mary can you hear us recording in progress there you yes i can now okay great okay welcome everyone to the april 7th 2025 meeting of the yarmouth board of health uh just one item to mention
for kickoff here it's a hybrid meeting which we've been doing this since since co um that essentially means people can come to the town hall or they can connect with us listening or actually participating by calling uh and speaking
up there we have a number of ways to get on there's a phone number and i can read it right now and that's 25532158782 or 1312 6266799 and you would enter the id
number which is 871526 3955 if you wanted to speak just press number nine it's a lot this will be on the website if you go there and certainly the connection to zoom in is on the website as
well uh to start with we'll go with some attendance as usual gentleman to my left are you here eric present illard i'm here larry here okay so charlie i know is is not attending tonight
so eric it's okay with me if uh or you rather to call to order the meeting abs go for it okay there we go and i'm here and i'm sorry i'm sorry about mary okay
um we just need a declaration of quorum we we have a new list this was written up a little differently well done very so we're just working our way yeah it's very official looking yeah
makes us feel something i don't know but it's uh so it's it's new for all of us okay so next up was the declaration of quorum right uh since we have four people here um i would declare we we have a quorum would you agree tonight i
agree you definitely would okay so public comment as usual so anyone that's the opportunity to come forward uh make a comment ask questions and anyone could be at home calling in via zoom or right here in
town hall if anyone like to come forward i don't see any hands no hands okay let's let's start we're on number four that's englewood condos60 broadway and uh the topic
tonight is pool rules and regulations um barry any comments to just get this going um so the you come on up and then all right yeah and you can introduce yourself they uh
it's a condominium complex down off of barry avenue on broadway street um it's a transient with the owners that come and go a lot so please sit down yeah go ahead have a seat yeah um and once and
it's to have someone staffed on it it's they're not always there so um we have done this practice in the past we have given you a list of resorts and the even the most previous ones so we'll let them discuss why they decided to come
before you okay so just for the minutes just introduce yourselves carl neof owner okay president of the board of englewood condominium beach association and my name is uh salvig also known as
sunny because it's a little easier lond i'm also an owner and i'm also a member of the board of the condo association great welcome thank you thanks for having us okay so and why are you here tonight so um i know that the pre we are brand
new members um of the board but um we heard that the previous board started the process of trying to um have some relief from the requirement for cpr certification for the pool because it
used to be that some of the units were time share units and they were eliminated in 2022 so as of now the condominium consists of 19 privatelyowned units there are no more time
shares um some of us uh live on premises year round and some owners are only there for a month or two in the summer um currently there are a few units that are rented to year round tenants we do
not permit short-term tenants there and um so when the previous board started the process in 2023 um i think they didn't really know i don't think they got very far but they
had been in discussions with u mr know about this the the procedures and what would it entail and um how how could we not have to have the cpr certification for all the owners um and at the same
time provide a safe environment and a safe um swimming pool both for owners occupants and the neighborhood so that's what we believe that we've been able to do um and so we would like to have a
variance from the cpr certification as well as lifeguard not to have a lifeguard there's never been a lifeguard there yeah okay board members have some questions comments okay miss long did you say there are no short-term like renters
like in the summer or anything no no there's only uh yearly tenants there now that's not allowed that's is that in the deed or is that no it's it's part of the um the rules and regulations that short-term rentals are not wanted
desired or permitted on premises i i have a question sure um under your pool rules and regulations it talks about the owners um who are users of the pool they're required to get training in pool chemicals and
testing and must commit to testing the pool and keeping accurate records as required does that mean you don't have a pool technician who takes care of that for you no we do have a pool technician who comes in i believe weekly but um the
pool was not open last year because there was construction going on the pool area so it wasn't deemed very safe to keep it open but uh the year prior to that uh we had a um system where when an owner first opened the pool in the
morning before anyone was allowed in the pool it would be tested and um it would be kept in a log and so and that would take take place four times a day um we are not seeking a variance from that
requirement so in addition to the pool technician coming in and overseeing the pool the owners are still responsible for daily pool testing and log keeping so is that assigned or is it just depend on the first person to use the pool to
know that they need to do the testing it's u the first person who opened up the pool um and if they stayed at the pool we would have a log where it would be distributed evenly throughout the the hours that the pool would be open
another one other question you you talked about a safe pool for your your owners and residents and the neighborhood but but you are not letting anyone other than owners and residents utilize the pool correct that is correct
thank you sure thank you anyone else mr chair as you can see um phil has provided you a list of other establishments in the in the past that have asked for the same variance right we've we've had at least one of them
come before us yes yeah so is there a request surveillance also for the water safety certification because a lot of those other pools uh have requested that as well the cpr and the lifeguard and i don't see that on on the lifeguard is
not required so no of course not what i'm asking is um are they requesting water safety certification variants on that because it looks like a lot of the pools have three things there i didn't see that on the application um
and i'm not quite sure the details of the water safety certification what that means but it looks like a lot of the pools have a variance i guess in not having the certification i think that's the same one kind of it falls in the same line as the cpr um but they do have
the cho the certifi cpo certified pool operator um that does their maintenance and make sure all the equipment's still up to standards the the emergency phone is up to standards the lines the all the lines
are painted numbers are painted stuff like that are they're they're not asking for a variance for that okay at some point why don't you just get back to us just what exactly the water safety certification's all about uh i would have known if i had seen all the other pools it looks like they asked
for that variance when was the last time the pool was inspected that would have been in the summer of 23 because it was not opened last year it was totally shut down and what's what's what's the approximate size of the pool what kind of pool are we talking about
is uh roughly 22 by 32 ft okay and are pets allowed in the area of the pool no okay i'm not sure that's in your regulations or not i don't think it is no i mean we have a strict pet policy anyway um is only for service animals
and emotional support support dogs but um they're not permitted in common areas okay all right so pretty straightforward anybody and they and they know soon as they uh when the season gets closer that
they're on the list to be inspected phil will go out and do do a full complete inspection for you guys thank you yeah larry i' i've gone on just when i first started the board it's interesting just to do an inspection once with phil he's great so something to keep in mind okay
i i think the the uh rules and regulations seem very very comprehensive and and fairly strict um i guess i just hope that all of the owners are self-p policing because i don't know that anyone else is going to
be making certain that that these are all honored can i comment on that yes of course um so we we had actually a an owners meeting um last week where this came up for discussion and um i i do have to say
that all of the owners are uh if i might use a a good word mature people and they they were very concerned about you know enforcement of the rules and i think um last year um it was also strictly policed because
we are very concerned about the safety there are children on premises and um you know if someone isn't following the rules no one is afraid to say something but um i i personally have no concerns
about that most of the owners are into their 50s and 60s we have a couple of younger families with children but last year or two years ago they were also very good about you know keeping their children in check and and behaving
around the pool so there was never a situation in my mind that i thought you know this this is really not safe it's a fairly um law-abiding group of people who live there do you allow owners to bring
guests the owners can bring the guests into the pool um but if they have guests staying in a unit guests are not allowed to be unsupervised without an owner in the pool area okay and um so therefore
we also have a strict policy with a key access to the pool only the owners are allowed to have the key um the yearround tenants are allowed in the pool area if the pool has been opened by an owner um
but they are not permitted to have a key and they're not permitted to be in there without an owner being present uh we've also implemented um some stricter control over that because for anyone to be able to use the pool um they have to
meet with the board and get a thorough introduction to the rules and regulations and we have a sign signing sheet where they need to sign to acknowledge that they will adhere to the rules and if they do not um their pool privilege will be revoked okay and
because we're a small property we know exactly who's not supposed to be there or not so i think it's oversight in itself okay thank you so um it's time to make a decision about
whether to grant a variance or not so if anyone wants to make a motion that would be helpful uh i i'll move that we approve the uh variance request for 60 broadway west yarmouth anglewood beach condominiums pending a passing
successful passing inspection uh prior to the commissioning of the pool for 2025 second thank you great any further discussion requiring anything anyone so let's vote all in favor of granting the variance just raise your hand say i hi
great okay all right enjoy the pool very much appreciate it thank you okay uh number five here is outer cape healthc care brian smith overview of services provided barry yeah i'm not
sure what what's up rihanna's on on the zoom right now um out of cape healthcare she's going to go over the services we provided so last meeting we talked about um helping people that with hoarding issues with mental illness and stuff
like that and what we could do so i reached out to briana i've worked with her in the past with on several um situations several occasions she's a wealth of knowledge wealth of resources and she's going to tell us a little about what she does and what how she helps other our town and other towns so
that's great it's really a complicated issue for sure so welcome hello brand can you hear me now yes we can yes [Applause] and she did send some slides in so we
have the slideshow over here okay thank you so we're an anxiously awaiting your information for us to get started here well um oh if i am able to see the
slides on my screen i don't know if that's possible um you can just tell me if you want i can move through the here we go thank you oh nope you tell us what slide you want we'll
we'll have it up on our sorry about that it's okay i think it might just be picking up on me because i'm the speaker and then hopping off the slides um over to my blank screen because i'm the speaker but that is okay i will pull them up in the background for myself one
second unless you're able to take the view off speaker liam can you do that you can pin our video on her end if i start talking will it jump to me he said if you pin the video on your
end you'll be able to do it sorry folks talk amongst yourselves we're only five years into this if you can see your slides on your end we can show them on ours right that's what i'm gonna do because i don't think i can pin things with the view that i
have so my name's bri my name's bri um thank you barry very much for the introduction i am the director of behavioral health at outer cape health services and barry asked me to come here tonight to provide some information
regarding what outer cape health has to offer as a community health center um and in particular probably a few of our programs which i'll get to in more detail next slide please you're up
oh outer cape health we provide um and we are a federally qualified community health center um so we provide primary care we provide behavioral health services we provide recovery services uh in particular i've worked with barry in
the past regarding our community resource navigator program and then we have some other uh additional supports that we offer at the health center i'm not sure everybody maybe knows about us as a community health center not just a doctor's office so i was just going to go through some of what we have to offer
next slide please we are a primary care provider you're looking at the lobby of our haritch office right there um we have health centers in harbitchport ac right on 28 across from satucken harbor we have a clinic in wellfleet and we have a clinic
in provintown also in wellfleet we have a uh the aim wellness center that just opened the fall i'll talk a little bit more about our recovery services that happen there so we provide primary care that's pediatrics all the way up um we
do have one midwife on staff um jodie bellson who works out of all of the clinics so we do have we have primary care um next slide please we also have behavioral health services so we provide um a few
different behavioral health services at the health center we have psychiatry most people are pretty familiar with that that is uh a medication management for mental health concerns so some people choose to take medication for uh mental health issues and that would be
psychiatry so we do have psychiatry at outercape health we also offer uh psychotherapy so traditional therapy what most folks might think of when they think of going to see a therapist so we have about eight full-time clinicians
that work as a long-term individual therapist at all of the health centers as well as remote and then we have collaborative care that is a short-term brief treatment model for behavioral health services uh that's for mild to
moderate um type of behavioral health issues maybe grief life transitions the whole thought there is if we can get people timely appropriate care we can keep u behavioral health issues from growing into longer more severe persistent mental health issues so we
offer again our uh behavioral health services both in person and remotely for all of the health centers next slide please we also offer recovery services at the health center so we do a we have
an obat program that stands for officebased addiction treatment um some folks might also know that as mat medically assisted treatment and that's for individuals that have substance use disorders that um a medication is helpful in their recovery process so we
have about 200 patients that are in our obat program and that is again at all three of our health centers in harport and walthy and in province town we do not prescribe methadone but one of the things that i'm most proud about the health center is that we work very
closely in collaboration with other um not only town departments but other uh medical facilities or human service providers so while we don't provide methadone the comprehensive treatment centers in yarmouth does um and about two years ago maybe um they have one
mobile unit that for all of new england and they asked if they could utilize that on the outer cape so that we didn't have folks from the outer cape having to drive down to yarmouth every single day um for their medication so we now have a methadone van that parks behind our
wellness center in wellfleet 6 days a week in the morning so very happy to be providing that closer to home for lots of folks we have oh oh there they are oh no they're gone uh we have a day treatment program that happens at the wellness
center out in wellfleet and that is an iop program for anybody who's familiar so um lots of times folks with substance use disorders might decide to go to detox or to rehab or an inpatient level of care um other folks at times decide
to do outpatient work which might be therapy which is one hour a week but that middle level of care is what's considered intensive outpatient um not a whole lot of places do that gznull does provide that on cape but they have closed the offices that have been
closest to us so we took on the venture probably about five years ago to start a day treatment program that runs now in person in welfle that runs tuesday wednesday thursdays from 9 to 12:30 so the participants get about 12 hours a
week of substance use support that's comprised of groups focusing around early recovery skills relapse prevention long-term recovery planning um that was running virtually until we were able to open the wellness center in
wellfleet and we also offer recovery coaching we work very closely with the towns of harwitch and chadam um through their opioid remediation funds to support some specific recovery coach support so we have recovery coaches on staff who are in recovery themselves
it's a one-to-one peer-based model they're able to help them connect with services and supports related to sobriety and recovery and whatever that means to them so that is a wonderful treatment model that we have in addition to the behavioral health and the medical
services regarding substance use disorders next slide please and then as i mentioned we have our community resource navigator program and that is where barry and i have done some work together um that's an outreach
service that's provided for free it is essentially a community health worker program for anyone who's familiar with community health workers so we provide information regarding available programs supports entitlements benefits and then
we help folks connect to all that uh support and help that's out there in the community so we help people navigate community resources and we do that by next slide please we are assessing for social
determinance of health so when we meet with folks who can be referred from anyone and everywhere including the health department so um i've i've worked with barrier with regards to some homes in town so um people can self-refer other agencies can refer we work really
closely with health departments police departments councils on aging but we ask about these types of issues so food security so do you have access to food and really being mindful if it's not just access to food period is it
nutritious food is it culturally appropriate food is this food that you can prepare in the living quarters that you have are you able-bodied enough to be able to do meal prep and make yourself meals so asking about food but in detail about food we ask about
housing so what's the what's the housing situation again um really going into is this year round housing are we doing a winter rental campground or summer rental shuffle is this safe for you for your family is this affordable um we ask about
transportation is there reliable transportation depending on where you are on the cape this varies is it reliable is it realistic um financial issues are people behind on their bills do we having housing instability because people are housed low behind on their
bills um we prefer any programs that are low barrier and strength-based we love the needy fund that covers the town of yarmouth um always very very grateful for all the financial assistance out there we ask folks if they need any behavioral health or substance use
supports or if there's any misuse that's concerning for them community involvement is another one of the biggies um folks need connection with others they need a sense of purpose we need to have support so it's important for us that we're really helping people
develop their own care team um so we ask about social determiners of health and we listen and then we help connect people back to the programs the services the agencies that are able to provide some support so similar into a situation that barry may have mentioned you know
if there might be a hoarding situation um there's a lot of lot of help that's needed there you know not just behavioral health support and addressing maybe a a hoarding concern um but there's a very practical cleanout of the house um there's there's a trash pickup
and disposal on an ongoing basis so there's there's a lot that goes into any particular situation um but we assess for social determinance of health we help connect people back to what's available to them next slide
please um we like to be very involved in in the community we sit for office hours in the where towns in which we contract with them um for specific support either through recovery coaching or for the navigators we sit for office hours so i'm i'm not a huge fan well now my
camera's off but now you can see me of facebook however the police departments think it's hilarious so um i sit at the east welf and truro police departments for office hours every week for people to find us um you can find us at libraries councils on aging schools so
we sit out and about to make ourselves available but really the bread and butter is we do home visits next slide please and then i what i think is you know one of the great parts as well is that um because we're working in the field and
we see people at home that we get a lot of real time information regarding what are gaps what are barriers and what are ways that we can be supportive of our communities on what i would say a meo and macro level so we like to work in collaboration with our partners and our friends so one of the things that we did
on the outer cape was we started a cultural prescription program with one of the art museums pam um they gave us free museum passes for patients that were lonely that were isolated that needed points of connection um then we were able to find some funding to bring
them on site to run free art classes we've done um four cycles of that and patients love it so a cultural prescription program um very popular as an adjunct behavioral health treatment um certainly good for recovery as well
next slide please we run a food is medicine program um we do enroll people in the town of yarmouth in that that is what started as a small pilot of 25 individuals um working with sustainable cape in the turo farmers market has now become a
covered benefit through a lot of advocacy um a covered benefit under mass health um one of their acos where now this is paid so we are able to enroll this year 75 residents um on the on the cape in this produce
prescription program that is free deliveries of produce every other week in the winter and every week during the season at the truro farmers market um so not only are we able to provide some food support uh and be combating food insecurity in the area but also very
much helps our local farmers when they know that they have 75 people that will be buying from them that week so uh the food is medicine program is very popular next slide please we got a federal grant to embed into or open what's considered a
school-based service site so we have uh we've embedded into monoy high school we have a community resource navigator that sits there full-time to help connect students families and the school with any social determinant of health need um
we have a uh a dedicated therapist um who's actually practicing virt hybrid so she's in person three days a week and virtually two days a week um a dedicated therapist just for the high school students and then we have one of our
lead uh pediatric primary care providers and our women's health midwife who are able to provide medical appointments um all either in person or by teleaalth from a location at the school next slide
please and we are also i'm sure you are familiar with um or if you're not behavioral health innovators that is out an agency out of chadam they started a the alternative peer group which was one of the only and best substance use
supports for youth in the area or on cape cod in partnership with duffy health center um we were approached a few years ago about being the clinical partner for them at pass the positive alternative to school suspension now has been renamed the positive alternative
for student support because um students do not have to wait until they're facing suspension to go they can opt into going so this runs out of the the high school version is at the central rec center which is where you see there we have a clinician that screens every student for
anxiety depression trauma and substance use we then make recommendations back to the family in the school regarding any ongoing care and we hold re-entry meetings um and you can see there from a dy is a sending partner at that school
so students at um dennis yarmouth high school have an option to go into pass if they are facing suspension next slide please we're always happy to do community education and training um
routinely do suicide the qpr trainings which is a 1-hour suicide prevention training um we do trauma i do trauma-informed care trainings for the community as well as for town staff um i will say i let my mental health first aid certification laps but that was an 8
hour training that was a very long one but i've done those for uh police departments in the past um town staff as well as other human service agency staff next slide please and then lastly i will just say that in
addition to primary care and behavioral health and recovery services and our navigator program we do have some other services at the health center we have pharmacies in the health centers we have quest labs in the health centers and the haritch office we have a wick uh office
which is women infants and children's we have healthy connections workers at every location that do insurance enrollment we have a sexual health test and treat program in province town and then because province town is so far away we do have some specialty services
including dermatology infectious disease radiology and opthalmology and next slide please i'd be happy to answer any questions that was great thank you i i really had i didn't have a clue of how extensive
your services are that's great thank you bri um what's your funding for for any particular program or the health center in general for the health center uh in general oh i wouldn't be able to give you the
exact spread i mean we we are a federally qualified community health center so we do get a significant portion of our funding from the federal government um otherwise we also i would say the general two other buckets because i'm not in development would be
um development and we are a a uh a doctor's office and behavioral health office so we do build to generate insurance revenue um that federal support is that you suspect that might be in jeopardy or is that fairly well above my pay grade
thank goodness to speak to i would not i would not necessarily know about the details of that okay could you tell us um how many staff you have in your behavioral health department
it's about i would say 20 25 um actually if and if we want to include the psychiatrist and the obat nurses is probably closer to 35 staff um but between the therapists and the navigators and the recovery staff there's about 25 members so just in
behavioral health and then you've got the other areas that you told us about oh yes outer cape health has about 230 employees okay thank you you're welcome you you do a lot with that we certainly try our best
as for social determinance of health um you help people with medication in other words cost is a is a problem for a lot of people here and it looks like it's going to be a greater problem for people on fixed incomes and question about
insurance yes yes um anytime that there's a difficulty paying for anything it's looking at the options of is there a way we can reduce the cost or get some help with this actual thing or is there um ways we can offset cost in other places
so if somebody's having issues uh paying for their prescriptions of course we're going to look at things like uh your in you know can we get you connected with someone to look at your insurance coverage or is there any financial assistance to help with co-pays or deductible you might have um
or sometimes we have to get creative and say we can't really do anything about the cost of your prescription your insurance is what it is are there any other ways that we can help are there rental assistance programs we could get or food support to help bring down your expenses somewhere else um fin i mean
finances are something for all of us including our seniors thank you one reason i think u the reason why you probably are speaking here tonight was uh the issue of of someone potentially
having a hoarding disorder and uh would you be okay if i just presented a very simple fictional case and just to get your ideas about it something i love that okay
uh let's say um you have a 68 68 year old person living alone uh doesn't have any family um and is living in in an unsafe
environment and is refusing any support so that's that's the case um and i don't think it's an uncommon one here uh on the cape with people who have a hoarding disorder or suspected one
so we welcome any ideas because i think we probably have that problem so i would probably start to look more at at the at what's being deemed unsafe um you know we come up against all of the time um
people not not wanting help so you know it's not always the case of somebody has a need and they're not able to get connected or they're not aware sometimes is that somebody does is says thank you but no thank you um so thinking about
what is making that situation unsafe and um i'm sure obviously because i'm speaking to the board of health it's come to your attention as the board of health um you know so what what are the possible ramifications or what are the
adjustments that need to be made um as opposed to sometimes we have you know maybe family members or neighbors or whatnot that don't like the condition of someone's home or the way they the way they are living and then there's not a whole lot we can do if the person says that this is what i want to do and no
thanks so at the end of the day for us it's all about establishing a relationship and a rapport um i mean i i think i've worked with a few people with barry that you know it's not always the the easiest thing to to come in and do and and try to align with someone um
when they're feeling threatened um you know their own perception of what a situation is so um having to figure out like i said what exactly are those safety concerns and at what level of those safety concerns if they went left unadressed what are the
possible rami ra ra ra ra ra ra ra ra ra ra ra ra ra ra ra ra ra ra ra ra ramifications which sometimes it goes down that path um and then would the person be willing to at least start to work with someone to look at the issue address it in their own pace in their
own time um so i guess that's a very social worker way of answering your question so people have gone to a a home and and trying to speak with someone
who's willing to talk a little bit or the person who doesn't want to talk how do you get therapy started so to speak it i mean it's a disorder a difficult one to treat and you know we all talk about getting a dumpster you know in the yard but that's
that's not going to be the answer uh overall for treatment you know we i mean what we're scared about is if newspapers are stacked up everywhere and you can't even get to a door uh obviously there's there's a danger there and some of these
people have insight into what they have and some of them don't of of their problem right so you know i think that um that is where it can be really valuable i think that the beauty of the navigator program is it's very non-judgmental and
non-threatening because we don't go in as a therapist um because a lot of people don't necessarily want to talk to a therapist or don't think that they have a you know a need a need to so when when we go in and i i will say i still practice as a navigator i'm the director
of behavioral life out of cape health for eight years but when i started i started as a navigator and that's you know still the capacity in which i go out and see folks um so being able to go in there and hear from them um even
sometimes how frustrating it is to have you know neighbors complain or the board of health coming over whatever it may be um going in and not having an agenda about what they need to be doing and and really just kind of listen and see the big picture and sometimes it is something else that they want help and
assistance with and kind of baby stepping it to at some point maybe somebody um recognizing that it's it may be a mental health condition that they want to speak to a clinician about it but um exactly to your point like i said earlier you
know it's not just a matter of connecting them with a therapist i mean then there's the the practical matter of actually cleaning the place out and it's just a lot goes into a situation um like hoarding and it's not always hoarding as well um just cuz there's a
lot of stuff so i think that that's where it can be helpful um if i myself am able to go in as a as a clinician and sometimes tease tease a little bit of it out whether or not it's actually hoarding or it's a situation that's gotten out of control
um so that's what i would say is we don't go in off the bat offering therapy um we go in just kind of being curious about how somebody's doing and often times that enables us to continue a conversation which hopefully leads to
some progress have you ever needed legal services in other words what you're entitled to or legally can do i can see that being a problem you're on somebody else's property who doesn't want you there so i'm not trying to make this difficult
but i think it's it's practical we we need to know this from somehow we don't we don't go where we're not invited i mean it's it's all completely voluntary um so i might go i might co-respond you know i might go out with someone else um
but i us and and on our own do not go out uninvited or unannounced um so we might go out with a health agent to introduce ourselves um and hopefully make a time for us to come back and speak with them afterwards which usually
works other times it's um leaving our business card or information and the person can reach out and sometimes the person flat out says no you know and we respect that so do we access legal services yes for other types of things um because people of legal matters but
not in the case of you know how we do our work i we're of course covered out outer cape health policies but um we're not going in to do anything somebody has not asked us to do okay that's clear thank you so uh barry um if you had a
situation in yarmouth that you were concerned about how would you deal with could could you approach bri about oh well that's how bri and i were introduced yeah um i i go i go out and i assess the situation if there's if the
person is beyond my scope i i'm more than happy bree's always more than happy to get quickly get back to me i've worked with her on three or four cases we've done great things together to help homes and people in in need in this
situation so can you think of a case like a a a pending case that you could i have two in mind that definitely i could i'll be reaching out to bri in the near future
on to get see how we can work together and pick our brains together and get together to do this so is is a can a board of health members help out or is that something we should just again like like brie said it's very traumatic if
like i show up i'm not a small guy i show up in in a big mark car and somebody else shows up and sometimes it's better just like if i go and just knock and talk to them say hey i do you mind if i are you willing to get some help i have a great connection her
name's bri she can she reach out to you and that's a that's a good foot in the or i give them give bri their information or give them bree's information let them connect together and then once they get the relationship established then bri and i get back together and then we continue to work
together to help these people do uh do any of these people have pets uh they've been relinquished i see yeah both of them that i know of have already been relinquished so because my thought is as a veterinarian maybe that's one
way i could help yeah they in a non-confrontational way to the uh the two situations that i i'm can kind of think of both uh the pets have been relinquished to friends or family so was that voluntary relation
not necessarily but they saw it at the they saw the big picture and they knew it was for the best yeah i'm just thinking that that that might be an approach though with a certain person if they did have a pet if we could make the
pet the focal point that we might be able to approach the whole issue from that perspective definitely i'd be it's a great it's a great avenue to try so i'm sure bri would agree with that also i would lot people do lots of
things that they'll do for their pets that they won't do for other people so experience can you tell me of the the hoarding cases that you've worked with how many have been successfully resolved or at
least remediated somewhat by your approach which sounds very reasonable and kind to me oh i don't have any sort of stats off the top you know i think what is
resolved and you know kind of um addressed varies by by the circumstance um and it certainly you know i say go the runs the gamut from you know i won't pretend here from people saying
absolutely not um to you know i worked with a woman who was had was was a um had an issue with hoarding and reached out to me when she was 86 and worked almost until her passing um you know did
we ever make did we ever clean out the house no but was she working on it you know continuously absolutely um so there's there's a lot of different outcomes sometimes it's just dealing with what is bringing them to your
attention and having kind of the bare minimum that's an option and for some people that's what they're willing to do and that's what is will be acceptable um for any code violation so um it it's hard to say i won't say they're all wins
but do i say more times than not the far majority of the time are we able to at least make some headway and progress absolutely well i would call those wins oh thank you erica one of the big ones that bri and i worked on um it was just
they simply just couldn't they didn't have money for a dump sticker and it just had piled up and piled up piled up and bri was able to get her resources and to get a a a a trash truck over there to empty out the garage and stuff
like that um and i've driven by this house and once it was done it wasn't i was 99% better than what it was originally but when i go back and it's definitely not where it was but it's still not where it
was at all so it's it helps it's sometimes it's just little things like that just hey we can do this for you it's definitely not going in and making taj mahals out of these homes but just little things it's like and once they get behind it's just it's scary for them
they just they get overwhelmed with it and we just help them take that extra step and just take that extra little burden off of them so so it's it's that kind of person probably doesn't have a um a hoarding disorder or
obsessivecompulsive disorder that's interfering it's just it's poverty is what you're saying yes right or a situation out of control as brie said yeah a lot of times it's uh people inherit it
from their folks um and they're like they're they're like "what do we do i i don't have money to get 18 dumpsters out of here." so right and it just over time it just it builds up and they don't see it building up because they live with it
but from the neighbors they see it and they but what little we can help with it's it makes it nice and the last property i don't know if i worked with bion but i got a very nice thank you letter from the from the homeowners of
for what we did for them so great great it's terrific anyone else any questions or comments because this has been really helpful thanks for the presentation it was very enlightening brie thank you for letting me reach out to you thank you welcome or
more than happy to come back anytime okay always happy to talk about what we're doing okay thank you be well thank you you as well thanks okay we're up to number six here is the green burial it says it's for a vote tonight uh hopefully everyone got a
chance in their uh to read what i suspect is the final version of the uh green home burial regulation so board members so this is going to be i have a comment this is going to be a vote to move forward to
with a public hearing and then we can go from there so we but it's a vote first on the regulation and if it passes then we would go uh to open yeah okay i i have one comment um and i i hope it doesn't delay anything
but on the paragraph beneath health regulation for green burials on private property in yarmouth massachusetts the last sentence in that first paragraph is missing one word the last sentence should read "each green
burial must first and finally be reviewed and approved by d." where we at again mary i apologize that's all right but but you you it was there originally right what what paragraph we on what page oh
okay we're on the page one we're on the first paragraph of the actual regulation and it's the last sentence it that reads each green burial and there should be a the word must first and finally be
reviewed and approved by dp and that word must is not there it should be between burial and first so it's essentially the second paragraph on the page there are four four lines and it's the fourth line the word and it starts
with burial each green burial must first and finally be reviewed by dp that's a simple fix right good yeah because that that was in the when we made our
original comments i think it was just a omission good good pick up thanks mary that's all i have that's positive anyone else okay
um i don't know is someone interested in making a motion here finally i move that we accept this draft version of the green home home burial regulation for yarmouth massachusetts that one edit right with that one edit
yes i'll second okay any further discussion anyone see there's none let's let's take a vote all in favor of passing the regulation raise your hand say i i i okay unanimous so regulations
passed we we have one so once you okay mary okay don't get up yet anyway um so what's the next step uh next step is uh move forward to the public hearing okay
and how soon can we have that how about the next meeting that's fine yeah okay and but we also need to come up with an application process and a fee process right so okay so maybe is that needs to
be done before the meeting yes okay so there there's stumbling block i guess um can that be done remotely can we do this or not or what do people think or do we need to have another meeting to
produce those two documents we can put together an application um and then i would like the board the board to decide an appropriate fee and then we can put that on the application also sure so if
you want to discuss that now we can do the application and the fee and i can present it in front of the next meeting so okay okay so what would be a reasonable fee we don't have any precedents here we're talking about the the application that's in front of us
now yes the one that we've already seen yeah for the for the green burial represent that application yeah so we're going to we're going to formulate an application and with that application there needs to be a fee attached to it so and the the application will
basically be a checklist right yes ma'am yes okay we'll go through this the green barrier regulations that we just voted on and now it'll just be a checklist right so which which sounds simple but but it's it's going to be a bit complicated because of all the different
things that are involved um what is a reasonable fee do you think barry i would say 250 good that's exactly what i thought why would there be a fee we have fees for everything and hence we're going to
go over all that in a little bit so and it's and it's a timeconsuming as we all know it's we have to review it we have to go it's it's it has to pay for itself so sure right also i mean hopefully covered all
of the different things but we might not have so it could be complicated i spent hundreds of hours on this so far yep uh so it sounds like we need the next meeting uh deal with the application then and then the following meeting
could be the open meeting yep public meeting okay mary any comments eric larry do you need a motion for the for the fee because that's what mary needs from us right now sure
i move that the fee for the application for the green home burial be $250 second anyone second good thank you any further discussion let's vote all in favor of the stated
fee raise your hand say i i i okay it's unanimous as well okay we got that down so we'll start working on getting the application together um i can send out uh drafts to you guys just so you can review it we can email them and then
i'll get the once we get back from you we can update it and then i can get it in your packets and it'll be a quick vote and next meeting so sounds good right there may be an application out there somewhere to yeah i believe there
is with our um to use it and gov program and it's we can take the housing one or another one we can just go from there and then just get all these bullet points in there so great okay uh number seven we're up to that's
the update on rentals pools and housing permits i got that for you great um as of march 15th uh we have received 2,577 uh rental registrations in
comparison of that from a year earlier was the total year of 24 was 3,186 so that means we've already gotten um over 81% of last year's total by mid-march which is great and deb got me these
numbers 10 like two weeks ago so i'm these these numbers have even gone up even more so we're doing really good on our uh rental registrations um again now that we're down an office assistant it's sarah has
a lot on her plate so we're still getting them out our my housing inspectors are working hard every day making calls getting setting up inspections and everything so they're doing great there um and then phil just got me his um food and retail tobacco
motel stuff um out of the total of 159 food establishments the annuals 119 two have not been received yet just um because the they're remodeling and the seasonal uh 47 haven't been moved yet
just because again they're seasonal we we're not surprised about that um retail food tobacco all have been received all 44 um retail food and tobacco motel and lodges we have
59 19 of them have um been done one is closed for renovation and that's not that's the yarmmouth resort they're closed for right now then the seasonals 17 have not been received yet uh but they're all coming along like
similar with the englewood pools and all that all the outdoor pools are phil's gearing up for a busy busy time right now so sure um he he's he's got a lot going on um all the annual pools have been done and the 88 of the seasonal
pools so he's he's this is phil's busy time and i i'm helping him as much as he can but he's been doing it for 21 years and he knows he's got a good system going down so he's not underwater so
not at all good work yeah okay we can move on number eight let's review and approve minutes for march 17th 2025 meeting anyone read it over i move that we
approve the minutes for the april um oh gosh sorry for the march 17 2025 meeting second thank you larry uh any comments on it anything need to be changed added whatever no good all in favor passing
the minutes for the 17th raise your hand say i i okay done and it's open let's see we got new and old business next so for the new and old business a couple things there is a open
meeting law training that will be sent out to the board members since just so you guys can update yourself and be familiar with the new rules and regulations of open law uh meetings so it's just it's a link you can watch it
how long is it sarah it's an hour it's an hour so it's it's good to know it's uh what we're supposed to be doing what you're supposed to be doing so we'll get that information out to you appreciate it that's great um the second thing is i
sorry mayor you don't have it um we do have a list of all of our fees we have been asked by the select board to review our fees um the the board does set the fees we're not looking
to go up by a percentage on every one of them we we need to justify the reasoning um for increase the fees uh so this will be brought up at the next meeting i just wanted to give you this just
to pre okay that's helpful thanks pre get this going and mary i'll get you a copy of this we'll get it emailed to you okay um you could just email it in in the in the past what we have done is um looked at the other communities towns on
the cape yep what fees they are charging and kind of use that as a um a touch point anyway for what what we are and we are in the process of getting um information from the other from the other departments around good good and
we'll get you i'll get you that information also prior to so like i said the select board uh i was at the select board meeting last week and this is something every department is they're getting asked to review so right
right um i have one item from the um rack meeting just one uh mary just still on this um permit fees i just had one question yes sir um is there anything that jumps out at you uh barry uh on
these fees that uh should you should bring to our attention or um there was no not really they're all pretty common um we're thinking about actually maybe condensing some of them instead of
having this and this and maybe just make it a little easier if we maybe want to think about condensing it to be one one fee so and as you can see in the food permits there's a lot of them motel there's some so it's all and there isn't any on here
that don't jump out to me that we don't do so and we'll be adding one more we'll be adding the burial permit application yes ma'am they'll like that so i have one comment from the rack
meeting because i go and i listen and um you know from a board of health standpoint there aren't a lot of things that come up however um on the agenda tonight um the opm said that they had
requested a waiver from mass d on the total um organic uh carbon that's being removed from the treated wastewater that's going to be going to bayberry um and i asked if this had become an issue
when they had requested to um increase the amount of effluent going to bayberry and they said no that this was always always an issue but i hadn't heard it come up before but because it's it's
zone two um there has to be this waiver so you know total organic uh carbon frankly isn't something that i have heard come up in our board of health meetings so barry do you have
anything you can tell me about that uh may that's the first i've heard it also so i'd be more than happy to do some research on this i know i did go out uh month ago when they were doing all the test holes at at
bayberry um they had they did nine nine test pits and they all were very good that exactly what they were looking for so good yeah this is this is treated waste water
but apparently um it is not up to what d requires for being um dumped in a zone 2 mary do you ever get um do they ever
have reports on um waste water or reclaimed water that's produced from facilities that are already um in in production does does that question make sense
in production meaning what like it would be interesting to see a a report done on effluent water that's that's coming out of a reclamation facility or a wastewater treatment facility to so we knew what was being applied at at a
facility like bayberry or one of the golf courses where they'll be using the reclaimed water for i assume for irrigation purposes right wouldn't that be regulated to begin with yes yeah that would be the regulation rather than what other people are doing it would be what
dp requires well i guess my question is is that is that information that's reviewed by rack or is that something that we would maybe source on our own if we were interested
um no i mean we don't look at other communities [Music] um wastewater treatment efficiencies or or results okay and and and you know frankly on the cape i mean
orleans i think is the only town that has progressed that far with wastewater treatment but but it's it's actually you know mass dp's regulations about the total organic
carbon is that helpful yeah it's seems like it would be possible to take a look at that okay mass d i mean i don't know how many other towns are looking at their
effluent being you know brought to bayberry and bayberry golf course and of course that's a that's the the secondary one the the first one's going to um to where the the
um the it's going to parker's river golf first and then it's going to bayberry so um yeah you know i i don't think there's any towns on the cape that are this far along um or that have dealt with
effluent uh needing to go to a secondary location so i'm not quite sure what why you want to know that information i mean this is the the
the consultants are and the people that are doing the engineering are coming up with say these secondary sites and then testing them like barry said they're doing a lot of testing and they're and they're going through a lot of a lot of
meetings at least for the last year about where the additional effluent especially during the summer and we're talking about that's when the most of it's going to be generated you know where it can go um and bayberry was selected as the
place um but again now i guess we're at the point where some of the testing showed that the treated wastewater will not meet their standards dp standards for total organic carbon removed since
it in zone two yeah yeah i mean i guess that's that's my interest right there in seeing not necessarily a report but just understanding what d's regulations are for for that water and i don't know the specifics for that
they just said that they had requested a waiver from the mass d's regulation regarding total organic carbon removal yeah yeah i mean as you mentioned carbon's not typically something we look at right here so that's that's my
curiosity is just you know what does a a report look like for that water just just strictly out of curiosity and that doesn't come to us at at rack no yeah that makes sense that goes to the con you know the engineers and the consultant
the project manager and then they they deal with that um we don't get involved in that level of detail of dealing with the regulatory agencies and all mary thank you like i said it doesn't
come up go ahead mary i was going to say it doesn't come up much that there's something that might relate to the board of health so i just wanted to bring that up that that was out there and the first time i'd heard that it was something that was an issue from the beginning so
so barry how does this effluent get to pump stations right pump stations that's the big the big uh pipes they're putting in and that get it from pump station to pump station irrigation system yes it will be eventually yeah
right holding tanks and then yeah so the big deep pump stations okay and use it my my understanding is that the use of reclaimed water for irrigation is pretty common practice elsewhere in the country
i think so be interesting to learn a little more about it on the cape what's that we're have the greenest golf on the cape yes it may help cut back on fertilizer use then in poland mary thanks again you putting a lot of
effort and time into this thank you i just have one item on uh new business and that's the website which i periodically bring up and um that we don't right now don't have a lot of uh information uh about health issues uh
for the public you know looking at the the first page i looked at before on the website before i came in tonight it was wastewater construction employment opportunities channel 8 emergency communication center and that's what you see um and i didn't find i tried to
navigate the website and really didn't come up with very much trying to find updated measles mosquitoes which we know a lot more about since our last meeting uh bird flu is there's really not a lot on the website i have requests
uh there's stuff on there from a while the uh the person in the it department that did the website has retired they're in the process of looking for somebody so they're they're short two or three people over in the it department so
they're trying to get as fast as we can we we're trying to update i know sarah's has sent a couple um requests i've sent a couple requests so we we have some stuff that we're trying to get on there definitely because there's i think at least one simple thing i had i
had sent it in uh to the health department it was just a list of things about mosquitoes that we learned uh that she had put together to make it very simple some of the key things to keep in mind so it doesn't have to be complicated at all no one wants to read
complicated long things so it may be the top five things on measles that's all i forwarded that email you sent to me that soon as i opened it up i read it i forwarded on and we saw where it landed so i'll uh i'll
get with the with mark as the director of the special services see if he can talk to it to get some more stuff on that if i can participate in that i'd be happy to you can maybe get something up there these are kind of really important issues
uh the next thing would be uh scheduling a next meeting um if it's in two weeks that would be april 21st and we are off that day uh that's easter monday uh that's uh patriots day patriots day y okay so where does that place us then
for the next meeting would be all the way to may 5th or if you want to do it sooner we could do the 28th or we can go all the way to may 5th that's your call board members what do you what would you like to do here obviously an emergency
comes up we meet it doesn't even have to be on a monday so um assuming there are no emergencies what would people like to do hold off till may 5th secret of my own we can have nachos
i'm free i i'll just have to do it by zoom because i'll be in brainree with my grandchildren but i can still make that well the material will be age appropriate so don't worry they can watch
yeah we're we're a pretty good group um i'm okay there so we'll do may may 5th sure sounds good we do have a couple items on that agenda already so we'll be good to go okay any
um applicants for the director position well we we did have a second one right and uh the gentleman that took another job yes and so the previous one yes u so that's where we are right now i i don't think anyone's
being interviewed i don't think so if not that i'm aware of i know that i know it's out there i know it's on the mass municipal association website it's on mhoa website it's it's out there so yeah it's posted
um i know bruce is looking for someone have they found someone you know do not know there's four towns that are looking for directors or assistant directors well what other towns which who uh harwitch
is looking for a senior um health agent brewster and then dennis and i think there's one more town i'm not for sure okay for something what are the requirements for board of health director versus a assistant board
of health director is there a big difference it would actually be a health department we're a separate entity being the board so yes it would be a director and an assistant director for the health department uh but is there a difference between those two positions as far as
qualifications um yes certainly you know more than i do sure on the um what's it called the uh posting the general postings yeah there there's a lot little more qualifications
a little more time effort uh some extra certifications that are needed so i see yeah it's quite a bit of formal education and certificates and then there's previous jobs of course sure
um obviously where someone's living is important you know so that's obviously an issue here on the cape you're welcome to apply sure over my head here so
eric no okay forget that okay um i was thinking of barry okay i'm still looking to get a couple call get a couple more certifications i'm actually currently t enrolled in classes at uh 4c's community college
taking some science classes so i can get enough i have a master's degree and when i went to go apply for the um my registered sanitarium my my certified health officer i was denied and i was really surprised why i was denied come
to find out i didn't have enough science credits um my background is in business so i had math and marketing and stuff like that so i am currently this semester i'm enrolled in 12 hours at 4c's last semester i just went and uh
i'm enrolling in uh four uh four credit short-term summer and another four term second term short term so i'll be taking another eight hours this summer um and hopefully by then i'll be real close to
be able to reapply to be able to take my registered sanitarian okayification exciting that's great yep good luck thank you man i think you're you give the chair here some credit because we're going to get out in time to watch the finals tonight
um right dr vinnie sounds good great last night yes was a great game anyone see it yeah or saturday night actually the last three minutes of the duke game was was great this you don't have to put this in the minutes but anyway
um so who are you going with tonight larry um it's florida and i'm a big 12 guy so i have to go with houston yeah i do too they're not supposed to win but i think they will well i don't
know this speak to you have time they came from both yeah it' be great all right so uh let's move along anyone want to make a roll of motion please i move we adjourn second okay it's at least one there okay all in favor of leaving here
tonight raise your hand say i i okay this meeting is adjourned thank you everyone thank you good night good night mary