Health Department

The meeting convened at 1:10 PM. Present were Chairman Louis Fazen, III, Members Nancy A. Sacco and Richard H. Seder, Public Health Director Paul C. Pisinski, Public Health Nurse Leslie Chamberlin, Sanitary Inspector Dennis Costello and Administrative Assistant Barbara M. Luther.
The review of minutes of the March 13, 2008 was postponed until next meeting.

Members were briefed on the agenda and any scheduled appointments.
Mr. Pisinski reminded the members that public safety officials would be attending this meeting to begin the determination of whether Police, Fire and Public Health might work in a coordinated effort toward advancing common goals for the Town of Southborough. He advised members that he has some issue which he felt were necessary to discuss under New Business and hoped that there would be ample time in the very full agenda before the board.

REPORT ON CORE DIRECTIVES
Tobacco Control – Mr. Costello reported that although the Mobile station has not failed twice in twelve months, this is not the first time that Mr. Aoude’s station has failed a compliance check. Therefore, he visited Mr. Aoude to provide the him with educational material to help he and his staff comply with the town’s Tobacco Regulation. The material is provided free through the WRTCC to assist vendors with compliance.
Mrs. Luther asked the board members if they wished to participate in another program that the WRTCC was offering, which provides a one time payment of $50 to a tobacco vender who agrees to place a banner advertising that no tobacco sales would be made to anyone who looks like they are under 27 without checking their identification, and absolutely no sales of tobacco product would be made to anyone under the age of 18. It was decided that at this time Southborough would not participate in the program because the compliance rate is good in town. However the board reserved the right to require such a banner, without offering the $50 if a particular vender appeared to need the reminder.

Emergency Preparedness
Mr. Pisinski advised the Board that Region 4A has provided $2,000 per town for training this year. In the past the towns have been given $1,000 and used the money to send members and staff to the MHOA Annual Conference. There are several other trainings that become available during the year and the money could be used for those also. It was decided that some of the training money would be used for Andrew Gleckel to take some emergency preparedness courses or to provide some for CERT/MRC volunteers.

Emergency Preparedness Planning Book - Summary Handbook Review – Mrs. Chamberlin provided the members with a DRAFT copy of the Town Of Southborough Health Department Emergency Response Employee Handbook, which is a summary of the large Continuity of Operations Plan (COOP) Plan that she and Consultant Bryan Murphy-Eustes have been developing. The “summary” is required as part of the “deliverables” for 2008. She has much of the information already provided in the handbook, but needs the board’s input on several key positions required for emergency response. The board agreed on how several positions would be filled and by whom. To complete the booklet, information regarding a mutual aid agreement that the Southborough Board of Health has with any other Region 4A town should be entered. Board members stated that it appears that only one other Region 4A town has even developed wording for a mutual aid agreement, and they will wait on the Region to determine how to meet this particular requirement. Mrs. Chamberlin was asked to request that the subject be on the agenda at one of the next Region 4A meetings. Mrs. Pisinski stated that he thought that it might work better if we made agreements with contiguous town like the towns that were part of the Rte. Nine Tobacco Consortium.

Discussion/Planning of COOP Table Talk Exercise on May 29, 2008 – The members were given a copy of the invitation that was sent out to 27 individuals inviting them to attend a table talk exercise in which a pandemic influenza scenario will be discussed. As the invitations were discussed Dr. Fazen noted that only one person, the Superintendent, was invited from the school department, and suggested that the head nurse and even the principals be invited. Mrs. Chamberlin explained that space was an issue, and advised that she had discussed the list with Archana Joshi, the DPH Region 4A Emergency Preparedness Coordinator, and together they had whittled the long list of possible participants down to its current invitees. Mrs. Luther will contact all invitees on May 1st and if any spots open up additional members of the school department will be invited.
Suggested inventory to be purchased with MRC Grant Money – Mrs. Chamberlin provided the board member with a list of emergency preparedness items she would like to purchase with the MRC Grant money. The list included a stipend for Andrew Gleckel of $599.99, as he is expected to be approved by the board as MRC/CERT Coordinator. Mrs. Chamberlin was asked to review, for the members, the supplies to be approved for purchase. Among the items was a dolly truck for loading items into the trailer that would be used to transport supplies to any site and would also be able to be used as a command post, with detachable whiteboard on the sides. A trailer is the most expensive item to be purchased. The Board was given a list of items totally approximately $5,658 before shipping and handling costs are added. Mrs. Chamberlin advised that because DPH staff would be attending the Table Talk Exercise she would use the money remaining after shipping costs to cater a luncheon immediately following the exercise as is the usual practice. A discussion about syringes ensued regarding whether the board should have a stockpile on hand or whether the state can be relied upon to provide them at the time of need. It was determined that it might be good to have some on hand and rotate them during flu clinics. Dr. Fazen moved to authorize Mrs. Chamberlin to purchase syringes, Dr. Seder seconded and Mrs. Sacco made it unanimous. Mrs. Chamberlin reminded the members that she would need a prescription for the purchase.
Andrew Gleckel Consultant for Southborough’s MRC - Dr. Fazen advised Mr. Gleckel that there is some training money that he might be able to use to further train himself regarding the MRC and Emergency Planning. He was also advised that because he is also an employee of the Town of Southborough the most that he can receive as a consultant is $599.99. Mr. Gleckel agreed to the sum. Dr. Fazen moved that the Mrs. Gleckel be paid a stipend of $599.99 out of the MRC Grant money, Dr. Seder seconded the motion and Mrs. Sacco made it unanimous.
Mr. Gleckel told the members that he has scheduled an orientation for April 26 at 10 AM and May 6 at 7 PM for all the MRC and CERT volunteers. He invited all the board members to attend a meeting if they were available. Mr. Gleckel will hand out CORI sheets and applications to those who haven’t fill them out. He also told the members that Tony Rae, an MRC volunteer has agreed to assist him with developing/coordinating these volunteers in Southborough. Mr. Rae has many certifications, is a member of H.O.P.E. Hummer Owners Prepared for Emergencies. H.O.P.E. members are certified by the Red Cross. With Mr. Gleckel and Mr. Rae’s guidance, the MRC/CERT volunteers will attend the same meetings and training because the need for both or either will often overlap. In the case of the need or an Emergency Dispensing Site, the medical staff from the MRC will require administrative and traffic control, which can be provided by CERT members. Transportation of supplies may also be done by CERT volunteers.

Wellness/Obesity - Mrs. Sacco reported that Ms. Doreen Ferguson participated in a video conference regarding the International Walk to School Day that the Board of Health and Recreation Department are planning for October of the next school year. Ms. Ferguson will provide Mrs. Sacco with a report any information gathered from the conference. Mrs. Sacco will then provide the information to the board members of the progress at the next meeting.

Working with Other Departments – Police Chief William Webber and Officer David Hagen arrived at 2:00 PM. Dr. Fazen greeted them by explaining that Working with Other Departments toward a healthy community is a priority for this board and a regular agenda item. This is because the board feels that there are health issues involved with all aspects of a community and the board wants to be a source of help and input wherever needed. Chief Webber yielded to Officer Hagen to explain the reason for his department’s desire to explore a working relationship with the Board of Health. Officer Hagen explained that when he began to work on a strategic plan for the future of the police department, which was to be presented to the Board of Selectmen, and Advisory Committee as part of the budget process, Chief Webber asked that he also include other public safety department in the process. Office Hagen said that he hoped that this meeting may be a means of determining whether the three (3) agencies, police, fire, and health might work together in untraditional ways to positively affect the public safety and health of the residents of Southborough. His suggestion is to form a “work group” that would take a look at the issues each department is faced with and develop a plan to share resources. Dr. Fazen’s initial thought was a concern about guns and shootings we hear about in many schools, asking Chief Webber is his department had any programs designed to address this issue. Dr. Fazen believes that this could also be addressed as a health issue. The Chief explained that there is a strategy designed to deal with this of violence, however no actual exercise has been done. There is training, maps and blue prints, all available to address violence in the schools but no exercise as of yet. Dr. Seder asked if there is a program developed to make the students aware of these dangerous situations. Chief explained that there is a policy booklet that all teachers and administrators have which addressed what they do in each specific instance. Fay School has hired a consultant and has done table top exercises with the police department, but public schools do need some more work to complete their programs. Dr. Seder asked if the school have a psychologist to help the children. Mrs. Sacco advised that they do. Dr. Fazen said he believes that the issue of guns is one area that the police and health departments should be involved with the schools. Mrs. Sacco felt that the issue of violence, all types of violence is an area that needs to be addressed by police and health in conjunction with the schools, noting the incident in Holden recently where a student was beaten with pipes. She said that she knows that D.A.R.E. Program addresses the issue of violence, but that is with younger kids, and she would like to see it addressed with the older students also. Dr. Fazen said that the issue of violence opens up a large area of concern, asking Chief Webber if his department keep records of violent incidents. The Chief reported that there were 18 domestic assaults in 2007 and double that in domestic complaints that weren’t classified as assaults. The issue at the schools is mostly due to restraining orders and a non-custodial parent trying to pick up a kid without permission. Dr. Fazen agreed with Mrs. Sacco that violence and gun issues are items that the board can work on programs of prevention and intervention. Chief Webber reminded the members that the high schools are in Northboro so it is the Northboro Police Department that deals with that type of violence that occurs mainly with the older students. Southborough Police Department deals only with the two private schools and the 4 elementary/middle schools here. Dr. Fazen said that he believes that the board should know what types of violence occurs in the high schools. Dr. Seder asked if the police have a list of registered firearms in Southborough and if there are any programs on how to keep guns safe. Chief Webber advised that his department does has a list of register guns and explained the Massachusetts law that requires guns to be locked in a case or have a safety lock on them. Dr. Fazen advised that the issue of weapons was a lead article in the New England Journal of Medicine, saying that there already is precedence set for health agencies to become involved with guns and violence.
Mrs. Sacco advised Chief Webber and Officer Hagen that the board will be asking for their assistance in the International Walk to School Day that the board will be sponsoring in the fall. She explained that it is the hope of the board that more students will choose to walk to school after participating in this international event. She said that realizing that the infrastructure of the town isn’t good for walking to school, a police presence would be necessary if children begin to walk to their schools. She noted that it is amazing the number of calories that are burned just in walking to school each day and believes that this could be good for the town’s young people. Chief Webber suggested that at least the three departments, health, police and schools might begin to dialog about this event and that maybe the DPW would have to also be involved.
Chief Webber then referenced a situation just over a year ago when all the area roads came to a standstill because of spill on Rte. 495. He believes that we need to look at how we are going to address a similar situation. Dr. Fazen said that he had been stuck in the tie-up and became concerned about emergency preparedness in any other situation such as that one, so he brought it to the Region 4A Emergency Preparedness meeting looking for support with the state after that incident seemed to be largely ignored. Chief Webber agreed that it would be a good idea to have a working group to determine how all departments would deal with a similar situation. Mrs. Chamberlin suggested that the issue be brought before the LEPC because it includes all department heads and could be a starting place to look at how transportation would be address under difficult circumstance. Officer Hagen said that his only concern with starting with LEPC is that LEPC is at a tactical level. He believes the discussion needs to be brought up to the level of what is the objective of each discipline, then down to the local level of what each group brings to each other, and then down to the tactical LEPC type level. He suggests that the police department come back in a month with a list of who should be a part of the working group and what they feel should be discussed by the group; the fire department and the health department would likewise bring their people and ideas to the working group and all would start at the “whiteboard working group” level.
Dr. Seder said he is concerned about highway safety especially if we have a mass exodus from Southborough or a dirty bomb in Boston which sends refugees coming out this way. He asked if we are prepared for such events. Chief Webber stated that he believes that the magnitude will be greater than what is currently expected. The state believes that within 30-40 minutes much of the refugees would be out here, but he believes that it will be more like four hours and that traffic will be at a standstill, with each town basically on its own. We have a well organized plan, but we will also be effected by Westborough, and Marlborough issues that will have to be addressed as they come. Dr. Fazen asked, if we do have numerous people fleeing Boston come here are we equipped to set up cots, and provide for them? Mrs. Chamberlin stated that we are working on that. We have made our first round of emergency preparedness purchased with that in mind and have just begun the second round, with an eye towards transporting what’s needed. She reported that supplies are now centralized, which is a good step in the preparation.
Dr. Fazen said that he believes that using LEPC is a way to look some of these issues; that highway safety is a police and health issue that maybe the DPW needs also to be involved in if we seek to prevent speeding and accidents. Jean Kitchen, Town Administrator, who was in the audience, questioned the connection between speed/driving and the Board of Health. Dr. Fazen responded by saying that we need to begin thinking differently. He advised that the leading cause of death in the United States is automobile accidents, and anything that is a leading cause of death is a public health issue. He continued by stating that he believes that almost every issue has a health component and references an article on accidents, injury, and firearms in the New England Journal of Medicine. Dr. Fazen then summarized the board’s four issues of concern for the proposed working group; Local Emergency Planning, Highway Safety, which include speeding and drinking, Violence/Gun issues and the Health of our First Responders. Dr. Fazen also told the group that he had spoken to several firefighters about the importance of immunizations. Mrs. Sacco asked if it might not be helpful if from time to time the board offered monitoring of blood pressure, glucose levels, etc. Everyone agreed that that might be a good idea. It was shared that during negation officers were interested in stipends for physical fitness. Mr. Pisinski asked if it would be helpful if the Board of Health assisted in providing backup information during negotiations regarding immunizations. Dr. Fazen stated that education on personal health for first responders is primary and said that he would be happy to facilitate an educational meeting.
Although Chief Mauro wasn’t able to attend the meeting, Mr. Pisinski brought up a concern that he has had for some time; 24/7 coverage by the health department. Mr. Pisinski stated that is all the years he has worked in Southborough and responded to restaurant emergencies or fires, no one has gotten sick but perception is critical. Even though presentations indicate that there in no real harm to the public the concern about a response is causing undo alarm. Dr. Fazen said that we don’t have 24/7 coverage, but that in the past members have responded to emergencies, and there is a basic call down list in effect. He believes that this is a Region 4A issue and that it may take a regional response to provide. Mrs. Kitchen advised that there is a Bill on the State Legislature to allow Boards of Selectmen to act on Mutual Aid Agreement rather than having to go to Town Meeting.
All agreed that public a safety/health strategy should be developed, and Officer Hagen suggested that there might be time on the May Board of Health agenda at for the police, fire, health department and LEPC to share who they want in the “Working Group” that will ultimately report the concerns each department has and how they all might work together for a healthier community.
Dr. Fazen showed everyone a draft of the Public Health Advisory Committee report regarding a Healthy Community and advised that what makes a healthy community is long range planning that involves several of the community’s departments/agencies all working toward the same goal. Schools, Recreation, Council on Aging, Police, Fire, DPW all can work together to create a healthy community. Officer Hagen advised the board members that Kevin Landry is the liaison between the police and the school department and Officer Hagen believes that he or someone from the schools might be included in the working group, which would determine how a program such as this might coordinate and actually reach its common goal of increasing the life span of Southborough residents. A scenario might have the police working on curbing speed, the fire department on hazardous materials, the Board of Health on education along with the schools. Dr. Fazen agreed and added that there might even be the potential of decreasing budgets as departments interact toward the same goal. Officer Hagen stated that as procedures are reviewed and the process is agreed upon we may find that the process is the product. Mrs. Chamberlin agreed that this speaks to gathering together resources in the town of which people may not be aware. Dr. Fazen added that as most Massachusetts towns are between 5 and 10 thousand in population, and Southborough is able to develop this program it may very well be used as a model for other towns.

NOTIFICATION OF ACTIONS BETWEEN MEETINGS & PENDING ITEMS
Licenses: None issued since last meeting.
Septic:
St Name Applicant Name # Bdrms/GPD Explanation Engineering Permit Issued
2 Southville Rd. RCG realty Trust Component Repair A.S. Engineering 4/1/2008
19 School St. Matt Whelan 3 Complete Replacement GREEN HILL ENGINEERING 4/1/2008
124 Parkerville Rd. Stonegate Realty Trust 4 Update METROWEST ENGINEERING 4/1/2008
27 John St. Ashwani Kaul & Mona Bham 4 New CONNORSTONE, INC. 4/3/2008

NEW BUSINESS
Discussion on adopting a new Betterment Loan Policy which requires participants to sign an affidavit stating that they will not sell their property for and certain number of years after participating in the betterment program. The policy would also levy a penalty for paying off the loan equal to a pre-determined number of years of interest that the town would have collected on the loan. The board members felt that this might be a good idea and asked the staff to look into the specifics and report back.

Town Water Quality – Because of an issue addressed at the Town Meeting, Dr. Fazen asked Mr. Pisinski if the Board of Health has been involved in monitoring the quality of the town’s water. Mr. Pisinski stated that the Board does receive an annual report regarding the water testing that the Water Department is required to do by statute and also quarterly reports from the MWRA regarding their tests and finding. Mr. Pisinski believes that the issue with water quality are often overblown which create some very difficult and unnecessary concerns for the Water Department and the public. Tests are regularly done for total coliform, and lead. On occasion a total coliform count, which is greater that acceptable, is discovered. It is usually as a result of dead ends in the pipes or areas that are not regularly flushed. The pipes are flushed and the problem is usually solved.
Dr. Fazen said that he would like the Board to be more knowledgeable with regards to what is happening with the town water. He believes that this is an intrinsic health issue that the Board can respond to and provide support for the water department and its programs adding a medical and health input to address issues of water quality. Dr. Seder advised that other members that he has been involved with water supply issues for much of his public health career and would be very interested in addressing water quality related issues for the board. Dr. Fazen asked if Mr. Costello would join with Dr. Seder as a subcommittee to look into the town’s water. Mr. Pisinski suggested they invite the DPW Superintendent, Karen Galligan to a Board of Health meeting to determine how best the board might be of help. Dr. Fazen said that he believes that the board should be able to respond to or take a stance regarding questions of water quality or public concern. Dr. Seder said that on the whole the MWRA water is good, much improved since the new water treatment was built, and often time the problem occurs in the town distribution or in home pipes. The consensus of the board was that this issue should be included in the regular agenda items related to working with other department to develop a healthy community. Ms. Galligan will be invited to a meeting and if she desires can bring Town Engineer John Woodsmall. Dr. Seder and Mr. Costello will attempt to meet with DPW Dir. Galligan prior to her attending a board meeting. The intent is to review this issue, bring pharmaceutical concerns into it is necessary, and have a report ready before the next year’s town meeting.

Possible plaque on New Office site to honor previous elected Board Member(s)
Dr. Fazen had asked Mr. Pisinski to check with Dr. Stone after last months meeting when he suggested that the new Board of Health locations have a plaque in commemoration of Dr. Stone’s years of service on the board. Mr. Pisinski met with Dr. Stone who said that he would strongly suggest that if a plaque be made Philip G. Mauch be included on it. This is because Dr. Stone believes that Mr. Mauch was the one who held the Board of Health together for most of the years it was in existence and feels that his contributions also should be noted. Mr. Pisinski suggested that the board ask Donna McDaniels, to create an Honor Roll plaque. Mr. Pisinski suggested her because of an article she had done in 1999 when the Annual Report was dedicated to both Dr. Stone and Mr. Mauch. He will have a copy of the article for the next meeting.

Discussion:
Creation of a Board of Health Agent, Administrative Agent or similar professional position
Mr. Pisinski asked the board to consider the concept of creating the position of Administrative Agent. He explained that the new part-time position of Public Health Director and Contracted Sanitary Inspector has worked well this past year for everyone but Mrs. Luther. He advised that she has taken on several new responsibilities without appropriate compensation or recognition. He would like to prepare a job description for a position called Administrative Agent or some other title that would enumerate a position which entails some of the duties he had when he first started in Southborough. He will have a draft job description ready for the June meeting. Dr. Seder said that he supports such a position, but questions the impact it would have on the budget. Mr. Pisinski advised that the board members that, the Personnel Board, and the Selectmen would have to approved such a position therefore it would not be worked into the budget until Fiscal 2010 taking effect July 1, 2009. The effect on the budget would be looked at during budget preparation which begins in the fall.
A case of viral meningitis was reported, and Mrs. Chamberlin will follow up of reporting procedures.
The meeting adjourned at 5:15 PM

Respectfully submitted by: Barbara M. Luther, Administrative Assistant to the Board of Health