The meeting convened at 2:00 PM. Present were Chairman Louis Fazen, III, Members Ruth C. Brefka, and Nancy A. Sacco, Public Health Director Paul C. Pisinski and Administrative Assistant Barbara M. Luther.

The minutes of the June 7, 2006 and July 19 were reviewed and approved with some corrections and clarifications, as moved by Mrs. Sacco, Mrs. Brefka seconded and Dr. Fazen made it unanimous.

In reviewing the minutes of June 7, 2006 Dr. Fazen told the Board Members that after the Board had unanimously agreed that he should investigate/review, with the Fire Chief the May 19th local emergency situation, involving a Liquid Nitrogen Tanker accident, he also brought the incident to the attention of the Region 4A group. The incident closed down 495 and I-90 (Mass Turnpike) clogging local roads with traffic. Dr. Fazen was pleased to report that Region 4A will also be reviewing the incident to determine what can be learned from the incident and used in emergency planning.
Also, during review of the June 7 meeting, Mr. Pisinski explained that he has spoken with Counsel from the Department of Environmental Protection (DEP) and learned that there will be no need for the Board of Health to hold a $250 deposit for approval of subsurface sewage disposal plans to insure submittal of “as-builts” as was voted in June. This is because DEP requires all Engineers and Installers to submit as-builts to the local authority regardless of payment status between them and their client. Mr. Pisinski suggested a letter be sent to engineers and installers advising them that the Southborough Board of Health will, in the case of an engineer, be forced to report non-submittal to D.E.P. and possibly the State Board of Licensing for Engineers and Registered Sanitarians. In the case of installers the Board of Health could refuse to renew their license for non-submittal of as-built drawings.

Vouchers totaling $382.42 were approved for payment from the Board of Health Budget.

Members were briefed on the agenda and any scheduled appointments.

Mr. Pisinski briefed the members on agenda items as follows: A septic design plan for 5 John St. is coming before the board today for a Variance Request Public Hearing. The variance request is necessary due to the size of the lot and the poor soil that exists in that area. The design engineer will present a design plan with the system less than 10 ft. from the property line; this requires the abutters to be notified and a Public Hearing at which the Board Members review the plan.

In the second briefing he advised the Board Members that, as they requested, the Town Administrator, Jean Kitchens and at least one Selectman will be coming to the meeting at 3:00 PM to hear the Board’s plans for department staffing once Mr. Pisinski becomes part-time and eventually retires. Mr. Pisinski reminded the Board Members that in the Annual Report he used the income generated by the Board of Health from fees, grants and interest from the Betterment Loan Program to calculate the actual per capita cost to Southborough Taxpayers of this department, the amount calculated to be approximately $3.41. Compared to other “non-sewered” towns this is very, very low. Also, when compared to other Town of Southborough department operating budgets the cost is still low. Counsel on Aging spends approximately $16.00 per capita, Youth and Family Services spends about $12.30 per capita and even Recreation, which gets approximately one half of its budget through fees, still cost tax payers about $6.00 per capita. Mr. Pisinski pointed out that school nurses cost the town approximately $24.00 per capita and although he realizes that school nurses are also dealing with unfunded State Mandates, taxpayers need to know that the Board of Health is also charged to fulfill several unfunded State Mandates as well. He explained the very real possibility of State intervention if a town doesn’t fulfill State Mandates, sighting towns that let their septic systems fall into such disrepair and non compliance that the State ordered sewerage treatment plants to be built costing taxpayers much more that building an entire new school.

PETITIONS/PUBLIC HEARINGS
2:30 PM Linda Nolls, 5 Johns St. - Public Hearing The Public Hearing opened at 2:40 PM, with the property owner present. Her design engineer had not arrived as of yet and Mr. Pisinski offered to explain the requested variance involved in the design of Mrs. Nolls’ subsurface sewage disposal system as well as the reason for which it is required. Dr. Fazen asked Ms. Nolls if she would prefer to wait for her engineer, and she answered, “no, please have Mr. Pisinski explain”. The variance request involves the close proximity of the septic system to the property line. Ms. Nolls provided the Board with a copy of the letter sent to the abutters with their comments/approval of the design hand written on the bottom of the notice. Mr. Pisinski explained that the house takes up almost all of the lot. The proposed pump system is in the front of the property, and within 10 feet of the property line.
Peter Bemis, Engineering Design Consultants arrived at 2:45 PM and continued to explain the proposed system relieving Mr. Pisinski. Mr. Bemis explained that there will be two barriers around the soil absorption system, an impervious barrier and a retaining wall. He explained how the impervious barrier is used to prevent any lateral transmission of the effluent, and the purpose of the retaining wall. After being shown a sample of the material used in the impervious barrier, the Board unanimously approved granting the variance request and local upgrade waiver, signed the permit and the plans, allowing Ms. Nolls to take the approved plans with her when she left at 3:00 PM.
REPORT ON CORE DIRECTIVES
Tobacco Control – Public School Signage Mrs. Brefka explained she had gone with Mr. Pisinski to the last Tobacco Control meeting and is intending to go to the next meeting, which will be held on September 26th starting at 9:30 AM. Mrs. Sacco will join Mrs. Brefka and Mr. Pisinski at the next meeting. Mr. Pisinski advised that the Tobacco Control Consortium has advised that the state wants signs posted in all schools (3 per school). Mrs. Brefka & Mrs. Sacco will contact each principal and Mrs. Sacco will take the signs to each school asking the custodial staff to mount them.
Follow-up on “Private” Club smoking issue The issue of smoking in Private Clubs will be discussed at the next meeting. Mr. Pisinski explained that he will be speaking with D.J. Wilson the attorney for The Department of Public Health, asking him to further clarify the requirements of a “Private Club”. If a club is truly a private club, meeting all the requirements the State has set up, the Board of Health cannot prevent smoking in the club. However, Mr. Pisinski doesn’t believe that any of the clubs in Southborough that call themselves “private” actually meet the criteria. However, he wants to have all the details available to the Board before they make a decision.
Anti-Smoking Calendar Program – Mrs. Sacco expects to receive information on the calendar program very soon. She will mention it to the Principals and School Nurses prior to getting the material. Mrs. Brefka asked who voted on the winning pictures and Dr. Fazen advised that the members of the Mass Medical Society, his group cast their votes for the drawings.

NOTIFICATION OF ACTIONS BETWEEN MEETINGS & PENDING ITEMS
38 Turnpike Rd., Failed Septic System has been replaced and issued a Certificate of Completion and Compliance
The Board Members reviewed a letter from Town Counsel regarding 38 Turnpike Rd., which is finally in compliance with the Title 5 Code having its failing cesspool replaced with a new compliant septic system. In reviewing the letter Dr. Fazen noted that this was the first time that the Board of Health had been forced to go to a criminal prosecution to resolve a failed system. Dr. Fazen read into the Minutes Town Counsel’s acclamation of Mr. Pisinski’s professionalism and assistance during the prosecution.
Update on 84, 88, 90 Turnpike Rd. (a.k.a. 2 Woodland Rd.) Mr. Pisinski advised the Board Members that Mr. Heavey has currently schedule a pre-construction meeting on Monday, September 11, 2006. The meeting will consist of Mr. Heavey, who will be installing the system and a representative from the design engineer Ms. Joann Teachout. Mr. Pisinski assured the Board Members that he will work closely with Mr. Heavey during the installation to insure that it is completed timely and properly. Mr. Pisinski further explained to the Board Members that he had adjusted the special condition voted on at the last meeting regarding the order to have Mr. Heavey pump each of the systems weekly until the new systems were installed. Mr. Pisinski explained that Mr. Heavey had refused to sign the “special conditions” portion of the permit that required the pumping. This is because his engineer had advised him not to, pending a decision from the Conservation Commission. The concern was that the Conservation Commission would not give their approval and the required pumping would continue indefinitely at no fault of Mr. Heavey. Therefore, Mr. Pisinski changed the wording on the special conditions to read, “as needed”, advising Mr. Heavey that a licensed pumper would have to be the one to determine how often the system needed to be pumped, with reports sent to the Board of Health.

Licenses:
260801 Mark Sutton Play Soccer Day Camp New
260802 Mike Reilly/John Bizzozero Iron Mountain/Aramark Food Est. New
260803 Richard F. Casaceli Casaceli Trucking, Inc. Installer Renewal
260804 Rebecca Susi Nurturing Touch Massage Est. New
260805 Rebecca Susi Nurturing Touch Massage Therapist New
260806 Cheryl A. Butkus Nurturing Touch Massage Therapist New
260807 Shannon Barbara Ann McGrew dba Peaceful Minds Nurturing Touch Massage Therapist New
260808 Lee Billiard, Academy Director Mass Premier Soccer Day Camp Renewal
260809 F. Joe Cueroni C.Construx Corp. Installer Renewal

Septic Systems
Permit Number St Name Applicant Name Map # Parcel# # Bdrms/GPD Explanation
2006W02 60 Breakneck Hill Rd. ER Sullivan for Beverly Fallon 29 36 Well
2006024 8 Sears Rd. John Kelly 52 7B 5 Revision
9705064 5 Fitzgerald Ln. Michael Martin 3 67 4 Revision
2006026A 2 Meadow Ln. William & Marian Stapleton 47 2 4 Complete Replacement
2006026 12 Rock Point Rd. Elaine Warshofsky 14 22 3 Complete Replacement
BUDGET
Listing of Vouches/Transaction signed by Public Health Director - Upper Blackstone Septage Disposal $1,183.00, Massachusetts Public Health Nurses Assoc. $25.00, Corporate Express (Office Supplies) $79.75, Hopkins Medical Products (Personal Protection Kits) MRC Grant $259.50

NEW BUSINESS
3:00 PM - Staffing for FY 2008 – Town Administrator and Member of Board of Selectmen are invited to the meeting – Town Administrator, Jean Kitchens and Selectmen Roger Challen arrived at 3:05 PM to hear the plans that the Board Members have for staffing after Public Health Director Paul Pisinski retires. Dr. Fazen began by explaining how this Board of Health sees itself and the direction they believe the citizens of Southborough have given them. He said that because they are an elected body the town’s people have the power to remove them from the Board if it is felt that the members are doing more than expected, or less than expected, spending too much money, or etc. He also explained that the members feel that the department is very technical in what it is called to do. Dr. Fazen said that Mrs. Luther does more and more with finances, and administration of specific public health functions. He said Mr. Pisinski is unique, at the peek of his career knowing a great deal about a lot of areas such as state regulations, and other technical areas. He educates and advises the elected Board Members in the segments of Public Health in which they with their Medical backgrounds are not familiar. The former Board of Health spent more time addressing septic issues, all of which was paid for by fees. Up until 9/11 it was easy for the Board of Health to function on a fee-for-service basis, however things have changed and this Board believes that the Town’s people have elected them to address not only the Title 5 type public health issues, but medical and emergency planning, i.e. pandemic preparation, emergency preparedness, Tobacco Control, wellness and obesity. He explained that both Mr. Pisinski and he are members of the Local Emergency Planning Committee (LEPC); Mr. Pisinski as a full member and Dr. Fazen as an Associate Member. Both Dr. Fazen and Mrs. Sacco explained that they had run against engineering type people for their positions on the Board. Mrs. Sacco shared her experiences with the citizens of Southborough; when speaking with her, they are more interested in EEE , West Nile Disease or a pandemic than they are about Septic Systems. Dr. Fazen expressed agreement and credited the former Board of Health, for their careful attention to the protection of the environment with their own regulations and administration of the Title 5 Code over the last 50 years in Southborough. This Board, he explained, believes that they have been elected to add some new public health services. Looking forward, they believe that there will be cooperation and involvement with Region 4A of Massachusetts Public Health Emergency Preparedness Coalition, which has already been meeting and has provided money to purchase equipment, and is beginning the development of Medical Reserve Corps (MRC) in area towns. To date, Southborough has had over 30 interested residents and has 18 Medical/Pharmaceutical/Psychological professionals volunteer registered for our local MRC. These and other individuals will be trained to be available for any pandemic flu, or like situations, and along with the State, will be prepared to respond to the medical aspects of any disaster situations if needed. Dr. Fazen reminded Mrs. Kitchen and Mr. Challen that the Board of Health is set up by the State Constitution and State Statutes to be a critical part or any town. This Board believes that it has to expand and will go to the Town Meeting prepared to explain to the governing body what Public Health should look like in this post 9/11 world; it will have to cost something. He explained that a request has been sent to the Town Counsel to have him review a Memorandum of Understand for Municipal Mutual Aid but advised that the local authority is called to work towards public health protection in their individual towns.. The Board believes it is required to expand from the fee-for-service department it has always been to a department able to nurture the MRC, cooperate with Police and Fire and participate in the LEPC.
Reviewing the per capita cost of the Board of Health to a few other department that are directed only at specific groups, for illustration purposes only, the Board Members explained that the cost of the Board of Health, which serves the entire population, is one quarter the cost of these other services. It is the desire of this Board to turn the loss of Mr. Pisinski into something positive. The Board members advised that they have been reviewing several scenarios one being that Mr. Pisinski, during his part-time years would train another person to understand the particulars of the Town of Southborough and eventually take over his position. Another scenario would be a partial fee-for-service department, subcontracting out areas like the Title 5 Code, Food Service, Pool, Day Camp Inspections, and Housing Complaints etc. thus allowing the department to be re-configured and move forward towards meeting the new expectations being placed on the Board of Health. Mr. Pisinski explained that one scenario that was being discussed was something like the Regional Tobacco Control Consortium of which Southborough is a member. The Worcester Health Department is the nucleus and there are now 17 to 18 participating towns. This program is run with State money, provides legal assistance and advice and does “compliance checks” for participating towns. It may be possible for Worcester Health Department to supply Food Inspectors, Pool Inspectors and other Inspectional services, for a fee paid for by the entity receiving the service. Mrs. Kitchen told the Board Members that in Groton, the Board of Health has a contract with Nashoba Regional Health Services, which is great on inspections, but a little light on enforcement.
Board Members wanted to make it clear, however, that they all agreed that with any of these scenarios the Board of Health budget may require an increase in staff to meet the new direction. Mrs. Sacco said that the hours for the Public Health Nurse will have to increase. Dr. Fazen advised that they anticipate maybe a half-time Nurse, and a developmental type person, one proficient in grant writing etc, as the “person-in-charge”, agent or director.
Mrs. Kitchen said that getting a new position approved will be very difficult in the next few years and suggested that the Board think about going in with a few other towns to cover services and Mr. Challen agreed saying that he doesn’t see very many boards or department being approved for new positions. He felt that shared services would definitely sell better at Town Meeting, suggesting that while using shared staff, the Board could track the success of programs and move toward a new position incrementally.
Dr. Fazen related conversations with other towns in Region 4a which indicated that towns that are spending upwards of $15.00 per capita for Public Health would not be interested in joining into an agreement of mutual aide services with a town that spend $3.41 per capital on Public Health. He felt that this might be a difficulty in developing a Mutual Aid agreement with another town. Mr. Pisinski told Mrs. Kitchen and Mr. Challen about the Fired Department’s request to have the Board of Health do TB testing on all the Firefighters, and Mrs. Brefka explained that the Board of Health is required to perform SORI’s and CORI’s on all MRC volunteers, therefore added even another responsibility/task to the department’s staff.
Mrs. Kitchen advised the Board Members that the Budget would have to be ready by December 1, 2006, and that a plan should be presented on paper for review by the Board of Selectmen and the Advisory Committee.
Stating that the Board had nothing really solid except the contracted 2 years of part-time work for Mr. Pisinski, Dr. Fazen said that the Board will provide a plan for years 1, 2 and 3, but that there will most likely be an increase in the cost of Public Health in Southborough.
Mrs. Kitchens said that she felt that the Board should connect with Police and Fire, to which Mr. Sacco explained that they have already begun a connection and intend to continue a co-operation. However, unfortunately Police, Fire and Public Health are all in different state established regions, set up by each different discipline rather than by towns as a whole entity. Dr. Fazen asked if there might be $5,000 in the general budget to allow the Board to hire a one-time consultant to assist in the steps needed to redirect the Board of Health towards the post 9/11 services that members believe they have been charged to take on. Mr. Challen and Mrs. Kitchen both advised that there was not money available. Mr. Challen suggested that the Board might wait for Town Meeting or see if they can latch onto the Police or Fire Department as part of their work study. Mr. Challen reminded the Board Members that often the town’s people would like a service to be provided them, but are not too keen toward paying for it. Mrs. Kitchen offered to assist the Board in any way she could, they both thanked the Board for inviting them to the meeting, suggested that the Board be ready for Town Meeting with a clear plan and left at 3:20 PM.

The conversation regarding Mr. Pisinski’s pending retirement continued with Dr. Fazen reaffirming his belief that the Board may require a consultant to move the Board into actual planning of how the department should look in the future. Mrs. Sacco said that she felt that the Board of Health still needs to provide the services that Mr. Pisinski is providing now as well as moving in the new post 9/11 direction. It was decided that a student intern might be the way to get someone capable of developing a plan that reflects the Boards view of the future direction at a very low cost. Mrs. Brefka volunteered to contact colleges such as Boston University, University of Massachusetts, Harvard School of Public Health, etc. to investigate the possibility of an intern. Another scenario discussed was that the Board sub-contract out all septic reviews and inspection, pool, food, day camp, housing complaint inspection, etc and pay Mr. Pisinski to develop a plan for moving forward into the new direction, and get the MRC up and running. Mr. Pisinski responded by saying that he doesn’t feel qualified to develop the MRC, but could provide direction and outline many other Board of Health functional responsibilities. He could also help in the development of job descriptions for an agent of the Board and for the inspectors. Dr. Fazen suggested that the Title 5 functions could be contracted out, use revolving funds to pay for them and coordinate mutual aid situations for other inspectors. He reaffirmed his belief that the next Board of Health Agent should be someone with grant writing experience, a planner/thinker. Mr. Pisinski could be used to help write contracts and coordinate a system of sub-contractors.
Mrs. Sacco asked Mr. Pisinski what his contract said his responsibilities are. Mr. Pisinski said that his contract said he would be responsible for all Title 5 related issues and the training of all new employees.
The consensus reached was that the Board will have to go to the town to fund the “new” public health functions and set up a system to have the continual basic functions pay for themselves. It was agreed that the Board may need to ask for another $100,000 to properly address the post 9/11 issues that are necessary in this new Public Health era. Mr. Pisinski will develop plans for how years 1, 2 and 3 will look like, set up contracts for sub-contractors and the reserve accounts needed to pay for contracted employees. There is a precedent set to operate with sub-contractors doing inspections as in the past food, pool and camp inspections had been contracted out to Tom Rice who is still available and could provide this service for several more years until the Board reorganizes.

MRC/LEPC CONNECTION
Mrs. Sacco told the other Board Members that she and PHN, Mrs. Chamberlin had scheduled a meeting with the Fire Chief and Firefighter Pelletier to begin the interaction between the Board of Health sponsored Medical Reserve Corps and the Local Emergency Planning Committee in hopes of developing a sense of cooperation between the Fire Department, which has been and will be the “Command Center” in most emergency situations, and the Board of Health, which has been called into the area of emergency planning.
She also advised that she had been in contact with other Towns in the region and discovered that in Maynard, the Public Health Director Mr. Collins has very little to do with their MRC. Maynard developed an executive committee from the volunteers who now are the ones that virtually run the program. It was decided that the Board of Health will have a booth at the Heritage Day Celebration in hopes of generating interest and getting more volunteers for the MRC.
Working with other Departments – Fire Dept. has asked the PHN, Leslie to run a TB testing clinic for them. There are 26 Fire Fighters 20 FT and 6 PT. Leslie has asked for a determination on whether she should run the clinic or tell FD to find a different means.
A decision on whether the Public Health Nurse will be able to administer TB tests to the members of the Fire Department was briefly discussed. There are a few issues that must be resolved if Mrs. Chamberlin is to be able to provide this service. First is the issue of “Standing Orders”, or a physician to sign for Mrs. Chamberlin to be allowed to do the testing. Dr. Fazen doesn’t believe that he could do this because his malpractice insurance does not cover him outside of his office. Also, there is a concern about the time this service would take away from the limited Public Health Nursing Hours. Dr. Fazen is hoping that a “quid pro quo” agreement might be established between the two departments. It is thought that the Fire Department might have a physician available to them and that maybe he/she might be able to sign the standing orders. Dr. Fazen agreed to contact the Fire Chief and discuss the issue.

Memo for Facilities Committee Board of Health Office space needs – Board members were given a copy of a memo that Mr. Pisinski has given to the Facilities Committee of which he is a member. They were asked to review it and let him know if there is anything they would like added or deleted. Members all agreed that they need a space to meet and space in the office area.

Next Meeting(s) The next meeting is scheduled for October 11 at 7:00 PM at the Fire Station. The Board will meet in November at 2 PM in the Thomas McAuliffe Hearing room and hold the next MRC meeting on Wednesday, November 15 at the Cordaville Hall beginning at 7:30 PM. The topics of discussion at the next MRC meeting will include LEPC Relation, CORI/SORI, Trainings (maybe local) and hopefully receive new members. Volunteers will be given Personal Protection Kits at this meeting.
The meeting adjourned at 5:50 PM
Respectfully submitted by: Barbara M. Luther, Administrative Assistant to the Board of Health