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MEETING PACKET JULY 2011 1 - ''I ��\, �,, I 1 I�� I �; y ` I �i v� yi � .,• a , " CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH 120 WASHINGTON STREET,4m FLOOR KIMBERLEY DRISCOLL TEL. (978)741-1800 FAX(978) 745-0343 MAYOR Iramdin(@saletn.com LARRY RAMDIN,RS/REHS,CHO,CP-FS HEALTH AGENT NOTICE OF MEETING You are hereby notified that the Salem Board of Health will hold its regularly scheduled meeting Tuesday, July 12,2011 at 7.00 PM City Hall Annex, 120 Washington St. Room 311 MEETING AGENDA 1. Call to order 2. Approval of Minutes from June 14, 2011 3. Chairperson Announcements r' • 4. Public Health Announcements/Reports/Updates ;" a. Health Agent Y b. Public Health Nurse. M` c. Administrative d. Councilor Liaison 5. Discussion of Board of Health mission, objectives,responsibilities and plans 6. Miscellaneous .T his Wlco 0006 i on "Official 90 �d" 7. Adjournment -Itgl Hall. sillem, Mass. © y4/� ? in accordww Larry Ramdin :. Health Agent cc: Mayor Kimberley Driscoll, Board of Health, City Councilors Next regularly scheduled meeting is August 9, 2011 at 7pm at City Hall Annex, 120 Wash* on,Street Room 311. Know your rights under the open meeting law MGL Chapter 39 Section 23B and City Ordinance section 2- 2028 through 2-2033 �is agenda has been prepared in advance and represents a list of topics that the Chair reasonably anticipates will ue discussed at the meeting. However,the agenda does not necessarily include all matters which may be taken up at this meeting. CITY OF SALEM BOARD OF HEALTH MEETING MINUTES • June 14, 2011 DRAFT MEMBERS PRESENT: Dr. Barbara Poremba, Chair, Martin Fair, Marc Salinas, Robert Dionne & Dr. Larissa Lucas OTHERS PRESENT: Larry Ramdin, Health Agent MEMBERS EXCUSED: Gayle Sullivan, Councilor Liaison Furey TOPIC DISCUSSION/ACTION 1. Call to Order Meeting called to order by Dr. Poremba, Chair, at 7:00pm. 2. Minutes of Last Meeting Motion to approve minutes L. Lucas 2"d R. Dionne (May 10, 2011) M. Salinas abstained(was not present at last month meeting) Motion passed. 3. Chairperson Announcements Dr. Poremba presented a copy of"City of Salem BOH Planning FY 05". This is in need of updating. G. Sullivan(who is unable to be at this meeting) suggested that the Board have a retreat type meeting with the Health Agent to discuss and revise mission, goals, objectives, duties and responsibilities of the BOH and initiatives that may advance these. Possibilities included a Thursday night or Saturday morning or during a regularly scheduled meeting. No date decided. Dr. Poremba asked the members to review what is on the website and the documents given about the BOH in order to participate in this. The Health Agent will be updating a community assessment that is necessary for these revisions. Further discussion at next meeting. • Dr. Poremba commented on the `This is Public Health' campaign to educate the community on the purposes and values of public health (available @ http://www.thisispublichealth.org/). She may be able to recruit SSU Nursing Students to assist with the project and suggests this as a good way to aid the BOH in connecting with the community and providing new initiatives. Per custom, Dr. Poremba stated that unless unusual circumstances develop, there would be no August meeting. The July meeting is scheduled but if there is no new business, it may not be necessary. Dr. Poremba will make an executive decision regarding the meetings. All members were in agreement. 4. Monthly Reports-Updates A. Health Agent Presented and approved. Copy available in office Report A packet was passed out to the Board Members that included the open meeting law and a guideline of the legal authority and procedures of the Board of Health. L. Ramdin presented to the Board some training opportunities available to enhance the understanding of their role and function on BOH, including: • Introduction to Local Boards of Health htti)://www.masslocalinstitute.orq/?i)=541. • Foundations of Local Public Health(3 week sessions), • MAHB Certification Program(scheduled for November, will • inform the board of specific dates) L Ramdin suggested combining Health Agent and Public Health Nurse's report into a full department report sub-headed into environmental health, community health and other information that the board would like to see. The Board supports this plan. Some initiatives being pursed include: • Setting up blood pressure clinics at the Senior Center, senior housing and low income housing in Salem. • Having a BOH table at the Farmers Market to provide information on services and public health issues. • • Working with the Salem Family Health Center on a chronic disease project. • Creating walking routes in different neighborhoods in the city L. Ramdin presented a letter to the board about a measles incident in Salem. There was a brief discussion. No further action necessary B. Public Health Presented and approved. Copy available in office. T. Giarla will be attending Nurse Report a 4 day seminar on Pandemic Influenza Preparedness and Planning at the Center for Domestic Preparedness in Alabama. C. Administrative Presented and approved. Copy available in office. Report D. City Council Councilor Furey was unable to make the meeting due to a scheduling Liaison conflict. He has sent a letter to Rich Viscay regarding establishing a Updates revolving account for the BOH. M. LaChapelle presented request for work space variance. Possible 5. New Business health implications discussed. None identified.. A. Body Art Establishment Motion L. Lucas 2nd M. Salinas to approve variance to leave 1.5 feet Variance request from between the walls and ceilings of the work space and to add a small Michael LaChapelle window for viewing in each work space with the amendment to • ensure that the window can be configured to allow for client privacy. Motion passed unanimously M. Fair suggested the Board delay amending the regulations pending observations on a job site with the HEPA filter in use. These observations B. BOH Exterior Paint will continue and Health Agent will advise board on the process for any Removal Proposed potential amendments to the current regulations. Regulations & RRP L. Lucas &R. Dionne have not witnessed any smoking in taxi cabs at the train station. L. Ramdin stated that department staff have been making spot checks and have not seen smoking in taxis. A letter was sent to the C. Update on smoking in taxi taxicab companies reminding them that state law prohibits smoking in cabs cabs as well as stickers for placement in the cabs. L. Lucas suggested sending a copy of the letter to the Salem Chamber. HQA will send this. Copy of the letter on file in BOH office. None 6. Miscellaneous 7. MEETING ADJOURNED: 8:28 p.m. Respectfully submitted, • Heather Lyons-Paul Clerk of the Board Next regularly scheduled meeting is July 12, 2011 at 7pm, City Hall Annex, 120 Washington S4 Room 311 i CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH • 120 WASHINGTON STREET,4"'FLOOR TEL. (978) 741-1800 KIMBI✓RLLY DRISCOLL FAX(978) 745-0343 MAYOR Iramdin(a,salem.com LAR.RY RAM.DIN,RS/RF,I IS,C110,CP-F''S M.'AI:n.I AGI N'1' Public Health Nurse Report June 2011 Activities Disease Prevention • In contact with North Shore Pulmonary Clinic regarding active cases and case contacts. • Investigated communicable disease cases and reported to the MDPH. • Meetings/Clinics • Blood Pressure Clinic held at Police Headquarters. • Met with Camp Kernwood Director to discuss camp regulations. • Met with Children's Island Camp Director to discuss camp regulations. • Attended seminar"TB beyond the basics" sponsored by New Jersey Medical School Global Tuberculosis Institute. • Inspected YMCA camp at Legg's Hill YMCA . All camps permitted for 2011. • Assisted the Peabody Public Health Nurse on June 20 and June 22 with TB contact testing. 17 work contacts were tested. • Campfire camp inspected and permitted for 2011. • Inspected and permitted Children's Island Day Camp for 2011 season. • Attended the North Shore Cape Ann Emergency Preparedness Coalition meeting. • • Inspected and permitted YMCA camp at Camp Naumkeag, and the YMCA camp at Sewell Street. • • Salem State College camps were inspected and permitted for 2011. • Attended American Red Cross workshop for Mass Care in Shelters. • Inspected and permitted Boys and Girls Club Day Camp. • Assisted David Greenbaum with two elders at risk. Residence was condemned, and the couple was referred to North Shore Elder Services. Emergency housing provided with assistance from Salem Council on Aging. MONTHLY REPORT OF COMMUNICABLE DISEASES JUNE 201 1 DISEASE NEW CARRY OVER DISCHARGED REPORTED CAMPYLOBACTER 3 0 2 2 HEPATITIS C 3 0 3 3 HEP C: THREE CHRONIC HEP C CASES REPORTED. • CAMPYLOBACTER: 60 Y/O NONFOOD HANDLER. HE BELIEVED THE SOURCE OF INFECTION CAME FROM FOOD CONSUMED AT A RESTAURANT IN DANVERS. REPORTED TO DANVERS INSPECTOR AND FOOD PROTECTION PROGRAM. CAMPYLOBACTER: 22 Y/O MALE. NON FOODHANDLER. SOURCE OF INFECTION UNKNOWN. CAMPYLOBACTER: 57 Y/O MALE. LEFT A VOICE MESSAGE. WILL FOLLOW UP. • Administration Monthly Report June-II Burial Permits @$25.00 $1,750.00 Permits $6,440.00 Certificate of Fitness@$50.00 $3,900.00 Copies Fines Total Monies Collected = $12,090.00 Annual Budget Expended Finance Dept Total$ Transferred on 1118110 Available Balance Total Salary/Longevity $337,609.00 ® $275,924.25 ® $4,571.66 $66,256.41 Annual Budget ® Expended Available Balance Non-Personnel $21,200.00 $20,840.00 $360.00 (Mileage reimbursment) t CHAPTER 2 LEGAL AUTHORITY AND PROCEDURES SOURCES AND SCOPE OF LEGAL AUTHORITY In the area of public health, there are three primary repositories of authority: the federal government,the state government,and local authorities.Examination of the constitutional basis of power at each level of government helps one understand the role of local official health agencies. The Federal Government: The powers of the federal government are limited to those functions explicitly delegated by the Constitution. All other powers are reserved for the states or the people. Although powers delegated to the federal government are limited,and although health and safety matters have traditionally been considered matters properly regulated by state and local governments,federal regulatory action derived from the powers to regulate interstate commerce and to levy taxes for the general welfare has considerable impact on state and local health programs and enforcement. The State Government: In contrast to the defined powers of the federal government, state governments have broad powers. These include Apowers to prescribe,within the limits of the state and federal constitutions,reasonable regulations necessary to preserve the public • health,safety,and welfare.@ These powers are commonly referred to as Apolice powers@ and are derived from the nature of state government. While there is no specific definition of the states=police powers,the courts have historically found two basic purposes that justify a state=s actions with regard to the public health: $ actions for the protection of a given individual; and $ actions for the protection of society at large. It is a widely accepted function of government to protect the health of society, even at the expense of the individual=s freedom. Although the state government is the primary repository of authority in public health matters,there are constraints on this authority. In some cases,these may be explicit powers granted to the federal government,or prohibited to the states by the federal constitution or federal laws. In other cases,individual rights of citizens,as they are expressly enumerated in the federal and state constitutions,may take precedence over the state=s authority. In public health, policies such as requiring adequate sewage systems and performing inspections of private dwellings depend on a balance between the individual=s right to privacy and the governing agency=s overall concern with the health of the individual involved and society at large. State governments are clearly the primary authority in the field of public health and possess the power to make laws for the public health. This power consists, in part,of being able to delegate authority. It is from this power that state agencies and local boards of health derive • most of their authority. State agencies derive virtually all of their powers from laws enacted by the state legislature and approved by the Governor. Local governments also derive most (but not all)of their authority from such state laws. Local Authorities: Local public health departments and agencies derive their authority • primarily through explicit and specific delegation of power from the state legislature. This authority includes both the powers that are expressly granted by state statutes and those powers that are necessarily implied from those statutes. In delegating power, the state legislature places limits on the exercise of that power. In this way the state specifies the manner in which the power is to be exercised,the consequences of failure to exercise it,and the consequences of improper exercise of that power. The extent of the state=s delegation of power varies from designating the board of health as the primary enforcement agent of the state=s regulations (as is the case with the housing section of the Sanitary Code)to authorizing the board of health to draft its own regulations regarding public health matters (see M.G.L. c. 111 '31). The only absolute restraint is that such regulations must be consistent with state law. In certain cases, statutes specify that local regulations must be approved by a state regulatory agency before they may become effective (e.g. air pollution, food service, radiation control, etc.). Local regulations may be more stringent than existing state mandates,but in no case may they be inconsistent with state regulations. In addition, regulations must be Areasonable@ solutions to the problems they address. AReasonableness@ may be tested in court. It should also be recognized, however, that local governments may also act without delegation of authority from the state, under their own ordinances or bylaws, subject to certain limitations.Under an amendment to the Massachusetts Constitution promulgated in 1986(the AHome Rule Amendment@),local governments have the power,through their own ordinances and bylaws and without specific authorization by the state,to regulate in areas in which state law does not prohibit them from regulating. Cities and towns may, under this • Ahome rule@ power,(by approval of the city council and mayor in cities or by approval from the board of selectmen and town meeting in a town) promulgate general ordinances and bylaws relating to health matters(e.g. rubbish storage and collection, insecticide spraying, etc.).These ordinances and bylaws may,by their terms,be enforceable by the local board of health or some other public board or official(e.g.building inspector,police,etc.). They may also grant rule making authority to the local board of health. In short, cities and towns are free to promulgate health related bylaws and ordinances governing all subjects that are not prohibited (by state or federal law) from being regulated. However, such ordinances and regulations are not enforceable if they conflict with applicable federal or state law or if they are unconstitutional(because they are not reasonably related to legitimate local government interest, or some other reason). To effect enforcement of the health regulations or ordinances promulgated by the local board or the city or town, and those regulations and statutes promulgated by the state but enforceable by the local board,the local boards are sometimes granted the power(in those regulations,statutes and ordinances)to make inspections and examinations,to issue,revoke or suspend licenses and permits,and to issue orders to any individual or business which is in violation of the regulations or standards. The local boards are directly responsible for the enforcement of these standards. Failure of a board of health to enforce the Sanitary Code or the Environmental Code may result in the state re-assuming its power to enforce state laws and regulations. If it is determined by the Commissioner of the Department of Public Health (DPH), the Commissioner of the Department of Environmental Protection(DEP)or their designees that • the local board of health has failed after a reasonable time to enforce the Sanitary or Environmental Code, DPH or DEP may assume enforcement powers to effect compliance with the Code(see M.G.L. c. 111 '127A and 105 CMR 400.3oo as well as M.G.L. C. 21A '13 • and 310 CMR moo). Determination by the Commissioner is made in the following manner: If,as a result of a study,inspection,or survey,the DPH or DEP determines that the board of health has not effected compliance with the Sanitary or Environmental Code, DPH or DEP will send a notice to the board of health. The notice gives the board of health a reasonable amount of time to effect compliance,and requests the board to notify the DPH or DEP as to what action has been taken to effect compliance with the Code. If the board of health fails to provide this information, or if DPH or DEP decides that insufficient action has been taken to effect compliance,it will be deemed that the board of health has failed in its duties, and DPH or DEP may assume the board=s power to effect compliance. Certain statutes provide for Acoordinate powers@ of DPH with local boards of health (e.g. M.G.L.c.111 '7 concerning the investigation of contagious or infectious diseases), or Aconcurrent responsibility and authority@ (e.g.M.G.L.c.111 1198 concerning enforcement of lead poisoning prevention and control statutes). RULE MAKING: PROCEDURES FOR MAKING LOCAL REGULATIONS • Historically,legislation and regulation have been tools for translating knowledge of causes of disease and ill-health into programs for the protection of public health. Boards of health may determine that regulations are necessary to control the causes or to outline methods of dealing with a public health problem. Local regulations may not be inconsistent with state or federal regulations, but may be more stringent. Most state regulations are called Aminimum standards@ and local boards are authorized to make stricter standards. The process of drafting regulations usually requires collaboration between the board of health and the town counsel or city solicitor who provides or coordinates the legal expertise necessary for the proper drafting of the regulations. If the town or city employs a health officer,he/she may be asked to assume responsibility for defining and documenting the problem and drafting a proposed regulation (with the assistance of the city or town=s attorney) for presentation to the board. The board then considers the issues, holds hearings as necessary, and makes the final decision. Regulations may be prospective in nature.That is,boards of health may require precautions to avoid potential dangers as well as to restrict conditions proven to be harmful. (Benes et. al.1995)• M.G.L.c. 111 '31 is an unusually broad grant of authority which empowers boards of health to adopt Areasonable health regulations.@ The power of boards of health to adopt regulations • under section 31 is extensive and Aprovides a comprehensive,separate,additional source of authority for health regulations@ (Benes et. al.1995)• ' 1 / The following section is intended to assist the board in drafting regulations. Note that the • first step in this process is developing and checking the rationale - the nature, documentation, extent and impact of the problem or need - before the board of health proceeds to the rule making stage. It may be that health problems or needs can be addressed through the use of existing state law,thus making new regulations unnecessary. Guidelines for Drafting and Promulgating Regulations I. RATIONALE AND CONSENSUS OF BOARD A. define problem B. demonstrate need for regulation C. get Ago ahead@ from the entire board prior to drafting D. hold public meeting or hearing on the problem if desired or required by general laws regulating the overall activity(e.g. assignment of sanitary landfill site) II. CONTENT A. Title and table of contents of regulation(s) B. Define terms C. Designate individual or agency responsible for enforcement D. Establish standards E. Describe duties and procedures F. Describe enforcement and sanctions $ nature of sanctions $ conditions warranting sanctions $ process for applying sanctions • G. Indicate the specific sections of the general laws under which the regulations P g g are adopted H. Specify by what authority the regulations are adopted(M.G.L. c. in '31 and other relevant sections of the general laws) I. Indicate the effective date of the regulations J. Indicate the relationship of the new regulation(s)to any relevant existing regulations(s), including specific provision for regulation(s)to be repealed by acceptance of the new regulation(s) III. STYLE/ FORMAT A. Be brief B. Follow conventional numbering system for regulation(s), as defined by general laws or local regulations C. Express regulations in the present tense D. Use active voice E. Use third person singular to the extent possible F. Follow accepted punctuation form $the meaning of the regulations should not depend solely on the punctuation $ if a minor change in punctuation changes the meaning of the regulations, they should be rewritten IV. PROMULGATION A. For Title V(septic system) regulations, hold a public hearing on regulations, with notice of hearing published twice and the first notice published 14 days • prior to the hearing. For other regulations, a public hearing is not required. B. Approve regulations by a majority vote of the board � 9 • C. Publish a summary of the regulations in the newspaper D. File attested copies of all regulations with DEP V. LANGUAGE: Use clear and consistent definitions that are substantially consistent with traditional meaning. (For a good example of locally drafted regulations, see the Dumpster Regulations of the Town of Winchester in the Appendix). PERMITS AND FEES A board of health can require a permit, set a fee, or set out substantive performance standards as a part of a regulation. Boards may regulate by describing in a regulation all possible conditions under which an activity can be conducted without substantial injury to the public health and without a permit. In some instances, it would be difficult, if not impossible, to specify in a regulation conditions under which a person could conduct an activity without board of health review. The board may instead require a permit,whereby the board makes a decision based upon evidence presented on a case by case basis(Benes et. al. 1995)• Permits and fees may be authorized by a state statute.or regulation,such as a permit for the transportation of garbage or refuse required by M.G.L.c.111 '31B. Boards of health may also require permits and set fees where there is no direct statutory authorization for a specific type of permit, such as the,above,but is a necessary part of their general regulatory power. For instance,boards of health could adopt regulations,pursuant to their general regulatory • powers under M.G.L. c. 111 '31, to require every person who owns or operates a genetic engineering facility to register and receive a permit prior to operation(Benes et. a1.1995)• Boards of health may also be authorized to require permits and set fees pursuant to a town bylaw or city ordinance. If the amount of the fee is not determined by state statute or by a general town bylaw or ordinance,then boards may set the fee(Benes et.a1.1995)• However, the amount of the fee must be reasonably related to the administrative costs expected to be incurred by the board in connection with the board=s regulation of the activity(i.e.the costs of board inspections, administrative and record keeping duties, etc.). Fees: Fees imposed by the municipality tend to fall into one of two categories: user fees, based on the rights of the municipality as proprietor of the instrumentalities used; or regulatory fees (including licensing and inspection fees), founded on the police power to regulate particular businesses or activities (Benes et.al.1995)• Such fees are distinguishable from taxes in that: $ they are charges in exchange for a particular governmental service which benefits the party paying the fee in a manner Anot shared by other members of society@ $ they are paid by choice, in that the party paying the fee has the option of not utilizing the governmental service $ the charges are collected, not to raise revenues, but to compensate the governmental entity providing the services for its expenses (Benes et.al.1995)• • Permits: If the board of health requires a permit as part of the regulatory process,it should set out standards on which it will rely in reaching a decision. It is not necessary for those standards to be excessively detailed, for it may be impossible Ato specify in what • circumstances permits should be granted and in what circumstances denied. Each case must depend upon its particular facts.@ Nonetheless, the board is obligated in its regulation to provide standard or guidelines that the board will use in exercising its permit-granting authority (Benes et.a1.1995)• If a permit is required for an activity,then the board of health,which has the power to grant or to withhold the permit,must decide what action to take Ain a fair,judicial and reasonable manner upon the evidence as presented ... keeping in mind the object of the applicable regulation@ (Benes et. al. 1995)• INFLUENCING STATE ADOPTION OF REGULATIONS: If the board of health wishes to influence or change state regulations,or to call attention to a regional problem, it can follow several courses of action: $ contact relevant committees or boards $ discuss the issues with DPH or DEP and other regional officials $ contact DPH, DEP or other state agencies $ attend, and testify at, hearings held by DPH or DEP on proposed regulations. The executive departments of the state government have rules of procedure and rules for adopting administrative regulations(e.g.310 CMR 2.00,Rules for Adopting Administrative Regulations). It may be useful for you to review these rules to help you understand how state regulations are adopted. • ENFORCEMENT AND DUE PROCESS Local boards of health have the power and responsibility to enforce regulations made under the State Sanitary Code and Environmental Code(see M.G.L.c.111 ' '127A and 127B and 105 CMR 400.00o and other chapters of the State Sanitary Code. See also M.G.L.C.21A '13,310 CMR ll.00 and .10 CMR 1 .o 3 5 ) M.G.L. c. 111 '187 specifically authorizes boards of health to apply to the Supreme Judicial Court or Superior Court for enforcement of its orders relative to the public health, and specifies the applicability of M.G.L. C. 214 ' '11-12. Jurisdiction over certain civil actions (such as actions for injunctions and actions for receiverships) brought by local boards of health to enforce Chapter II of the State Sanitary Code (Housing) is vested in the Superior Court, District Court and/or Housing Court under various provisions of M.G.L. c. 111 ' '127A-127I. Jurisdiction over criminal actions to enforce state and local regulations and ordinances and any other misdemeanors established by law is vested in the district courts, the Boston Municipal Court and the Superior Court under M.G.L. C. 218 '26. It should be stated that a criminal proceeding can only be commenced if there is a specific state statute which makes the public health violation a criminal offense. A board cannot proceed against a violator criminally in the absence of such a statute. In trying to determine whether a state statute is a criminal statute, the most relevant question is: Does the statute say that violators may be punished by a Afine@ or Apenalty@ or by Aimprisonment?@ If the statute contains no such • language, it is very unlikely that the board can commence any criminal proceeding. To effect the enforcement of the Sanitary and Environmental Codes,local boards of health , • are encouraged to exhaust all administrative enforcement actions before pursuing court action. The procedural provisions of these codes are quite specific and should be referred to and followed exactly in each instance. The following outline suggests general strategies for the enforcement of the Sanitary Code and Environmental Code. A. Make an inspection 1. routine, or 2. upon request or complaint. B. If you anticipate enforcement problems, you may want to take photographs of violations and, if court action is contemplated, take samples as necessary and observe procedure if specified in regulation. C. Serve notice of the violation(s)and/or serve a copy of any orders;indicate statutory or regulatory basis for your enforcement action in the notice or order. D. Determine whether the violation or condition constitutes an Aemergency@ or Aimminent health threat.@ 1. If the violation or condition constitutes an Aemergency@ or Aimminent health threat,@ the board should consider whether you can/should either order the owner to correct the violation immediately(e.g.within 24 or 48 hours)or to cease operations completely until the violation has been corrected (which may require a suspension of the owner=s permit without a prior hearing). 2. If the violation or condition does not constitute an emergency, the board • should issue an order allowing a reasonable time for correction (Note: the specific code chapter under which the board is acting may specify a Astandard@ time for correction, such as io days). E. Make a re-inspection on or soon after the deadline for correction(or,if the facility is closed due to an emergency permit suspension by the board,upon receipt from the owner of a verbal or written assertion that the violation leading to the suspension has been corrected). F. If correction has not been achieved,issue a notice of non-compliance which states the grounds for the finding of noncompliance and lists what actions the board is taking (i.e. license or permit revocation or suspension or administrative penalty assessment)and which advises the owner of his right to a hearing before the board concerning that administrative action. If no license or permit suspension or revocation action or administrative penalty imposition is involved, skip below to item J; otherwise,go to item G. G. Arrange hearing, if appropriate. H. Hold hearing before the full board;board to issue decision after hearing. I. Serve notice of imposition or penalty or revocation of license or permit,if applicable, after holding any hearings required by law and serving adequate notice. J. In cases where no administrative action is to be taken,you may go directly to court and file a criminal or civil action, depending on the circumstances. Generally, criminal • actions in the district court are appropriate for seeking payment of fines or penalties and civil actions in the Superior Court are appropriate when you are seeking injunctions (i.e. court orders to enforce a Board of Health order or decision). } K. Proceed with civil or criminal process. • Since legal action can be expensive,time-consuming and exhausting,especially for a small staff, it is important for the board to use administrative sanctions at its disposal, such as revocation of licenses and permits and imposition of administrative penalties, where e possible. When administrative sanctions are no available, t a able a criminal complaint may P p y be required to obtain compliance. Inspections: Numerous provisions of the General Laws as well as Chapter I of the Sanitary Code and Title i of the Environmental Code authorize local boards of health to enter and examine certain premises or facilities either upon complaint or according to a local plan for systematic, periodic area inspection. Inspections are to be conducted in the manner described in the relevant statute or the relevant provision or article of the Sanitary or Environmental Code. Generally, the statutes and regulations allow such inspections to be performed, without prior notice to the facility owner, at any Areasonable time.@ (See sections below, items in Appendices,and subsequent chapters for additional information). Periodic Area Inspections: Periodic area inspections serve to determine whether conditions exist that are deleterious to the health and well-being of the public. These maybe regular(i.e.once a year,twice a year,etc.)or periodic Amonitoring@ inspections intended to make sure that the regulated facility is in compliance. Inspections Upon Request or Complaint: Inspections may be performed upon the request or complaint of a person that credibly appears to have reason to believe that a facility is out of compliance with applicable regulations. These inspections typically involve the examination of premises for specific alleged conditions that may constitute violations of law, • rather than a comprehensive examination of the entire premises. If an occupant or owner objects to such an inspection, it is necessary to obtain a warrant to conduct the inspection. Chapter I of the Sanitary Code authorizes local boards of health to obtain a search warrant to conduct an inspection,Aif any owner,occupant,or other person refuses,impedes,inhibits,interferes with,restricts or obstructs entry or free access to every part of the structure, operation or premises where inspection authorized by(the) Code is sought.@ The board should have substantial evidence indicating that a search is necessary. If cause for a search is judged to be warranted,officials of the district court,with the help of the board or health officer, will develop an affidavit recommending that the court magistrate issue a search warrant (M.G.L. c. 111 '5(1)). The warrant apprises the owner, occupant or other person of the nature of and justification for the inspection. The board may seek police assistance in presenting the warrant. If efforts to conduct an inspection are impeded by an owner,occupant or other person,the board of health may revoke or suspend any license,permit or other permission regulated by the board. This power should provide considerable leverage to the board to obtain compliance. Suggestions for Conducting an Inspection: Routine inspection of housing units should take place at a mutually convenient time. Establishments such as catering services, recreational camps, refuse disposal facilities and food manufacturing plants should be inspected at times when they are operating, when possible problems can be observed. • The inspector should identify him/herself, show his/her credentials, and state 1 • his/her intent to inspect the premises and the nature of the inspection. If entry is refused, the inspector should leave and report the refusal to the board of health for further action,such as approval of obtaining a search warrant for the inspection. At the time of inspection,the inspector should note all violations and complete the appropriate inspection forms. If expert assistance is deemed necessary but is not available at the time of the inspection,the inspector should complete the form to the best of his/her ability, indicating areas that require a separate inspection with expert assistance. The board should promptly schedule the expert inspection. At the conclusion of an inspection, the inspector should report all violations to the owner or occupant of the premises, the operator of the establishment, or some other responsible person as may be specified in statutes and regulations. Orders: Public health officials may issue an order for compliance with the Sanitary or Environmental Codes whenever a violation is found. Such an order gives notice to the violator that a violation exists and serves notice upon him/her to correct it within a specified time. Failure to comply with an order may result in other legally sanctioned procedures, such as commencement of civil proceedings or criminal prosecution in court. • In enforcing local regulations and the Sanitary and Environmental Codes,local boards have the authority to serve orders on all persons in violation of regulations. Orders are served in the following manner: $ personally,by any person authorized to serve civil process, or by any person authorized to serve civil process,by leaving a copy of the order at the individual=s last and usual place of abode, or $by sending the individual a copy of the order by registered or certified mail,return receipt requested, if the individual is within the Commonwealth, or $by posting a copy of the order in a conspicuous place on or about the premises and by advertising it for at least three out of five consecutive days in one or more newspapers of general circulation within the municipality where the building or premises affected is situated, if the individual=s last and usual place of abode is unknown or outside the Commonwealth. Emergency Powers: In addition,local boards possess enforcement powers for emergency situations. Regulations 105 CMR 400.000 (Chapter I of the Sanitary Code) and 310 CMR 11.00(Title I of the Environmental Code)grant local boards the authority,in accordance with the provisions of M.G.L.c. 111 '30,to dispense with ordinary enforcement procedures in the interest of protecting the public health in emergency situations. The board may, without notice or hearing,issue an order citing the existence of an emergency and requiring that such action be taken as the board of health deems necessary. • The agent of the board of health, or director or commissioner of the health department, as the case may be,is authorized to act for the board in cases of emergency or in cases when the board cannot conveniently meet. She/he has all the authority that the board has,but must report emergency actions to the board for approval within two days, and must be directly • responsible to and under the control of the board(M.G.L. c. 111 '30). Hearings: Boards of health may hold hearings upon their own initiative,or upon petition by any party wishing to be heard concerning a public health matter. Usually hearings are requested by people who wish to contest an order issued by the board of health for correction of a violation of state or local regulations.Hearings typically provide opportunities for individuals to show why an order should be modified or withdrawn. In addition,hearings may serve as a forum for the discussion of proposed or existing local or state regulations. In certain cases specified in statutes or regulations,the board may be required to hold a public hearing before granting a license,before making local regulations,or before revoking a license or permit. For example,a hearing must be held before the board grants variances under the Sanitary or Environmental Codes. Unless it is specifically prohibited by an article of the Sanitary or Environmental Codes(in which case an appeals process is outlined), any person or group of people may request a hearing following an order served on that individual or group by the board of health. $ The petition must be in writing and received by the board within seven days after the order was served, unless differently specified by local regulation. If the petition is not received within seven days, each day=s violation constitutes a separate offense. $ The board must arrange the hearings within 3o days after the order was served and • must inform the petitioner of the time and place of the hearing under provisions of the Code. $ The hearing may be postponed if the petitioner supplies sufficient reason. $ After the hearing,the board sustains,modifies,or withdraws the order and informs the petitioner of the decision in writing. $ If the order is sustained or modified,it must be carried out within the time period designated in the original order or in the modification. Each day=s failure to comply constitutes a separate offense. $ The board of health must make every notice,order and other documentation of the hearing a matter of public record in the office of the town or city clerk, or in the office of the board of health. Boards of health conduct hearings that are either quasi-judicial(concerning orders,licenses, permits or other such matters) or quasi-legislative in nature (involving debate of new or existing local regulations). The following outlines suggest practices for each type of hearing: Quasi-Judicial Hearings: . $ The hearing officer should be impartial and yet familiar with the particular case • and the laws and regulations pertinent to the case(M.G.L. c. 3oA '1A J. $ Hearings must be public unless permitted by the open meeting law to be closed according to the procedure outlined in M.G.L. c. 3oA ' 11A_. Massachuseffs BOH GuidebookMay, - • •l Authority • • Procedures1 • $ The parties involved may be represented by counsel. The counsel may be either a lawyer or non-lawyer. s The names of all parties, counsel and witnesses (and on whose behalf they are appearing) should be included in the hearing records. s The health officer should introduce him/herself and direct the hearing by stating the purpose of the hearing and highlighting the main issues of the case. $ Although agencies need not observe the rules of evidence observed by courts, evidence may be admitted Aonly if it is the kind of evidence on which reasonable persons are accustomed to rely in the conduct of serious affairs@ (M.G.L.C.3oA '11). Evidence may be taken in any order. s The petitioner has the burden of proof and should proceed first. s Both parties should be allowed sufficient time to state their cases. Any witness may be cross-examined by either party. s In very informal hearings,it may be appropriate for the hearing officer to help the party present his/her full case and offer advice as to his/her legal rights. $ In minor matters,the hearing officer may announce the decision immediately. The decision should be immediately noted on the record. In lengthy or complex hearings,it is better to reserve the decision and render a determination in writing with a well-reasoned opinion in support of the decision. The decision must be served on the party and the party=s counsel. Decisions maybe delivered by mail. Information describing procedures for appeal should be included in the decision. Quasi-Legislative Hearings: Quasi-legislative hearings are usually held before the board • of health promulgates rules,regulations or standards. The participation of interested groups in quasi-legislative hearings provides local boards with a basis of information for the development of effective regulations and may help secure voluntary compliance with new or existing regulations. s Hearings should be scheduled far enough in advance for the parties involved to arrange their representation and to prepare their testimony. s Notice of the hearing may be made by publication in a local newspaper and through letters to interested groups and corporations. s When a new regulation is proposed, a preliminary draft ought to be available in advance of the hearing. s All parties should be given equal time to present their case. s Only hearing officers may ask questions of either party. Cross-examination is not allowed in quasi-legislative hearings. s Each group should be given the opportunity to submit a supplementary written statement. $ Participation of parties is voluntary. Only in very rare instances is specific information subpoenaed for quasi-legislative hearings. Appeals: After the hearing,any individual not satisfied with the final decision of the board may appeal the decision to a court of competent jurisdiction to the extent allowed by law. The right of the aggrieved party to appeal the board=s decision is not automatic. There is no statute giving an aggrieved party the right to challenge any final administrative decision of a local board of health,as there is with final state agency administrative decisions(see M.G.L. c. 3oA). However, aggrieved parties may bring an action under M.G.L. c. 12 '11I alleging • that their civil rights were violated. Alternatively,an aggrieved party could bring Aan action in the nature of certiorari@ in Superior Court under M.G.L. C. 249 14 seeking to Acorrect errors@ in the administrative proceedings before the board of health. Penalties: The local board of health may revoke or suspend permits and licenses it has • granted,with or without a hearing,as specified in the applicable laws and regulations. It is also authorized to seek in court to impose penalties on any individuals who violate provisions of the Sanitary or Environment Codes in any or all of the three following ways: $ Anyone who impedes inspection of any structure, operation or premises after a search warrant has been presented shall be fined not less than$io nor more than $500. $ Anyone who fails to comply with an order issued by the board of health shall be fined, upon conviction in court, not less than $io nor more than $50o. Each day=s failure to comply with an order is considered to be a separate violation. $ Anyone who violates any provision of the Sanitary or Environmental Codes for which no penalty is provided in the code or in the General Laws shall be fined upon conviction in court,not less than$io nor more than$500(see M.G.L.c. ill '127A,and the Sanitary and Environmental Codes: 105 CMR400.700;310 CMR 11.10). Variances: The board of health may grant a variance to the application of any provision of the Sanitary or Environmental Code (except provisions regarding conditions deemed to endanger or impair health or safety,and those regarding solid waste disposal facilities which may only be granted by DEP)when,in the opinion of the board,the enforcement would do a manifest injustice, provided that the variance: (i)does not conflict with the spirit of the minimum standards, • (2)all affected parties have been notified, and (3)a hearing has been held. Variances granted by the board of health must be in writing. A copy of each variance must be kept in the office of the board of health. Notice of the grant of variance must be filed with the Commissioner of Public Health,or with the Commissioner of Department of Environmental Protection,in a case in which a variance to a provision of the Environmental Code is granted. The board may limit the variance by whatever qualifications or conditions (including time limitations)it deems necessary. The board may also revoke,modify or suspend the variance Y f1' P , in whole or in part, by notifying the holder in writing. If this happens, the holder of the variance in question may request a hearing in accordance with 105 CMR 400.800(B) (Chapter I of the Sanitary Code) and 310 CMR 11.12 (Title 1 of the Environmental Code). Court Procedures:The board of health may commence a court action when other efforts to obtain compliance with local or state laws or regulations have failed. There are two basic types of action - civil and criminal. An example of a civil action is an action in Superior Court under M.G.L.c. ill ' 127A to Aenjoin@ (i.e.stop)a violation of the State Sanitary Code. An example of a criminal action is an action in the District Court seeking monetary penalties for violations of the Sanitary Code. In a civil action,the town attorney must file a complaint in court and serve a copy of it to the defendant. To start a criminal action to enforce compliance with the law,the health officer (or member of the board of health or an agent of the board) signs and files, with the court • having jurisdiction, an application for a complaint, sometimes called an Ainformation,@ setting forth completely and precisely the violations. The city or town attorney may file the application. A clerk in the court will serve the complaint on the defendant. The parties will then be required to appear at a show cause hearing before a magistrate. If the magistrate finds just cause, a complaint will be issued and a trial will be scheduled. Civil Proceedings: Civil proceedings usually follow this pattern: Complaint by board Answer to complaint by defendant Period of Adiscovery@ Trial If the board prevails,court will Aexecute judgment@: judge may make appropriate order to correct violation (injunction) impose fine or other penalty, and/or may attach the property or garnish wages of the violator. Criminal Proceedings: In criminal proceedings,the sequence of events is approximately as follows: $ Board or its agent files complaint/application in court(usually in the district court) $ Clerk of court issues summons(upon application by board of health or other applicant) $ Show cause hearing is held to determine whether a complaint should be issued by the court $ Court issues complaint, if clerk decides there is cause $ Defendant answers or files motion to dismiss complaint for lack of cause $ If complaint is not dismissed, case proceeds to trial $ If board prevails at trial, court will Aexecute judgment@:judge sets fine, prison term, or other penalty. • Boards of health also have recourse to the courts for other actions, such as a petition to establish a rent receivership,to obtain a cease and desist order,to recover expenses incurred in removing a nuisance, or to obtain a search warrant. Persons upon whom the board of health have served an order may appeal, or in certain cases(i.e. those involving a board=s order to abate certain nuisances), Afile a petition for review of such order in the district court@ as provided in specific statutes(see M.G.L.c. ill ' '125A,and 143). The statute and regulations describe more fully the alternative enforcement methods available to boards of health. Community Awareness of Public Health Standards: Frequent campaigns to remind the public and commercial and industrial establishments about minimum standards for housing, sewage and waste disposal, water, food, and other areas under board of health jurisdiction may help the board reduce the burden of enforcement. Public education, combined with regular inspections and constructive approaches to resolving problems can mobilize community awareness of public health mandates. The board of health can establish and maintain its credibility and community visibility by sending press releases to the local paper on current activities and on local and state regulations affecting seasonal activities(such as community fairs or bake sales,percolation tests,campgrounds and camps,flu immunizations,etc.). (See Guidebook chapter on media relations). Public hearings and notices about such things as landfill use, availability of recycling, housing conditions, and other problems and concerns will also increase public awareness of the board=s function in town government. • LIABILITY ISSUES Liability for Negligence: The Massachusetts Tort Claims Act (M.G.L. C. 258) makes • public employers liable for the negligent acts or omissions of public employees and immunizes those employees from personal liability for negligence. APublic employee@ is broadly defined in the Act to include officers and employees of any public employer. APublic employer@ includes any county,city,town,public health district or joint district or regional health board established pursuant to the provisions of M.G.L. c. 111 ' '27A or 27B. Discretionary Acts: The Tort Claims Act exempts public employers from liability for any claim based on the employer or employee=s performance (or failure to perform) a discretionary function, whether or not the discretion is abused. At the same time, a public employee is immune from personal liability for discretionary decision-making as long as he acts in good faith and without malice or corruption.The courts have defined a discretionary function as one characterized by a high degree of discretion and judgment invoked in weighing alternatives and making choices with respect to public policy and planning. Therefore, health officials will generally not be liable for mistakes or errors of judgment in the performance of duties where they are empowered to exercise judgment or discretion. Intentional Torts/Civil Rights Violations: Under the Tort Claims Act, the public employer does not assume liability for civil rights violations or for intentional torts committed by public employees during the course of their employment. Instead, the employee remains personally liable for civil rights violations and for intentional torts,such as assault,battery,false imprisonment,false arrest,intentional infliction of emotional distress, malicious prosecution,malicious abuse of process,libel,slander,misrepresentation,deceit, invasion of privacy,interference with advantageous relations or interference with contractual i relations. However,an employee-will not be liable for an intentional tort arising out of a discretionary • act. For instance, a board of health member could not be held liable for slander based on statements made during deliberations over adoption of policy provided that he acted in good faith and without malice or corruption. It should be noted that although the public employer is not liable for a civil rights violation or an intentional tort committed by a public employee,the employer is authorized by the Tort Claims Act to indemnify the employee in an amount up to $1 million, except that a public employer is not allowed to indemnify an employee for violation of civil rights if the employee acted in a Agrossly negligent,willful, or malicious manner.@ Medical Treatment of Minors: As a general rule, parents retain the legal authority to make decisions concerning a minor=s medical care. However, statutes and case law have carved out significant exceptions to the general rule and.a few of these exceptions are outlined below: M.G.L. c. 112 '12F permits emergency examination and treatment, including blood transfusions,when delay will endanger the life,limb or mental well-being of a so-called Aemancipated minor,@( i.e. a minor who is married, the parent of a child, pregnant, a member of the armed forces, living apart from his parents and supporting himself financially, or reasonably believes he is suffering from or been in contact with a disease dangerous to the public health). M.G.L.c. 112 '12E provides that a minor 12 years of age or older may consent to hospital and medical care related to the diagnosis and treatment of drug dependency. • M.G.L.c. 112 ' 12S authorizes an abortion if the pregnant woman is less than 18 years old and both she and her parents or legal guardian consent. If the minor chooses not to seek • parental consent, she can seek authorization in Superior Court. The courts in Massachusetts have recognized a general right of Amature minors@ to make decisions about medical treatment. As a general rule,physicians have a duty not to disclose medical information about a patient without consent. The sole exception is where there is a serious danger to the patient or others. Reporting Child Abuse and Neglect. M.G.L.c. 119 '51A mandates certain categories of professionals who come in contact with children to report suspected abuse or neglect to the Massachusetts Department of Social Services. Mandated reporters include such individuals as physicians, medical interns, hospital personnel, medical examiners, psychologists, emergency medical technicians,dentists,nurses,chiropractors,podiatrists,public or private school teachers, educational administrators, guidance or family counselors, probation officers,social workers,foster parents,fire fighters,police officers as well as administrators of child centers and licensed family day care providers and all their employees. A mandated reporter must file a report if he/she has reasonable cause to believe that: $ a child is suffering from physical or emotional injury resulting from abuse, including sexual abuse; $ a child is suffering from neglect, including malnutrition; or $ a child is physically dependent upon an addictive drug at birth. • There is no category of mandated reporter specifically for board of health members or agents. However,board of health members or agents may,because of their professional status,such as nurses,fall within one of these categories. Board of health members or agents may file a report if he/she has reasonable cause to believe that a child is suffering from,or has died as a result of,abuse or neglect. Information on how and where to report abuse and neglect is included at the end of this chapter. THE CONFLICT OF INTEREST LAW (taken from MAHB Legal Handbook for Boards of Health,June 1995)• The Conflict of Interest Law,M.G.L.C.268A,sets minimum standards of ethical conduct for all municipal employees and officials.Board of health members are municipal employees and are bound by this law.All municipal employees,whether elected or appointed,full or part- time, paid or unpaid, must abide by the law=s restrictions. The purpose of the law is to ensure that a municipal official or employee=s private financial interests and relationships do not conflict with his/her official municipal responsibilities. The law is written broadly in order to prevent a municipal official from becoming involved in a situation which could result in a conflict or even give the appearance of a conflict. Some municipal employees may be designated as special municipal employees. A municipal employee may be given special employee status by a vote of the board of selectmen or city council, provided that the employee: • $ is not paid; or $ holds a part-time position which allows them to work at another job during normal work hours; or • $ they were not paid by the city or town for more than Boo working hours during the preceding 365 days. Certain sections of the law apply less restrictively to special employees. It should be noted that a municipal position is designated as having a special status, not an individual. Therefore, all employees holding the same office or position must have the same classification as special municipal employees. Activities Covered by the Law: The Conflict of Interest Law applies to a variety of activities. For example, Section 2 prohibits bribes. If a board member seeks payment to perform or not perform official duties in a certain manner,the law imposes penalties upon the member seeking to receive the payment as well as the party who offers the payment. Section of the law applies to the acceptance of gifts. You ma y a not accept o gi ft or PP P � Y p g anything of substantial value($50 or more)given to you because of the position you hold on the board, or in return for work you performed that was part of your job responsibilities. Even if a person gives you this gift simply to thank you for doing a good job,you as a board member may not accept the gift. You may accept a gift valued at less than$50 provided that it is not intended as a bribe. Any bribe,however,no matter how little its value,will violate the conflict of interest law. Section 17 pertains to outside activities of municipal officials. Generally,a regular municipal employee cannot be compensated by anyone other than the municipality in relation to any particular matter in which the municipality is a parry or has a direct and • substantial interest. Even if the interest is held by another agency in the municipality,other than the board of health, you cannot be compensated by another party in relation to the issue. If you are a regular municipal employee,you may not act as an agent or attorney for a private party before city or town boards. This restriction applies whether you are paid or not. If you are a Aspecial@ municipal employee, you may represent private parties before town boards other than the board of health, unless your representation pertains to a matter in which you participated or which is now or within the past year was within your official responsibility as a member of the board of health. If your representation would involve matters reviewed by the board of health, you cannot represent a private party before any municipal board. Section 18 deals with the activities of former municipal employees. It prohibits a former municipal employee from using the relationships which they develop during their employment, and the confidential information which they were privy to, to gain unfair advantages. If you participated in a particular matter as a municipal employee, you can never become involved in that same particular matter after you leave municipal service. Partners of a former municipal employee are bound by the same restriction for one year. If you had official responsibility for a particular matter as a member of the board,you may not appear personally before any agency of your city or town on behalf of a private party in connection with this matter,for a period of one year after leaving the municipal position. Under Section ig,you may not act as a board of health member on a matter that affects your own financial interest or that of your immediate family,or that of a .business or organization in which you serve as an officer, director,partner or • trustee. You must also refrain from acting on matters that affect your business competitors. • This section is also referred to as the Aanti-nepotism@ provision. As a member of the board of health,you may not have any significant involvement in the hiring of an immediate family member,or in decisions relating to pay raises,promotions,etc. You also may not have day- to-day supervision of an immediate family member. There are two possible exceptions to this rule. Appointed board members may act on matters involving their financial interest if they obtain prior written permission from their appointing authority. The second exception allows members of the board to act on any matter of general policy that affects a substantial segment of the community=s population in the same way. In addition,the rule of necessity allows a member with a conflict to act if the board cannot otherwise obtain a quorum. You should obtain advice from counsel or the State Ethics Commission prior to invoking the rule of necessity. Section 20 concerns municipal contracts. A member of the board of health is prohibited from having a direct or indirect financial interest in a contract made by any municipal agency. If you discover that you have a financial interest in a contract made by a municipal agency,you must fully disclose your financial interest to the agency and terminate or dispose of your interest within 3o days. There are a number of exceptions which allow you to contract with other town agencies, such as where it is publicly bid. There are very few instances where you may contract with the board of health, however. You should consult with your city solicitor or town counsel, or the State Ethics Commission for specific questions. • A contract includes a salary from the city or town. Accordingly, holding more than one position where at least one is paid could be a conflict of interest. There are numerous exceptions to this rule,also,which are beyond the scope of this book. Consult with your city solicitor or town counsel or the State Ethics Commission for specifics. Section 23 provides the general standards of conduct that are required of municipal employees. A municipal employee may not: $ accept other employment involving compensation of substantial value if the responsibilities of the other employment conflict directly with the responsibilities of his public office; $ use his public position to obtain unfair privileges and advantages that are of substantial value and not available to others; $ act in such a way that reasonable people would believe that he could be improperly influenced or act in violation of his public duties. A municipal employee can avoid the appearance of a conflict by disclosing,in writing,to his appointing authority, or if an elected official, by disclosing in writing and filing this disclosure with the city or town clerk, any facts or information which might cause a reasonable person to believe that he was being unduly influenced or might be obtaining unfair privileges for himself or others. Enforcement: The State Ethics Commission was established by the Legislature to enforce the conflict of interest law. District attorneys and municipal officials also have a responsibility to enforce the law at the municipal level. Anyone can file a complaint if they have reason to believe that the conflict of interest law has been violated. You may file a complaint by writing, calling or visiting the State Ethics Commission, 617-727-oo6o. The commission is required bylaw to keep the identity of all complainants confidential(M.G.L. • C. 268B '4). Also, M.G.L. C. 268B 18 shields complainants from retribution if they file a complaint with the Commission. Board members may call the State Ethics Commission Legal Division for informal advice regarding the Conflict of Interest Law. You may also seek written advisory opinions from your town counsel, city solicitor or the State Ethics Commission if you have any questions about the law or about any of your own actions. It is extremely important that you, as a member of the board of health,become familiar with this law,and that you seek advice prior to committing any actions which may be a violation of the law. PRECEDENCE OF LAW The various written(or statutory)laws in this country are in order of diminishing precedence as follows: The Federal Constitution Acts of Congress and treaties Rules and regulations of certain executive departments State Constitutions Laws enacted by state legislatures Rules and regulations of state agencies Municipal charters granted by states Municipal legislation Rules and regulations of local boards of health. AREAS OF JURISDICTION: STATE, LOCAL&FEDERAL • In general, local board of health responsibilities for enforcement of state and local regulations extend to privately owned or municipally owned or operated facilities,buildings, or programs, within the boundaries of the municipality. Privately owned or operated concessions, camps, schools or other facilities are subject to applicable local licenses and inspections whether located on public or private land. For example, ice cream vendors on public beaches, private day camps in state parks, private concession snack bars in federal office buildings and other such program and services must obtain local licenses and comply with state and local minimum standards and regulations. When programs, facilities or services involve more than one town (such as recreational camps,beaches or private schools on land in two adjoining towns),statutes and regulations usually specify that the boards of health of the towns involved Amay coordinate activities in effecting compliance@ with regulations. In practice,there may be a division of responsibility according to where the structures,headquarters or facilities are in fact located. For instance, a camp whose buildings are in one town will probably seek its camp license from that town, but if its swimming pool is in another town=s boundaries, it may seek its swimming pool permit from the town in which the pool is located. In any case,it is important that each town be sure that the camp is appropriately licensed and inspected and that state officials check water sources and sewage disposal facilities. Homeowners and others who happen to be located on town lines do frequently have to obtain permits from both towns for such things as individual sewage disposal system and private wells. If local regulations in the towns differ, the owner/operator will typically be • requested to comply with the more stringent regulations. • When sanitary or health problems arise in state or federally owned facilities over which the board of health has little or no jurisdiction, the board may wish to send a formal notice or complaint to the responsible agency, and investigate various alternatives for obtaining proper enforcement of the Sanitary or Environmental Codes or other regulations. For example, a board of health may receive a complaint regarding conditions in state-owned housing units at a state college or university, or the board might be aware of unsanitary conditions in a state-operated food service establishment. If a direct complaint to the agency involved does not get results,the local board of health should request advice and assistance from DPH or DEP, as appropriate. The board of health may also assist tenants and other affected persons in determining their rights to petition state agencies or the courts to seek enforcement of minimum standards. Checking with DPH or DEP regional offices, legal departments,and with town counsel may provide the board with a sound basis for following a particular course of action. In some cases, however, where jurisdictional boundaries are unclear,the board of health may find that a court test is the most satisfactory way to obtain clarification. When the source of a problem affecting a town is located in a different town, the board of health may seek to have the board of health in the town where the source is located take necessary action to remedy the situation. If the matter cannot be resolved locally,the town may request DPH or DEP to take action, especially if violation of state regulations is involved. Regional authorities may also be involved, especially if air or water pollution or other problems dealt with on a regional basis are the cause of concern. State and federal authorities regulate intrastate and interstate commerce, respectively,and provide or help to finance a wide variety of programs to promote the general health and • welfare. State or federally funded programs may finance, through grants or contracts, services and facilities that are subject to local inspections and permit requirements. Unless the state specifically provides for enforcement of the Sanitary and Environmental Codes by a state agency in such facilities as halfway houses for de-institutionalized patients, the local board of health should assume that it has the same authority and responsibility as it has over any other private facility. The board may wish to notify the state contracting agency as well as the facility itself of any problems or violations or regulations. The board may find that a constructive approach to follow with any program for special population groups is to inform the program about board of health services and responsibilities, and request that the program provide the board with a full description of its services, clientele, special needs, problems and administration. The board of health may also initiate communications with relevant state agencies to be kept informed so that it can anticipate and plan for substantial changes that have an impact on need for nursing services, sanitarian=s services or other board of health involvement. Checking the sanitary conditions of jails, lockups, prisons, houses of correction and reformatories is the explicit responsibility of the Department of Public Health,as specified in M.G.L. c. 111 ' '20 and 21. If any problems come to the attention of the local board of health, it should notify the Regional Office of DPH so that the district health officer can investigate. - V15jutems • The Commonwealth of Massachusetts Executive Office of Health and Human Services Department of Health REQUIRED DUTIES OF LOCAL BOARDS OF HEALTH IN MASSACHUSETTS Local boards of health in Massachusetts are required by state statutes and regulations to perform many important and crucial duties relative to the protection of public health, the control of disease, the promotion of sanitary living conditions, and the protection of the environment from damage and pollution. These requirements reflect the legislature's understanding that many critical health problems are best handled by the involvement of local community officials familiar with local conditions. The following is a list of duties and responsibilities of local boards of health in Massachusetts. Each item includes a citation to the statute or regulation which imposes the duty or responsibility. The items have been grouped under general subject categories. • Following this listing of Required Duties is a list of Additional Powers of local boards of health which extend the local board's authority over the broad range of health, sanitation and environmental problems. A. Records, Recordkeepina and Reports 1. In cities, submit an annual report to the city council concerning the board's activities during the preceding year and concerning the sanitary condition of the city. M.G.L. c.111, s.28. 2. Maintain numerous records and retain them for required minimum retention periods. (A list of approximately three dozen categories of board of health records and their retention periods, will be found in the Guidebook for Massachusetts Boards of Health published by the Massachusetts Association of Health Boards. 3. Process numerous types of reports of cases of diseases. These reports are detailed in Food Borne Illness Investigation and Control Reference Manual, and MAHB Guide book. 4. Process of death certificates. M.G.L. c.46, s.11. B. Health Care and Disease Control: • 1. Upon request, telephone to a gas and electric utility company and certify in writing within seven (7) days of said telephone call that there is a serious illness in a residence such that no gas or electric company shall shut off or fail to restore r gas or electric service in any residence during such time as there is a serious illness. M.G.L. c.164, s.124A; 220 CMR 25.03(2). 2. Receive reports of cases of disease dangerous to public health. Keep records of these reports and also forward copies of these reports to the local school • committee, and to other local boards in whose jurisdiction the patient resides, or may have contracted the disease, or may have exposed others. M.G.L. c.111, s.111. See 105 CMR 300.100 for list of diseases required to be reported. 3. Report cases of dangerous diseases to the Department of Public Health within twenty-four hours. M.G.L. c.111, s.112. See 105 CMR 300.100 for a list of diseases required to be reported. 4. Consult with the Department p t of Public Health regarding the prevention of dangerous diseases. M.G.L. C.111,s.7. 5. Send to the Department of Public Health weekly reports of deaths due to dangerous diseases. M.G.L. c.111 s.29. 6. Receive notices of school children sent home because of dangerous disease. M.G.L. c.71, s.55A. See the School Health Manual 7. Report to the Department of Public Health cases of a certain contagious disease occurring at diary farms. See 105 CMR 310.100-110 for list of such diseases required to be reported. 8. Receive reports of any inflammation, swelling, redness or unnatural discharge from the eyes of an infant less than two weeks old, and take immediate action to prevent blindness. M.G.L. c.111, s.110. • 9. Receive reports of persons afflicted with cerebral palsy, and submit an annual report of these cases to the Department of Public Health. M.G.L. c.111, s.111A. 10. Provide anti-rabic vaccine and treatment. M.G.L. c.140, s.145A, 105 CMR 335. 11. Supervise or carry out the disinfection of dwellings which have housed a person who has suffered from or died of a disease dangerous to the public health. M.G.L. c.111, s.109. 12. Receive reports of food poisoning and send these reports to the State Department of Public Health, 105 CMR 300.100, 105 CMR 300.131. 13. Receive notices from inspectors of the Division of Occupation) Safety regarding violations of health laws or nuisances in industrial establishments, investigate these reports, and enforce appropriate laws. M.G.L. c.149, s.136. C. Housing and Dwellings: 1. Enforce Chapter II of the State Sanitary Code: Minimum Standards of Fitness for Human Habitation, M.G.L. c.111, ss.127A and 12713: 105 CMR 410.000. enforcement of Chapter II includes inspecting dwellings (upon request or upon the board's initiative) for compliance with the minimum standards, certifying violations, issuing orders, holding hearings, granting variances and instituting court proceedings if necessary to enforce such orders. • 2. Enforce the State Lead Poisoning Prevention regulations. M.G.L. c.111, s.198; 105 CMR 460.000. Enforcement of these regulations includes inspecting dwellings (upon request or upon the board's initiative) for lead paint, issuing orders for removal of lead paint, and instituting court proceedings to enforce such • orders if necessary. 3. Review and approve or disapprove preliminary and definitive plans for the subdivision of land. M.G.L. c.41, ss.81 S-81 V. 4. Inspect and certify public lodging houses for waterclosets, urinals, ventilation and cleaning. M.G.L. c.140, s.36. D. Hazardous Wastes: 1. Assign the site for a hazardous waste disposal facility as follows (M.G.L. c.111, s.15013): a. Notify the Department of Environmental Protection (DEP) of the receipt of an application to assign a site. b. Assess significance and degree of danger to public health and consider and evaluate any evidence submitted. C. Give public notice and hold a public hearing. d. Every decision of the board in assigning or refusing to assign a site must be in writing and include a statement of reasons and facts relied on. 2. Chairperson of board serves on the local assessment committee, established • whenever a developer seeks to construct and operate a hazardous waste facility within the city or town. Committee has certain duties including negotiating with the developer, entering a contract, and adopting necessary rules and procedures. M.G.L. c.21D, s.5. 3. Notify the mayor and city council or board of selectmen of the following (M.G.L. c.21 C, s.4): a. Pending applications for licenses for the collection, storage, treatment, or disposal of hazardous waste, upon notification from DEP. b. Information supplied annually by DEP identifying types and quantities of hazardous waste generated, stored, treated or disposed of within the city or town. E. Solid Waste: 1. Assign sites of sanitary landfills, refuse incinerators, waste storage or treatment plants, and refuse transfer stations, after a public hearing. Ensure that these do not present a danger to public health. M.G.L. c.111, s.150A. 2. Consider and act on applications for permits for the disposal of special wastes. 310 CMR 19.061. p F. Medical and Biological Waste • 1. Authorized to enter, examine, or survey at any reasonable time such medical and biological waste facility as is necessary to protect public health. 105 CMR 480.600(B). i 2. Issue notice of violation to waste generator setting forth the nature of the violation and warning that a second violation may result in legal action. 105 CMR 480.600(C). 3. Initiate proceedings to enforce 105 CMR 480.000 without prior notice if there is an imminent risk to public health or safety. 105 CMR 480.600(C). • 4. Notify the appropriate professional registration board if a notice pursuant to 105 CMR 480.600(C) is issued or a conviction and/or fine is obtained pursuant to 105 CMR 480.600(D) is obtained. 105 CMR 480.600(H). 5. Inspect all Sharps Collection Centers including kiosks prior to initial operation. 105 CMR 480.135(F). 6. Notify the Department of Health within 30 days of initial inspection of the location, and address of the Sharps Collection Center(s), including kiosks. 105 CMR 480.135(G). G. Septage and Garbage ' 1. Enforce Title V of the State Environmental Code; Minimum Requirements for the Subsurface disposal Sewage, 310.CMR 15.00. 2. Make rules and regulations for the removal, transportation and disposal of garbage, offal and other offensive substances. M.G.L. c.111, s.31B. 3. Issue permits for the removal or transportation of garbage, offal or offensive substances when such refuse has been collected in the city or town. Keep registry of all transporters of refuse through the city or town, and enforce local rules and regulations regarding such transport. M.G.L. c.111, s.31A. H. Nuisances: 1. Investigate nuisances which in the board's opinion may be injurious to health. The board shall destroy, prevent or remove such nuisances, and shall make • regulations relative to nuisances. M.G.L. c.111, s.122. 2. Assign location for noisome trades M.G.L. c.111, s.143. 3. Assign location for slaughter houses or other noxious or offensive trade. M.G.L. c.111, s.151. I. Food: 1. Issue permits for all food service establishments, including restaurants and food service facilities in stores, recreational camps for children, family style campgrounds, institutions, hotels, motels, schools, retail food store, mobile food units and pushcarts, etc., 105 CMR 590.012. 2. Enforce Chapter X of the State Sanitary Code: Minimum Sanitation Standards for Food Establishments, 105 CMR 590.000. Enforcement includes conducting inspections, issuing orders, suspending or revoking permits where necessary. 3. Issue permits for plants which break and can eggs. M.G.L. c.94, s.89. 4. License milk pasteurization plants. M.G.L. c.94,s.48A. 5. City health departments shall have milk inspectors. Town boards may appoint milk inspector. • Inspectors must inspect and license milk producers and dealers. M.G.L. c.94, s.33 and s.40. 0 6. Issue permits for plants that bottle carbonated non-alcoholic beverages. M.G.L. c.94, s.10A; inspect such plants, and revoke permits where plants are found to be unsanitary or otherwise in violation of public health rules and regulations, M.G.L. 94 s.10C; 105 CMR 570 et. Seq. Send to the Department of Public • Health copies of all licenses, applications and half the license fees, 105 CMR 570.002. Notify each owner prior to the expiration date of each permit and close plants that fail to renew such permits, M.G.L. c.94, s.10C. 7. Register and inspect bakeries. M.G.L. c.94, s.94F; 105 CMR 550.000; 105 CMR 551.000. Furnish DPH with monthly reports of inspections, 105 CMR 550.001. 8. License plants that manufacture frozen desserts, M.G.L. c.94, ss. 9D-9M. 9. Inspect cold storage and refrigerated warehouses, M.G.L. c.94, s.67. 10. Enforce M.G.L. c.130, s.81 which prohibits importation of shellfish which have not been certified by a United States or foreign shellfish regulating agency. 11. Enforce statutes and regulations relative to the adulteration and misbranding of food. M.G.L. c.94, ss.186-195. J. Pools and Beaches: 1. Enforcement Chapter V of the State Sanitary Code: Minimum Standards for Swimming Pools, 105 CMR 435.000. Enforcement includes issuing annual permits, conducting examinations, issuing orders, holding hearings, granting variances, taking water samples. 2. Enforce Chapter VII of the State Sanitary Code: Minimum Standards for Bathing • Beaches, 105 CMR 445.000. Enforcement includes issuing annual licenses, approving plans for new or altered beaches, issuing orders, holding hearings, granting variances, receiving reports of accidents, taking water samples. 3. Shall test, monitor and analyze all bathing waters within its municipality and report test results to the Department of Health. M.G.L. c.111 s.5S. 4. Notify Department of Health of violation of minimum sanitation standards no later than 24 hours after discovery and post signs no later than 24 hours after discovery. M.G.L. c.111 s.5S. 5. Prohibit swimming in water that fails to meet proscribed standards for bathing, 105 CMR 445.10 (-3). 6. Review plans for new or altered bathing beaches, 105 CMR 445.16. K. Camps. Motels and Mobile Home Parks 1. Inspect all recreational camps for children and family style campgrounds, motels, mobile home parks and cabins; and annually issue licenses for these facilities, M.G.L. c.140, ss.32B and 32C. Send copies of family style campground permits to the Department of Environmental Protection. 2. Enforce Chapter VI of the State Sanitary Code: Minimum Standards for Developed Family type Campgrounds, 105 CMR 440.000. Enforcement includes conducting examination; issuing orders; issuing, suspending and revoking • licenses; holding hearings; granting variances. 3. Enforce Chapter IV of the State Sanitary Code: Sanitary Standards for Recreational Camps for Children, 105 CMR 430.000. Enforcement includes inspection, issuing orders and licenses, conducting hearings, granting variances. L. Miscellaneous: • 1. Pesticides a) Local boards may make reasonable health regulations regarding pesticides provided such regulations are not inconsistent with the Massachusetts Pesticide Control Act, M.G.L. c.132B or state regulations, 333 CMR 2.00. Wendell v. Attorney General 476 NE 2"d 585, 394 Mass 518 (1985). For example, a city or town may want to give its board of health an opportunity to determine whether the proposed application of pesticides in particular locations would be consistent with the products labeling or other restrictions imposed by the Department, Wendell v. Attorney General supra 394 Mass at 528 b) Receive public notice of the application of herbides from applicants that intend to maintain a right of way by the application of herbides. 333 CMR 11.07. 2. Boards of health in towns may nominate animal inspectors, M.G.L. c.129, s.15. 3. Authorize the use of traps to capture furbearing mammals to protect from threats to human health and safety, issuing emergency permits for such traps, not to exceed a period of ten days. M.G.L. c.131 s.80A. 4. License massage parlors, M.G.L. c.140, s.51. • 5. Issue burial permits, M.G.L. c.114, s.45. 6. License and if necessary revoke licenses for funeral directors. Transmit to the board of registration in embalming names and addresses of all licensees, M.G.L. c.114, s.49. 7. Approve location of cemeteries, M.G.L. c.114. s.34. 8. Retain charge of any case arising under M.G.L. c.111 in which the board has acted. M.G.L. c.111, s.32. 9. Enforce all local health regulations promulgated pursuant to M.G.L. c.111, s.31. M. Smokina I. Enforce the provisions of the Smoke-Free Workplace Act, M.G.L. c.270 s.22(m)(1). 2. Receive complaints regarding the failure or refusal to comply with the Smoke- Free Workplace Act. M.G.L. c.270 s.22(m)(3). 3. Inspect the area described in the complaint and enforce no-smoking laws. M.G.L. c.270 s.22. • 4. Report annually to the Commissioner of Public Health the number of citations issued; the workplaces that have been issued citations and the number of i citations issued to each workplace; the amount that each workplace has been fined; and the total amount collected in fines. M.G.L. c.270 s.22(n). • ADDITIONAL POWERS AND AUTHORITY OF LOCAL BOARDS OF HEALTH IN MASSACHUSETTS Local boards of health in Massachusetts have historically played a crucial role in the protection of public health, promotion of sanitary living conditions and protection of the environment. In recognition of the importance of local leadership and action in these areas, the legislature has enacted over the years numerous statutes which authorize and thereby encourage local boards to be responsible for dealing with the broad range of health, sanitation and environmental problems at the local community level. The following is a list of statutes which grant additional powers and authority to local boards of health. Each time includes a citation to the appropriate statute. The items have been grouped under general subject categories which parallel, where possible, the categories in the prior lists of required local activities. A. General Health Protection and Regulation: 1. Adopt and enforce any reasonable health regulations. M.G.L. c.111, s.31. 2. Issue an order reciting the existence of an emergency and requiring that such action be taken as the board deems necessary to meet the emergency. State • Sanitary Code, Chapter 1, 105 CMR 400.200(B), pursuant to M.G.L. c.111, s.127A; and State Environmental Code, Title I, 310 CMR 11.05(1). B. Health Care and Disease Control: 1. Direct the operation of and adopt rules for city and town medical dental and health clinics, M.G.L. c.111, s.50 and hospitals, M.G.L. c.111, s.92. 2. Require vaccination of inhabitants of the city or town. M.G.L. c.111, s.181. 3. Order the fluoridation of public water supplies. (This order may be overturned by a referendum vote.) M.G.L. c.111, s.8C. 4. Appoint school physicians. M.G.L. c.71, s.53. 5. In cities, and in towns with a population greater than ten thousand, establish public sanitary stations. M.G.L. c.111, s.33. 6. Isolation and quarantine of individuals and property relative to communicable disease Chapter 111 sections 92-121A C. Housing and Dwellings: 1. Condemn a dwelling which is unfit for human habitation, order the occupants to • vacate, order the owner to clean the dwelling or tear it down (or the board may itself clean or tear down). M.G.L. c.111, s.127B. D. Nuisances: i 1. Condemn all nuisances; clean or tear down a nuisance. M.G.L. c.111, s.125. • E. Food: 1. Inspect and condemn all unfit meat, fish vegetables, produce, fruit or provisions of any kind. M.G.L.. c.94, s.146; 105 CMR 590.013. 2. Adopt and enforce regulations relative to the keeping and exposure of food for sale. M.G.L. c.94, 2.146. 3• Adopt and enforce regulations for bakeries and close bakeries found unfit for the production of handling of food or dangerous to the health of its employees. M.G.L. c.94 s.9D-9M. 4. In towns, appoint milk inspectors. (City boards of health are required to appoint milk inspectors.) M.G.L. c.94, s.33. 5. Adopt bacterial standards for milk which are stricter than the standards adopted by the Department of Public Health M.G.L. c.94, s.13E. 6. Upon determination that drinking water in a dwelling or food service establishment is unsafe, order discontinuance of use or order provisions of a new source. M.G.L. 011, • s.122A. F. Miscellaneous: 1. Adopt and enforce regulations to control air pollution. M.G.L. c.111, s.31C. INSPECTION TIMETABLE FOR BOARDS OF HEALTH The following list describes the majority of inspections Boards of Health are required to perform. It is not intended to be a comprehensive formal listing of all inspection requirements. 1) Food Establishments 105 CMR 590.000, State Sanitary Code Chapter X -Inspect food establishments every six months. 2) Bathing Beaches 105 CMR 445.000, State Sanitary Code Chapter VII -Inspect accredited bathing beaches twice during operating season. -Take water samples twice monthly from accredited bathing beaches during bathing season. -Periodically inspect no accredited beaches to determine compliance with physical and bacteriological water quality standards. 3) Swimming Pools 105 CMR 435.000, State Sanitary Code Chapter V • -Inspect periodically and before issuing annual permit. -Take samples of swimming, wading or special purpose pool water for bacteriological analysis prior to its opening. 4) Family Type Campgrounds 105 CMR 440.000, State Sanitary Code Chapter VI -Inspect periodically with the exception of those operated by the Commonwealth. • -Renew license annually if inspection reveals compliance with the provisions of the code. 5) Recreational Camps for Children 105 CMR 430.000, State Sanitary Code Chapter IV -Inspect yearly and issue license annually if found to be in compliance with requirements of the code. Other town inspectors also must approve for license. Board of Health may also inspect at any time if there is reason to believe that a violation or violations of this chapter exist or upon request or complaint for any reason. 6) Subsurface Disposal of Sanitary Sewage 105 CMR 15.00, State Environmental Code Title 5, -Inspect the installation of all sewage disposal systems. -Witness percolation tests, deep observation holes, and perform site examinations for each system. 7) Housing (Human Habitation) 105 CMR 410.000, State Sanitary Code Chapter II —Inspect a dwelling or dwelling unit upon receipt of a written, oral or telephone request. Refer to code for specific timetable requirements. 8) Cabins, Motels and Mobile Home Parks M.G.L. Chapter 140, Section 32B, 32C -Inspect periodically and renew licenses annually, of inspection reveals • compliance with applicable regulations. 9) Disposal of Solid Waste by Landfill 310 CMR 19.000, State Environmental Code -Periodically examine and evaluate sanitary landfills. STATE REGULATIONS COMMONLY USED BY LOCAL BOARDS OF HEALTH MASS. DEPT. OF PUBLIC HEALTH: THE STATE SANITARY CODE 105 CMR 300.00 Reportable Diseases and Isolation and Quarantine Requirements 105 CMR 400.000 General Administrative Procedures 105 CMR 410.000 Minimum Standards of Fitness for Human Habitation 105 CMR 430.000 Minimum Sanitation and Safety Standards for Recreational Camps for Children 105 CMR 435.000 Minimum Standards for Swimming Pools *(310 CMR 12.00) 105 CMR 440.000 Minimum Standards for Developed Family type Camp Grounds *(310 CMR 14.00) • 105 CMR 445.000 Minimum Standard for Bathing Beaches "(310 CMR 17.00 a • Y 105 CMR 460.000 Regulations for Lead Poisoning Prevention and Control 105 CMR 590.000 Minimum Sanitation Standards For Food Establishments *Regulations which were previously available under asterisked D.E.P. CMR numbers. (State • Legislature transferred to MDPH FY87) 310 CMR 15.00 Title 5 Minimum Requirements for Subsurface Disposal of Sanitary Sewage 310 CMR 19.00 Disposal of Solid Waste by Sanitary Landfill • • The Commonwealth of Massachusetts Executive Office of Health and Human Services Department of Public Health f State Laboratory Institute 305 South Street, Jamaica Plain, MA 02130 BUREAU OF COMMUNICABLE DISEASE CONTROL March 2003 CLINICAL ACTIVITIES RELATED TO COMMUNICABLE DISEASE PREVENTION AND CONTROL BY LOCAL BOARDS OF HEALTH Local boards of health have a crucial role in the prevention and control of communicable diseases. The continued successful control of communicable diseases depends on the following: maintaining the communicable disease surveillance system; follow-up of disease reports; control of outbreaks; enforcement of isolation and quarantine regulations; ensuring treatment; provision of immunizations; assurance of safe and sanitary conditions; and effective communication/collaboration with health care • providers. These activities help protect the safety of the public, many of them are mandated by statute and regulation and require clinical assessment and intervention. Clinical intervention provided by nurses and other health care practitioners is critical to infection control at the community level. Broad and comprehensive training of nurses includes clinical evaluation, case management, epidemiology, community health and health education. These skills are essential for: assessment; diagnosis; development of care plans administration of medications and vaccines; disease investigation; interpretation of signs, symptoms and laboratory results; provision of health care advice and information; formulation of disease control guidelines and strategies; implementation of guidelines and strategies; • evaluation While we try to cope with an often insufficient public health infrastructure, • we must keep in focus critical and essential activities. Failure to do this results in increased morbidity and mortality, the spread of communicable disease, and compounding of cost and suffering that occurs when basic disease prevention is no longer effective. The following is a list of responsibilities of local boards of health, established by law, regulation and good practice, which require clinical skills. • Receive reports of diseases dangerous to the public 'health (MGL c.111, ss.6, 7, 18 and 111; 105 CMR 300.100). Requires interpretation and evaluation of clinical data. Reports must be sent to other jurisdictions where an infected individual may reside, where the patient is known to have contracted the disease and where the patient is known to have exposed another person to the disease. This activity requires detailed knowledge of the epidemiology of a number of contagious diseases. Case investigation forms for many diseases require awareness to numerous and complex medical questions. • Report cases of dangerous diseases to the Department of Public Health within twenty-four hours (MGL c.111, s.112; 105 CMR 300.110). Clusters or outbreaks must be reported immediately to the • Department (105 CMR 300.130). Requires clinical judgment as to whether the available information constitutes an adequate diagnosis. • Treatment, transportation and protection of a sick person and the protection of the community at-large in the case of a disease dangerous to the public health (MGL c.111, ss.6, 7, 94A; 95, 96, 96A, 97, 104). Requires persons trained in the care of persons with diseases dangerous to the public health. • Consultation with the Department of Public Health regarding prevention of dangerous diseases (MGL c.111, s.7). Requires a clinical background to be able to investigate outbreaks and discuss control, and implement interventions. • Enforce isolation and quarantine regulations (MGL c.111, ss.6, 95; 105 CMR 300.200). Requires clinical interpretation and correct information transmitted to a variety of institutions and public facilities, including health care facilities. • Refer exposed individuals for anti-rabic vaccine and treatment (MGL c.140, s.145A) and, on occasion, administer post-exposure prophylaxis. • r • Maintenance of close contact with area physicians and other • practitioners is essential for successful disease intervention, adequate surveillance and prevention of outbreaks. • Receive reports of food poisonings and send these reports to the Department of Public Health (105 CMR 300.120). Requires understanding of signs and symptoms of foodborne disease and epidemiologic parameters to interpret reports, implement control interventions and provide for enforcement of Chapter X of the State Sanitary Code which regulates food service establishments (MGL c.111, s.127A, 105 CMR 590.000). • Immunization and up-to-date immunization guidelines and procedures must be interpreted and implemented. • Provide means for vaccinations, without charge, if such vaccinations are required by the board (MGL c.111, s.181). Requires personnel to administer such vaccinations in an appropriate and safe manner as necessary. Immunization clinics have been shown to be a highly cost- effective public health activity. Expansion of immunization clinic services during influenza season and during outbreaks is essential to limit the spread of this vaccine-preventable disease. • • Maintenance of an established biologic (vaccine) distribution station (105 CMR 730.000). Requires knowledge of appropriate handling of biologics and dispensing of vaccine with adequate and accurate information. • Receive and record reports of pulmonary and extrapulmonary tuberculosis (MGL c.111, ss.7, 112, 113). Requires interpretation of medical reports and laboratory studies (105 CMR 300.140 (d) and 105 CMR 350.000). • Investigate each reported case or suspect case of tuberculosis to determine the source and possible spread of infection to other persons. Identify contacts and determine if infected. Screen selected groups using the Mantoux tuberculin skin test procedure. Requires knowledge of the medical and epidemiologic aspects of tuberculosis and the administration and interpretation of the Mantoux skin test. (MGL. c.111, s.81A) • Assist in the identification, transportation and hospitalization of patients eligible for admission to the hospital designated by the Department of Public Health for tuberculosis treatment (MGL c.111, s.94A; 105 CMR 360.000). Requires clinical case management. • • Ensure prompt diagnostic and follow-up examinations of patients and • suspected tuberculosis cases and the uninterrupted treatment of patients with diagnosed tuberculosis (105 CMR 365.000). Requires knowledge of the epidemiology of tuberculosis and control methods. • Collaborate with hospitals and other care facilities in the discharge planning for patients with confirmed or suspected tuberculosis (105 CMR 365.000). Requires knowledge of community resources, as well as knowledge of the epidemiology and treatment of tuberculosis. • Provide appropriate case management and nursing services, under medical orders, for administration of injectable anti-tuberculosis drugs or supervised chemotherapy apart from a tuberculosis clinic. These services must be provided until the patient has completed therapy (105 CMR 365.000). • Proceed with compulsory hospitalization of uncooperative tuberculosis patients after exhausting all reasonable attempts to influence the patient to accept treatment or isolation (MGL c.111, ss.94A through 94C). • Designate a staff person or a person or agency under contract as a clinical case manager to enforce the laws, rules and regulations • pertaining to tuberculosis and related public health duties and responsibilities (105 CMR 365.000). The public health nurse has traditionally and effectively performed this function and is uniquely suited to these activities. • Resident aliens newly arrived in the United States, with diagnosed or suspected tuberculosis must be identified and all appropriate forms must be completed (Federal P.L. 87-301). This requires the evaluation of medical records, an understanding of tuberculosis clinical guidelines and procedures and proper implementation of disease control protocols. 13 - C . B . O .H . A . Berkshire County Boards of Health Association LBOH Core Duties* C. Record Keeping,Budgeting, Secure and available to the Assume forever unless Computer programs,. I bud-gets, 1.Can,charge for Administration, Office operations Public permi'ssion to destroy database,office skills,MARB copies/:researeh Food Establishments . Inspections&Permit 2/year ServeSafe Certification Yes • Restaurants and cafeterias 0 Before opening Follow tip Special Event Regulation • Retail Food F-stablisimm" * 2 x annually Complaints • Catering and Caterers 9 Complaints • Mobile Food Wagons • Temporary Food Service * Fire/Floods • Frozen Deserts e Water supply • Bakery • Milk • Non-profits serving food to public 0 Special Events with food & Egg processors * Cold Storage warehouses 0 Shell Fish labeling enforcement 0 Food safety Beaches Testing&Inspections I week in season Yes Swimming Pools Inspections&Permit _ Opening/periodically Certified Pool Operator Yes Camps -Family and Recreational Inspections&Permit __2penir!IL/penodically Basic Cam p Inspection Course Yes Complaints Investigate Within 24 hours Basic Housing Code Trainings Fees difficult: - Housing,including heat Enforce Housing Court Pre-rental - Public Buildings, safety Protect the Public Health Hoarding Trainings inspection - Mold and dampness and environment Aggressive People Awareness program with - Unsafe or unsanitary Lead Inspector Training appropriate - Air Quality Food and Water Emergencies fees can be - Lead Sanitary Survey of Carnivals used. - Sound,smells Private Wells and Public Water - Drinking water Indoor Air Quality - Smoking Chemical Spills - Food Meth Labs P.O.Box 60,LEE,MA 01238 PHONE:413.441.9060 FA3C413-528-4310 WWW.BCBOHA.0RG NFO@9CBOH&0RG - Septic Issues Self Defense - Nuisances,pesticides - Mosquitoes,insects - Garbage,wastes Motels/Hotels/B&B/Mobile Home Permit,Inspect Annual before Parks h' Irt Housing Inspection Course Yes Body Art Practitioner Permit,Inspect Annually before permit Infection Control Establishment Yes Tanning Parlors pest,Inspect Mhssage Parlors License and Inspect Annually Septage and Gar ajNW, Haulers License Annuaflv Solid Wastes/DEP courses Yes Animals -Rabies -Report P-Provide vaccine As needed Animal Inspectors and Animal No Co -Other diseases -Collect samples training -License via2eries.etc. Septic Systems Construction or Repair - DSCP -Plan Review/Permit Before issuing Sic System Design Yes Excavation g BCBOHA Installers Course Yes FinalOII 'Inspection Before Filling Hydric Soils Yes Inspecti -Inspection Before Covering- Pumps and I/A Technology -Inspection Before C of C Yes - - Septic Installers -License Yes Pere Tests&Deep Holes Witness Yes On�� Soil Evaluator Certification Yes Title 5 Inspections Advanced Soil Evaluator Review or Witness U transfer System or Certification Yes Disease surveillance,sampling, Reporting and Follow up, Varies,but most within Infectious Disease Training No investigation,treatment,studies TB went 24 hours arse for TB treatment Wells Permit,decommission,protect Beavers on/Permit Within 24 hours Pesticides Wetlands Identification Yes Emergency Pesticide Within 24 hours Pesticide Training Ma ybe a Permit at schools y Tobacco Control,Youth Access License and Annually Demolition Permits B2jgM for rodents As needed Tri-Town Health Tobacco y� Buildiruz Permit sign off Certify Water&Sewerage Pests,Asbestos.Mere Can e�B _ = . needed n Hazardous Waste Haulers License ' '. Annually Toxics and Hazardous Wastes Yes P.O.Box 60,LEE,MA 01238 2 PHONE:413.441-9060 F,Yx:413-528-4310 W W W.BCBOHA_ORG RMO@BMOHA.ORG Animal Inspectors Nominate,disease reports Wy No Death Reports Deaths-Dangerous Diseases ly to DPH No Cemeteries _AETrove locations On request Yes Death Certificates Process Usually delegated Yes Burial Permits Issue Usually delegated Yes Funeral Directors PermiVbspection Annually Yes Noisome Trades Permit,Regulate As needed Yes Vaccinations,Flu Clinic,etc. Provide to the Public Annually,as needed Registered Nurse Sometimes Emergencies Planning and - Continuity of operations As needed, should be NIMS 700,ICS 100,200,300 No Response Plans(COOP) annually updated Pandemic Flu - Disease Surveillance HSEEP - Disease Investigation Risk Communications - Sampling Behavioral Health Fast Aid - Isolation and Quarantine Isolation and Quarantine - Mass Prophylaxis(EDS) Personal Protective Equipment . - Medical Shelters Radiological Training - Animal Shelters Agricultural Terrorism - Behavioral Health Weapons of Mass Destruction - Risk Communications Animals in Disasters - Mass Burials Unattended Deaths - Debris Disposal ARC Shelter Training Solid Waste Sites/Transfer Station Approve Sites/Inspect Periodically DEP S s/Hazardous Wastes Yes Local Regulation passed As Needed Ongoing Sometimes Subdivisions Review lens 30 days to approve Yes aiedat?l77777 Wellness Promotion Ongoing No Disease Prevention OngoingNo Social Services SOngoingNo Improve Public Health Practices o' No Provide Public Health Leadership Ongoing— No _SupportWorkforce Development OngoingNo *The Ten Essential Public Health Services 1.Monitor health status S.Develop policies and plans 8.Assure a competent worktorc e-public health 2.Diagnose and investigate health problems S.Enfor+ca laws and regulations and personal care 3.Inform,educate and empower people 7.Link people to needed health services 8.Evaluate health services 4.Mobilize to address health problems I O.Conduct research for new innovations 'Sanitarian and Certified Health Officers(CHO)have many of these trainings and certifications as part of their cerdfcation. Foundations for Local Public Health Practices cover many of these training areas as well. P.O.Box 60,LEE,MA 01238 3 PHONE:413.441-9060 FAx:413-528-4310 W W W.BCBOHA.ORG 1NFOCa 3MOHA.ORG i I • en eetin aw ul e i COMMONWEALTH OFFICE OFATToRNEYGENERAL MARTHA COAKLEY ' ' � Y • Dear Massachusetts Residents: On July 1, 2010, the Attorney General's Office assumed responsibility for the enforcement of the Open Meeting Law(OML) from the state's District Attorneys. We believe that transferring all enforcement to one central statewide office will allow for greater consistency and will ensure that local officials have access to the information they need to comply with the law. Our office is committed to ensuring that the changes to the Open Meeting Law will provide for greater transparency and clarity—both of which are hallmarks of good government. We are focused on providing educational materials, outreach and training sessions to ensure that all members of the public understand the law. • Whether you are a town clerk or town manager, a member of a public body, or an involved resident, I want to thank you for taking the time to understand the Open Meeting Law. We strive to be a resource to you, and encourage you to contact the Division of Open Government at (617) 963-2540 or visit our website at www.mass.gov/ago/openmeeting for more information. Cordially, Martha Coakley Massachusetts Attorney General • • -Attorney General's Open Meeting Law Guide Overview +� Purpose of the Law The purpose of the Open Meeting Law is to ensure transparency in the deliberations on which public policy is based. Because the democratic process depends on the public having knowledge about the considerations underlying governmental action,the Open Meeting Law requires,with some exceptions,that meetings of public bodies be open to the public. It also seeks to balance the public's interest in witnessing the deliberations of public officials with the government's need to manage its operations efficiently. AGO Authority The Open Meeting Law was revised as part of the 2009 Ethics Reform Bill,and now centralizes responsibility for statewide enforcement of the law in the Attorney General's Office(AGO). G.L. c.30A, §19(a). To help public bodies understand and comply with the revised law,the Attorney General has created the Division of Open Government. The Division of Open Government provides training,responds to inquiries, investigates • complaints,and when necessary, makes findings and takes remedial action to address violations of the law. The purpose of this Guide is to inform elected and appointed members of public bodies,as well as the interested public, of the basic requirements of the law. Certification Within two weeks of a member's election or appointment or the taking of the oath of office,whichever occurs later,all members of public bodies must complete the attached Certificate of Receipt of Open Meeting Law Materials certifying that they have received these materials,and that they understand the requirements of the Open Meeting Law and the consequences for violating it. The certification must be retained where the body maintains its official records. All public body members should familiarize themselves with the Open Meeting Law,Attorney General's regulations,and this Guide. Where no term of office for a member of a public body is specified,the member must complete the Certificate of Receipt on a biannual basis by January 14 of a calendar year, beginning on January 14,2011. Where a member's term of office began prior to July 1, 2010,and will not expire until after July 1,2011,the member should have completed the Certificate of Receipt by January 14, 2011. In the event a Certificate has not yet been completed by a member of a public body,the member should complete and submit the Certificate at the earliest opportunity to be considered in compliance with the law. • Open Meeting Law Guide Pagel Version 3.24.11 Open Meeting Website • This Guide is intended to be a clear and concise explanation of the Open Meeting Law's requirements. A more in-depth explanation of the law along with up-to-date regulations, training materials, advisory opinions and orders can be found on the Attorney General's Open Meeting website, http://www.mass.gov/aeo/openmeeting. Local and state government officials, members of public bodies and the public are encouraged to visit the website regularly for updates,as well as to view additional Open Meeting Law materials. What meetings are covered by the Open Meeting Law? With certain exceptions, all meetings of a public body must be open to the public. A meeting is generally defined as "a deliberation by a public body with respect to any matter within the body's jurisdiction." As explained more fully below, a deliberation is a communication between or among members of a public body. These four questions will help determine whether a communication constitutes a meeting subject to the law: 1) is the communication between members of a public body; 2)does the communication constitute a deliberation; • 3)does the communication involve a matter within the body's jurisdiction;and 4) does the communication fall within an exception listed in the law? What constitutes a public body? While there is no comprehensive list of public bodies,any multi-member board, commission,council,authority, committee or subcommittee within the Executive branch of state government,or within any county,district, city, region or town,which has been established to serve a public purpose,is subject to the law. The law includes any multi-member body created to advise or make recommendations to a public body, and also includes the board of any local housing or redevelopment authority,and the governing board or body of any authority established by the Legislature to serve a public purpose. The law excludes the Legislature and its committees, bodies of the judicial branch, and bodies appointed by a constitutional officer for the purpose of advising a constitutional officer. Boards of selectmen and school committees are certainly subject to the Open Meeting Law, as are subcommittees of public bodies, regardless of whether their role is decision-making or advisory. Neither individual government officials,such as a mayor or police chief, nor members of their staffs, are"public bodies"subject to the law,and so they may meet with one another to discuss public business without needing to comply with Open Meeting Law requirements. Bodies appointed by a public official solely for the purpose of advising on a decision that the individual could make himself or herself are not public bodies subject to the Open Meeting Law. • Open Meeting Law Guide Page 2 Version 3.24.11 • For example, a school superintendent appoints a four member advisory body to assist her in nominating candidates for school principal,a task the superintendent could perform herself. That advisory body would not be subject to the Open Meeting Law.' What constitutes a deliberation? The Open Meeting Law defines deliberation as"an oral or written communication through any medium, including electronic mail, between or among a quorum of a public body on any public business within its jurisdiction." Distributing a meeting agenda,scheduling or procedural information,or reports or documents that may be discussed at the meeting will not constitute deliberation,so long as the material does not express the opinion of a member of the public body. E-mail exchanges between or among a quorum of members of a public body discussing matters within the body's jurisdiction may constitute deliberation,even where the sender of the email does not ask for a response from the recipients. To be a deliberation,the communication must involve a quorum of the public body. A quorum is usually a simple majority of the members of a public body. Thus, a communication among fewer than a quorum of the members of a public body will not be a deliberation, unless there are multiple communications among the members of the public body that would together be a communication among a quorum of members. Courts have held that the Open Meeting Law applies when members of a public body communicate in a manner that seeks to evade the • application of the law. Thus, in some circumstances,communications between two members of a public body,when taken together with other communications,may be a deliberation. What matters are within the jurisdiction of the public body? The Open Meeting Law applies only to the discussion of any"matter within the body's jurisdiction." The law does not specifically define"jurisdiction." But as a general rule, any matter of public business on which a quorum of the public body may make a decision or recommendation would be considered a matter within the jurisdiction of the public body. What are the exceptions to the definition of a meeting? There are five exceptions to the definition of a meeting under the Open Meeting Law. 1. Members of a public body may conduct an onsite inspection of a project or program; however,they cannot deliberate at such gatherings; 2. Members of a public body may attend a conference,training program or event; however,they cannot deliberate at such gatherings; • See Connelly v,School Committee of Hanover,409 Mass.232,565 N.E.2d 449(1991). Open Meeting Law Guide Page 3 Version 3.24.11 3. Members of a public body may attend a meeting of another public body provided that • they communicate only by open participation; however,they cannot deliberate at such gatherings; 4. Meetings of quasi-judicial boards or commissions held solely to make decisions in an adjudicatory proceeding are not subject to the Open Meeting Law; and, S. Town Meetings are not subject to the Open Meeting Law. See G.L.c. 39, §9. For quasi-judicial boards or commissions,"the AGO interprets this exemption to apply only to certain state"quasi-judicial" bodies,and a very limited number of public bodies at other levels of government whose proceedings are specifically defined as"agencies"for purposes of G.L. c.30A. What are the requirements for filing and posting meeting notices of local public bodies? Except in cases of emergency, a public body must provide the public with notice of its meeting 48 hours in advance,excluding Saturdays,Sundays and legal holidays. Notice of emergency meetings must be posted as soon as reasonably possible prior to the meeting. • For local public bodies, meeting notices must be filed with the municipal clerk sufficiently in advance of a public meeting to permit posting of the notice at least 48 hours in advance of the public meeting. Notices may be posted on a bulletin board, in a • loose-leaf binder or on any electronic display (e.g.television,computer monitor, or an electronic bulletin board), provided that the notice is conspicuously visible to the public at all hours in or on the municipal building in which the clerk's office is located. In the event that the meeting notices posted in the municipal building are not visible to the public at all hours,then the municipality must either post notices on the outside of the building or follow one of the alternative posting methods approved by the Attorney General: • public bodies may post notice of meetings on the municipal website; • public bodies may post notice of meetings on cable television,AND, post notice or provide cable television access in an alternate municipal building(e.g., police or fire station)where the notice is accessible at all hours; • public bodies may post notice of meetings in a newspaper of general circulation in the municipality,AND, post notice or a copy of the newspaper containing the meeting notice at an alternate municipal building(e.g., police or fire station)where the notice is accessible at all hours; • public bodies may place a computer monitor or electronic or physical bulletin board displaying meeting notices on or in a door,window,or near the entrance of the municipal building in which the clerk's office is located in such a manner as to be visible to the public from outside the building, or; • Open Meeting Law Guide Page 4 Version 3.24.11 • • public bodies may provide an audio recording of meeting notices,available to the public by telephone at all hours. If one of these alternative posting methods is used,the clerk of the municipality must inform the Division of Open Government of its notice posting method, and update the Division of any future change. All public bodies shall consistently use the most current notice posting method on file with the Division. What are the requirements for posting notices for regional, district, county and state public bodies? • For regional or district public bodies and regional school districts, meeting notices must be filed and posted in the same manner required of local public bodies, in each of the communities within the region or district. As an alternative method of notice, a regional or district public body may post a meeting notice on the regional or district public body's website. A copy of the notice shall be filed and kept by the chair of the public body or the chair's designee. • County public bodies must file meeting notices in the office of the county commissioners and post notice of the meeting in a manner conspicuously visible to the public at all hours at a place or places designated by the county commissioners for • notice postings. As an alternative method of notice, a county public body may post a meeting on the county public body's website.A copy of the notice shall be filed and kept by the chair of the county public body or the chair's designee. • State public bodies must file meeting notices by posting the notice on the website of the public body or its parent agency. A copy of the notice must be sent to the Secretary of State's Regulations Division. State public bodies should also forward a copy of notices to the Executive Office of Administration and Finance,which maintains a listing of state public body meetings. A Note About Accessibility Public bodies are subject to all applicable state and federal laws that govern accessibility for persons with disabilities. These laws include the Americans with Disabilities Act,the federal Rehabilitation Act of 1973, and state constitutional provisions. For instance, public bodies that adopt website posting as an alternative method of notice must ensure that the website utilizes technology that is readily accessible to people with disabilities, including individuals who use screen readers. All open meetings of public bodies must be accessible to persons with disabilities. Meeting locations must be accessible by wheelchair,without the need for special assistance. Also sign language interpreters for deaf or hearing-impaired persons must be provided,subject to reasonable advance notice.2 The Attorney General's Disability Rights Project is available to answer questions about accessibility and may be reached at (617) 727-2200. • 2 The Massachusetts Commission for the Deaf and Hard of Hearing will assist with arrangements for a sign language interpreter.The Commission may be reached at 617-740-1600 VOICE and 617-740-1700 TTY. Open Meeting Law Guide Page S Version 3.24.11 r What information must meeting notices contain? • Meeting notices must be posted in a legible,easily understandable format;contain the date, time and place of the meeting; and list the topics that,as of the time the notice is filed,the chair reasonably anticipates will be discussed at the meeting. The list of topics must be sufficiently specific to reasonably inform the public of the issues to be discussed at the meeting. While not required under the Open Meeting Law, public bodies are encouraged to make a revised list of topics to be discussed available to the public in advance of the meeting if the body intends to discuss topics that come up after posting but before the meeting convenes. When can a public body meet in executive session? While all meetings of public bodies must be open to the public,certain topics may be discussed in executive,or closed,session. Before going into an executive session,the chair of the public body must: • First convene in open session. • State the reason for the executive session,stating all subjects that may be revealed without compromising the purpose for which the executive session was called. • State whether the public body will reconvene at the end of the executive session. • Take a roll call vote of the body to enter executive session. • While in executive session,the public body must keep accurate records and must take a roll call vote of all votes taken and may only discuss matters for which the executive session was called. • Open Meeting Law Guide Page 6 Version 3.24.11 • The Ten Purposes for Executive Session The law defines ten specific Purposes for which an executive session may be held, and emphasizes that these are the only purposes for which a public body may enter executive session. The ten Purposes for which a public body may vote to hold an executive session are: 1. To discuss the reputation,character,physical condition or mental health, rather than professional competence,of an individual, or to discuss the discipline or dismissal of, or complaints or charges brought against,a public officer,employee,staff member or individual. The individual to be discussed in such executive session shall be notified in writing by the public body at least 48 hours prior to the proposed executive session; provided,however,that notification may be waived upon written agreement of the parties. This Purpose is designed to protect the rights and reputation of individuals. Nevertheless, it appears at least that where a public body is discussing an employee evaluation, considering applicants for a position,or discussing the qualifications of any individual,these discussions should be held in open session to the extent that that the discussion deals with issues other than the reputation,character, health, or any complaints or charges against the individual. An executive session called for this Purpose triggers certain rights on • the part of an individual who is the subject of the discussion. The individual's right to choose to have his or her dismissal considered at an open meeting takes precedence over the general right of the public body to go into executive session. While the proposed imposition of disciplinary sanctions by a public body on an individual fits within this Purpose,this Purpose does not apply if,for example, the public body is deciding whether to lay off a large number of employees because of budgetary constraints. 2. To conduct strategy sessions in preparation for negotiations with nonunion personnel or to conduct collective bargaining sessions or contract negotiations with nonunion personnel; Collective Bargaining Sessions:These include not only the bargaining sessions but also include grievance hearings that are called for under a collective bargaining agreement. 3. To discuss strategy with respect to collective bargaining or litigation if an open meeting may have a detrimental effect on the bargaining or litigating position of the public body and the chair so declares; Collective Bargaining Strategy: Discussions with respect to collective bargaining • strategy include discussions of proposals for wage and benefit packages or working Open Meeting Law Guide Page 7 Version 3.24.11 I Y conditions for union employees. The public body, if challenged,carries the burden of • proving that an open meeting might have a detrimental effect on its bargaining position to justify an executive session on the basis of this Purpose. The showing that must be made is that the open discussion may have a detrimental impact on the collective bargaining process;the body is not required to demonstrate or specify a definite harm that would have arisen. At the time that the executive session is proposed and voted on,the chair must state on the record that having the discussion in an open session may be detrimental to the public body's bargaining or litigating position. Litigation Strategy: Discussions concerning strategy with respect to ongoing litigation obviously fit within this Purpose, but only if an open meeting may have a detrimental effect on the litigating position of the public body. Discussions relating to potential litigation are not covered by this exemption unless that litigation is clearly and imminently threatened or otherwise demonstrably likely. That a person is represented by counsel and supports a position adverse to the public body's does not by itself mean that litigation is imminently threatened or likely. Nor does the fact that a newspaper reports a party has threatened to sue necessarily mean imminent litigation. Note:A public body's discussions with its counsel do not automatically fall under this or any other Purpose for holding an executive session. 4. To discuss the deployment of security personnel or devices,or strategies with • respect thereto; S. To investigate charges of criminal misconduct or to consider the filing of criminal complaints,- This Purpose permits an executive session to investigate charges of criminal misconduct and to consider the filing of criminal complaints. Thus it primarily involves discussions that would precede the formal criminal process in court. Purpose 1 is related, in that it permits an executive session to discuss certain complaints or charges,which may include criminal complaints or charges, but only those that have already been brought. Also, unlike Purpose 5, Purpose 1 confers certain rights of participation on the individual involved, as well as the right for the individual to insist that the discussion occur in open sessio n. To the limited extent that there is overlap between Purposes 1 and 5,a public body has discretion to choose which Purpose to invoke when going into executive session. 6. To consider the purchase,exchange, lease or value of real property if the chair declares that an open meeting may have a detrimental effect on the negotiating position of the public body; Under this Purpose, as with the collective bargaining and litigation Purpose, an executive session may only be held where an open meeting may have a • detrimental impact on the body's negotiating position with a third party. At the Open Meeting Law Guide Page 8 Version 3.24.11 i • time that the executive session is proposed and voted on,the chair must state .on the record that having the discussion in an open session may be detrimental to the public body's negotiating position. 7. To comply with,or act under the authority of,any general or special law or federal grant-in-aid requirements There may be provisions in certain statutes or federal grants which require or specifically allow that a public body consider a particular issue in a closed session. Additionally, as the following section discusses,where Purpose(8)does not apply, Purpose (7) may nevertheless apply to the initial stage of a hiring process. 8. To consider or interview applicants for employment or appointment by a preliminary screening committee if the chair declares that an open meeting will have a detrimental effect in obtaining qualified applicants;provided, however,that this clause shall not apply to any meeting,including meetings of a preliminary screening committee,to consider and interview applicants who have passed a prior preliminary screening This Purpose permits a hiring subcommittee of a public body or a preliminary screening committee to conduct the initial screening process in executive • session. This Purpose does not apply to any stage in the hiring process after the screening committee or subcommittee votes to recommend a candidate or candidates to its parent body. At the time that the executive session is proposed and voted on,the chair must state on the record that having the discussion in an open session will be detrimental to the public body's ability to attract qualified applicants for the position. If the public body opts to convene a preliminary screening committee,the committee must contain fewer than a quorum of the members of the parent public body. The committee may also contain members who are not members of the parent public body. 9. To meet or confer with a mediator,as defined in section 23C of chapter 233, with respect to any litigation or decision on any public business within its jurisdiction involving another party,group or entity,provided that: (i)any decision to participate in mediation shall be made in an open session and the parties, issues involved and purpose of the mediation shall be disclosed; and (ii) no action shall be taken by any public body with respect to those issues which are the subject of the mediation without deliberation and approval for such action at an open session 10. To discuss trade secrets or confidential,competitively-sensitive or other proprietary information provided: • Open Meeting Law Guide Page 9 Version 3.24.11 i a. in the course of activities conducted by a governmental body as an energy supplier • under a license granted by the department of public utilities pursuant to section 1F of chapter 164, b. in the course of activities conducted as a municipal aggregator under section 134 of said chapter 164,or c. in the course of activities conducted by a cooperative consisting of governmental entities organized pursuant to section 136 of said chapter 164, d. when such governmental body, municipal aggregator or cooperative determines that such disclosure will adversely affect its ability to conduct business in relation to other entities making,selling or distributing electric power and energy May a member of the public body participate remotely? The Attorney General is authorized under the Open Meeting Law to permit remote participation by members of a public body not present at the meeting location. This issue is under consideration by the AGO. While the issue is under consideration,remote participation by members of public bodies is not permitted under the Open Meeting Law. What public participation in meetings must be allowed? Under the Open Meeting Law,the public is permitted to attend meetings of public bodies • but is excluded from an executive session that is called for a valid purpose listed in the law. Any member of the public also has a right to make an audio or video recording of an open session of a public me eting.eeting. A member of the public who wishes to record a meeting must first notify the chair and must comply with reasonable requirements regarding audio or video equipment established by the chair so as not to interfere with the meeting. The chair is required to inform other attendees of such recording at the beginning of the meeting. While the public is permitted to attend an open meeting,an individual may not address the public body without permission of the chair. An individual is not permitted to disrupt a meeting of a public body,and at the request of the chair, all members of the public shall be silent. If after clear warning, a person continues to be disruptive,the chair may order the person to leave the meeting, and if the person does not leave,the chair may authorize a constable or other officer to remove the person. What records of public meetings must be kept? Public bodies are required to create and maintain accurate minutes of all meetings, including executive sessions. The minutes, which must be created and approved in a timely manner, must state the date,time and place of the meeting, a list of the members present or absent, and the decisions made and actions taken including a record of all votes. While the minutes must also include a summary of the discussions on each subject, a transcript is not • Open Meeting Law Guide Page 10 Version 3.24.11 I • required. No vote taken by'a public body, either in an open or in an executive session,shall be by secret ballot. All votes taken in executive session must be by roll call and the results recorded in the minutes. In addition,the minutes must include a list of the documents and other exhibits used at the meeting. While public bodies are required to retain these records in accordance with records retention laws,the documents and exhibits listed in the minutes need not be attached to or physically stored with the minutes. The minutes,documents and exhibits are public records and a part of the official record of the meeting. Records may be subject to disclosure under either the Open Meeting Law or Public Records Law and must be retained in accordance with the Secretary of State's record retention schedule. The State and Municipal Record Retention Schedules are available through the Secretary of State's website at:.http://www.sec.state.ma.us/arc/arcrmu/rmuidx.htm. Open Session Meeting Records The Open Meeting Law requires public bodies to create and approve minutes in a timely manner. The law requires that existing minutes be made available to the public within 10 days upon request,whether they have been approved or remain in draft form. Materials or other exhibits used by the public body in an open meeting are also to be made available to the public within 10 days upon request. There are two exemptions to the open session records disclosure requirement: 1) • materials (other than those that were created by members of the public body for the purpose of the evaluation)used in a performance evaluation of an individual bearing on his professional competence,and 2) materials (other than any resume submitted by an applicant which is always subject to disclosure) used in deliberations about employment or appointment of individuals, including applications and supporting materials. Documents created by members of the public body for the purpose of performing an evaluation are subject to disclosure. This applies to both individual evaluations and evaluation compilations, provided the documents were created by members of the public body for the purpose of the evaluation. Executive Session Meeting Records Public bodies are not required to disclose the minutes, notes or other materials used in an executive session where the disclosure of these records may defeat the lawful purposes of the executive session. Once disclosure would no longer defeat the purposes of the executive session, minutes and other records from that executive session must be disclosed unless they are within an exemption to the Public Records Law, G.L. c.4,§ 7,cl.26, or are attorney-client privileged. The public body is also required to periodically review the executive session minutes to determine whether continued non-disclosure is warranted, and such determination must be included in the subsequent meeting minutes. A public body must respond to a request to inspect or copy executive session minutes within 10 days of request and promptly release the records if they are subject to disclosure. If the body has not performed a review to determine whether they are subject to disclosure, it must do so • prior to its next meeting or within 30 days,whichever is sooner. Open Meeting Law Guide Page 11 Version 3.24.11 What is the Attorney General's role in enforcing the Open Meeting Law? • The Attorney General's Division of Open Government is responsible for enforcing the Open Meeting Law. The Attorney General has the authority to take and investigate complaints, bring enforcement actions, issue advisory opinions and issue regulations. The Division of Open Government regularly seeks feedback from the public on ways in which it can better support public bodies to help them comply with the law's requirements,and will provide online and in-person trainings on the Open Meeting Law. The Division of Open Government will also respond to information requests from public bodies and the public. The Division of Open Government will take complaints from members of the public and will work with public bodies to resolve problems. While any member of the public may file a complaint with a public body alleging a violation of the Open Meeting Law,a public body need not, and the Division of Open Government will not, investigate anonymous complaints. What is the Open Meeting Law complaint procedure? Step 1. Filing a Complaint with the Public Body Individuals who allege a violation of the Open Meeting Law must first file a complaint with • the public body alleged to have violated the OML. The complaint must be filed within 30 days of the date of the violation, or the date the complainant could reasonably have known of the violation. The complaint must be filed on a Complaint Form available on the AGO website. When filing a complaint with a local public body,the complainant must also file a copy of the complaint with the municipal clerk. Step 2. The Public Body's Response Upon receipt,the Chair of the public body should distribute copies of the complaint to the members of the public body. The public body has 14 business days from the date of receipt to review the complainant's allegations;take remedial action if appropriate; notify the complainant of the remedial action;and forward a copy of the complaint and description of the remedial action taken to the AGO. The public body may request additional information from the complainant. The public body may also request an extension of time to respond to the complaint. A request for an extension should be made within 14 business days of receipt of the complaint by the public body. The request for an extension should be made in writing to the Division of Open Government,and should state the reason for the requested extension. Step 3. Filing a Complaint with the Attorney General's Office A complaint is ripe for review by the AGO 30 days after the complaint is filed with the public body. This 30-day period is intended to provide a reasonable opportunity for the complainant and the public body to resolve the initial complaint. It is important to note that complaints are not automatically treated as filed for review by the AGO upon filing with the public body. A complainant who has filed a complaint with a public body, and seeks further review by the Division of Open Government, must file the complaint with the AGO after the 30-day local • Open Meeting Law Guide Page 12 Version 3.24.11 • review period has elapsed but before 90 days have,passed since the date of the violation.When filing the complaint with the AGO,the complainant must include a copy of the original complaint and may include any other materials the complainant feels are relevant, including an explanation of why the complainant is not satisfied with the remedial action taken by the public body. Complaints filed with the AGO are public records. The AGO will review the complaint and any remedial action taken by the public body. The AGO may request additional information from both the complainant and the public body. The AGO will seek to resolve complaints in a reasonable period of time,generally within 90 days of the complaint becoming ripe for review by our office. The AGO may decline to investigate a complaint where more than 90 days have passed since the date of the alleged violation. Will the Attorney General's Office provide training on the Open Meeting Law? The Open Meeting Law directs the AGO to create educational materials and provide training to public bodies to foster awareness of and compliance with the Open Meeting Law. The AGO has established an Open Meeting Law website,www.mass.gov/ago/openmeetina on which government officials and members of public bodies can find the statute, regulations, FACts, training materials and other resources.The AGO will provide regional trainings for members of public bodies and will hold periodic online webinars. • Contacting the Attorney General If you have any questions about the Open Meeting Law or anything contained in this guide, please contact the AGO's Division of Open Government. The AGO also welcomes any comments,feedback,or suggestions you may have about the Open Meeting Law or this guide. Division of Open Government Office of the Attorney General 617-963-2540 www.mass.gov/ago/openmeetinp, OpenMeeting@state.ma.us One Ashburton Place Boston, MA 02108 • Open Meeting Law Guide Page 13 Version 3.24.11 THE COMMONWEALTH OF MASSACHUSETTS • OPEN MEETING LAW,G.L.c. 30A, §§18-25' Chapter 28 of the Acts of 2009,sections 17-20,repealed the existing state Open Meeting Law, G.L. c. 30A, §§11A, 11A-1/2, county Open Meeting Law, G.L. c. 34, §9F,9G,and municipal Open Meeting Law, G.L. c. 39, §§23A,238, and 23C, and replaced them with a single Open Meeting Law covering all public bodies, G.L. c. 30A, §§I8-25, enforced by the Attorney General. * rr Section 18: [DEFINITIONS] As used in this section and sections 19 to 25, inclusive,the following words shall, unless the context clearly requires otherwise, have the following meanings: "Deliberation",an oral or written communication through any medium, including electronic mail, between or among a quorum of a public body on any public business within its jurisdiction; provided, however,that "deliberation"shall not include the distribution of a meeting agenda, scheduling information or distribution of other procedural meeting or the distribution of reports or documents that may be discussed at a meeting, provided that no opinion of a member is expressed. • "Emergency",a sudden,generally unexpected occurrence or set of circumstances demanding immediate action. "Executive session",any part of a meeting of a public body closed to the public for deliberation of certain matters. "Intentional violation", an act or omission by a public body or a member thereof, in knowing violation of the open meeting law. "Meeting", a deliberation by a public body with respect to any matter within the body's jurisdiction;provided, however, "meeting"shall not include: (a) an on-site inspection of a project or program,so long as the members do not deliberate; (b) attendance by a quorum of a public body at a public or private gathering, including a conference or training program or a media,social or other event,so long as the members do not deliberate; (c) attendance by a quorum of a public body at a meeting of another public body that has complied with the notice requirements of the open meeting law,so long as the 3 NOTICE:This is NOT the official version of the Massachusetts General Law(MGL).While reasonable efforts have been made to ensure the accuracy and currency of the data provided,do not rely on this • information without first checking an official edition of the MGL. Open Meeting Law Guide Page 14 Version 3.24.11 • visiting members communicate only by open participation in the meeting on those P g matters under discussion by the host body and do not deliberate; (d)a meeting of a quasi-judicial board or commission held for the sole purpose of making a decision required in an adjudicatory proceeding brought before it; or (e)a session of a town meeting convened under section 9 of chapter 39 which would include the attendance by a quorum of a public body at any such session. "Minutes",the written report of a meeting created by a public body required by subsection (a)of section 22 and section 5A of chapter 66. "Open meeting law",sections 18 to 25, inclusive. "Post notice",to display conspicuously the written announcement of a meeting either in hard copy or electronic format. "Preliminary screening",the initial stage of screening applicants conducted by a committee or subcommittee of a public body solely for the purpose of providing to the public body a list of those applicants qualified for further consideration or interview. "Public body",a.multiple-member board,commission,committee or subcommittee within the executive or legislative branch or within any county,district,city, region or town, however created,elected,appointed or otherwise constituted,established to serve a public purpose; • provided,however,that the governing board of a local housing, redevelopment or other similar authority shall be deemed a local public body; provided,further, that the governing board or body of any other authority established by the general court to serve a public purpose in the commonwealth or any part thereof shall be deemed a state public body; provided,further,that "public body" shall not include the general court or the committees or recess commissions thereof, bodies of the judicial branch or bodies appointed by a constitutional officer solely for the purpose of advising a constitutional officer and shall not include the board of bank incorporation or the policyholders protective board; and provided further,that a subcommittee shall include any multiple-member body created to advise or make recommendations to a public body. "Quorum",a simple majority of the members of the public body, unless otherwise provided in a general or special law,executive order or other authorizing provision. Section 19. [DIVISION OF OPEN GOVERNMENT AND ADVISORY COMMISSION] (a)There shall be in the department of the attorney general a division of open government under the direction of a director of open government.The attorney general shall designate an assistant attorney general as the director of the open government division.The director may appoint and remove,subject to the approval of the attorney general,such expert, clerical and • other assistants as the work of the division may require.The division shall perform the duties Open Meeting Law Guide Page 15 Version 3.24.11 imposed upon the attorney general by the open meeting law,which may include participating, • appearing and intervening in any administrative and judicial proceedings pertaining to the enforcement of the open meeting law. For the purpose of such participation,appearance, intervention and training authorized by this chapter the attorney general may expend such funds as may be appropriated therefor. (b)The attorney general shall create and distribute educational materials and provide training to public bodies in order to foster awareness and compliance with the open meeting law. Open meeting law training may include, but shall not be limited to, instruction in: (1)the general background of the legal requirements for the open meeting law; (2) applicability of sections 18 to 25, inclusive,to governmental bodies; (3)the role of the attorney general in enforcing the open meeting law; and (4) penalties and other consequences for failure to comply with this chapter. (c)There shall be an open meeting law advisory commission.The commission shall consist of 5 members,2 of whom shall be the chairmen of the joint committee on state administration and regulatory oversight; 1 of whom shall be the president of the Massachusetts Municipal Association or his designee; 1 of whom shall be the president of the Massachusetts Newspaper Publishers Association or his designee; and 1 of whom shall be the attorney general or his designee. The commission shall review issues relative to the open meeting law and shall submit to the • attorney general recommendations for changes to the regulations,trainings, and educational initiatives relative to the open meeting law as it deems necessary and appropriate. (d)The attorney general shall, not later than January 31,file annually with the commission a report providing information on the enforcement of the open meeting law during the preceding calendar year. The report shall include, but not be limited to: (1)the number of open meeting law complaints received by the attorney general; (2)the number of hearings convened as the result of open meeting law complaints by the attorney general; (3) a summary of the determinations of violations made by the attorney general; (4) a summary of the orders issued as the result of the determination of an open meeting law violation by the attorney general; (5) an accounting of the fines obtained by the attorney general as the result of open meeting law enforcement actions; (6)the number of actions filed in superior court seeking relief from an order of the attorney general; and (7) any additional information relevant to the administration and enforcement of the open meeting law that the attorney general deems appropriate. • Open Meeting Law Guide Page 16 Version 3.24.11 • y Section 20. [NOTICE, REMOTE PARTICIPATION,PUBLIC PARTICIPATION,CERTIFICATION] (a) Except as provided in section 21,all meetings of a public body shall be open to the public. (b) Except in an emergency, in addition to any notice otherwise required by law,a public body shall post notice of every meeting at least 48 hours prior to such meeting,excluding Saturdays,Sundays and legal holidays. In an emergency, a public body shall post notice as soon as reasonably possible prior to such meeting. Notice shall be printed in a legible,easily understandable format and shall contain the date,time and place of such meeting and a listing of topics that the chair reasonably anticipates will be discussed at the meeting. (c) For meetings of a local public body, notice shall be filed with the municipal clerk and posted in a manner conspicuously visible to the public at all hours in or on the municipal building in which the clerk's office is located. For meetings of a regional or district public body, notice shall be filed and posted in each city or town within the region or district in the manner prescribed for local public bodies. For meetings of a regional school district,the secretary of the regional school district committee shall be considered to be its clerk and shall file notice with the clerk of each city or town within such district and shall post the notice in the manner prescribed for local public bodies. For • meetings of a county public body, notice shall be filed in the office of the county commissioners and a copy of the notice shall be publicly posted in a manner conspicuously visible to the public at all hours in such place or places as the county commissioners shall designate for the purpose. For meetings of a state public body,notice shall be filed with the attorney general by posting on a website in accordance with procedures established for this purpose and a duplicate copy of the notice shall be filed with the regulations division of the state secretary's office. The attorney general shall have the authority to prescribe or approve alternative methods of notice where the attorney general determines such alternative will afford more effective notice to the public. (d)The attorney general may by regulation or letter ruling,authorize remote participation by members of a public body not present at the meeting location; provided, however,that the absent members and all persons present at the meeting location are clearly audible to each other; and provided,further,that a quorum of the body, including the chair,are present at the meeting location.Such authorized members may vote and shall not be deemed absent for the purposes of section 23D of chapter 39. (e)After notifying the chair of the public body,any person may make a video or audio recording of an open session of a meeting of a public body, or may transmit the meeting through any medium,subject to reasonable requirements of the chair as to the number, • placement and operation of equipment used so as not to interfere with the conduct of the Open Meeting Law Guide Page 17 Version 3.24.11 meeting.At the beginning of the meeting the chair shall inform other attendees of any such • recordings. (f) No person shall address a meeting of a public body without permission of the chair, and all persons shall, at the request of the chair, be silent. No person shall disrupt the proceedings of a meeting of a public body. If, after clear warning from the chair,a person continues to disrupt the proceedings,the chair may order the person to withdraw from the meeting and if the person does not withdraw,the chair may authorize a constable or other officer to remove the person from the meeting. (g) Within 2 weeks of qualification for office, all persons serving on a public body shall certify, on a form prescribed by the attorney general,the receipt of a copy of the open meeting law, regulations promulgated pursuant to section 25 and a copy of the educational materials prepared by the attorney general explaining the open meeting law and its application pursuant to section 19. Unless otherwise directed or approved by the attorney general,the appointing authority,city or town clerk or the executive director or other appropriate administrator of a state or regional body,or their designees,shall obtain such certification from each person upon entering service and shall retain it subject to the applicable records retention schedule where the body maintains its official records.The certification shall be evidence that the member of a public body has read and understands the requirements of the open meeting law and the consequences of violating it. • Section 21. [EXECUTIVE SESSIONS] (a)A public body may meet in executive session only for the following purposes: 1.To discuss the reputation, character, physical condition or mental health, rather than professional competence, of an individual,or to discuss the discipline or dismissal of, or complaints or charges brought against, a public officer, employee,staff member or individual.The individual to be discussed in such executive session shall be notified in writing by the public body at least 48 hours prior to the proposed executive session; provided,however,that notification may be waived upon written agreement of the parties.A public body shall hold an open session if the individual involved requests that the session be open. If an executive session is held,such individual shall have the following rights: i.to be present at such executive session during deliberations which involve that individual; ii.to have counsel or a representative of his own choosing present and attending for the purpose of advising the individual and not for the purpose of active participation in the executive session; iii.to speak on his own behalf; and • Open Meeting Law Guide Page 18 Version 3.24.11 • iv.to cause an independent record to be created of said x p a d executive session by audio-recording or transcription, at the individual's expense. The rights of an individual set forth in this paragraph are in addition to the rights that he may have from any other source, including, but not limited to, rights under any laws or collective bargaining agreements and the exercise or non-exercise of the individual rights under this section shall not be construed as a waiver of any rights of the individual. 2.To conduct strategy sessions in preparation for negotiations with nonunion personnel or to conduct collective bargaining sessions or contract negotiations with nonunion personnel; 3.To discuss strategy with respect to collective bargaining or litigation if an open meeting may have a detrimental effect on the bargaining or litigating position of the public body and the chair so declares; 4.To discuss the deployment of security personnel or devices, or strategies with respect thereto; 5.To investigate charges of criminal misconduct or to consider the filing of criminal complaints; 6.To consider the purchase,exchange, lease or value of real property if the chair • declares that an open meeting may have a detrimental effect on the negotiating position of the public body; 7.To comply with,or act under the authority of,-any general or special law or federal grant-in-aid requirements; 8.To consider or interview applicants for employment or appointment by a preliminary screening committee if the chair declares that an open meeting will have a detrimental effect in obtaining qualified applicants; provided,however,that this clause shall not apply to any meeting, including meetings of a preliminary screening committee,to consider and interview applicants who have passed a prior preliminary screening; 9.To meet or confer with a mediator,as defined in section 23C of chapter 233,with respect to any litigation or decision on any public business within its jurisdiction involving another party,group or entity, provided that: (i) any decision to participate in mediation shall be made in an open session and the parties, issues involved and purpose of the mediation shall be disclosed; and (ii)no action shall be taken by any public body with respect to those issues which are the subject of the mediation without deliberation and approval for such action at an open session;or 10.To discuss trade secrets or confidential,competitively-sensitive or other proprietary information provided in the course of activities conducted by a governmental body as an energy supplier under a license granted by the department of public utilities • pursuant to section 1F of chapter 164, in the course of activities conducted as a Open Meeting Law Guide Page 19 Version 3.24.11 municipal aggregator under section 134 of said chapter 164 or in the course of activities • conducted by a cooperative consisting of governmental entities organized pursuant to section 136 of said chapter 164,when such governmental body,municipal aggregator or cooperative determines that such disclosure will adversely affect its ability to conduct business in relation to other entities making,selling or distributing electric power and energy. (b)A public body may meet in closed session for 1 or more of the purposes enumerated in subsection (a) provided that: 1.the body has first convened in an open session pursuant to section 21; 2. a majority of members of the body have voted to go into executive session and the vote of each member is recorded by roll call and entered into the minutes; 3. before the executive session,the chair shall state the purpose for the executive session,stating all subjects that may be revealed without compromising the purpose for which the executive session was called; 4.the chair shall publicly announce whether the open session will reconvene at the conclusion of the executive session; and 5. accurate records of the executive session shall be maintained pursuant to section 23. Section 22. [MINUTES, RECORDS] • (a)A public body shall create and maintain accurate minutes of all meetings, including executive sessions,setting forth the date,time and place,the members present or absent, a summary of the discussions on each subject,a list of documents and other exhibits used at the meeting,the decisions made and the actions taken at each meeting, including the record of all votes. (b) No vote taken at an open session shall be by secret ballot.Any vote taken at an executive session shall be recorded by roll call and entered into the minutes. (c) Minutes of all open sessions shall be created and approved in a timely manner.The minutes of an open session, if they exist and whether approved or in draft form,shall be made available upon request by any person within 10 days. (d) Documents and other exhibits,such as photographs, recordings or maps, used by the body at an open or executive session shall, along with the minutes, be part of the official record of the session. (e)The minutes of any open session,the notes, recordings or other materials used in the preparation of such minutes and all documents and exhibits used at the session,shall be public records in their entirety and not exempt from disclosure pursuant to any of the exemptions under clause Twenty-sixth of section 7 of chapter 4. Notwithstanding this paragraph,the • Open Meeting Law Guide Page 20 Version 3.24.11 • following materials shall be exempt from disclosure to the public as personnel information: (1) materials used in a performance evaluation of an individual bearing on his professional competence, provided they were not created by the members of the body for the purposes of the evaluation;and (2) materials used in deliberations about employment or appointment of individuals, including applications and supporting materials; provided, however,that any resume submitted by an applicant shall not be exempt. (f)The minutes of any executive session,the notes, recordings or other materials used in the preparation of such minutes and all documents and exhibits used at the session, may be withheld from disclosure to the public in their entirety under subclause(a)of clause Twenty- sixth of section 7 of chapter 4,as long as publication may defeat the lawful purposes of the executive session, but no longer; provided, however,that the executive session was held in compliance with section 21. When the purpose for which a valid executive session was held has been served,the minutes, preparatory materials and documents and exhibits of the session shall be disclosed unless the attorney-client privilege or 1 or more of the exemptions under said clause Twenty- sixth of said section 7 of said chapter 4 apply to withhold these records,or any portion thereof, from disclosure. For purposes of this subsection, if an executive session is held pursuant to clause(2)or(3)of • subsections (a)of section 21,then the minutes, preparatory materials and documents and exhibits used at the session may be withheld from disclosure to the public in their entirety, unless and until such time as a litigating, negotiating or bargaining position is no longer jeopardized by such disclosure,at which time they shall be disclosed unless the attorney-client privilege or 1 or more of the exemptions under said clause Twenty-sixth of said section 7 of said chapter 4 apply to withhold these records,or any portion thereof,from disclosure. (g)(1)The public body,or its chair or designee,shall,at reasonable intervals, review the minutes of executive sessions to determine if the provisions of this subsection warrant continued non-disclosure.Such determination shall be announced at the body's next meeting and such announcement shall be included in the minutes of that meeting. (2) Upon request by any person to inspect or copy the minutes of an executive session or any portion thereof,the body shall respond to the request within 10 days following receipt and shall release any such minutes not covered by an exemption under subsection (f); provided, however,that if the body has not performed a review pursuant to paragraph (1),the public body shall perform the review and release the non-exempt minutes, or any portion thereof, not later than the body's next meeting or 30 days,whichever first occurs.A public body shall not assess a fee for the time spent in its review. • Open Meeting Law Guide Page 21 Version 3.24.11 Section 23. [COMPLAINTS, REMEDIES] • (a)Subject to appropriation,the attorney general shall interpret and enforce the open meeting law. (b)At least 30 days prior to the filing of a complaint with the attorney general,the complainant shall file a written complaint with the public body,setting forth the circumstances which constitute the alleged violation and giving the body an opportunity to remedy the alleged violation; provided, however,that such complaint shall be filed within 30 days of the date of the alleged violation. The public body shall,within 14 business days of receipt of a complaint,send a copy of the complaint to the attorney general and notify the attorney general of any remedial action taken. Any remedial action taken by the public body in response to a complaint under this subsection shall not be admissible as evidence against the public body that a violation occurred in any later administrative or judicial proceeding relating to such alleged violation.The attorney general may authorize an extension of time to the public body for the purpose of taking remedial action upon the written request of the public body and a showing of good cause to grant the extension. (c) Upon the receipt of a complaint by any person,the attorney general shall determine, in a timely manner, whether there has been a violation of the open meeting law.The attorney general may,and before imposing any civil penalty on a public body shall, hold a hearing on any such complaint. Following a determination that a violation has occurred,the attorney general • shall determine whether the public body, 1 or more of the members, or both,are responsible and whether the violation was intentional or unintentional. Upon the finding of a violation,the attorney general may issue an order to: (1) compel immediate and future compliance with the open meeting law; (2) compel attendance at a training session authorized by the attorney general; (3) nullify in whole or in part any action taken at the meeting; (4) impose a civil penalty upon the public body of not more than $1,000 for each intentional violation; (5) reinstate an employee without loss of compensation,seniority,tenure or other benefits; (6) compel that minutes, records or other materials be made public; or (7) prescribe other appropriate action. (d)A public body or any member of a body aggrieved by any order issued pursuant to this section may,notwithstanding any general or special law to the contrary,obtain judicial review of the order only through an action in superior court seeking relief in the nature of certiorari; provided,however,that notwithstandingi section 4 of chapter 249 p ,any such action shall be commenced in superior court within 21 days of receipt of the order.Any order issued under this section shall be stayed pending judicial review; provided, however,that if the order nullifies an action of the public body,the body shall not implement such action pending judicial review. • Open Meeting Law Guide Page 22 Version 3.24.11 • (e) If any public body or member thereof shall fail to comply with the requirements set forth in any order issued by the attorney general,or shall fail to pay any civil penalty imposed within 21 days of the date of issuance of such order or within 30 days following the decision of the superior court if judicial review of such order has been timely sought,the attorney general may file an action to compel compliance. Such action shall be filed in Suffolk superior court with respect to state public bodies and,with respect to all other public bodies, in the superior court in any county in which the public body acts or meets. If such body or member has not timely sought judicial review of the order,such order shall not be open to review in an action to compel compliance. (f)As an alternative to the procedure in subsection (b),the attorney general or 3 or more registered voters may initiate a civil action to enforce the open meeting law. Any action under this subsection shall be filed in Suffolk superior court with respect to state public bodies and,with respect to all other public bodies, in the superior court in any county in which the>public body acts or meets. In any action filed pursuant to this subsection, in addition to all other remedies available to the superior court, in law or in equity,the court shall have all of the remedies set forth in subsection (c). • In any action filed under this subsection,the order of notice on the complaint shall be returnable not later than 10 days after the filing and the complaint shall be heard and determined on the return day or on such day as the court shall fix, having regard to the speediest possible determination of the cause consistent with the rights of the parties; provided,however,that orders may be issued at any time on or after the filing of the complaint without notice when such order is necessary to fulfill the purposes of the open meeting law. In the hearing of any action under this subsection,the burden shall be on the respondent to show by a preponderance of the evidence that the action complained of in such complaint was in accordance with and authorized by the open meeting law; provided, however,that no civil penalty may be imposed on an individual absent proof that the action complained of violated the open meeting law. (g) It shall be a defense to the imposition of a penalty that the public body,after full disclosure,acted in good faith compliance with the advice of the public body's legal counsel. (h) Payment of civil penalties under this section paid to or received by the attorney general shall be paid into the general fund of the commonwealth. Section 24. [INVESTIGATIONS, HEARINGS) (a)Whenever the attorney general has reasonable cause to believe that a person, including • any public body and any other state, regional,county, municipal or other governmental official Open Meeting Law Guide Page 23 Version 3.24.11 or entity, has violated the open meeting law,the attorney general may conduct an investigation • to ascertain whether in fact such person has violated the open meeting law. Upon notification of an investigation, any person, public body or any other state, regional,county,municipal or other governmental official or entity who is the subject of an investigation,shall make all information necessary to conduct such investigation available to the attorney general. In the event that the person, public body or any other state, regional,county, municipal or other governmental official or entity being investigated does not voluntarily provide relevant information to the attorney general within 30 days of receiving notice of the investigation,the attorney general may: (1)take testimony under oath concerning such alleged violation of the open meeting law; (2) examine or cause to be examined any documentary material of whatever nature relevant to such alleged violation of the open meeting law; and (3) require attendance during such examination of documentary material of any person having knowledge of the documentary material and take testimony under oath or acknowledgment in respect of any such documentary material.Such testimony and examination shall take place in the county where such person resides or has a place of business or, if the parties consent or such person is a nonresident or has no place of business within the commonwealth, in Suffolk county. (b) Notice of the time, place and cause of such taking of testimony,examination or attendance shall be given by the attorney general at least 10 days prior to the date of such taking of testimony or examination. (c)Service of any such notice may be made by: (1)delivering a duly-executed copy to the • person to be served or to a partner or to any officer or agent authorized by appointment or by law to receive service of process on behalf of such person; (2)delivering a duly-executed copy to the principal place of business in the commonwealth of the person to be served;or(3) mailing by registered or certified mail a duly-executed copy addressed to the person to be served at the principal place of business in the commonwealth or, if said person has no place of business in the commonwealth,to his principal office or place of business. (d) Each such notice shall: (1)state the time and place for the taking of testimony or the examination and the name and address of each person to be examined, if known and, if the name is not known, a general description sufficient to identify him or the particular class or group to which he belongs; (2)state the statute and section thereof,the alleged violation of which is under investigation and the general subject matter of the investigation; (3)describe the class or classes of documentary material.to be produced thereunder with reasonable specificity, so as fairly to indicate the material demanded; (4) prescribe a return date within which the documentary material is to be produced;and(5)identify the members of the attorney general's staff to whom such documentary material is to be made available for inspection and copying. (e) No such notice shall contain any requirement which would be unreasonable or improper if contained in a subpoena duces tecum issued by a court of the commonwealth or require the disclosure of any documentary material which would be privileged,or which for any other • Open Meeting Law Guide Page 24 Version 3.24.11 f t tlr • reason would not be required by a subpoena duces tecum issued by a court of the commonwealth, (f)Any documentary material or other information produced by any person pursuant to this section shall not, unless otherwise ordered by a court of the commonwealth for good cause shown, be disclosed to any person other than the authorized agent or representative of the attorney general, unless with the consent of the person producing the same; provided, however,that such material or information may be disclosed by the attorney general in court pleadings or other papers filed in court. (g)At any time prior to the date specified in the notice, or within 21 days after the notice has been served,whichever period is shorter,the court may, upon motion for good cause shown,extend such reporting date or modify or set aside such demand or grant a protective order in accordance with the standards set forth in Rule 26(c)of the Massachusetts Rules of Civil Procedure.The motion may be filed in the superior court of the county in which the person served resides or has his usual place of business or in Suffolk county.This section shall not be applicable to any criminal proceeding nor shall information obtained under the authority of this section be admissible in evidence in any criminal prosecution for substantially identical transactions. Section 25. [REGULATIONS, LETTER RULINGS,ADVISORY OPINIONS] • (a)The attorney general shall have the authority to promulgate rules and regulations to carry out enforcement of the open meeting law. (b)The attorney general shall have the authority to interpret the open meeting law and to issue written letter rulings or advisory opinions according to rules established under this section. • Open Meeting Law Guide Page 25 Version 3.24.11 CERTIFICATE OF RECEIPT OF OPEN MEETING LAW MATERIALS • � who qualified for the office of (Name) on , certify pursuant (Office) (Date) to G.L. c. 30A, §20(g),that I have received copies of the following Open Meeting Law materials: 1) the Open Meeting Law, G.L. c. 30A, §§ 18-25; 2) regulations promulgated by the Attorney General under G.L. c. 30A, §25;and 3) educational materials promulgated by the Attorney General under G.L. c. 30A,§ 19(b), explaining the Open Meeting Law and its application. I have read and understand the requirements of the Open Meeting Law and the consequences for violating it. I further understand that the materials I have received may be • revised or updated from time to time, and that I have a continuing obligation to implement any changes in the Open Meeting Law during my term of office. (Name) (Name of Public Body) (Date) Pursuant to G.L. c.30A,§20(g),an executed copy of this certificate shall be retained,according to the relevant records retention schedule, by the appointing authority,city or town clerk,or the executive director or other appropriate administrator of a state or regional body, or their designee. • Open Meeting Law Guide Page 26 Version 3.24.11 i U.S. Census Bureau iQffinder DP-1 Profile of General Population and Housing Characteristics: 2010 2010 Demographic Profile Data NOTE:For more information on confidentiality protection,nonsampling error,and definitions,see http://www.census.gov/prod/cen2010/profiletd.pdf. GEO:Salem city,Massachusetts Subject Number Percent - - ---- -- - _ -- -- . _-....-_ EX AND AGE Total population 41,340 100.0 Under 5 years 2,307 5.6 5 to 9 years 2,108 5.1 10 to 14 years 1,953 4.7 15 to 19 years 2,965 7.2 20 to 24 years 3,692 8.9 25 to 29 years 3,204 7.8 30 to 34 years 3,017 7.3 35 to 39 years 2,789 6.7 40 to 44 years 2,798 6.8 45 to 49 years 3,065 7.4 50 to 54 years 2,995 7.2 55 to 59 years 5 2,715 6.6 60 to 64 years 2,390 5.8 5 to 69 years 1,520 3.7 14 0 to 74 years 1,150 2.8 75 to 79 years 998 2.4 80 to 84 years 803 1.9 85 years and over 871 2.1 Median age(years) 37.6 (X) 16 years and over 34,537 83.5 18 years and over 33,612 81.3 21 years and over 31,131 75.3 62 years and over 6,754 16.3 65 years and over 5,342 12.9 Male population 19,233 46.5 Under 5years 1,198 2.9 5 to 9 years 1,078 2.6 10 to 14 years 972 2.4 15 to 19 years 1,395 3.4 20 to 24 years 1,679 4.1 25 to 29 years 1,491 3.6 30 to 34 years 1,453 3.5 35 to 39 years 1,370 3.3 40 to 44 years 1,345 3.3 45 to 49 years 1,472 3.6 50 to 54 years 1,369 3.3 55Tto 59 years 1,211 2.9 60 to 64 years 1,065 2.6 65 to 69 years 669 1.6 0 to 74 years 519 1.3 to 79 years 404 1.0 I80 to 84 years 283 0.7 85 years and over 260 0.6 1 of 4 07/11/2011 i Subject Number Percent _.-....._.._ _ --- ------ Median age(years) _ 36.3 (X) 16 years and over 15,760 38.1 18 years and over 15,299 37.0 21 years and over 14,212 34.4 •62 years and over 2,774 6.7 65 years and over 2,135 5.2 Female population 22,107 53.5 Under 5years 1,109 2.7 5 to 9 years 1,030 2.5 10 to 14 years 981 2.4 15 to 19 years 1,570 3.8 20 to 24 years 2,013 4.9 25 to 29 years 1,713 4.1 30 to 34 years 1,564 3.8 35 to 39 years 1,419 3.4 40 to 44 years 1,453 3.5 45 to 49 years 1,593 3.9 50 to 54 years 1,626 3.9 55 to 59 years 1,504 3.6 60 to 64 years 1,325 3.2 65 to 69 years 851 2.1 70 to 74 years 631 1.5 75 to 79 years 594 1.4 80 to 84 years 520 1.3 85 years and over 611 1.5 Median age(years) 38.8 (X) 16 years and over 18,777 45.4 18 years and over 18,313 44.3 21 years and over 16,919 40.9 62 years and over 3,980 9.6 65 years and over 3,207 7.8 CE Total population 41,340 100.0 One Race 39,932 96.6 White 33,694 81.5 Black or African American 2,040 4.9 American Indian and Alaska Native 173 0.4 Asian 1,095 2.6 Asian Indian 144 0.3 Chinese 239 0.6 Filipino 282 0.7 Japanese 65 0.2 Korean 47 0.1 Vietnamese 170 0.4 Other Asian[1] 148 0.4 Native Hawaiian and Other Pacific Islander 21 0.1 Native Hawaiian 6 0.0 Guamanian or Chamorro 4 0.0 Samoan 3 0.0 Other Pacific Islander[2] 8 0.0 Some Other Race 2,909 7.0 Two or More Races 1,408 3.4 White;American Indian and Alaska Native[3] 129 0.3 White;Asian[3] 177 0.4 White;Black or African American[3] 437 1.1 White;Some Other Race[3] 288 0.7 Race alone or in combination with one or more other es:[4j white 34,826 84.2 IBlack or African American 2,694 6.5 American Indian and Alaska Native 434 1.0 2 of 4 07/11/2011 Subject Number Percent As_ian-- - -- - - -- --- 1,344 3.3 Native Hawaiian and Other Pacific Islander 97 0.2 Some Other Race 3,455 8.4 HISPANIC OR LATINO otal population 41,3401 100.0. MPFHispanic or Latino(of any race) 6,465 15.6 Mexican 224 0.5 Puerto Rican 1,191 2.9 Cuban 73 0.2 Other Hispanic or Latino[5] 4,977 12.0 Not Hispanic or Latino 34,875 84.4 HISPANIC OR LATINO AND RACE Total population 41,340 100.0 Hispanic or Latino 6,465 15.6 White alone 2,317 5.6 Black or African American alone 590 1.4 American Indian and Alaska Native alone 107 0.3 Asian alone 12 0.0 Native Hawaiian and Other Pacific Islander alone 4 0.0 Some Other Race alone } 2,743 6.6 Two or More Races 692 1.7 Not Hispanic or Latino 34,875 84.4 White alone 31,377 75.9 Black or African American alone 1,450 3.5 American Indian and Alaska Native alone 66 0.2 Asian alone 1,083 2.6 Native Hawaiian and Other Pacific Islander alone 17 0.0 Some Other Race alone 166 0.4 Two or More Races 716 1.7 RELATIONSHIP �otal population 41,340 100.0 n households 39,570 95.7 Householder 17,842 43.2 Spouse[6] 6,363 15.4 Child 10,120 24.5 Own child under 18 years 6,976 16.9 Other relatives 2,002 4.8 Under 18 years 642 1.6 65 years and over 395 1.0 Nonrelatives 3,243 7.8 Under 18 years 91 0.2 65 years and over 115 0.3 Unmarried partner 1,518 3.7 In group quarters 1,770 4.3 Institutionalized population 167 0.4 Male 43 0.1 Female 124 0.3 Non institutionalized population 1,603 3.9 Male 623 1.5 Female 980 2.4 HOUSEHOLDS BY TYPE Total households 17,842 100.0 Family households(families)[7] 9,648 54.1 With own children under 18 years 4,107 23.0 m Husband-wife family 6,363 35.7 With own children under 18 years 2,332 13.1 Male householder,no wife present 719 4.0 With own children under 18 years 312 1.7 I Female householder,no husband present 2,566 14.4 With own children under 18 years 1,463 8.2 3 of 4 07/11/2011 Subject Number Percent Nonfamily households[7] 8,194 45.9 Householder living alone 6,301 35.3 Male 2,556 14.3 65 years and over 496 2.8 Female 3,745 21.0 65 years and over 1,374 7.7 Households with individuals under 18 years 4,511 25.3 Households with individuals 65 years and over 4,058 22.7 Average household size 2.22 (X) Average family size[7] 2.92 (X) HOUSING OCCUPANCY Total housing units 19,130 100.0 Occupied housing units 17,842 93.3 Vacant housing units 1,288 6.7 For rent 623 3.3 Rented,not occupied 19 0.1 For sale only 134 0.7 Sold,not occupied 50 0.3 For seasonal,recreational,or occasional use 132 0.7 All other vacants 330 1.7 Homeowner vacancy rate(percent)[8] 1.5 (X) Rental vacancy rate(percent)[9] 6.6 (X) HOUSING TENURE Occupied housing units 17,842 100.0 Owner-occupied housing units 9,048 50.7 Population in owner-occupied housing units 21,115 (X) Average household size of owner-occupied units 2.33 (X) Renter-occupied housing units 8,794 49.3 Population in renter-occupied housing units 18,455 (X) Average household size of renter-occupied units 2.10 (X) X Not applicable. [1]Other Asian alone,or two or more Asian categories. [2]Other Pacific Islander alone,or two or more Native Hawaiian and Other Pacific Islander categories. [3]One of the four most commonly reported multiple-race combinations nationwide in Census 2000. [4]In combination with one or more of the other races listed.The six numbers may add to more than the total population,and the six percentages may add to more than 100 percent because individuals may report more than one race. [5]This category is composed of people whose origins are from the Dominican Republic,Spain,and Spanish-speaking Central or South American countries.It also includes general origin responses such as"Latino"or"Hispanic." [6]"Spouse"represents spouse of the householder.It does not reflect all spouses in a household.Responses of"same-sex spouse"were edited during processing to"unmarried partner." [7]"Family households"consist of a householder and one or more other people related to the householder by birth,marriage,or adoption.They do not include same-sex married couples even if the marriage was performed in a state issuing marriage certificates for same-sex couples.Same-sex couple households are included in the family households category if there is at least one additional person related to the householder by birth or adoption. Same-sex couple households with no relatives of the householder present are tabulated in nonfamily households."Nonfamily households"consist of people living alone and households which do not have any members related to the householder. (8]The homeowner vacancy rate is the proportion of the homeowner inventory that is vacant"for sale."It is computed by dividing the total number of vacant units"for sale only"by the sum of owner-occupied units,vacant units that are"for sale only,"and vacant units that have been sold but not yet occupied;and then multiplying by 100. [9]The rental vacancy rate is the proportion of the rental inventory that is vacant"for rent."It is computed by dividing the total number of vacant units "for rent"by the sum of the renter-occupied units,vacant units that are"for rent,"and vacant units that have been rented but not yet occupied;and then multiplying by 100. Source:U.S.Census Bureau,2010 Census. • 4 of 4 07/11/2011 MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH MassCHIP Massachusetts Community Health Information Profile Health Status Indicators Report for Salem • Demographic Indicators • All Perinatal and Child Health Indicators • Infectious Disease Indicators • Injury Indicators • Chronic Disease Indicators • Substance Abuse Indicators • • Hospital Discharges • Report Specific Notes More detail for specific datasets is available by using custom reports General Notes: Notes on Population data Population data are used as the denominators for all rates in MassCHIP except for Infant Deaths and Early Intervention clients which use the Births file as the denominator. The population data used for a given rate depends on the year of the numerator: MISER Estimates for 1991-1998 MDPH Preliminary Estimates for 1999 MDPH Preliminary Estimates for 2000 (any stratification that includes Race/Hispanic ethnicity) Census Counts for 2000 (any stratification that does not include Race/Hispanic ethnicity) 1 present in this report es. These data as Counts and Percentages. Population data may also be p s p g are Census counts for 2000 or DPH Preliminary Estimates for 2000 (by Race/Hispanic ethnicity). Any population data that have more detail than geography, age, sex and or • Race/Hispanic ethnicity are from the selected sample data for 2000 from the U.S. Census Bureau Summary File 3 (SF3). • Limitations of Small Numbers Cells in some tables in MassCHIP reports, and particularly those specific to individual cities and towns, contain small numbers. In general, rates and proportions based upon less than five observations are suppressed (specific protocols differ by data sets and are noted on the relevant reports). Whether or not the small numbers are suppressed, rates and trends based upon small numbers should be interpreted cautiously. Note on NA MassCHIP marks cells with the tag "NA" if one or more of the following is true: • The data are suppressed for confidentiality reasons. See report-specific notes for Suppression Rules specific to the data sets used in this Standard Report. • The particular combination of data element, selector value and statistical calculation is not available. • The population on which a particular cell is based is too small to calculate reliable results. Differences with Previously Published Data Numbers and rates in MassCHIP reports may differ slightly from those contained in • previous reports or other publications. These differences may be due to file updates; slight variations in coding schemes used in categorizing the data; differences in the formulas used in calculating rates; and the re-calculating of rates using updates of population estimates from the Massachusetts Institute for Social and Economic Research (MISER). Note on Time Period Counts for most data sets are cumulative for the given Calendar or Fiscal year. Children in Foster Care (DSS), WIC, Child Care Services (OCCS) and Department of Transitional Assistance (DTA) data sets give point in time 'snapshot' counts. These are counts taken at a specified point during the year. See last page for additional informational report-specific notes. Demographic Indicators: Salem Copyright© 1995-2009 Massachusetts Department of Public Health-All Rights Reserved,Printed: 6/16/2009, 17:05:59 Area IArea I State • Count 1percent jPercent • Per Capita Income * $23,857 $25,952 Population below 100% of poverty level * 3,787 9.7 9.3 Population below 200%of poverty level * 18,935 22.8 21.7 Children less than 18 years of age living below 100% of poverty 994 12.5 12.0 line * Unemployed persons age 16 and over 11,165 4.9 1 5.0 * 2000 Census Counts or Sampling Data Denominator for persons age less than 18 and living in poverty is all persons age less than 18. Unemployment Rate: all unemployed persons in labor force divided by all persons in labor force • Census 2000 Summary File 3 (Sample data prepared by the U.S.Census Bureau) • 2006 Employment and Training(DET) Area Area State Count Percent Percent Persons under 18 years of age * 8,157 20.2 23.6 Persons under 20 years of age 9,520 22.9 25.5 Persons age 65 years and over 5,689 13.7 13.3 • White non-Hispanic persons 33,221 79.8 81.0 Black non-Hispanic persons 1,310 3.2 6.0 Hispanic persons 5,911 14.2 7.9 Asian persons 1,118 2.7 4.9 AFDC Medicaid Recipients 3,191 9.4 1 7.1 Multiple Assistance Unit Medicaid Recipients 91 0.7 1.2 * the most recent population Estimates (2000). AFDC recipients percent denominator is persons age less than 65 (eligible population based on age). Multiple Assistance Unit recipients percent denominator is persons age less than 25 (eligible population based on age). • See Notes on Population Data • 1996 Medicaid(MassHealth) • 2000 Census 2000 Summary File 1 (Massachusetts)/prepared by the U.S. Census Bureau All Perinatal and Child Health Indicators: Salem Copyright© 1995-2009 Massachusetts Department of Public Health-All Rights Reserved,Printed: • 6/16/2009, 17:05:59 • Area Area State Fertility Fertility Count Rate Rate Births to women ages 15 to 44 509 52.6 57.2 White non-Hispanic F 361 48.3 50.8 Black non-Hispanic 17 47.0 66.3 Hispanic 95 64.2 79.5 Asian 30 86.2 64.7 Area Area Infant State Infant Count Mortality Mortality Rate Rate Infant Deaths 4 7.8 4.9 White non-Hispanic 1 NA 3.9 Black non-Hispanic 1 NA 10.2 Hispanic 1 NA 7.5 Asian 1 NA 3.1 Area Area State Count Percent Percent Low Birthweight( less than 2500 grams) 46 9.0 7.9 Births to adolescent mothers 31 6.1 6.4 • Mothers not receiving prenatal care in first trimester 114 22.4 18.0 Mothers with adequate prenatal care fa422 83.2 82.8 Mothers receiving publicly funded prenatal care 185 36.5 35.6 Area Area State Count Rate Rate Lead poisoning cases (blood lead levels greater than or 1 0.7 0.4 equal to 25 µg/dL in children ages 6 mos - 5 yrs) Fertility Rate is expressed per 1,000 women ages 15 to 44 (of a given race/ethnicity where mentioned). Infant Mortality Rate (IMR) is expressed per 1,000 live births in the same data year. Lead poisoning rates are expressed per 1,000 children screened. Unknown values of Prenatal care adequacy, Trimester prenatal care began or Prenatal care payment source are excluded from the denominator. • See Notes on Population Data • 2006 Lead Poisoning Prevention Program(CLPPP)-fiscal year • 2007 Births(Vital Records) • 2007 Infant Deaths(Vital Records) Infectious Disease: Salem Copyright© 1995-2009 Massachusetts Department of Public Health-All Rights Reserved,Printed: • 6/16/2009, 17:05:59 • Area Area State Count Crude Rate Crude Rate Newly diagnosed HIV cases NA NA 11.7 Persons with HIV/AIDS 104 249.7 261.6 AIDS and HIV-related deaths 0 0.0 2.2 Tuberculosis NA NA 3.5 Pertussis NA NA 18.7 Hepatitis-B NA NA 6.9 Syphilis NA NA 6.1 Gonorrhea 9 21.6 37.7 Chlamydia 130 312.2 236.6 Area Area State Count Age-specific Age-specific Rate Lcl Rate LcJ Syphilis, ages 15-19 0 0.0 2.9 Gonorrhea, ages 15-19 0 0.0 110.5 Chlamydia, ages 15-19 43 1713.3 1079.E Crude rates are expressed per 100,000 persons. Age-specific rates are expressed per 100,000 persons in the specific age group. • See Notes on Population Data • • 2006 HIV/AIDS Surveillance Program • 2007 Division of Epidemiology and Immunization • 2007 Division of Sexually Transmitted Disease Prevention • 2007 Division of Tuberculosis Prevention and Control • 2007 Mortality(Vital Records)ICD-10 based Injury Indicators: Salem Copyright© 1995-2009 Massachusetts Department of Public Health-All Rights Reserved,Printed: 6/16/2009, 17:05:59 Area Area State Count Crude Rate Crude Rate Motor vehicle related injury deaths 2 4.8 6.8 Suicide 2 4.8 7.8 Homicide 1 2.4 2.8 Crude rates are expressed per 100,000 persons • See Notes on Population Data • 2007 Mortality(Vital Records)ICD-10 based • Chronic Disease Indicators: Salem • Copyright© 1995-2009 Massachusetts Department of Public Health-All Rights Reserved,Printed: 6/16/2009, 17:05:59 Area Area State Count Age-adjusted Age-adjusted Rate JdJ Rate Total deaths (all causes) 355 720.3 699.7 Total cancer deaths 87 187.1 178.9 Lung cancer deaths 38 82.2 50.8 Breast cancer deaths 6 25.6 20.1 Cardiovascular disease deaths 128 250.0 F214.4 Age adjusted rates are expressed per 100,000 persons, see note (d) for details. • See Notes on Population Data • 2007 Mortality(Vital Records)ICD-10 based Substance Abuse Indicators: Salem Copyright© 1995-2009 Massachusetts Department of Public Health-All Rights Reserved,Printed: 6/16/2009, 17:05:59 Area Area State • Count Crude Crude Rate Rate Admissions to DPH funded treatment programs 599 1438.3 1636.5 Injection drug user admissions to DPH funded 141 338.6 504.3 treatment program Alcohol and other drug related hospital discharges 210 504.2 362.0 Crude rates are expressed per 100,000 persons. Age adjusted rates are expressed per 100,000 persons, see note (d) for details. • See Notes on Population Data • 2006 Calendar Year Hospital Discharges(UHDDS) • 2007 Substance Abuse(BSAS)DPH funded program utilization Hospital Discharges for Primary Care Manageable Conditions: Salem MassCHIP v3.0 r323.0 Printed: 6/16/2009, 17:05:59 Copyright© 1995-2009 Massachusetts Department of Public Health-All Rights Reserved,Printed: 6/16/2009, 17:05:59 Area Area State Count Age-adjusted Age-adjusted Rate J!41 Rate • Asthma 63 153.1 146.9 • Angina NA NA 14.5 Bacterial pneumonia 135 291.8 329.6 Age adjusted rates are expressed per 100,000 persons, see note(d) for details. • See Notes on Population Data • 2006 Calendar Year Hospital Discharges(UHDDS) Health Status Indicators Report Notes a. The Adequacy of Prenatal Care Utilization(APNCU) Index attempts to characterize prenatal care (PNC)utilization on two independent and distinctive dimensions - namely adequacy of initiation of PNC and adequacy of received services (once PNC has begun). The index uses information readily available on U.S. birth certificates (month of initial PNC visit, number of visits, and gestational age). This index does not assess quality of the prenatal care that is delivered, only its utilization. This classification is adjusted for gestational age to allow for proper classification of premature births. b. The source of payment for prenatal care is a self-reported item on the birth certificate. Publicly-funded prenatal care includes Medicaid, Medicare, Healthy • Start, free care and other government sources. Healthy Start is a Massachusetts- funded program providing services and financing for prenatal care to low-income women. c. Age-specific rate: A rate for a specific age group. The numerator and denominator refer to the same age group. Age-specific rates are expressed per 100,000 persons in the specific age group. Denominators use 1990 Census counts and MISER population estimates. d. Age-adjusted rate: A procedure for adjusting rates, designed to minimize the effects of differences in age distributions when comparing rates for different populations. Age-adjusted rates are usually expressed per 100,000 persons. For standardization within MassCHIP the standard population used is the 2000 US population. Suppression Rules: • Counts and related calculations of 1 - 4 [Births, Communicable Diseases] are suppressed • Counts and related calculations of 1 - 6 [Hospital Discharges] are suppressed • Counts and related calculations of 1 - 9 [Substance Abuse] are suppressed • Calculations of infant mortality rate (IMR) when denominator is less than 500 are • suppressed For Information or Assistance, contact MassCHIP Massachusetts Department of Public Health 250 Washington Street Boston, MA 02108 Voice: In MA: (888) MAS-CHIP Outside MA: (617) 624-5629 E-Mail: MassCHIP.Support@state.ma.us • MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH MassCHIP Massachusetts Community Health Information Profile Healthy People 2010 - Chronic Disease Objectives Report (a) for Salem • Chronic Disease Objectives • Report Specific Notes More detail for specific datasets is available by using custom reports General Notes: Notes on Population data Population data are used as the denominators for all rates in MassCHIP except for Infant Deaths and Early Intervention clients which use the Births file as the denominator. The population data used for a given rate depends on the year of the numerator: MDPH Estimates for 2008 (only available at the state level) MDPH Estimates for 2005 (available at the city/town level) Population data may also be present in this report as Counts and Percentages. These data are Census counts for 2000. Any population data that have more detail than geography, age, sex and or Race/Hispanic ethnicity are from the selected sample data for 2000 from the U.S. Census Bureau Summary File 3 (SF3). Limitations of Small Numbers Cells in some tables in MassCHIP reports, and particularly those specific to individual cities and towns, contain small numbers. In general, rates and proportions based upon less than five observations are suppressed (specific protocols differ by data sets and are noted on the relevant reports). Whether or not the small numbers are suppressed, rates and trends based upon small numbers should be interpreted cautiously. • Note on NA • MassCHIP marks cells with the tag "NA" if one or more of the following is true: • The data are suppressed for confidentiality reasons. See report-specific notes for Suppression Rules specific to the data sets used in this Standard Report. • The particular combination of data element, selector value and statistical calculation is not available. • The population on which a particular cell is based is too small to calculate reliable results. Differences with Previously Published Data Numbers and rates in MassCHIP reports may differ slightly from those contained in previous reports or other publications. These differences may be due to file updates; slight variations in coding schemes used in categorizing the data; differences in the formulas used in calculating rates; and the re-calculating of rates using updates of population estimates from the Massachusetts Institute for Social and Economic Research (MISER). Note on Time Period Counts for most data sets are cumulative for the given Calendar or Fiscal year. Children in Foster Care (DSS), WIC, Child Care Services (OCCS) and Department of Transitional • Assistance (DTA) data sets give point in time 'snapshot' counts. These are counts taken at a specified point during the year. See last page for additional informational report-specific notes. Chronic Disease Objectives: Salem Copyright&copy2010 Massachusetts Department of Public Health-All Rights Reserved,Printed: 12/6/2010, 15:23:01 Area Area State Age- Age- Count adjusted adjusted Rate (b) Rate 3-01: 101 219.7 177.4 Reduce the overall cancer death rate to no more more than 159.9 per 100,000 population. (Cancer: All types - Deaths (ICD 10 based)) 3-02: 19 41.0 49.4 • Slow the rise in lung cancer deaths to achieve a rate of no • more than 44.9 per 100,000 population. (Cancer: Lung - Deaths (ICD 10 based)) 3-03: 7 28.2 21.2 Reduce Breast Cancer deaths to no more than 22.3 per 100,000 females. (Cancer: Female Breast- Deaths (ICD 10 based)) 3-04: 0 0.0 1.2 Reduce deaths from cancer of the uterine cervix to no more than 2.0 per 100,000 women. (Cancer: Cervical (Cervix Uteri) =Deaths) 3-05: 14 30.9 15.5 Reduce colo-rectal cancer deaths to no more than 13.9 per 100,000 population. (Cancer: Colo-Rectal -Deaths (ICD 10 based)) 3-06 0 0.0 2.5 Reduce oropharyngeal cancer death rate to no more than: 13.9 per 100,000 population. • (Cancer: Oral Cavity - Deaths (ICD 10 based)) 3-07: 7 38.3 22.1 Reduce prostate cancer death rate to no more than: 28.8 per 100,000 males. (Cancer: Prostate - Deaths (ICD 10 based)) Community Health Network Area (CHNA): Area (for BRFSS data,most cities/towns are not a stable survey CHNA State population.Instead the CHNA geographic level data is presented as Percent Percent the Area Percent) 3-1la: 95.2 94.0 Increase the proportion of women aged 18 years and older (92.9 - (93.4 - ,who have ever received a Pap test to 97% Lc). 97.5) 94.5) (Cervical: Ever Had Pap Test- BRFS Survey) ;3-11b: 86.4 84.5 Increase the proportion of women aged 18 years and older (82.7 - (83.8 - ;who have received a Pap test within the preceding 3 years 90.1) 85.3) ;to 90%(c). ,(Cervical: Had Pap Test in Last 3 Years - BRFS Survey) • 13-13: 82.6 84.7 lIncrease the proportion of women aged 40 and older who (78.1 - (83.9 - • have received a mammogram within the preceding 2 87.0) 85.5) years to 70%. (Mammogram: Had in Last 1 Year - BRFS Survey (BY AGE)) 5-03: 7.1 7.5 Reduce the ovarall rate of diabetes that is clinically (5.5 - 8.7) (7.2 - 7.8) diagnosed to no more than 25 per 1,000 people (=2.5%) (d)• (Diabetes: Ever Been Told Have - BRFS Survey) Area Area State Age- Age- Count adjusted adjusted Rate (b) Rate 5-05: 2 4.3 14.5 Reduce diabetes death rate to no more than 45 per 100,000 people (e). (Endocrine: Diabetes Mellitus - Deaths (ICD 10 based)) 12-01: 52 104.0 107.2 • Reduce coronary heart disease deaths to no more than 166 per 100,000 population. (Circulatory Coronary Heart Disease - Deaths (ICD 10 based)) 12-07: 22 42.0 33.3 Reduce stroke deaths to no more than 48 per 100,000 population. (Circulatory: Cerebrovascular Disease - Deaths (ICD 10 based)) Community Health Network Area (CHNA): Area (for BRFSS data,most cities/towns are not a stable survey CHNA State population.Instead the CHNA geographic level data is presented as percent Percent the Area Percent) 12-15: 80.3 82.6 'Increase to at least 80 percent the proportion of adults (75.8 - (81.9 - who have had their blood cholesterol checked within the 84.7) 83.3) ,preceding 5 years. ;(Cholesterol: Checked in Last 5 Years - BRFS Survey) :19-02: 24.5 21.7 • ;Reduce the proportion of adults who are obese to no more (20.9 - (21.1 - • than 15%(f 28.0) 22.3) (Obese: Based on Body Mass Index - BRFS Survey) 0 Area Area State Age- Age- Count specific specific Rate Rate W 24-01 a: 0 0.0 0.0 Reduce asthma deaths among children under age 5 years to no more than 0.1 deaths per 100,000 populations . (Respiratory: Asthma- Deaths (ICD 10 based)) 24-0 l b: 0 0.0 0.0 Reduce asthma deaths among children aged 5 to 14 years to no more than 0.1 deaths per 100,000 populations . (Respiratory: Asthma- Deaths (ICD 10 based)) 24-01 c: 0 0.0 0.3 Reduce asthma deaths among adolescents and adults aged 15 to 34 years to no more than 0.2 deaths per 100,000 • populations . (Respiratory: Asthma- Deaths (ICD 10 based)) 24-0 l d: 0 0.0 0.6 Reduce asthma deaths among adults aged 35 to 64 years to no more than 0.9 deaths per 100,000 populations . (Respiratory: Asthma-Deaths (ICD 10 based)) ;24-Ole: 0 0.0 2.9 ,Reduce asthma deaths among adults aged 65 years and older to no more than 6.0 deaths per 100,000 populations . (Respiratory: Asthma- Deaths (ICD 10 based)) ;24-02a: 11 445.8 483.6 Reduce hospitalizations for asthma among children under 'age 5 years to no more than 250 hospitalizations per 100,000 populationQ. j(Respiratory: Asthma- Hospitalization) I24-02b: 43 128.4 115.3 Reduce hospitalizations for asthma among children and • adults aged 5 to 64 years to no more than 77 • hospitalizations per 100,000 population@. (Respiratory: Asthma- Hospitalization) 24-02c: 15 263.6 275.9 Reduce hospitalizations for asthma among adults aged 65 years and older to no more than 110 hospitalizations per 100,000 population@. (Respiratory: Asthma- Hospitalization) ,24-10: 16 100.0 97.3 Slow the rise in deaths from chronic obstructive pulmonary diseases (COPD) among adults aged 45 and older to achieve a rate of no more than 60 per 100,000 peopleW. (Respiratory: Chronic Lower Respiratory Diseases (CLRD), All - Deaths (ICD 10 based)) Area Area State Age- Age- Count adjusted adjusted Rate (b) Rate • 26-02: 1 2.3 8.1 Reduce cirrhosis deaths to no more than 3 deaths per 100,000 population. (Digestive: Chronic Liver Disease - Deaths (ICD 10 based)) Community Health Network Area (CHNA): Area (for BRFSS data,most cities/towns are not a stable survey CHNA State population.Instead the CHNA geographic level data is presented as percent percent the Area Percent) 27-01 a: 19.7 15.8 Reduce cigarette smoking among adults aged 18 years (16.5 - (15.3 - and older to 12%.(d) 22.9) 16.3) (Smoking Incidence: Current Smoker- BRFS Survey) �27-05: 54.3 60.3 ,Increase smoking cessation attempts by adult smokers (45.0 - (58.5 - aged 18 years and older to 75%. 63.6) 62.0) (Smoking Quit: Quit for 1+ Days in Last Year - BRFS ,Survey) • Behavioral Risk Factor Surveillance System(BRFSS)for the most recent 3 years available • • See Notes on Population Data • 2008 Calendar Year Hospital Discharges(UHDDS) • • 2008 Mortality(Vital Records)ICD-10 based Healthy People Chronic Disease Report Notes a. In some cases, the MassCHIP measure is closely related to, but not an exact or complete match, with the Healthy People 2010 measure. These are further noted below. b. Age-adjusted rate: A procedure for adjusting rates, designed to minimize the effects of differences in age distributions when comparing rates for different populations. Age-adjusted rates are usually expressed per 100,000 persons. For standardization within MassCHIP the standard population used is the 2000 US population. c. MassCHIP can approximately measure both sections of this Objective. MassCHIP contains data elements from the BRFSS Data Set among women who have not had a hysterectomy, whereas the Objective refers to all women(a minor discrepancy in most cases). d. The BRFSS Data Set data element(persons who have ever been told he/she had diabetes) only captures data on adults, although the Objective measures • prevalence in the entire population. [In addition, survey responses may differ from other methods of determining the prevalence of diabetes in a population.] The BRFSS data are reported as a percent, while the objective refers to the number of cases per 1,000. To convert the BRFSS data to the same scale, multiply the percent by 10. MassCHIP has a data element(Endocrine: Diabetes Mellitus) from the Hospital Discharge related to but not an exact match to Objective 5-02 which may be of interest to some MassCHIP users. This data element only captures certain cases. e. The MassCHIP definition of"diabetes-related" causes of death includes only those deaths with ICD-10 code E10-E14 as the underlying cause of death. This may differ from other definitions of the Healthy People 2010 objective and may understate the death rates in Massachusetts. A related data element in MassCHIP is drawn from the Hospital Discharge Data Set and can identify hospital discharges due both to diabetes and to "complications of diabetes". f. MassCHIP also has the data element "Endocrine: Obesity - Hospitalizations" related to this Objective (from the Hospital Discharge Data Set) which may be of interest to some MassCHIP users. g. Age-specific rate: A rate for a specific age group. The numerator and denominator refer to the same age group. Age-specific rates are expressed per 100,000 persons in the specific • • age group. Denominators use 1990, 2000 Census counts and inter-censal population estimates. h. Objectives 24-01(a-e)have been reworded, but maintains the same meaning. The objectives seeks a rate of deaths per 1.0 million. The modified definition converts the rate to deaths per 100,000. i. MassCHIP can only approximately measure Objective 24-02(a-c). Hospital Discharges data set does not include emergency room visits, where many cases of asthma are seen. Objectives 24-02(a-c)have been reworded, but maintains the same meaning. The objectives seeks a rate of hospitilizations per 10,000. The modified definition converts the rate to deaths per 100,000. j. The ICD 10 based Mortality dataset labels COPD as Chronic Lower Respiratory Disease (CLRD) Suppression Rules: • Counts and related calculations of 1 - 6 [Hospital Discharges] are suppressed • Calculations of infant mortality rate (IMR) when denominator is less than 500 are suppressed For Information or Assistance, contact MassCHIP Massachusetts Department of Public Health 250 Washington Street Boston, MA 02108 Voice: In MA: (888) MAS-CHIP Outside MA: (617) 624-5629 E-mail: masschip.supportgstate.ma.us • • Bedford MA VISION: Helping neighbors lead healthy lives in Bedford. MISSION:We are dedicated to our mission,to serve all Bedford residents, particularly the under served, and to promote healthy people, healthy families, and a healthy environment through compassionate care, education, and prevention. The Board will create needed regulations, set policy, hold hearings, and consider variances. Your health is our concern. VALUES: Maintaining a balance between short-term benefit(s)to human life vs. long-term risk. Decision making priority is given to town/community needs vs. individual needs. Mission Statement The mission of the Reading Board of Health's is to protect and promote the health and well being of the citizens of Reading and the quality of the environment • • • The Board of Health: * Responsible for protecting and promoting resident and visitor health through enforcement of MA Department of Public Health and MA Department of Environmental Protection sanitary and environmental codes and statutes, as well as local regulations and ordinances. *Works to improve residents' health status by enhancing access to health care for the most vulnerable of the population; limiting youth access to tobacco products; providing vaccines to the health care providers; operating clinics; conducting surveillance of contagious diseases; and collaborating with other agencies that promote health. *Actively planning for infectious disease emergencies that may be presented by bio- terrorism. Such planning improves our ability to respond to natural threats, as well such as SARS and the Avian Influenza virus. Housing Authority Mission Statement The Salem Housing Authority is committed to providing a full range of affordable housing opportunities that are decent, safe,and sanitary to eligible low income elderly, family, and handicapped persons in a fair manner. We strive to make the best use of all available resources • so that our residents and participants may live in an environment that is clean, well maintained and attractive by taking advantage of available government resources. Our goal is to manage our public housing units in a manner that is consistent with good, financially sound property management practices. We endeavor to instill pride and a desire for an enhanced quality of life for our residents and their families. We are committed to servicing our residents and participants and this entire community in a manner that demonstrates professional courtesy, respect and caring. We are committed to fair and non-discriminatory practices throughout all of our housing programs and design policies that aim to de-concentrate poverty and provide support to access affordable housing opportunities. The Salem Housing Authority is committed to assisting all residents who are moving from welfare-to-work with affordable housing opportunities that do not act as disincentives to economic advancement Newton : The mission of thle Department of Health and Human Services is to protect, promote, and sustain the health, harmony, and well being of all Newton residents, in a culturally sensitive, customer friendly manner. Our focus is on prevention • Health Agent June 2011 Report Meetings/Trainings 1. Larry Ramdin and Tracy Giarla attended the meeting on the Northshore Cape Ann Emergency Preparedness Coalition. The Coalition held its annual elections and William Burke of Beverly was elected Chair, Sharon Cameron of Peabody, Vice Chair, Max Schenk of Gloucester, Secretary. The current grant year ends in August, outstanding deliverable is the Technical Assessment report (TAR) due on July 12. 2. Larry Ramdin attended City Council Public Health Safety and Environment committee meeting to discuss gas station at 111 North Street. The neighborhood has several,complaints about filling in a buffer area , installing drainage without permission and other construction related complaints 3. Larry Ramdin attended the City Council meeting that dealt with the City • budget. The Health Department budget was approved as presented. The Council passed the Mayor's Budget with amendments 4. David Greenbaum and Larry Ramdin attended Northshore REACT meeting. The meeting discussed programs for elders at risk, and highlighted best practices in the communities. Mayor Kim Driscoll attended the meeting. 5. David Greenbaum, Elizabeth Salandrea and Jennifer Keogh attended the quarterly MHOA educational meeting in Dedham. The presenter was Dr. Robert Powitz who discussed "The Art and Science of Inspections. " The lecture was designed to enhance /improve practitioner skills when conducting inspections 6. Larry Ramdin attended the pilot of a Food Inspector Certification training program where he presented on "Inspection equipment" and "Basic inspection techniques and evaluation" the program is the first of its kind in Massachusetts and seeks to provide standard methodologies for conducting Food Inspections. 7. The Regionalization Project conducted an interview with Larry Ramdin as part of the planning grant, needs assessment. • 8. Larry Ramdin participated in the Annual Arbovirus conference call with the Department of Public Health. There have been no reported cases of either EEE or West Nile Virus, to date. There has been an increase in mosquito activity due to an unseasonable increase in rainfall. Significant Communication or Complaints from Residents 1. A bank representative called regarding unsanitary conditions at the property at 16 Dunlap Street. The house was deemed unfit for human habitation and condemned. 2. An investigation into a food borne illness was conducted at Sammy's Roast Beef. During the investigation it was deemed that there were numerous critical violations that could increase the risk of food borne illness, including improper hand washing, time and temperature abuse and lack of sanitizing. The food permit for this establishment was temporarily suspended. Food Establishment remedied all critical violations and was allowed to reopen Other Activities 1. Change of ownership inspections conducted at : Bob's Famous Fried Clams ,Sushi Garden and Foodies Feast. 2. Plans were reviewed for the following establishments: North House of • Pizza and Sushi Garden. 3. Conducted opening inspections of the following establishments: Friendly Mini Market and The Little Store. 4. Health Department staff conducted a) 13 housing inspections b) 36 Certificates of Fitness Inspections c) 9 Pool Inspections d) 9 camp inspections e) 4 Food Inspections f) Investigated 1 nuisance complaint, 5 trash complaints g) Collected Beach samples on three days 5. Met with owner of Mahi Cruises to discuss expansion of operations options 6. Larry Ramdin met with Intern candidate to discuss Healthy Salem project. Ms. Wallace is a graduate student at Northeastern University and will be interning with the Salem Health Department, from September- December to assist in the assessment/planning phase of the project. • • The Board of Health: * Responsible for protecting and promoting resident and visitor health through enforcement of MA Department of Public Health and MA Department of Environmental Protection sanitary and environmental codes and statutes, as well as local regulations and ordinances. *Works to improve residents' health status by enhancing access to health care for the most vulnerable of the population; limiting youth access to tobacco products; providing vaccines to the health care providers; operating clinics; conducting surveillance of contagious diseases; and collaborating with other agencies that promote health. *Actively planning for infectious disease emergencies that may be presented by bio- terrorism. Such planning improves our ability to respond to natural threats, as well such as SARS and the Avian Influenza virus. Housing Authority Mission Statement The Salem Housing Authority is committed to providing a full range of affordable housing opportunities that are decent, safe,and sanitary to eligible low income elderly, family,and handicapped persons in a fair manner. We strive to make the best use of all available resources • so that our residents and participants may live in an environment that is clean,well maintained and attractive by taking advantage of available government resources. Our goal is to manage our public housing units in a manner that is consistent with good,financially sound property management practices. We endeavor to instill pride and a desire for an enhanced quality of life for our residents and their families. We are committed to servicing our residents and participants and this entire community in a manner that demonstrates professional courtesy,respect and caring. We are committed to fair and non-discriminatory practices throughout all of our housing programs and design policies that aim to de-concentrate poverty and provide support to access affordable housing opportunities. The Salem Housing Authority is committed to assisting all residents who are moving from welfare-to-work with affordable housing opportunities that do not act as disincentives to economic advancement Newton : The mission of the Department of Health and Human Services is to protect, promote, and sustain the health, harmony, and well being of all Newton residents, in a culturally sensitive, customer friendly manner. Our focus is on prevention Bedford MA • VISION: Helping neighbors lead healthy lives in Bedford. MISSION:We are dedicated to our mission,to serve all Bedford residents, particularly the under served, and to promote healthy people, healthy families,and a healthy environment through compassionate care, education,and prevention. The Board will create needed regulations,set policy, hold hearings,and consider variances. Your health is our concern. VALUES: Maintaining a balance between short-term benefit(s)to human life vs. long-term risk. Decision making priority is given to town/community needs vs. individual needs. Mission Statement The mission of the Reading Board of Health's is to protect and promote the health and well being of the citizens of Reading and the quality of the environment • • The Board of Health: * Responsible for protecting and promoting resident and visitor health through enforcement of MA Department of Public Health and MA Department of Environmental Protection sanitary and environmental codes and statutes, as well as local regulations and ordinances. *Works to improve residents' health status by enhancing access to health care for the most vulnerable of the population; limiting youth access to tobacco products; providing vaccines to the health care providers; operating clinics; conducting surveillance of contagious diseases; and collaborating with other agencies that promote health. *Actively planning for infectious disease emergencies that may be presented by bio- terrorism. Such planning improves our ability to respond to natural threats, as well such as SARS and the Avian Influenza virus. Housing Authority Mission Statement The Salem Housing Authority is committed to providing a full range of affordable housing opportunities that are decent, safe,and sanitary to eligible low income elderly,family, and handicapped persons in a fair manner. We strive to make the best use of all available resources so that our residents and participants may live in an environment that is clean,well maintained and attractive by taking advantage of available government resources. Our goal is to manage our public housing units in a manner that is consistent with good, financially sound property management practices. We endeavor to instill pride and a desire for an enhanced quality of life for our residents and their families..We are committed to servicing our residents and participants and this entire community in a manner that demonstrates professional courtesy,respect and caring. We are committed to fair and non-discriminatory practices throughout all of our housing programs and design policies that aim to de-concentrate poverty and provide support to access affordable housing opportunities. The Salem Housing Authority is committed to assisting all residents who are moving from welfare-to-work with affordable housing opportunities that do not act as disincentives to economic advancement Newton : The mission of the Department of Health and Human Services is to protect, promote, and sustain the health, harmony, and well being of all Newton residents, in a culturally sensitive, customer friendly manner. Our focus is on prevention Bedford MA VISION: Helping neighbors lead healthy lives in Bedford. MISSION:We are dedicated to our mission,to serve all Bedford residents, particularly the under served, and to promote healthy people, healthy families, and a healthy environment through compassionate care, education, and prevention. The Board will create needed regulations, set policy, hold hearings,and consider variances. Your health is our concern. VALUES: Maintaining a balance between short-term benefit(s)to human life vs. long-term risk. Decision making priority is given to town/community needs vs. individual needs. Mission Statement The mission of the Reading Board of Health's is to protect and promote the health and well being of the citizens of Reading and the quality of the environment