WEBVTT

METADATA
Video-Count: 1
Video-1: youtube.com/watch?v=DzCOCLk8aQM

NOTE
MEETING SECTIONS:

Part 1 (Video ID: DzCOCLk8aQM):
- 00:00:04: Board of Health Meeting Opens: Minutes and Introductions
- 00:01:18: Public Comment Period Deferred; Old Business Introduction
- 00:05:36: SAFE 2.0 Discussion: Blueprint and Vision for Excellence
- 00:13:29: Distinguishing Health Departments and Boards of Health
- 00:23:59: Shared Service Collaborations: Board of Health Oversight
- 00:30:55: Local Boards vs. State; Tobacco-Free Generation Legislation
- 00:39:07: SAFE 2.0 Survey and Long-Term Goals Discussion
- 00:43:46: Variance Request: Septic System Installation Approval
- 00:50:08: Director's Update: Tick-Borne Illness Awareness Campaign
- 01:17:39: No Public Comment; Board Member Introductions Begin


Part: 1

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Hi everyone. Um I want to officially open the May 6 board of health meeting. It is 502. Um and we have myself, Risha H the chair, Betsy Brooks, Jack Gems, and

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Ilana Kerrion as well as uh Kiko and Maheen from the Department of Public Health. Um, Premula is not yet in attendance. So, the first item of our agenda is on the minutes from last month. Uh, did

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anyone have any comments, clarifications, suggestions on those? >> Look good to me. >> Yeah, >> I didn't notice anything either. So, if that's the case, um, does someone want to make a motion to approve the minutes?

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>> Betsy makes the motion. A second. >> Second. >> Okay. And then all those in favor and abstained because she wasn't here for the last meeting. And everyone else approved.

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Okay. um we open with a um public comment session, but I don't see that there is anyone from the public here to comment. So, I'll wait a few seconds, but

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we may push any comments to the the next time we do that, which is at the end of the meeting. Okay, since I don't see anybody here that would want to make a comment, we will move that to the end of the meeting. Um, and so that gets us into

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old business. Um, and Kiko, I'm going to hand it over to you and I assume we can let Cheryl in as well. >> Yeah. So, and it so as it says on the agenda, we have Cheryl Sabara and Sam Wong is supposed to be joining us. Um, let's go ahead and promote Cheryl to

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panelist. main if you want to do that and then um hopefully Sam will be coming short shortly. >> I know Sam um is intending to be here. >> Okay. It could be that we're a little bit ahead of schedule. You know, it does say 5:15 is when we thought we might be

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starting this agenda item, but it's only 504. So, um, yes, I wonder if we can I think we should do a round of introductions for our I don't think we should wait on that. Hopefully, Prem can

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join maybe towards the end. And the other good news is that we'll all be in person in June. We'll have our first in-person meeting of the year. So, that will be a chance for people to get to know each other a little bit better in person. Um, but why don't we just start uh Risha if you want to facilitate that.

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>> Sure. And I'll just flag that Sam is now in the attendee. >> Excellent. Okay. Oh, well, >> so maybe >> chair, what would you like to do? >> I think maybe we go into this next agenda item. Um, again, because if we can have Premla, it would make this all

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easier for introductions. >> Great. Okay. And then just Cheryl, just so you know, I is a new board member, so that's why we're inter introductions. But since >> Thank you. Um, Mah, can you promote Sam also?

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>> What a committee running ahead of schedule. >> I know has even from California runs a tight ship. >> Hi Sam, welcome. Um, we're laughing. Yeah, we're laughing because we're actually running a meeting ahead of

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schedule. When does that ever happen with a public meeting, so we're starting on our old business item at 5:15 a little bit early. Um, so I just wanted to thank both you and Cheryl for being with us today. Um, Cheryl Sabar, you've been, you know, a not infrequent

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participant on these meetings with all >> No, my car knows how to drive by itself. >> Excellent. So, thank you um for joining us this evening. And Sam Wong is the director of the office of local and regional health with mass Massachusetts Department of Public Health and a former

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health director himself has that background. So has been steeped in public health and is a wonderful spokesperson for safe 2.0 the state action for public health excellence legislation. So Sam, just to give you a little background, um, you know, I often talk with the board about PH activities,

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you know, vaccine clinics that we're doing through PHE. And so it's PHE is something that people had heard of, but we hadn't really done a deep dive into what it actually means. um what the legislation says. Um and of course it's been, you know, top of mind for me because I just finished doing the

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performance standard survey. And so I was telling people about that and really felt like it would be so valuable for folks to hear from you directly about SAFE 2.0, you know, what it is, what your vision is for it. And then we had some specific questions um really specifically about a board of health in

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a town that also has a health department and how they would be interacting with safe 2.0. So we can save that but if you want to start off by just you know doing your spiel that would be excellent. >> Thank you. Thank you Kiko. Um thank you

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for this opportunity and inviting me to join um this meeting that is ahead of schedule. Um not only I used to work as a health director for many years but I also for a number of years I was a board

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member at my hometown as well. a board of health member. So fully appreciate everybody volunteering their time um to to work on public health issues and very nice to see Iana um

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my um former colleagues here at DPH. Good to see you in this new role. >> Nice to see you Sam. >> Um I I don't >> I was just going to say Sam this is Iana's first board meeting. She's a brand new board of health member. So

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>> I have to switch switch off the program coordinator cap and put on the board of health member hat on. >> You don't work for DPH anymore, so you don't have to speak for us. And you can ask any question that you always wanted to ask, but

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you're you're you're not part of the team um at DPH anymore. So um I don't know how or how are we going to move forward. Um do should you ask questions

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directly or how does it work? >> I think it might help. I mean we we had wanted you to come to an earlier meeting and I didn't plan well so you weren't available. So we had a discussion about safe 2.0 know as a board and I presented some information, you know, a summary

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and we sent everybody a handout. So, I feel like folks are wellversed. It's been a month or two, I guess, since we talked about it. Um, maybe it would benefit the group to just have you do a a high level summary maybe and and and I think especially hearing from you, what

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what's your vision like? What do you hope will happen with SAFE 2.0 for public health in Massachusetts? >> Got it. Thank you. Um, to talk about STA 2.0 know we really should be talking about the special commission and the blueprint.

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Um if you have read the um the um one pager or two pager that Cheryl and MHP put together there's some background information. The special commission was created in 2016.

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Um from many different sectors within the um the state, not just from public health, but healthcare, from um business, from taxpayer foundation, from the legislature. Really dive deep and look at what are

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the um deficiencies in our local public health system in Massachusetts. As you know, we have one of the most decentralized local public health system um in the country. Vast majority of other stateates operate

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at a county level for local public health services. We don't have much of a county structure anymore. So, we operate at a municipal level. um which brings a lot of other um efficiency issues, equity issues and

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resource issues because it's largely funded by municipal budgets at that time. The special commission produced published a final report we call it blueprint for public health excellence in 2019 right before the pandemic laid

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out six interlocking recommendations and that's really the blueprint of the safe legislations. Um the state enacted what we call a safe 1.0 old legislation back in actually right in the middle of

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the pandemic in second half of 2020 because by then we know how um inadequate in terms of capacity of our local public health system in responding to a pandemic of that size

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that has worked fairly well. It helped us with some dedicated resources from the state and established the PG public health actions for share services grant program and also we established the first ever

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performance standards for local public health in the fall of 2023 and also established a multi-ter training program for local public health. There has never been a structured training program for local

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public health before. That's all because of SAFE 1.0. And fast forward to 2024, um the legislature um updated the safe 1.0 legislation and

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it becomes safe 2.0. It added some new elements to it including accountability for local boards of health. Yes, we established the performance standards as part of safe 1.0, but it's never a mandate for local boards of health to

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meet that performance standards. Under safe 2.0, it becomes a requirement. SAFE 2.0 also um provided other measures including a number of reportings that DPH needs to produce

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some of them annually, some of them by annually. It also require every single local boss of fail to file a annual report to the department. Um that's what Kiko mentioned earlier that the performance standards survey is our way

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to um fulfill that requirement in the law. I'm going to stop here um to see if Cheryl has any additional things you want to cover. >> I think you've covered most of it. Um,

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one thing that I would just note is, you know, Amherst is one of our best boards of health. I, and I'm not being prejudiced here. I'm being honest. Um, so a lot of the issues that

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um really necessitated both SAFE 1.0 and SAFE 2.0 know were that many many many municipalities in Massachusetts, including many in Western Mass, were unable to meet the minimum statutory and

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regulatory um duties and obligations that they have pursuant to current Massachusetts laws and regulations. and even a mun municipality that's as advanced as Amherst um if you

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look at the manual of public health laws um the the knowledge base is extremely great and um I don't even think Amherst um or even Boston if if you just look at

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the multitude of obligations that we we have as boards of health it's extremely challenging ing to meet them. And I think part of um SAFE 2.0 and part of

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the public health excellence program is is designed to assist all municipalities to be able to perform all of the services that are even right now statutoily and regulatory required.

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I don't know if you have specific questions. So, let me ask a question then. I think because part of what's confusing is that board of health and public health department get used interchangeably sometimes. In some towns, all that exists is a board of health. You know,

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it might be just a part-time person volunteer who's that or three members who are volunteers who are responsible for all all of those things that you're describing that are supposed to be the standards. In Ammerst, we have a public health department. It's small, but you know, there are four of us and we are able to do a lot of the work that

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wouldn't happen in those smaller communities where they don't have staff people. And then we have this board of health who I think is an excellent board of health has done some really made some beautiful thoughtful recommendations and regulations. Um, and so I think what what we asked about, what the board

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asked last time was when you have both a port of board of health and a public health department. It's the health department that's really being held accountable for meeting all the standards and the codes and most of it. I mean, there were some questions in the survey that were specifically about do you have a board of health for the right

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amount of members? Do you have minutes? Do you meet regularly? Things like that, which I was able to say yes, yes, yes, we do all that. But what else is it that the board of health would be doing differently perhaps in a town like Ammerst as a result of >> this is this is really an interesting

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question Kiko because uh when I first started doing this work um it we the difference between a health department and a board of health um people got very confused. a a health department is

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statutoily created. Um, and most municipalities, unless they're cities, do not really have a statutoily created health department. So the default here is that um a a municipality, a board of

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health says they're a health department if they have one staff member because that staff member is then um you know usually delegated with the board of health's authority to maintain and uh protect public

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health. So your authority and and every staff member's authority um comes directly from the board of health. It's the board of health that has the legal authority and the legal

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obligation to protect um public health, safety and welfare. And that comes under the police power very similarly to what um police and fire. They also operate under the opices of the of protecting

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the public health, safety and welfare. So regardless of whether you're Deerfield or your Amherst, you have the same obligation to protect public health. It's just you and in and years ago

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people would I I remember being in a a municipality a couple last winter I think it was where they were so confused about are we a board of health or are we a health department that I had to go out

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and give a presentation to them about how it really doesn't matter. you can call yourself a health department for the purposes of how um you do your job, but there are very few and and I'm not

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sure whether maybe in the Amherst charter or you're shaking your head. No. um you know whether you have been designated as a statutory health department but even if you have that really it doesn't make a bit of

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difference you still have the same obligations so in cities you know there's a legal statutoily and I'll I'll pull up the statute um definition of them as a health department but it's

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really just based on resources and staff it doesn't change the obligation of the board of health, which is, you know, I mean, Paul Rivere, I mean, we we like our independence and our um home rule,

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the home rule amendment and chapter 111 section 31, which gives not only boards of health have their own legal authority in chapter 111, but then the home rule amendment from 1966

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in our constitution in the Massachusetts constitution gives that independence to cities and towns so that they can create laws and they can self-govern and that's why that amendment to the constitution

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was was passed. So, it's it presents challenges because we have 351 um autonomous municipalities. Um but it also creates opportunities

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to pass local laws that are designed for what your residents want or what the board believes would be in the best interest of your residents. having heard from them because I've been to your

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public hearings and have heard from from residents and you you know are are doing your best to um enact regulations and do enforcement in a way that your residents want you to. So that's a long-winded way

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of saying all boards have the same statutory obligations. It's just how they carry them out and in what manner they carry them out which is largely based on resources which isn't fair.

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>> I I I would add that um in terms of safe 2.0 know the um requirement is directed to the each local boards of health, >> right? >> And the health department often functions as the agent of the board.

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>> Yeah. >> Um can I ask a question? Um >> go ahead. It feels very clear to me um in normal times how the division happens and so for Ammerst

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we've really divided it as the board sets policies and the health department enacts those policies. Um what I'm wondering is in a in a more crisis um situation if someone had to

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shut down I guess I mean I guess Kiko you do this now. If you shut down puffers that's a health department decision. Um I'm thinking through some of the the trainings that we had um in the past few

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weeks, but in those more crisis situations, where do does the board need to become more active in thinking through those um those kinds of decisions on closing things down on

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um restricting things? Because that's not a role we typically think of for ourselves on this board. That's an interesting question, too. Um, I'm going to date myself here, but you had a health director probably 20 years

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ago, um, who really felt that that was the health director's obligation, not the board of health. So, whenever there was an enforcement issue, um, I'm not even they would um indicate

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to the board of health, this isn't your issue. I'll take care of this issue. And one of the board of health members contacted me and said, "Is that true?" Like, do we have any say in enforcement

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either in an emergency or not in an emergency? And I would say um your health agent derives their authority from you. whatever authority you give the health agent is the authority that

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they have. And I actually had to come out and say this in front of the town manager and the health director because she was oops was confused about the role of a health director versus um a board

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of health. So any emergency orders or whatever, you know, your health director has whatever authority you've delegated to that health director. So, in an emergency, what's going to happen most likely is that your health director is

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going to make decisions and then report them back to you and make sure their decisions, you know, within 48 hours if there's an emergency um the health director can make a decision and then with a in 48 hours the board meets to um

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acknowledge that decision and either approve it or disapprove it. So the the ultimate authority is and and obligations are with the board. Um but I you know there are boards have standard operating procedures. If you have a

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health director that you feel very comfortable delegating a lot of authority to that's your right as board of health members. But the the puck stops with you not with the health director. It it it stops with you.

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>> Okay. That's that's a useful thing because I think it's something that we should sort >> um before a crisis happens, right? So that it's very clear that everyone feels very comfortable with. So, you know, with the the health director taking that immediate response without consultation

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>> and then that we know that 48 Yeah. that within 48 hours we would have a chance to to jump in. Betsy, I see your hand up. >> Not emergencies. I have an emergency that I have to attend to. I'm going to sign off and join back later. Thank you. So,

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>> thanks. Hope is okay. >> And we had a town there was a there's a Lexington a few years ago. Um, their board of health was very concerned about giving up any of their legal authority.

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and MAHB helped them write some um some motions where they would indicate what authority they were comfortable giving up and what authority they weren't comfortable giving up and um you know it became an issue for them and it was new

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board of health members that were coming on board that had just some issues on delegating their authority. >> Yeah. And I mean just to be clear I think there's no tension around it now. I just think This was decades ago >> to to think through in terms of that

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there's no surprises when decisions need to be >> no >> to be made quickly. >> I mean I Cheryl I really want to thank you for that. That was crystal clear and I don't think anybody's ever explained that to me in the way that you just did. I feel like we should have recorded that

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and make it part of the orientation that we give to all new board members so they really understand what the scope of their authority is. It's yeah it's quite powerful actually. Um, >> it is recorded. >> Yeah. Right. Of course, we'll snip it out and turn it into a part of our

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orientation manual. And I was shaking my head when you were talking because I don't think that the health department is statutoily um mandated, if that's the correct word, but I don't know. I'll have to go and check, but my sense is not. >> Yeah. I I would doubt it unless it's in town charter the town charter.

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>> Yeah. In the charter. Yeah. >> Most of the charters just say board of health. >> Okay. and they refer to board of health throughout whether there's a health department or not. >> Yeah. Okay. Well, that that was really helpful. Thank you. Are there other questions?

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Okay. Well, I have one more. Um because this was something also that you all talked about last time we covered this topic was about um board of health involvement or oversight in a shared service collaboration. So, and if there is there anything that you might share

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about how that works? So, again, in our shared services arrangement, some of the people who come to the meetings are board of health members because that's all that exists in their town. >> Exactly. >> I'm but I'm the delegated person to represent this board of health in those. So, how what are your thoughts about that?

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>> Um, do you want me to go first, Sam? And then do you want to >> Okay. So, so here's here's what what frustrates me sometimes. Um, board of health members should know number one that they're in

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in a PHE collaborative and number two what is happening within that PHE collaborative. And I know that your board members know that because you report back to them what's happening in the PHE collaboratives. Unfortunately,

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we have some um boards of health that have really not been informed about what's going on in their public health excellence collaborative. And you know, they may

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have appointed their health director or a health agent or a public health nurse, whatever, whatever they may have. Um, and that person is really falling down on their job if they're not reporting back to the board of health about what's

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happening in a public health excellence program because, you know, you're bringing in that PHE collaborative is bringing in more excellent public health work into Amherst um that isn't being

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paid for out of your municipal budget. So, they're bringing in additional um really good work to Amherst and the Board of Health should know that and and their agents should um be bringing that

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information back because they're agents of the board of health. >> That's all I have to say on that. I I will add that the intent of the PG grant program is to support local public

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health in their capacity to meet the performance standard. That's the ultimate intent because we know that through the blueprint and the special commission we know that um there are a very large

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variet variation in different local boards of health's ability to meet the performance standard to meet the bare minimum. So the the grand funding is to support local boards of health in a regional setting to provide those um gap

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resources so that collectively as a group they're better able to meet the performance standards. That's the intent. So it really Cheryl is right. It really is up to each member municipalities, whether it's through a

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board member or through in your case the health director to really advocate for resources in a group setting that can help individual towns to be able to meet the performance standard better. >> Yeah. I mean, if I think about our

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shared services arrangement that Ammerst is in, you know, some of the other towns include towns like Chesterfield and Huntington, Cummington, they're very small towns. They don't have inspectors, health inspectors on staff. We do. We have two health inspectors, Susan, who we're going to ask to join us in a little bit to go over an agenda item,

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and Grace. So, I mean, they don't work, they're not they don't report to me. They're in infection services, but you know, I work with them very closely. You've all met them. You know who they are. um in Cumington it's the PHE collaborative that provides their helps to do that those inspections for them if

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they have you know hotels or food establishments. So that's a very concrete way that SSA's help with concrete tasks that we in Ammerst don't need so much help with. But there are other things that they do for us like Maven coverage. Maven is you know where we get all of our cases um communicable

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disease and Olivia manages those. If she goes on vacation the PH group covers that for us. Um, they also provide reports. When I presented those data to you last time about Lyme disease and the regional number and the town number of Lyme disease cases, that came from the PHE data source. So, those are the kinds

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of things that help us here to do to meet some of those standards. Um, just to reiterate some of the things I think I've talked to you all about before. Um, so I have more questions, but I think if board members want to I'm gonna pause for a second. Betsy, you had to jump

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off. I hope all is okay. >> Thank you. I had one question and this came up in the context of someone writing about a regulation that was being suggested statewide that would nullify

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the tobaccof free generation uh legislation saying that there would be a state law sort of pre preempting what local boards of health might do. How does um how does this fit with um

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these these different relationships? it does not sit well um with MAHB and we're on it and we're studying it very carefully and the Coalition for Local

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Public Health is um submitting um a letter of opposition that MAHB wrote. Um I'm happy to share it with you. We're cautiously optimistic that um it's

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been filed before this and and it's not just about um the nicotine-free generation. This is a law that would preempt boards of health. Um and and it it also flies in the face of the home rule amendment. So, we are cautiously

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optimistic that it will not be going anywhere. I'm happy to share the information and you as board members if you would contact your reps and senators that would be wonderful because you're the people they should be listening to.

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You know the legislature are they're the legislators are generalists. They're they don't know what you know about public health and about your legal authority. So, I'm happy to send that information to Kiko if she would like that tomorrow.

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>> In in terms of a um subject subject agnostic uh question on on what Betsy said, I mean obviously the the state and I assume it's the state health department uh the DPH can set rules that then all

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of us have to uh abide by, right? we have to include the the 21 plus in our regulations etc. Um obviously the the marijuana legislation is completely outside of the local boards. So

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technically they the state can set Is it the legislature that's the difference on this one? >> Yeah, the the history behind this is is interesting. Um, Brookline passed this um many years ago and they started

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enforcing it. I'm going to say two or three years ago and the industry was not pleased and they sued >> nicot means the nicotine free generation. >> The nicotine free generation. Brookline

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passed it. um the industry sued um and the case went all the way up to the Supreme Judicial Court and it was argued there by one of my colleagues from the public health advocacy institute. He

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argued um on behalf of Brooklyn and another attorney from the industry argued on behalf of the industry and the SJC upheld um in Brooklyn it was a bylaw, not a regulation, but it means

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the same thing. They upheld it and said that it was a perfectly legal regulation. The state law that increased the age to 21 did not preempt or prevent the town

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itself from further regulating um and incre well incrementally increasing the age that that was not a violation of the state law. It did not conflict with the state law. It made the state law

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stricter. Um, so the only other option that you would have if you don't like the decision of the Supreme Judicial Court is to change the legislation, is to amend the law or to add a new law

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that would prevent cities and towns from further regulating. And it's not just tobacco, it's also alcohol, gambling, cannabis. Um those are all within the bill that was filed both in the House

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and in the Senate. So that's why legally the only way because the SJC is the highest court you can go to in Massachusetts and this is not a federal issue. So you couldn't bring it to the Supreme Court or they

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would have probably. Um, so the only way to change this now is to change the law, but that's not going to happen. We're going to fight it. >> Yeah. I had heard from some people on

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the call earlier today that they were feeling they had been feeling a bit nervous about this, but now people are feeling like it's it's not going to pass. It's going to be >> it's going to be a fight, but it's not going to >> be a fight. Okay. Okay. Okay. We win those fights. >> Yeah. Good.

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>> At least in Massachusetts, we do >> thankfully. Um Betsy, did you have anything else you wanted to ask about that? >> No, I think that I think that that was was helpful. And as an FYI, um I got a copy of some of that. Uh Stuffen wrote a

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letter to our two local reps, Mindy and um >> Senator Carter. >> Yeah. Yeah. and and uh if anyone wants to see a copy of the thing that I wrote and send a similar one to them. >> Great. Thank you.

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>> That could be done. >> Yeah, thanks for doing that, Betsy. Someone had reach a pet another physician had reached out to you specifically physician to physician wanting to have more doctors weighing in on this. So, thanks for doing that. >> Yeah, and I think there was that question that I had about, you know, if

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there's a particular piece of legis legislation. We had had this training saying that if you're a board member, you can't lobby on an issue that's gone before the board. So, I was a little confused about that. But this seems like there was a deliberate decision to make

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this uh about the general relationship between uh legislation and membership and a board of health advocacy. Exactly. >> Whose whose whose decision was that?

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that boards of health couldn't lobby on an issue that was before >> this ethics training that told us we can't uh we can't lobby >> the conflict of interest training >> of interest training told us >> I'm going to have to look into that because lobbying in my opinion is your civic duty

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>> I I that way and I and I I I asked the question after I had been reached out to on this issue was whether I could say I'm doing this as a physician not as a member of the board of Um

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>> yeah I mean I I have not heard that but >> I will follow up on that >> that I had I was going to uh ask Risha about it but I've had a lot of things going on and I just didn't get around to >> was my concern from the training that we had

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to take. >> Yeah I mean and I think I referred you to the state ethics commission to ask that question. I don't know if you got a chance to do that but I know you're busy. Um, but it would be helpful, Cheryl, any light that you might be able to sh crystal clear. That would be great. And then I wanted to ask Sam, um,

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so the survey, which I filled out, which I have to say I enjoyed. Probably no one has said this. I enjoyed filling it out because it was really informative about, you know, what what we are doing well and what we could use, you know, where the gaps are. It's always good to do an assessment. So, I thought I wanted to

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ask you and of course I had huge help from Susan, our health inspector, um, on the environmental health pieces, but what is your advice about sharing that survey? It's long. It's a 70page document once it's all printed out with my answers, but you know, given everything that we've heard today about

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the scope of the board of health authority, I feel like it's information that should come back to the board. Here's what the health director on your behalf filled out in terms of what the strengths and gaps are here in Ammeris public health. What what's your advice about that, Sam? >> Were you able to print it out?

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>> I did print it out. Yeah, >> share it. You are completing the um the survey on behalf of the board of health. >> Correct. Yeah, >> I encourage you to share. >> Thank you. I mean, that's that's homework. It's actually a pretty interesting read because you just go you

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just look through and see all the questions and how I answered them. And it might be really interesting to all of you to see that. So I will send I'll PDF it and I'll send it along for you all to review. >> Our experience is that we know

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as Cheryl will agree that a local board of health duties and responsibilities are so vast. We don't expect any health director to know everything on that survey.

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I certainly I certainly didn't know everything when I was a health director. So completing the survey not only is an opportunity for us to assess the strength and and and area for improvement but also we see that as an

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educational piece as well as especially for certain things that you don't come across that often. Now you have an opportunity to brush up to learn about oh that's a requirement I didn't know about that. >> Exactly. There were definitely some that

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I marked. I did not know this was a requirement. So, it was, like I said, a learning experience for me. Um, exactly. >> Yeah. So, I'm conscious of time because we do have another agenda item, but I wanted to ask Sam if or either of you. So, what what's the long game with SAFE

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2.0? What do you hope you it will achieve? Like, we don't have a county health system here. It's very decentralized. It's difficult to have 351 local boards of health. This is a way to kind of move towards a more regional structure. What do you hope will happen like 10 years from now?

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>> Our hope is vast majority of cities and town they're able to meet the um performance standards. That's our hope. >> And I I would go a little further too. Um and and that a vast majority would be

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able to meet the performance standard and would be comfortable and it would just be sort of a standard operating procedure to share public health services. that there will be more

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collaboration >> between municipalities both the halves and the have nots um so that they can so that everybody gets equitable services and that we also find with in in 10 years I hope that we also

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have a more sustainable um resourced public health system in the state and you know we didn't have a line item in the budget until what was it six years ago or something, Sam? Um, and you

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know, I I I hope in 10 years that the public will also understand that police and fire and health are within the police power of the state. >> Thank you for that. I really appreciate

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it. Um, I think we're any burning questions because we're about out of time. Anything we didn't cover? >> No, I just want to add, Kiko, uh, please don't not send us things because it's too much reading. That's our our

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responsibility, not yours to worry about. >> Thank you, Risha. >> If people can't read it, they can't read it. But that's not on you. >> Uh, thank you. >> And and thank you, Cheryl and Sam. Really appreciate that. Um, I think we will have more questions as we learn

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more about our roles, but um, that that was much clearer than I had heard before. So, thank you for that. >> Great. Glad we could help. >> Thank you both so much. >> Thank you for what you do. Thank you. >> Thank you, S. >> Okay, I'm gonna take off.

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>> Thank you. >> Bye. Thank you. >> Great. And so the next item of business is um the request for variance on 52 Elf Hill Road.

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>> Yep. Um and we have um Mcken, if you could promote uh Daniel Pope, Susan Malone, and Alan Weiss. It looks like Alan Weiss logged on twice. Hope you can promote all those folks, those four people to panelist. And I'll just say for any attendees that

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uh because you weren't here at the beginning, we do have public comment uh times at the beginning and end of each meeting. So since the beginning has already gone by, there will be another public comment uh section at the end of the meeting. Great. So, it looks like we have

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everyone. Welcome to the Pope family. And Alan, I see you've unmuted yourself. Oh, there we go. Great. >> Greetings. It took me a minute, but I hope you me now. >> And your audio is a little low, just so you know. At least for me. Maybe others can hear you.

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>> Um, I think this is input auto. I'm not sure. >> It's better now. It's better now. It's okay. >> Greetings to everyone. It's been a little while. I'm not sure any of you know me um but I've been doing this type of work in Amoris for nearly four decades now. Um

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so having said that um that is relevant to what we're talking about tonight which is an approval which has been approved many times in the past um for certain areas of town that are challenging we'll just say like High

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Point Drive like Stage Coach and Hul and this part the lower part of Elfill. Um and what you're dealing with there is high groundwater tables sometimes and difficult um places to properly site soil absorption

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systems for leech fields. And uh that said um we had to request a 1-T reduction in the offset of the bottom of the leeching area of the leech field um to get this to work by gravity flow versus

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adding a pump system and raising it up more and creating a very tough system to fit by by adding that one foot. So what we have here at this point is a simple gravity flow septic tank and leech fuel

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system that satisfies the code um in the intent of protecting public health and uh groundwater and all those wonderful things. And um we're simply asking for a one-oot reduction in height. And this is

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from um the standpoint of going with a three-foot offset to groundwater as opposed to what traditionally we all see which is four. Sometimes we use a five- foot offset when it's just all pure sand and very fast perk tests and things like

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that. But that um that's not what this material was. It was a little bit slower. It's actually a good filtration medium. The naturally occurring soil there. Um so that and it will help to protect the nearby resources which would

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be of course Lawrence swamp um if you um and that that we've requested from conservation being right on the 100 foot line at the closest here just that Aaron review and offer us an emergency certificate so the work can proceed as soon as possible. We've already had the

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delay in waiting for your meeting and as I think most of you are aware the re only reason we had to wait and go through the process this way was you uh lost one of my favorite people Ed Smith who was a soil evaluator for a little while in Ammerst many years and um

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unfortunately Susan is not able to provide that certification at this time and um neither was Ron Mora who attended it but that all said we're just asking for the comfort reduction which has been approved in by Ammerst in the past for similar reasons. The only difference

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here is one of the board of health one of the health department members or inspection services members was not also a soil evaluator. >> Great. Does any do any board members or public health department members have any questions on this hearing?

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>> Yeah. Um, I reviewed the package that that Allen uh provided. I actually spoke with them and uh I understand the limitations and the justification for you know the waiver for this uh

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variance and I think it'll perform you know as as required with this modification. There there are definitely you know safety factors built into the regulation. So this is dropping it from four to three foot vertical separation

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makes a lot of sense to simplify the system and yet still you know achieve the performance standards there. >> Thank you. And for those of you who don't know Jack is our board uh expert on this so we often defer to his

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opinion. Does anyone have any other >> I just >> I just want to thank um thank you Jack for taking the time to know to review that and to render a professional opinion because I didn't feel capable of

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doing that. So thank you for that. >> Well we we we uh we're good about things like that, aren't we? >> All right. Okay. Well, if nobody has any other questions, does someone want to make a move to approve the variance?

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Betsy has made the motion. Can I have a second? >> I'll second. >> Jack second. All those in favor. All right. That is one, two, three, four, five of five. And that's unanimous. Uh to the popes, thank you. I

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know that this can be a long process waiting for our meeting. Hopefully, this is the least painful part of it. >> Thank you very much. Appreciate it. >> Yeah. I'll just offer thank you to the board and Jack, thanks for your time. >> Yeah.

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>> Thank you. >> Thanks, Alan. >> Good night. >> Thank you. Thanks for joining us. >> Okay. Uh the next topics on the agenda are the director's update.

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>> Yeah. Okay. So, um am I muted? No, I'm not. Okay, good. So, I wanted to um get back to the issue of tickborn illness. Um just to say that, you know, as I said last time, we are it's already a pretty bad tick season. um and the statistics

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that I had provided last time about how Amoris has kind of more than its fair share of lime cases. Um I did confirm actually that I made a mistake in the last time we spoke because there was a basically I had made an um kind of a assessment that older folks are

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disproportionately affected by tickbornne illness or older people people over the age of 50 in our town and then Risha had said well wait don't the students aren't lumped in with that and in fact the students are in our Maven workflow so when we go into Maven we do see all student cases we just

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don't follow them up they're followed up by UMass Ammerst. So, it is it still it seems that older people in our community are at higher risk or are being disproportionately affected. So, it's just making me think about a campaign that we could do specifically targeting,

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you know, people who might be retired who are walking in the woods, you know, just doing a better job um with educating those folks who are more likely to be coming in contact with ticks and getting Lyme disease seems like it would be a good idea. Um, and then Risha, you also had an idea because this is lime awareness month, right? I

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think May is correct. Did I get that right? I think Dak, you would know, right? I feel like you sent me something about that, but I I read it somewhere. >> Every every month is Lime awareness month. >> Um, yeah. so that we could, you know,

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maybe do some, you know, work with Scott Mersbach from the Gazette or, you know, other news outlets to do an article about tickbornne illness. We could, you know, about the prevalence of lime, about what it means to live with Lyme disease. There are a lot of people in our community who've been affected by

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this. I was at the sustainability fair at the end of April on Saturday. It was I was so busy. The organizer of the fair even said, "Your booth was the busiest of all the booths." because I had a spinning wheel and I had qu questions that I was asking people and I had giveaways. I was giving away tick

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removal kits and I I didn't stop talking about many things but mostly tickborne illness for about five hours. So I was glad to be able to have that opportunity to talk to people but I think that there's more that we could do. Um so I I just wondered I mean Risha you had the idea to do something you know kind of

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with the media. Did you want to say more about that? Yeah, I had just reached out to Kiko and said, you know, given what we're seeing on the tick season, um, and I I I was originally referred to the local epidemiologist uh newsletter

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through this board. Um, but they showed the graph nationally and made the point that it's unclear if this is an early season or a much worse season. But for this time of year, there is much more activity, many more um emergency room or

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doctor's office visits and most in the Northeast, you know, for us. Um, and so it does make sense to me to do something as as far as a campaign. The first thing that came to my mind was thinking maybe of a letter to the editor uh you know an

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opinion piece in the Gazette and any other newspapers as well. Um and I was thinking you know who would do would that be signed by the board? It could be certainly if we wanted to um it could also be uh from any board members um and

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you know co-authored by Kiko sort of let just you know focus however you want but I would think prevention probably um is is the way to go here. Um, and then thinking through um, and Jack obviously

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you would be the the a great co-author um, to speak from lived experience on it. Um, I also and and I found a tick this week. So, you know, yeah, >> I think we all have everyone I've talked to has found one. I have to say like

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there there are you know these easements which provide like the KC trail goes through the Eversource hightension electric uh and so I've walked through this path and I literally got swarmed by text. I've never seen

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>> what I saw this year. So I it makes sense that we're seeing it in the emergency room uh with people, you know, I'm not sure why they're making that visit, but uh wondering whether they need pel penicellin and maybe to get the ticks removed. I'm not sure what the

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emergency room aspect of it is, but uh it's it is it's it's an interesting trend, I think. So >> yeah, from what what they are saying is that it's a combination of people, you know, it's hard to know when you got the tick if you didn't notice it right away. And so it's that it they're they're

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afraid to take it out because it's embedded and it needs higher level of care or just because they're not sure. >> Um or it's a place they can't reach on their body and so they need someone's help. Um, and then there's of course the and it very few people I had to remind

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when I found the tick I had to remind myself of the details. You know, at what point do I need to be asking for further help and what are the other signs and all of that. So, um, I think it'd be great if if if you and Kiko would want to write something. I also think u maybe

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in those key walking areas, the dog park, the the key trails, if we would want to put something on a sign board of of just, hey, it's a particularly bad season. Um try to remember to do all the things.

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>> Yeah, I was I was wondering the same um in terms of signage and you know, warning. And tell the truth, I'm just I'm I'm wondering about if if we're creating habitat like for certain certain areas

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um with regard how the the ement has to be, you know, grassy areas that aren't ever mowed and things like that. But I don't know, it's a shame that we always great trails and then that we can't use them unless you you you have the permission and >> and tucking all your things in. I mean,

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just not exposing skin. There are ways to use them that are better than others. I see a hand up. >> Thanks. Thanks, Risha. Um, I was just going to say right before meeting I actually pulled a tick off of my dog. So, I think putting maybe some sort of the article in addition to maybe some

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signs like the Ammeris dog park cuz I've been there and seen ticks on dogs or for example the Sweet Alice trail that I I go on a lot and it has a lot of tall grass where my my dog gets swamped with ticks and I do too, especially the bottom of my feet would be really helpful just cuz I've seen a lot of

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people probably 50 and over walking there and I myself go there a lot with my dogs. So, I I think those places would be really helpful for catching people um just to be aware of what to do and also maybe in the article mentioning some safety tips because a few months ago I also took a tick off of me

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probably from my dog and um you know I didn't know that taking doxycyc within you know a few days could really help reduce your risk of any lime. So those are just some things I think maybe would be helpful to add. Thanks. Yeah, thank you, Betsy.

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>> A a couple of things. I think that this is a great idea. This is um unlike the headache awareness, I think this is a place where there's really an action set of action items that make sense to to kind of weigh in on doing something here. I was thinking about the elderly

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and how much might be related to poor vision or living alone. people who live alone or have mobility issues maybe not being able to to inspect themselves as carefully as younger people might be able to. So

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>> to be fair, I'm now considered part of the elderly group. So let's not go too hard on the elderly. I may be thinking about this personally with with my own issues, but I but I think um you know that Kiko probably has a list of the 10 most

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frequently asked questions, too. I think you know when you've done a public event, you can know what people >> what people's questions are. But I think, you know, knowing um that when you walk in an area with high grass that you should check yourself thoroughly the

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evening after and that you have a certain window to take it off and then you don't need prophylaxis. Then after that, you do need to contact your PCP >> given the shortages of PCPs. You know what if you don't have a PCP where you

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would go for care. Um, so I I think there there's a whole list of of um you know issues uh pictures of what the pictures list of

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symptoms. I think an educational campaign really makes sense. Um I'm about to enter a very busy time in my life. I I would be very happy to read and comment but probably not to play lead on on um this project.

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>> Thanks Betsy. Yeah, and I would say I mean I think that because of the activity we're seeing in ticks, it usually it's when you're out in tall grass now it seems to be if you're just outside um that you you should be thinking about it every time you're you know off a

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paved street. Um, but I think Premla, did you put your hand down? You were the next hand. >> Yeah, I did because Betsy essentially said what I was going to say, which is I really do think the emergency room visits end up really just sort of again

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pointing to access, you know, lack of primary care providers, also lack of information. But I think if if you don't have a primary care provider or you can't contact yours, that would be the logical thing to do. I also think I really I mean I know from

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personal experience that people who live by themselves have a very hard time checking for ticks completely. So >> yeah, >> Jack, you were the next hand. Yeah, I was uh I was going to say that the grass length uh that's what boggles my mind is

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I was walking on a a path that the grass was not high at all. I mean, it was not even up to the the rubber part of the of the shoe and they were just again uh all over. Um,

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and then but but you know with regard to the the safety aspect of it, these were dog ticks, so they they were the larger kind and they don't carry the disease. So that you know there's that. But I mean amongst the couple of dozen that were on me, I I think there was one

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small one that sometimes that's a juvenile one, but most, you know, that's the ones you got to worry about. The deer ticks are very small and that's where they go undetected and you probably don't even know you have one on, you know, basically because they're

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so small. U it's it's quite insidious. So that's all >> Jack. Oh, sorry. Go ahead, Betsy. >> One clinical point. I think many people don't know that flu-l like symptoms

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following a tick bite can be early lime. And at that point, it's still very easily treated with a relatively short course of oral antibiotics. So, I think there's just a lot of things that really helpful for people to know.

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>> Yeah. >> So, how do we want to decide? I mean, Kiko, I can just hand it to you and you can do what you think is best. Um, I I I do think sort of people are talking about it on local news, on local media. So, it would be

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useful to to make sure that the accuracy of information coming through and and letting people know that the town exists to answer questions if people have them. Um, but so, and I do think newspaper

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um readership, it does skew older, which might be useful in this particular case. Um, so I don't know if if you and Jack are willing to to do a letter or if you have another set of plans. I'm happy to support whatever. But

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>> yeah, I I I think if Kiko can get like a word count of what, you know, they may be looking for, then we can just kind of fit what we need to say uh through that. But I am uh very involved with being on, you know, message boards about

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it. And >> it's a lot of information comes from the patients not unfortunately not from uh what we call lime literate MDs which are very few um among us.

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So >> well and then maybe it does make sense to have Betsy and you know the more either all of us or you know to include so I mean for this particular issue we are a very well-formed board

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right we have lived experience we have the medical expertise we have >> sort of all of the epidemiology side >> um and each of those has a real value and and you know the the reason I think Jack, I mean, I I think hearing the

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story from someone who knows what it's like to go through it is so powerful. >> Um, that I think that that a lot of what we're seeing is sort of CDC fact sheets, which are also really good, but don't don't have quite the same impact as someone who can tell us

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>> uh prem. I just wanted to say that I I actually think it would be a good idea to be signed for by all the board members because it just has adds a certain weight to it. Not that uh Jack and Kiko aren't enough, but you know what I mean.

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It's like if you see several names under an article, it might sort of gain more attention. >> So, what what would be the organs for uh where this would appear? Are we

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talking about the Gazette? Are we talking about the indie? Are we talking about uh what are the local >> Those are the main two. Um there's also things like NEPMs um the local 413

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podcast um other mediums. I I don't know the policy on newspapers of submitting the same letter to the editor to to more than one newspaper. I assume a newspaper wouldn't want to publish the exact same letter that someone else is publishing. Um, but we can certainly figure that out

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pretty easily. Preml, is your hand still up or is that from before? Okay, >> thanks Risha. Um, I was just going to mention the Ammerst bulletin too because I used to read that one more often. And

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I also wanted to ask about potentially um if we're you know if Kiko and Jack are going to write something if in another language because I know there's a Hispanic population here in Ammerst. So you know I'm me and my mom were Puerto Rican. I'm happy to help translate anything but um maybe having

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it in more than one language would be helpful or at least some of the warning signs if we're going to start putting them in different places in town. >> Very important. That's a great suggestion. Um, and is there a Spanish language newspaper or anything like that

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around? >> I can check, but I think maybe in other towns like Holio and Springfield, they might have some. >> Um, but I can definitely look into it to see if there's one that's in Spanish that maybe we can publish something in there because I do think having it in Spanish would be really helpful.

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>> Yeah, I I really I think that's a great idea. I think doing signage at trail heads would be great. I have to look and see what our resources are for that sort of thing. Um, but if we were to do that, I would want them to be bilingual. I think that would be important. Um, so >> are you talking about like a a sign

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beware of ticks and then also a FAQ or, you know, an information? >> Yeah. Or, you know, I mean, I I really am a big fan of the QR code. Um, you know, if you most people have their phones with them when they're hiking, you know, just for safety reasons. And it's easy enough to mo I was in a meeting with a bunch of people who were

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self-described lites, people in their 70s, like I can't do that. a QR code thing, but we taught them and now they've got it. So, I really think it's possible. That's one way to get people information without having to clutter up a sign. Right. >> Right. That sounds great. >> Yeah.

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>> Well, this sounds like a real campaign. >> Yeah. So, again, I have to look at our resources, but I think this is very important and I'm glad that you all are enthusiastic about it. I just wanted to suggest also and I you know I know demographically this might

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have shifted but in the past we've had a significant Cambodian community that farms um you know or does community gardens. So I think that might it would be great if we could translate it into that in addition to Spanish.

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I actually >> So I was just going to say that I have an open PO with a translation contractor that has to be spent by the end of the calendar year. So this would be a great thing to spend that money on. Good idea. Go ahead, Risha. Sorry. >> I was just going to say I think

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typically I I grew up here when there was a large Cambodian population. I think typically it's now Mandarin that's the big demand locally. um in addition to Spanish and a few others. >> Well, maybe your budget that you have to

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spend will go to all of those. >> All of them. >> Great. Uh any uh Well, that was just the first part of the director's update. Pico, >> yeah, let me I'll just quickly buzz through the others. Um so, I I talked last time about um you know, our increased focus on getting more access

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to Narcan and the lock zone um out in the community. So, we're still working on the two outdoor Narcan cabinets. Those haven't been installed yet, but we do have um Nlloxx boxes, as they're called, indoors at the Bangs, Town Hall, Police Department, and all three library

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locations. So, we're happy about that. And I we will do a map eventually so people can log on to the website and and see a map of where Narcan is in the community. And I think we'll probably do some kind of press release around that um once we get it all set. Um, I also

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wanted to say that that we I ordered these purple air sensors. I applied for a grant through Mass D to get five free purple air sensors. I think I mentioned it all to you some time ago, and those are starting to be installed. There's one at War Memorial Pool. There's one at

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Mill River. There's one going up at Grath Park, but it hasn't been connected to the Wi-Fi yet. They have they need outside power and Wi-Fi. Those three sites have those things mostly. the Wi-Fi I'm still working on. But then they will they pick up particulate matter in the air and then that data is

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transferred to the Purple Air map. So if you log on to Purple Air, you just Google it, you'll be able to see what these sensors are picking up in our town. Eventually there'll be five of them. I'm still working on the location for the other two. Um, but this is just a way, especially with wildfire season coming, we know we've had poor air

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quality in the past from Canadian wildfires. It's a nice way for people to be able to know like real lo hyper local data about what the air quality is. So, more to come on that. Um, and then the final thing and then we want to move to introductions because we don't want

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don't want to forget to spend time introducing ourselves to Ilana. But my last item is just about um some recent emergency preparedness trainings that I've been involved in coordinating as co-chair of the Hampshire Public Health Preparedness Coalition. Risha has been involved in some of those meetings and

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she came to one of the trainings that we did last week about crisis and emergency risk communication. We got some good tips about how to manage um communication issues in the from a public health standpoint in the event of an emergency. We did some sort of um practice examples. One of them was

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around triple E and one was about uh derailment train derailment and subsequent fire. So that was that was interesting. And then today there was another training about um how we work together with all of our emergency management personnel in town and across also the region um to manage something

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like it was the scenario was an ice storm. So we talked about that together for a couple of hours. Um, and it was really good to form relationships and think about things we haven't planned for, things we don't exactly have dialed in just yet that we should start to be thinking about before the emergency

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happens so we can be better poised. You know, as the public health director and as the board of health, you know, as your designated agent, it is my responsibility to manage public health issues um, in the event of an emergency. So, this is all again part of our broad scope and good stuff to be thinking

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about. Um, so I was happy to be part of that. More to come on that too. And I think that's it for me. Um, great. And I'll just say I I found the communication train. There was a virtual

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and then a inerson part of that uh to be really great and I would have would have um attended today's if I were not traveling. So I'm sorry to have missed that. I think these are really important. Uh it it is amazing to meet the other folks from other towns and uh

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there are a lot of differences but it it helps to understand where we can connect and support each other. Betsy >> I was thinking that the Narcan cabinets might be another place where we'd want to do a a real public outreach so that community knows about um that resource.

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I think >> agree. Yes. Yeah. We've been thinking about doing that too. Once we're ready we'll do that. Yeah. >> Uh the other question I had is a while ago we had had this discussion about the epinephrine for uh an you know epipens

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>> and whether or not um uh you know the standing order orders for uh you know epinephrine in case of an allergic anaphylactic reaction. um you know whether given the sort of

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price gouging that's being done in the private pharm pharmaceutical world uh has priced this out of um you know local budgets and I just wondered if you had an update or you you

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know if those issues had been resolved or you know whether these are still problems. >> Yeah, we did resolve it. Um, we talked we toyed with the idea of getting the different formulation or the I think it was a nasal application. Um, but that was maybe less expensive but not as

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reliable and didn't there were issues with it. So, we just found the funds and we got two of the regular Ebie pens. So, we have them >> now. Yeah. Risho, you're muted. >> Zoom just told me that. Thank you. Uh oh, Promo, do you have a question

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before? >> No, I I didn't know if we were up to topics not anticipated. I will speak when that is the case. >> Well, that was just what I was going to ask. Do we have any topics not anticipated? >> Can we do introductions quickly before >> can I suggest actually can we finish the

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meeting agenda? Um, and then I don't think we need to bore the public with our who we all are. Um, and we can introduce at the very end of the meeting. >> Sure, we can do that. I I think it's actually helpful for the public to know who's on the board and I being a new

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member, it's it's okay for it to be part of this recorded meeting, but happy to wait till the end. It's fine. >> Okay, Prem, go ahead. >> Um, okay. Just two things quickly. I wanted to say that I attended u uh the presentation of honors thesis by a group

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of students in environmental policy at Smith and they did a study about curbside composting in Ammerst. So they are going to send us their uh reports and presentation and so I just wanted to

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mention that and when I get it I will share it. Um, and the other thing I wanted to say is maybe some of you are aware, but um, and and I just think of this in terms of boosting the tobaccofree generation

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effort because, um, the UK Tobacco and Vapes Act of 2026, which received Royal Ascent on April 29th, creates a smoke-free generation uh, by per permanently banning the sale of tobacco to anyone born on or after

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January 1st. 2009. So, you know, and that it's going to change every year. And this is the whole country. We're not talking about a state or a county or for the entire UK. So, I find that encouraging. >> Great. Yeah. And I had heard that it's

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it's interesting to see whole countries passing it. >> I just want Oh, go ahead. I was I was going to switch slightly. So, you go ahead. >> Yeah. So I just wanted to say that that New Zealand I think had done that and then they um went they they sort of

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repealed it because they had a change in administration with a different view. So that was in effect for a while and then they they dialed it back. So it's interesting to see how these things go. Yeah. >> Sorry. No, I was going to flag um if anybody watches this week tonight with John

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Oliver, they did a um last week's episode was on Katam and other uh what they were calling gas station drugs. Um so a much more in-depth report than I had even though it's a comedy show uh

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than I had seen prior. >> Was it also >> Yeah, it is a comedy show but it's pretty well researched. Oh, I got to watch that one. That'd be good. >> Any other topics not anticipated? >> Okay. Uh, is there anybody in the

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audience that would like to make a public comment? If so, please raise the the Zoom virtual hand. Okay, I don't see any hands. So, we will close the the public comment section and we will do introductions at

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the end of a meeting, of course. Um, so I do want to start by introducing yourself. >> Yeah, thank you. Thank you so much, Arisha. Hi. I'm I'm um I'm from Ammerst, Mass. I grew up here. I've lived here my

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whole life. Um I'm currently a PhD student at UMass Ammerst in the School of Public Health and this is my um first year. Before that I worked for the Mass DPH and Sam Wong was actually my the top supervisor. So I haven't seen him in in a while. It was really nice to see him

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in this meeting. Um so when they were talking about the public health excellence grant, I really resonated with everything they were saying because I used to be a program coordinator and I managed the grantees in Western Mass, Ammeris included. But since Ammeris is in the Northampton group, I mainly dealt

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with the um the links in Northampton. So, um yeah, I don't know if maybe you've seen me running around my dog in Amoris. I'm constantly outside of Ammeris um with my dog, Enzo, and I'm really happy to be here. This is the first board of health um uh board that

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I've been I've been on. So, I'm definitely open to learning a lot of new things. Um I appreciate the warm welcome. I appreciate Kiko as a leader and I'm really happy to to be here. Um, and I hope this will be a great learning experience and if there's anything I can try to bring on the table from my past

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experience working under the public health excellence grant, I'm happy to. Um, and yeah, I'm really excited to meet you all in person also. >> Yeah, it'll be nice to to see everyone in person next month. Um, I'm just going to go around in the order I see you

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guys. So, Betsy, you want to introduce yourself? Ah, there I am. Hi, I'm Betsy Brooks. I'm a retired pediatrician. Um, I was at Holio Pediatrics for a gazillion years, 35 maybe. Uh, and um

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um have lived here for almost 50 years. So, uh, nice to meet you. Welcome to the board. Um, >> great, Jack. >> Yep. Uh, I live in South Amoris and been here what,

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since 2000. And I am a licensed site professional, so a consultant, environmental consultant, uh, specialize in hydrogeeology. And yeah, I'm the one that has Lyme disease on the board, I think. So,

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that's out of the bag. Um, but what Oh, I served on the planning board for for six years and I'm on the water supply protection committee uh as well. So, anyway, welcome, Elelliana.

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I did I pronounce that right? >> You did. I appreciate I was going to say um so far I've learned from me if I find a tick, you're the you're the guy. You're the person I go to. that I have to add that my brother is a retired MD, but he is way up there in terms of

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national notoriety in terms of an MD that services, you know, lime patients for a long time. So, if you Google my last name, you'll see it's all about him. So, >> good to know. >> Yeah.

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>> Did it get you to treat yourself early? some free medical services, you know. >> Yeah. I um it the way it evolved with me, it was just kind of backwards because I have chronic and so, you know,

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it was kind of too late. But anyway, yeah, I refer to him uh every once in a while. So, good guy to know. >> Was he an expert before you contracted it? >> Oh, yeah. He uh so he he he started as

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his practice in the 80s down in North Carolina and he treated AIDS patients. So he's an internal medicine infectuous disease guy and so he had a little bit of entrepreneur to him. So as the AIDS as we got a he you know got our hands

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around the AIDS epidemic he looked and saw a similar type problem in the early 90s or mid 90s with lime. So he's been doing it for a long time like 30 years. Um so he he's he's he's

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you know one of the experts but retired now within the last year. >> Mah, do you want to introduce yourself? >> Yeah, I'm Maheen. I'm the program assistant at the health department. Um I studied public health at UMass. I grew up here. Um you'll see me sending out

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the meeting packets, um the agendas, all the emails basically. I apologize. My internet connection is fading. So if I uh don't say something where I'm supposed to be, just assume I I actually can't get in. Um Premala.

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>> Hi, I'm Premla Nyer. a retired nurse practitioner but still practicing predium. I had lived in Ammeris for 35 years. Um I worked in a federally funded community health center for a number of

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years and then uh did primarily student health both at UMass Ammerston and fi finally at Smith College. Um, and I think I'm the long the board of health member who's been on for the longest period of time.

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Whatever distinction that brings me, >> it's a huge distinction and we're so grateful. You're the only one who can bridge the gap of what happened before. Uh, Kiko >> Illiana knows me.

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Yeah, we worked together when she was the PHE regional coordinator and then have kept in touch. So, it's just really happy to have you. Welcome. >> And so, that's me. I'm Risha. Uh, I work in international public health mostly on women's health um and more as the

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partic. So, I think it was actually great to hear all of your bios again. I learn something new each time. So, uh that that was wonderful. I were so thrilled to have you. Um I think you really fill a lot of important gaps on this board.

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Um and oh yeah, I guess we were all saying how long we have been in Ammerst. Um and I didn't do that. Uh I grew up in Ammerst and then left and came back six years ago. And they have been a very quick six years. >> Um

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>> and moved next door to me. >> Yes. and move next door to Betsy. >> Mother, >> sure. My mother, but also Betsy. >> Um, so great. Thank you all. Uh, next month is in person if all goes well. Um,

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and it'll be great to see you all. And with that, I need a uh a motion to close the meeting. Betsy motions. Can I get a sec? Jack seconds. And so we will close the meeting at uh 6:28.

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Thank you all. Bye >> bye everybody.