 2020 orders. Oops, continue. Okay, sorry. I'll start again. Pursuant to Governor Baker's March 12, 2020 orders suspending certain provisions of the open meeting law, general law, Chapter 30A, Section 18. This meeting of the Board of Health is being conducted via remote participation. I will have a roll call to make sure everyone's video and audio is working properly and that the meeting is being recorded to the web and can be shown on Amherst media and broadcast on the town of Amherst YouTube channel. So the meeting is called to order and Maureen. Present. Tim. Here. John. Here. Steve. Here. Nancy here. So the meeting is open and the first item is to review the minutes of the May 13th meeting. Okay. I just have one very small addition, Steve. Yeah. And that is under community health assessment where it says, assistance of UMass students. It's UMass public health students. Okay. Okay. Yep. Anybody else have any additions, comments, corrections? Okay. Hearing none. There's actually two words that are out of order, but I fixed them. So let's just... Oh, I missed that. I always see these things after. We did that or I put them in deliberately to see if anybody reads it. But anyway, no problem. I did notice that, but it wasn't too consequential. All right. It's fixed already. Okay. May I have a motion to accept the minutes as amended? A move. We accept the minutes of our May 13th meeting as amended. Second. I'll second that. Maureen. Okay. So all in favor of accepting the minutes. Maureen. Yes. Tim. Hi. John. Hi. Steve. Yes. Nancy. Hi. Okay. First of the old business. Review prohibiting smoking on workplace and public places. And we have Alyssa Brewer's comments. Try to make those more visible. Yes. It was very helpful. Yeah. I had to open on my laptop. When I opened it on my iPad, I never got the comments. That's why I never saw them the last go around. Yeah. I remember looking, thinking there must be something there. Otherwise, why would it be sent back to us? Then it took me steps to find them. Anyway. Does anyone have any comments? Well, I looked at this in the last day or so. And for one thing about, I don't know if I'm going in order, but there was some question about those regional schools. The regional schools already banned smoking in their buildings, facilities, and grounds. Although it's out of date somewhat and that it doesn't include vaping. I don't know that we need to do anything about it. Yeah. I had the same thought because it's already prohibited. And then I guess the other questions are a matter of opinion about the commons and any other areas where we might want to ban smoking. I also, the whole thing with the UU and the wall there, that's private property. We can't, we don't have jurisdiction over that. Great. I thought we would let that go, let that alone. Yeah. And there was this one guy who I often bought a Coke for, a homeless guy who would sit over by the monkey bar, Bistro 63. And then I noticed he moved. So I chatted with him. I said, Oh, I'm glad you moved because yes, the smoke was too close. So he moved way down, down past the funeral home. And he said, yes, I don't want to be a problem to them. And so he, he dealt with that problem because I don't know if Emma, you mentioned that or something, but he was very nice. Yeah. Yeah, that was a concern that got brought forward to us. Because if with smoking within 20 feet of outdoor dining, and then I had reached out to Northampton to see if they were having, going to have any restrictions or around that. And Meredith didn't have a response for that. And I know we have also reached out to Mike Coughlin at DPH and, and he didn't really have a response either. But I know that is one of the concerns with the outdoor dining. Yeah, and food trucks, that's a, that's a. Is it brought up with regard to food trucks or brought up with regard to the new places that are out on the sidewalk and into the road? It was brought up with the seating on the sidewalks, not the food trucks. But I think one of, Alyssa's comments was about food trucks. Well, I think that was the people sitting on the wall. They're parking near there. Right. Do we want to add, because we've talked about, let's see, about the commons, town on playgrounds, parks, is it a common, a park? I guess not. Leely, or leely or formally, it's not, yeah. Okay. So should we add town commons? Because there are one to, so there's south commons, east commons, north commons, and the main commons, south north, right? And south commons. South Amherst commons. I mean, yeah, that's what I meant. South Amherst commons. And the south commons, people think it's part of Amherst college. The north part of the commons, which is our major commons. And then the, the commons in East Amherst, you know, White Fort River. Yeah. Cushman, is that a commons up in Cushman or is that a park? Or what is that? I don't know. I don't know. Didn't think to look it up. I would add lowercase commons. I mean, just like we have lowercase P and R, you know, those all have legal definitions and things, but none of those are uppercase, like formal names of anything. Do other people want, do you want to make a motion to add that, John? Sure. Let's think. I mean, is there other, I guess her other comment in there is, is there other town owned land that is being addressed by this? She brings up conservation areas and walking trees. Commons, regional schools, those are covered, right? We talked about and town controlled properties, but not, I don't know what an example of that is. No, I couldn't, I couldn't, I don't know that either. Town controlled, but not owned. So that would be like Lawrence swamp and sweet Alice. Those are conservation areas. And my thought is that we're talking about people's exposure to secondhand smoke here. And I don't think that's a problem in sweet Alice. I think ticks and definitely are, but not not secondhand smoke. Right. I mean, our, this point is about places where people gather close to one another. And so comments make sense to, I don't know that anything else. I agree with that. I agree too. It seemed to me that either present or former conservation areas that are intended for people to gather at or have been converted to parks or recreation areas or comments. So something like that. Yeah. The one conservation area that people do gather is the Mount Pollux, I think that I can think of, but I, and they don't spoke tobacco there that often. But I, you know, it still doesn't seem like it rises to the occasion. You can move away from some, you know, there's, it just doesn't seem like a problem. Well, it seems like we all agree that adding, adding comments with lower case C to that list is good. And we don't have emotion on that because we're going to have to vote the whole thing anyway later. Yeah, we didn't have emotions on every edit. That's right. So let's just add commons there. Are there any other changes? No, Alyssa was asking about, I guess, Uber, you know, she was wondering about when we say public transportation services in item I, do we just mean bus stops or do we really mean something else? We mean just bus stops. Let's just say that, but maybe the senior Surrey stops, but that's a bus. Or the bicycle. The Valley bike stations. That's right. Yeah, that's true. Yeah. You know, I think we thought we were including the Uber and Lyfts as public transportations there, but I'm not sure we can. And it doesn't seem like there's a single gathering spot for that kind of activity at this point. I can't remember because I've used Uber and Lyft, but you're not allowed to smoke in cars with Uber and Lyft. Well, I think one of them you kept you, they don't have any rules, but maybe the driver does. And the other one does have a restriction against smoking. And I can't remember which is which. I think Lyft was the one that banned smoking. So I thought I should use Lyft more than Uber, but I've never encountered smoking, a smoky car. So should we just leave it as stated there? The public transportation will be the bus and the bike, you know. Yeah. If you get more detailed than that, it's so pretty slow. Yeah. The needs of public transportation are changing constantly. Is it a place where there's electric scooters? Is it a place where there's Uber? Is there a place where there's electric bikes? Is it a place? So I think public transportation, the whole, it's pretty obvious, self-explanatory what it means to me. Yeah. And she also had a comment up under the definition of smoking. She wants to be sure that we don't try to regulate cannabis, at least not try to regulate it here. I agree, we should not try to regulate that in these regulations. And so she wanted to add, under smoking, kind of redundantly of tobacco or nicotine, but I don't think that's a good idea because it defines smoking in this context as now already. And it will just raise, why are they saying that if it's defined that way? Right. So just leave it as it has been. Like I said, tobacco product. I mean, this is, yeah. It's very well defined. Yeah. Yeah. I don't think we need that. Okay. And tobacco product is extremely well and extensively defined. Over and over again. Oh yeah. Maybe she has something in mind, she wants to smoke that's not tobacco or nicotine and doesn't want it to be banned. I have no idea, but well, it's cannabis. She's really concerned about making sure that in the future, the town can have social consumption on. We'll have, we'll be involved with that. Right. But tobacco product is defined here. But the state hasn't even moved forward on that. And they already have said that you can't smoke in cannabis cafes indoors, only outdoors. And there's only a pilot project for cannabis. And I don't think any cafes. But Elisa has us on the pilot. I know she's on the, she's on the committee. Right. But Cheryl Sabaris says it's a long way down the road and we can put things in place. But where are my notes from her? But it hasn't even gone through in the legislature yet. Here are my notes. Cannabis cafes have to be smoke free. No smoking allowed inside. Vaping and ventilated room only. The staff has to have vapor free room. It will be voted at the buy annual election to permit the cafe. The state law has to be amended. The bill has to be refiled. It hasn't even been refiled with the secretary of state. There's no process yet. It'll be at least two years. And then the board of health can have local regulations relative to cannabis. And we can require a local permit to open. And there will be regulations of 21 and over to enter no self-service, no vending, no smoking in the cafe, no alcohol. And then the cafe definition has to be in the marijuana establishment. And we need to have a bylaw to allow the cafe. Those are my notes from Cheryl Sabaris. So she said it's a process way down the line. And she'll keep us informed as to what we can and should be doing as that progresses. So okay, back to the smoking and vaping in workplaces and public places. Is, you know, with the outdoor dining, is it worth adding something within 20 feet of an outdoor dining site? Or I don't even know how to describe it. Area? I don't know. What is our, what is our feet in front of municipal buildings? Is that 20 or 25? I think it's, I thought it was 25. So we should possibly just stick with 25 then. Whatever that was. Right. Again, it's private property in some cases, but we're not trying to regulate that. But some of it is like. Some of it is, yeah. Maybe in public, I don't know how you say that. Somebody drives by the car right next to one of those. Should we leave it as is and if we start getting a lot of complaints, then think of amending something? Because how long are we going to have the public dining? You know, are we going to have other, I mean, we can take up space, parking spaces up and down, North prospect and South prospects forever for dining. It will kind of a time limited issue, maybe. And just wait and see if we get any, any complaints and see how they are handled. Yeah, I think that might be the best way to go with it because this is new updates and let's see how things work out. We always have that opportunity. Yeah. You know, it's the fine line. I mean, me, I'd have no smoking all over the world, but there's a fine line and then who are you penalizing? And it's usually more disenfranchised populations who are doing more of the smoking and people that don't have a permanent residence. So okay, should we have a motion to accept these regulations with anyone? So what's it where are we at? It's supposed to take effect now, right? Soon, right? Well, we can check, we can worry about that. I mean, it might be July 1st is a bit soon now, but we can talk about that. But we, yeah, so what you're saying, we want to vote on the, these regulations of to adopt the regulation. So we signed the document and all that stuff. Is having June for Emma is having June 1st as the effective day to, I mean, July 1st is a problem. Should we move it to August 1st or September 1st or? Oh, I think it should be a problem because I can get these out and stuff. Okay. Very quickly. Yep. Okay. So the only update is going to be the comments and. The word comments. That's it. That's it. I love how the alarm went off just as everyone said that's it. That was great. Just under the wire. Well, I will now move that the Board of Health adopt the regulations and that they be, they go into effect on July 1st, 2021. In the second. John seconds. Okay. All in favor. Maureen. Hi. Tim. Hi. John. Hi. Steve. Hi. Nancy. Hi. So it has been passed. Thank you. Thank you Maureen and Nancy for what's I'll send these to you properly and I'll just show you. Yeah, but everybody had a little hand in this. But yeah. But we just edit that word in and then have something we somehow we sign this. Yeah. How are we going to sign? Oh, how many people are going to that? June. Thank you, picnic. Oh, for volunteers. Yeah. For Juneteenth. Celebration. For the listening sessions. Our next meeting may be in person. Yeah, maybe depending on if the legislature passes that info. But yes, I was going to discuss that during the director's report, all those updates. I think signing is, you know, we can, we'll sign it. It doesn't have to be signed the moment we adopt. And the bang centers open now, correct? Yeah, it's open for some limited classes and everything like that. However, if we could have it here at the board of health office, and if individuals want to come down and sign it, you can just call our office number and we can get you in here and have you sign it. Okay. So can it be digital signatures? I know that digital signatures during COVID were still accepted. And I believe since the state of emergency has not been lifted yet, that would be acceptable up until the 15th. I can come and sign. Or I can drive to your house, Tim. We will find a way. No, I can come and I'm just wondering this one option and it might be quicker. Yeah. Okay. For some of us. Okay. So next is update on the health inspections, outdoor dining, farmers market inspections, etc. Yep. So I reached out to Susan Malone and Ed Smith. And there were not really any updates for them to bring today. So they're not in attendance. We have been getting inquiries for the 61 and 63 Main Street property, where the lone wolf and I believe it was the Himalayan restaurant were, with revisiting having two food establishments there. So that's been in discussion. I'm in working with that with Dave Zomek and John Thompson. And we're probably going to go more of an enforcement model this time. We're not sure yet, but I have been informed of the lengthy history there and the intense work of the Board of Health with that property. So, but those questions are coming up. So in terms of having two food establishments there. It was my understanding when in the past that the belief or the feeling was not to let any restaurant go back to where the Himalayan was, because it's a dirt basement and problem prone. Yes. Yes. That is the gist of what was communicated to me. So, but I do feel like since I'm new in my position, I have to do some due diligence here and revisit it since someone brought it forward. Water problem, water problem, cockroach problem for a while. The lone wolf was called the lone cockroach. Are either of those businesses reopening? No. So, yeah. So I know they're trying to show the property and get, see for new tenants, what could be options? Our friend on North Pleasant, Hungry Horse. Hi, Horst. What is it? What is it? Hi, Horst. Hi, Horst. Sorry, Hungry. Hi, Horst. Hi, Horst. What's going, what happened there? Um, I, as far as I know, I know that they just closed up shop. So for the pandemic, his license expired on May 1st, I believe. So, yeah, yeah, yeah. Just curious if anybody knew anything about plans for reopening? I have, I have not heard. So that's him. That's pretty much all that's been going on. Is the farmers market going to stay in the common versus its old location? Yep. What I've heard is that it's going to maintain on the common right now, just because they do have such a system and an established pattern for at least this year with the exception of the Juneteenth celebration. I think they're going to be closing early. So that way the common can be open for that. So I'm trying to think I'm looking at my notes. And we already kind of went over the outdoor dining. Um, so here we are. Okay. So new business, it's really old business. Board of Health. So I've been continuing to try and reach out for individuals who would be willing to serve on the Board of Health. It's very important to me and I think everyone in this group that we are able to represent the diversity in Amherst. So we're still looking for that person that could be a representative of the Black community or Latinx. So if and we still haven't found someone. So, uh, but I want, I know we want to find the right person to be on this Board that is going to be able to share good information and ideas and concepts to move Amherst forward. And Anita Sorrow has reached out to D. Shabazz to see if there's anyone from from her groups. Great. That's a possibility, but we haven't had any takers yet. And the other thought Emma had was to try and advertise or ask at the Juneteenth program. I thought that might be a nice idea to kind of do with our tabling event there. You never know, right? Until you try. Is that kind of it for Board of Health appointments, you think, Nancy? Yeah. Anybody else have any ideas? Right. So listening session. Oh, this is fun. I sent all the materials out as I was doing them. And I was meeting with Emma. I had some input from Mary Beth at the senior center and Anita Sorrow and Jen Brown. And then this is what we met, what Monday, finalized thing. So I was, I hope you felt informed as I was sending everything out as it was happening. And so we're open for discussion here. Questions, ideas, comments. One of them is for town employees, I believe, right? One of the sessions. And how does that work in terms of their job? In other words, is it during working hours? Do they have time off for that? Or how is it because there's a lot of sensitivity about putting demands on town employees outside of normal work. Emma's accepted, she can work 24 hours a day, but everybody else is supposed to work. It's during working hours. It is, okay. And all those. Unless you're working an odd shift. But it's between two 30 to four. And the other one is like 537 or something? Yeah. Correct. Whoops, yeah, I have five. It's 537 type of there. And we'll need volunteers to be note takers at the tables. We don't know how many people will be there, but we'll have easels with those, you know, newspaper prints so that the note taker would be writing down the key points. As they're discussed. Nancy, do you mean literally note takers and not facilitators? Note takers, not facilitators. Just writing down what the key points are. Not facilitators because it is supposed to be spontaneous with the group. And nobody's kind of keeping track of the time. The eye will, as the moderator will be keeping track of the time. Yeah, and you need to keep things a little moving. Each question has 15 minutes for the discussion. So making sure that it's staying on time for that. And Nancy brought a good point forward where so that way people can feel comfortable and open to really share fully their thoughts and experiences that I should probably not be there and possibly Jim Brown as well. So Jen and Emma won't be at them because they're the two key employees of the town for that put it on. So would any of you be able to volunteer? I know Anita said she would volunteer as a note taker. I asked my husband, but he said, you can't read his writing. He said, not only could we not read his writing, if he wrote things down, he might not be able to read his writing. I believe that. So, yeah. I'm familiar with his writing. Yeah, yes. I'll certainly be able to do it if you'd like somebody to take notes on it. Yeah, I just checked and I could do it too. Okay. Steve, Maureen, Anita, and I'll just, if we had either Tobiah or Lillian, would they be neutral enough? What do you think, Emma? I don't think either one of them would have anything really to say or would shift content. I think that they would be transparent, especially with being newer and temporary team members. Okay. So with Tobiah, Lillian, Steve, Maureen, and Anita, we should have enough. Okay, great. The invitations went out. Did any of the emails bounce back? Were all the emails corrected, Tobiah? Yeah, the only one that bounced back was one that we had transcribed incorrectly and we resent. So, none of them of the others bounced back. For the faith organizations that we added, we just couldn't find emails for them, but we sent those out in the mail today. Okay, great. And we already had a couple people sign up saying that they were going to come. An RSVP. That is great. So, Board of Health members, do you have questions or thoughts? Or, and I volunteer to write this up and have it done within three weeks, within two weeks after. Problem is, my vacation is scheduled right after for three week vacation, but I'll do it while I'm on vacation too. Do you have comments, questions, thoughts, no? So, one thought is, so we have four questions, 15 minutes each. I'm just curious if that is sufficient time and if it's possible for people to communicate in a different way, like they could add their notes somewhere or collaboratively beyond that 15 minutes. I'm just curious if that is something possible. We could say that they could send an email and I'd have it to me if they had any other thoughts or ideas. I know 15 minutes, the questions sort of flow in between each other and I know 15 minutes is a short period of time, but yeah, we don't want to have this go on for hours, you know, keeping it to an hour and a half. But that's a good thought. Also, we're going to try and have a Zoom one if possible and possibly a Spanish speaking one. But we'd have to use UMass translation services, but Anita was talking to Dee Shabazz about using the UMass services. And also, if we do the Zoom, having someone with the UMass account, because if I do Zoom, oh, you say it, do you have the ability through the town? Yeah, we would have to just get someone assigned those rules to translate for those rooms. But we have the capacity. Okay, great. Great. So we'll do it through the town then. Other comments? The Spanish one is not Zoom or I'm going to be. The Spanish one isn't even set up yet. Okay. It's not, it's a thought, it's complicated. It's down the road. But I'm glad we're thinking about it. Yes. Okay. So I will keep you informed. And thank you, Steve and Maureen, for volunteering to be note takers. Hopefully we'll get good data. And it's the piece. Okay. All right. Public Health Excellence Grant. And I just, I didn't really read that email. I looked at the email that came out, what, 20 minutes before our board meeting. So, so back in February, people in this room might have heard me discussing that the state for the Office of Local and Regional Boards of Health was putting out Public Health Excellence Grants for a total of 30 grants that would be accepted, move forward, which is really to follow and model the blueprint of Public Health Excellence that was put forward in 2019 to increase shared services and local, improve local public health response. That's the blueprint for Public Health Excellence that you're referring to. Right. Correct. And Northampton did submit a proposal and it was accepted. And there's what Meredith O'Leary had proposed is under the, that Northampton under the Hampshire Preparedness Coalition would really do shared nursing services with epidemiological and data analysis with a shared informational platform, similar to what they have for their opioid program. And so that was approved for all 20 towns. And later this month, they'll be reaching out for letters of support if municipalities want to engage with that. Are you part, is the Amherst part of this, that? All 20 Hampshire County communities were under Meredith O'Leary's proposal. Okay. Coabin Health District also got a Public Health Excellence grant, as did the Foothills District, as did the Furcog, many municipalities that are already shared services, got them to improve their nature. With that being said, this grant was closed on April, at the end of March, but it reopened April 1st. And, or was it May? I can't remember. But in discussions with South Hadley Health Department, Coabin Health District, and the Hadley Board of Health, I was really hoping that we would submit a new Public Health Excellence grant proposal for the seven Eastern Hampshire County Town since Amherst has the highest environmental justice population in all of Hampshire County, along with where being second to improve our active preventative work and also obtain data and be able to analyze that Public Health data for some case management, behavioral health, and physical screenings, vaccine clinics if we were to provide them, as well as maybe mobile testing if we were doing that for COVID and that came back, as well as educational support for those towns. This would have several employees under it, one to do data analysis, 1.5 nurses, 1.5 community health workers. And the idea with that is that they would have service areas where they would be able to focus their work on to really build relationships with the communities of their service area. And it would kind of be a continuation if you want to think of it as the kind of this listening session by doing that deep dive into our communities where we have pockets and service gaps. So right now we just finished writing up our narratives for the grant. And I have been discussing this grant with those communities prior to submission, which is a little different than how Northampton did it. Northampton wrote the proposal and submitted it and didn't discuss it with all of the communities. So really making sure that there's buy-in and support for this has been really important to me and to listen to the communities and see what their needs are. So that's the Public Health Excellence grant. It would be a three-year grant, up to $300,000 each year. And I think we could do a lot with it. So it's due on the 29th of this month. So it's coming up. Does anybody have any questions? No, sounds ambitious. It's great. We'll see if it gets accepted, but you know, thinking about it is the first step. So you can help. Can you send us, send it to us so we can look at it and see what's accomplishing it. Did you mention one and a half positions for nurses and one and a half? How is it going to work? So it would be 3.5 nurses. So like 320-hour nurses or 320-hour and three community health workers or social workers that would work in teams in their service areas. Would they be outreach workers then? Would that be what they... Pretty much. And would you be using the blueprint for excellence for the education and credentialing? There's, I know there's that there's a chart in there. I don't know where it is. I have it here for what educational backgrounds and people should have. I don't know where that chart is. And the primary focus where this would specifically touch on the blueprint for public health excellence is on cross jurisdictional sharing, data reporting and analysis, resources to meet our system needs and continuity and sustainability. And certainly with Amherst being the largest community, the highest percentage of that environmental justice population, residents of color and English isolation, we have the greatest need and I think would be make sense to lead this program for Eastern Hampshire County. I just found it's on page 61. It says the position required at higher, required after higher and recommended. So they have, they have recommendations for who you... Yeah, so I'm sure you know that. I just found that on page 61 of that excellence report, the blueprint. Okay, anyone else have questions on it? So is there any specific plans for the English isolation community? So they're in the proposal in terms of the needs for this and what I did write in the each narrative had to be around 300 words if that's a sense for anybody. Is that AHD program staff will be representative of the population needs areas will be prioritized to increase trust and remove linguistic cultural and logistical barriers and promote engagement with its constituents. It'll serve as a comfortable entry point to the health system for patients who may be disengaged or distrustful of health care system and will customize care to delivery and care delivery to the special populations in each identified community. So if we were to get this grant that hiring individuals that would be part of that and be able to connect with those pockets is really what I'm hoping for because we're totally missing that right now, which I wish we weren't. But that's a priority of this grant. And I'll certainly send out those stuff after the meeting. Any other questions? Thank you all for your suggestions and your support. I can't believe I've only been here since November. So many things have happened. I don't know if this is the appropriate time to bring it up, but as you're looking to expand and look for grant money, which is only three years, one thing that Emma told me and I'm very concerned about is that the town manager and the finance committee is only level funding the department for next year, which whether we get the grant or not, I think doesn't address the need. I put a little few that and when you look at nationally, we need a foundational public health structure, infrastructure, which we don't have. And it's, you know, all departments and ours is understaffed and under-resourced. And we need to have a robust prepared staff to meet the public health emergencies as they emerge. I mean, we did okay, but what is next? We really have to have and we don't have culturally and linguistically appropriate staff and approaches. It's important to have credentialing and the blueprint talks about credentialing standards for workforce development. There's the local public health institute, which is online, but we have to provide time, which is money for our staff to take these courses. So I don't know what, if this is the appropriate time to bring it up, because you're talking about applying for this grant, but yet the town is only going to level fund you, which isn't enough going forward, given what we've just come through and how are we going to be prepared to meet the needs. And then when you see what else is going on in town, we have a huge cultural, linguistic, racial issues to address by all departments, including the health department. Other people's thoughts or comments, and I thought maybe we could write a letter to the town manager, town counselors, and finance committee saying that this is not, and we're vaccine clinics are bringing in money. How many vaccine immunizations have you done, Emma? At clinics we've done over 12,000. Over 12,000. Almost 500 for homebound, over 490. Okay, so we're going to be bringing in several thousand dollars, you know, and am I correct when you said that Paul said we'll just hire per diem nurses as you need them. Is that correct? Yeah, so we did get approved for a temporary nurse position to, I guess we're into health department development. Okay, right. We, a temporary nurse position to offset Jen Brown's reduction in hours. She's going to be going down to 20 hours, but the town was not in a place where they were able to post a town regular position to offset those hours. So since I've been here, Jen Brown was first working 32 hours, and then she went up to 37 and a half, and then dropped down and has been back at 32 hours. And then this fall is going to be dropping again to 20 hours a week. So I had proposed a 20 hour nurse position, a regular benefited position to offset her, which unfortunately was not a, I actually asked for two 32 hour nurses. So that way, when someone goes on vacation or takes a day off or has to do that training off site or something, Nancy, that we would have a full compliment. So yeah, so I know here, we've in the office, we've been doing lots of looking up with what our staffing should be for the health department based off of standards by the National Association of County and City Health Officials, NACHO, and by our population estimate, they recommend that we should have a total of 14 FTEs, but that would include inspection services. But that's by their recommendation. And when we broke out the financials for how much Amherst is currently funding the health expenditures per capita, it's $3.77. The national standard is, oh goodness, I lost my slide. The median, the 50%, is anywhere from $37 to $41 per capita. And Amherst is spending $3.77. And then when you look at the regional efforts for that as well, Amherst is the lowest with where being next, then East Hampton, South Hadley, and North Hampton being the greatest with over $20 per capita. Respect for public health. It's quite a discrepancy. Yeah. It doesn't make sense. We're going to make it better. How did we get there at this low level? Yeah, I'm not quite sure, but I know that it has to change. And we're doing good work with the people that we have, but we have to make it better. And I'm hoping that if we do get this grant that we can show the work that needs to be done, be representative of our community engaged with our community and show the needs for moving forward. But I think what happened was under Musanti, there were things that were changing and developing, but it was down at a low and then he died. And so it was in transition where they had moved the inspection services, but then they were going to build other things for the health department. And oh, there was, I can't remember, it's on the website. I can't remember the name of it. But then Musanti died and no one's put money or thought back in to the health department. Despite this year that we've been through. Yeah. And as I've told Emma, when I first moved to the area, so in the 70s, the health department had a home care division, had the school nurses had the inspection, had the whole top level and part of the second level of the community center. It was a booming. And then in the late 80s, early 90s, the select board got rid of the home care nurses, the visiting nurses, and then they moved the school nurses to the school department. And then everything just kept shrinking and they then, oh my God, she went to Springfield and I'm blocking her name. She'd help me for blocking her name. She left. She just said, you're eviscerating the town. And she became the assistant director of public health in Springfield. And it's been limping by ever since. And the thing is that when public health works, nobody really knows about it. And we have prevented huge disasters by hard work, prayer and luck. But one of these days, it's, we're not going to have the resources that we need. And we're going to have problems that we can't face and deal with. And we're not going to be prepared and we're not going to have adequate staff. We're going to be understaffed, under-resourced. So I don't know what other people's thoughts are about writing a letter. One thing about writing a letter, I think the timing is fairly important to get it at a time when it can make a difference within that next cycle. And I don't know all the details in the new charter system how it exactly goes. But it seems, so you'd be talking about the, not the coming fiscal year, but the follow-up. But getting it on board now, just to set the, we are very concerned about the actions that you're already taking. Yeah. Yeah. And then the point is that you have time, because you're not talking about the upcoming fiscal year, to make the full case with the things that Emma was talking about. And then the board could, I think that would be a good thing to do to write a very complete letter with all of those things at a time when it, there's enough time to get it acted on before the next budget. But I think we have to respond to what's happening right now. Do other people feel or think the way I'm thinking with level funding? A 20-hour nurse? Come on. It seems absurdly low, but the budgeting has been done for next fiscal year. Is that? I believe finance is voting this week or I don't know when their meeting is. Right now. Are they meeting at the same time? I don't know. But I mean, John, we also don't have any regular administrative support for the department. For the health department? Yeah. The regular health department staff was me and Jen Brown. And before that, it was a PAM feel. Is the PAM help? She did all the minutes. You didn't have to take minutes, Steve. Well, what I was going to say before, certainly, I have the same concern and it seems absurd. I was going to say, I don't know where we are relative to others. I wouldn't feel comfortable making a statement, but Emma just described the status to be, which is pretty concerning relative to national leverage. And I mean, it's astounding to me, actually. This town in this state, relative to that, at this point. Well, they're going to say, well, if you count the inspection services and the school nurses, which depends on what you count as. Well, I realize, but so that's what's going to be my question. We have to have apples to apples. So the NATO standards for staffing do not include school nurses. Right. All school nurses have slowly gotten moved out of health departments and put into schools. That was the trend in the 90s. So that national average number doesn't include school nurses. Correct. But it includes inspection services. But inspection services, how many people are in inspection services, Emma? Because you do interact with them. So for health inspections, it's only two staff. So you could come up with the number per capita that we're spending, including inspection services. So that means you have a number without it, right? 377, you said? Yeah, it's a number without it. Even if we add in Susan Malone and Ed Smith's pay, and Ed isn't even a full-time health inspector, he's shared with inspection services for building code. Yeah. I don't think we would be the lowest. We would still be the lowest. Where spends over $5 per capita, East Hampton, just shy of 10, South Hadley spends 13. I mean, it does seem crazy. Let me look. Yes. So we're going to make it better. Yes, I'd be able to sign that. Unless you have support and you get money. Let's be realistic. So should we write a letter, not saying, but just as a board that we are very concerned that it has been level funded for this year? Well, I think I'd put it in the relative terms of some kind of per capita expense relative to the region, right? Because maybe level is excellent if this year was abnormally excellent. You know, I mean, I think it has to be in absolute terms, not the level, just level funded. There's a lot of things that for a variety of reasons this fiscal year are being level funded because of everything that's going on. I just do want to highlight that North Hampton Health Department has an expansion of, I believe it's over $130,000 to increase their department. I think it was over 20% for four new positions, including an assistant director, a full-time public health nurse, and a program lead for their substance abuse program. So other health departments aren't being level funded in our area because of COVID. Coab and district also got approved for their public health excellence grant to increase so did the Foothills District. So this is not normal right now, or I shouldn't say normal. This isn't what other health departments are experiencing regionally. In terms of health department development, we also, we requested, we know one of social media accounts that would be approved under the term. We're not sure where those have gone. I have to follow up. I think one of the challenges with public health is you said it, Nancy. People don't know all the work we do until they see us. And one of the ways that we know we can get out there where we can get noticed for the work we do, educate the public, put out notifications, regular updates would be through social media. The town really like prefers to channel everything through the main town accounts. But we're still working on this because we feel, I feel strongly about it, that kind of any way to get out there improves the visibility of the work that we do. So that's been going on. I did interview for that temporary public health nurse position to compliment Jen Brown's hours. And then we have had the continued work and support with Nancy Schroeder, Tobiah, and Lillian and their administrative roles, which has been said to continue with finance through October or November for those temporary positions right now. In terms of, we've also been working on the pamphlets for the mosquito education to compliment our opt out that the town signed on for. We are members now of the Pine Valley Mosquito Control District. So that was exciting. And I believe it's on the 15th, or it's the 14th, that the state is going to start setting out those mosquito traps and start the testing for the West Isle Virus and Triple E. And in terms of development, I think that's it, but maybe I can swing right into our COVID-19 update. What do you think about that Nancy? Perfect. Great. So our numbers continue to be low. Our last positive PCR result was I believe May 30th. The town is up to only three active cases at this time. The state of emergency, as we all know, for this state is ending on the 15th. The town will also be lifting its local state of emergency on that day. We are going to continue mask wearing in town buildings unless individuals are stationary at their desks and away six feet away from others. If you're meeting with someone and able to be six feet or in private, you can ask that with their comfort level with mask wearing, but really the standard, whether you're vaccinated or not currently as we start to reopen buildings, is going to be where your mask to respect others' comfort level. I am concerned about the vaccination rate in Amherst being 43%. It does look when you look at the breakout data to primarily be between those 20 and 20 to 29 and 30. Let me make this bigger. The 16 to 29 year olds, which make up the over 64% of our population. We're not sure what that is, hoping that when the students come back in the fall, that'll be higher as all five colleges are requiring vaccines. The other vaccine age groups are really good, and the majority of them are over 90%. I think that's pretty much it for COVID in terms of numbers. Here we do continue to wind down now with our last scheduled clinic here at the Bang Center. It's going to be June 28th. Right now we are only doing second dose Moderna and Pfizer and J&J, but we're no longer doing first dose appointments for Pfizer or Moderna other than the Juneteenth event and we'll be offering them then. We are changing to doing mobile style clinics. We're going to be going with mobile market. We've been engaging volunteers that are bilingual for that and working with their staff to get out information for that program so we can go along with them. Like I said before, we're going to have a table on the common next to the COVID ambassadors where we're going to be out there for hopefully doing some vaccines, but also just getting out that word out there for the public health awareness and also we'll have that education and information about mosquitoes and tick-borne information. We've been doing a lot of work and we continue to support and partner with regional health for school-based clinics. Tomorrow we'll be South Hadley. By the end of all the school clinics, we'll have done seven schools and five municipalities and it's looking like over 400 kids, so that feels really good. Does anyone have any questions? Is the State Department of Public Health have any information about this variant that latest rant is of concern in the world? I can't remember where it is. Yeah, they're really not talking to us much about the variants specifically other than do all those gold standard practices of trying to maintain distance. That's part of the reason why I'm really wanting us to ease into not wearing masks. I think our area has done a really good job in terms of keeping cases low, but I do want us to be postured for the fall influx of students from all over the world when our density increases again. We aren't sure, John, how well the vaccines work against those variants yet. I think that the CDC and the state wants people to be encouraged to get the vaccine, which is why I think that you can take off your mask. Part of it came out and with the science, but I'm not sure where that'll bring us in the fall, but we'll all have to see. Have there been discussions about the logistics of having that requirement for people to be vaccinated, but maybe they're coming from abroad and can't be vaccinated, and then all these unvaccinated, not quite ready students arise. Is there any discussions about how they might handle that kind of thing? I haven't been on any five college meetings lately. They kind of picked up shot. Yeah, they've disappeared. So I'm not sure about those new students that are coming back, but I know that each college did have their vaccine clinics as they left, but for those other students coming in, because I do know that we've been getting inquiries about family members that are traveling in from Denmark or Japan and other countries where they haven't had vaccine access yet. In my old hat, I was just thinking how would you deal with folks coming from say like Japan where it hasn't been very available or some place else where it hasn't been very available? And those kids have been kind of out of this country for a long time because they weren't able to travel here last year. And where do you put them until they're vaccinated? Yeah. Don't know. I'm sure there'll be a plan. Yeah. You know, do they get their keys? There are places that won't let you have your keys until you've had all the vaccines that you are required to have. They don't let you check into your room, but this in this case, that wouldn't really, it's not a one and done thing. And it really wouldn't be the answer. All right. Topics not anticipated by the chair. So I just sent out the community assessment material yesterday because I got way late doing working on that because of the listening session. So I sent it out. I don't know if you got a chance to look at it. This is something, Emma, that's going to need some funding with stipends. And should this be the discussion for our next Board of Health meeting? I don't know if people looked at it. I mean, I looked at it though. It's a huge amount of information that you'd want to fill in. I mean, it's every topic under the sun. What's the, are you trying to get quantitative data on all of these things every one of these quantitative and qualitative. A lot of it is from records. Obviously, the quantitative comes from all records. So it's a lot of red. Yeah. And then the qualitative is focus groups, key informant interviews, listening sessions, public sessions. And this will be done by public health students. Yeah. But what did you think of the proposal piece? And this is a document that, so there were two documents. One was the proposal and one was the tool. Tool can be amended. It's, I merged a public health nursing tool and the University of Kansas community toolbox tool and put Healthy People 2030 in with health disparities and social determinants. Well, when I saw the list of like, for example, every possible public school and private schools, what exactly is that going to tell you? I mean, the public schools will tell you a lot. The public schools will tell you, let me get my things with a free lunch. Okay. So our kids getting dental services. Who's succeeding? Where is that piece of paper? And I had students, you know, the free lunch, absenteeism, special education, English language learners, MCAS tests. It gives you a picture of how successful and what might not be, might be used. And the reparations committee used all of this in their assessment only they used for black students. So I can kind of see that for black students compared to others, for example, you can see the disparity there. But from the point of view of the health assessment, what question is it designed to answer when you say that, you know, it gives you a picture of the school, it gives you a picture of the school. And if you see that over half of the kids are on free or reduced lunch, it says, okay, do they have health insurance? Do they have dental insurance? How are they getting these services? There have been the chips. Child health insurance that comes from the federal government. Massachusetts does pretty well with it. Not all states do. It gives you a picture of the town and what are some of the needs. And if you have, if you have a lot of English language learners, are they gonna, because education is a social determinant. And if you're going to address social determinants, you need to know should be, we should, should someone in town, not the health department, but point this out that this is a social determinant and we have so many kids that are not doing well in school. And what are we going to do for them? Because for the future, they're going to have health problems. And this stuff, you just get off of the department, the desi website. I noticed one of the statements said that this kind of an assessment is required if you're going to try to be an accredited health department. Yes. That's something we would like to be going forward. You know, in another decade or two, there are only three accredited health departments right now. But when you, I don't know if I'll hold it up, but it's called the blueprint for public health excellence, recommendations for improved effectiveness and efficiency of local public health protections. It's put out by the state. And under it, they talk about the foundational public health services, and they want all health departments to be able to provide foundational public health services. And the first one is assessment and surveillance under the foundational public health services. So if you look at any of these documents, it would put us ahead, but it also would help us look at do we need funding so that we're helping. And Emma, it's really to help make informed decisions, provide help set priorities, identify needs, ways to reach at risk and disenfranchise populations. There are lots of systemic health problems. One is, you know, public health is not funded and help promote equity and help us guide advocacy, not that we're going to do everything. And it's really a team. Yeah, that was what I was thinking of reading this just because a lot of the things have to do with the social determinants of health, which include, you know, secure housing and nutrition and well, mental health is health, but transportation and all these kinds of things that it really is, you know, it's really involves maybe a restructuring almost of how everything works in town into more of an umbrella organization that includes all of those services, but so then the health department and the Board of Health can go to those tables for these discussions. And this is going to be coming up, especially with Cress and the equity group. And we can be informed and support Emma in her in her plan so that if we find out, and when we were doing fluoride, the number of kids on free lunch in our in our public grammar schools, do we need as Emma wanted a van, do we need a van that then can go to the schools to provide something and have maybe oral health, not that they do dental carries, but have one of those little little chairs where you have a hygienist examine kids mouths to say, okay, these kids really need dentists. I'm just pulling this stuff out. But it would help Emma make make those kinds of plans and support how she wants to develop. And I've had nursing students between in the in the over decades that I worked do full pieces of this assessment for health departments and they would hand in binders this big, you know, it was before all everything was electronic. And the health departments would use this data but we'd ask the health department what what part of this assessment data do you need. And you know when it was setting up emergency dispensing sites is it was population pyramids by census tract to see and a lot of transportation issues by census tract. Where would you look for for funding for such a thing the community assessment like this. Part of it is getting graduate students at UMass School of Public Health, and I have four people on board that are willing so this could be a master's project or something like that with funding from where well or unfunded course. I'm trying to get from them what type of funding would they like to see for this but they want to see the proposal before they can tell me that what which they what the School of Public Health. On is there a professor also. I will tell you who Mary Ellen Lynn Linceno who is the director of career planning Amy Gilbert who's the assistant director for internships and Risa Silverman who is in charge of community services and outreach the three of them are on board and said yes they're very interested please send us the proposal and other things and I keep saying what would you see for stipends what do you want to see and they say well we have to see the proposal so yeah but they've been very receptive matter of fact I hadn't gotten I sent this information way out after our April meeting and Mary Ellen and Amy immediately responded but Risa just called me Tuesday morning and I said the board was meeting Thursday and Emma what are your thoughts on the whole community health needs assessment yeah well I think it's a great idea I think me in this role I would love to see us accredited health department and a robust department that's a that kind of appropriately and effectively meet the needs of all of our residents and I feel like this is a step forward to be able to do that I know that it said that oh Cooley does a community health needs assessment but they do it for the area they don't do a deep dive like this is doing and an assessment like this hasn't been done in a long time and I think it would be really valuable and all hospitals under the Affordable Care Act had to do a needs assessment so they all cough up money and there are all these consultants that will put stuff together for them would Paul where would some funding I don't even know where to begin with what you needed for funding for this yeah I think first I think the first step would be be pretty much have you pretty much have done the write-up for the proposal and see what UMass what the public health school is thinking and and then go from there and see what we can acquire so should I send the proposal to people at UMass and see what their feedback is I would say why not and also one thing I'm seeing is this assessment has lot of information that that is of useful to many other departments in in the town I mean it should be a combined effort it's not just the health department and I'm sure pitching it to a broader you know interdepartmental level effort but I think some of the data I'm seeing you know from roads bridges electricity and everything out of course everyone will be other departments would be really really interested in this data so I think we should see you know if they can pitch in you know pull up money you know yeah and it's an interdisciplinary it's a team it's many stakeholders it's not just the health department and it is to build collaborative relationships and partnerships the process helps helps that happen it was interesting I reached out to the school of nursing and I spoke to someone there who I know because they have a doctor of nursing practice but they never jumped on this but the school of public health I sent the email out within 24 hours they were on it right so one comment on the structure itself is it's just a baseline assessment that we are we wanted to know what the status is I think a comparative assessment that is where the policy comes in which is essentially saying where do you want to go you know how are we comparing with the region or state or national level I think that is probably maybe a second level on because for the comparison purpose that's where the future policies can gear towards you know where do we immerse strength how do we move towards that national standards or regional standards yeah is the would the Cooley Dickinson data be a helpful comparison or is that just more not broken down in a way that's helpful I didn't look at it while I was doing this which was a mistake of mine do you have it Emma I don't have it right in front of me but the link to it um I would just have to pull it up if you do you know maybe can send it to all of us yeah it just it kind of seems overwhelming to me it's like well what do we do with all this but it sounds like a reasonably good idea to kind of know where we are and where our issues are I mean I think our listening you know sessions are part of that and obviously those are also part of this deeper process um how do you use it I guess and how do you use it to move forward and you know whether you can use it to make the arguments that we want to make about building more robust health department so it's it's to identify the needs and then prioritize and then see what partnerships you have to build and how do we start addressing this and and I think this would go a lot with the reparations that's why Anita's very jumped on board to help because she sees the the blending with a lot of the reparations and if any of you listened did any of you listen to the reparations assessment basically is this only they just did it for black african-american residents in in Amherst but it's very similar to the data here I mean is the data here but for but for that subpopulation in town they really went into the schools with a fine tooth bone so I found the last um can you help needs assessment on available from Cooley from in 2019 and I'm gonna forward that to all of you okay great thank you okay so I will send the comments of what these things look like to some degree you know in terms of what what you see at the end you know you always regret I cleaned my office this winter and I threw out binders and binders of the community assessments that my students did for holy oak for chickpea of course I did that last January all went out and of course I don't have it but I could have shown you um uh the the the paper because these were from like 2005 to 2009 they were not and they were paper they were not online I think it will uh the frequency of this assessment is also important I mean even though it might be 2005 or 2010 it will tell it will tell us some sort of the trends and how we are progressing or not progressing so it's important to have some sort of a repeated assessments or at least at the at the measures you're trying to address you know right back you might be more selective in that going forward or well when you prioritize your need and you establish your plan you establish outcomes and then you have to evaluate your outcomes so that you can evaluate them at at at certain year intervals to see how you're progressing are you maintaining or not so I will send it out to you mess let's see what they say and the other thing I have is John this is your last meeting oh my goodness and and we've sent an email around because usually we have like a little of you know refreshments or something so instead we're getting out not women did it come off and and we oh did you get it Maureen well yeah if you John check at home you have there's a card that I need Leslie and I signed everybody's name thank you and something check your your Comcast email for a little refreshments since we couldn't do refreshments at well thank you okay and then Maureen send us emails for how much we have to send you okay so this is what we pulled together electronically in the past three days yeah I know I know it's a weird time to do that well yeah I you know I really enjoyed have enjoyed this this work and this this everybody who's been involved with the board and the issues and they're all there but anyway I only got so much time to go around and I need to adjust some things at some time and not keep doing the same thing for too many decades but I'm sorry I haven't been able to produce a environmental engineer or an engineer that sort of fill that niche and I'm happy to consult on anything you know I'm not I'm a I'm a member of town I'm a citizen here I serve in the water supply protection committee so you know I'm not going to go away for at least for a few years so I'm happy to don't hesitate to reach out for a particular technical expertise thank you for all your work especially when we were doing the current center in the Hitchcock Center I'll probably come back so yeah that those particular things for example yeah I'd be happy to weigh in on and you know I do feel bad and I think maybe Tim can I'm happy to weigh on this too but our private and we're doing some project with private wells right now statewide and I do feel like we need to that is an area I'd hope to sink my teeth into a little bit but maybe without doing other stuff and it can be something I can provide some advice on I mean you know we haven't updated those in a bit and they have some odd things about them and not you know we don't have many private wells in town so it's not a big issue it's not like being in Belcher Town or or Paloma Shoots but Shoots Bay right now has got some challenges coming up the PFAS issue in groundwater is really kind of getting a lot of attention all over the state because it's coming in public water supplies in a fair amount of private wells too and unfortunately compounds we used in lots of materials in lots of places and they don't go away but John you know in addition you know this expertise is terrific but there's something else that you do that I think is so incredibly good and that is we have a long complex discussion and we're moving towards emotion but how do you encapsulate that in a single sentence that is legally binding every single time you come up with it really yes you do and it's just exactly the right motion that we need to vote on so that's an incredible talent I'm sure that's why that your leadership at UMass is in such demand well I tried to have to consolidate some things yeah yeah yeah well I could see an encore after your retirement that's right yeah yeah well yeah there's when that occurs is the subject of debate but anyway yeah um now there's uh many things to do here but I'm I'm yeah it's just I know I did this year beyond the six but yeah a lot of yeah well Nancy's the ultimate right to come back after being we're lucky to have and Nancy thanks for your leadership of now and in the past and other times and and Steve you know taking and everybody's insight I mean it's really like I said it's been a great board to interact with over the whole period of time and I'm glad I happened to be there when these current center and other stuff issues were coming up so but I don't think interesting health environment water intersections are likely to go away so no probably not so um yeah we'll see what the future holds but thank you for uh very thing and I am glad that the town hired Emma when Julie retired um and I guess I will say because I didn't hear the numbers but I am I am appalled at that level of funding of our health department in this town that's just like a little wall you know like really um so you know happy to uh push for support either here or otherwise so but thank you very much yeah we got to figure out how to let people back into you mash you were talking about meeting sort of had a Tim I don't know if you saw that email a couple days ago from the VCRE sort of a green light for everybody to come back so subtly stated so I'm trying to update uh two-year-old seating charts like where the hell are we gonna put these students who's here and who's not here so kind of fun it's good it'll be good to have people back here well thank you thank you john you're welcome right we appreciate it say hi to leslie and enjoy your retirement from the board of health okay well ironically there's a I'm one of my particular areas of expertise is manganese and drinking water and there's been a subcommittee of the national A.W.W.A. which is association what uh american associate waterworks association that's had a monthly meeting on thursdays that exactly is lined up with this meeting and it's I always have to leave that one to go to this one so uh uh next month I won't have to do that so that'll be that'll be useful to do just serendipity right it was the second thursday of every month so anyway thank you thank you all thank you so do we have do I need to make a motion to adjourn yes any other comments yes any other thing okay I move we adjourn for the okay john moved adjourned yeah I'll second it okay all in favor tim hi john hi maureen hi fancy hi thank you all those the 15th for next meeting what yeah July 15th I hope it's still zoom because July 15th I'm in I'm away like we can make it zoom right I don't know that's an interesting question is the town address that um that so that's we have to wait for that legislature um and the all the details haven't been able to be ironed out um because without that legislature being passed um with that being said um has has I know the town council is taking I think this summer off or a month off maybe or no I'm probably miss speaking look at john's face um I have no idea I'm just not I don't know but I know health often didn't meet in august I do remember that or or July I can't remember one or the other so but more to come with that um the challenge is is the public participation um with zoom um if we're supposed to be hybrid and having devices and tech support yeah okay yeah okay all right well thank everybody and have a good month I'll be in touch and then I'll see you on the 19th for the dune teams if not before awesome bye everybody hi bye thank you