Board of Health - Regular Meeting

and welcome to this the February 12 2025 meeting of the town of Littleton Board of Health in attendance tonight we have Matt Wason Dan Kane Kevin Davis and our health director Francis tagel we have a quorum and so we will get started our first agenda item 7 o'cl discussion how to approach non-compliant food establishments Francis this is thank you um so we briefly just touched on it last meeting at the end um while we're setting up things is there' be good to have a standard operating procedure going forward and how the board would like to address chronic violators um so I think we're going to have one coming up and I think it'd be good to have something in place for everybody at this point really um to determine like how long you want to let it go how many repeats until there is some form of action and when do you want them to appear before the board so just as um for consumption um essentially when we're doing a food inspection there's three categories of violations um so there are what's called priority priority foundation and core core is typically like non-critical violations um it could be like dirty walls dirty floors equipment related stuff um so non-critical priority and priority Foundation are both higher risk so priority is directly leading to foodborn illness um foundational would be more things that are directly related to that so it's still high risk but it's not as high risk um so when we're marking things down based on violations not necessarily pass or fail it's just a matter of how many violations and how critical they are is how we kind of

determine how to go forward so typically for priorities it's going to be 24 hours because it's very serious um priority Foundation depending on the severity and how much it's contributing can be up to 10 10 days it's up to the discretion of the inspector um and then core can be done at the last at the next routine inspection but typically I would like walk in in two weeks to do a spot check and make sure that they're not still doing it um so the question comes down to so when we're looking at non-critical how many if we have someone who just has non-criticals every single inspection how many times do we want to let that go before we say Hey you have to go to the board or hey you've been doing so many violations that I'm going to have to start finding you or do we find per violation um so that' be the first question um before we dive into the discussion the time frames you just described for those are those set somewhere regulatory wise yep um so those are the FDA set standards okay does part of the reason I asked is because I know historically I've seen some paper reports that had like 30 followups for some sort of problem resolution yeah the core um category of violation is like really open-ended it could be till the next one so yeah it could be six months even I mean leaving something past 30 days is really probably not okay but um so typically for how I do it I check in two weeks after no I I much prefer an answer of two weeks than oh see you is fine um so even even for something non-critical it's still a finding it's still something that we would rather see done

better and so yes I would much prefer a turn around this within at least 30 days so I'm happy with the two weeks but that was my only clarifying question there so Francis says asked the board a question who wants to dive in first so go ahead Kevin so I am I'm assuming because it's Massachusetts there's a whole host of regulations and laws that establish the inspection and follow up their is that correct kind of um establishes the inspection establishes what areas that you're going to look at and what violations and it constitutes the level of risk and then is it up to the individual towns to then hand out this is the you know reinspection times this is like you said how many numbers kind of go it's all up to the individual towns that do that it is yep um and so I've kind of looked a little bit also trying to look around and there seems to be a pretty wide latitude on what towns do what towns have done historically sorry yeah and and it seems to the state and the court seem to give us fairly wide latitude on what we want to kind of how we want to enforce it yep absolutely nail on the head okay um I'd like to think about it from a risk chart so when you're dealing with program management stuff it's kind of the things that I deal with every day we kind of come up with a risk chart and the risk chart generally has the top right quadrant um being your area in red and then it kind of goes to a yellow

then it kind of goes to a green and the X and Y AIS you can Define as a you know a bunch of different things so maybe it's you know number of you know number of criticals number of mids number of you know lows or whatever those three different levels it kind of goes into this risk chart then you can kind of say you know this is where it is this is where it is you know kind of go we could establish that and then depending upon where they land and like how they've gone through and removed the inspection you know the defaults or not defaults the defects in their inspection you then would say with when you resolve it it'll move you to here when you resolve this it'll move you to there so when you get things in the green you're good to go but if you're still in the yellow or the red you have to kind of still take action and have remediation that's kind of my first thought on this yep that's kind of how I see it too I was going to try to break it out in terms of further questions talking about in The Next Step critical chronic um so I was just doing it a different way sorry for those confusing oh it was fine no it makes sense um Dan you w to keep going um yeah I mean it's always a balance one um just to we all clear the math and federal standard is um health or food institution should be inspected every 6 months unless they are classified low risk but and you have a standardized what constitutes a low risk have that in place as an accepted regulation and then you can shift a an institution to a low risk some place that has a vending machine and and snacks is much different than some place that's serving milk and baked goods and or or you know fresh meats whatever so but our standard I think at this point

cuz we do not have a lowrisk established regulation is every food establishment should be inspected every 6 months so that how long is that NE next inspection is it a year is it two years it should be six months um as far as the chronic folks um I'm kind of that same piece is that I want to make sure we can be consistent and the problem is with we have so many variables that how do you make it consistent well okay so you get one priority it's a it's a critical that's going to be reassessed in 24 hours and then you know whether it's a month later two months later was a drop in or six Monon inspection you're having the same issue again you know what okay that's that's a pattern you were addressed it was re it was it was remediated but now we're back with the same thing again that is a leadership organizational pattern it's not it seems unlikely it's a fluke if your fridge temperatures are consistently warm you went back now it's fixed six months later it's warm again or you it's out outside the safe Zone that's a pattern and I think we need to address it as it's a pattern once if it happens twice in a row what a pattern um for something like this if I consistently walk into a establishment and floors are dirty counters are dirty um that I don't think that necessarily hits priority unless you look working with cross contamination kind of things but it's a concerning pattern as well if it's repeated um but how do we I kind that risk pattern how do we balance okay you got one priority and three cores you get 10 cores you got five priorities and two at what point I mean I hate saying it kind of needs to be a bit Case by case because you can't make it consistent but there's too many variables I think to

really come up with a a guideline that can be consistently applied fairly you know you get two criticals and and you have the same two criticals or two critical in general two inspections or three inspections out of the last or two inspections out of the last three that's a different piece and it's time for a conversation perhaps beyond the you know the department level um I agree it's important and it needs to be addressed and I understand you're you're bringing it to us I'm not sure the best way other than how how is the inspection are I know they're obviously checked but are they scored are things you have critical you have asteris I'm I'm going to play my teacher role that you have critical fails you have Aster items you have to hit at least 80% of the items on your list but if you miss a start item then it's an automatic fail those kind like that kind of mindset do we get you know is it your second automatic fail it's before the board an explanation is it a percentage overall I'm I'm not sure I just want I'm trying to come up with some way of making it consistent and uh I admit I have not looked at a restaurant inspection form for probably about a year and a half now um to remember what's on the list and I think they've changed since since then can you kind of walk us through a little bit of kind of the items on there what kind of thing yeah what would a what would I what would a failed inspection look like for core only fails so not any high priority which would be that Aster start items but what would it look what would look like either a fail or a concerning inspection for core level and then give me a couple you know real not NE real examples but rather than food safety piece of yeah you're storing raw meat and you know finished goods next to each

other for a priority kind of fail just we have a sense of like what we kind of make it make sense of it yeah sure um so I guess to piece this out even more is you know we can look at non-critical uh and we can look at you know chronic vers non-chronic whatever um so when we look at critical um The Next Step Beyond the board would be hiring a food safety consultant and they would have to contract with them for three to six months typically depending on the severity um to be training and then there's a question of when they get a food safety consultant do we have them come every month with the consultant and the representative from The Establishment to give us updates or do we just have them send a report and we can review it as a group um and then make determinations how to go forward so that that'd be the next escalation above the board if that's helpful um but in term noncritical so I mean you might have a wash rag that clearly seems It's not been in the sanitizer and sanitizer hasn't been tested in a while um you might have a dirty wall from lunch hour the floors might be dirty especially during winter you're going to get a lot of traction from the outdoors um so it's kind of facility messiness so it's not going to cause a foodborn Illness but if you spot let's say prepped raw chicken sitting in a container out on the counter that's 54 degrees that would be kind of your basis of what's critical what is like if you serve this someone's going to die someone's going to get sick um so it's it goes on a whole different you know level um but there could be stuff like uh let's say you don't have your sanitation strips which is not foodborn Illness but it directly relates to not being able to test your sanitizer solution which in terms leaves bacteria

and germs on boards and everything else um so there's definitely severity Factor so that's why I kind of like to do non-critical so typically in the past what I would do is is usually if there's non-critical chronics after four inspections I bring it to the board to say here's the reports and the last inspections here's where the things are here's how these all tie into a foodborn illness that I think could be coming or graduating um and then the board reviews it and makes a decision okay let's should we bring them to the next meeting to talk about it should we issue some kind of order letter or some kind of finding system saying that you've been a bad actor multiple times been warned by the inspector um to do better food safety um those are kind of lowkey when it comes to critical and chronic usually I think three times is kind of the max um so you know a lot of stuff can be corrected on site so I will tell them you throw the chicken right now that's it um but they might be doing it every day as ter their prep you don't know so then you ask their staff okay show me how you prep this tell me when you prep this give me a list of employees who prepped this um and you kind of figure out what their process is and you try to work with them to educate them how to cut down on time and how to make sure that's it's done in a certain way so you say let me see a chart I want you to um you know notate when you do these steps and I will randomly spot check you um and that's kind of how I've treated those situations and then if it hits three for any reason I think it's either becomes a fine or goes to the board and depending on how severe it is that's when I say I might recommend a food safety consultant might be appropriate at this time um thank you for the further detail Francis I know both Kevin and Dan were also hit on the same kind of well it's

quantity and it's quality and how are we going to take both things into account um and I I think that you've got a lot of the framework already in your head already which is great and we're not going to be able to come up with a um better system than whatever you're going to come up with but I think our our input is valuable so we can kind of give the guidance um for example on the non-critical stuff uh yeah my gut instinct before you were saying anything else was if you have the same problem three times in a row then that like you need you're not doing a good enough job you're something's not clicking with you and there should be some escalation at that at that point um I think if you have uh repeated findings that are different in an establishment I think that's probably going to be the hardest one to deal with um you know every every three weeks you go back and find a new core problem but the last one's taken care of but now we have a new one um does that just become a an endless spiral for you without some sort of framework so I don't I don't know I don't have a good feeling for kind of how to guide that kind of scenario um but I would say for kind of repeat offenders I think you said four I I like I said in my head it was just three strikes that seemed reasonable to me if you're talking about the same thing three times in a row um then maybe maybe the fourth finding brings it to the board or maybe it's enough to bring it to the board after the third i' I'd be interested to other people um as for the As for critical components um three seems too much uh especially if it's a competing thing and so I feel like if you've gone in and found had a critical finding and you go back for a inspection and you find the exact same critical finding again is that is that enough in your mind is that

enough to say oh we're we are now at the escalation phase um I'm not sure and perhaps what it should be is depending on the criticality level perhaps for the cores it's coming to the board and I assume coming to the board is just making them try to have some accountability and communicate to this group of officials what's going on um but perhaps when it gets into the foundation and the highest critical one whichever that one was um should those have the fines included even at that point because they are more severe and they are more dangerous to our community um Kevin you suck your hand up yeah the other thing I'm curious about too is surveillance and then reporting right remember how we had um we had the thought of here's the QR code to go back to find out your last inspection was here you got a grade of negative 10 million or whatever I'm not saying that that's a thing but whatever um we need to like how are we what kind of things are we putting in place to kind to show okay over the last five inspections you were awesome you got three lows no mids and no highs you know what are those how are we showing like over time um how well the inspections are going and things like that so that way we have some surveillance I mean for the most part there should be no violations and that's kind of how you go is if you're a good actor then I will see you in 6 months and you're trusted to continue operations but but so like what I did during the inspections is although it's required to be every 6 months anybody who I wasn't really crazy about their inspection they're now on a every four

month schedule instead of every six months so they basically have three inspections a year now instead of the two um so I did that I think with like 10 places in town um so that's kind of how we treat tracking them and Reporting them is just being more frequent about when we go in and spot checking is there a is there I would I would say Kevin honestly that it needs a short memory because honestly do I care how well you did two years ago if you have critical findings today I honestly don't it's about today because that's when we're using the establishment and so the system is is equipped to be able to keep track of the ones we need to revisit sooner right Francis so that's what I care most about so that if there's a f and there needs to be followup the followup is tracked um and so I I think you're only caring about the history of of of the very recent because there's been a problem um and so you're monitoring that more closely to say there's been a problem there's been a problem there's been a problem do you think we need to escalate Beyond three inspections a year do we think we need to like if you make it to the next inspection you know like you know four months later and there's more problems than there was the previous time do you put them on in every other other month inspection at that point you know where does where does the criticality I think he's saying that the Cadence increases for places that are potentially problematic but if you have findings you're getting repeat inspections almost immediately until you've shown that that's resolved right I mean your most critical cockroach would probably be where you would be like yeah I'm going to be in every week so uh like Dan said it can be a lot of CAS by case basis too yeah absolutely okay I'm

good well but so the key question is when when does this board want to see the restaurant operator I think if you have repeated mid tier I think they need to have come in and I think if they have the highest level if they have the highest level I think we need to be aware of it definitely but then if it like happens again then you need to kind of like you got to go see the board or something like that and that's my opinion it's like getting sent to the vice principal than the principal's office and I mean honestly Perhaps Perhaps three strikes works for all of the levels knowing that if it's highly critical the three strikes are just happening within a week as opposed to something that's less critical the three strikes are happening over months so may maybe that's sufficient to say if you rack up the three strikes in the time frame of the reinspection then you're coming to the board before your fourth inspection basically I also think if you have the repeated like if you have um missing test strips or something like that and you have missing test strips three in a row or whatever it is it's if it's the same violation three times in a row like the exact same violation I think somebody should kind of come in and have a talking with I don't know what other bit everybody else says but it's that seems to like oh you're not doing the right

okay the question is what's the stick after that so one way we could do it is maybe I just bring it to the chair and the chair goes we should send this to a me you know they can make that determination seems fair what do you think Dan um I think the three strike in general is probably okay I mean we're looking at that point at really a year and a half or a year inspection six months inspection six months so a year between first concerning finding and it coming before us which seems like a long time of an ongoing pattern but certainly for our our lower things of non food safety cleanliness kind of stuff um is probably okay that mid levally you know your dishwasher temps aren't high enough your you're not you don't have sanitizing strips which means you tested through the first bottle or you threw them away and you never replaced your bottle because no one's checking until six months from now or at that point five months from now it's not a concern in your head that I'm not sure if if three strikes is easy three is easy I think that's probably pretty reasonable I agree if that if it's I've got a food board I've got raw chicken next to ready to serve food gets the education on it you go back a week later and there's still the behaviors is the same you go back a month after that the behavior is still the same it's back to us and whether that's Francis ordering a consultant or ordering a consultant um I think that's a pretty big stick only because there's

cost involved that is probably going to be significantly higher than fines we would Levy um I think for us the next big stick because we can certainly find is going to be your closed down until you you know that's the challenge at that point is Okay so we've closed you down because you're storing raw chicken next to ready the thir food well we closed you down you're not doing that anymore when you open that back up are you going to in fact stop that behavior which previous observations and and Remediation hasn't changed hopefully having to close for two or three or five or whatever days um is a stick I'm not sure how it's an intellectually effective stick I'm not sure how effective would be in practice I I I'm just not sure but if I have to close down yep you teach me a lesson but telling me beforehand that was going to shut me down if I don't take care of my chicken appropriately and I'm still not doing it I'm just not quite sure if if education GNA be effective in that case I mean the one I mean the one that comes to mind right now for me is norovirus as the example right I know raw food raw chicken things like that but I'm also thinking like norov virus and things like that because that's easily spread somebody comes in sick blah blah blah so I mean in that case we would shut down automatically anyway because everybody would need to test so and that' be the Safeguard essentially we would shut them down and then bring them to the board to discuss what happened and the results of the testing um so I mean certainly in terms of shutdown there's a process too separate in its own and I assume you have access to Maven as well right correct yeah

um I think the only thing I want to clarify for Dan's comments was hopefully not hopefully three strikes would never take a year because if you've gotten a strike it means you're getting a more frequent followup within 30 days even for core right ideally two weeks so I see that as you're getting three strikes even for something non-critical that's happening within a couple of months and we know about it um so France I feel like there's kind of reasonable consensus that three for a repeating thing um I think the other question is what if it's not repeating um I feel like if you have critical findings I would say three of any critical finding in a row is probably probably a reason to bring it to us um but when you slide down to the less critical things uh I think that's the one area where you start to go well if every month you go in and it's something different is three strikes enough to bring it to the board because there's not enough attention to detail going on or is that one where you want to perhaps like you said just converse with the chair and say let's let's let this one go a little bit further and keep an eye on it and agree on a more stringent follow-up process I would be okay with that okay okay and then do we have a fee structure set up as a regulation somewhere that we can actually use I don't think we do actually um I will double check for the next meeting okay so some of this is going to be making a process for you to follow but it sounds like we might also need to pass a regulation that says we can find yeah I'll look into it further I'll have an answer for the next meeting

so I know we have a townwide violation fine schedule that I mean obviously any of our regulations fall under basically Town bylaw so we should be able to find under violation of a inspection violation I believe should be enough to trigger a a regulation violation if if we chose to go that route early on um as opposed to warnings but we could certainly look at that is it effective and and clarify if we want to but we should all all Health Board of Health regulations have the same enforceability as Town bylaw so it should fall into the town by law find schedule we we wrote something and I I recall we basically copied the town one but we included it in our own document and maybe that wasn't necessary for ref falling the town um in this case I would just make sure that it's not something like first offense is this second offense is this and it doesn't align correctly with what we're talking about that might be the only reason that we'd have to have a a different one in this case um all right anything else on that topic Francis no thank you all right our next agenda item I don't think we have any audience members that I hear nobody in attendance uh so our next agenda item 710 discussion on the opioid settlement fund yep just want to give the board a quick update um so as we're looking at the funds um I also connected within the region as well and that's a conversation we'll have to have at some point is how much do we want to spend regionally and how much do we want to spend solo um so with the regional group right now we've been moving along and I did send the

group um a description of what a sub Abuse Prevention Coordinator would be and asked if there be any interest in that um there is some interest the more established towns that work together as a group do have this type of position in place um it's definitely a viable option for opiate funds um and we haven't really gotten far on the conversation but we've just thrown it at this point for them to bring back to their towns as well and discuss and then we'll meet up again um so I just wanted to update the board early on and where we are with the regional [Music] discussions any questions from our group Kevin no I like um working with our partners here in town um I know we've kind of gone back and forth a little bit on who kind of owns the process who's driving the process um do we have a a sense of is this under Town Administrator with advice and consent is this being driven by ELD Human Services By Us by law enforcement by fire or by like kind of what is that it comes into the general fund but it's dedicated what it can be spent on who I'm just curious who's driving it or who who who own ultimately owns the process uh not by choice but um it was thrown at me so um I am guiding the process it's a lot of work but not necessarily a bad

thing it is we're looking at a group called Advocate the town also be with law enforcement you know there's a group called Pari um and I'm sure Dan knows yeah um that instead of going for the arrest route it's more seeking treatment and connecting to resources um so I've asked to meet with Advocate next week to kind of discuss how that works and if they worked in the town in the past how that's worked as well see if there's anything in there um I also requested uh the in Sudbury the health director there hired a substance abuse coordinator so I asked if um that person would be able to meet with me or the regional group and kind of discuss what they've seen as the role being what the towns have gravitated towards in terms of focus and having someone that's actually in spirits in the role and knows the subject matter um where they say the focuses should be right from the start and what they see as a pattern um because obviously they probably talk to other ones as well throughout the state because there's probably a good maybe handful maybe 10 um of them at this point uh like I said more established towns have kind of gone that route because it makes a lot of sense having a subject matter expert be able to look at the problem develop Implement and build um rather than us trying to figure it out so um I should have some better ideas of where to go maybe and talk to the group further and after I talk to them as well all right I don't have any further questions either so thank you for your continued work on

those and that takes us to our 7:20 p.m. discussion on the short-term rentals yeah document there's a document included in our packet for review talking about the short-term rentals so D sure so I just want to put it on everybody's radar um short-term rentals sometimes the Board of Health becomes involved sometimes they don't um looking at the survey results so far it seems to be a desire to have short-term rentals obviously that could impact us as well in terms of septic systems as well as having short-term rentals so communities that typically do this the boards of Health should really go out and inspect the properties and also set a baseline for nuisance noise control that type of stuff um so even though it's still as a survey right now I think it's good to kind of bring it up early on saying do we want to be a part of that process do we want to start getting involved in maybe inspections or licensing some to some degree these short-term rentals that may exist and also it's interesting to look at the Adu um where now it's changing as well as part of that where it doesn't have to be owner occupied and that kind of creates its own element in itself as well um so it might be something we might want to look at further as the survey goes on and planning is starting developing whatever they may have we might want to do a joint meeting with them or something like that do we have a sense of what other communities do for this Pro for the inspection process I mean I've done it um so in my last job we had some in one of the towns we had

three kind of Airbnb type of situations um and so basically it's essentially what's called a Certificate of Fitness so you take the human habitation standards from the code for the state and it's kind of mure version of that making sure all those ele elements exist in the house so it's kind of like a dumb down housing inspection basically um so you just make sure the essentials are there i' create like a certificate of some form and make sure that they annually renew when we inspect U we'd also put in some kind of language about nuisance and noise and security and you know stuff like that thank you Kevin you're on mute Kevin sorry I just want to make sure that we're involved in the process and make sure that the health stuff is actually like being brought forth with the town that's probably my biggest concern is that there'll be something that'll be done and and it'll go against what we kind of like want to have happen so making sure that we're involved is appropriate um yeah I like your idea about having a inspection form similar to what was there for a regular dwelling but fit appropriately for the job that it needs to be done um yeah so like our dwelling unit zoning code right now and litton's like 12200 square feet but the one that the state passed was 900 so how do we kind of like rectify the two or do we make two classes do we have one where it's up to 900 square feet it's these things that are you know by right and then things between 900 and no more than 12200 have to follow all of the things are already in the town so that's kind of where I'm at yeah I thought it'd be good to bring

up now too because next meeting we'll probably talk about um additions and basements and all that too as well so looking at that in that context as well might be helpful thinking ahead yep yep so yes I know that at least one time in history um the right to have an Adu was also interpreted as a right to go beyond the design septic size which is not just an automatic stamp um just because you might have the um ability to create an Adu does not mean that you get to just supersede the rules required of your septic system um so I think we just as we kind of go down this path we want to make sure the public understands and that it there are still rules that have to be followed no matter what's going on whether you can have one or not um I I agree with Kevin I appreciate having some sort of just inspection system for a short-term rental um I would ask what requirements are there for a long-term rental um it's a good question there there really isn't on our side it's still the same basic factors of human habitation so um in terms of length of stay we don't really have anything to do with that but right with short term it's more of a nuisance and it's more of an overcrowding issue as well so just kind of a different Beast oh oh no it is it's but it becomes a a spectrum of you know what what do you do about a hotel versus a long-term rental versus a short-term rental versus what short a medium-term rental and so um I I I think we might find ourselves someday into needing even more framework um but I appreciate that you're kind of getting in front of this

now and um curious to see how the survey continues to turn out but uh yes I'm of the opinion that something like this because it becomes basically another um quasi commercial Enterprise of housing that there needs to be some good understanding by the board in the town of what's going on what are the quantities that are out there and I think it's not unreasonable to have some um inspections and some uh licenses to have those things right if you want to operate one of these things then apply through the the health department and get your license and get your inspection and you'll be good to go for a year is that the direction you're thinking yeah essentially okay I'm assuming we already have some sort of inspections for the hotel that we have in town right yeah once a year um a little different but yeah that it Kevin yeah that's it okay sorry you're still churning I just want to make sure no all good uh I didn't catch that Kevin you mentioned that the Littleton Adu actually has a different definition for the size yeah so you g to have if you go look at the like you go into the um if you click on the lion Adu bylaw it's 1200 it's 1,200 square feet so I'm sitting there going okay if by right you have 900 square feet great

peace out here are the requirements for those 900 square ft right to meet all of the language and the law that feeds the 900 but then it should be an easy step up to the no more than 12200 square feet right and here's what that says because it's you know it's it's more does that make sense that that's one way to look at it another way to look at it is we change our 1200 to 900 and that's the category I hear you it's it's a it's a consideration is there uh I doubt Francis would potentially know I don't know about anything else Dan Dan always knows the stuff uh is there a did the state size change did it used to be 1200 do we know where our 1200 came from any sort of historical Kevin seems to know I I honestly think it was a one of these grab it out of the airs it would be interesting if somebody had some notes or minutes about how they discussed how that came about but it wasn't us well we HT ourselves now so yeah I think the states always been 900 okay no I think that's a that's a question that we should ask then is I understand yes we could have our own little well up to 900 means this rule set and from 900 1200 you're kind of in this rule set but is that what we want to manage and it appears that it's in the

accessory dwelling unit so I wonder if there is let's see [Music] M Unit S footage it's 900 feet in the Spate that's interesting wonder where that came from okay I'm done well and accessory dependent gets a definition of 12200 but accessory gets the definition of the smaller of 1200 or dimensional limitation set forth in a different article or rule y us oh then then it's a percentage base both floor area and land area oh the detached accessory Apartments yeah okay all right so I'll talk to planning make sure that we're part of the process as it starts to go forward sounds good next on the agenda then is 7:30 our infectious disease decision support

tool I will share that come on so covid-19 current variants uh they're flip-flopping between the xcc and the KP 311 they're both Omron variants um both are expecting optimistic reasonable cover from vaccination the xcc one is the one that has been particularly transmissible so it's spreading pretty well um I think it's a little surprised that do actually not spread further in our area but it's at 38% for the New England area uh vaccinations sit at uh whopping 30% as of the start of February and you can see our weekly case counts are now going up for four straight reporting weeks um which is a concern and I'll remind everybody that these case counts are are only from identified cases in healthcare establishments and test test done that way right your home tests don't count and people who have covid who just stay home for a couple days or keep going to work for a couple of days don't necessarily show up on here so the real number is bigger so if you look at this and you say it's less than 10 that's no big deal that's a A Min School percentage of our community that's understandable but at the same time there are plenty out there that are not captured in this chart um that's the POS posi in that if the disease is not make peing people as ill that means they're not going to be going to the hospital potentially not going to their doctor as much um but I don't like the fact that it's going up and our vaccination rates are still low

the good news is the Wastewater numbers have actually dropped um over the last month so perhaps this is a Wastewater Peak followed by a case Peak um and maybe we're on the the downswing of this particular w but uh that remains to be seen what it's going to be I I know I you know kind of mentioned last time and probably the time before that and probably the 18 times before that that I our vaccination rates in Littleton are just are just not good they are not what we need them to be to be a safe and healthy Community um we're getting to the point of this season where it might be too a little too late if we were to bump it up um but I would say that we set ourselves a challenge for the next season because we have plenty of time between now and then and I I would like to see our health department Francis thank you set set a Target and and drive to try to meet that Target um it only does so much for us to sit every two weeks and and look at a number on a screen if it's not going to actually affect some change so um looking forward to next season I think we need to come up with some solutions knowing that this is how our track record has been and try to figure out how we can get a better start on it and get better penetration for these programs um all scroll down influenza is better we're at 49% but still not not where we want the community to be um for influenza the uh flu the last time I reported which was probably two meetings ago so a month ago the status and Massachusetts was still low and it has jumped up to very high now for influenza so um highest risk that they have lots of cases going on the CDC numbers show

just a tremendous spike in influenza rates um the the good news a little further down is that RSV has is going in the other direction so RSV is getting better but the influenza cases are justo shooting shooting up so um I think their numbers were we are up to this is not for the uh Littleton is for the whole state of Massachusetts but we have 20% of emergency department visits are now due to some acute respiratory disease so um about half of those being influenza so those are both numbers that I think we don't want to see you don't want one of every five patients coming into your ER having some sort of um respiratory illness and half of which are influenza which we know we have some vaccinations for that if you get your vaccination you're more likely to be kept out of the emergency room so we're in the thick of respiratory illness season and that's what's going on questions about these uh just at home tests like uh um can also detect the flu a and flu B type as well as covid-19 so for those people that are wondering you can get a single test that'll look at all three at home so that way if you're feeling cruddy you can see if it's one of the three and then call your doctor appropriately then the other piece uh I did not add it to the dashboard we talked about it um not sure if there's anything to add

right now but that's about the bird flu Aven influenza so um thank you Francis we have a now information on our health department Town web page um and the CDC is obviously continuing to monitor it um 68 human cases in the United States but still nothing near New England I think Michigan the Midwest there's some few cases in the midwest um so I I think we pretty low risk for any human cases right now but as to your birds and fowl please please please keep an eye on your animals and if they show any signs of illness that's when you need to be doing something about it to reduce the spread yep so if you go on our website um fish and wildlife have asked that anybody get uh that sees problematic birds that they be reported through their um website the form is on our web page for that as well as the contact if any animals personally domesticated um are acting odd or feel sick so great can I show that really quick then one sec so here is our page on bird flu so where should they go to report that uh I think it's near the bottom uh last one yep that one oh that's not a link yep have them that be corrected and I and I wonder if that's important

enough uh if if this if this whole section actually just could put right up here okay because the rest of this is informational basically um but that one if we're asking people to take an action let's let's make it a little more prominent so that they know um right up front in case somebody doesn't look that far down okay good idea anything else on infectious diseases then we have 740 administrative matters starting with meeting minutes approval there are meeting minutes from the last meeting of January 22nd which I was not present at therefore we do not have enough members to vote to approve those minutes right okay so we will have to push those to our next meeting and that brings us to our last agenda item which is correspondence and member updates I'm sorry to all those who missed out on Super Saturday it was really fun thank you to Dan for being there yes thank you Dan I I did not do much if anything I made things worse because I was there in moral support and was placed in a position of um more than that and without backstory so I I didn't help our case much unfortunately

but did you was there any updates that you are able to or interested in Sharing or you can talk to the chair at regularly scheduled yeah still flux kind of what we talked about yeah so I you know once I get an update either way thank you sir all right anything else Francis um we have an intern starting next week her name is Emmy she's coming from March College she'll be with us um so the end of April pretty much she'll be working on um opiate related stuff Promotional and presentation wise is kind of where I think we landed um if there's time she might do some more kind of educational materials um also um we submitted our application to dph for their Grant intern program so that'd be $44,000 a semester to pay an intern place them with a project that we create um so that person we put as the um for the community health assessment um so they'll help with that that'll be a good help um we also the CDC website is frozen and kind of has a checkback later for for um the fellowship Grant not totally unexpected so so I just keep checking every day and maybe it'll open one day all right um my only other uh question for was just to make sure that Jim Dugan gets the fee sched SCH y

okay okay any other updates Kevin no updates for me thank you all right Dan I don't think I have anything this one all right um I don't think I have any other updates uh like I kind of mentioned before the meeting um I am going to send a communication out saying that if you are going to be unable to attend a meeting uh please communicate it to the chair at the time um I I understand we all we all have stuff going on Wednesdays have become particularly Troublesome for me all of a sudden apologies for that um but uh thank you Kevin for picking up the role when I when I need it but um again it's just make sure you're communicating send it to the chair as soon as you know and that way we can make sure we're canceling meetings if we don't have Quorum or trying to figure out if there's some something else that we need to do to try to cover for it um I think it's hard if we expect people to be here and then they they no show because it can also really impact our ability to have fruitful discussion if we don't get to hear from all of our members so I know this meeting tonight didn't have the heaviest of agendas and no public hearings but it's valuable discussion time and that's part of why I want to make sure we kept meeting twice a month is because when we don't have proper business pulling us One Direction that's the time to talk about policy and regulations and continuing to move this this board forward and our actual Health Department that we now have so um this could be a really exciting year for us um and I would like that to be exciting from a regulatory standpoint not an exciting from an event standpoint just so clear not good okay so I'll get sent out but uh that's all I

had therefore I'll make a motion to adjourn turn we have motion a second roll call vote Kevin Davis yes Dan Kane Dan Kane votes yes and Matt Wason votes yes thank you all for coming and thank you for a good meeting thanks everybody thanks everybody thank