B in terms of both the status of the practitioner and the type of procedure. And I don't think any of these types of procedures are considered high risk. I mean, they're talking about surgery deep in some person's body where you can't see where the needles are going basically and things like that. So I think we can take hepatitis B and HIV out because there might be some kind of concern about being discriminatory for, but these other infectious diseases are, are more temporary things as a physician. It's more, my point was really more about whether it was a HIPAA violation or not. And I don't have any problem with removing the, the two that you mentioned. Yeah. The HIPAA applies in the setting either. It's not a medical setting, but. Can I just ask a clarifying question? When you're saying take out HIV and hepatitis, are you talking about the section on page three? Yes. Communicable because it's also mentioned in the verbal information that you should be giving to clients. And I think it should stay there. I do too. I do too. I just wanted to be clear where we're suggesting taking it out. The definition should be, we might want to remove that, but in terms of the risks and the information given to clients, I think it should stay there. Okay. And then my understanding of HIPAA again has, has some holes, but asking vaccine status from employees is not a violation. No. So the, the HIPAA vaccine, I think we're fine on the communicable disease, but I don't know the details on that. I don't think we're asking for that. Right. It just says you shouldn't do it if you have it. Right. And I guess the question for a tattoo shop owner would be, does that mean I should ask? Or is that just something that we are assuming everybody. You know, knows that about themselves and wouldn't go to work with that. I think we have to leave. Like people know that that's their responsibility. And if they have that diagnosis, they shouldn't be going to work. Like with, with other kinds of occupations as well, you wouldn't go to work if you're sick and you're going to make somebody else sick. You know, that's a really important thing. I think that's a really important thing. I think that's a really important thing. Like some of these skin infections and. Other other risk. Again, it's, I think there's a lot of common sense involved in terms of risks and using by universal precautions with gloves and, you know, we don't talk anything about masks in this setting. But I think we've all learned a little bit about preventing skin infections and other things. I, I didn't see that in any other body art establishment, like any other regulations around body art. None of them, I think we're in the last three years. And just to reiterate then, I definitely would take HIV and have be off of the definition of communicable diseases because we don't want to limit. HIV positive people from being able to do the work. Right. I think that that's what I recognize that. That there are situations where that's not a good idea. And that's something that the physician, the person's physician and. Our practitioner and the. Should just have that discussion about what it what it what's safe and what's not safe. And for the most part with universal precautions, all these types of procedures would be considered safe. The other thing. I know we're jumping around a little bit, but I think that's one change I think we will. I would propose we make another one is the thing you mentioned, Risha in our last meeting and I was hesitant to make a change right then because everything was going out the door for publication. But the idea of gloves, what are gloves? I think we need a definition to add a definition for gloves. And I have one to propose that I. I found. Find it now. It says, here's my suggestion because I found what I learned was that there are medical grade gloves that are, they have a lower chance of ripping or tearing. Then something for utility gloves or for food service gloves. So here's what I found. Medical grade gloves show me medical grade single use disposable gloves that may be a STM standard for medical examination gloves or surgical gloves as required by the CDC. And so medical gloves. Are less fitted than surgical gloves. That's sort of the main difference. And some people might for this kind of work use surgical gloves, which would be absolutely fine. And medical gloves are usually for more examination. I don't know if we need to include that definition as well, but we could if we wanted to. Great. And then to make that consistent, we would need to go through and take out any reference to type of glove throughout the tech. So it just says gloves and it goes back to that definition. Because my concern was that it sometimes said medical gloves, sometimes said surgical gloves. And I didn't want people to have to have two types of gloves. And over. Right. I could do that. I guess. That definition sounds fine to me. Okay. So we can change the changes about gloves. Changes about HIV. You talked about potentially removing the criminal background provision. Yeah, I actually make an argument for keeping that. I think it's not. It's kind of a standard. Request for someone who's. As an interaction with the public. On this, like similar to this, like a nurse or nurse practitioner or a physician or. Any, any kind of. Contact like this seems to. It seems like it's not too high. Big and ask. To try to make sure that. There isn't an excessive risk involved. Did you say that that, that wasn't in the regulations before, but it was. It was not. We did not have it in the regulation before many other. Towns and cities do. I mean, Risha, I know you, you had said something about that. So I just was wondering what your thoughts were about it. I would rather take it out. But it. I don't know how this goes if it's a consensus or majority rule. We could vote. On these things. Why would you like to take it out? It just seems like a barrier that doesn't provide a lot of protection. So, you know, if. If we think about being with children, there's all these regulations that the parents have to be there and sign the. The things and it just, it feels like a. Even though we are saying right now that this wouldn't necessarily make someone not get a license. That might not be something that is known in the application process. And so. It might affect hiring decisions. Or it might affect someone's willingness to apply. And so. And I don't want to create unnecessary barriers if we aren't actually doing any, if it doesn't mean you can't. Provide the service. The cost value thing to me doesn't line up. So that's my reasoning. Any other thoughts about that? This. Well, I can't remember who. Mentioned this. But it. I think there was some comment about how it. Might be helpful to have the information. If an incident. Comes up. That's what I recall was said. I'm not quite sure how. I mean, I get, I get what you're saying. Risha. It seems like a standard provision. I guess I would say it's the only. Argument. And I'm not necessarily saying that that's the reason to do it. But. I favor to keep it only because. Just like any other information they are providing. You know, it gives the full information of a particular. Apprentice, you know. I don't think it creates a barrier. In my opinion, because. We are asking for all sorts of things like social security numbers and. Data birds and. Out of things, you know, which could be used for. Discrimination. But that's not the main, main reason. I think the. Information. Might be useful to actually get the background up. Of an individual who is going to be in track with the public. You know, And I was the one that mentioned that if there is any incident. Which might be coming up in the future, that might be some sort of a disinformation. Might be useful. You know, I didn't look to see if things like where the state. Licenses, you know. Barbers or cosmetologists or whatever, whether that's a. That would be a similar. Standard or not. I honestly didn't. Didn't. Look at that. I feel like it's a, it's a potentially. Sensitive issue. And maybe it is something that you all want to research a bit more before making a decision. As you said, Marine. Yeah. It might make sense for us to take it out. A breath and look at that. Yeah. One thing we did drop was a high school diploma because that was considered a barrier. Yeah. You know, just an age of 18. And so that was something we did try to do to lower. That barrier. And that was actually Stephen's recommendation. And other towns like Northampton did not have that. Not to belabor the point, but just so I understand the logic. So if an incident happened. And presumably, you know, someone makes a complaint or there's a lawsuit or some such thing. And then we say, okay, well, we see on this. This license form that this person has a history of. Whatever. How does that help? Well, at that stage, it may not help much. But at least, you know, we have that information earlier. You know, if an incident happens later on. It's again, a learning process. So maybe that is something could be a, should be a part of that. I just reviewed the cosmetology licenses. Okay. They have to complete a query. As part of the application. That's in Massachusetts. Right. Why the state doesn't. Regulate these. The body. Our body. I don't know, but in any case, all the towns are on their own to kind of figure this out. I guess what was it? Why was I thinking of this? I mean, I feel like this is a fairly intimate. Contact with, with piercing a very possibly. Intimate sites. And if you found that. Someone had a significant past history of being. What a sexual predator or something. You didn't know that and you gave them the license. Is that okay? I don't know. I think that's. Like. One in a billion risk of that happening, but. But there is a little bit of responsibility here. You know, these aren't big organizations where there are lots of people around. It just could be just two people. In, in the setting. I don't know. I might be more inclined. Put something in that specific like that. Because I do understand that risk. But I worry about. I had a weed charge in my, when I was 19 and now I. You know, this shop might hesitate to give me a job because they know I have to declare it on my license. And. That might not happen. And so. Maybe it is worth being more specific on that. Yeah. I think that. Like I said, I think the board would probably not take. Make that an issue. But. I can see your concern about. It being a threshold issue of being outed or somehow. Keep. Keep. Keep someone. Keep someone. Keep someone. Keep someone. Keep. Keep someone from applying for a job or going and starting to. Go into this field. Yep. Sorry. I was going to slightly change the topic. So let me. Yeah. If there's anything finished on this. I think I guess we're going back to the drawing board on this and then come back to it at our next meeting. So let's put that one to. Any other. Yeah, it'll be helpful to know. What is the reason. Applicants of. Barbering and cosmetology are required to do a query. Submission in that application. So if we can go back and see, you know, what, why they are requiring that, that might help us to actually make a decision, you know, because barbering and cosmetology looks like, you know, interacting with public, you know, and how do they use that one, you know, do they use it or do they not use it? And I think if, if we can review that. Application process. It will help us in our own decisions. So let me show you had another area that you wanted to look into. As I was trying to look at the Massachusetts licensing for tattooing to see if there was criminal record referenced. It does say. Two years. For apprentice. And so I'm wondering if it's the piercing. That is three years in some places or. Where are you finding this? I don't, I guess I, I went through. There were some, there's a template, I guess. I didn't think there was a Massachusetts template for body art apprentices. There's town by town. And I really followed closely. North Hampton. And I think each Hampton is the same. It. And it does. I mean, it's. I mean, I think to, to, but I think piercing was only one year. Actually apprenticeship with two years of. Like a provisional license. And. And tattooing was two years of apprenticeship with one year provisional license. And to have a full license. People need to have three years of experience. So it, I think they, they, they, I think it's to make them all line up so that it's about a three year experience. Then you have your full license. Like if someone came from another city or town or state or whatever. The requirement for the license. Was three years. So I think it's to make things equivalent. Over. Over those categories. And I'm happy to have somebody go into the weeds on this. Cause it drove me pretty crazy when I was looking at it. And trying to. Trying to. Make. Make it make sense to me. I mean, I think the. The logic of having it match. The bigger towns of North Hampton and East Hampton nearby. Makes sense to me. So if that's the case, then I would. I'd support it. I just wanted to look in because I was looking for something else. And then saw two years. Yeah. And it looks like it's just giving a. Overview of. Massachusetts. And they say most require two years. I see. Apprentices. They don't list the actual towns that do or don't. So. So I guess for all of us, we can. Maybe try to. Look at some of the highlight highlights that. That Stephen brought up. And. And come back next month with. Some ideas about how we want to proceed on those issues. And I guess. The primary one is, is the criminal record. I think it's a little hard. Can double check on the apprenticeship length, but I think that. Is consistent with what I said. And. The whole communicable disease thing it is. They are guidelines that say. What we want. To know about health issues. That make them at higher risk for complications of. Of this procedure, but it doesn't mean they can't have it. And. And it asks. That. Practitioners are healthy and don't have a commitment. Communicable disease that is. Currently contagious, I guess, in the setting. But also emphasizes the precautions as far as happy goes. It's pretty standard for people who work in risky situations. That they are offered. Hepatitis B vaccine. They may decline, but they need to sign that they decline. And that they need to have training in universal precautions. For. For safety. So I think that's a pretty standard approach. Would I like to know people's status? Maybe that would be helpful, but it's not. It's not a necessary part of this. I think there were, there were three other things that Stephen mentioned that I made note of. There was a comment about the piercing guns that can't be properly sanitized. Well, there are different ones now that come with a cassette. And this is something that isn't. Isn't included in the. I don't think it's included in the piercers. Don't use them. It's like. It's not regulated. Okay. In our, in this setting. It's our outside of the regulations. We could just ban them all together. I mean, we, I don't know of anybody that uses items. Claire's still in the mall doing that. I think those have changed in the last many years. Since my. Left them all. Then I don't think there's anybody else out there with one of those guns. I actually bought my own one. We're a little, because I didn't like the idea of them, but we, it's possible just, we could decide to just ban those entirely. I think they're better now than they used to be because they come with a cassette that's totally replaceable. And it's not quite the way the old ones were, but it's also the piercers don't like them because I think they say it causes. More trauma. The, because the earring itself is not that sharp. And it causes more trauma to the tissues and it's not, it's not a good way to pierce. But. I looked for reference to the gun. There is no, there's no word gun in the document. I assume it's talking about the exemptions. Individuals who only pierce. Who pierce. A low with a pre sterilized single use stud and class ear piercing system. Yeah. That's the system. I think they, they aren't even always. A lot of the system. There's some now, there's some things that are just. Like a cassette. And you just like. Rest them. And those. Although they might not be the ideal way to pierce an ear, but those should be fine. So I'm not sure we need to do that. Because the way, the way I looked at them, they were single use and they didn't reuse a. And implemented to do that. Like that. Was in touch with somebody's body. Or their bodily fluids. But I don't know. I don't know. I don't know. I don't know. I don't know. I don't know. I don't know. I don't know. I don't know. I don't know. I don't know. I don't know. I don't know. I don't know. Maybe they don't have a body or their bodily fluids. But my read of this is saying that this document does not apply to people using. Those systems. Right. And so I think Stephen was actually saying yes, because they are not. Used by. License. Right. Right. They're not. Okay. I think as Tim pointed out, the tradition of piercing young children, you know, it's, you know, it's popular in different, at different times and also in certain cultures there's a lot of piercing of even very young children ear lobes and we don't want to interfere with that practice. So. That's thank you. I think there were two other things I'm just trying to be thorough that I know that I think we want to know what we're going to do. Yeah. I mean, I think we've covered the really significant ones. The other thing, two other things was about the, the things that are prohibited what is not allowed. And Stephen said guest artists may want to do some of these things you, I think, maybe you want to address that and then the tattoo parlors, the open concept tattoo parlor versus the stalls or whatever my call them yeah. The actual list of of the band types of piercing or body art came from really from Northampton so I was trying to make it similar to the other towns in our area. There are also in many other other parts of the state as well that that particular list I found many places. It's very hard to research which body art practices are higher risk and there's not a lot of data, but let's And actually, even I went to sites or likes for like piercers that there are a couple of websites of associations for piercers and for tattoo artists. And one, at least one of the piercing sites had a bunch of things that they thought were not a good thing to do so that that. All piercings are not good things to do. But I think I think this broadens our our field. It's immensely compared to the previous previous regulation so I think it's the right way, the right step to take. If, if, yeah, like I said I don't think there was a step by step of this particular thing, this particular procedure has a lot of data about how many complications there are, but these were kind of generally recognized as higher risk. And the lap. And the open concept I hadn't heard of that before I didn't see anything about that those 45s where the areas that are partially separated I think piercing it has to be have full walls but with with tattooing it can be partial walls. I can try to find some regulations that mention open concept shops, but I hadn't seen that. So we have a little more homework to do. I'm glad we're at this stage where we really are honing in on this and then pinning pinning things down and really happy that people are really looking at this care. So. All right, any other comments on this for tonight. All right. I'm going to have to watch the video of this and get all or get the details from the minutes. So where are we. I've lost track of my agenda here it is. So we're now up to new business. And I was just going to bring up this idea. I was thinking we're done with by our but we have a little more to do. There might be some additional attention needed for the tobacco sales regulations. Those were revised in either night in either 2020 or 2021. So they're pretty much up to date, but I did attend a session at the one on by by the Massachusetts Health Officers Association and Pioneer Valley Tobacco Control Collaborative on September 13, 2023, that raised a few issues that we might want to strengthen our regulation or tighten some of the wording. One is that there are new products that are called referred that are non menthol cooling sensation producing chemicals. And those are being marketed as menthol like basically it's like a non mental Newport cigarette and a cool Lux and they don't have mental but they have this is this chemical. And it's WS three menthol carboxomide, and it doesn't taste like anything but changes the taste or effect of the product. So that was one thing. The other thing we had some issues with our adult only tobacco retailers definition where people try to think try to think from who are taking over a liquor store said that their store was adult only and therefore could sell cigarettes. And it really wasn't but if you looked at the wording of our regulation it kind of leaves a little bit of an opening so I think that should be tightened. And then there are other misleading products like vapes without any flavor or any, any nicotine and what you do with those. So, again, I think it's just worth our looking at. Again, and I don't know if there's anybody willing to just take that on and start doing that. Another part of this is the tobacco pioneer back to tobacco control collaborative and the Massachusetts Association of health boards can be really helpful because they have model model regulations and resources where you can talk to people and have them review your regulations and how, how, how to, how to write them. So it's not as hard as the body arc has been. So, is, so I don't know if there's anyone who's interested in stepping, stepping forward, I think traditionally we've had one or two people be the point people on a project like this and kind of bring it back back to the board. I don't see people jumping so I would be willing to do it. Okay. I'd also be willing to not do it if someone really wants to. I'd be willing to work with you on that. We shall. Great. I, because Tim and I, I, this, this was a long, I think it actually preceded the time when Tim and I were on the board actually where the, where the current regulations were in process so it, it took many years this last time. It was more complicated and we're fortunate that we're pretty up to date on the state regulations now and it's not going to be quite the heavy lift it was at that time. So, all right. And so, now we have some geothermal wells for first for 49 kestreling. Now is in here tonight or we just have his, his letter. Yeah, he's not able to attend this evening so he just we sent ahead the materials that he prepared. And I'm, I must say I'm not terribly conversant on this topic so I was hoping that people reviewed what he said and maybe you all have some experience, having reviewed these before. I think. Yeah, we have have certain there have been a number of these in the last couple years. And they're all quite, quite similar. From, from my experience of the last couple years I didn't see anything that stood out as problematic, but I would turn to Tim who's environmental scientist. Did you see any, any concerns in those. I think you know Ed has mentioned something about being careful in the work area, not allowing the turbid waters to travel towards a jurisdictional resource area I'm not sure what he means by that. In his, in his letter I think he mentions that you know so that's more related to practices to minimize any type of a turbid water running off from the site. It's the only thing I'm, I have concern but other than that I think we had been approving these installations, because they are closed loop. They don't have much of spills, even if a spill it's not it's not like a toxic chemical spilling out. It's a food grade. So, I think we, you know, we should approve you know, making making sure its recommendation on taking care of the runoff water is is some sort of a monitored and prevented. I don't, I'm not at home and I don't think I copy those documents. Did he mention anything about conservation, conservation commission involvement. No, I think he mentioned that it's outside the concom jurisdiction. Okay, okay. So it's not a resource area or wetland or anything like that. It's kind of close but probably not right, not as not per the regulations. And it was a, it was a two or well, which is a simple, simple project relatively that and we've approved things like this before I, I agree that we can, we can approve this application. I don't know if you're familiar with the geothermal Have you heard seen this before. No, it's different. I offer no value in this conversation. Okay. Yeah, basically, those, the, they drill down and insert a pipe that connects at the bottom, you know, the bottom of this deep site and comes up the other side so, so there's no interchange with the groundwater or or at all it should all stay within the system. And the only thing that moves back and forth is heat. Like, Tim said the only it's basically water with maybe a very non toxic kind of anti freeze Brooklyn glycol or something in it. And, and with the limited number of wells. It's, it's pretty simple. So I, I, does anyone have questions about this. So we have a motion to vote to approve. Yeah, I can make a motion to approve the application for a geothermal well on 49 kestrel lane in Amherst. And I can second that. Pramela, you want to vote. Hi, Tim. Marie. Hi, Lisa. Hi. Okay. So that well is approved. The second part of this and is what the process should be going forward and I think the question there is whether each and every one of these applications needs to come before the board, because they're relatively relatively straightforward. But I guess we might want to have criteria for when they should come before the board. Tim do you have any thoughts about that. So I would recommend the number of wells as a criteria. I would say if it's more than two wells, and I think it should come to the board. If it's, you know, one well or two wells, I think it, it should, it should be decided by ad, you know, it's very easy. But I have seen, you know, if there is a very large installation. We should consider to review it. That's one thing. The second thing is, if it is very close to a resource area. Like say, for example, water supplies or wetlands, or even downstream if there is any potential public sites, like public, like schools or those types of situations I think even though it might have a approving letter. It'll be good for the board to just have a quick review. So criteria one is number of wells. And the second criteria is if it is having any impact on local resource areas. What I mean by that is potential impact on water supplies or any public public areas, which are downstream to it. Or wetlands. So those are things I would be, I would like to have the board to review it. All right. When you say two wells, you mean like this one that we just approved. Exactly. Yeah. Often what we've seen are people have like two different zones and they'll have two different units. They'll have four bores is that I guess that's like wondered if that exceeds the number we should. Why I was thinking of that in our number is because there are potential proposals which are going to have much more higher number of wells. And, and higher density of wells. Right. And those in those cases I think, even though they may, it's all closed loop systems, they may not have any potential impacts on groundwater, but still having dense installations, you know, potential concern, you know, if there is some sort of a disturbance to your land, landforms itself, I think, you know, these are like a very big installations. So, I think if the unit which is actually two wells and then if they, if they are applying for that one type of unit, that'll be fine. But if it's twice that applied, I think that's also fine. I think, like if it's, that would be four wells, right? Yeah, yeah. I guess, you know, for me, I was trying to think of a number two as well. And I launched here I was looking at this and I was reading some things from the state and some of it was old. They used to require a state permit for these geothermal wells. But they changed that in maybe 2017. So it was fewer than five wells that it didn't need that permit. So I was thinking, well, maybe that's a number that's reasonable. And it's a number that we've seen. We've seen mostly two, sometimes four wells on a property. But I agree. Anything more than that. And I guess the thing that's coming down the road is going to be the Fort River School. The school is going to have, like, what, 190 or so? I forget. It's some really, really big number. And so that will, the state will be involved in, I think as well, but you probably should be there. I don't know if you would be willing to like enumerate the, you know, those sensitive areas for us. Yeah, I can do that. Yeah. Yeah, that would be good. We could do with two, four wells, which will be a reasonable one. I could enumerate those some sort of basic criteria, you know, so. Okay. And I don't know if you need to have numbers of feet and all of that stuff, but yeah, because, yeah. All right, well, that would be great. That would be great now that because then because for the most part we've been just like looking at Ed's letter and and everything's fine and just voting on it and without much added value. All right. All right. So we got a plan for that. So now we're at the director's update. Yeah, and I just wanted to add that that's great. I'm glad you established some criteria and I think, you know, there might be some unusual circumstances or something's contested or something's really, you know, different than that would be something that would come to the board. And he sort of said it could be analogous to what happens with septic the title five used to approve every single one and now you don't do that any longer and so something along the same line so that that's helpful. I think it's a good conversation. Okay, so directors update, let's see. Yeah, I mentioned in our last meeting that we had a number of COVID and flu vaccine clinics planned for late October, November. So those of all concluded, we had successful vaccine clinics in collaboration with the North Hampton Department of Health and Human Services through the public health excellence grant which has funds for regional work. So they bring all the vaccine, all the staff, they organize everything it's a well oiled machine they do a great job. So we had a really successful one at Clark House where we saw almost a third of the residents there for either flow flew COVID or both. We did something at Craig's doors, mostly guests and staff of Craig's doors with a few other walk ins they were 18 people I think there. There were 30 something at Clark House so that's there about 100 people who live in that building so that was really successful. And we plan to do that on an annual basis it was very well received at Clark House. And we did at the bank center just this past Tuesday we had a community clinic which we promoted pretty widely on our website and just two people walking by the health department. So that was in conjunction with election day. It was not nearly as busy as I thought it might be I was afraid we were just going to be swamped with people. Like it wasn't a sort of crowd control nightmare which I was happy about, but we did see a number of people we had 87 appointments and 20 walk ins number of whom were folks who had come to vote and thought oh, it's Christmas I'm going to get my vaccine at the same time so they just popped in to get a vaccine. And it was again very smooth and well received. It was nice to be able to offer both COVID and flu. So it was so well received I think that we're thinking about maybe doing one more before the end of the season with Northampton because I think as I've mentioned before, because the COVID vaccine is commercialized we don't have large supplies of it we only have a small amount that's only for uninsured and underinsured, whereas at these clinics the Northampton folks collect people's insurance information and they build people's insurance so they won't turn anybody away they see anyone insured uninsured doesn't matter. So that's a very, very nice flexibility they have with these clinics. So that was successful I mean the staff put quite a bit of energy into organizing that promoting that and we're happy to get those went well. And it's good. Yeah. So yeah you don't know how many people will want to walk in, I guess. And I looked in it, all the appointments had been taken when I looked at it so I thought that was good. Yeah, yeah, I mean in the end I think we had some people who didn't show for appointments, you know what happens you make plans and exchange. But overall it was, it was, you know, busy and just in all the right way so that was good. I didn't just on the COVID theme we're also giving away COVID tests at the Health Department we were able to get 1800 free tests from the, from the state. And so we ordered those they came very quickly and people are overjoyed because they've been coming by the office for weeks on and asking about COVID tests and we never had any but now we have a lot so we're giving those away and it's great just good for people to have those as a resource especially with the holidays coming up and people, you know, gathering in person. The next item about inspection division staffing changes is about Ed's role, which is that he is going to be promoted to lead code enforcement role. That was the job that john I don't remember his last name had before retiring, probably you all know him. So Ed will be moving into that role, it's more of a supervisory role, and I think well deserved for him he's such a great inspector and so knowledgeable. So, currently, john, Ed and Susan are managing the work of three people they're just the two of them and they're doing since john retired, the work of three inspectors. When Ed moves into that role, they'll be hiring another inspector so we'll be back to a team of three. So they're a little bit understaffed right now, but they're still managing to keep up with the work and do well and I've been working with them closely it's been really, you know, educational for me so that's been really a good experience so far. So that's that staffing update. And congratulations to Ed well deserved. We don't have them coming up for all. Yeah, he might not be coming. Thank you so much. Yeah, yeah, we'll see how that plays out. And then anything else about that. Okay. So the talks of chemicals resource page so we. We have something almost ready to go I had hoped to be able to tell you it's on the web by today but we've been just a little bit busy with these clinics getting these clinics done so what we've designed is sort of a brief landing page for the website that will be similar to what you see for air quality when you go to our air quality page just has a couple of sentences and then a few links. So from that page we will link to the longer document Tim that you and Kyle worked on, which I reformatted just a little bit to make it you know pop look a little better you know sort of flow a little better be a little bit more reader friendly for the reader. And then we'll add all of these links for alternatives to toxic chemicals that people can use as a first step in community education with more to come in the future. So, next time I see you all that will be up and live. We'll send you a note when we get it up so you can check it out when it's there. Thank you. Yeah. I don't think I have anything else those are my those were my three items. If there are any other questions for me. Any topics unanticipated. I haven't heard of any topics unanticipated by the by the chair. You know question about releasing the video. To a person. Oh, yeah. Art keen the reporter who often comes to these meetings and covers them for the indie. Yeah, I resolve that with him and he said he was able to get these recordings but tomorrow is a holiday for us in the town so it's going to I think he's actually not doing after all so yeah. Yeah. No problem with that. All right. All right. Anyone have other questions for Pico or thoughts. All right. I guess we can go ahead to look for a motion to close the meeting. I can make a motion to adjourn our board of health meeting on November 9. Okay. I'll second that. I can't hear you. We just disappeared. Well, just it just sort of, I must have hit a button accident. Happens. Okay. Misha. Hi. Tim. Hi. Maureen. Hi. And so our next meeting is scheduled for December 14 at 530. Yeah, I don't know if it's useful. I will not be able to join. I will be out of. I will be traveling that day. Okay. I'll miss you. Okay. Well, yeah, well, that'll help us make the agenda. We won't bring up this tobacco thing again for a while till January. Okay. I'm happy to talk with you. Yeah. Outside of the meeting and figure out where to start on that. Okay. All right. Sounds good. Great. All right. Thanks everybody. Thanks for coming and goings of this evening. Thank you. Yeah, thanks for your patience with everything. Take care.