All right. So, we will open the May 1st meeting at 502. And uh welcome everyone. The uh first item on the agenda is reviewing the minutes from last meeting. Um I did
review them and didn't see anything that needed correcting. Did anyone else have any? I think my only comment is it looks like it was a good discussion and I agree with all of the conclusions and I realize that I was supposed to say
who's here uh for the public record. So um from the board we have myself, Risha H, Premla, Betsy and Jack. From the health department, we have Kiko, Maheen, and Susan. Um, so sorry about that.
Okay. So, does anyone want to move to accept the minutes if there's no comments? I'll move to accept the minutes. Okay. And a second. I'll second. All those in favor? Great. All right. So, the next part of
the agenda is public comment. Um, and so usually the way we do this is if you would like to be promoted to be able to speak, uh, raise your virtual hand through Zoom and we will promote you. So I see five people in the waiting
room. I think most of them are associated with the agenda item about the Fort River geothermal well. Um, so but if any of you are here for other reasons and you want to make public comment, please do raise your virtual hand and we'll allow you to we'll unmute
you so you can make your comment. If I don't see a hand, then we won't unmute you. Okay. Okay. So, we'll go on to the next agenda item. Moving right along. Um, so the it's the
old business and what we have here is the body art regulations. Um, and so Kiko, I assume that you have an update on whether or not we have to have a public hearing or if it's all fine. And I given the title, I'm assuming it's all fine
and we just need to set an effective date. Yeah, we don't need to hold a public hearing. We do need to put a a little announcement in the gazette when the regulations are signed and and effective. So Nancy will do that. Um she's going to put in something that will say that both tobacco and body art
are effective or in you know revised and updated and effective so that we can save a little money because those ads are expensive. Um uh so that's all done. I think there are just two things to talk about with respect to the body art regulations. One is to set an effective
date as it says in the agenda. And the other is that I and Susan, it's great that you're here. You're here mostly for the geothermal item, but I think that you can also weigh in on this one. Um, which is that I did show the regulations to Susan, and it was so helpful to have her input before, which was really what
drove the revision, the most recent revision, her experience of having putting them in having put them into practice. And so, she suggested that we add a little bit of clarifying language, which we don't need to take to a vote. It's just something to make the things seem a little bit more um clear which is
just um when it comes to the training the in annex the where we list the trainings to put in a disclaimer of some type which is that essentially that the board of health doesn't recommend a specific one of the organizations and doesn't preclude other one not other
organizations not on the list that meet the specified requirements from being a training that somebody could take. So, um, that's just something that's normally put in when there are other required trainings. Say for food certification, if there's a whole list, there's usually a disclaimer that says, "Here's the list, but we don't endorse
any particular one or there might be others out there, um, that meet the requirements." So, um, and also just to say that the list is updated on a certain time and it's subject to change, so to go back and update it or check it periodically. So, that was one disclaimer that she recommended. And
then the other disclaimer in annex was to add a statement that says comments by the apprentice and the trainer should indicate how progress is being made to complete the training period requirements as described in the regulations so that you can ensure that the person is just not not just sitting
there but is actually doing stuff during the time that they are um do uh you know in their apprenticeship. Um so just a little bit more detail about that. Again, these are just clarifying statements we can add to the two annexes. Um, and Susan, did did I
capture that? Anything you want to add as long as we have you? No, I thought you made that very clear. Thank you. Well, I think that's great news that there weren't more because uh you're the ones who are clear on where we have gaps
in in our in our regulations. So, thank you for reviewing those. And thank you and both for all the work you put into this because it's greatly appreciated and I think it really will make a difference as we uh review applications.
Great. So I don't have the same concerns about delaying an effective date on these as I did with tobacco. um in that I think this is more demand driven from it it helps the uh the one uh business that it
applies to in town uh rather than you know requires them to prepare something and um and change a policy. So are we able to do it sooner? What what's the Yeah, definitely sooner. No need to wait
three months as you said. No, no products have to come off the shelves or anything like that as with the tobacco regulations. So, it could be effective immediately or effective, you know, June 1st or, you know, I Yeah, I don't think it really matters that much. I don't know. Susan, do you have
another Do you have a second thought about that? No, I I think you um to make them effective in one month uh will uh allow people a moment to take a breath about it, but I don't see any
reason to really delay. Okay. So, shall we say effective June 1st? I assume we have to have a vote on that. Yes. moved. Okay. Seconded. Thank you, Prem. All those in favor of
June 1st. Great. Um, and then just one last thing, Risha, before you all move on to new business, which is that both the body art regulations and the tobacco regulations need actual physical signatures from all
of you. Um, I think what we've done in the past is that we've made home visits, um, you know, with the hard copies. you can sign them. Um, so we're happy to do that if it's easier on folks or if people want to come here to the office, that's also an option. Um, just wondering what people's preferences
would be. I think the sooner we're actually getting requests, especially for the tobacco regulations, people do want to see the executed copies. So, it' be good to get this done soon. So, what are people's preferences? I can stop by, but I live close by, so Okay, that's great, Grand P.
I can I can stop by, but if you're going to see Risha, we're a twofer. That's right. I I could come by on Tuesday afternoon if if we want something that's before 400 pm, then you might have to
come to me. That's per I mean, that's fine. If you Okay, so Premla, when would you be able to come by? Uh, I could do it as soon as tomorrow. Um, as long as you say, you
know, the hour. I mean, I'm assuming 9 to 4 or Yeah. 9 to 4. Yep. Yeah. Okay, that's great. So, and um that works, Risha, for you to come on Tuesday after 4 basically. It'll be about like 4:05 or
something. Yeah. I Yeah, I'm I'm always here after 4, so that's not a problem. And um I don't know, Jack, about you, Betsy. What about you and Jack? I'll do it either Friday or I'll do it on Friday, probably around 9.
Excellent. Okay. Friday, like tomorrow? Okay. Okay. Great. Yes. Yeah. Just um I can just come in sometime tomorrow, too. Oh. Uh do you need a time? No, I'm going to be here
all day tomorrow. I I have a little meeting from 9 to 10. So Betsy, just so you know, I'm actually facilitating a Zoom meeting from 9:00 to 10:00, so I wouldn't be so available. And my here in the office tomorrow, so anytime after 10 tomorrow is better for me if possible.
I might do it then on Monday morning because I I I always feel like I'm going to try and get out early in the morning, but but it'll be it'll be sometime on Friday or else first thing in the
morning Monday. Okay. Excellent. Okay, good. Thank you. Um, we don't have Dia uh sign them because she's not here now even though she was part of the Yeah, I did ask um Angela Mills um the
assistant to the town manager that question and she said no, she wouldn't sign them since she's no longer on the board. So, okay. Yeah. Great. Anything else on old business before we move on? I think that's it. Okay. Well, our first up for new
business is the Fort River geo thermal well application. And I think that's everyone who's here. So, I don't know if it's Kiko or Susan over to one of you. Yeah. Um, Susan, do you want to give an intro? Sure. Um, so you have the
attachments. I'll just briefly refer to the geothermal well application summary for board of health review. Uh it starts with the pertinent information. This is property owned by the town of Ammerst that we usually refer to as the Fort
River project. It is well application number well-25-1. Um the what we have the applicant Nick I believe is here. Um the project manager is James and the well driller name and registration number is provided.
Um the attachment includes uh several pages of the uh site plan for review and there's one plan review and it shows the field where and there's it's because there's quite a few bore
holes um 84 bhole holes all together. So it's a large project. Um, I provided a number of maps to give you different flavors, but I did go out to visit the site, did not observe any issues that
would be objectionable. Um, I also included comments by the wetlands administrator, Aaron Jax, who um set some conditions uh mostly having to do with
um the dewatering. So the one concern I think that Aaron had was that if the water um that is pulled uh from the
ground that's when where she first refers to dewatering discharge sedimentation. Um the project managers jurors proposed that there would be um uh basins on site. So the water would be
returned on site for the um water storage of these um of the water pulled from the ground. And Aaron wanted to be sure that if this water storage on site exceeded
capacity that at that point a frack tank system would be set up on site to remove excess water. Aaron had noted to me that it's common to have this uh frack tank
on site and in previous projects such as Ammerst College, they did provide um you know trucks with with tanks to remove uh the this water. So as long as this requirement is on site, Erin was
comfortable signing off on this step of the plan. Um but she does note that there are still conditions to be satisfied uh uh from with the orders of condition um from um uh uh her her um department.
So, uh, generally she doesn't go into a great deal about that, but, um, she does meet, uh, back with the project manager to make sure and and does an on-site inspection to ensure that those orders
are um, met. So, I think we are at this point um, as far as I can see that uh, it is ready the the application is ready for approval by the board. And Susan, do you know if um
uh Jared or uh Melanie or Nick want to make any comments or do does the board have any questions? I can promote folks to panelists if they want to be able to have a conversation with the board of health about this application.
I think they wanted to be able to attend and hear the meeting and be available, but they didn't specify that they wanted to speak at the meeting. Okay. So then I I would ask then if the board members have any questions, Jack in particular, and then folks in the waiting room, if you do want to say something, please
just raise your hand and we can unmute you or promote you into the meeting. So, so for board members who reviewed the application, you heard what Susan had to say. Seems fairly straightforward. Are there any questions, comments, concerns?
Okay. Okay. So, they're not they're not going to um present anything other than the paper. I don't I don't Yeah, I don't think so. I mean, there certain if you have questions, Jack, certainly ask them and we can um have them be part of
the conversation. You you know my general feeling about the geothermal wells, but um I you know, I don't feel like we got it. a lot of details here. [Music]
Um, but again, I feel like this is already, you know, adequately regulated with the other uh town committees and boards and and staff, you know, Aaron Jacques and all
that. I'm just bringing some of some of the things up. So rather than keep everybody waiting, I I you know, I don't know what to say. I mean it it it I don't imagine there's nothing that really red
flags for me um on the project but I think the last geothermal project we had more of a presentation. Yeah. Um so Susan, should we call on um would it be Nick to uh say a few words
just you know Nick is the applicant. Yes. Okay. So Nick, I'm gonna unmute you. I'm actually gonna promote you to panelist so you can join us and you should appear. I would just comment um to Jack and say that you know
when we don't have a lot of detail, we don't request very much information on the application. So I when you look at this summary, I've collected all of the information that we request of them at
the time of the application. So So they did comply with all of that was requested of them. Okay. Did everybody hear me? Yep. Hi, we can hear you and see you. I also did promote Melanie as well since
Susan said that she's also representing the project. So, go ahead. All right. I'm actually on a plane right now, so it might be if Melanie can say a couple things about the um GE geothermal in general. Um the I was at the project
and again you can't hear me just promote Melanie. Um I was at the project site today. It looks really straightforward. Alli Geothermal has done over 8 million miles of geothermal drilling and um this is a relatively straightforward project.
I don't see any concerns um that would be an issue to the the town at all. Um so any specific questions with regards to anything? I didn't sorry I didn't have anything prepared.
Yeah, I mean I guess you know I I don't see this as in a particularly you know sensitive area. Um I don't I don't believe it's within an aquifer you know setting. Um do do you know what the depth of
bedrock is right there? The depth of bed rock is um on the test wall I believe it was about 90 ft. We're going to be sending 6 in steel casing section in steel casing in within 10 ft
into the bedrock. Okay. Back on the and the is it till or sandy gravel? what is I don't believe it's it's part of the town algorith again I'm not sure that was requested but I had on the Tesla we had sandy gravel
up until somewhere between 90 and 100 ft and then it was red do we have a copy of that log So we do not and uh maybe that would be a good thing. We
um did not receive an application for the test bore holes and if we had there would have followed with a well completion report. So I think that's what we're looking for here is a well completion report for the test
wells a bore holes. Yeah. I mean, I guess I just um and whether it's, you know, within a wellhead contribution area, I don't think it is, but [Music] um it looks like on the surface, you know, with regard to working with the
conservation uh conservation commission that the drilling wastes and and and liquids are properly being handled. Um, and Aaron is is happy with that part of it. I guess
uh that is I don't know who I mean the the the town is this is the town project, right? It is. Yeah. So Nick, would you please provide us with
copies of the well completion reports for the test wells and we will add it to your current application and not require you to generate a new application request. I can I can include
those. We didn't do the the well complete just so you know we didn't do those tests. They were completed by another drilling company. But we have it in our Oh, thank you. I was not aware of that. Thank you. We We'll follow up on that and see what
information we can get. Thank you. Yeah, we're more than happy. We have a copy of the drill log and the geothermal conductivity test report that we'd be more than happy to provide, but as far as the actual well completion, it would have to be from the local driller.
Now, who is that speaking? This is Melanie Jud with Allied Drilling as well. Oh, okay. All right. My apologies. Yeah, norm norm. Yeah, sometimes the people are even Susan uh she's speaking in the in the
her a prompt doesn't come up uh within the the Hollywood squares, you know. I thought that I thought everybody once but somebody started speaking that there would be like an icon or something. Yeah, it's supposed to do that, but I I don't know.
It's been a while since I've been on a Zoom call, too. We're usually dealing with Google Meets or uh something along those lines. Yeah. Yeah. Well, well, Susan, my my I don't believe this is within a um an
aquifer a mapped a aquifer area, the the Fort River uh property. Correct. Okay. All right. So, I would I would just say, you know, I'm I'm I'm okay with with voting on that, but
if we just, you know, have that sent along separately, that that would be fine. But I don't think we need to impede um uh the project, you know, waiting for more information. I agree. Mhm.
Um I just wanted to clarify at least for me, Jack, I don't know about for you, but um Susan and Melanie and um um Nick's car cameras were not turned on, but when they're speaking that their name is a big in a big black box on my screen, so maybe that's not showing up
for you, but I'm able to Okay, that's probably maybe it's a setting for me. I don't know. Maybe perhaps. Um but that's that's what I'm looking for, though. Yeah. Yeah. Um, but I also, so thank you for what you just said. And then I wanted to ask though, Susan, I see that Lois has raised her hand in the in the
waiting room. I'm assuming Lois is part of this project. I'm not familiar with that name. I'm not familiar with the name Lois. So, um, just because, you know, in terms of taking comments,
um, it would have to be related, uh, we don't take public comment unless the person's been invited to the meeting. So, I'm not really sure. Um, I think I'm gonna Oops. Maybe I can allow Lois to talk and then just figure out if she's somehow Does any Do either do Nick or Melanie
know who Lois is related to this project in any way? I do not I don't have a Lois. Sorry, my phone cut out while I was on the plane. Still, that's okay. We've actually been able to hear you fairly well. not aware of of
anybody by that name on our side either. Um, so Lois, if you can hear me, um, I just want to clarify that we are only, if you're somehow involved as a driller or person with this, professionally with this, if you
have a concern about this project, that should have been public comment at the beginning. I don't believe we can take that public comment now. Um, so we're only taking comments from people who are sort of part of this presentation who are the folks who have speak spoken already. So in that case, I'm assuming
that you would lower your hand knowing that we can't take public comment from you about this project if that's what your hand is raised for. And sorry, this is very awkward that I can't see you. I'm talking to basically just to open space hoping that you're hearing me. Um, but as far as I understand it, and
please rear anybody else jump in. Um, we don't know who Lois is. She doesn't seem to be affiliated with this project professionally. So, I don't know that we can take a comment from her at this point, but I'm open to other thoughts if I'm mis if I'm misinformed. My only thought is that
sometimes people's usernames are not their names and because they've logged on using someone else's account. Um, so I would be open to to hearing what the person has to say and then if it it If it is not a or hearing whether the
person is part of the team. Okay. If they are not um obviously we can't put their comment in record. Okay. I'm Lois. I'm going to allow you to talk. Hey, this is Jack. Bob Parent just called and that's his wife's name. So
that's Bob Parent. Yeah. Gotcha. Okay. Um so Bob Parent is with the town. Um, yeah, thank you for that clarity. You should be able to speak now. Certainly. Can you hear me? Yes. Yep. I I realized I'd have to log off and log
back on to change the username. So, I'm glad you let me in. Um, for folks that don't know who I am, Bob Parent. I work for the town of Amherst. My title is special capital projects coordinator which makes me the goeteen between the town and the contractor and the designers on projects
like the school project and other projects in town. So um I can add a little bit more information if folks would like um regarding this project. I know Jack you were asking about a well log. I don't have the geotech well log
handy, but I do have um uh test boring logs that were done by Seaboard on behalf of Otto. Um just to give you a sense of what the soil types are down good 60 plus feet. We're looking at
silts and clays most of the depth. Um so it's pretty clear we're not in an aquifer area here. We're in a a pretty dense um area of poor soils. Uh poor enough that as part of the original site preparation, the early site package, we
had to go through a preloading process as well as a ground improvement pro uh process with uh rammed aggregate peers because of the soil po the poor soil conditions. Um so if that helps a little bit, Jack, in terms of understanding
what we're dealing with, that is perfect. Yes. Um I just hadn't seen the resource maps for that area, so I didn't know off the top of my head what we were looking at. And I can add just a little bit of more information to
follow up on what Susan shared. Um myself and Aaron have been working together very closely in this project because Aaron obviously has a major role as the conservation commission agent. I have a role as well in that I'm signatory to the storm water pollution prevention plan on behalf of the town.
So as a town representative, I'm certifying that the storm water plan that the contractor CTA has put together complies with EPA requirements. Um, so both Aaron and I looked at what was proposed very closely and as recently as
yesterday, uh, we were interacting with the contractor relative to what they were planning to do with the dewatering water and, um, Aaron ultimately was very happy with what's being proposed. Uh they're proposing completely separate uh
detention locations for the dewatering water from the site storm water and they are proposing not to have any of that dewatering water leave the site. They believe they can they can infiltrate at all onto the site um after it's detained.
That's always good. Yeah. Thank you. Yeah. So that Yeah. Thanks. Uh so I don't Yeah, I don't have any other other questions or concerns. I don't either. And I'm assuming Premla and Betsy who have not
gotten off mute do either. So shall we take a vote? Um and what what is the I I always get confused on what are we
actually approving just the application or is there something more specific? This is a well construction permit. So you you are approving the well construction permit for application
well-25-1. So moved. Yes, I second. Great. And so all those in favor. All right. Glad to see the project uh progressing.
Thank you. Yeah. Okay. Great. Thank you. And thank you to Nick and Melanie and Bob for joining. I think that's our first participant calling in from a plane is making us all look bad. Yes. All right. So, the next agenda item is
planning future board of health work and priorities. And um I know Kiko had given this some thought, so I'm going to hand it back over to you. Yeah. So I think um a couple of meetings ago we had talked about um what sort of work the board of health
would like to do in the future and we we have spent a lot of time as Premla and I discussed when we saw each other last week on these body art and tobacco regulations more more time I think than any of us sort of anticipated but I think that we've come to some good places um and created good regulations
the board has so it's good it's good work that's been done um I I know that there is a commitment to revisit this nicotine-free generation provision sometime later on where we could do a really good job of um getting more input from the Ammerst community on that
particular issue. So, that's a little bit on hold for the moment. But I think some of the other things that we've talked about and it's relevant I think to our the last agenda item which you made reference to Jack is just the whole geothermal um permitting application coming before
the board um and whether that makes sense. I mean just really thinking about the well regulations in general that are currently within the board of health's purview that could be shifted, changed, redeveloped. So that's one thing that we had talked about. Um, that's uh, you know, something that is really more
within Jack's expertise than anybody else's. It might not be something that makes sense for this whole group to work on, you know, through a series of board meetings as we have with the other regulations, but it is something I think that that the board could decide they want to do differently. Um, maybe it
doesn't make sense to do it the way we're doing it right now. So, that's one discussion point. Um, another thing that we brought up sort of in passing was just the issue of fidation, which we know is very much of a political and a hot topic right now. Um, and I again
don't know whether it makes sense. I think one thing we talked about, the group had talked about was being proactive about some health issues. Um, not sure if fluidation is one of those. Currently, the water is fluidated in Ammerst. There's certainly a move
nationwide to stop fluidating water. State of Utah has stopped doing that. Other towns across the country have stopped doing it. Um, and it's it's it's a sort of nuanced issue, but I think the data are from a public health standpoint pretty clear that fluoride at low levels
does not present prevent does not present a risk and does promote, you know, fewer cavities. So anyway, that's something that I think could be fraught. maybe we don't want to talk about that. Um it's a question to the board. Um but that was something that had come up in
the past. Um the other I sort of ideas that I had was um just thinking back to other things people had talked about before that wastewater surveillance we do for COVID. Um and it's been really really helpful to have that. We know we get actually quite a bit of feedback
from the community about how helpful it is to have information about COVID levels in our wastewater. And there are other things that UMass Ammerst is looking at in wastewater. There could conceivably be partnerships, projects between the board of health, public health department, UMass around different other things that we could
look at in waste water surveillance. Just a thought, just an idea for the board to kind of, you know, think about um and then other then there so those are kind of the first two things are definitely policy things and the board of health is really a policymaking body. So thinking about well regulations,
thinking about fluidation, those are squarely within the board's purview. I think wastewater surveillance, I'm not sure what kind of policy the board could make around that, but there might be something. And then there are other sort of programmatic things. Betsy, I remember that you had mentioned when you first started the idea of defibr having
more defibrillators around um especially in certain places like I think playing fields was one that you had suggested. Um Dia when she was here had talked about, you know, mental health programming. I don't know if there could be policies related to these program areas. Perhaps there are. Um so those
are kind of the things that I was thinking about, but I really feel like it's up to these folks, and we are missing a member, so we do have a a vacant slot, which I hope will be filled in the coming months. It's really up to the town manager's office to do that. Um, but to come up with maybe a prioritized list of things that the
board can be proactive about that we think are really critical to the health of the Amoris community while still reserving some time to be reactive because sometimes we do have to be reactive to things that come our way. But how can the board be proactive about some of these health issues and kind of build on the experience that we've had
together around some of these regulations that might need some to be thought about differently from the board of health's perspective. So those are my initial thoughts. Can I make a comment, please? So, um I'm hoping we don't have to go into
fluoride, but I'm curious about whether anyone has lobbied uh the health department to relook at our fidation. Um, since I've been here, I think I've received a couple of emails, phone calls, so maybe two in the last year and
a half from people who were considering we're were requesting that the board of health look at that issue. But there hasn't been any uh in the current political moment which is question Moride. I have not heard from anybody in the
recently. No, I I I think my own personal sense is uh to not go there then to be to um to not go there un unless there was a public swellow of interest in the issue.
Um I I do uh have a couple of things on the wastewater surveillance. I know. I found it very interesting and I suspect others did to hear that, you know, high levels of flu were circulating in the wastewater uh when that was happening. And I wonder
whether things like flu, RSV, uh, and COVID that do have some, u diagnostic and therapeutic, um, uh, action attached to the surveillance data that, you know, just
monitoring that is a helpful thing. and then connecting with uh local medical providers if that's showing interesting things or publicizing that data. Um the another uh issue that I of
that I thought be beyond the defibrillator issue which I I still think is a really important one you know making sure that that uh children's sports teen sports um uh that that that
coaches have have been trained for for using defibrillators and they're available to sports team team teams. I think I you know I don't I don't know what the policies are on that but I do think that's a very useful thing. Um and I also think it's such you know looking
at the whole issue of the um the town uh pond um that's uh probably not going to open again this summer because of um water contamination. I think there's
a lot of interest, you know, it is a health and well-being issue and um you know I wonder whether an understanding of um what's going on there and is there
anything that can be done to um I'm I'm blanking on the name now. Um Puffer Pond. Puffers. Puffers Pond. I think there's a lot of people very interested in Puffers Pond. a lot of sadness about the amount of closure there. And when I
when I uh interviewed um with the town manager, I asked him about it and he was telling me that basically he thinks that there's just a lot of very marginal septic systems that drain into it and he didn't think it was going to be something that was solvable. But I I do
think there's a public interest as a health um health and recreation issue and um I wonder whether we want to at least be part of that discussion as a as a proactive positive
uh positive issue. So with regard to Puffer Pond, I guarantee you that there are many eager students and graduate students at UMass that would love to uh be able to research a little bit
um with regard to the surface water groundwater interaction around Trevor Pond. And there may be a little bit of that going on right now by one of the faculty there or um the state geologists who who I'm I'm on the water supply
protection committee with uh Brian Yellen. Um but I um you know I could probably even help kind of steward something if we want to take a closer look at that along with the the the well regulations.
Yeah, I should have a little bit more time uh moving forward. So, do do others agree that this is something there's a lot of community interest in? I think so. Yes, I do. Definitely. I've had a lot of people ask what's going on
comes up at the beginning of every summer and it really would be a good idea to explore it as opposed to, you know, throwing our hands up. Um, so I I think it's it would be very
meaningful to the community. The other Oh, sorry. Go ahead, Risha. Well, my my thought process on this is what role can the board play? Um because our I don't know what to call it. It's not a mandate, but um
it's very much to revise. So create new regulations, review existing regulations, and determine variance requests. Um, so I can't figure out on some of these topics and puffers
specifically what that might look like from our end. It might it feels like it might be more of a department of health uh issue rather than a board of health issue. H is it that there's
um is there any complexity about whether it's correct that that this that puffer should be closed for the reasons it's being closed? Is that is that is is there agreement that actually it really shouldn't be used for
swimming? Yeah. So I can jump in a little bit here. So yeah, there's no there's no question that when it's very there the standards are very clear and set by the state that when the ecoli is over a certain level that the pond should that you know it's not safe for swimming. And so that's there's no
quarrel about that and we do a really good job testing and we are in conversation with the state. There's a portal that we upload all the information to. So that that part is clear. What's um what's un what's tricky is trying to figure out what's driving this. There are there are a lot of
reasons and there have been actually quite a few conversations about this and as Jack said, Brian Yellen is somebody who is working with students and other people on general water quality issues in the Fort River watershed and other streams that fill swimming holes in the
area. So there is an effort being made to look at sources um um sometimes when water sources are downstream from farms where there are heavy concentration of cattle that can be a the way bacteria
get introduced into the stream. So there's stuff people are looking at that. Um another source though which I think is relevant to the board of health's purview as you pointed out Risha is um so aging sewers and sewer o sewage overflows can also be a problem
and when people put the wrong things down the drain like fog fats oils and greases and wipes whenever we have a sewage overflow those are the culprits. wipes that are not really disposable even though they say they are on the package and fog fats, oils, and greases.
So, a lot of people may not be aware that when you you can't put olive oil down your drain, even though it's liquid, when it's in the drain and it's cold under the ground, it congeals and that can cause sewage overflows that can leak nasty stuff into the water into,
you know, the wershed. So, this town doesn't have a fog ordinance. Um, some towns do. Um, this is something that Susan and I have talked about. It is something that the board of health could implement. Um, and it would be sort of a very upstream, pun, um, way to address
the puffer pond issue. It wouldn't be everything, but it would it's a possible contributor to the poor water quality in puffers. Um, and it so it's a small thing. It wouldn't fix the problem, but it's related to the problem. And I did notice that I was comparing
what for instance Northampton has as regulations versus what Ammerst has and and that's one of the ones that jumped out at me that Northampton has a policy on that and we don't. So I think Oh, sorry. Go ahead, Jack.
Well, I'm just saying I' I've been on a couple of things. I don't know what the difference are but you know you have task forces which is sanctioned by the town uh you know working groups but it there could be a you know a subcommittee that puts some energy into getting
puffers pond uh to something that's that can be you know utilized and enjoyed for all its intended purposes and yeah I think that that would be something that the board of health
could you know forge ahead on and and and perhaps lead and and the notion I guess there isn't a regulation and I appreci I appreciate Risha that that uh that you have um this expertise about following a charter and
sticking to the mission of the organization but I think when we think about health broadly having safe recreation you know fits people's intuitive sense of what health is and
what the health of the community is. Yeah. And also from a climate change standpoint, you know, cooling centers are very important and freshwater holes, you know, swimming outdoor swimming spaces where people can go to cool off. That's a very real public health
concern, not having those places. Yeah. And and I don't mean to insinuate that it's not a public health concern. I'm just trying to delineate what the what falls in within the remmit of the board versus the Kiko's department of health
um because they are more the implementation and this feels more like an implementation. But I I I see some opportunities here to to think about how to integrate policy into a solution. Yeah, I appreciate you bringing that up because I think that's a constant
tension is just, you know, which falls what what things fall into which purview, policy or program. Is it board of health? Is it public program? Is it public health department? And I think that this is something that has pieces of it that could fall into both spots. Um, so I also know that what thing
something we've done in the past is um sent sort of letters of support or letters of I mean we we could make a statement that we think this is an important thing for the um the town to address from a health standpoint. But we
wouldn't be able to actually do anything beyond that unless they put together a task force and asked for participation in that to my understanding. I am certainly not the expert on how the town works, but that's my understanding. Um,
speaking of a letter and and environmental health, I also would like to see followup about the waste hauler proposal. I know the board wrote when Nancy was the board chair wrote a letter I think a year
after at least a year after the proposal um was accepted and it's still lost somewhere in in committee or something. I mean this and this relates because um
uh trash haulers would then all you know it would have a competitive bidding process and um I'm oversimplifying you would have to look at the proposal but the the piece that's important to me is that they would have
compost pickup for uh for all households. So, um, you know, I would like to see followup on that at least to know where we are on the issue. So, Preml, I think where we are on that
issue is that I've been told that it's going to come back up that there has been this conversation about whether um the town is going to contract with a company that would allow that um composting piece. You're right.
The board of health did have something which predates me that I should go back and look at that sort of, you know, wrote some regulations about this, but I think it hasn't they haven't there hasn't yet been the ability to implement them. So, that's something to look back on. As I said, I'm being told that it
will be coming up again soon this issue, but I haven't heard anything recently. Yeah, I just, you know, I think maybe an update would be helpful. It's just been it's been in process for quite a long time now.
Yes, it has. Yeah. Um I have one other question that I um you know that is sort of it's a bit of a halfbaked question, but it's whether or not there are any concerns
about immunization uh requirements in public schools being weakened. Uh and uh whether that's something that um um you know will be ha handled at a
state level and we have a very good state system. So we may not be uh im impacted by but whether this is uh something that you're expecting to become controversial in in the current moment.
Um so what as far as I know I don't expect that to become controversial in Massachusetts. Um I heard from the um health commissioner Robbie Goldstein at a meeting I was at a little while ago that you know we have high rates of vaccination in Massachusetts. Most
people in Massachusetts are inclined to vaccinate their children. There are just there are pockets especially in the western part of the state where folks are less likely to vaccinate. Um but we have a really good infrastructure as well as funding. There's a pediatric vaccine trust. So if the federal money
were to fall out from vaccines, I think I might have said this in our last meeting, but that there the state could sort of fill in. Um so and and I think I also know that there is some legislation that's being introduced to um do away with the religious exemption for
vaccines and only allow medical exemptions for childhood vaccines. Um which I think has also is gaining momentum. I think that legislation has been introduced a couple years in the past and didn't pass. But the person I know, Dr. John Snyder, who you may know, um, who's been working on that. He seems
to feel like there's good momentum here in Massachusetts for something like that to pass. So, what happens at the federal level is a big question mark. I think there's always the question about funding falling out for many public health things. I mean, I know our counterparts in Northampton have lost a
million dollars in funding as a result of federal their health departments work. We don't have that problem here. Um, so far we're able to get vaccine and I think Massachusetts will be able to continue to get vaccine, but we don't know for certain. There are a lot of things that could happen that are out of
our control. Right. Well, one of the things that I see as the the biggest risk to this is that the EPSDT, which are the regulations that um undergur the the Medicaid program, which covers about half of the children in the
western part of the state. Um, well, it's not just the EPST. There there's a a requirement that in insurance companies pay for uh all vaccination and preventive care that uh
has been endorsed federally. And if that stops being uh an EPSDT requirement or if it stops being uh an adoption of the bright futures
recommendation and insurance companies no longer reimburse for these parts of wellchild care or immunizations, I can imagine that cost could become a real issue for [Music]
uh a lot of families. And I I you know I don't I don't know if that's a you know the the sky is falling down thing to think about when the sky if and when the sky falls down or whether you know just kind of understanding what safety net there is
out here for these programs and yeah it's just hard so hard to know what's going to happen because I think a lot of things that were unexpected have happened and nobody really predicted the the degree of cuts that have happened to Health and Human Services. So, it's it's
a tough time. Like right now, we're okay, but I don't know what it will be like in six to 12 months. Um, so but I do I do feel confident that Massachusetts leadership is very public health oriented, very public health
focused. We have money in the state. you know, it just we we need to take care of these issues on our own, even if the federal government is not providing the support they used to. Yeah. So, you know, but yeah, but you're getting you're getting good uh information that that those funds will be there for you
to feel pretty confident that the funding for vaccination will stay even if those federal programs Yeah, I I do I hope I mean I that's what I'm hearing from the commissioner, right? He was very reassuring in his answer to my question. Um, I do know
that funding has fallen out for, for example, COVID vaccine. So, you know, we we get our we do our vaccine clinics in partnership with the public health with Northampton through the public health excellence grant. That grant is still intact, but the vaccine is very expensive now. It's not subsidized by
the state or the feds. So, Northampton has to find the money in their various funding streams to purchase it. And there used to be a federal stream that helped them. That federal stream is gone for COVID vaccine. So it that it's going to be tough organizing vaccine clinics in the fall. It's going to be different this fall. We don't have the resources
that we had this last fall. That's because of what's happening at the federal level. Um and then I think what you're saying about Medicaid would be if there were changes to Medicaid that's going to affect children across the country. That's going to be tough. So I hope that doesn't happen. Yeah. But even
beyond Medicaid, the the whole Obamacare reforms that required insuranceances to cover everything that had the recommendation of Yeah. of Yeah. I know. So, I mean, this is the I don't
know how this relates to a policy move that the board could make right now. I think it's going to be very important for board of health members to be informed of what what's happening and there may be something that the board would do in response to things happening at the federal level. I don't know. I think we have to be nimble and we have
to be poised to sort of respond in a way that makes sense within your purview. Um but for now we're just doing our best to keep everybody informed and stay on top of things. So um I don't know Risha where you go ahead. I feel like Premma might have tried to say something earlier about an
idea. Well, no, that this was about following up on the um the waist hauler uh proposal and we'll see where that is. Um, I also wanted to say in in um to add
on to what Betsy was saying um about immunizations, you know, I I really feel like we and the department should pay attention to the needs of the more vulnerable of Ammerst's population who
are probably laying really low because of um immigration enforcement and so on. And uh you know I I really would like I mean I this is probably more a
department uh uh initiative but happy to help in any way. Um I know Nancy the previous chair again had done a needs assessment um in Ammerst but I I'm not sure whether
uh you know whether generally underrepresented uh populations were were involved or not and it you know probably requires some outreach maybe work for interns and so on. I I just wanted for
us to be thinking about that. Yeah. I had put on my list um you know health equity which is is not a thing you can do right. It's a very broad um but one of the ideas I had was maybe um
to more holistically sort of prepare ourselves as things come is to try to do outreach to the various other boards that um so you know we've we've affordable housing trust we have the council on aging we have crest
um you know are there groups that we should be strategically building relationships with now so that they see us as an ally if things start getting worse um so that we can sort of work together to protect the health of
of folks. I'm not sure what that looks like. I just know I have never spoken I I served on the affordable housing trust a few years ago so I know them but I've never personally spoken to any of these. There's not initiatives where like the chairs of all the boards get together you know quarterly or something. So
maybe we need to be a little bit more uh proactive in doing that. I know is there a you've been here longest. Is this something that has happened strategically or does it h okay not not
not in my time on the board. So, I mean, there's also the school committees, the elementary school buildings. You know, we we certainly have had some conversations about indoor air quality at the school, at the middle school. Um, so yeah, it feels like maybe
we should be try to be a little more outward f focused as as well as reactive if we don't have to be looking at policies for the next few months. Do we have a sense of um like how what is the vulnerable
population? How large is it? What are the unmet needs? What are the emerging challenges? How many unhoused children, elementary age children do we have in our community? How many
um you know kids have parents that have at risk uh um statuses?
Uh do we do we know who our vulnerable populations are? I know some of these and I think it would be a triangulation of of different data. sources. So there is an estimate on the gaps in affordable housing. So that would be um you know people who are
on the edge of becoming houseless or leaving the area um etc. Then there's the um the schools have good records on who has um school
lunches or uh those kinds of things. And then of course the the senior center has has data on that. So I think survival center would have data on who comes uh for
services um and and the you know the language is spoken and you know they do a lot of work I'm on their board um they do a lot of work with making sure that they both have language and then um culturally relevant food. So they they do have a really good sense of the
proportions of different groups coming in. Um I'm sure Crest and others would have d So I think it'd be a triangulation of a bunch of different sources, but we could get a reasonable estimate. And Betsy, when you were talking about
marginalized communities, were you talking about specifically with respect to vaccination or just more generally? I just think like we're it seems like we're going to be heading in for a difficult time now for many of the families in the community. Who are the
people at risk and uh what are their risk factors? What are their resources? What's the health of our community? um what when you look really big picture, what are the biggest risks in
our community? And um I mean that seems like you know in some ways of course it's a very big picture uh project maybe far removed from the
practicality of you know looking at specific regulations but it it fits an intuitive sense about you know what the mission of improving the health of the community, like just understanding who's at risk, what the
risks are, what the resources are, where are the gaps. Yeah. So, um just a couple things about that. The the needs assessment premola that you mentioned that was done by students that Nancy sort of championed, um it's it's now a couple of years old. Um it it did find some things, you know,
that weren't maybe a surprise. you know, many Amoris residents struggle with food insecurity. Housing security is a big issue. Transportation is a challenge. It didn't really focus so much on the needs of families per se. It didn't have a lot of data about immigrant or refugee folks
and what their issues, concerns might be. Um we are connected with there's a group that meets monthly um um the emergency shelter family shelters um have received a lot of refugees especially from Haiti in the last couple of months and so they most of those
folks have been connected to us for vaccines if their children needed vaccines to be enrolled in school. So Olivia, our public health nurse, is pretty well connected to you. Some of those families actually found their ways to themselves. They found their way to
us without even being referred to us. So I think we are doing a good job of at least people know that we're here to provide vaccines to folks who don't know where to get them otherwise. Um, childhood vaccines I'm talking about. So we have a little bit of a sense of what's out there. But I and but I think
there's a lot more that we could do. Um I also wanted to mention that we really have been um champions of this red card campaign um which we have a big poster in our health department. There are posters all over the town hall. Maheen made a beautiful poster that's we put up
everywhere. Also at the Mante Clinic which informs um immigrants about their rights, you know, should ICE come knocking to your house, what what you can and can't do. what you should do is like don't open the door, slide the card underneath because the the card explains
what your rights are and also emphasizes that um you know town buildings because Ammerst is a sanctuary city that town employees are not allowed to cooperate with ICE agents to enforce any kind of immigration um you know you know any
kind of immigration enforcement. So we wanted people to feel like town buildings are safe spaces. I think there's a lot of fear in the community. I hear from folks who work with largely immigrant communities that people don't want to leave their homes and I understand that. But we also just want people to know if they need healthare,
they can come here. We're not collaborating with ICE. You know, we're to the best of our ability. We're trying to keep people safe to as much as we can and have them have access to resources. So, um, that red card campaign got quite a lot of publicity. There was a news
story that was done and it's the the cards are actually disappearing. We're having to print more of them. So I feel like we're at least doing something there, but you know, being able to help people with more things, challenges like housing and food. I mean, there are food resources, housing is a big issue. So
all that to say, I think we have a sense and we're doing what we can to for people who come to us, but there's obviously a lot more data we could gather about, you know, at risk communities and there's more that we probably could be doing with our limited capacity to reach people. So I don't know if this is something that you think
we should try to gather more data on maybe do a presentation to the board. I don't know whether what the board to your earlier question Risha what would the board of health's role be with respect to this is it just understanding what's going on to your community in your community and going from
there it's going to be it's going to be a big issue I think that'll get worse from here not better I mean one way to think about this is I I think I saw I think I was looking for Northampton's department of public health um policies and found in
Northampton and another uh their health department strategic plan. And so one, you know, one thing we could work on is having a strategic plan. And maybe part of the priority is
a better sense of the need and the the populations. You know, where I come from, we would think of this as, you know, the the causes of morbidity and mortality. What is we don't have a huge amount of deaths here so maybe morbidity is not the right uh qualifier but what
is taking people away from being able to be healthy in their lives. So um you know what is causing that and and help focus the health department because we we probably can't do the things um but
to provide you know that kind of support I it's not really our mandate right that we don't um but if there's want regulations that need to be regulated it feels like it might be anyway I think maybe a strategic plan at
a very very light level I don't mean a, you know, monthsl long, you know, big endeavor, but to to just sort of outline where we want to spend our time um when things are not when we're not reacting to what's in
front of us. Yeah. Did anyone else have any ideas that I I think we've all been taking notes. Did anyone else have any ideas of of things that they wanted to to spend time on that hasn't come up yet? Yeah.
Um I I went for a walk yesterday and had n a number of ticks. Six I I think there were 16 ticks. Wow. And and I I have had lime. I I have chronic lime. Um, so obviously that's
that's a subject that is kind of near uh and dear to my heart. And and this is just using the paths. I just walked down the KC trail and there's no grass. I mean, it's all just lowlying stuff. And yet,
you know, it's just it's it's awful. So anyway, I know I'm supposed to wear, you know, gators and the permit whatever that chemical is. North Socks. Yeah. Yeah. So, um, but I know
you talked about, you know, West, uh, West Nile virus and things like that. So, just continuing that kind of awareness and but it's again another limitation of using our all these abundant, you know,
natural resources in town. We have just so many trails, great trails, and you get this limiting factor. It's sort of like a analogy to the puffer pond thing, not being able to to swim in because of some quality issues. But
yeah, and I would add that vector mosquito-born illnesses is one of those things that keeps sort of popping up in my sphere in terms of people having questions. And um I tried to refer someone to your one pager from last year, Kiko. Unfortunately, I think I
think the town of Ammer's website does is not accessible from overseas. What um I was not able to get in, so I couldn't send the link, but Oh. Um it was the whole town. It's not the public health department. Um, but yes,
it it's come up again on the the parents groups. And so, I mean, I think the two things I hear the most conversation about on from the parents is the school uh air quality and which is that there was a mold uh issue at the middle school
or potential mold issue. Um, and then the the mosquito blind. Okay. So, it's good to know what the things Oh, go ahead Betsy. Go ahead. it is overdose and the uh you know narcan
availability and suboxone treatment in town um you know I used to follow this very closely with the pediatric world I don't know whether those services are
widely widely enough available have you have you heard anything about that one way or another um I think that UMass is doing a really good job getting Narcan out into the community. Tapestry comes into Amoris regularly. Um we do
Narcan distribution here through the health department. I think we could be doing more. Um we just recently entered into an arrangement with Northampton and Eastampton to do um have Tapestry do more work. So we're using some of our opioid settlement funds to increase the amount of Narcan um education harm
reduction work that's going on in the community. So that that's something that we are working on a little bit and I'm actually hoping to get a student intern this summer who could do more assessment and more of a program plan related to the opioid crisis and how to mitigate that. Um so I feel in terms of suboxone
I know some people do it some people don't. What's happening in Ammerst with relation to that? I don't know about treatment options. I know in other places it's available. I don't know so much about treatment here in Amoris, but in in surrounding communities, it's it's available. Is it available through the
Musante Center? I do not know. It's a good question. I don't know. Yeah. So I guess I the only other thing I I realized there was a recent conversation amongst the parents on um bathrooms in the high school were being closed
because uh there was a lot of vaping going on and the the staff sort of couldn't make it to that corner where those bathrooms were and so they just closed them and then everyone had an upper because bathrooms are closed etc. But that to me says that there might be some
vaping, you know, childhood teen vaping um conversations that might be useful. I don't not the we we passed the regulations. There's no more regulations on it, but yeah. Um put that in the mix. Well, I think you've raised a lot of
important public health topics. Um I like the idea idea of doing some kind of a strategic plan but as you said rea you know light because you can spend months doing a strategic plan I don't want to do that but I think some kind of a guiding framework with some thoughts about you know what the what the primary
health concerns are and and what are there any policy angles that could help improve the well-being health and well-being of people in Ammerst. Um that's something that I think we could work on. So my my thought is just to kind of digest this a little bit. Um, and maybe Risha, you and I could talk
more about what we want to do at the next meeting to drill down on any one of these things. Um, but I did just want to ask about the well regulations. Is that something that people have an appetite for now, later? thoughts about it just because I feel like we're it's continues
to come up, you know, these geothermal and other well regulations and how much time does the board of health want to spend on them or do we want to change things up so that we are this, you know, viewing these things differently and when would that be? So, I'm just wondering what your thoughts are about that.
I honestly feel like I add no value at all in reviewing those things. So I would be uh I'd be very happy not to not not to be doing that. I just don't seems like a
more technical expertise and I'm very grateful that Jack has has done that but I I think most of us are not adding much value to that. Yeah. I mean, like I said, I I think I I'm going to be able to get to it
versus several months ago, I I wasn't able to. So, we can start talking about that more in earnest and kind of streamline it a little bit to where we really are looking at health related issues when it comes to
to wells and and drilling and things like that and not the engineering. Right. Exactly. Yeah. That's so smart. So then Jack, that's something that you and I could work on separately when you time and then we could work something up that would eventually come to the board
just for everyone's weigh in. I think people can have some opinion about it even if they're not the experts. Oh, that makes sense. This is what we want to spend time on as a board and then there can be a vote that's taken. So we can be 100%. Okay, good. Good.
Thanks for that, Jack. I think that's a huge value ad. No, I'm I happy to do it and uh just sorry hadn't had time up to this point. So, no worries. I mean, I think it's, you know, decades in the making that people have
been doing it this way. So, if you're able to give it fresh eyes and make it make more sense, I think, you know, that's not a delay of a year. Great. Uh the next on the I the next item is just to decide on our meeting schedule. I suspect this is about
October, but maybe there's more. I don't know if that's Maheen that's leading that discussion or Kiko. Yeah, I can. So, originally we had planned to have the meeting on October 2nd, but we didn't realize that that's a holiday. So, um we can either do the 9th or the
16th. So that I know Jack said he might have a meeting on the knife. It it an alternate uh so this is more important. Uh so it looks like that's going to be
more uh favorable for most everyone. So I I'll definitely be able to to wing it. Okay. So is someone not available on the 16? I'm not I'm not available. Okay. Okay.
Yeah. Are we are we wedded to the Thursday? Um I think for continuity's sake, it's better just to keep it on the Thursday. We've done that before where we've had to switch from the first to the second if there was a conflict. And I really apologize for overlooking the Jewish holidays. That is a big fauxpaw on our
part. Sorry. It's not a big deal for me personally. I these are calendaring is so complicated it's tricky but we do have a list of all the holidays so we need to pay attention to that when we're setting meeting dates. Um but so it did seem like the 9th would be better for everybody because at least one person I
guess it was just Premla I thought maybe it was somebody else too couldn't do the 16th. So thanks Jack for being available. I think that seems like the better way to go. Yeah. And did Okay. in in general. So, Maheen and I just came up with that idea of,
you know, let's not have in-person meetings when the weather's likely to be bad. And so, that's how we came up with the dates that we floated past you all. It sounded like everybody was okay with that. Yeah. Nahim, will you send around the final Yeah, I will. schedule again.
Thank you. Thanks. Oh, you're probably looking at me and I shouldn't be changing my calendar after October 9th. Um, so moving to the director's update. Yeah, I think we actually covered a lot of this stuff during the course of our conversation about um work priorities for the board.
Um but just to remind people that we are doing um public health nursing dropin hours once a week starting May. So in Wednesday afternoons um Olivia has dropin hours and then she does childhood vaccines later in that afternoon. So
that will be great to offer that service to people. We we're actually having a lot more people just kind of come in and want a blood pressure check or want to ask us about something. So we're feeling happy about that. Um, we are going to be getting more COVID tests in. Um, there's still an interest in having them. I
think, um, the low levels are very, very low right now. Flu season is finally over. Um, COVID levels are low, but in the past there has been a summer surge, especially when it's been a low winter COVID season. So, we're eyeing that. We're watching the wastewater carefully,
and I think it may be helpful to have tests in stock if that happens. So, we're hoping those will come in in the next week or so. Um and then Mahina and I are working with other people including John Snyder um Betsy on a vaccine vaccine information campaign. We have kind of
convened a group of people to come up with a slogan and we're going to do a website and so it's Oh, that's great. And that's John John's really good on that. He's loved this topic for ages. Yeah, he's amazing. He's a great resource and he's got the time and it's just and we have a good group. It's very
exciting. So hopefully we'll have something this summer. Also, we'll have two interns to help work on that over the summer and we'll get stuff out there. So, that's exciting. Um, I also just wanted to briefly mention the wellness learning community, which is a a joint effort between public health and
the senior center. And now since I'm in charge of both of those operations right now, I'm paying a lot more attention to this wellness learning community and trying to have it's a weekly thing on Tuesdays here at the Bangs on various topics from stroke education to a
watercolor workshop like a watercolormed workshop that we're doing. Um to the Amoris Police Department presenting on scams and how to protect yourself from scams. Um to a group of people who do hikes in the woods and write poetry and music about those hikes and show beautiful photographs. of the hikes that
they do. So, we're just trying to bring a community of people together to learn cool stuff and connect with each other. Um, it hasn't been that well attended. I think we need to do a better job kind of getting the word out about it. Um, but been trying to work on that a little bit more. Um, I mentioned the red cards
campaign. We still have the red cards kit here. People are welcome to come pick them up so they can give them to folks out in the community. Um and then the last thing on my list was really to check in with Premla about the MAHB um BOH certificate program that you went to
last Saturday and how was it? Really interesting. I you know I I mean I it it um gave me a lot of background information um and you know they spoke about the legal authority
uh boards of health which is pretty broad as it turns out and um you know and then they talked about public records open meeting law conflict of interest um and then
um safe 2.0 know which I wasn't aware of you know and when I when we entered the space it asked are you part of the public health excellence and you know I didn't know I you've mentioned it before now that I think about it but I didn't I
I didn't come to me at the time so um anyway so that's and then they also talked about li liability um protection for boards of health um and then there was also information about conducting
uh quai administrative and quai judicial hearings which you know that there was a lot of overlap with the tobacco uh hearing for instance um yeah so it was well worth attending for me um very interesting
you you may know a lot of this information already Kiko so I'm not sure you how relev it would be for you, but it was very interesting for me as a board member. So, you'd recommend it for other board members? Thought it
Yeah, I hope they do it again because the next one's in Marlboro um in two weeks time and that's a bit of a drive. Um so, I don't know how if they do it once a year. Sounds like they do it annually, do they? Okay. Yeah. All
right. Good. Well, thanks for the report. Go ahead, Betsy. What one other question just in terms of uh uh topics to put in that big bucket of things to think about uh is the primary care shortage in the in in our
community. I mean I don't know whether there's anything we can do about it but um is it just our community? Well I think nationally but I think it is very much a problem in our community.
And when you say our community, you don't mean just Amoris. It's Western Mass. It's definitely an issue in the region, right? Yeah. I mean, it's less so in pediatrics. I think there's, you know, there's some shortages, but I think for internal
medicine and um I I have so many friends who have had one person after another their PCP leave and there's no one available to take them. Um, and you know, I don't know whether I
don't know whether just highlighting the issue and having it on our, you know, on our radar is something that's a problem in search of and Betsy, do you have any like insight on is it because Western Mass, you know, might have
lower, you know, salaries or something like that or just So I I actually have um a a train some of my uh doctor friends have been sharing with me which I could share with this group. Um but
you know part of it is just nationally primary care is um you know is less popular than specialty care and some of it has to do with the cost of education versus
um salary potential. But I think it's also that um uh you know working in an area in western Mass is a little bit harder because there there are fewer of the specialty
resources than there are in say Boston or other places. So that the job is actually harder. And I think, boy, when I used to serve on some of the medical uh uh boards, there was a lot of
um uh like Medicare reimbursement is lower in um in Western Mass compared to uh the eastern part of the state. Um and there's a higher low income. you know, it's it's you know,
it's it's it's f it's it's the money that's available to fund primary care and the resources available for primary care to use to do its job and the overall decline in primary care. I think all of those factors are kind of additive. Um, and there probably are
no easiest solutions, but um I think it's a real problem. Why would Medicare reimbursement Isn't that said? There's a factor that has to do with the cost of living in in
an area. Okay. But, you know, the nursing salaries and nursing shortages are an an issue. Um, so
yeah, I agree. I think it's something to keep on our radar. It's a big problem. I don't know how um the board of health could be involved with that, but just something to think about. And Musante probably I mean I assume
they're incredibly busy, but they probably have a role to play in in being um you know, I I can speak to that. Um, I just I know that because they're
struggling financially, they've had to make some staff cuts which impact uh scheduling appointments for new patients and so on. Um, I I think that's taken a big hit and it's taking a lot
longer. Um, so I just, you know, It's not as straightforward as you would think. No. And I wouldn't think it's straightforward at all. It's even more, you know, it's even more comp. I mean, I just know that, you
know, you have to leave a phone message if you want to make a new patient appointment and then they'll call you. probably not dissimilar to uh the way it is in other primary care offices, but they have fewer staff to deal with
things now. So, yeah, nobody answers their phone anymore. Anyway, that's it for me for my updates. Thank you. Okay, then the next is topics not anticipated. Does anyone have any? Okay. And then if not
then it is time to adjourn. Um I think we need a motion. So moved. Seconded. All right. All those in favor of adjournment. Thank you all. Um it was it
was nice to brainstorm on these topics today. Appreciate it. Yeah. Thanks everybody. Thanks everyone. Have a good evening. Bye. Bye.