Pepperell Board of Health
June 18, 2009 Meeting Minutes
Call to order:†††††††††††††† The meeting was called to order at 3:33pm.
Members Present:†††††††† Robert Lambert, Chairperson, John Marriner, Alfred Buckley†
Staff Present:††††††††††††† †Sandra Grogan Board Secretary
Guest Present:†††††††††††† Robert Hanson, Town Administrator, James Garreffi, Nashoba Associated Boards of Health
Topic of Discussion
Discussion of staffing office for FY 2010
∑ Mr. Lambert opened the meeting by discussing the secretaryís hours. Mr. Lambert feels in order to run the office properly the secretaryís hours need to be increased from 15 hours beginning July 1, 2009 to 30 hours per week. He feels there is no way to run the office on 15 hours a week. A letter from the Board would be signed by all members if they were in agreement and forwarded to the accountant.
∑ Mr. Lambert explained to Mr. Garreffi, the monthly calendar the Board receives. Whoever represents Pepperell from Nashoba may want one in case the Board needs to have him/her present at the Pepperell Board of Health meeting.
∑ Mr. Hanson entered into the meeting and looked at the motion the Board passed regarding the increase of hours for the secretarial position. He stated your increasing the hours at the presumption that when the Special Town Meeting takes place in the fall, the town will vote to give you enough money to continue the secretary through the rest of the year.
∑ Mr. Lambert told Mr. Hanson he has already spoken to the Town Accountant.
∑ Mr. Buckley asked if we pull enough money off the permit fees perhaps in the future this money could be used to off set wages.
∑ Mr. Hanson said at one time this may have been probable but this is no longer the case.
∑ Mr. Lambert said fee money canít be used for that purpose.
∑ Mr. Hanson replied all money collected would go into the general fund.
∑ Mr. Lambert asked if there were any permits and warrants to sign.
∑ Mrs. Grogan passed the Board, a Construction Permit to approve and sign for 7 Robin Lane.
∑ Mr. Marriner said we are approving this, but it sounds like Nashoba will be inspecting someone elseís approval. They may not want to do that.
∑ Mr. Garreffi said they would take a look at it at outstanding permits and if we had concerns we would tell you.
∑ Mr. Marriner said if the design engineer designed it wrong then Nashoba should have some say in this.
∑ Mr. Hanson said I think what the Board needs to have some kind of blanket understanding. Anything that Nashoba is going to approve is subject to full review before it moves forward.
∑ Mr. Garreffi interjected that Nashoba is pretty flexible and they would take a look at it. They donít want to hold up anyone. We want to make sure all designs meet the regulations in Title V. If we see something that is an issue we will talk to the Board members.
∑ Mr. Buckley expressed his concern if a permit had been approved for 15 feet of dirt then Nashoba says they want 20 feet of dirt it would bother him for the fact the contractor had bid on 15 feet of dirt now an additional 5 feet of fill has to be brought in.
∑ Mr. Marriner said thatís a fair statement.
∑ Mr. Garreffi said they would go by the set of plans by the design engineer.
∑ Mr. Marriner had asked about me putting in for mileage.
∑ Mr. Buckley stated I should have something to back up my request for being paid for my mileage.
∑ Mrs. Grogan explained she used her vehicle for traveling to the post office several times.
Mr. Buckley made a motion to accept the secretaries position be increased from the FY 2010 hrs of 15 hours per week to 30 hours per week.
Mr. Marriner seconded it.
Mr. Marriner makes a motion to approve the permit.
Mr. Buckley seconded it.
A vote was taken.
All were in favor
A vote was taken.
All were in favor.
James Garreffi, Nashoba Associated Boards of Health
Board Vote to Join Nashoba Associated Boards of Health.
∑ Mr. Marriner opened the dialogue by asking Mr. Garreffi about Nashoba Boards of Health Nursing services. He would like to know if a shelter had to be opened would there be a nurse present from Nashoba.
∑ Mr. Garreffi said no not from Nashoba. This is some of things we need to work out. During the ice-storm, one of our nurseís lives in Townsend worked a shift at the shelter in Townsend but we donít have enough nurses to put in all shelters including Pepperell.
∑ Mr. Marriner asked what happens in the eventuality we are made an island and people need blood pressure checks or medicine.
∑ Mr. Garreffi spoke to Carol Horgan our community health nurse. She has already met with Ellen and they went through the schedule where and when the clinics are held. Nashoba Nursing believes they can meet the existing schedule.
∑ Mr. Marriner said that is under normal conditions, say we have an earthquake or hurricane and its abnormal conditions and those people need still need medicine or blood pressure taken.
∑ Mr. Garreffi said we can do what we can do.
∑ Mr. Lambert asked about the ice-storm. How did make out on that.
∑ Mr. Garreffi said we took care of our patients. The nurses went and dealt with the patients that we have on our Health Promotion list. Our nursing service took care of the ones they have on regular service.
∑ Mr. Buckley asked if that would include the ones in Pepperell that would need the same services.
∑ †Mr. Garreffi said yes. The nurses spoke to Ellen and one of things they wanted to do is look at the patient records. Mrs. Castellano wouldnít allow this, until Nashoba becomes part of Pepperell. The nurses were concerned when Mrs. Castellano mentioned deleting patient records.
∑ Mr. Hanson responded by saying she has no authority to delete records as these records belong to the Town.
∑ Mr. Buckley agreed.
∑ Mr. Marriner is a little bit concerned if a pandemic was declared. Where do we stand?
∑ Mr. Garreffi said right now the H1N1 flu, has been declared a pandemic. Right now there is no vaccine. People would want to follow rules of DPH, stay at home and follow up with your doctor.
∑ Mr. Marriner asked about vaccines.
∑ Mr. Garreffi said the H1Ni vaccine is being worked on. †Probably you will see the vaccine in late September. In addition, we probably have some extra flu vaccines from the past flu clinic in the refrigerator.
∑ Mr. Marriner said he was appointed to the Emergency Preparedness Committee and they meet monthly at the Police department. He has not seen anyone representing Nashoba.
∑ Mr. Garreffi canít make it on Tuesday. I am working with Littleton for shelter plans. For dispensing sites Iím working with Lunenburg, Ashburnham and Littleton. †Even though Iím not at the meetings Iím working actively with these towns with Police and Fire departments. I work with Littleton Medical Reserve Core.
∑ Mr. Marriner wanted to know if Nashoba does the seasonal flu clinic and is there a cost.
∑ Mr. Garreffi said they do the regular clinics and try to encourage people to come to these. There is no cost. If someone has Medicare we will bill them. He said we donít ask for money. The nurses will give flu vaccine at the locations that Mrs. Castellano dispensed them. He said if a Pepperell resident missed the flu vaccine they can go to Townsend when they hold their flu clinics and received a flu shot.
∑ Mr. Marriner asked if the Fire Chief wanted his men/women vaccinated on a meeting night at the fire station would Nashoba come out.
∑ Mr. Garreffi said they could but all parties must cooperate. We canít keep sending a nurse out and only a couple of people show up.
∑ Mr. Marriner said Pepperell BOH works for the tax payer and we donít want them to have to go to Ayer for a shot.
∑ Mr. Garreffi reiterated Nashoba will be present in Pepperell for flu clinics.
∑ Mr. Marriner asked if someone gets sick at 3:00am can they call the nurse. He asked if a patient has a serious condition will the nurse come to Pepperell during that time.
∑ Mr. Garreffi said if a patient is extremely sick, the nursing staff would advise them to call 911. We have a telephone number patients can call and explain symptoms.
∑ Mr. Hanson asked if he understands correctly, when that call is made and its not clear if itís a true emergency the nurse or whoever is on call will perform some type of triage to try to ascertain the situation.
∑ Mr. Garreffi said that is his understanding of the nursing services.
∑ Mr. Marriner said the patient can call and they wonít have to wait 20 minutes for a return call.
∑ Mr. Garreffi said they should get right through.
∑ Mr. Buckley asked if records are registered.
∑ Mr. Garreffi said they donít have that kind of system. They write it down when calls come in. We want to take care of all patients in Pepperell.
∑ The discussion switched to Title 5 services.
∑ Mr. Buckley asked how long it would take before they come out to do an inspection.
∑ Mr. Garreffi said they usually ask for 24 hours advance.
∑ Mr. Buckley asked what would be the turn around time for signing off on a permit.
∑ Mr. Garreffi said he tells a person if they get all the paperwork in itís usually takes seven days. It depends what is happening on any given time
∑ Mr. Buckley said if Nashoba comes out and inspects the work and says itís good and signs his name and letter of compliance comes here or to you for final compliance for a guy to get his pay check. To finish checking things off that a total of nine days thatís a long time.
∑ Mr. Garreffi said they have a list the conditions to follow. We need the as builts from the engineer.
∑ Mr. Buckley said if you donít have everything in your hands that would be the applicants fault not Nashobaís. Iím going on the assumption that everything is there.
∑ Mr. Garreffi said there will be a person coming in your town so many days per week which affords the opportunity to get the necessary paperwork in. †For me I get them done as fast as I can so it wonít go past the seven days. I even ask applicants if they have a closing coming up. I canít give you a hard and fast number of days because each application can be all over the place.
∑ Mr. Lambert said if someone comes in a week before we can look and approve it and then sign off at meeting. It wonít go more than 14 days.
∑ Mr. Garreffi said in most cases the permits get signed off, we can issue the certificate of compliance from our office. This is one of the things I would like to talk about. We have standard forms we would do a plan review and we would send you the plan and a review form with any issues or send you a plan thatís acceptable with a permit attached to it saying here is the plan we reviewed with your regulations and according to Title 5. If the process is alright with the Board, once the application is complete Nashoba can sign off on the permit. It all depends on upon the Boards comfort level. The town of Boxborough has given me permission to sign the certificate of compliance for them.
∑ Mr. Lambert expressed as a Board they would like to sign the permits.
∑ Mr. Garreffi said that is fine as other Boards do the same. It is just the Boards preference.†
∑ Mr. Marriner wanted to go back and talk about the cost of the services that Pepperell BOH, will be paying for Nashobaís services. He doesnít understand why such a high cost.
∑ Mr. Garreffi referred to the cost of the environmental and the nursing cost. He said they take the assessment and divide it by the populations. We charge other towns for both assessments.
∑ Mr. Marriner asked if Groton and Townsend get both environmental and health assessment.
∑ Mr. Garreffi said they do. He did say those towns donít have nurses sitting in the senior centers. They are out in the field.
∑ Mr. Marriner asked if other towns received the dental services.
∑ Mr. Garreffi said they do. The dental hygienist will go into Pepperellís designated grades and do a dental screening for the children. If an issue has to be addressed a note would go home to the parents so they can take their child to there own family dentist.
∑ Mr. Marriner is looking for ways to cut cost.
∑ Mr. Hanson suggested look at the budget in six months, you may want it to remain as is or not. If there is money left over it will come back to Pepperell. To cut the number now when you donít know what the number is you are cutting off your foot.
∑ Mr. Lambert expressed that Nashoba is taking a chance, just as Pepperell may be taking a chance.
∑ Mr. Lambert asked Mr. Garreffi if someone has committed violations and they donít correct them, then who is the responsible party that would take them court
∑ Mr. Garreffi said Nashoba does the court filing. If they have to, they will go to court. Mr. Garreffi asked if Pepperell has any pending legalities.
∑ Mr. Lambert said no.
∑ Mr. Buckley asked regarding billing and records would it be possible for Nashoba to send a copy of the nursing services performed in Pepperell.
∑ Mr. Garreffi said they normally donít do that but he will ask the nurse for a break down.
∑ Mr. Marriner wanted Mr. Garreffi to let Pepperell BOH know if anything needs correction on the part of persons please advice the Board.
∑ Mr. Lambert said he doesnít want people to take advantage of you and your people representing Pepperell.
∑ Mr. Buckley brought up doing inspections. He asked to be excused from going into restaurantsí for inspection.
∑ Mr. Lambert said that he would go with the agent to introduce him/her and show him/her where restaurants are located in Pepperell.
∑ A motion was read that the Board of Health agrees to membership for the Town of Pepperell in Nashoba Associated Boards of Health. Effective July 1, 2009.
Mr. Buckley made the motion.
Mr. Marriner seconded the motion.
A vote was taken.
All were in favor.
Meeting adjourned: 4:54 PM. Mr. Buckley made a motion to adjourn the meeting. Mr. Marriner seconded it. A vote was taken. All were in favor
Respectfully submitted by:†† Sandra Grogan
_____________________________††† †††††††††††††††_____________________________††††††††††††††††† _________________
† Robert Lambert, Chairperson†††††††††††††††††††††††††† John Marriner†††††††††††††††††††††††††††††††††††††† Alfred Buckley