Board of Health: November 14, 2023

Transcript captured from MHTV’s Vimeo auto-captioning. No speaker labels; proper names and dollar figures occasionally misheard. Click any timecode to jump to that moment in the source video.

0:24 You all set?

0:28 Alright. Um, I think we’re kind coming into, what, six months of, uh, this board meeting, and I think we’re getting to know each other a little bit, and I just, uh, think it’s a good time to talk about coming together and working together as a team. Could you speak up just a little bit? It’s hard to hear, please. Thank you. I will repeat myself. Thanks. I said we’re coming on to six months of being together as a board, and I think that it’s, uh, we’re coming together and trying to start working as a team. And I, it’s that, um, I’m looking forward to the next six months and the rest of each of our terms.

1:17 So, um, with that, can I, can I interrupt you and, um, would it be okay if I shared a couple of thoughts that I’ve had Recently? You can, you know, I’m gonna share it Somehow. I, I have A feeling. Yes. Um, So given, um, it looks like the actually minutes Address the chair, but The chair Yes. I may, I have a few minutes to share some thoughts. So, um, let’s see. I, last week I was on vacation and I was in Italy actually, with my husband, and it was a dream vacation. And, uh, while I was on the vacation, I received an email from my colleague and he was expressing some concerns. And, um, it, you know, brought me back

2:02 as oftentimes we’re on vacation and we have to go back and think about things. We had responsibilities at home, but also I wanna share that while I was on this vacation, it was actually the second time I was in Italy, and the first time wasn’t, you know, The easiest time. I, I got an invitation from my college roommate. She invited me to come, she had a place in Italy, and I had three little kids. And I, I was like, of course we have to go. But it was kind of a, um, a challenge because we had lost my children’s father the year before. And so I was like, what do you do with like, taking three little kids to this country? And I did it because I came up with this calculus that, um,

2:49 we had lost their dad, and if he had been with us, we would’ve gone. So I thought that if we go, it’ll be one less loss about that experience. And I was reflecting on it a lot while I was away last week thinking what a difference it was. Having three kids that are like, no more churches, no more museums. And, you know, and the contrast was pretty, pretty bold. And the reason I wanted to talk about this this evening is because it’s a story that I would share with colleagues if I was at my job. And I have shared kind of these stories with my colleagues at my job, because when you work with people, you often get a chance to know them by having conversations with them and learning about them and learning their stories

3:34 and what’s important to them and how they see things and what their perspectives are. And I, I just think it’s a really, really important part of working together, building trust through conversation. So that’s kind of why I thought that might be a fun way to really kind of demonstrate what we’re kind of missing here, working as a board of three, that we don’t get to talk outside of public meeting when we’re in public meeting. Um, it’s kind of time constraint, and I’m taking up some time here, but it’s a real challenge because we can’t have those conversations and build the kind of trust that makes for really positive and impactful working relationships. And thinking about this, I thought it was valuable

4:19 to talk about last month we did come together as a really, um, unanimous, uh, op opportunity to say, we need to change this. And we voted on having a five member board going forward. And I think there’s so much value to that because it’s gonna enable us to have really important conversations and learn one another’s perspectives and build the trust and communicate, which is really essential, I think. So I’m very grateful that we are able to successfully and unanimously put that forward. And Ben Helene also put forward a suggestion for another solution last month about having a subcommittee around public health and looking forward at different obstacles

5:07 and challenges we’re gonna have down the road. And what do we do, what do we need to do to prepare for our public health future in Marblehead? Um, and again, unanimous vote, I think each of us lean in and said, yeah, that’s really important. Great idea. Let’s do it. And we voted and I I thank you for your leadership in those two initiatives, Helaine. And, uh, two months ago, Tom, you brought up fentanyl strips. Mm-Hmm. And what a timely and important and impactful that was that you left, because again, the three of us heard your argument and agreed with you, and we had a unanimous vote that this should be accomplished. And I just think those are three really important things

5:53 that we were successful in doing together. And, um, I, I think now with the news, the Boston Globe was talking about what happened in Lynn this past week with a millions of fentanyl pills that were confiscated. Um, but what, what, we don’t know what was still out there. Those were found and destroyed and taken away and out of the sales cycle, but there’s a lot of threats out there. And so now we’ve got these trips and I’m really grateful that you led with that. So I just really wanna focus on the fact that we’ve had some great success as a, as a Board of Health recently with some of these initiatives. And, um, also, I wanna, you know, take a moment

6:41 to address the concern that Tom raised to me when I was on Italy back to Italy. We can just go on and on about Italy. But, um, I think part of your concern was about feeling unheard that you were not being heard. And that is, that is, I, I wanna apologize for that because we should all be heard here at this table. We are all elected members of the Board of Health, and we each were elected by the voters in Marblehead and Helaine and myself and Tom were elected different years. And I think if we can move forward and listen to one another and also speak to one another as

7:30 the people that were elected by the voters, because we’re kind of speaking to the voters in a, in a manner of speaking. And, um, I, I just think that there’s so much that we can do together successfully. And I think we’ve already got a platform here. I think I named three initiatives that I’m really grateful that we are working on. And both of you have led in those areas and we’ve had unanimous support as an organization. Um, and it’s our responsibility to, uh, execute our role as elected officials. So I have some confidence that we can proceed positively. And I, I, uh, I just wanted to make those statements

8:15 because this was a lot of my head space when I was on this trip. You know, I had time to actually really think about this. And I, I look forward to working together, and I think in the future when the board is five members, it’ll be a lot easier to, to understand one another’s perspectives and to build that collaboration and respect sooner. And I just have to say That I’m very touched by your very personal words. And I, I’ve known your story, but I haven’t heard it like this. And you’ve given us much inspiration. And, um, I know now that we can all be a team, and that’s what I asked for when we opened.

9:00 And, um, I just think back about our first meeting when I, we talked about, uh, coming together at our first meeting that I looked forward to healthy discussions and, and collegiality, and we address issues and to improve the health of our residents. And it takes a lot of teamwork to do that. And I hope that we can continue. So, um, So naturally we’re talking about the, an email I sent to the other board members about my frustrations, about my agenda items not getting on the agenda. And this has been something since day one. So what I have to do when I’ve cut, when I put agenda items on there, and like I said in the email, Joanne, I don’t know

9:47 how aware you are of this, if I put five or six things on there, I’m expecting maybe one or two to get on. I’m doing a lot of work outside of this. This past weekend I spent six, seven hours talking to families affected by substance abuse. I mean, these types of, and that’s just one thing, you know. Um, but when I put all that work and then I can’t have the conversation because it’s not brought to the table, I go into every meeting knowing when I see the agenda, I’d be like, okay, I can weasel this in here or insert this in here. And, and it sounds, my mom watched a meeting for the first time last meeting, and she goes, you know, I like everything you’re saying, but it sounds like chaos. And I’m like, yeah, that’s ‘cause I have to insert everything into a, into these random areas where I think they fit. And that just shows lack of respect for me.

10:34 I was elected on, on ideas. I know emails were sent before I was elected saying I was a liar. They never pointed to a lie. ‘cause I never lied. But, um, you know, you, you gotta accept. You can disagree with me and that’s fine. I’m totally fine with that. But I go into every meeting and my mentality is I have to insert this in somewhere. Helene’s gonna object and obstruct and I have to convince Joanne. And that’s my mentality every meeting. And that’s never the way it should be. If people have followed me at all when I, when you did the three five, if you bring an idea that’s up there, you, you don’t hear me object. If it’s a good idea, I don’t like, if it’s a good idea, I’m with it. And it’s the same if you’ve seen me outside this, A lot of people fall on my Facebook, you know, that watch these things.

11:19 I’m not a democrat. I’m not a Republican. I believe in ideas only and I shut out anything else. And the, I will listen to an idea and if it’s a good idea, I’ll go with it. I don’t play teams, I don’t play favorites. I don’t do any of that. So I expect the same kind of respect. And when I put an agenda item out there, realize I worked real hard on it during that time and that I expect it to make that agenda. And if there’s not enough time on that, that’s why I said maybe there’s another meeting, which last meeting we said, well, if there’s more then we’ll do more meetings. I always have more Thank you for your thoughts, and I’m sorry that you feel that your agenda items aren’t on there, but I too got, as Joanne said, got the email, which I’m not sure whether it was it breached the open meeting law.

12:06 I didn’t care if it did or if it didn’t. But I specifically wrote on it, uh, this is not a dialogue, did not respond to it. So it’s just a statement. So if anyone wants to file an OML on me, that’s fine, I’ll do it. But It went to three people, two other people. Mm-Hmm. So I, I’m, I’m not, uh, knowledgeable about that. I’d have to look into it, which I haven’t chosen to do. But, um, I, uh,

12:30 want to say that once I saw that I looked back on all your requests with Andrew and all your requests were on each of the, I brought copies expecting you to say that so I could show that they’re not E each of the three, I have the copies too. They’re in here. I’m not gonna take the time to do that. We have a doctor here that’s gonna speak to us. We can, uh, uh, send that to Andrew and we can, we can see that, uh, to see, you know, exactly what is the case. But I’m glad that we’ve had this sharing tonight. And, um, it seems that we all are frustrated. And I think that now that, as I said that we’re next month, six months into the, uh, year, and I, I am sure

13:15 that we’re gonna move forward in, in a positive way. So with that, um, I would like to ex tell everyone the first item on the agenda is approving the minutes, which are not here. Yeah. Uh, our administrative assistant has two jobs with us. He not only sits here in the evening, he’s at the, he’s in the office during the day, then he has to run over to the transfer station, which is where we stole him to begin with. Maybe he likes him better over there than he likes us. I don’t know. I like you pretty well though, so, so he’s doing a great job. So, um, look for those next month. Um, if you wanna see the meetings again, you can look them up. So, uh, we’ll have those for the summary.

14:03 Um, Dr. Thomas Mauro, would you like to step up here? And I’d like to have a few words to say. Um,

14:17 I’m pleased to welcome you tonight, uh, Tom, uh, because you approached me with some ideas that you had and, um, together we’ve de we determined that we could help the Board of Health work toward the future. Our board is busy with our day-to-Day work for our Marblehead residents. Dr. Zaro will speak tonight for us about a long range planning for our local public health. But before Tom begins, I want to give you a small insight into his extensive bio. Pardon me if I don’t do justice to these, this, You don’t have to go through anything. I’m here as, as a resident of Marblehead. But, you know, a lot of us know, even a lot of us do not. And I think if we’re gonna listen

15:04 to some professional remarks and see them on the screen, I think that you’re, you’re deserving of it. Uh, and Dr. Nazar received his MD from the University of Wisconsin, his business degree from Stanford, the Graduate School of Business, his engineering degrees from MIT Cornell and the University of California Berkeley. His residency is training phone at the University of Colorado in Denver.

15:32 And he, uh, he’s a Harrison Foundation Professor of Medicine and Law Emeritus at the University of Virginia, where he served in numerous capacities, uh, both in the, uh, medical school that the Graduate School of business. He is an attending physician. And then he did a real about face, I shouldn’t say a about face, but he went to Botswana and founded, he was the founding dean of the, uh, school of Medicine, a brand new school of medicine. So, a at that makes me feel real good about it, something like that. Uh, in the past, his research has been supported by grants from NIH, uh, the Colorado Heart Association,

16:18 cystic Fibrosis, the Commonwealth Fund, among others. So I think now I’d like to present Dr. Zaro. Thank you. I brought some hard, not that I don’t trust the technology yet, Andrew. A couple of hard copies if anybody wants, but I, I welcome the opportunity. Thank you for the introduction. I welcome the opportunity to speak about the future of public health in the US and in Marblehead. ‘cause I think we can align our future with what might be going on in the country. Um, do I have the slides or I’ll stage them up. It’s really a good time to be reconsidering public health

17:06 at the local level. I think it’s a great time because I’ve been here 18 months now, and most of the conversation in this meeting has been about the transfer station. The transfer station, I think we’ll hear a little bit later, is poised to come to a very positive and successful conclusion after many years and many dollars in the state. So that’s a real positive. At the same time, nationally, there’s an awful lot of introspection going on in part because of the, the pandemic. But nonetheless, people are looking at what we can do to make public health better in this country.

17:52 So, let’s see. I I, I wanna see at least, is there any way we can help align those two, those two, uh, uh, change change levels? Uh, next slide, please. Um, the, the, the general the next slide, please. Yeah, it takes a little general Oh, okay. Delayed. Yes. Sorry. If you, I, I, there’s a couple of references, but there are hundreds of post pandemic assessments out there. And I think the bottom line out there really is that the federal government really was unprepared to deal with a crisis like it had, whether it was the White House or the FDA or the CDC, uh, but there were more problems than we needed.

18:40 I was Chief Medical Officer in New Mexico at the time, and I can tell you, chief medical officers for every state in the country, met twice a week to try to figure out what was going on in Washington, how we could pass it on down to the local jurisdictions. By and large, all things considered, I think the local jurisdictions, the local communities, did a fantastic job given the confusion that was coming outta Washington. And so that’s where we are. That’s why the introspection is occurring out there. The next slide really talks about, well, the red line in this, in the red sentence, in this slide is important because it, it reconfirms the importance of community health

19:28 and how it impacts on individual health. It says, communities make a difference. We can exercise, we can eat well, we can do those sorts of things, but the environment in which we live also influences our health status. Now, the challenge in the United States, next slide, please, is that we live in the United States. The United States has a very different healthcare system than the rest of the world. The, the, um, major, the major countries, the major economies of the world have a political economy that brings public health, social welfare issues, and the delivery system altogether

20:14 under one philosophical structure. The United States is very different in that the delivery system is not as con is, that’s clearly not controlled by the government social welfare structure. It is a market oriented system. We can have lots of conversations of whether that’s better or worse, but it is different. And it does mean that the normal communication between public health and the deliveries, that the, by the delivery system, I mean the doctors and the nurses in the hospitals that deal with disease processes. Okay? And so basically we need to figure out workarounds in to deal with this infrastructure so the public health can communicate better

21:02 with the delivery system and the delivery system can communicate better with, with us. Now, historically, doctors fought that, but the doctors are no longer fighting. That doctors have come to finally realize that public health is in the best interest of their patients and their own best interests. So let’s talk about what is public health for a minute. I love this definition. There are dozens of definition of what public health is, but public health is what we do together as a society to create the conditions in which everyone can be healthy. It doesn’t make constraints,

21:47 it doesn’t do a whole lot of things. But it says, we should consider in this room, the three of you should be considering every week. What can you do to make changes that’ll make the community healthier? And, and that’s an incredibly high powered and noble, you’re, you’re very lucky people to have that, that kind of responsibility. Um, we today don’t do very well with how we manage that. If you look at the other wealth, the OECD countries, the wealthy countries we’re less in almost all important health status measurements. Yesterday, jama, the one of the journals, the the docs read,

22:36 produced another piece of data that said the, the, the, the life expectancy of the Society of the United States went down again last year and even more. What? Good thing, we have two women on the board. The gap between men’s life expectancy and women’s life expectancy has increased almost record levels. So we have the highest gap between women and men’s lives, and that’s the kind of issue that public health should be dealing, should be dealing with. Okay. Um, next slide. The Commonwealth Fund is a major philanthropic group that deals with health, situa health systems

23:21 that the US system and international health systems. And they put together a high powered group in 2022 to look at what we can do better. What, how might we improve the, the, the, the national public health system in the country. And they, they made a whole bunch of recommendations, but they made three recommendations for local jurisdictions. And the three local, the three, uh, recommendations were, we should examine our own health department and see what capacities we have now, what are they, and how they, how they relate to what this, this, this, the community, the town in which we live, what needs

24:08 that they might have. And if we’re not meeting all of the needs, what can we do to either expand those capacities or we, maybe if we can’t grow, we ought to merge or partner or in some way work with others, uh, other jurisdictions to, to meet those issues at the same time. So that’s one of their key issues. The second one, they, they certainly go after the, the, the previous slide that I showed where the public health and the delivery system don’t talk to each other, and they suggest we really ought to be working very hard to put together some requirements for public health and the healthcare system to work. But Massachusetts has probably the world’s best medical, uh,

24:58 system, healthcare delivery system. And it has one of the world’s best public public health schools. But we need to, we need to figure out how we can bridge the, the two of those. And then finally, we need to more actively engage community residents in the decision making regarding public health priorities. Whether in New Mexico, whether it’s was was Marblehead, whether it was North Carolina, Wyoming, no one felt that they were in control in the pandemic. It was chaos because of what was happening in Washington. But we need to figure out how to get community residents involved much more.

25:45 At the same time that I recently just found this out, that there is a bill going through, um, um, the state legislature that the authors of the bill must have read the Commonwealth Fund report for sure, but they’re making very similar recommendations. They say that they want to, to help assist the boards of health, to adopt practices and to improve the efficiency and effectiveness of the local boards. They wanna provide resources to make that happen. And if it can’t happen, if we can’t grow, then they want to encourage these cross jurisdiction, um, partnerships and alliances out there in the community.

26:33 So we have a national study group that’s suggesting these things, and we have the conditions, uh, being considered in our legislature. Um, Andrew’s insight is that this might pass. So this would be a very interesting opportunity for us. The next slide, I think that, that, that with this background and with Marblehead history of independence and self-governance, I would think that Marblehead would wanna raise its hand and say, Hey, yeah, we want to be, we wanna get better in our health, uh, public health system, and we certainly wanna include more of our people in public health decision making. So I think that one of the things we ought to do within

27:21 that conversation is to ask ourselves, what would we do? How can the community benefit if we expand what we now do? We’re pretty limited in the, the resources that we apply. The, um, so what I’m proposing, the next slide is, I guess you talked about it last, um, j Joanne was lucky enough to be in Italy last week. I was, I was in France when you were talking about this last week. But the up, um, the next slide is I propose a, is it a subcommittee on the future of public health, or whether you call it a planning group or whatever. A planning group seems to me that it’s, it, it’s a policymaking group. I see this as advisory to you all

28:06 who have the elected authority. And I see it as a, as a body that would develop background information. Todd City works seven, seven or eight hours over the weekend dealing with fentanyl. We would wanna be doing things like that to present those issues to the board, to the town for the conversation that’s out there. If we got good at this, then we could share with the board, with the town and the board in any number of ways. Uh, it, it, it, it, it, it would be, I think, uh, for me at least, uh, as a, a recovering academic and teacher, it would, uh, add some value to the community, and it should, it should be grade fun. Last slide is hopefully,

28:53 maybe the most important one is one person’s assessment of how to expand the public health portfolio. How, what would this subcommittee consider if it were to think about enlarging the public health profile in Marblehead or some other partners partnering arrangement that we, we might have? The core, the core skill of public health is prevention, early intervention, and community-based care. We, we can’t give that up, but we need, we need to really begin to focus more on the issues of inequalities and disparities that are in the community.

29:40 We know the data are robust, that the disadvantaged, economically disadvantaged in the, in the community have the lower healthcare status. And, and that’s something that the community should be working on. Um, I’m a pediatrician, so you can say the third one is just bias, but I have good data to show that you invest in a kid, you’ll get more money back in that investment than you’re delivering. For sure. Child maternal health should be high priority. We’ve already begun to talk about directly addressing, Joanne runs the, uh, me and Helene started before that. The, the, the mental health task force.

30:26 I, I sit in, it’s one of the most interesting, um, committees that I’ve worked on in a very long time making real progress about understanding what’s going on. But it’s got to become more direct as, as I think you’re, you’re pushing to get at these issues of substance abuse. The reason why the United States has the highest level of preventive deaths in the world of developed world is, is in great part due to issues of things like substance abuse. We are killing a whole number of people in, in our society, and we really have to deal with that at the next level. We’ve gotta deal with violence, whether it be violence

31:12 or guns, violence and, and social relationships, domestic violence, just the, the violent way we treat each other, road rage. Um, um, the driving on Massachusetts freeways, all of those sort of things are a violent level. I think we need to improve the collaboration with primary care. We’ve got, again, great health status, sy health health systems in the state. We need to develop bridges to talk to them, particularly at the primary care. And a great example is the country’s about to spend a thousand dollars a week for every obese person in the country who wants to get involved with these, uh, GLP one drugs at a thousand dollars a week.

31:59 Well, let’s try some community-based exercising, uh, good. Those sorts of things. Now, for some people, we’re gonna have to deal with maybe the drugs, but, but the, the reflex in the United States has historically been go to the health system for your health first. And what we need to think about is making public health suggestions where you might go to the public health community, uh, uh, initially, but then again, that does, those are my biases. And then finally, I think it would be in very interesting, a little scary maybe that we start anticipating the, uh, the, uh, potential effects of climate, the health, health effects of climate change. There is beginning

32:45 to be a literature now in both the public health literature and the medical literature literature. We, I’m kidding, Andrew, these days that we’re gonna have malaria and, and marblehead, um, if we aren’t careful. Thank you very much. Uh, it’s obviously an area that I, I have, I have enthusiasm about. And thank you very much for the three of you agreeing to invite me. Well, we certainly do have enthusiasm. Thanks. We, you and I, when we talked, we did say that I, I would like it to go further and set up a committee and you said you would like some time to talk to some people that you feel would be appropriate. Would you mind if people, uh, sent some, uh, of their interest to the, to Andrew’s office to

33:33 Of course, any, any way we can find out? What I think we wanna make certain we do is make it as broad as possible. You want, you would like to have a town committee that everyone trusts. And, and the, the only, I think the only way you’re gonna have trust is if you have respect, you respect different, we, we clearly need somebody who knows a little bit about epidemiology, but maybe we don’t have an epidemiologist in the town. Well, maybe a couple of us will have to buy a textbook and begin to read and ask for some help, get a consultant, that sort of thing. But absolutely, let’s just find, uh, let’s, one of the reasons why I get excited about doing this

34:19 in Marblehead is because of the talent in Marblehead, you’ve not only got serious professional people living in Marblehead, you’ve got a culture of entrepreneurship, of growth and innovation. And at the same time, you’ve got a base in the community that has stable long-term values as well. So begin bringing both of those groups together in a trusting environment that they’re learning about other things is, is it could be a very positive. So any, any volunteers, any, any people make additional, uh, input into the list. That’s only one person’s list.

35:07 Um, and hopefully we can follow the bill to see if it passes and if there’s money available, we should do whatever we can to be first in line with our hands out and our tinned cup, trying to figure out what we can do to, to grow Marblehead, uh, the public health and marblehead to improve the health status of this community. Thank You. Why don’t you give us a few more suggestions of, of types of individuals that you’d like seated at the, at the table? Well, I, we clearly, ultimately, cost benefit is very important. So people who, who know economics, sociology, and change management, to me, is a very important issue. Most of us, certainly those of us in the senior

35:56 situation have our, our ideas firmly in place. But one can change over time if information is presented in, in the, in the right way. So if we have somebody on the committee who, who’s read a few books or funnel on about how to, how to change, maybe it’s a pastor who knows how to bring somebody from the flock in in a different way. I don’t know. But, but for me, that would be important. In, in, in New Mexico, we were lucky enough to have a contract with, uh, one of the national labs for modelers. We were able to model how the pandemic was rolling out,

36:41 and the modelers were able to say to us, gee, if you do a certain thing in, in your schools, if you go to school every other day, it’ll have a certain impact in the society if you go another way. But so someone who has the ability to model communities, again, I I I, we don’t have every, we’re not gonna have everyone in this, in this kind of an environment. But if you’re curious about this kind of thing, if you’re willing to read a paper, if you’re willing to talk to some people and, and develop some skills. So I would think that we wanna have a, certainly a monthly session where maybe we talk about one or two topics. What do we know what, what’s come up? I mean, if there were the meeting tomorrow,

37:29 I would like people to say, what can you do to reduce the gender gap between both increase the, the life expectancy of men and women, but maybe men a little bit longer than women right now. But that should be parody. There’s nothing biological that said the say, men should die that much sooner. Um, may there might be, I I, I’m not an endocrinologist, but, but in any event, that’s the kind of thing I think we need in the in, it’s not just public health. It’s, it’s, it’s someone who, who finds the human specie to be worth studying. And if you study the human species as a sort of a polygon,

38:16 you have different people looking at it from different angles and different sides. So you all, before I open to the committee, because I’m sure they have questions, um, That’s it. Wait a minute. Oh, really? I don’t know if that’s okay. Um, we’re first at this table with questions, but, um, you also re recommended that you would like to come back next month with a few more solidified ideas after you’ve spoken around to a few, uh, folks. Yeah, I, I think it was great that, that the idea of the committee cut through so quickly, and so we haven’t voted On it yet. I’m a little surprised. Well,

39:01 Joanne said you mentioned it last time. Yes, I’m a little surprised we Talked about it, but, okay. But I, But what would be the most efficient way? How do we make it work? Um, and I, I actually want to talk to some people in the delivery system. ‘cause clearly on that group, it would be great to have a nurse or a doc that had a day-to-day responsibility in the delivery system. Uh, and, and brought those, that insight and came with respect of the public health community. Because there are many of, I think there are many of us in the public health community who respect the delivery system. And we, we, we, we would want, and, and so I wanna see who might be available, that kind of thing.

39:48 Well, okay, so we, I have said that you’re, you would be willing to people send their, um, resume to, uh, to the office. Sure. And Andrew can be in touch with you to go over them. And what we did with the mental health task forces, we as a committee looked at them and we chose who we thought you have much more expertise in this area that I think that it would Be, well, you’re kind, but I’m, I’m, But if you looked at the resumes and maybe presented them to us, so I think that that would be a, a good way, which means this means that we would want you to come back because you might have a group of people. Well, my sense is for any one of us to go out

40:35 and ask someone to spend more of their personal time on a community effort on the week before the holidays begin is probably not the smartest thing we could do. So we might wanna wait a little while to keep the membership open. Okay. Our, our next meeting, as I was gonna announce at the end of the meeting is December 12th. Okay. So, um, Well, I’ll do whatever, But if you prefer to wait till the first of the year, that’s, I, I want you to have a committee that you feel is a working committee. And if you feel that a month would make a difference, then that’s, Well let, I’ll try and make a month. If not, I can let you, I’m allowed to talk to all three of you. Right.

41:21 We can’t talk to us. Yeah, you are. So, uh, but I think that, uh, we’re on, we may not be there by December 12th. We may have one application. We may. And so, uh, and you, hopefully you’ll be, uh, looking around the community and asking people. Yeah. So since I’ve been doing most of the talking right now, uh, does, do either one of you have any questions for Tom? Yeah, No, Tom, more comments than anything. You know, I love the public engagement thing and, you know, I open myself up as much as I can. I hate social media, but I built a social media so that I could communicate with Steve who messaged me all the time. And I think, and there’s not one person I haven’t emailed back, messaged back. I think it’s really important. And I think it’s important

42:06 because anyone at this table is the expert in town at nothing. There’s always someone smarter out there. And if you don’t make them feel invited and that you’ll listen, you’re never gonna hear from them. They just, they’re gonna give up. So it’s always important to open up to them. And I, so I fully agree, and that’s why I respond to everyone. ‘cause I want them to know that they can reach out and I want them to tell someone else that they reached out and I listened to them. And I think that’s incredibly, incredibly important. So I’m glad, I’m glad you, uh, mentioned that. Um, and then you also mentioned, you know, the resources as far as like prevention and all that stuff. And one thing that I had hoped to bring up this meeting was addition to the website where I did, um,

42:48 public health services in town where someone like you, who’s only been here 18 months, might not know about all these things. So I have mental health resources, physical health resources and abuse resources down here where, you know, this is 2023. So we, everyone does everything, you know, on the internet first to search out their answers. And if we don’t have all the answers in our own health department, you know, they’re not, how are they supposed to, you know, it, it just leaves people in chaos. So knowing where to reach out, knowing where to try is important for prevention and things like that. I’m a huge advocate of, of physical health as, as a preventative measure for everything. I think it’s the cornerstone and I think it improves, you know, I also brought articles here on the link between mental health and physical health, uh, because I think these things are so important. So I’m glad you’re bringing up those and that that’s something that you recognize.

43:35 And I look forward to working with you on all those things.

43:40 Okay. Um, thank you Tom. I, I, uh, I’m really excited about this. I really appreciate the work you’ve done and you’ve framed this out and made it really comprehensive. And my question would be, I, I think finding the people, to your point, this community is very rich in really bright minds, and they’re one of our best resources. And I wonder if we could make a plan to do some pr, you know, search in terms of just put it out there because there’s people, I mean, the next few weeks are gonna be really challenging to get people’s attention away from the Turkey, but, um, we have at least what we have, uh, yes we do. And I think working with, um, maybe getting you in front of our newspapers and have conversations so that maybe this story can come

44:27 to light and people that are interested can, can connect with this opportunity. Because, um, I do know that some people that we’ve discussed in the talking about this, uh, are really excited about this. I think that, um, I think that you’ll find, Uh, a wealth of, interesting example Of Marblehead. I’ve lived in lots of different places. Absolutely. The best post office, the friendliest people in New Mexico. You, you were frightened to go to the post office ‘cause people were so rude. Now they were also short staffed and they were, you know, good reason I’m saying. But going to, going to post prospects here is almost enjoyable. ‘cause we have such good people who seem

45:13 to like other people. 15th of December. Sorry, what? Wait for the 15th of December. Same thing at the transfer station. If I can put in a plug, you get lots of really Helpful. The transfer Time sold Live in the town with a transfer station. What a, what a benefit. Holy mackerel. I agree. Anyway, no, I agree. This is an amazing place. I I, I’m so grateful that my wife took a job at Salem State and we moved here and, um, I I, I love helping out as much as I can. Well, we love having you. Thanks. Thank you for, for the, your time, for the preparation that you did and, uh, for all that you’ve done for all these youngsters in the past.

46:00 Yes, sir. We appreciate it. So let us know if you wanna come back on the 12th or in January. Okay. Thank you. Thank you.

46:18 Okay. Um, taskforce update. I think you had a meeting last night. We did right Here with this working technology. Thank you. Andrew came and helped me get set up. Um, our last meeting was last night, and our task force, um, discussed some changes to our membership. We’ve unfortunately had two members, um, that had to step down. So we’re looking to, um, potentially fill those roles. And, um, the task force has been out for almost three years now, so there may be some transitions, um, and new opportunities for people, uh, within the school specifically that we’re going to be looking forward to filling. Um, are you also Looking for people to apply to the office? Well, We, are you feelers though? We do have our physician, um,

47:05 Kim Leventhal is a psychiatrist here in town, and she has two young children who are very active and her husband travels a great deal for work. So, um, she had to step down because her Responsibilities were making it Difficult for her to attend. So her role was as the, um, Uh, town representative. So she was, even though she was a psychiatrist, she was a professional in mental health, but, um, her role on the task force was town representative. So it’ll be a community member. And I think, uh, that’s gonna be under Mark Labon, the co-chairs jurisdiction working on membership. Oh, good. So, yeah, so it’ll be an exciting opportunity to welcome someone new, a new perspective as well. Um, and I, I’m gonna have to read on this

47:52 because read this, it’s a, we did have a pretty big conversation about engaging a community needs assessment through UMass Boston Health Sciences, um, to conduct a study focusing on the needs and interests of Marble Head’s adult population as it relates to mental and behavioral health across the lifespan. Uh, this was something our member, uh, Lisa Hooper at the Council on Aging had asked about, um, many neighboring communities have done this assessment. And, uh, there’s a, a strong interest in learning what are the needs in our community. Um, the proposed project is guided by the Federal Substance Abuse and Mental Health Services Administration,

48:40 Sam, H-S-A-M-H-S-A, which is Whole Person Wellness Model. And it’s used to guide the task force in its efforts to address and provide the appropriate intervention strategies to guide residents, particularly the most vulnerable toward improved mental health. So we did sit in on a meeting with this group. Um, we are, however, moving very cautiously and slowly because it’s a big expensive project, and we’re interested in finding out, once we put this time and effort and expense into getting this data, what kind of interventions can you apply to solve the problems? So we’re looking at, many of our neighboring communities have done this research,

49:28 invested this monies and these monies, and we wanna find out, um, as we move forward slowly towards this, um, effort because, uh, is it big investment? And then what are they doing to apply interventions to meet the needs that are revealed in this assessment? So, um, but these are all really important conversations we’re having. Um, and, uh, let’s see. I I just wanna share that we just had the meeting last night, so I haven’t done the minutes. Um, it’s a pretty extensive meeting and I go back and watch it a few times to, to make sure I capture the, um, the conversations that we had. So at our next meeting, I will follow up more on the, the task force and some of the things we, we are working on. Um, but I’m happy to share that we have a co-chair. Uh, Dr.

50:16 Mark Lavonne is serving as co-chair and has been a tremendous asset already. He brings a wealth of experience and leadership to the task force. So it’s, I’m grateful to be sharing that responsibility. That Takes a lot of pressure off you. It’s just wonderful to have that partnership and to have that, uh, you know, he has a, a strong background in leading mental health organizations. So we are a mental health organization, so he brings a lot of energy and, uh, strategy to the role that I’m grateful to have. You mentioned one thing about something costing a lot of money about, about the senior contract. Yes. Are you, are you gonna be looking for a grant or, Well, I think before we, it’s, it’s a $35,000 investment to do this assessment and, uh, I know there’s a lot

51:04 of interest, but I think before we, as we explore whether this investment would be a a, a value to the community, we’re really gonna do a lot of research before we ask for the community to invest in this. Because the question that was raised is, once we have this understanding of where there are needs, what kind of interventions and resources can we apply because it’s a very expensive way to find out what the needs are, and then what kind of resources will We have available too? So you’re really not there Yet. We’re not there yet, but we are doing a lot of exploring and having some really important conversations. And I think that’s, you know, phrasing more questions about what’s, what, what are the best steps to take in in the meantime, you know, we talked about the, the high school has done the risk needs assessment,

51:52 risk assessments, and we’re really trying to uncover how we can support some of those needs that have been revealed, um, and support the schools. Great. I will have more. Our next um, meeting is actually, I just put that away. Our next meeting is in, um, January 8th at 7:00 PM There’s going to be a subcommittee meeting in December, but our next full meeting of the Mental’s Health Task Force will be In January. Thank you for This. To you, this is like what I said with Thomas Arnold, like mental health, physical health connected, something to talk about there. That’s, you know, the Paul Reed, I don’t know, maybe you know him, Tom, that he is the rear admiral US Public Health Service Deputy Assistant Secretary for Health

52:37 and the director of office Disease prevention and health promotion. So that’s from health.gov. Just talking about the correlation between the two, because I think they’re definitely correlated. And so I think we should, um, try to incorporate that. And I know there was a mental health five K two, three weeks ago. I think that was like a great combination of the two. I saw some little kids, uh, Brett Murray’s son, uh, kick some ass in it and so, and he looked very accomplished at the end and I’m sure he felt awesome because he did awesome and yeah, things like that, everything he Was at the, um, Dallas awesome. Mm-Hmm. Yeah, so he’s nice truck. Alright, um, I’m going on to the transfer station.

53:25 Alright, lot’s of update on this one. So we have our new compactor on site, um, that’s arrived. It’s sitting in the back area protected. Uh, we shrink wrap that because we don’t know exactly when that’s gonna be installed, but that’s on site and that was a huge piece of equipment that we were waiting for and that was a huge feed time, so that’s really good. Uh, the second piece is the trailer. The trailer’s gonna be replaced November 30th. Okay. Um, because we’re outside of our construction, we wanted to make sure this was done as the board wished, uh, before the winter and stuff like that. It’s gonna take a day to take the trailer apart. I need to move the equipment out of the trailer, so that’s another half day. Um, the trailer should be set pretty quickly and then a day to put it back together. Mm-Hmm. So ideally if everything goes well, we’ll be down

54:11 for two and a half days. Mm-Hmm. Um, that’s, if everything, you know, goes back together, we don’t have any issues. We need to install a couple extra, you know, a water meter. Um, but nothing crazy. The trailer’s able to stay right in the same location. It’s outside of the footprint for the new scale house. And so it’s, that should work. And so eventually when that trailer leaves, you would be moving into the new scale house and you’d have to finish up, um, some minor work, um, for curving and some landscaping and stuff like that, that will be in that area. Um, the estimated cost is just over $6,000. Um, so it’s about $2,200 for the trailer and $2,000 a day for all the, the carpenter, the, the electricians, the, the con you know, the contractor for that piece.

54:57 So that’s moving forward. Just curious, are you using, uh, local guys for contract or Yeah. Yeah, I was gonna, they’ll probably be more dependable knowing that it’s in town and Yes. Yeah. Yeah. So you know, no travel time right there. He’s there all the time. He’s been doing all our electric work. He knows everybody. Um, he’s got a crane truck to hold the wires up. Um, we’re hoping that we can stay open for residents, but obviously there’s gonna be some moving parts in the front, so there might be times when we have to completely close a facility. Um, but as soon as the scale comes offline, I’m closed for commercial. Mm-Hmm. Um, so that’s the biggest piece, but, you know, two and a half days and stuff like that, it’s pretty good. Except the 30th is on a Thursday. I under I understand. So obviously to Monday then, no. So Thursday the trailer would be on site getting back

55:43 together, um, and if we had to do another day, that would be Friday. And the idea would be that we’d be fully operational for Saturday. I obviously like this is a really busy time for leaves and all that stuff. Um, and that would be a huge inconvenience for everybody. So we’re just trying to work around that schedule. Um, they had given us another date of Tuesday before Thanksgiving and I said, no, I’m not doing that. Mm-Hmm. Um, so we’re moving forward with that. Um, we have not heard back from Max DEP, they have all our construction documents. Our engineer was gonna reach out to Ricker, mass, DEP today, um, to see what was going on. Um, we have sent all our construction documents over to the estimator, um, and wait, that will take approximately three weeks to come back. Um, and this will give us a really good idea of

56:29 where we stand, um, and then bidding. So we, you know, technically you can go out to bid right now, we do not feel like it’s a good idea. We’re being encouraged to wait till they after the first of the year, um, and that people are actually will give better numbers at that time. Mm-Hmm. Yes. Can You explain that a little bit? Why it’s not a good idea to do so earlier? It’s not my expertise, but you know, a lot of times people during the holidays and stuff like that are not necessarily concentrated on that. Um, and it just kind of explained that most likely you’ll get better numbers after the first of the year, Which is opposite from kind of businesses that I know, like the business they wanna sell at the end of the year to get their numbers. Yeah. And obviously you’re not gonna get the work done, so you’re all the work’s gonna be in the next year, so you know your work’s gonna be there,

57:15 but you know that that is, you know, what our procurement officer is recommending to us. Um, and that’s what we’re kind of hearing, so we’ll push that off to that. Um, obviously, you know, we’ll, we’ll do as quick a bid period as possible, um, and, and can, you know, try to, you know, we really wanna get this project up and running as quickly as possible. Obviously that compactor, that current compactor makes me nervous. Mm-Hmm. Um, we had a, you know, a breakdown and, you know, it’s hard to get parts and stuff like that and you know, so as soon as we can get this new compactor in place, um, I will feel a little bit better about that. Sure. Um, as far as the feasibility study goes. Yeah. Um, so we will be reaching out to, um, I’d like to speak with three engineers, uh, to explain the scope

58:02 to them and to get an estimate of what it’s gonna cost to get the feasibility study done. Mm-Hmm. So I’ll reach out to Hailey and Ward and three other engineers that we, you know, somebody recommends to us. Um, and then they will give us an idea of what the estimate should be and we’ll use that number for town. Meaning now for town meaning we’ll have a choice of two different ways to do it. We could potentially use waste revolving account and the costs of that. Or you could ask for, um, money to be spent on that GPS and you know, is either gonna be part of the budget or would it be, you know, I we’d wanna kind of stay away from any kind of threat but, you know Yeah, yeah. For the feasibility Study. Yeah. Just it can be covered by the waste revolving account. Yeah. Yep. So as long as we agree to that, I can include

58:50 that in the letter to the select defendant. Say, we’ll have a number and say this will be part of the waste revolving account. Um, and then that would be an expend known expenditure out of that. Yeah. The only thing I think which will be important down the road too is, but even for the feasibility, just for transparency with the town, I think there needs to be some kind of letter that can be put in the current whatever, wherever, um, talking about what went wrong from Lisa Mead, you know, that doesn’t jeopardize any settlement or anything. It doesn’t have to be super law, but really that residents can be happy with because that’s always a big question. And any override or anything without something like that is gonna be dead on arrival. Yeah. Obviously, like, you know, um, for talent meetings and stuff like that, you’re gonna have to get up

59:35 for the waste revolving account, you know, explain what you’re asking for. You can also give an explanation. I’ll do it, Um, at that time and say, you know, this is why we’re here, this is what we’re trying to do. I I think preparation up to that though is important. Definitely. And so I don’t think that would be a huge ask from Lee. Like I, she probably knows, you know, with the settlement and everything, what can, she can touch whatever, just one letter, you know, I can put it out there, put you put it out to the papers and just get it Out there. Yep. We can figure that out. Yeah. Something like that would be important for anything going forward as far as like, because you know, with the sorting floor there is gonna be a dead exclusion override involved with that. Yep. So, like I said, it’d be dead on a arrival without Anything like that. And obviously with the feasibility study, you know, that’s gonna look at all the costs.

1:00:21 Yeah. You know, how much material’s in town, why we’re trying to do this. Yeah. Um, and so that’s gonna give us, you know, once when you do the feasibility study, that’s gonna give you a lot of, um, information to bring to town Union and say, this is what we’re trying to do, this is the money that we can bring in this is the money that Yep. You won’t have, you know, that’s the whole reason for it. Yeah, no, I get that. Hopefully prepared and all that Stuff. Yeah. Yeah.

1:00:44 Um, that’s really it for the, um, the transfer station update. Any other questions from the horn? But no, obviously, you know, the, the trailer’s really important. Mm-Hmm. Um, and hopefully that goes smooth. Um, but we do have a great contractor, um, and so I’m confident that we’ll go, you know, get done. Are you Willing to say the name? I don’t need to announce the name here. Stuff like that. Yeah. All right. Um, so what next on the agenda is Fentanyl test strips and the Narcan? Um, I, I know that, uh, that, that, um, count was dissatisfied. I, I did find out that fire station, the police station are willing to put up, uh, the boxes.

1:01:32 Yep. I think the more you have, the better. Um, I don’t think the police station will get much use, but that’s fine. Yeah, that’s fine. You know, if it’s there, it’s there. And I think the fire station is by far, you know, I, I don’t know. Is there one up here? Yeah, yeah. There’s one at the front door. Yeah. Okay. ‘cause me, and, well, it’s a perfect example ‘cause I didn’t know, and me and my wife drove up here Saturday night looking for it and we didn’t find it. Now that could be anyone because you know, I, I didn’t know where it was, so we went to every exit, every entrance we’re looking like, is that it? Is that in contour? Yeah, but we couldn’t find it. And that’s the thing. It’s like, you can say you found it, but we drove up here, two people and we’re like, looking consciously where it is at the fire. I mean, this is a big complicated building. Lots of turns, fire station’s nice and square. I think it makes a lot of sense. Uh, yeah. So you’re put at the fire station,

1:02:17 like you said, the police station and any other locations that the board feels is Appropriate. Yeah, I mean, I kind of, you know, I, I don’t know how I feel about the school, but it’s like, I mixed emotions on that one because I don’t wanna encourage anything. But like, I, I don’t know, you know, so I, maybe I’ll get more town input and we’ll bring that up later on. So we don’t have jurisdiction over the school, but I believe the school is looking at doing programs around the Narcan and the Fentanyl strips. Okay. Um, with, you know, with Gina Heart and stuff like that. Yeah. And by the way, the, I don’t know about the fire station, but I did speak with the, uh, the police chief. They, um, they have Narcan and Fentanyl inside. They’ve had it there as Yeah, but it’s a police station.

1:03:02 I’m sorry. But I lived on my short drive for 10 years and then I also lived on, well, I live near the trail and I can’t tell you how many people have assisted just between drunk driving accidents. Um, teenage like broke and alcohol fueled arguments happening at the red light. Uh, teenagers running off from home, angry with their parents, threatening to, I, I’ve come in and that’s the work I do. So I come into it anyways. But knowing a lot of addicts, um, and knowing the amount of suffering the small area has endured in the last 20 years, I think that the police station would probably be the least in place that a kid would go. What they used to do is when somebody would overdose, the people would just leave the person

1:03:48 and die, drop, throw ‘em out of the backseat of the car. Now they have the safe harbor, like the safe protection Laws and Good Samaritan laws. So now the people don’t, people don’t get in trouble. However, they’re still dying alone. And now the stuff out there is so toxic that it would kill anybody that would touch it. So there was some problem on my street, um, where the kids hang out and play and had anybody younger grabbed that and touched it, they would’ve been dead. I mean, anybody, anybody in this room who doesn’t have a tolerance, you don’t not touching that. It, well, well, you know what I mean, like, kids using it, using it. Right. Not knowing like it’s candy. I don’t know. You don’t know What No, that, that story from the globe, actually I’ve seen it. You identify themselves. Is that okay?

1:04:33 Can ask the people on the trail. They come in from all over the place. Yeah. That would be helpful. Mm-Hmm. It’s an idea like where the dog you find exact, so if the kids grab it, run two. ‘cause it’s like seconds. You only have seconds. I’m with You. Other more. We’ll wait to finish that Conversation. Yeah, absolutely. During public comment, but I just wanted to make before Which premature. Yeah. But the, I mean, the police station fine, you know, have it there. It’s better there than not there, but it’s, you know, people that are doing drugs, the last place they’re gonna go to the police station. So the fire station just being huge and central, everyone knows where it is. I knew where it was when I was five and I didn’t know where this place was till I was 35, you know, so,

1:05:16 So yeah, we’ll get, get those up, you know, as soon as possible. Mm-Hmm. Okay. So that, that works out well. So now we’re back to you with the director’s report, Uh, director’s report. So just a couple few things. Um, I do wanna talk to you guys about mattresses. So we received an extreme number of mattresses for mattress recycling. Um, we are on the low end for costs. Um, so currently we charge, um, $35 per piece. So it’s $35 for, not just $35 for the box spring. The average cost or cost, the state right now is 60 and $65. Um, I know that’s a huge increase in stuff like that. Um, I don’t have it on the agenda tonight, so if the board wants to, you know, talk about that and increase the cost, I can add that

1:06:03 to the agenda at next meeting and we can discuss that. What’s the disposal cost? No, no, no. Not for the residents. I’m asking for the, for the 60? No, it’s like $25 a piece. Yeah. Yeah. So in my mind, I want to keep it as cheap for residents as possible. Yeah. Let me go back and bring the, what our actual bill is and stuff like that. Mm-Hmm. Um, and yeah, I understand what you’re trying to do. Yeah. The hard thing is that because everybody, because we’re the cheapest place. Yep. We’ll see mattresses all coming, you know, from close to the, like a huge area. Yeah, no, and that’s what I mean. Yeah. I, for Marblehead, residents with stickers, I’d see one price and for anyone outside of town, I’d see a different price. Yeah. But I, I was just curiously talking

1:06:48 with someone who’s moving in Swamp, Scott, and uh, he said he went to Swamp Scott. The tag there is $20 a piece, so we’re not the lowest. And that might be for like, marble, uh, for swamp Scott, residents only, stuff like that. Yeah, right. But you’re, but yeah, let me take a look at the bill because the price keep increasing on us and stuff like that. So we’re 35 a piece right now. Yep. Four residents. Yeah. It’s for everyone. For Everyone. Well, he’s 20 and I don’t know whether it’s for everyone or not, but maybe that would be something you’d wanna find out. Yep. Because if it, they can, if our people can bring them to Marble that a Swamp Squad the 20, then that’ll help you. You won’t give as many mattresses,

1:07:32 Uh, website. Tom, I know you wanted to kind of touch base on the website a little bit. Yeah, no, I saw some of the updates there that it looks good. And, um, what I had mentioned before, Tom, so I think like, you know, it’s 2023 websites, that’s kind of the first thing you do is go on the internet to find your answers. So the more we have on there, the better. Um, so this is something I whipped up to expand,

1:07:58 Uh, The website. And basically what it is, is I, so I went to that, um, power Up and I had that, uh, the little conference I guess on, uh, domestic violence. And I didn’t see anything on our website for it. Andrew, am I missing it? Uh, yeah, So it’s under Hawk Butt. Oh, okay. So all I did was add something at the bottom and I did Hawk. Yeah. And there’s a couple others. I didn’t, I didn’t see it, so I just didn’t Nope. So like, obviously the fact that like you didn’t see it and stuff like that. Yeah. You know, we need to make that a little bit More. There was a couple others they had. I could talk to them about it. I just, that was the one I remembered just for the picture here. Um, Yeah, so the one thing that we need to kind of talk to procurement about, um, is talking. So generally we do not promote businesses on our website. Right. Um, so that’s just like the one thing that we Yeah,

1:08:45 I, I know it would be kind of an exception, but it’s like, I mean, you could, I know counseling center’s kind of a business. I guess it’s a non-profit, but it’s, I mean, It’s still a town business and stuff like that. So we’ll have to pass that through that. Yeah, no, but I think anything, you know, I would say make an exception if it makes it a healthier community and the things that are out there people don’t know about, really. And I mean, most people have never heard of achieved performance. No. Anyone, anyone. Drew, he’s the man used to be running back in Michigan and in the NFL, extremely smart guy. And he is great to talk to. You know, you have VJ over at the JCC, who’s one of my guys too. And you know, you have, uh, lighthouse Fitness, Kim Crowley. So what I had put here was, and I mean all of ‘em, no, no discrimination on them. And I can put it together if, you know, as far

1:09:31 as I did an example of Kim Crowley’s, where it’s just a brief, this is what we have, this is who we care to. Little logo after you click on this and that’s it. And I can get all that information and uh, make it in copy paste format and it, you know, benefits the community and it shows you what’s out there. ‘cause some things are for seniors, some things are for kids, international TaeKwonDo Academy, I can’t believe it’s still here, but Brian Mallick keep going. And, um, yeah, things like that, you, you wouldn’t know about it. I mean, if anyone doesn’t know where the International TaeKwonDo Academy is, it’s fantastic. And it’s up on Tioga Way and there’s barely any signage. You only get it from word of mouth. So knowing if you’re new to town, knowing something like that exists by just having a central area and to get your kid involved, to get them, you know,

1:10:17 meeting other kids and, you know, building confidence. Like things like that are fantastic. And so if we can advertise those things to make it healthier community, as Tom pointed out, I think that’s low hanging fruit. Are there any town websites that do promote, or, I mean, I don’t know that this is promote, but share the companies that are available in town. Google, I didn’t know what the Chamber shares and stuff like that. I know if all these people are, you know, chamber members. Um, let me speak with the procurement officer and see what she has to say about it. Mm-Hmm. Go from there. That’s a quick sketch there. What it would be like. And like I said, I’ll do all the, I’ll make it as copy and paste as I can if it go, if, I don’t know if you wanna add on the agenda next time you guys can take a look at it, see what it looks like. But like I said, the more resources you have in one central

1:11:04 earlier area, it’ll send more people there being dependent on it, knowing where they can find the information they need. And that’s where we’re at now. And if you could, could have a hyperlink with the mental health, um, task force. I, I got them there. Okay. I see that. It can, it can send them to our website. It’s, Yeah, I, whatever you wanna do that’s in the Inner Explorer thing. I had no idea about it until I did the five K and seemed like a pretty cool program. I still don’t fully understand it because I haven’t had any, found any literature on it. But if there was literature on it here, this is something that’s gonna continue in the schools, it’d be great to know about. So, Uh, we have household hazardous waste coming up on Saturday. Uh, the swap shop will be closed on Saturday. Uh, the event runs from nine to 12. Uh, it’s a paid event.

1:11:51 Obviously we’ve spoken about this quite a bit. That’s with Swamp Scott Also that’s with S Swamp Scott as well. Um, residents that will be coming to the household. Hazardous waste, they’ll be entering in the Green Street and coming up that and, um, lining up there. That’s how we’ve done this in the past. Um, this is how we used to run it. Then we switched over to the home pickup and now we’re back to this. Yeah. Is, is that, um, something people have to go online and book prior to? No, it’s not. No. So for the other ones where it was home pickup, you had to book ahead. This one, you need to come and obviously, so it’s, uh, you’re paying for the amount of quantity that you have. Can we work with maybe sending a notice to, you know, some town, uh, social media posts, like to let people know? Yeah. So it should have been

1:12:36 cycling out there and stuff like that. ‘cause we’ve been sending it out, but we can definitely, um, push it back out again tomorrow. We’ll, you know, we’ll, we’ll resend everything out that we have. Great. I think that’s good. Can I just make a real Quick look? Yeah. It has gone up multiple times. If you are on the, um, email subscribe list for the Health Department updates and news, um, that information has gone out. If you’re not, you can get that from the main page at at subscribe. So when you’re on the homepage, you click that, it’ll bring you in, you put your email address in below the code red part, you’ll see it says enter your email address, and then it says reenter your email address. And then you’ll select where you want them from and make sure you go to the bottom and click submit. Once you do that, you’ll be on the list. And when any of this goes out, it’ll show open your email box. Thank you, Marty. Great.

1:13:24 Uh, and last that I have is the North Shore Public Health Collaborative. This is an I municipal agreement. Uh, so kind of touching base on what some of the stuff that Tom talked about. Um, in 2014, public health, uh, departments on the North Shore, uh, it was called the North Shore Shared Public Health Services Program received one of only five public health district incentive grants offered by the state of Massachusetts, um, Massachusetts Department of Public Health. Uh, the communities included in this program were Salem Peabody, Lynn Beverly Danvers, Nahant, Marblehead, and Swamp Scott. Uh, we also received funding from the North Shore Community Health Network. This funding increased our ability to improve health on the North Shore. The funding was used to strengthen our ability to deliver core public health services, such

1:14:10 as environmental inspections, disease surveillance, and to enhance our ability to work on regional initiatives to prevent chronic disease through education and environmental interventions. Two of the major accomplishments was the development of tobacco regulations that were required Smoke-free Public housing and tobacco 21, uh, that was later adopted statewide. Um, so we had started that and we’ve been working on that for quite some time. Uh, along comes the pandemic. The state realizes that there’s many health departments out there that are woefully underfunded. Um, when the state, the Mass Department of Public Health looks at communities and what they’re supposed to be providing as a budget, um, they believe that the minimum should be approximately, uh, $36 and 96 cents per citizen.

1:14:57 Um, that would give us an annual budget about $729,000. So we’re not even close to that. Um, you know, we’re, we’re around the $300,000 range. Um, but so to try to fix this, um, the state has come up with this new grant. Um, so this one’s called, uh, ours is deemed the North Shore of Public Health Collaborative. Uh, it’s funded through the Massachusetts Department of Public Health Excellence Grant. The go, the goal of the grant is to adopt the recommendations and the blueprint for Public health excellence with an emphasis on public health shared services. Uh, Salem is the fiscal agent for the grant. And other participating, participating committees include the same ones. Um, Beverly Denvers, Lynn Marblehead and Ha Peabody and Swar Scot.

1:15:43 Um, the North Shore Public Health Collaborative received $300,000 in funding for FY 23, uh, $709,000 for FY 24. Uh, the grant is expected to continue through at least June of 2033. Uh, but the contract must be renewed on an annual basis. One of the requirements of the grant is that we cannot decrease our current staffing levels increase. We need to increase. Correct. But that, so the concern is that, you know, communities receive these grants and then they start to decrease and say, well, they we’re getting all this funding, we, we will decrease and try to offset some budget stuff. And that’s not allowed. Um, so current future projects, oh, so staffing, just to kind of go over some staffing for you as well.

1:16:28 Um, so the North Shore Public Health Collaborative members, um, request support from any of the shared services staff. This currently includes a regional public health coordinator, a regional epidemiologist, a regional public health nurse, and a regional sanitarian. Uh, the collaborative plans to hire a regional social worker and a regional community health worker in the fall of 2023. Um, examples of the services provided by the staff include vaccination, clinic support, pool and food inspections, data analysis, program evaluation, grant applications, communication materials, and Maven, which is our disease surveillance system. So obviously that only touches on a very small bit. Um, and obviously when the group gets together and starts to really dive into the needs of Marblehead, um,

1:17:14 you know, we’ll take a look at all that stuff. But this is what this grant currently is covering. Um, current future project programs. Uh, so we have a North Shore mother visiting program, um, home visits from a public health nurse to provide resources and information for parents who recently had a baby, uh, national Council on Aging Vaccine Uptake initiatives, um, providing funding to support the North Shore, uh, public health collaborative vaccine vaccination clinics. Um, we have a Sun Site Safety Initiatives. Um, we have a regional field training hub, um, which provides free comprehensive training opportunities for all public health staff and a shared service agreement, um, and communication activities, including regional website. Um, so obviously I need to vote, uh, the board to vote to,

1:18:02 uh, to continue into this and entering into this, uh, inter municipal. Well, it’s certainly a terrific, uh, group and you’ve gotten a lot out of it. Not only, not only personally, but funding. Yeah. So there’s no reason not to vote. So I’m looking for A motion. Can I, can I ask one quick? Yeah. So in terms of that 700,000 they’re gonna have for FY 24. Yeah. How do they, I mean, how does, how are the needs assessed? Where does it, how Make that work? So the needs assessment, so sale is the grant holder. Okay. So all the money goes to sale. Yep. Uh, the directors get together and see what we can do. Interm, municipally. So obviously the biggest part are a lot of communities are missing inspections, pool inspections. Okay. So you gotta make sure that you’re hitting all your core mandates.

1:18:48 So a lot of money goes to all that. Um, again, they’re trying to continue on with the vaccinations. Uh, so a lot of resources are going to holding vaccination clinics, um, flu, um, it could be RSV, it could be covid. Um, so a lot of technology and stuff like that. Um, you’re using, you know, programs like Color Now, um, and some additional nursing supplies and stuff like that. Um, so a lot of the money gets, you know, very basic stuff. But when you’re looking at the number of, you know, communities that are involved, um, the money goes very quickly. I can imagine. Yeah. But so obviously the ideas, you know, with that is that you’d look at other funding opportunities that, you know, that group could grab. We would write the grant and the money would be allocated here. Yeah. So if that say the $700,000 would,

1:19:35 and they’ve got quite a significant staff, which I’m very impressed with. Yep. Is that the staff is paid from a different Nope. The, the staff is paid for through the Grant. Okay. So that’s part of it. And then the rest of the dollars are dispersed to execute the services. Yep. But there’s a few cities in that group and they probably get more medical. It’s all equal. It’s all equal. Yeah. Okay. Thank you. I mean, obviously it’s like, you know, it’s all equal that, you know, it’s, it’s, there’s more money that’s spent in puberty because they have a greater population. So when you’re holding clinics and stuff like that, you need more staff for their, say you held a clinic and stuff like that. But yeah, it’s essentially all equal.

1:20:18 Alright. So I’ll make a motion to proceed and continue with this agreement. Alright. Enter into the inter Yeah. With Northshore Public Health, with the Northshore Public Health Collaborative. Yep. I’ll second. All favor in favor? It’s unanimous. It’s unique. Vote carried. Great. Um, alright, so anything else before, uh, Yeah, just the last thing. So we do have, um, COVID vaccination clinics. Um, the next one is November 6th, and this is gonna be held in Danvers Council on Aging. And that’s three to 5:30 PM Um, the information should be up on our website. We’ll double check. Um, and we can also send this out to other, sir, where Are we on Dan? Uh,

1:21:03 the council on agent. That’s Okay. Um, and you, you said we had one last week, but was we ly attended when I met with you this Week? That’s correct. So that, that’s too bad because You know, we’re kind of seeing that across the board right now. Um, just, just the way it’s Well we’re coming into winter too. Yep. People are gonna be around, uh, family members. Yep. So get your vaccines correct. Um, alright, so, uh, before the public comment, I just want to, uh, make statement one. Our next meeting is December 12th. And, uh, that will be the last meeting of the year and, um, of this calendar year.

1:21:51 And, um, we’ll go for the public comment, but I’d like people to state their name and address for the recorder. Wonderful, Marty. And, and your comments, uh, will, will, will be listened to. This is not, uh, a time for the public to to have a conversation. It’s for you to issue your, your comments. But the com the committee will certainly take your concerns under advisement. You heard tonight that two of us talked about one of, one of the audience members had some concerns about what was going on at the table and we happened to respond to it. So, um, any, any hands?

1:22:37 Yes, Steve. Hi, my name’s Steve Elliot. I live in Turner Road. First thing I wanna mention is, um, last month when you mentioned that Tom was coming, I said, Hmm, is that something that’s gonna really interest me or not? ‘cause primarily I’m interested in the dump. I admit it, I’m up there regular, the rest of the board health stuff, I don’t know that much about it, but that was a fantastic presentation. It really opened my eyes up to a lot of stuff. I think you need to get a little more publicity out there as to what the Board of Health really does. From my perspective, it’s, you know, you run the transfer station from somebody else’s perspective. Might be they do the, um, counseling center up, uh, by the school. Um, I just, it never dawned on me that much.

1:23:25 So it opened my eyes and I’m glad I was here to hear that thought. You did super job. Thank you to my primary concern, which is the transfer station. I got a few thoughts, comments and the first one is, um, the new employee up there, Mike seems to be fitting in super, a nice, easy to get along with guy, but he makes people do what they’re supposed to do. So I, I like him just letting you know this positive thing. Uh, and I was glad to see the compact arrive. I have to be up there that day. That was good. Uh, do you have the money in your current budget to hook that up or is that something that’s gonna be part of the next go around when this project goes up to bid So that it’s mean this is public comment

1:24:12 period, not back and forth? I think that’s a fair question. I think it’s Certain back to that. Uh, I don’t wanna deter anyone from asking important questions either. I, I, I mean I personally don’t agree with it being public. I prefer public dialogue. So the hard thing is like, so town council has advised us not to engage during uh, public. That’s fine. I understand because it can potentially violate open meeting law. Mm-Hmm. Okay. But you evidently have some plan going forward to take and get the trailer changed, which yes. Fantastic. We do have the money currently, so we have money in our office revolving account to, to install that. So if I broke down again and that was gonna be a long period of time,

1:24:59 I would consider maybe installing that. Okay. Yeah, I mean obviously operations The trailer needs it be. Yeah. Can you tell us approximately what the average daily intake is from the commercial dump going up there? I don’t have the numbers with me currently. So we do about 13,000 tons a year. Um, and I’d have to look at, yeah, so total, yeah, uh, 60% of that is residential. 40% uh, is commercial. Obviously you see seasonal highs and lows. Um, we do track all these numbers so um, I can get kind of give you a, a month to month. Well what I’m sort of leading up to is a lot of people think the last 20 some million dollars we’ve spent up there was a complete waste of money.

1:25:45 I’m not necessarily one of those people because they just have lost faith that we’re gonna spend money, we’re gonna get a good return on it. If some people had any idea of how much money you generate to offset those costs and what a blessing it is to be able to do that. I know I go to other dumps from time to time and most of ‘em do have a scale where residents pay X number of dollars. Non-residents have access to it, but they pay considerably more because not only is the fee helping to support your transfer station and all the other wonderful things, the board of helped us, but um, the tax dollars also support a lot of that.

1:26:31 If I’m coming from swamps get to get rid of my mattresses or whatever, why should I not expect to pay a little bit more where I’m not a taxpayer? And I think one of the things that we need to try to figure out is who do you really want to serve? Do you, do you wanna serve more than the population of Marblehead? You wanna serve people outside of Marblehead and looking at those costs and the revenues, you know, potential there. Um, and so yeah, we’re trying to gather as much data as possibly currently. Um, so we can make some of the best informed decisions on that. Now we have obviously, and why Don’t you put that on the agenda. Okay. The people are interested in cost and what’s going on The um, I Think that would be helpful. President Compact’s been hanging on with bubble gum and tailing wiring duct tape for the last couple of years.

1:27:20 Uh, personally I think I see awful lot of vehicles coming from out of town dumping their stuff there, which is generates revenue, but it also is a lot more wear and care on the equipment. So somehow we gotta figure out how to offset that.

1:27:36 Overall I’m pleased with, especially the people that work up there. You were right, you’ve got some super people up there, not just Mar he’s okay. And you’re always welcome to come and talk to me about this. You know, we, we can spend a long time no talking about the operations and stuff like that and um, gathering the data and all that. I see you heading in the right direction, but it’s gonna be a hard sell to get money and you gotta start now. Mm-Hmm. Doing the Groundwork for that so people know what’s going on. That’s it. Thank you. Any other comments? Alan? Alan Waller 1 59,

1:28:11 uh, last meeting. I suggest that you bring Lisa meet in to give a presentation tonight and I see he decided not to take, take me up on that suggestion. Uh, the board should recognize that you don’t operate in the backing here. The town is gonna come and found meeting probably for an operational override. This here, right now we’re spending $400,000 a year in debt service for a transfer station that we don’t have. People are very skeptical about the way people, by the way, the town has spent the money and they come for the operational override and things like this come up. It’s not helpful. You have to recognize you have a responsibility to,

1:28:58 to diffuse all this because there’s no question the town needs the money for its services, but you’re not gonna get it if people don’t believe in the honesty and the, and the clarity of town government. And you’re a prime example of it. That’s why I agree, Alan, that the letter or something from Lisa like needs to come out that the town is satisfied with. Right, right. Now we have hundred percent dialogue though. I’m gonna dialogue.

1:29:33 Have you heard anything else, Alan? No, that’s, that’s that’s good enough. I can keep going.

1:29:42 It’s, it’s your turn. Well, my my point is you people are not, this is what goes on in this room is not restricted to this room. There’s ramifications for what you people do town wide. And what’s gonna happen is I’m gonna go to the next select board. I’ve got issues with the select board. But right now, uh, the credibility of the town is like rock bottom. Nobody believes the way the town is run is done in a, in a, uh, in a, uh, transparent fashion and the, uh, resources are being properly utilized. So as I point out, I think there’s no doubt that we didn’t override it, but people are not gonna support it if people don’t believe the money’s gonna be used appropriately.

1:30:27 A large part of that comes from, from this, this, uh, particular exercise that we put on here. You have to remedy it.

1:30:37 Thank for your thoughts. ‘cause I know you know the ins and outs of it ‘cause I’ve been right there when you’ve been proud of it. Uh, anybody else? Yes. Um, excuse me. I’m Tom Day. I’m Stony Brook Road and I’m not sure what I heard about the DEP approval from Andrew’s presentation, but I know that, um, going back month after month after month, we keep hearing that we’re waiting for DEP approval. I think what you said is somebody’s going to check on it tomorrow. Uh, so somebody should have called today. Um, so you know, the engineers and the architect we’re a little behind with all their construction documents. Um, but yes, we’re still waiting for DEP approval. Um, and yes, they’re gonna reach out to them to see where everything stands.

1:31:24 So is that a month away, two months away? Do you know? I can’t answer Question is what happens after that? What are the steps after that until we can start, um, sending out bids? Uh, so we are waiting for an estimate and once we ever estimate, then we would be going up to bid. About how long is that? So we talked about, uh, first of the year.

1:31:49 Okay. I thought we were gonna be starting construction and I would’ve loved to have been starting construction today. I know. Um, but you know, I I can’t do all the drawings and stuff like that, so I, you know, I, you know Sure. You go. That’s good. Anyone else?

1:32:09 Ear earlier? I didn’t wanna cut you off. I know, I’m sorry. But it’s just so important because I, I live on the trail. I Yeah. Maybe 60 Boat Road and I know, I I I’m sorry for speaking out. Um, typically I wouldn’t do that, but it, it’s such an important topic and living on the trail and having been a cheerleading coach and worked in the field and worked in the system, having teenagers myself, I’ve had, uh, many kids that I’ve found on the trail that are not in great condition and that I not heard something outside, it might not be okay. Um, a couple weeks ago there was a fight down at the, uh, pier. One of the kids got so scared that he jumped in fully clothed on a 30 degree night into

1:32:55 the harbor and swam across. I mean, these are things that used to be the talk of the town you’d hear it from. I’m originally from Swamp Squad, so sorry, but you’d hear it in a Swamp Squad or something like that happened, but now you don’t hear about it at all. Um, when the police are being called for absolutely a hundred percent assault and batteries, they’re not making arrests. The transparency is like nothing I’ve ever seen. It’s like a secret society in every committee, not just the Board of Health. The board of Health is starting to have some transparency. Um, we spend an awful lot of money, but I I we see things getting worse. The school, I’m sorry, I just rant, but there’s a lot. I mean, I’ve filed complaints

1:33:40 for five residents on my street alone. Um, I’ve brought up complaints regarding the, uh, large sinkhole that is abutting the baseball field, the trail along with like the, um, department of Environmental protection, land wetlands protection. And nothing’s been done about it. Uh, well, what’s been done? I’ve been called crazy and my reputation’s been absolutely destroyed. But besides that, nothing has been done to resolve the issue. Um, and what’s just is, is that kids are right there. Like things are just getting worse. Um, I used to drive through Chelsea on a regular basis. When I come home every night, I feel like I’m reliving the days in Chelsea. The streets are so terrible.

1:34:26 And, and then we have a 70% elder population Last time I looked, how are they getting around time if they have any type of mobility issue, even the younger folks, how are they getting around the kids? It’s so dangerous to sign everywhere. It’s just, there’s so many concerns and I’m hoping that things change and I hope every year there is and I say, be better marblehead. And I just see nothing changed. So those are my concerns. Those are the things I’ve raised. Like hope. There’s things that will be done about it. I Think your first comments that you brought when you had our meeting were appropriate for this board. But I think you wish, Well, they were all the committees and just, they can’t help you. They’re all same thing. And they all deal with public health. It’s balance of the community. It’s really head state, but everything.

1:35:13 So that’s about it. That’s all I have to say. Well, thank you for your concern, Heather. Shoot me an email and I’ll come to you. No problem. I’m Gonna fill a thank you. I could put the foundation in my house. Well, actually, speaking of foundations, so I did live on my shore drive, like I mentioned for 10 years. And I have been a taxpayer in the community before I lived on Broken Road for the past couple of years. Um, there was a stark difference in the treatment by the municipal offices, including that. Specifically. This one, my, um, I used to stay up late because I had two young children and I could constantly hear these trucks between midnight and about four or 5:00 AM coming down the road. And I thought, how many businesses are there at Toyota wedding?

1:35:58 Damn, very much. Go do an awful lot of alcohol on Friday and Saturday nights. And then I realized that it was out of town, maybe contractors coming in with these giant trucks. And then I looked like at the wear and tear at the front of my foundation and my front, um, porch, and it’s destroyed and we just had it done. So those, that’s just a concern with the streets. So like maybe, you know, that’s something that should be looked at also.

1:36:26 Okay. Very much. Anyone Else about public health issues? Not, um, I’ll ask for the meeting to adjourn. Motion to adjourn. Second. All in favor? In favor. Favor question and request.