Board of Health: March 4, 2025

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.

0:08 I am waiting a few more seconds.

0:30 Alright. It’s seven 30 and the board health meeting on March 4th is to begin. And, um, before I, uh, go to the agenda, I have a few comments to make, um, and I think it’ll be of interest. Uh, first I’d like to, uh, talk about, uh, what happened with our three, three to five member board. I don’t think it’s going to happen this year, so I wanna share it with the town, what’s been reported by the local press. At the upcoming town election, voters will not be voting to increase the Board of Health from three to five members, even though it was overwhelmingly approved at last year’s town meeting. It seems that the select board only recently sent the request to the State House. Now it has to go in line

1:16 with all the other bills to be passed. Even our se uh, state rep, Jenny meaning says she cannot perform any miracle to push this through at this late date. It is truly disappointing that the board will have to wait another year. So I just wanted to, we’ve talked about it at two meetings and I just wanted to make this as the final statement. Uh, so we will be seeing this on the ballot a year from now. Hopefully you have to go on the ballot again. No, no. Mm-hmm. I don’t mean on the ballot. I apologize. Yep. I apo it. It will, um, just be a done please. Once you, it’ll be passed. I apologize for the, thank you for the correction. Last meeting, one of the reporters asked me if I planned

2:02 to run again when my term was up in June. My reply to the, to the board was, I was too busy with the board and it was too soon for me to think about it. Since then, I’ve had some time to come to the decision that after 37 years in elected office in the town of Marblehead, I will not be seeking reelection. It has been my honor to have served 28 years on the Board of Health five years as chair. Prior to that, I was elected three terms, nine years to the school committee. I’m proud of the numerous accomplishments the Board of Health has made during the almost three decades. I have served the one of which I’m most proud and certainly the most challenging was working with my Board of Health colleagues and Director Petty guiding the towns through the, through the c COVID-19 pandemic.

2:47 During that difficult time, the board met weekly on Zoom as we navigated our way through protocols and decisions, always following the Commonwealth’s guidelines regarding masking distancing, outdoor dining, vaccinations, isolation, childcare needs, lack of work, and food insecurity. With all that power happening, there were mental health issues that were starting to affect many residents. The Board of Health established the mental health task force to try to answer that, and they’re doing a great job. Over the years, the Board of Health has been on the cutting edge of adopting policies and regulations, including organic pest management for town owned properties, banning tobacco,

3:33 tobacco use on all public properties, banning the idling of buses and delivery trucks, and banning the use of plastic bags in markets. And sharps. A transfer station continues to be the board’s most extensive project with curbside pickup, recycling, and composting and important components. I want to acknowledge my former board, my former board members attorney Kyle Goodman, Dr. David Becker, Dr. Todd, be Becker, Michelle Gottlieb, and Joanne Miller. I learned much from them as we work collaboratively as a team to maintain and improve the health of our community. I look to my fellow current board members, Dr. Tom Zaro and Tom McMahon Tokin, to continue their dedication to our mission, to quote, to promote

4:20 and protect the health, wellness, and safety of all citizens. End of quote, with the findings of the Bureau of Substance Abuse survey occurring during the next month, and the UMass Boston’s creating a healthier Marblehead survey being conducted in the fall, the upcoming substance abuse seminar, and the completion of the final phase of the transfer station, they have a busy and productive rest of 2025. You hear that, gentlemen? I must thank a former director, Wayne Andridge and the current director Andrew Petty, for their guidance and all the day-to-day work involved while ma managing a dedicated staff. When I stepped down in June from this very large part of my volunteer service to the town, I love, I’m not giving out my other community work,

5:07 which is so meaningful to me. I encourage you, all of you who have the knowledge, expertise in medicine, healthcare, or public health, to take out nomination papers to rent for the one open seat on the Board of Health. Remember, it’s one open seat this year. The nominate nomination papers will be available at the Town Clerk’s office on Monday, March 17th. I know the town needs you and I’m sure you’ll be fulfilled. Now, back to the business of

5:42 So town website. Um, so the town is in the process of switching over to a new town website. We were supposed to be live at this point. Unfortunately, they ran into some issues. There’s some bugs that need to be worked out. Um, and that should be coming in the near future. As soon as it is live, I need all of us to take a look at it, make sure all the links work, make sure it looks the way we want it to. Um, we can continue to talk about adjustments that we want for the website. Um, so that’s really the big piece. It was supposed to be live at this point. This is why we had it on the agenda. But again, they have to work out some of the issues with it and we’ll go be going back to that. Yeah. And Steve, Steve Elliott was all over it. Finding little holes and stuff like that. And every community member should take a look.

6:29 Not just at across departments, but like everyone, it, it stuff isn’t easy to find, you know, say it because it should be, we should make the website as good as possible. Correct. I mean, the amount of traffic that goes through there is huge. We want it to be user friendly. Mm-hmm. We want it to be pretty, we want it to be put, you know, user friendly is the big piece. Mm-hmm. We want things to be able to be found. Um, so yeah, we, we appreciate all your help. Do, do you think the people that that were engaged to do this are doing a good job? Or do you think it’s, I’m not the tech savvy person from websites, so I, I’m not really sure what happened with it. I saw it for five minutes, you know, then, then when I went to look the next day it was gone, so, yeah. Oh yeah. And I think what happened there was a lot

7:15 of links that were broken, so people were clicking on things you couldn’t, you know, it wasn’t connecting where you’re supposed to go. Yeah. Um, so that was the biggest piece. So more to come with that. But yeah, that’s kind of the quick update on that one.

7:31 All right. So, um, you have no idea when that would I do Not tell Your Fix. I’m not a website. I haven’t built a website in 24 years, so I’m not the guy. But Were the websites 24 years ago. Yeah, I, yeah. Um, the mental health task force, if you would ask to put this on, but I wanted to just make an introduction of, ‘cause I did hear that they may be going in a different direction. Let me, you you wanna say that the conversation that led to that. Okay. Um, my mother would say your ears would’ve been ringing because you and Andrew were brought up fairly significantly.

8:17 There were some, there’s an evolution that’s been recommended, but the evolution, everyone sees as incredibly positive because of what you and Andrew and your, our predecessors have done to create both the counseling center and, uh, the Marble Hill Mental Health Task force. So the, the provider community that’s on the, on the mental health task force believes because of your work and, and your conceptual, uh, framing of how things should be done in the town, we are ready to move to the next, the next step. So on behalf of the, the task force,

9:06 I, we thank you both. I think that they, that the task force will be better served. Well, let, let’s say what the task, it’s the suggestion. I’m, I’m the liaison for the task force. And last night at the, at this, at the, um, regular monthly meeting, um, Dr. Lavo that who’s been chair for I guess almost a year, but, um, really felt that, that the task force in its current structure had reached its peak. And in many ways, the best way to handle mental health issues in today’s world is to encourage the practice

9:52 of caring about and for them. And the town has a, a great facility for caring for mental health services, delivering mental health services. And so it’s the request of the, the task force that the leadership of the board and the leadership of the counseling center come together to try to develop a future where the mental health task force will be much more closely aligned with the counseling center on a day-to-day, um, patient to patient idea to idea basis. Well, we, they have the staff to handle that kind of business, and we don’t handle that every time here.

10:38 That’s right. That it, I think they will be better served. But do they have the staff and the capacity to do it? Well, Terry was, McDonough was on the, uh, was on the call last night, and she’s quite comfortable that it’s a win-win. Okay. Um, no, I think she’s already had, uh, uh, uh, some conversation with her chair, but, but, uh, probably more needs to be done. But the, the people in the room, certainly the people in the room that have been on the task force, um, see this as a real positive. Um, and most of them know the Counseling Center pretty well. Well, you know, it’s, it, it’s not, we,

11:27 we are not gonna think of it as a negative thing because when you start something, it’s good and you spin it off. Yeah. That’s, that’s even better. Yeah. No, Uh, Because that means they go off, your little chickens fly away and, uh, there’s No question they’re On their own. And I think that that’s, I feel proud You should A proud mother. Yeah. So A couple little Times. Two website, A couple additions to that. So obviously the website for the mental health task force was a big piece, and so we wanna make sure that we preserve all that. Um, then, uh, the Marblehead Counseling Center has a very robust website. Um, but, and so we’ll make sure that everything that the Marblehead Task Force has on their website gets

12:13 incorporated into the, the Marblehead Counseling website. And obviously the easiest thing for us to do is that on the Marblehead, um, health Department, or we will have a link from the Marblehead website directly to the counseling center to make sure people can still have access to all this information. That’s like a big piece. Um, that was a huge piece for when the mental health task force was formed, making sure people had access to certain information, um, and all of that. The other piece that has been huge benefit for the mental health task force is bringing together all the different departments, making sure we can work together. Uh, and the Counseling Center will continue to make sure that those connections occur. Um, obviously I work very closely with Terry McDonough, um,

12:59 and I’ll work with her to make sure that we can continue to have certain meetings and make sure everybody that wants to be at the table is there. And if there’s people that we feel are that need to be at the table, we’ll make sure that those people in are invited as well. Um, along with that, we wanna make sure that we continue to all attend, um, marble Lake Providers meeting that really is put on by the Female Humane Society. We’ll all continue to attend those, uh, making sure everybody’s voices are heard in the community. What do you mean we all, ‘cause I haven’t attended one Of those, so, yeah. So generally, so that, you know, I represent the Health department or the health office to that meeting, um, generally Dennis King from the, the police department, it’s there. Sometimes the, or, you know, there’s a representative from the COA, some

13:45 of the different, um, community housing, Marblehead Housing. Yeah. Um, is there Terry’s there? Yeah, Terry’s there. It’s a way for us to make sure that if we have questions of each other, we can ask those at that time. If we have concerns, we can bring them up to the meetings or we can have offline conversations with people that are there Now, humane Societies chairs that, That meeting, they put it together and Yeah. They, they essentially facilitate that meeting. Yeah. Great. I think without saying, I don’t know this without saying it, most of the participants are people that Humane Society supports. Oh. One way or the other. Well, then they have to hear from them. Yeah. So you’re gonna move all the information on the Mental Health Task Force website to, it’s gonna be moved to the counseling center. Yeah. So

14:32 We could obviously talk about this if there’s things that we need to keep in a certain place. Well, What I was gonna ask is that, um, it’s marveled cares.com, right? Yep. Okay. Most other towns, which I found actually have like the same, their name cares. Yep. And they’re all related to substance abuse. Okay. So if we’re not gonna use it, if that’s gonna get retired, that website, maybe keep the domain. Yeah. Let me talk to them about keeping the domain and see what we can do. Yeah. Because if we fall in line with all the other towns with the same kind of theme on a website name, that would be good. I don’t think there’s been any thought of giving up that name, But, okay. Oh, no, but I, well, I was just saying if you, if it’s no longer gonna be used

15:18 and all the information is gonna, I mean, if it’s still gonna be used, that’s fine. You know, I, it sounded like it wasn’t gonna be used, which is why I mentioned that. ‘cause like, I think it’s like sous cares and all those, what, like they’re all Yeah. They’re all related to substance use and like resources for that. So if every town kind of had the SA and Yeah. So if every town kind of had the same one, you’re kind of linked up and I don’t know. Right. It’s kind of an easy thing for people to remember. You know, in our in Swamp Scott, it’s, you know, swamps cares or, you know, s August, it’s August cares. Yeah. You know, it’s, when somebody moves into town, it might be the easiest thing for them to do and say, all right, lemme see what’s on the Marvel Head Cares piece. Yeah. So, um, so let me dive into that a little bit. Yeah. Like I said, Tom, only if it’s just gonna be retired and not used anymore, then, then that’s, that would be a good use for the name. No reason not to put it on both, both the organizations,

16:06 I mean, both the, both the Gordon Hills and, and the No, I agree. I’m just, I’m just saying like, it’s an easy thing to remember and like every other town has it like that. So it would be a good use. Yes. The biggest piece, and, and again, I’m not the tech, you know Yeah. Website page. We wanna make sure that if like one page is updated, the other gets updated, the same information. Um, if you’re truly marrying each other, they need to be updated at the same time. Yeah. And I’m not talking about anything in, okay. Yeah. Yeah, obviously. Well, if just, just a quick thought from hearing that. Yeah. That was the first time I’ve heard That. Definitely. So we’ll take a look at that. Yeah. Um, but no, I think this is a great move. I think it will be too very well, um, you know, they’ve accomplished a lot of great work. Um, and then we’ll continue, you know, all that great work will continue with the Marvel Ed Councils in America.

16:51 And a lot of it started out with the fact that they, if they were under apices, they needed to be run by the open meeting law. Correct. And I think that’s what started the whole thing. And it got pretty bogged down if they didn’t have a quorum. If they were, you know, their committee is larger. How many, you’ve got seven or eight people on your committee? No, it’s still, uh, well, I don’t know. I think it’s five. It’s certainly not my committee. They Ran, they ran into the same thing. They didn’t have three people there. They couldn’t have their, their Meetings and, and particularly the way the committee looks, it has certain representation that’s required. Uh, first three meetings I went to canceled because there was no board. No. So I think this is going, Yeah. This is, this is

17:37 a real plus for everyone. I think. I think Dr. Labon is gonna come to our first meeting in, in, in Mar uh, it’s March already, um, in April. Is that correct? Because we can, yeah. Let me, let me just confirm with him when he is gonna be here so he has this further. Yeah. Um, because I think it would be nice to see him, and now that we’ve been introduced to this, we can, uh, deep dig in a little deeper. Yeah. Alright. Great. Well, lots of good luck. My chicken is Every, everyone’s grateful for only done. Thank you. Um, May I rearrange, arrange my two agenda items that I can do? Bird flu? Andrew and I can do bird flu very quickly.

18:25 Okay, good. And then, uh, the other may take a, a, a little bit or a lot longer. Um, Andrew and I have entered since before I’ve been on the board, talk about our respective fields, looking at H five N one. And we’ve said that many times that eventually we want to be talking about that here. Um, and, um, I don’t know if, uh, many of you saw last week or two weeks ago, Ashish Ja, the chair of the Dean of Public Health at Brown had an article in the Globe looking back on the mistakes

19:14 that were made in, uh, COVID. Was He part of it? He, He, he, he was part of it. He accepted responsibility, but he, but the point I wanna make, one of his recommendations, one of the mistakes he thinks we made, that at least we would, the board, we would like the Andrew and I the board to make sure we don’t make that same mistake. And the mistake was, he thinks that we were ne the public health officials were never successful in convincing the public how dynamic science is.

19:55 And whether it was an in intentional or not. What came to people as the solutions to covid were church sought, uh, was that science was rigid and therefore we had to deal with rigidity. And his sense is, boy, you, it’s, it’s exactly the opposite. We have to learn as we go along. So I think the, the, the commitment that Andrew and I have talked about, about H five N one is how can we help this, both this table and this community understand The science says it’s evolving.

20:43 And we will try to do that one without being boring, boring. And two, not to take a great deal of time. But I can tell you in the clinical literature I read, um, today the, the, the version of the New England Journal of Medicine that came out last week. It’s the first time they had three articles on H five N one. And the editorial, one of those articles talked about the emerging threat of H five N one to human health. So organized medicine, it has now begun to take H five N one seriously. So I will report from that perspective

21:32 to the extent that I can You wanna work? Yeah. And so from my side of, and obviously I always have to report out what we, information that we get from the state updates, notifications. Um, so recently we’ve put out notifications, uh, regarding HPI. Um, so that is also connected to H five N one, but that’s on the Wild Bird side. Um, so we’ve given notifications. So we have two pieces that obviously we’re a coastal community, so we have a lot of seabirds that travel through this area, especially during migration season. So we’ve put out notification regarding dead seabirds and, and making sure that you either contact this office or Mass Department of Public Health, or Mass Department of Agriculture. Um, we have all the information on the website.

22:18 The other piece that we have here is that we also permit backyard flocks. So chickens, ducks, other, you know, pigeons and stuff like that. And so we wanna make sure that we are providing relevant information to that. Um, so recently, um, in Barnesville and Des County, um, there was a recent case in which a residential initially reported a sick backyard flock. Um, and this was through mass Department of Ag Agricultural, um, so MDAR, um, through the bird reporting portal. Um, and after follow up with MEMA and MDAR and a local veterinarian, the flock tested positive and was actually called, they had to create a 10 kilometer buffer zone, was established

23:04 around the effect flock and restricted the movement of chickens, poultry, and eggs in and out of that area. So we try to bring, obviously we are following this closely. We’re trying to bring relevant information to the, the community, um, but making sure everybody understands we’re not trying to raise alarm bells or any of that. We want, we wanna make sure people are educated about this and understand how dynamic it is. These things are very scientific, they change very quickly. Um, but, so yeah, we will continue to talk about this and, and other relevant cases out there across the world.

23:44 It’s interesting that, again, the New England Journal is saying one thing and looking at a relatively static approach to birds and chickens and all that. And now on the public health side, these flocks of wild birds really add a second level. And, uh, I just want to reinforce, the commitment is not to alarm anyone, but at least to make people comfortable to people who have the responsibility to keep up on what’s going on, are trying very hard to do that. And I just, uh, next time, if, uh, maybe you have good reason not to come to the next meeting, but I would like to spend at least five minutes

24:29 or 10 talking about what’s, what’s an H five N one anyway, but I’m gonna start it. What’s a virus? What’s a bacteria? Why do we care? Why are they different? And, um, is H five N one and H five N one anyway related to COVID-19 last year and all of that? So, um, you know, I’m a recovering academic. I love to do this kind of stuff. I will try to be short. But if, and, and I think we agreed this morning that what we’ll do in the new website, we will put a space for H five N one articles or data that we have or something like that for someone who wants to follow up or is curious that they’ll be able to do that.

25:18 And, um, so we’ll have a, a micro library about H five N one on, on the website if we can figure out, hopefully somebody can figure out how to, and, and we’ll try to include some Interesting facts, you know, some cool scientific facts, um, that might be interesting to your kids. Um, so Tom shared Some of those facts. Lemme give you interest. How many eggs do you think are produced in the United States?

25:49 In what timeframe? A year or a day? How many chickens are there? Well, depends on how you count the chickens. There are 1.2 billion broilers, God, but there are fewer helay or egg laying hens anyway, each in the best of most recent data I could find is in 2023, the United States produced 110 billion eggs. Amazing. Isn’t that enough? They don’t have to raise feast. Well, in, in, in, in, um, in the fourth quarter, well, actually in December and January, December 24, in January

26:35 of 25, 40 4 million were cu So it, it, it’s, it’s not, it’s 10% already that were, uh, we’re, we’re called. There are 379 million laying heads in the country. So if we called 40 million, we called 10% in a two month period

27:08 before some of the things that are being reported in the literature, uh, came up. So, um, probably some of the increase in price of eggs is due to panic buying, like toilet paper was during, uh, during covid. The life’s The, like, the shelf life isn’t as great as I as toilet paper, Toilet shelf life isn’t as great. And, um, some of it’s real. I, I would suspect because it, what what, oh, environment. The CDC medicine hasn’t, that isn’t in, in this business. But the CDC so far is saying that eating cooked eggs is not a problem if they’re well cooked.

27:53 Did they ever say they weren’t? I mean, why? No, but why you picking that up? They’re, um, well, only because I, at least I, I live with a, a woman who’s, who worries about things like that. So I thought there might be other people out there like that.

28:09 We just wanted to set a set up at ease Over easy isn’t good enough apparent so it scrambled dry or hard boil, that sort of thing. Um, But again, you know, scientists, government are looking at all this stuff when there are questions, they’re testing flocks if they have a concern like calling the whole flock. So technically, you know, our food chain is really important to us. Obviously we have a long history of making sure with food safety through the FDA and everybody. Um, but it is interesting science. Okay. So if you think this is the dumbest idea that the Board of Health has ever f thought about, let us know.

28:55 But otherwise, we’re gonna try, we’re gonna try to keep the community up to speed so that at least there won’t be surprises or disappointments that, that people haven’t thought about.

29:12 I think knowledge is important, if you can impart that. Hey, I, uh, okay. You want to be, uh, If I can now move to, um, creating a healthier marblehead. Um, we, I, I had a, a, a great conversation with, uh, UMass Boston 10 days ago or so. The timeframe that they presented to us, um, when, when Dr. Co met with us, when was it, November or something like that, is still online. And, uh, in fact, uh, she has a new colleague, which is a real plus in many ways. It’s a person that, that Andrew apparently knows, um, Megan Morgan Clark.

29:58 Yep. Uh, who has a PhD in public affairs and, uh, an MPH and ran a health Yeah. Department on the Cape. On the Cape, yep. For nine or 10 years. Oh. So she’s gonna be in, involved in this, um, uh, project as well. Um, the, this, we’re, we’re, as soon as we, uh,

30:24 can move forward from a funding perspective, um, we, we, there’s some challenges we want to, to fi figure out. We will be, I think the first municipality that UMass Boston has done that’s gone all the way to 18 years. We’ve, I I certainly, I think all of the people that I’ve talked to think that’s really quite important. You have to have the whole lifespan if you’re gonna talk about health in, in, in your community. And I think both Salem and Swamp Scott, in talking to them, wish they had done it. What, what, what age they stopped at? Well, 18. Because if you go lower in that, then you have to get parental permission to give them questions. So they did do 18. Oh, no, no, the other two.

31:12 Yeah, that’s, no, what, what is Salem Star? Uh, uh, Swampscott stopped at 50. Oh, that’s what I want. Estimate question. Yeah. And Salem, Salem I think stopped somewhere in that range. Oh, really? Yeah. No, it, well, Coyle’s home base is gerontology most of those things. Uh, the original plan was to, to give municipalities the capacity to be certified as a town, a, a a, a friendly town for aging and or, um, dementia. And so that, that was where the, the, uh, the gerontological people came in. But, but now we have a health person in there.

31:58 Everybody agrees we wanna do the a team. What, what historically they’ve done is they’ve had a paper survey, and for

32:08 people over 50 paper surveys are fine. But it’s quite clear that to get a 30 5-year-old to look at 45 questions on paper, we’re, we’re not gonna get the response that we need. So the first thing that we’re gonna have to work at once we get everything o online, is to try to really, how can we either do a hybrid, um, how do we encourage people to go online, put it on the phone? I mean, Andrew’s got, Andrew says he got a text, they Can come, they can come to Marty. And, uh, between two and four, he has a desk and everything for him. I’ll put some, you know, Oreo cookies and coffee. They, we’d Like, we’d like

32:54 to get a 50% survey response. And I think Marty’s got some other of things to do. Thank you. Okay. So I’m gonna be coming back on a regular basis, but I thought it, it, it, if the boards willing to tolerate, um, I’ve given, uh, talk trying to, to introduce the community to call many places, but I’ve really never done it here. So I would like it to be done here, if that’s okay. And to have that in the record. Well, then we can approve your, your lecture or not too, Hopefully you won’t reject it because they’ll have to go back to people I’ve talked to. But yes, we’re Not the ones that gave you money.

33:36 Did you, did you have an update on on Any No updates. No updates on Anymore on resources. Well, there was a word last night substantial was used, but No, I like that. You know, who knows? I had a great visit with the CC, but what I wanted there mostly is contacts with, uh, the hospital. And they, they were very positive about that. But let’s, let’s talk about strengthening public health in Marblehead. That’s how all of this started. Okay. Okay. Because that’s what we, we, we want at the end that public health will be much stronger here. And This is the presentation you’ve Given. That’s the presentation. I can’t, the next, that I can’t go to because we would be That’s right. Well, I, two members, let me, the next three slides,

34:25 I’ve not gone anywhere else but here because these, well, I didn’t, female Humane society didn’t part of this. The next three slides for me say, why is public health so important? And we’ll walk through that and then I’ll turn. Okay. So my, my comment, the, the slide title, um, is our public health glass half wall or half Flint Empty? There’s little doubt that Massachusetts is one of the strongest states both in the healthcare delivery system and in public health as a state. So from my perspective, the question is whether Massachusetts

35:12 and Marblehead as part of it, are comfortable being better than Alabama and Mississippi. Or we would, would we like to know a little bit more about the, um, international best practices that are out there? And can we really begin, can we begin to seek out, um, comparisons with international targets and see if we can make that happen? I, I think that it’s possible, but let’s, let’s next slide please, if I may. Okay. These slides come from the Commonwealth Fund, which is a major philanthropic group that studies healthcare

35:58 and always publishes international comparisons. And they’ve published most recently, um, women’s health and it’s, there are 20 or so slides. And the three, I’ll, two, two, I’ll show that say that Massachusetts is clearly, uh, the best of the American states, but still not very, um, at certainly nowhere near the best of the international public health environment, maternal mortality is an important issue. United States is one of the highest, has one of the highest levels of maternal mortality of any country,

36:45 certainly of the wealthy countries in the world. And the most difficult challenge for all of us is that it’s increasing rather than getting better. Yeah. We’re the only country of all of those on this slide that’s getting worse. You know, why would you attribute that? Well, it’s, we’ll never get the slides done. If I start answer, let’s get to the slide, the then, but you can see Massachusetts is, is fairly close. Uh, what’s, what’s the, is that New Zealand? Yes. Okay. On the left. Yeah. Uh, but even, even, look, look, I would think that we ought to be able to figure out how to, how to what, what,

37:30 what can we do, what little things might be done, um, to, to get us closer to a Canadian level, which is half of what we are today. I, I shared the maternal mort co-chaired maternal mortality, uh, uh, statewide in New Mexico. And there are some things that are out there, and there are some places we used, um, Kaiser Permanente, one of the Kaiser Permanente’s that really had a program that was really great for moms and infants. And, and that’s what I hope that we will start looking at. And I, you know, I love to do things like this. So it’s, it’s, I’d be happy if you’re gonna charge me

38:17 to do it, because I’m fascinated by things. I’ve been lucky enough to work or talk and, uh, half a dozen of these places, so I know a little bit about it. So, maternal mortality is a big deal back. I don’t have the slide on age, but of the same, if you look at the same countries, the OACD countries, I think there’re 26 of them, the wealthiest countries in the world, um, uh, the United States, male and females have the lowest life expectancies, the, the women, uh, between two and eight years of lower life expectancy when compared to, compared

39:04 to the international best practices. Mm-hmm. Um, so it, it, it, we, we have a long way to go. Um, okay. So, so next slide. And here, here’s an interesting one. Um, there’s a term called avoidable deaths that public health people look at in, in general. Um, and you can see again, the United States is pretty far, uh, ahead of many of the other countries. Uh, on, on the, on the chart, Massachusetts is well below the average of the United States. And there are avoidable deaths really means that if, um, everyone got

39:54 the best practice of their problem, then the avoidable desk would be zero.

40:05 But if everybody doesn’t get the best practice, uh, then you can count what, how many deaths there were and subtract from say. So. PP pediatrics, um, progress has been made. I think, uh, leukemia, 95% of all kids with a LL will will be, uh, uh, ca cancer free in five years. Um, so if, if you were to have a population which had more than that, then that would be an avoidable death. Now, there’s the problems that avoidable death. The biggest avoidable death for the United States is overdose, uh, gun violence, those sorts of things.

40:54 So we’re not gonna, you’re not gonna solve this overnight. But again, I think that because we are public health, we need to know things like this. And we need to be mindful, um, when we, when we, um, talk about how, what do we wanna do over the next five years. Okay. The next slide is, uh, a fascinating one. I had never seen this data, um, before the Commonwealth Fund came out. And I think this, uh, particular slide I don’t have where, where co, uh, Massachusetts sits, because I don’t know how to get this data in Massachusetts,

41:40 but this is saying that in the United States, 20, what? 25%, the 27% of all women in the United States states take four or more prescription drugs regularly. And Mr what age are we talking about? Uh, 18 and up and up. But I think it’s 18 and up, not just the ones that are, are, are, no, it’s not birth control pills. That’s, yeah. But you can see, uh, there’s an enormous range, and it’s particularly bad for, uh, the black population in the United States, which is interesting because lots of other things say it’s difficult for the black can be women to find primary care,

42:27 to find obstetricians. So whether they just get, uh, uh, they get to see a doc, the doc says, okay, well maybe you need the, the, the, the pills. And they, they write them scripts. And I’m, we haven’t looked at how we’re gonna, what questions we’re gonna ask in calm, but I would surely like to have something like this in there that we can start getting a baseline. One could argue, I think, in both directions, certain marble head’s, affluent people have good access to physicians, better than average. Uh, maybe they’ll have fewer, or they might be wealthy enough that the physicians will give them any drug they sort of want. There are studies in the medical literature that if, uh, a patient comes into the doctor

43:14 and says, I saw that little green pill on on tv, the doctor will be twice as likely to give them that little green pill. Really? Oh, yeah. Uh, in, in, in very reputable position groups. I haven’t seen recent data, but, but certainly when I was teaching, uh, I, I, I taught that all the time. But anyway, this is the kind of thing that we, I think that we as environment, when we move to five people and we have more time, uh, uh, to support what we’re going, what we’re doing with cuny, I think we should see not just Oregon and Colorado and Washington and Vermont as our comparators, but we should try to see ourselves in a global sense.

44:02 We wanna see ourselves in the global sense in biotech. We wanna see a big, certainly Mass General wants to be seen as the number one hospital in the United States and in the world. So why not have this, I mean, this isn’t gonna happen overnight. It’s certainly gonna have, well, I’m on the board, but we can start getting there. We could at least, again, with all due respect, talk less about the transfer station. Fix the transfer station and move forward. Talk about more public health. That’s okay. Okay. That’s what I think. So these three slides were not shared in general with people. Uh, other, other groups that I’ve talked to, uh, I, I did one of these with the Marble Head, with the Humane Female Humane Society. But I wanted to say this, when we talk

44:50 to the select board about why we wanna do this, I think this kind of slide is important because not everybody understands how important public health is and can be. And I think this gives a perspective that you can’t get any other way. So I’ll go through quickly now. Okay. Next slide To tell you. It’s certainly what we studied this kinda stuff when we were Right, but how many people have take, take the time to have, uh, a public health Conversation Or conversation or, or, uh, uh, Um, Uh, class anywhere. Right? Um, if you want these slides,

45:40 we can get you these slides. That would be lovely. No question. You only have to take, take them. Um, um, okay. W this is a slide. This is the first slide that I show to almost everybody. The state of Massachusetts says, in order to do a reasonable job, the local public health offices should be getting about $40 per resident. Um, in fact, we get something like 18 Yeah. Per resident. Uh, so the, the actual budget is 44% of what our own state says we should have. Now, we’re not alone. This is not a Marblehead problem. We talked about Safe 2.0 last time,

46:29 safe 2.0 is saying right at the beginning that a significant, maybe a majority of, of jurisdictions out there had not meet and do not get this kinda support from their, their, uh, jurisdiction. So I think that’s why we really, that Doesn’t mean we shouldn’t, that Doesn’t mean we shouldn’t. No. And well, and, and, and we, we, we were leaders. Uh, I wasn’t here. You were with tobacco. We maybe we turned it around. We hit the, we the courage to, to support public health in general. So next slide please. Well, just one moment though, that this isn’t the first time this, the community’s heard about those numbers because we, we’ve told them at at town meeting number one,

47:15 and, and maybe number one town meeting, number two, that number one, and Andrew and I, two years in a row have gone to the chair of the select board and to Thatcher since he’s come. And the one year when, when, uh, Jason was here Silva and told them those exact figures, and there’s no money, it doesn’t matter. We could stand on our head down there and we weren’t gonna get anything. We tell the finance committee and they brought it to town, meeting our liaison, brought it to town meeting. It’s been drilled into people’s heads for three years. Not longer than that, but for at least the last three years. But we’re gonna keep drilling into their head Of course, because we don’t give up, do we? No.

48:00 The money doesn’t come without trust. And there’s a lot of trust that needs to be built back up in the town or else asking for the money just to ain’t gonna happen. Yeah. Yeah. I Why we what we had to answer. Why, why does the state think it needs 40? And did the state not give 40? Well, this, because there’s so much need around here. What’s your budget of the mental health task force? $7,000 something. No, We’ve never spent, What do we give her That? No, it’s, it’s already gone. It’s been evaporated. We’ve thought mean, but we had it in a bank, but it didn’t get, we didn’t spend it. Alright, So zero it not seventh. What, what’s Actually, that’s part of the reason why the task force thinks they’ll be better off. And, and what’s, you know, what, what’s the money we’re getting to run the substance question survey? Nothing. Correct. I mean, that’s what I’m saying. We are running, we are saying to have trust,

48:47 we are doing things without any money. That’s not necessarily true. I pulled outta my pocket to do the health fair pull outta my pocket. But, but that is the problem is that, you know, for, you know, us to do, you know, great events like that mm-hmm. There’s no money for it. And, and individual members have to support those, those initiatives. And again, yes, we need to build the trust of the community. Mm-hmm. And then they can see how great these events are, and they can understand where we’re going with this, and they can understand the benefits of public health. Yeah. And with another thing it has to do with public health that, that I do all, all along is the task force against discrimination. I’ve told Thatcher, I said, I’m tired of doing the streets. Literally, that’s what I, my, my, my tagline.

49:34 Don’t get tired of that. That’s a, that’s a moving ceremony. No, but what I’m saying is that it, it’s hard to raise that money. Yeah. You gotta get out there and, and do the streets. Well, the point is, the commuted, I, the United States does not understand public health.

49:58 The battle between public health and organized medicine started in somewhere around 1912. But there were battles in, in the Social Security Act that Roosevelt signed in 33 or something like that. There was a place for a national health service, which meant that the meant that the government would employ the doctors and the nurses and build the hospitals. And that debate raised, raised from 33 to 1962 to 65, 64, when, when Lyndon Johnson decided that Medicare and Medicaid, uh, were, uh, gonna go into market based,

50:45 uh, healthcare system. Mm-hmm. And we, there has, there are benefits, uh, to that, but it’s very expensive. And, uh, we talked about the four, uh, that 27% of all women have four or more prescription drugs. When you think the fact that the United States pays at least twice for every, but twice what all the rest of those countries pay for those drugs, the United States is paying even more. Uh, yesterday’s club said that, that the, uh, what Blue Cross Blue Shield of Massachusetts is gonna lose $400 million this year because of the obesity drug phenomenon. I mean, we, we need,

51:31 and public health can maybe help those sorts of things. Uh, on that slide, I can tell you New Zealand was second from the lowest I was working in New Zealand when all of that occurred. And they were very aggressive about getting people to be mindful of that was when they didn’t have a lot of hard currency to, to buy things in the world. And they were very mindful about the docs and the, and the public u using meds very traditionally. Anyway, You know what the interesting part about that is? US and New Zealand being so far apart there, they’re the only two countries that are allowed to advertise on tv. Right? No, you’re, it’s, it’s amazing. The fact that they’re far apart is says we’re doing a lot wrong.

52:18 Well, if I were a marketing person in the drug company, I’d wonder, gee, why? We must not be getting as much as we should from the all the money. I mean, I, I, I can’t see more plaque psoriasis conversations. Glad Joann’s not here on the football games. Uh, anyway, uh, I think she’s on the screen supposedly. Yeah, probably. Uh, but we, she and I talked, she’s seen that slide. Um, anyway, I think that that’s yesterday’s public health today. I think that we, we are talking about the covid issues. We, what, uh, she saw talked about, um, COVID didn’t go as well as we all would like. There has been a loss of trust universally of all org,

53:06 all government, all organizations, but certainly with, uh, public health. But the good news, I think, is there are new perspectives to revitalize public health. And we hope that comp will be a first start for Marblehead to do that. Next slide, please. Okay.

53:27 Now, how do I say this? These slides were made by a person who remains an optimist regardless of what’s happening in Washington today. Is that you? Yeah. The first guest was right. First guest was right. So I believe one way or the other with it, people like us and people like in the audience that public health has to be, has to begin the conversations at the local level. That was also an Ashish Jaw’s awareness that it came down too much came down from

54:14 Atlanta to the local office. The local office should be a participant in the strategy. It can’t solve all the problems. It can’t make all the decisions, but local data are gonna be important for decision making. And the, the CDC is spending a lot of money to be able to develop, um, data type systems that will allow states and regions and localities to, to get information from my perspective, the other, the other most important part of the evolution of public health is really need to partner with local healthcare delivery systems

55:00 because of things like hipaa, the delivery systems, the hospitals, the doctors, doc doctors,

55:09 doctors are, are liable. First offense for HIPAA violation is $10,000. I mean, it’s a, it’s a very serious issue, but we have to figure out ways that we can get de-identified data that will allow decisions to be made about populations without violating HIPAA and other things. Okay. And the third thing that, that I think we’ll see in public health in the future is, uh, health promotion and public mental health activities like we’ve just talked about. Okay. Next slide please. And the new public health vision, we now have it on our, our report. Public health is what we do together as a society to create conditions which

55:56 everyone can be healthy or healthier. Um, and hopefully that’s where we’re Okay. Alright. Um, would You believe that there, there are, there are, uh, illnesses that chronic illnesses and that are beyond our control that everyone Can be? Well, but, but the optimism is if we, if we do some things early in life, my 17-year-old as a 17-year-old doesn’t have very many chronic illnesses. No. And so if we can, we, if we can encourage habits, uh, I mean, I, that’s the, the ideal, but, Well, um, I, I can tell you, having worked in, in New Zealand, having worked in, in, in Germany,

56:42 ha ha you know, have been built a public health department in, in Botswana, that’s where you have to start. Yeah. Mm-hmm. You, you, you just have to do it that way. Right? So if, if local health departments can forest all just one in 1000 preventable hospitalizations in Massachusetts, it would represent a savings of hundreds of thousands of dollars if they can, by educating the public and providing the opportunities to eat right. And exercise, steer those at risk for chronic diseases to healthier paths, the savings could be millions and more. Mm-hmm. Well, that’s that. So it’s all the things we’ve been talking about, but we can’t make people healthy. No. But we can provide information that benefits of great exercise, eating well, seeing doctors,

57:28 but it’s, you know, all these things that we’re talking about, the one thing that we’re missing is the data. So we’ve gotta get it. Yeah. Well, if, if we’re going to invest in trying to make people healthier, we need to know baseline, what are, how are, where are we today? And that’s the whole purpose of fraud. Now, this part you’ve heard before, so we’ll go through quickly. Um, if we wanna measure how effective we’re doing, we just need to have good data. Next slide, please. We know we’re going to try to go with UMass Boston Navajo. If we do with UMass Boston this time, get their skillset, and then we start doing this every five years, we can probably maybe bring that inhouse and we bring it to Salem State or any number of things.

58:15 But, but, but we need to be thinking five, 10 years downstream now. So, UMass Boston, I, I’m impressed by what, how UMass Boston is supporting the, the, the charter committee. And I, what we’ve, so far, what we’ve seen with our conversations has been positive swamps. Scott loves them. The Salem people said the same thing. That there’s a great, the charter Committees working with human tho Yes, Yes, yes. The Collin Center. Yeah. Okay. To next time, this is my favorite slide. Oh, because You like that, you like that gut. I wish I could do that balance at my age. Well, but community wellness includes all the aspects of health, physical, emotional,

59:01 intellectual, social, spiritual, and occupational. We’re gonna use the social determinants of health to, to the, the UMass Faucet is going to try to identify how Marblehead plays out in social determinants. Um, at the state of the town, somebody stood up and talked about how difficult it was for several of his neighbors to be getting old in Marblehead because of resources. So that’s the kind of metrics we need to know. Next slide, please. Okay. So in, you know, where the acronym comes from,

59:49 creating a healthy moral head. Next slide, please. Okay. And this is the process. This is Kaitlyn’s slide. They’re gonna do a document review, they’re gonna do demographic profiles. They, the survey of all the residents from 18. We have to figure out, we wanna be created to get, um, uh, Morgan said that they have done one survey in the Cape. I don’t, I don’t know where, but they actually got a 50% survey among seniors. Well, that’s, It’ll be easier to get seniors, but we have to figure out what it’ll take. How can we, how can we work it out? But in any event, that’ll be our challenge. Next slide, please. Okay. And then this is the last slide I usually show when among

1:00:37 how can organ this organization help increase community involvement? Uh, we, we need to recruit health promotion individuals. This is before we, we thought we were going to five. Uh, we clearly need to know who the stakeholders are in town. How do we get them to come together on focus groups, talk about the issues that need to be talked about. Um, uh, Tommy’s session in later in the year, uh, Marblehead and not immune, uh, uh, is, is the first step in that kind of thing. Uh, so, and we need re we need to do what we can

1:01:25 to encourage residents to complete the comp survey. So thank you. So just leave me your email address and I’ll mail the copy. I’m wondering, after seeing this, that maybe a couple of slides could be part of our board of Health presentation town meeting. That last one and the first one about the, not the first one, but the one about how that we only get, uh, 34%, what is it? 43. Six 44%. Okay. I’m not dyslexic. No. Alright, go backwards. Um, what do you think, Andrew? You think I’m trying to stop sharing. So I

1:02:17 try to,

1:02:20 Well, I hope that we get the opportunity to talk, to share, come with the select board even before all of that. And let’s see how that goes. Oh, between now and June, you mean? Hopefully. Yeah. I, I, I would if the board’s Okay, I would like to approach the select board and ask for time. Now, maybe they don’t want to see the slides, but one way or the other, the slides are very helpful. Do they have 40 minutes or whatever took, uh, I’ll take everything. They’ll, they’ll get us if the three of us wanna go. Or I would like to suggest that we look at, uh, an organizational structure that has three levels.

1:03:08 Uh, three co-chairs happens to be three, I would suggest Andrew, joy Miller, and me. Uh, Joanne was the one who, this time around started this whole interaction with UMass Boston. There, there were some inquiries as we talked about, but in any event, she’s a people person. She knows lots of people in town. So the three of us work to, to, to be chairs. Then I see co-chairs. Then I think that we’ll ask Andrew to work with town, the whole town to make sure everybody in good town government is on board with what we’re trying, trying to do.

1:03:55 Because a, a rising tide’s gonna float all ships in, in this. If marble heads healthier, parks and rec’s gonna be better, uh, the senior center’s gonna be better. Uh, hopefully the schools will be better and all of those places. So we need to have, we ha we need to have enthusiasm to the extent possible in the town. And then the third, I think we need, uh, the, the stakeholders, the business people downtown, the bankers, the, uh, the construction people who use the, the, the, the, the, uh, the transfer stations. Uh, all, uh, the mistake that s Swamp Scott made is they had too many, they couldn’t listen to all of them. So we need to be careful in how we select.

1:04:42 We somewhere maybe in 10 or 15 or max 20 people that would meet regularly hear what the focus groups are saying, help us de decide what questions go on in the survey, that sort of thing. So it, if, unless anyone objects to that, we, we, we, we think we, we sort of move in that general direction. Uh, Who are you speaking to next? Do you have anything like that?

1:05:12 I think I’m talking to the ministerial group on Thursday. Oh, good. But my pastor, our pastor hasn’t responded. Is he the chair? Sorry? The chair? No, he’s not the chair. And that’s Because the chair rotates. Yeah, he was chair. But I think I’m doing that Thursday. If not, it’ll be the first Thursday of April. Okay. Uh, I have, uh,

1:05:39 a meeting with, oh, I think Rabbi Sch a pediatric society, pediatric group. Rabbi Schwartz. Sorry. I think Rabbi Schwartz is the chair. Yeah. Um, That’s the one at the, up on the top of, at the, the across from the JCC. Well, I, I, I’ve started the, I presumably I have an invitation for Thursday and I’m gonna follow it up tomorrow. Okay. But, but I think that’s really important because I think those people have a sense of the community and the needs of the community, and we can make, uh, we could, we, we can help frame the stakeholder group around what we hear from them. Well, they’re certainly not the needs of the community

1:06:25 Because, well, anyway, um, thank you very much for the intention and in, uh, public health. So I think will matter more even in the future than it does in other places. It has in the past. This, with all of the challenges that the United States is facing today, public health is, is really a critical resource that we should nurture and this is the right state, uh, because it, it does have historic strength in the delivery system. Well, we’ve done a good job because the front page of the paper said today that children may get measles vaccines Now.

1:07:13 You like that? So we’ve, Yeah. And we’re back to the 20th century, but that’s, We were at the 18th century a week ago. I, I think the challenge is to remain optimistic and we just have to persevere. Um, that’s doing, and, uh, We are doing it. This, This is probably my mental health. It, it keeps me busy. Uh, and so I don’t mind doing this. I look forward to talking about viruses and genetic information. Well, Thank you for that. So if there are any questions, uh,

1:08:00 if, if you want, just, just let me know. Uh, No, it was very thorough. I just was, um, wondering if you Were going, this is gonna be a silly request, but I tapped out on survey recently because they didn’t stay how many questions there were. Oh, okay. At the very, at the very beginning. You like, you wanna know, even When you’re on each one, just do like one of 40 of 40, because I, I got like 30 in and I was like, this is never gonna end. And I just tapped out and I was like, so it’s There two more. Only two. Well, Maybe I could have been two, could have been a hundred. Could have been one. Right, right. Yeah. Valid point though. Yeah. Yeah. I think Kalin defines survey fatigue somewhere around 40. Yeah. And if we can get fewer, what I hope we can do

1:08:46 is do a tiered survey. So if you answer that you’re 30 5-year-old and you have two children, then you go to a subset of questions that asks you about what it’s like to raise a kid. But if you answer you, you’re 55 and your grandchildren live in Florida, then you’ll go to something else. What are the sidewalks like for your walker or your, that sort of thing. They’ve not done that yet. And so we need some time to work with them and to find people that are smart enough to figure out how they can do that. But they think it’s a good idea and they’re, they’re happy to have us as Guinea pigs to work.

1:09:29 All right. Thank you very much. Did you design all those, uh, sheets yourself? All those fancy things? Sorry, did you design all those fancy pages yourself With a little help from a guy named PowerPoint? I think Wasn’t a woman. She probably was, but I, yeah. Yeah. It comes, you can, you can do it any number of ways. The ideal, I don’t know if we have a logo for, uh, do we have a logo we can put on this for the board of health? A Logo? Yeah, we do have a logo. Yeah. Maybe we should put that as a matter and Yep. All right. So, uh, next is the director’s report. So may I take this as an endorsement to move forward? Absolutely. Okay. Just

1:10:18 I think you’re right to, to, um, down it down a little bit for outside people. This Yeah. Or H five N one. No, H five. This, it’s a, I mean, I don’t think you could do it probably in 20 minutes. Yeah. I, I don’t think even for the select board, maybe do one of the comparators. Okay. I, I don’t know. You, you, you know More about, I think it’s, it, it’s interesting I said to town meeting and I can see two of them being shown. Yeah. But I’d like to see town meeting get it. The two that I, the one about, uh, that our numbers are low and the, and the, the last, I think the last one we showed. So, yeah, I mean, we can talk about that more too. I think it would be it, the whole town should see it briefly.

1:11:06 Uh, so transfer station update. So we’re currently working with SL Chase, uh, steel to install the tipping floor. Um, the steel is currently still at being galvanized. Um, that should be completed, um, today or tomorrow. Um, that’s, so Chase will pick up the steel on Thursday. Um, there’s a chance that they’ll be on site on Friday and begin the install with that, or they’re gonna begin Monday morning and get right after it. Um, so that’s good. They’ll be getting the work and putting everything back together as soon as that work is complete or towards the end of that completion of that work. We’ll be communicating with the installers of the compactor to see if there’s any wiggle room in their current schedule. Um, they’re currently scheduled to come back March 24th, but again, once the install

1:11:51 of the tipping floor is complete, I can really talk, talk to them and say, this is where we are. We’ve completed that phase of it, we’re ready for you guys to come in and do the next phase. Um, so you feel like you’re on your original schedule or even Yeah, we’re pretty close. Yeah. If not up a little bit for us. So, uh, chase Steel. Mm-hmm. Um, but again, you know, I need them on site. I need them installing that. But yeah, you know, the galvanized galvanization process should be complete. Mm-hmm. Um, and we’re mo moving into the install phase of that. Um, I also met with the architects looking at the bigger projects, um, looking to kind of separate some of the items. We wanna focus on the site work of the original project. Uh, so the site work would include the installation

1:12:37 of the concrete and the concrete walls and the compactor building, moving the scale into the scale pit. Um, doing the site work upfront. So putting, you know, pushing deck material for the fence line, moving again, moving that scale over and building the foundation for the new scale house. That would put us in a really good position. You could get all that paving done. You could get lights in lights installed for traffic movements so you can get signage installed and all that stuff. That would really give us essentially full operational moving forward. Then after that point, um, we move after July 1st where we have another sum of money from our waste revolving account where we can look at doing what, you know, I’m gonna call phase two of this, where you’re looking

1:13:24 to do the work on the compact. You’re building itself, so the residing, the, the roof itself and then looking to build, uh, the scale house itself, um, is that, you know, obviously we’ve talked about this. Um, so that’s the direction we’re heading. Um, the architect is working to separate those items out. Um, give us an updated budget of what he needs to move all that stuff around and put this back out to bid. Um, he’s currently working on that. I should numbers next week or at the next, uh, meeting. Uh, what it’s gonna cost the architect to do that work and get this back out to bid. Um, so we can do the site work from the project.

1:14:05 Any questions? You seem to be moving along as quickly. You gotta try to keep it moving. Obviously, you know, because of this, you’re gonna be, because of the tipping floor, because of the compactor install, it is gonna stretch the construction period out, you know, for a longer duration. And so people are gonna have to deal with that, um, employees and re residents. But in the end, it’s gonna be a much better flow of traffic.

1:14:32 Assuming the answer is no, but they, when they’re building the pit structure, is that mean the pits just out during that period or So when they’re building the, no. Okay. So when they’re building the, so the site work Yeah. When they’re doing the scale pit, the pit’s gonna be closed. Right. When they’re doing work on the exterior of the compactor building. That’s what I mean. I see it being opened during those periods. Okay. Okay. Yeah. Yeah. No, I know it’ll have to go down with the scale’s being moved, But no, like once that compact is installed, um, yep. The two pieces that are gonna stop use of the compactor here, it’s gonna be the concrete work down below and the pit work, the scale pit work up top. Mm-hmm. Otherwise, when they’re doing the sheeting

1:15:18 for the roof and all that stuff, really they should be able to continue to do with the work. I have to, I’d have to think the concrete work would be pretty quick. Yeah. You Guys usually fly. Yes. Yeah. Obviously. So excavation for that. Yeah. Lay the, you know, lay all the forms, do the concrete work, you know, two weeks for cure, all that stuff. Yeah. Put it back together in and out. Yeah.

1:15:43 And obviously we’re trying to always, you know, our main focus is keeping the residential area open. Mm-hmm. Um, to try to maintain that being open during all of construction. And so yes, there might be some odd, um, traffic flow, but we should be able to do it. What do you think would be, what in your estimate now would be a start time where that would start after this, I have to talk to the architect to see how long it’s gonna take him to pull everything out, um, put everything back together and get it on, uh, project dog and, and give us some bid times and stuff like that. Yeah. But we’re talking maybe like a year almost. No, no. You think so? I wanna try to get this back out. And so to complete this work from, in a perfect world, we’re completing this work, um, before July 1st.

1:16:30 So July 1st, then you look at the second piece of doing the compactor, building the scale house. Okay. And do you think you’d be done by the end of the year? I can’t say that because I’m, I gotta get to, So we’re just gonna have short periods where things are down. Yeah. And so we just need to communicate that to the community with the workers and stuff being like, hurry up, do your big jobs. Right. Okay. Yep. I mean, you know, and there might be some other ways that we can kind of facilitate, keep, you know, keeping things open. Um, I know it’s been a long time for the commercial side, um, so, you know, it’s not nothing that we could have done now, but maybe moving forward there’ll be an opportunity for us to take some, you know,

1:17:18 waste and some commercial waste and stuff like that. Mm-hmm. But yeah, try trying to continue on, um, was shorter periods with downtime. Yeah. Yeah. Are we ready to go on? Mm-hmm. All right. So, uh, next is the breaks for the tobacco and tattoo. Should we do the tobacco first since you hopeful any of that? Um, well let me, let me start with the tattoo stuff. So the tattoo regulations, um, the North Shore Public Health Coalition has spent a long time with the tattoo regs. Um, those are really set to go. Um, I don’t know if, you know,

1:18:04 if the board present an opportunity to take a look at that stuff. Um, if you have comments, I can incorporate some of those comments in there. Um, but that’s really at a, at a point where I can send this out to council and say, Hey, you know, please take a quick look at this. All the councils have looked at this, we feel this is ready to go. Give us your feedback and we can really start to move on that one. Mm-hmm. I had a page that I had highlighted, plus I have some fees that I’d like to question. Yeah. So for the fees, you and I talked about the fees a little bit. Um, and again, obviously we’re gonna have to have a public hearing to talk about all this stuff. Um,

1:18:50 You want me to begin or? Yeah, go right ahead. Are you looking for something or No? So yeah, I was going to the fee page. So, um, we had proposed establishment plan review of $400 establishment permit application fee of $500. Um, practitioner was three 50, and I think you wanted to make some adjustments to those permit fees. Yeah. Um, I only had two of the numbers that you’re calling out. So that was, um, I had the practitioner and the, and the fee for the, for the facility. Yep. And maybe we could, you could tell me what the other No, you can, you can concentrate on those. Those are the main fees for the, for the Are ones that, but we might wanna, right now the, the, uh, the fee for the facility is $500. And that was put back in, what, what date was that?

1:19:37 Uh, 2003. Yeah. So it’s over, over over two BS and, and I’m recommending seven 15 for, for an increase. And, um, the, the $200 fee, I’m not gonna be as tough because the, the young people coming out, you know, they need, they need to take care of that themselves unless they’re their boss pays it for them. I don’t know. Do they, do they do that above? The fees are gonna be irrelevant in the end. No one’s gonna open a tattoo place in mar in Marblehead, and how much you charge for a tattoo would probably blow your mind. Yeah, right. So They’d be able to pay with one tattoo. Really? Yes. That’s, that’s why I’m not, you know, I think,

1:20:25 I think your felan, you know, is on part. So, you know, I think the $750 for, And that’s two 50 for the, for the operator. The practitioner we have the recommended is three 50. Three 50. Okay. Sorry. Thank you. So I’m, so those two were the ones that, that I highlighted. So what, what were the other two fees for? Uh, so we have an establishment plan review. So, um, and that’s $400. So when you have a new establishment, obviously we have to review the plans. Um, we currently do not do that. We don’t have a plan review for, um, food establishments. Tattooing’s not something that we do on a day-to-day basis. Um, and so generally the other communities are, have a fee to, to do a plan review. So it has to be there in case somebody

1:21:11 wants to do that. Right. This is what you charge ‘em to say, if you’re building a new facility, you have no choice but to pay this fee. And, And 400 is what’s that? It’s, yeah. That is what’s recommended. Good. Okay. And, and this the fourth one, Uh, there’s apprenticeship permit. So a lot of taxi parlors, they have apprentice. Um, so you wanna permit the apprentice, um, the, the apprentice permit application is $200 And that’s what we’re gonna have it as recommended. Yep. And then same thing, you know, tattooing, you often have a lot of guest tattoo artists. Um, so a guest practitioner, um, is recommended at $150. Why don’t you just make it the 200 instead of having another? Okay, That’s fine. Yeah. You all those numbers. Sorry, 200. Yep. Okay. And you know what? No, as he said, nobody’s gonna come in. So yeah,

1:21:58 Most likely you, you might see some permanent makeup establishments. Um, that would probably be the most, what we most likely see here in, And, and they, and a lot of them work under this, under the provider of our physician, and they don’t have to have this. Correct. So if they’re under a physician, they do not follow fall under us. They fall under the state of Massachusetts. I would think most of them would do that. So, um, so can we just agree on, on giving those numbers when we put the, Again, you have another opportunity to discuss it, you know, it is a public meeting, you’ll have to discuss all that stuff at that point. Mm-hmm. But at that point, we hope that people are pretty satisfied with what we’ve already sent to the council. Yeah. Yep. The other question I have, um,

1:22:44 on page seven about, uh,

1:22:49 an establishment, uh, permit shall be valid from the date of issuance, shall expire per the board of health’s permitting schedule permit. Is that a calendar year? We, So, yeah. So, so that’s how, so that’s the language in there. So we permit on a calendar year. So that’s, and so that’s how that would work. So We’ll put the word calendar here. Yeah. Alright. So I, good. I caught that and I put a old style thing. You’re the best proof reader I’ve seen.

1:23:17 Um, in the top, the B one I did highlight, I’m wondering why I did, but how, um, application establishment permit shall be made on a form prescribed by, by and available from the board of health. We need that form Whenever that is correct. So I will have the form again, we’ve created from, uh, the coalition so that form would be available. And I think that’s all I have. Okay. Just felt we needed to get that form and we Correct. No, ‘cause they’re going into, yeah, they go into the, Not my kids and grandchildren are allowed to go into those places. All right. So you guys were That’s what my mom said. That’s happened. But You didn’t listen. No, I was 16. Um, so I will pass these on

1:24:03 to council, I’ll talk to them about a schedule and we can move forward with that. Yeah, I think That need a motion? Yes. No, you can make a motion to move to, you know, move forward and, you know, go to council and then we’ll create a, um, a public So you would like a motion. Sure. Okay. So move that second To go forward and give this to council council. Mm-hmm. And we satisfied with what’s in here next. Yeah. Yeah. Okay. All in Favor? Yep. It’s a majority. Okay. Um, so for the TAC two regulat, I mean the tobacco regulations, tobacco regulations were updated in 2016. So these are pretty new. Um, you know, I didn’t know if there’s anything

1:24:49 that the board wants to dive right into. Are they satisfied with our current regulations? Do they feel that there needs to be some adjustments? Do you want to take a little bit more time with this one? Or where do you guys sit with this? Well, The only thing that I’m saying, um, one or two meetings with you I’ve had is this new product that we were asked to vote on to. So I think that we need to have that language in there and know what, so The synthetic marijuana is that, that’s the new product that you’re concerned about? So, synthetic marijuana is regulated by the Mass Department of Agriculture. So it’s outlawed in the state of Massachusetts. Adding the language into our regulations would allow for us, when we are conducting a tobacco inspection, we would be able to look for that product.

1:25:35 If we find that product, we could find the individual, we, you know, that that would be a violation of their permit. So that, that’s something you really wanna make sure is in there. And is it, Um, so no, we’ve talked, we’ve talked about it with Joyce. Right. Um, but no, that, that’s in the, you know, the language Yeah, the draft. I mean, is it in the draft? It is in the draft, yeah. So we’ll take that draft language and move it over. So into our, into ours. Yep. And then we’ve got, I’ve got a notation here above the, the, the 21 is in, of course. Yep. And the, the flavors and the vaping. What, what about that? So the flavors and the vaping are currently in ours, So we’re all set once we put in this new Yep. Um, so possibly you would show us

1:26:21 that language before. Um, Yeah. I can get the language for the synthetic marijuana. I can show that to you guys and then we can move forward On the 24th On the, at the next meeting. Yes. Yeah. Yep. Well, that would be good. And then I feel, did you see any, No, the only thing I saw was a positive that, which I wouldn’t have expected was the 20% decrease in high schoolers. Right. Which was pretty good for vaping. Right. I would’ve thought the opposite. So now vaping is still an ongoing issue. Um, and it’s more that you have a group of people that have started vaping. They’re having a really hard time quitting. Mm-hmm. Um, and so obviously, you know, there’s always work to be done with that. Yeah. From the medical perspective,

1:27:10 the sense is that cigarette smoke is worse than nicotine addiction so that you can stop smoking by vaping. You wanna try, but I, it’s, it’s complicated. That’s Not a statement you’re making, is it? No, that’s the debate that’s out there. Okay. Uh, I think what I’ve learned from my new 21-year-old I work with is that kids, which I kind of suspected are ordering the vapes from China. So they’re probably not up to par Correct. Of what the FDA is, you know? So they’re probably a lot more dangerous. Right. They’re probably less regulated Yeah. Than an American product.

1:27:56 Yeah. Which I kind of assumed they were doing anyway. Yeah. So, Well, we now know that they’re gonna cross 25% more. Yeah. So

1:28:07 They don’t care. Money’s no. Watch money’s no. For them, it’s the parents that are gonna be suffering with all the increases. Um, minute minutes. Uh, do, do we have minutes? Yeah. Yeah. You’re done. Mm-hmm. Yep. Guess what? Somebody gotta show me. I didn’t bring them With me. It’s lost in this pile. We Can do them. So we can go next time if you would like to. Yeah. It’s lost in this pile someplace. No worries. Um, so let’s put that on the next meeting if you don’t. My husband on the 24th. Yeah. Maybe we could have this meeting in that. Yep. I apologize for that. Worries. Um, we’re, we’re ready for public comments. One one. Anyone on the screen? Oh, Hi. I, um, so

1:28:53 Tom, I wanted just to make sure I got the language right. And what’s happening with the mental health task force? Is it disbanding, is it merging? What’s the verb that you wanna use with that? Well, it’s not disbanding. Okay. I would say it’s evolving into a partner, a stronger partnership with the, the task force did not believe it was appropriate for the task force alone to make those decisions. What the task force was asking is that the Board of health and the management team, the, the board, uh, counseling center get together and work these things out. The, the, uh, uh, the task force

1:29:38 did not, uh, Take any formal action yet. Okay. Yeah. No, I, the nature of the task force, it was created by the Board of Health. Right. And it is regulated by the Board of Health. So basically what the task force was asking last night was with it, parents would check with the other parents and see if the date was okay. Okay. Okay. Cool. So will it eventually, so are, do you have another meeting scheduled for the task force? Like, are you guys still meeting Dr. La Uh, did not book an April meeting. We have the room reserved. Okay. He will wait to see what the minutes of this meeting show

1:30:26 and then decide. Okay. Right. In other Words, he’s gotten a blessing though. I think he’s got your blessing now. I see. Yeah, That’s what he’s waiting. So he wanted to make sure. So you, so is it fair to say that the Board of Health approved the disbanding of the mental health task force? It’s not a Dis I don’t think they would say it’s disbanded. I think it’s evolving to, to, to Partner with. Like, you already were partnered with MC though This No, No. No. Okay. No, No. The only But you won’t have meetings anymore. Well, the, the meetings may be in, in the counseling center that, And they won’t have to be posted And they won’t have to be under the open meeting law. They Won’t have to be well open meeting because they’re gonna,

1:31:13 And one of the benefits for practitioners is that you can talk openly and all of that. Right, right. Okay. So, okay. Um, my other question was have you guys thought about, um, any kind of public awareness around the measles? Um, given that there’s an outbreak now in New Jersey, um, it’s getting a little bit closer. Um, I know you talked a lot about H one N one, but what about the measles in like, I know I personally wanted to know, should I get a booster? Should are boosters recognized? Um, what, what if people have questions about that, what, what’s your advice to folks? I’ll take that as their recommendation that I read up. Okay. I, I, I, I don’t, honestly, I can’t give you, okay. Did we get that answer At home? I did get that answer at home.

1:31:59 Like, so, um, yeah, my husband checked with an infectious disease doc at Beverly Hospital who said, adults do not need a booster. But I, I’m not the board of health. And again, We, we can check with the state. Yeah. See the recommendation is as well,

1:32:14 I’m traveling somewhere where there’s measles, uh, like I’m headed to the Southwest and for vacation. And so I just personally wanted to know if I should get a booster and I apparently do not need to. I don’t think so. But that’s not official like anyone else in the audience. Yes. I have a couple questions on the website. I, um, when the new one came online Yep. Briefly. Yep. Didn’t come on when it said it was, but it came on like a day after I looked at. Do you get the opportunity to see what they post on your behalf on that? Yeah. So the way it’s supposed to work is that all the old information is supposed to come in. We’re supposed to be able to look at it, make sure all the links are still there, and then if there’s information that are missing,

1:33:01 we can make sure that that’s brought over from the old website to the new one. And then obviously look at the format and change the format so that to like an updated format that, you know, um, is easier to read, easier to navigate all that stuff. In theory, Yes, in theory I was curious as to why I paid a hundred dollars for my note sticker, but in that few days that the new website was up, it was only 80 bucks. Yeah. That’s the old information. Yep. And that for the secondary sticker, it was only 25. Right. So, so they uploaded an older version Of the, I think on a lot of your pages that you have, if you would take like for instance, the trash recycling collection notice.

1:33:46 Yep. If in addition to when you said it goes into effect, if you put the date of the notice when it’s posted, because I get so confused going from one to the other, to the other. So on the current board of health site, uh, I can pay cash at the transfer station. Is that true? No. Okay. So when you go, I know you’re working on it, I’m trying To give you No, and I appreciate you looking at, so when you look at, so when I post a notice mm-hmm. You want the date to be up top of when it was posted? Exactly. Okay. It’s less confusing now. It’s less confusing. Now just tell me, you know, it Say, wait a minute. Yeah. Flick back and forth. But, uh, it’s a work in practice. Yeah. But I do really appreciate you taking a look at it. Um, the hard thing for us is that we know it so well that we

1:34:34 Go we’ll skip over it. We Skip over it. Yeah. It’s trying hard to proofread your own. Yeah, that’s exactly right. So I’ll do it for you. Thank you. There you go. No, that, that was basically it. If they let you look at it like in beta form before it goes live to look for, We did a whole bunch of stuff. You already Did that. Okay. Yeah. Okay. Like again, like the links been correct. There’s a whole bunch of Yeah. Yeah. Anyone online?

1:35:06 Nobody has their hand back. Oh. Oh.

1:35:13 I think you have to do it. You have to elevate them too. Yeah.

1:35:25 Diane, somebody, I can’t really read that.

1:35:30 So Diane, you should all, you can unmute yourself and then you should be able to speak.

1:35:37 Hi, Diane Gora, 24 Nicholson Street. I also have a question about the website. Um, when the initial website went live, um, there was no place, like right now, you can, um, go to one page and find all the meetings that are listed and be able to see the agendas. Yep. Um, is that going to, uh, come back to when they, um, repost the new website? Yes. That should be, there should be a page for that. And there should also be a master calendar is my understanding as well. Mm-hmm. Okay. I saw the same thing. It was hard to find you. You have to scroll down. Yeah. It was, it wasn’t as easy as it is on the No, when I tried to find, um, agenda, you had to go to the individual, um, yeah.

1:36:23 Group, like, you know, the health Department or task force against Discrimination. You had to individually look at all their pages to be able to get a meeting time or agenda. Okay. Which it, it’s makes it really hard to get that information. Mm-hmm. Okay. So I hope they’re going to put that in the new website design. Thank you. Good to see you. I just, anyone else? Nope, that’s it. So Meeting adjourned. I have copies of what I had to say. Yeah. I would love a copy. Yeah. Still. Um.