All right, I call the meeting to order. This is the Lawrence Board of Health. Welcome. Um, today is October 14th, 2025. And, um, we, uh, would like to begin by roll call, please. >> Dr. Gor,
>> present. Stephen Gil, Dr. Pimeto, >> he won't be in attendance tonight because he's indisposed with patience. So, but we do have a quorum, so we will proceed. Um, do I have a motion on the
floor to >> accept the minutes of September 9th, 2025? >> Second a motion. Motion carries. And so, let's uh move on. Public health updates from Dr. Gor. Um, I just have a few things to say. I'd
like to give my monthly COVID um and flu update. Um, COVID, the last summer surge that we just experienced peaked at the very beginning of September. Um, and cases of COVID 19 in the state of Massachusetts are trending down. Um, but
there's obviously still a recommendation from this board to get your COVID booster, especially if you're at high risk or have chronic conditions. Um, i.e. diabetes, COPD, asthma. Um, they're readily available and in the state of
Massachusetts, no one can be denied a COVID 19 vaccine at one of your localies. Um, next on to flu. Um I saw my first case of influenza A this year in my office about a week ago. Um it's a
little early to see flu cases but um um it's starting. I I did try to see if there was um you know in the state of Massachusetts but there are very few cases reported but I did see a case of influenza A and that's just a reminder to everybody especially our older
citizens um to go and get their flu shot. um they should be able to get their flu shots in either their primary care doctor's office or the local pharmacy. And that's all I have for a local public health update. Um, Caesar,
we're jumping to Caesar tobacco product sales update and we're going to piggy back on to uh public uh tobacco sales update with um the illegal sales activity. Oh, no, no. The uh tobacco 8
South Broadway Street home and more DBA out. >> So, we're going to do it all at the same time. >> We're going to do it all at the same time. >> All right. So, for the record, my name is Caesar Quum. I'm director of tobacco control. I'm not a member of this board. I'm an agent of this board. Uh, recently we did a round a couple a few rounds of compliance checks uh on October 3rd. Uh,
on September 29th, um September 27th and September 26th, we had seven violations. Um only one is before you tonight on a appeal hearing but uh all the other ones
include violations like in sale to a minor allowing a minor to enter into an adult only retail tobacco store presence of flavor tobacco products. So these are just to name a few of the violations that were found through these runs of compliance checks. So these
establishments will be before you either uh on an appeal if they request it within seven uh days within the time they receive the the notification of the violation or uh after they have paid the fine and they come before the board for a tobacco permanent suspension hearing. So they're not going to be here tonight.
The only one tonight will be hookah uh in tobacco. They're outside the sign sheet. I'm just going to call him right now. This is Amala and her attorney. They're representing
>> um home and more hookah tobacco outlet. as well. Just wait until you get a comm so we can't start the hearing. All right. So, uh, Amal Taha representing home in hookah and as well
as her attorney, Mr. Matthew. Can you say your full name, please? >> That's Iser I L E R. All right. You're here tonight representing hookah and tobacco. So, I'm going to do a reading of the infractions and then um Okay, no
appearance. All right. Thank you very much. All right. I just reported to the board there were we we did a a few rooms of compliance checks recently and we had a violation that occurred at home in in Moore doing business as hookback outlet
located at 8 South Broadway here in Lawrence. is uh so the purpose of this hearing is to hear their their uh they requested an appeal. So the purpose of the hearing is to consider their request and decide whether to uphold the $5,000
fine that I issued to that location as well as consider whether to suspend a permit for 30 consecutive business days. Thank you. All right. So counc have a seat. I just want to go through the reading uh and
then you can just pass your big word after you're done. I appreciate that. Thank you. >> So this is the purpose of the hearing to look at their request for an appeal and see if you decided to suspend or to uphold the $5,000 fine. But I issued to that location uh as well as to consider suspending that permit for 30
consecutive days. I want to I want to read the rule to you especially because we have an attorney here present. I want to make sure everybody's on the same page with this here. pursuant to 105 CMR 665045 letter A3 in the case of a third
violation within the period of 36 months from the first violation or additional violations during that period of time a fine of $5,000 shall be imposed. What this means is if you find that a violation occurred at that location and if the violation is a third violation
within 36 months, you must uphold the $5,000 fine. And it says, "And the prohibition on the sale of tobacco products may be imposed for at least seven consecutive business days and not 30 consecutive business days or for a longer term as enacted, adopted or
promulgated in a rule, regulation or other measure by the appropriate and legally designated health authority of the city. You are the legally designated health authority in the city. And pursuant to that portion, you adopted uh regulations that tweaked uh the language
of the state law by saying the following. Uh I'm reading the second paragraph. Presumed to regulations of the Lawrence Board of Health restricting the sale of tobacco products section P violations 1C in the case of three violations within a 36month period, a
fine of $5,000 and the tobacco product sales current shall be suspended for 30 consecutive business days. If you notice the difference in the language on the language of the state regulation, uh the suspicion can be from 7 days up to 30
days pursuant to the local regulation that the suspicion must be for 30 consecutive business days. So here's a summary of the facts. Home and more hookah tobacco outlet violated the affirmation state and local regulations by allowing a person under the age of 21
to enter its premises during routine compliance checks conducted by the law of health tobacco control program. So pursuant to the state regulation, this is the second violation of the same kind. So they allowed the miner to enter that store a while back and they did it
again this time all within three years and this is the third violation within the same 36 months. So I want to go into the definition of what a retail tobacco store is because that's very important to the decision in this case. Hookah uh
in uh tobacco a tobacco outlet is not a regular convenience store or uh grocery store. It's an adult only tobacco store. Uh, and they chose to be an adult only retail tobacco store because they wanted to be able to sell some products that
are prohibited from being sold at local convenience stores in Bavas. Namely, they uh wanted to operate as an adult only retail tobacco store because they wanted to be able to sell vaping products containing uh nicotine content of 5 milligrams or
more. 5% milligram or more. In other words, over 35 milligrams of nicotine per milliliter. So retail stores can do that. Adult only retail tobacco stores can't. That's why they chose to operate this way. Another reason why they chose to operate this way is because a few
years back this board adopted a drug paraphernalia regulation that restricted the sale of pipes, glass pipes, and other drug paraphernalia including hookah pipes only to adult only retail tobacco stores. So by being an adult only to tell us about your store, they
get to sell these products that can be used to our skin. By choosing that, they also uh were put under a high standard. They are expected to stop anyone younger than 21 from entering the premises at all times. Even if accompanied by the
parents, if a parent comes in with a four-year-old, that parent can come in, but the four-year-old can't. So they're both not going to come in. And most stores that operate as an adult only retailer stores here in other cities in the Commonwealth, they tend to operate
with a locked door and a buzza system. They have something similar there. They have like an outer door and you walk into it. They create sort of like a vestibule. There's a door. That door is locked and can be locked with a buzzer. So that is the opportunity they have to
ID the person that's coming in to make sure that anybody coming in is at least 21 years of age. So on the 26th of September at about 12:15 in the afternoon I sent in a 21 year old kid.
Here's a photograph of this kid. He was 18 on the day of that compliance check. He went in the outer door. The inner door was locked. Sule man. He identified himself as sele pressed the buzzer. There were three
workers there at that time. Sulleman was one of them. He pressed the buzzer. He entered the kid entered the store. After entering the store, he was IDed by another worker that was there. And so he was not sold any tobacco products, but they incurred the violation because they
they allowed the minor to enter that store. This is not a minor violation because uh the state regulation treats all these violations as as serious as a self to a minor. And this is a a a historic problem with that location.
I've worked with them for years. I've I I have several warnings that I gave him like verbal warnings because there's no warnings under the state regulation or local regulation. You got to get this under control because people doing it. The door was even left unlocked.
uh you know they were not following procedure and people were coming in and miners were coming in. So this is the second time that I send one of my miners into the location. Okay. U but they not violated the local regulations here. They violated state
federal law as well. They were signed by the FDA twice. They received by the FDA by the FDA uh uh what what's called a warning letter. And as you in your packet. There's I added uh
um an administrative complaint that was filed with the FDA seeking um a monetary fine of $685 if I'm not mistaken because uh this location has sold tobacco to a minor twice just uh in the last two
years. So a minor comes in, they sell tobacco to them. They allow in three times that they allow the minor to come in. They didn't ask for IV. That's another violation. And they sold tobacco to a minor. So, this is not something that happens on occasion. They have a pattern
of behavior that results in these violations. I've worked with them before and at some points I got frustrated and said, "Listen, if you guys don't shape up, I'm going to have to propose to the board of health to revoke your permit. We'll propose to the board of health not
to renew the tobacco permit because we can't trust that you're going to follow the regulations. We don't want kindness to be exposed to the marketing strategies used by the tobacco industry when they enter and install like this. That's why these regulations exist at the state level and at the local level
as well but all my attempts have not produced the desired outcome. So this is a third valuation within the last three years. I'm going to give you the dates of these violations so you can uh have as part of
uh before you can make a decision. Let's see. So on the date that we did this this run complaint checks on the 26 we checked 15 stores we had only one violation that violation occurred at home. All right. So they had a violation on
the 26th of September this month. They also had a civil money penalty issued by the FDA uh that was entered into the state database on April 16th of uh 2024. They also had a warning letter issued by
the FDA on May 25th of 2023 for the same reason. Uh on that document, you can see that on those two occasions that they're mentioning in February 2023, I believe, and there was another one. Let me just site the dates correctly. Hold on a second. Uh on that document, it says
that February 7th of 2024, they allowed the minor to go in. They sold the pack of cigars containing five cigars of the specific brand back with street aromatic. They also did the same thing on May 4th until 2023. Uh they allowed a person younger than 21
to enter and purchase a five pack of Backwoods original cigars. So because of those violations and the the collateral violations that go with them, allowing minor to go in and then not asking for ID, they sought that uh that penalty,
the civil penalty. And they state in this complaint that they uh this doesn't mean that all the violations are here. They're just signing a couple of them to justify why they sought the uh the penalty. So my recommendation to this
board at this stage even though I have considered proposal to this board revoking the permit for good or not renewing the tobacco permit is to apply the regulation as it is written both the state and local regulation. third viol is within three uh three years. Uh it's
a $5,000 fine which I issued and a 30-day suspension of death of accurate crime. >> I have a question. >> Um could you uh once again just go over the dates of the violation? >> Absolutely. So the first violation
in this in this uh 36 months it happens June 2nd. So the first one happened on March 18th, 2023. They allowed a minor to go in without checking ID. That money was not
sold to back. It was just entering. That was the violation. You issued a fine of $1,000. They paid that fine. Then on April 16th, I'm sorry, this would be I'm just going to mention right now the violations that occurred while
I'm performing these enforcement activities. The the next violation occurred on December 2nd. I'm sorry. I'm sorry that's incorrect. So the first one happened on March 18, 2023. The second one happened on February 12th of
2024. And then this last one happened on September 26 of 2025. All three dates happened within the last 36 months. >> Have there been any compliance checks where they actually did what they were
supposed to do? >> Um I believe so. I believe so. There's been a few compliance checks where they Well, they never sold sold to a minor doing my compliance checks. They sold to a minor doing the FDA compliance checks. So the FDA deputize state employees to
work as FDA inspectors for the purpose of conducting these inspections and compliance checks. And on the complaint that you have uh attached to uh the summary of this case today, they have the dates and a full description of the violations. All those two violations
they mentioned and the subsequent uh warning letters or the previous warning letters, they all happened uh at that location. They sold tobacco to a mine at that location. So I'm just going to summarize maybe I didn't understand. So we the city has
caught them three times and then the FDA separate from us have caught them two separate times >> at least two times. Yes. >> Within a three-year period. >> Plus in addition to that the department of revenue also department of revenue issued a suspension of their ability to
sell vaping products for 30 days. You also have a copy of that in the packet that I gave you. So this happened um this was entered in December 12th of 2024. So what happens is D goes does an
inspection they find they found in this particular case it was selling PP products without uh uh collecting taxes. So they cited them and they suspended that that specific license to sell products for 30 consecutive business
days. So this goes above and beyond our local enforcement and and inspection procedures here. It goes it in involves the FDA. It also involves the state department of revenue. You're violating everybody's regulations and they're subject to a high standard because
you're an adult only retail tobacco store. You're not obligated to cooperate as an adult tobacco store, but they choose to do so because of the advantages that they see in being able to sell vaping products containing more than 35 milligs of nicotine plus their pipes.
>> Council, would you like to chime in? >> Um, yes, please. So, I I had three copies um of Yes. Yeah.
And I also wanted to circulate. >> Sorry. >> Thank you. >> A copy. I have three copies here of the um code of mass regulations 105 CMR 665. >> Okay. >> Is it different from the one we just
read? >> I direct you in the circuit of that regulation. Yes. So, I included the whole out the whole section 665. I'm just going through this I'm just going through this handout
which I'm just seeing for the first time. Um, do we know what happened with the uh the FDA proceeding? All I know is that they filed that
complaint for monetary civil penalty and they entered that on a specific date on the state database with department of uh health. So as you can see on that complaint is not even signed but it has a date April 15th of uh I think it's 2024 and then that was added to the
state database on um April 16th of 2024. Okay. Since council mentioned the video, while I was there, after there was a violation, I went to the store. I went to talk to them, confirmed the description. I was there for 45 minutes.
While I was there, they he claimed that while somebody opened the door and allowed a customer to come in, a custod had been identified that the kids squeeze between and entered. So I said, "Well, let's take a look at that video."
So waiting for 45 minutes. While I was waiting for 45 minutes, I almost was assaulted by one of the customers because as a customer was coming in, he was showing a vertical ID, which usually means, not always, that the person might be an M21. So I asked, "Well, has
anybody checked his ID?" Because, you know, he's got a vertical ID and he took issue with that. So he almost assaulted me. But anyways, I waited 45 minutes until Mike, her father, sent the video, uh, the email. I watched the video. When that kid walked in, there was nobody
behind him in the best of you. There was nobody ahead of him in the best of you. And you can see the guy pressing the buzzer and allowing him to walk in. Um so again um we we don't know what happened with this uh Food and Drug
Administration proceeding. the penalty that was issued with this location. I don't know. I don't know what happened. All I know is what's on the record. The the penalty that was issued $5,000 plus what I'm recommending, which is a 30-day suspicion of death permit doesn't take
doesn't take counting the federal offenses or the alleged federal offenses or the DW offense. I'm only counting the violations that occurred under my specific watch. So the first viage that occurred here when they allowed a minor to enter do a compliance check, I was
doing a compliance check. So the second one when uh I responded to a complaint filed with the Massachusetts Department of Public Health alleged they were selling flavor products. I found the flavor products there. I issued them a fine of $2,000. If I'm not mistaken, I think you came in during >> I was here. Yes.
>> Right. So there was a hearing and she was present. And then the last one is this one. >> Can I mention something? Um so that last one where I was here There was one bottle of juice, darker colored, looks like it could have been tobacco flavored. It was chocolate. It
was expired by three or four years. So, it was something very old on our shelf. We still got issued defined and we still got our suspension. But just to take into context, like when you say you had this violation, this violation, that whole violation was off of an expired piece of juice that I would make zero
dollars on. We were not selling flavored products and we do not sell flavored products. I have no recollection of issuing a fine of $2,000 because we I found one item in there. >> If you look back, I guarantee you that is what the issue was and I was present as well. And >> but but that's beyond the point now. I
think >> correct. It's already been issued and that's why we're in this position now because this is just >> But you were here. >> I was here. Correct. Yeah. >> Okay. So just I'm just just so I'm clear. We don't know what happened in
that in that federal matter in that FDA matter. Is that correct? >> What I know about that that matter is that I you have a copy of that complaint seeking monetary civil penalty and there's an entry on the state database
that shows on April 16th, 2024 FDA enforcement civil money penalty. Can you tell us what happened with that FDA complaint? >> I'm unaware to be honest with you. I'm not always present at the I work in New Hampshire locations, >> right? And when you look at the
complaint that's attached, it it describes the following the follow the following protocol. They do the visit, they list the violations, and then they do another entry and say, "Hey, we notify them via letter and they received the letter on such and such day." If you read the complaint, you're going to see
they received the letter in such and such day. So they not only were found in violation but they were notified and there's confirmation they work they received a notification. Then uh on two occasions on October 12th 2017 the FDA issued a
warning letter to that location. The FDA did the same thing again on May 25th of 2023. So there's several several interactions with the FDA where they found violations. They were notified. they have confirmation notification. Uh,
and it wouldn't surprise me because I've been talking to them. I I spoke to Mike, her father. I spoke to I forget his name is always there. >> Hashim. >> Hashim. >> Hashim, right? And, uh, covering the basic things. I mean, it's not this is not rocket science. All it takes is
consistency. I mean, we're we're here trying to apply fines and regulations that we have in the city of Lawrence for a third violation in 36 months. But if you really take into consideration what's been going on with this establishment, this is not the third.
This is the sixth between the DR violations, the two FDA violations, the three uh minors entering and this is the this is the sixth violation. And so over there, why why can't you get this
right? If you were a a medical recreational like a marijuana dispensary, recreational marijuana shop. I mean, you know how they function. You go in, you can't get there's a somebody at a desk to scan
your ID and you don't proceed unless they configure ID. You have to really conduct your business in that way if you want to be a tobacco a retail adult tobacco retail shop. So, you're not getting it right and you fail like every step of the way. And to for him to show
such, you know, kind of frustration, I can sense the frustration with your establishment. We, this board member and I have been very lenient. I mean, one day suspensions when it really should be 7-day suspensions for first offense. We
give people the benefit of doubt, right, and left. And he faults us for that because we don't apply the Massachusetts state law like it's supposed to be. We have searched wiggle room, but you guys are like out to lunch. I'm sorry. This is really I'm looking at this as the
sixth violation. And I personally would take away your license, but that's not what he's proposing. And you're just getting away with the third violation. But I don't know. I I think you guys really on a slippery slope here. And you know, our goal as public health
officials in a board is to try to prevent the sale of tobacco products to minors and and not expose them to extreme marketing. And these rules exist for a reason. And you've just flaunted them and disregarded them every step of the way, thinking that that we're just going to give you a break every time.
And it's it's it's I'm not I'm not in the mood to give you a break at this point because it's not the third violation. It's the sixth violation. I mean, to not pay taxes, to have the FID, FDA breathing down your throat twice and now a third compliance check and you
just can't get it right. It doesn't make any sense to me. >> May I say something? >> Yeah. >> So, we take this very seriously. Obviously, >> clearly not, but I'm listening. >> So, I I do take this very seriously and
we do not allow miners to enter. The specific situations you're bringing up are not necessarily about the minors. You're talking about that bottle of juice and then we're saying, "Oh, would you let an underage person enter?" as well as the FDA things. You're not sure
of what went down there, but you're trying to use them against us in this specific situation we're in. So, it's a little bit >> an entry is not made on a state of based Department of Public Health about a civil penalty on an FDA case.
willy-nilly. >> Can I show the video? >> Sure, >> that's okay. Okay, >> sure. >> I want to see the video. >> I'm going to pass my phone. >> Can you go connect it to there? Play it on there. >> I don't have >> It's really up to you how you want to do
it. >> I wonder if you could email it. Could you email it to there? However you guys would like you this way. >> You've seen it. >> I've seen it. >> You want to see? >> He said, "You have ID?" >> Said, "No,
>> it was way behind." >> We let him go home. We did not allow him to do anything in our store. And the issue is upon entry. You can argue what is entry. Correct. >> Two feet inside. Two feet past the threshold. >> We wanted to get a good look at the guy.
We just asked him, "Do you have ID?" Like, you're making us seem like these horrible people just as long as they want. As long as they just let him. >> He said, "Bring him in. I want to take a good look at him." He comes around, sees
him, says, "No ID." All right. I'm sorry. You need to leave. If we were to sell to miners, you would have sold to him. And the issue here is upon what is entry? Why is this second door necessary? Back when you told us to put
this door in, Caesar, you had said put this second secondary door because you have tobacco on the shelf which is accessible to a customer. We no longer have tobacco on our shelves. >> You >> there's nothing accessible. So the
question of entry, I went to multiple stores in Lel and Lawrence that do not have a a second door or a buzz system. >> You don't have to have a second door. >> So then why so then why are we here? >> Let me just clarify something to the board. The regulation doesn't require them to lock the doors or to have a
second door. The regulation requires them to stop anyone younger than 21 from entry at any time. Entry is being uh is being uh enforced as 2 feet inside the threshold of the door. So you mentioned Lola, if you can see low, there's only
one store that has a vestibule. All the other ones, they lock the outer door. You guys chose not to lock the outer door. You want to have a chance to have the person come in. So if it was rainy, you know, and children were they were coming in, they didn't want to leave the children unattended, the children could
stay in the vestibu, that's why you chose to have the inner door. You're not obligated to have it, >> but they don't have locks on their doors. These other smoke shops in Lawrence and Lel. >> Well, if if there's one in Lawrence that doesn't have a locked door, it's a violation. >> None of them do. >> But the ones you mentioned in L, if we
show one of these establishments, >> these are smoke shops in Lel and in Lawrence that don't have this door. So, >> can I see it? >> When you walk into these stores, >> two of them are in lower, one of them's in. >> Well, if listen, when >> I think there's one, a new one on Newberry,
>> right? There's always a new one. >> Yeah, that's the one they sell retail tobacco stores. >> Sometimes inspections might issue a permit not knowing exactly the nature of the store and issue the permit before they know that this is a a retail tobacco store, like an adult only retail
tobacco store. So, by the time I get to them, they're already open. So when I do inspect them like for example I just mentioned on my report here there was a ANF hookah which is an adult tobaca store on Broadway they allow the same minor to go in that's a violation they
also hated flavor tobacco products in there so we treat everybody the same but we can't be at all places at the same time there's only one person here but that's going to change I'm hiring a contractor so uh there's there's no there's no I'm not giving anybody
permission to operate a open doors here and the other one to open lock doors. Nobody's required to have a locked door. But in low because I covered the city of L as well. All the adult retailers store choose to lock the outer door because if they don't do it, somebody's going to
push the door and enter >> the outer door or the inner door. >> Well, the outer door. The outer door because nobody's required to have inner door. >> You know, they they they wanted to create a vestibule of sorts. >> Can I ask you why? >> There's a place called Yaya. They had a
real vest in you which is which is you open the outer door and then there's in door and everything is locked up to the the ceiling in that location. They have like a and then a door. It's a half door. >> But what is the purpose of that door in your opinion? Because I don't see these
doors at other smoke shops. So I'm a little confused as to why you made >> you guys chose it because you didn't want to lock the outer door. >> Okay. So why are we locking to begin with? My question is why is there a locked door or an outer door? That's the only one that adult retail stores
managers found to properly manage the store because if they don't lock the doors, somebody's going to push the door and walk in. If a minor walk in >> That's not what we You told us when we put the door in. >> Exact. Absolutely not. Nobody's obligate. You guys didn't want to have the outer door locked.
>> That's not what I'm saying. I'm sorry. I think we're just not really understanding each other. The inner door was a choice, a business choice of yours, of your father so he can allow customers to walk in and stay in the vest of you in case there was like an inclement weather.
>> This is not my question, Caesar. I apologize, but why are we required to have this specific thing, the buzzer or even that? >> I just said they're not required to have either one >> with the outdoor >> locked. No, it does. They don't. They
have to contradict. No, the regulation doesn't say you have to lock the doors. The regulation says you can't allow a minor to walk in at any time at all times. So the only way that I found in other locations when people operate
successfully in these types of business is to lock the door and they choose to use a buzzer system. There's their business choice. It's not like we we're not mandated. >> But that's not what's happening across the state and in Lawrence or low. So that's why I'm confused here. We did for
his ID. He didn't have one. We told him to leave. So where? >> He was already inside. He was already inside. >> He was inside because that's how everyone operates. You walk in, hey, can I see your >> absolutely not? >> Yes, it is. >> I covered the city of L and I cover the city of Lawrence. >> And they don't have this system. I walked into this place on Broadway in
Lawrence and there was none of that. I walked in. >> Was that cited? >> Sorry. >> ANF supply. See, we we can't see when a retailer brings up other retailers that might be in violation. I mean, it's just a way to take your focus violation.
>> Listen, guys. >> Um, what can you do to make this better? >> I will do whatever it takes. And I promise you that the first violation he's talking about was out. I mean, it seems to me that I mean, when I look at the videos, Caesar, I mean, I understand
where your point is. Miners cannot enter the establishment. You can't let a minor enter and then say, "Do you have an ID?" And then kick them out. That's not going to that's not We don't want that. We want something different. Do you understand that? >> That's a really simple thing to understand. So, you understand that.
>> So, the way you have it set up and what I saw in the video is in our point of view illegal. Okay. But it to me it looks like a relatively minor infraction. I understand it's a recurrent infraction but it's a minor infraction in the sense that they were
like all on top of him. Do you have an idea? And the dude and they kicked him up. They didn't sell to him, which I find much more of an egregious offense, but this is not the law. He wants it to be done a certain way because he's trying to enforce the law and you guys
are not enforcing the law. So you have to redesign your whole situation. >> So can we operate without the door? And once they reach that counter, it's a very small entryway. Super small. Forget that second door because our first violation was the same thing as what we're
>> You cannot let a minor enter that establishment. >> We don't want them to enter. We just want >> They can enter that outside door into the vestibule, but you have to card them right there. >> Okay. >> Before they enter. >> You can the only store in Massachusetts. >> No, you're not. No, you're not. No,
you're not. You're no different in my eyes than than a dispenser. No different. >> The tobacco store. >> No marijuana dispenser. You're no different in terms of what we expect as public health officials. People can enter vestibule. They cannot enter
establishment until they show an ID. So, you can figure out how to do that. But I'm telling you that if you will be under the the the the magnifying glass and if there's another violation, I'm going to have absolutely
no qualms in implementing a 30-day suspension and a $5,000 fine and most likely reopening your license. >> Understood. >> Okay. >> Understood. >> Dr. May, may I say something? >> Will you be willing to lock the door? Set up that. >> I have to confirm this with my father. I
think it's fine to let people in the best of you. Just don't let them do the best of you. >> Can I ask you a question? Do you believe it was a violation that occurred at that location? >> Uh I think it was a what I would call a soft violation. >> Right. The state >> they didn't sell. They automatically carded. They all all were trying to make
an effort. Right. >> I don't think that was an egregious violation. I don't care whether it was >> Yes. >> Right. But the state regulation makes no distinction. >> I'm not making a distinction. You you can violation. >> I don't think that violation I'm allowed to voice my personal opinion. Yes.
>> I don't think that violation warrants a $5,000 fine and a 30-day suspension. Although it is the third violation, but if they if they had let him in and sold to him, I would be quick to just throw the book at you. >> Well, but I think it's it's important
they understand how the law is set up. >> I understand how the law is set up. If you don't enforce the state, if you find that a violation occurred, you must impose the fine and you must impose the suspension. If you don't, you open yourself up for liability because >> we talked about this before,
>> right? You can't >> a fine like this is like you going out of business. 5,000 in 30 days. >> I don't think they're going out of business. They have multiple sites. >> Yeah. >> So, so if if what you're doing, >> you give us no wiggle room >> because there is none. the more wiggle
room who you have in the regulations. That's why you amended the local regulation. >> I'm more concerned about them not carding and selling to miners. That's my real concern. >> But the thing is, I understand >> there was a concerted effort to card this kid >> and they threw him right out of the store. He didn't even make it one foot into the store.
>> But you're looking at just this, but there's a whole history. Listen, >> well, I understand. But if the history if this violation was more egregious, like they were skipping out on their taxes or they sold to a minor for the fifth time, yeah, I would I would vote to revoke their license. >> But if you found the violation occurred
pursuant to state law, you must impose the penalties. >> I don't know. >> As a board, >> I I'll open myself up to all of them. What do you think? >> Yeah, I I I say I would love to give them a pass, but if you should have brought us something a little bit more, >> if they come again against the board, I
want to revoke their license. This is in the city of Lawrence. There's no other store that has a worse history than this one. And >> well, you don't even let us reduce the fine. You don't even let us >> But it's not me, Dr. state law in a local local vote of health does not have
the authority to reduce a state law fine pursuing. >> Well, I don't you know I the sad part is I wish you had brought me something a little bit more like a sale to minor that. Well, I have to bring whatever happens. >> I know, but that this to do it with this
one is really unfortunate. I mean, with all the violations they've had and you bring us this this is a video of somebody not making it two feet into a storm before they toss them out. So, it's like it's hard to justify making such a >> There's no incentive for them to change
because it happens. >> I think this is more than enough incentive to change because they're going to get their license revoked the next time around. So I make a motion to dismiss uh in the following violation to revoke their license. >> What's that?
>> So I make a motion to dismiss the violation. >> But >> but next uh next in subsequent violation the license will revoke. >> You understand what revoke means? Means you lose your permit forever. >> I understand. >> I second the motion. All in favor?
>> I I Okay, you locked out on that one today. Thank you, doctor. Can I just mention the first entry? >> You got to fix it because the next time you >> Thank you so much, Mr. Thank you for coming.
>> Thank you. Thank you. >> Caesar, do you have a minute? We could just discuss maybe how how they can potentially avoid future problems. That would be have to be accurate. >> Just I'm going to make sure that you know
>> if we can have a >> give you one second. >> Can I take your papers or is this yours? >> Thank you everyone. >> All right. >> Thank you everyone. Thank you, >> C.
>> Um, all right. I'd like to go to the prevent presentation from the beautiful way foundation proposal for collaboration with the city of Lawrence and we have Rajie Chopra and you are also part of >> Yes, that's Jackson.
>> Very nice to meet you both. >> Thank you so much for listening to us and your time. Um, today we're going to present an over beautiful way foundation and we're going to discuss openly uh a new way of addressing public health
within the city of um we're looking to collaborate with the city on some new initiatives centered on public health outcomes. Um Tamika Jackson is the founder of the beautiful um foundation and she will introduce us.
>> Thank you. So, my name is Tena Jackson and I am the executive director and founder of the beautiful way. I started the beautiful way foundation right here in in Boston um about almost two years ago and I came from um life sciences um
making about 25 years in life science industry. So, I was responsible for getting drugs approved on the market to market uh to patients. But the beautiful way I've spent the 25 years focusing on um the product And then I realized I missed the people.
So I kind of switched my attention to be able to help the community. And now our goal is really bridging the gap between life sciences and the community. So what we're trying to do is ensure that we're empowering the the the community to be able to have the people have a person-
centered solution a process in which we operate by and then the policy where we can take the insights that we gather and then make the changes that are needed at the local level at in the industry level as well as even the federal level. >> So our vision here is just really
quickly we are uh paving the way free of barriers so that people can achieve their future potential. Now how we're doing that we're talking about center uh people centered solutions uh that expand access to these uh therapy therapies and so we are doing two things in our
mission we are improving health and we are creating opportunity and wealth in the under reppresented communities and then what we do is we bridge communities and life sciences organizations to do what to build trust. We know that is a huge issue in the
underrepresented community. And so our goal is to improve the engagement so that we can shape the policy. And so I'm not going to go over all of these slides because I think it's important to know that what you're going to see here is the reason why we have to come up with something different is because the
traditional way in which we approach the patient is not working. And the data that is being uh gathered is primarily to be get to get the product approved in the market. But we at the beautiful way see that these that's a a top- down
approach that the life sciences industry use and the bottom up approach of how we want to flip this traditional model upside down is to ensure that we put systems and processes in place that we are going to combat what is hasn't been done very well with the information that
we've been gathering. And so we put community specific social determinants of health components into our process, focus on what the individual needs within the community and then put together a team uh where we're the centralized hub. We triage the issues
and the the barriers that we find and we help find those solutions by uh bringing in strategic partners to do so. So Raj, you want to talk about some of the opportunities that we've seen here in Lawrence? >> Yeah, absolutely. So, so Lawrence is is an important city to us because of its
ecosystem. It's got such a strong commitment to public health. We we think this city is is a place where we can begin to change the equation of public health within Massachusetts. It's successful, but it's not successful
enough. The outcomes in Lawrence are worse for some things and better for other things. They're worse for chronic diseases like hypertension. um they're better for diseases like cancer. Um so this is important. So why are these differences these disparities here and
not in other places? One of the things the list of things that we want to do with Lawrence is here. We want to enhance trust and literacy within the micro communities that exist within Lawrence. We want to most importantly we want to work with the local leaders with
the the city with faith groups with advocacy groups with with the hospital systems with primary care people and we want to identify local leaders in the community to be our ambassadors for these public health initiatives. Our
personal interests align in terms of the research and clinical trial diversity that modern medicine medical innovations are not being accessed by the residents of war and therefore they're not influencing the outcomes. So we want to change that equation. Um and and one of
the big things we want to start with is to improve screening. Um the one that we have ongoing right now is colorctal cancer. We want to really bring a change to the number of people, the number of residents in Lawrence who are screened for these diseases which can make a huge
impact on the outcomes. >> And so what is our value prop in working with TBW? So for the city of Lawrence, we our method our methodology really is to identify community stakeholders like sitting around this table. We believe that if we are going into a city and we
want to be able to support that community, we have to get to know the people's needs by the folks that govern them, the folks that are directly involved with their lifestyle, their health, and we partner with those folks from the county to the city uh representatives. We take a look at
partnering with the FC FQC's, the federally qualified health centers, any faith leaders, and then our job is to understand the data that we're gathering in that community from psychological perspective. Um, we're looking at the social determinance of health. We're we're pulling the data to be able to
prepare for how we address that community from a cultural perspective. The literature that we provide those folks, we want to be able to understand what works best for your community. And the only way that we believe that we can get that information is we start with those leaders of the communities to have
that conversation. And so what that leads to is us building these relationships that increase participation and reduce skepticism. So one of the things that we recognize is that a lot of times this burden is put on the doctors, right? Um to be able to understand what the patients need in the
community and to be able to help them in every aspect of their life. And we look at the doctor as being that sole person or participant in the health journey of a particular community member or patient. But what we realize is it takes the whole community to be able to contribute to the outcome of the health
of a community. And so we are taking this information and gathering a team around us to be able to prepare to enter into these communities to be able to triage and help where we need to focus our efforts on. So for colurectal cancer for example, if there's a um co uh colon
cancer high a high area of colon cancer, we want to be able to prepare that community for the symptoms, educate them on the on materials and and how they can get help and testing that they can get and the risk and all those things. We want to be able to create processes around that in order to do that
effectively because whatever is working for a community, we want to standardize that and we want to educate the community stakeholders whether it's in the community itself or also folks in the life sciences, the corporate realm because they are coming into your communities and they are asking to
support your community's needs. And so we want to be able to train the stakeholders on the information that we're finding, the data that we're gathering to help support the change that needs to be made made and then empower the community itself to be able to understand what is going on with
their health, with their wealth, with their situation and making sure that they have the support that they need. And so the idea is to then turn that process into policy. The biggest thing that we want to do is we want to help cities and counties and even states be
able to make more informed decisions about what's really happening on the ground. We get the data, but are we leveraging the data to make the right change within these communities? We want to be able to help put that in place and inform the city and the county of of of standards and things that we found to be
able to support new policies um budgets that funding standards performance making sure that you have that data. You've been able to understand how that information is actually uh behaving on the ground where you should direct in order to get more of a positive outcome.
>> And so just really >> Yeah. you know, so so we're explaining a lot. We're trying to do as little detail as possible and make it as digestible as possible. Um, to boil it down, the first step we want to do is build a community.
A community which is not vested in a life science farmer world. It's not vested in the existing public health infrastructure. It's not vested in the advocacy group, but rather it's a combination of all of those things. Most importantly, we want to bring people
residents into the conversation who are not already in that conversation. That's step one, that community building piece, which is what we're looking for support from the board of health to do. Steps two and three are the really hard pieces where we try and change the dynamic of
public health engagement within the city of Lawrence. We're trying to improve on a good gas kind of basis point, but we want we need to do more. Um, and step three is the even harder piece of what do we learn from this process that's worked and then how do we influence
future aspects and then we repeat steps two and three. But really it's step one today to see can we partner with the city of Lawrence with individuals within the city of Lawrence to help create this ecosystem this to begin the process of
creating very specific public health engagements for micro communities within bars. What >> are you guys what are your thoughts? >> Well those are a lot of fancy words. Yeah, you struggling so much to present
this in a very succinct way. >> I mean I I I hear a lot going on there. I I just don't Are you looking I mean I it all sounds great to you know you know I you know but it's unclear to me whether you're looking to engage people
in clinical trials or you're looking to improve health outcomes by by this by by this collaboration with the city. I mean I mean a lot of that data is already being collected. We as primary care doctors collect every day of our lives.
Um you know HRSN screens you know SDOH screens social determinance of health is the focus of just about every physical that takes place. It's all documented in EMR. It's all extracted. The data is there. >> So do you mind if I interrupt just one
second? No. >> That's the piece that we challenge because I think you're absolutely correct. We have been collecting Massachusetts is a leader in country doing the outcome of that data collection hasn't resulted in the
benefit to every part of every >> I mean you gave one example of colarctal cancer screening and so give me an example of how data collection can assist in colarctal cancer screening and
how TVW would would develop systems that prove that just for one one example. >> Perfect. Perfect. So, so first first thing to emphasize is that the data we're talking about are not the kind of data you're already doing because we can't do better than the public health
system. The data we're talking about are health narratives and what we're talking about are conversations community members with residents that represent communities to understand >> why they're not going for their colonoscopy, >> what's going on in their lives that that
that kind of prevent them to do >> why are they not going for >> right that's that's the >> lot of I think we're in a new world where collecting those narratives as recordings with machine learning large language models AI we can then use that
efficiently to do microargeting >> give me another example of a public health focus >> so for for this community it would be hypertension >> right and I think you know for forens there's there's no real clear
understanding of why there is such such an issue within this community. >> You know, cancer isn't too bad here. For me, it would be breast cancer actually. That's what we're so women's health is a real passion of ours. But I think for specifically for Lawrence, um beyond the colorctal screening because we're doing
this right now, it would really be moving towards diabetes, hypertension, obesity. Those chronic health issues are complicated. The data we're collecting doesn't reflect this community because this community is so complicated and
diverse. We are collecting and it's making an impact in I'm a resident of Andover in Andover. It's making an impact in Andover and and other parts of the state we are seeing reduced but the delta to Lawrence is getting worse. It isn't translating. And what's
the reason for that? It's not the data collection traditional way. It's something else that we're trying to engineer a system where we ask the question of the residents, >> right? >> What is going on in your >> what do you need from FQC's and boards of health and primary
care docs to facilitate that conversation with individuals? >> Well, we know the data the structure data that we have access to that everyone has access to. But what we don't know, for example, when we go down into uh the city of Roxberry, which is what we're doing now, um we had an idea
that we wanted to be able to of cancer in that city and we wanted to be able to educate this um the community members on clinical trials and the importance of clinical trials and we go to the community and we talk to one of the leaders in the community and we sit down with them and we tell them we're going to call this we're going to have this
event we're going to do talk about clinical trials and she stopped me and she said no no no Tamica you have to understand the people that are here what they're really doing you have to understand that the stress level of the single moms which is the number one head of household in our district in our area
that is that stress alone is something that they're dealing with that's causing mental illness in our community and which is having them the health risk the health outcomes from that is what they're dealing with. We need to understand how to take care of that before you can tell me about a clinical trial. So those are the the data that
we're talking about. We need to understand what's really going on the real barriers that people are facing in these communities that we're not talking about. She also said, "Well, what a and the and the black men in our community, there's a high incarceration rate in the
city of Roxberry." And so, we're talking about the reincarceneration rate or the recidivism rate as well as the suicide rate because they come back into society and they're rejected. They can't get a job. These are the health issues that we're dealing with. Severe mental illness, suicide question,
>> what do you how do you begin um with the board of health with an FQC? How do you get to where you need to go? >> So, we'll be looking for your support to engage unbelievable people like me in helping us to understand where we can
pick the local ambassadors to begin our process. right >> where we'll be we'll be trying to recruit individuals >> and we know all the people that's why >> so this is the support we need and what
we commit to is coming back >> to to give you updates to give you our progress to give you kind of a sense of where we're going and look for your feedback >> as long as long as you're not secretly trying to recruit people for clinical trials and this is the sneaky way to do it because Lawrence has been very sensitive to that
>> and that is why they're here because what we're saying I'm a firm believer that if there is an option opportunity for me if I I'm sick and there's an opportunity for me to get some treatment that may help me I want to know that option I want to make that decision for
myself but that is not why we're here what is important to me is to identify those those hidden barriers that we don't know about that is affecting us the most and that once we identify those it is our job to connect the community
to to solutions that can eliminate those barriers. >> And we are we are to be transparent huge advocates of trust. >> We know this is our >> historically that's the sensitivity and our end we don't get the data to to improve our
situation. It gets extracted and taken to you know >> that is our end goal. Step three really is to make Lawrence a shining example of how this these residents could be at the front of medical. >> I mean, my experience of 30 years here is that there's a lot of organizations
trying to do exactly that, >> right? >> They're not working collaboratively, >> right? And I think that to me is it's not I think that will take care of itself. If we help to eliminate the barriers, then I think that people are going to start paying attention and taking control of their health a little bit more and stop putting it on the
doctor as the responsible person because this is my body, my health, right? And I need to understand it and know my options. And so if I can calm down some of the situations in my life, then that will help me to better focus on that. >> Great. Let me just ask you one more question. How do you get how do you get funded?
>> We grant we are donations. It has been tough. I have to say we're we're we're fairly new. And so what we've been doing is we're partnering with organizations or and not just organizations but with the cities and with the different um communities to be able to raise funds to
be able to do the work that we're doing and it's definitely difficult starting out. Um but >> especially now. >> Oh absolutely now. >> But there is a recognition in the life sciences industry that they are not doing the right thing >> that testing drugs on white affluent
people >> is not their patient population. >> So that's the goal. They want to test their drugs on you know underserved communities. I don't >> I'm masquerating as improving public health outcomes
conversation. That is where it's becomes a little disingenuous in my eyes. So I just want to make sure that's no I agree with you and I think it is our goal. One of the reasons why I went away from the for because I was going to actually add this as a service. >> Sorry to be I think this this is really
important. So so so I I my my career has been in researching new medicines. I I researched a new medicine for breast cancer. >> Okay. >> I went back and I looked at the patient population it was tested on. It was predominantly white women from area but
the prescriptions right now are for the whole population and in fact white women are predominant. I do want to change that. >> I think there's a definitely need to change that. >> Honest. >> Yeah. But I I do want the the goal to be
exclusively we want to recruit more minority underserved, you know, lower economic status populations in clinical trials because if that's the primary end goal, then you need to just come out and say that and then we'll work with you.
>> Yeah. I don't you know what I'm saying? >> Yeah. I think I think let me be very clear and transparent. So when I first started the uh the beautiful way foundation the goal was to increase uh access to clinical trials because I know we are taking medications that we don't
know is safe or efficacious for us. We know that because we're not represented in the data when the when the clinical trials are running. So I am afraid when I realize this my family I feel like is is in danger in some in some cases because there are certain medications
that can kill us that we may not know until after we start taking them. Why is that? Because we're not represented in the data that's being tested. >> I see what you're saying. >> Yeah. >> Okay. Well, we are >> but we want to do it with you and responsibly and transparently. >> We're not.
>> Yeah. And I think but I think to your point that is the that is the message that we're sending. We're not trying to get the numbers up for life sciences. We want to make sure that our children our grandchildren are safe. >> True intention that it's a noble one.
>> No, no, no. I I'd be happy to to collaborate in any way that she'll be your point guard. I'll be speaking to her a lot. >> A lot. Wonderful. >> This is this was our >> Thank you so much.
>> Thank you so much. >> Okay. So, I think um I think there's is there anything else? Legal sales activity, various street vendors in the city. Do we want to talk about that? >> No. 7:30.
>> Okay. Let's take it. Okay. Do I have a motion to adjurnn? >> Uh yes. Make a motion to adjurnn. >> The motion. >> Yes. Next meeting. The next meeting. Stephen, let's look at the calendar. Um,
all right. We're talking November 11th. >> No, you're not. Veterans Day. >> Oh, I just had that problem. >> Thank you. November 18th. >> Okay. >> November 18th, 6 p.m.
>> Okay. I don't mind meeting in here, but sometimes it's fun to occasionally meet down there. >> Oh, miss. They've been construction. >> No, that's okay. So, when whenever it opens up