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HomeMy Public PortalAboutBoard of Health -- 2023-08-16 Minutes�o��„rrrrrtiru�utitif��l+urr�uiirrii� Q .r• O 9t�'�n.� i a `:t E pi ° - - 0- - r ri����I�Ilrrlr111f1r1111�1111111111rrr��\\\\� Town of Brewster 2198 MAIN STREET BREWSTER, MASSACHUSETTS 0263 1-1 898 PHONE: 508.896.3701 EXT. 1120 FAX: 508.896.4538 brhealth a:brewster-i WWW.BREWSTER-MA.GOV Board of Health Meeting Wednesday, August 16, 2023 at 6:30PM Town Hall, Room A yi tl_%f5 ?R Fi UIR CLEW Health Department Amy L. von Hone, R.S., C.H.O. Director Sherrie McCullough, R.S. Assistant Director Tammi Mason Senior Department Assistant Board members present: David Bennett, Chair; Kimberley Crocker Pearson, MS, MD, MPH, Vice Chair; John Keith, Penny Holeman, MPH, MA, MS and Abigail Archer Others present: Amy von Hone, R.S., C.H.O., Health Director Call to Order Meeting was called to order at 6:30PM. 2. Declaration of a Quorum Quorum present. 3. Recording statement Noted. 4. Chair announcements None. 5. Citizen's Forum None. 6. Pressure Dose letter update AVH - the office has not received any additional comments or paperwork, submitted to the Health Department, since the last meeting. DB - recalls from speaking with Amy that there was in package a letter from one party who did comply by providing an inspection/ receipt that the system was pumped, and the filter had been cleaned. COA Liaison position update and possible vote DB - asked Amy to lead discussion AVH- conversion was put on hold from last week as the Board waited for Penny's ability to participate. Amy has received a response back from the Town Administration as to what the possible process can be for this Board to officially create a COA Liaison. It was recommended that the BOH use the Select Board Liaison Policy. If the Board is comfortable with the Select Board Policy from 2020, then we should take a vote on moving forward with that same policy. Amy will bring it back to Elton Cutler and COA Board to have them do the same type of process and approval before it becomes formal and official. It still needs to be a multi -step process. DB - did Penny have a chance to read the response from Amy? PH - has not read the response but will do so today. DB - should we proceed with accepting a motion to support the Committee with regards to this position and Penny being the liaison to the COA. KCP - Do we first need to adopt the Liaison policy and then we need to Vote on the position of the Liaison? AVH - We can vote on appointing Penny as the Liaison with agreement from the COA. There was a verbal agreement from the COA. Motion: Vote was to appoint Penny Holeman as the liaison to the COA Motion: John Keith Second: Abigail Archer Vote: 5-0 Action: Motion carried 8. I/A Enforcement Discussion N:\Health\from Shari\MSWORK FOLDERS\MEETINGS\BOH\Aug1623m.doc DB — confirmed that everyone reviewed the information in the package. What you have in your packages, is what Amy produced as part of the previous package, the spreadsheet shows the most recent average total nitrogen numbers for a select group of properties. We identified these properties to go through the approval process to screen whether a letter should go out to the property owners as was adopted by the BOH. DB — I must first recuse myself from any decision or vote as I was affiliated with one of the companies mentioned DB — I would like to go through these one at a time using the spreadsheet that we have and then take a vote with regards to issuing a letter DB — we are trying to keep these as anonymous as possible, I would ask you to refer to any specific project by the identification/permit number. In your package there was the flow chart for the compliance and monitoring I/A systems. PH — are we going to approve the flow chart, or has it been approved? DB — it has been approved PH — Currently the wording is: "Is property outside Zone 2". It should read: "Is the property inside Zone 2". Dave will make the update to the flow chart from outside to inside on the second box in the left-hand column. DB - This change should not take another vote DB — Amy has done a nice job of compiling the sensitive information and summarizing. AVH — We have not done a formal vote on the letter DB — We need to take a vote on the wording of the letter from the 8 16 23 meeting and follow the process outlined in the two flow charts with the new addendum wording from outside to inside Motion: Vote was on the wording of the letter Motion: Abigail Archer Second: Penny Holeman Vote: 5-0 Action: Motion carried Brew MCG039 DB — Turn to Page: Sample I/A Systems and Systems Out of Compliance. DB — Brew MCG039 — FAS System 2018 Installation of a Micro Fast, property which is in DCPC in Pleasant Bay and Herring Run Water Sheds Maximum 19 or 25, micro grams Because of the size of the Lot, they can go down to 19 micro grams, it is based on the square footing of the lot, depending on the square footage of the property you can request a reduction of nitrogen based on the square footage of the lot. 40,000 square feet for a 5 bedroom and then you adjust down from there. DB - Based on the Plan for this property the number of bedrooms approved: 4 on 18,000 square foot lot - This is a 19 part per million system, and this was limited to two bedrooms because they only have 18,000 square feet AVH — looking at System Design calculations — daily flow is at 200% capacity for the tank. However, what they have done on the plan and the System Design Flow is for 2 bedrooms the leaching capacity is for 3 bedroom and this was based on the 1995 Title V capacity. DB - Do they have enough square footage for a 3 bedroom? AVH — No, they do not have enough square footage. AVH — The easiest way to calculate is to calculate backwards. A 6 bedroom requires you have 40,000 square feet which is 6666 square feet per bedroom. 3 bedrooms would require just under 20,000 square feet. - This location does not have enough square footage to support 3 bedrooms. They can only have 2 bedrooms. DB — are we looking at 25 or 19 parts per million, they do have enough square footage for 2 bedrooms. DB — systems have different capabilities and some need to be at 19 where others can be at 25 The checklist was reviewed for this property and it was determined that a letter should be issued. Will this system meet the new Title V requirements? No The median number is 30, we are looking for something between 19 and 25 parts per million DB - We do not know the efficiency or the occupancy of this property DB — I would accept a motion to issue a letter for this property. KCP — It is in a future NSA area and a current NSA area and DCPC. KCP - If the fix for the system is pricy based on the Watersheds that we are talking about they might need to be told that unless Brewster gets a Watershed permit as it relates to the Herring River, then they will be forced to upgrade their system. They need to look at it from a cost benefit perspective. We can assume that we are going to have a permit for the Herring River but if that does not happen, they would put a lot of money into the system. DB —there was commitment that there would be watershed permits and we would share costs. Who and how it gets picked is something the joint meeting with the Select Board will need to answer? DB — we are trying to prove that technology does exist and has full approval which it does not. JK —We expect that there will be a Herring River watershed permit. We are looking to add the permits over the next 5 to 7 years. DB — we do have several alternatives: we could buy credits from Harwich and this would not be an issue JK — we could easily find out that the nitrogen removal within the various water bodies in the Herring River Watershed are such that the existing properties do not need to do anything. DS —that is a discussion that is being held at the Wastewater Task Force right now. I just learned today that these overlapping watersheds have a partial contribution for each one and I think what we must keep, the committee must keep in mind that we have to account for build out and we cannot have any more nitrogen. We either deny people any rights to build on vacant property or we must reduce nitrogen across the board. Because you cannot add a 4 - bedroom house with 10 milligrams per kilograms of nitrogen with an I/A System and still maintain a level at 0 nitrogen balance. It is very problematic. JK — And there are lot of alternatives AA — These are big decisions ahead for the property owners, and we want to make sure that we are not be leading them astray or not giving them all the information. We went back and looked at the letter and I think we are directing them to bring your system into compliance. You should speak with your wastewater system operator with regards to any deficiencies. Go talk to an expert and if the expert is recommending to not use this system, then you have other options. KCP — What are the odds that these people who have received a letter will be calling the Board of Health and how will the BOH be addressing the phone calls? N:\Health\from Shari\MSWORK FOLDERS\MEETINGS\BOH\Aug1623m.doc AVH - Based on the response or lack of response from the Pressure Dose Letter I am not expecting a lot of phone calls with regards to these letters. And I agree with Abigail that we should direct the homeowner to reach out to their wastewater system operator and determine why they are not meeting the requirements and determine next steps. KCP - Is it possible that the operator might say to them that they need a new system? AVH - I doubt it. KCP - Okay, that was my concern. They could be told now that they need a new system and in two years, whatever happens, they could be told again that they need a new system. I think we want to be as conservative as possible. Maybe we want to generate some sort of a grace period pending the decision of the town as to which direction they are going to go watershed versus individual homeowners. AVH - and I agree that this Board should be sensitive to all these issues. There is still a big question mark. DB - I think the intent of this letter and the discussion with the engineers is to bring this all out the problem is we do not have any directive, so we do not know what our solution is. We cannot say "we are going to need 70 I/As there because there are 60 lots and how are we going to do that'. Which is the problem in other places. DB - the idea is to engage and inform them to have consultations with their representative to do the right thing for us but right now we have an outstanding approval for meeting 25 and they are not doing it. The intent is to have these discussions. DB - this letter is not an enforcement, but we are asking them to engage us in the discussions because we are going through all of this in the context of the new regulations, but you are not meeting the current regulations. You need to understand you have an obligation on this lot that needs to be addressed AA - what about customer that find out later that they could have tested out an I/A system? Had we known about this opportunity we might have made a different decision. Is there a role for us to put in a one pager about the new Title V regulations along with this letter? This would show that the BoH had done their due diligence in letting them know that there are changes coming. DB - there was a letter that was supposed to be going out to all homeowners stating what this regulation would mean to them and who might be affected and what the general concepts are which will be reviewed during our Monday meeting with the Select Board. DB - The Title V gave a way to any new systems installed in the past 5 years. Correct? AVH - I thought it was less. DB - In the next 5 years we need to meet this requirement. This conversation is to bring the awareness under the new Title V regulations in the context of what are the alternatives. Motion: Vote was to issue the letter Motion: John Keith Second Kimberley Crocker Pearson Vote: 5-0 Action: Motion carried Brew TH0007ADV - 2006 Installation of an Advantics AX20 Property is in Zone 2 DCPC and Pleasant Bay Watershed - Review property against the two flow charts - Summary of the analytical results with a median of 30.85 Motion: Vote was to issue the letter Motion: Kimberley Crocker Pearson Second John Keith Vote: 5-0 Action: Motion carried Brew OLD078 200 Installation of a Single Air System Property is in a Zone 2 DCPC Private Well and Cape Cod Watershed - Reviewed what is Remedial Approval does not require the same level of testing - Reviewed property against the two flow charts - Summary property is within a nitrogen sensitive area; it does not meet the 300 -foot requirement - Has a private well did meet the 4 -bedroom 40,000 square foot requirement - Just doing a straight upgrade but they are on an undersized lot - This is a seasonal property total nitrogen is below the defined limits - If we do not send the letter, we would not exempt them from further testing. - Might want to ask for well testing to be done. Past test show nitrates less than 1 %. The well is between the pond and septic system Motion: Vote was to NOT issue the letter Motion: John Keith Second Kimberley Crocker Pearson Vote: 5-0 Action: Motion carried BREW LON159 John drove the discussion as David had a previous relationship with one of the companies mentioned Limit of 19 and the actual numbers reported have lows of 8 to highs of 79 Reviewed the property against the flow charts This is an older system: a BioClear System and the company does not do residential installation any more 15,000 square foot lot and was designed for 2 -bedrooms and is in Zone 2 in the DCPC The I/A system gave them the option to have a 2 -bedroom otherwise they would have been limited to a 1 -bedroom Could be a seasonal property and is beyond capacity during the summer season. The nitrate levels for 3 of the last 5 years are very high Motion: Vote was to issue the letter Motion: Kimberley Crocker Pearson Second Penny Holeman Vote: 5-0 Action: Motion carried N:\Health\from Shari\MSWORK FOLDERS\MEETINGS\BOH\Augl623m.doe 9. Liaison Reports Opioid/Narcan updates KCP — recapped what was reviewed during the last meeting and new developments with regards to regulatory changes There is new acute treatment which includes Narcan (Naloxone) which is now available over the counter. Currently your insurance will pay for the Narcan until the end of September 2023. There is a new campaign out of the DEA called the One Pill Can Kill initiative which is targeted to young adults. Based on the information from the last meeting we have the go-ahead to make a brief informational video for the town website. KCP will be working on the video which will include a few slides with a voice over and will include how to access Narcan and how to administer Narcan when dealing with an Opioid overdose. The video should be up on the website by next month. JK — talked to two people who have interest in this topic: 1 an EMT in Orleans and 2 CEO of lower Cape Outreach. The EMT stated that the EMT, Police and Fire Departments should all always keep Narcan available. If we had the money, how could we get Narcan to the people or the families of the people at risk. KCP — talked to a CVS Pharmacist that does presentation to kids about the dangers of Opioids. DB — Narcan is the reactive way to save lives, what we need to do is educate the public. DB — are there Fentanyl test kits? Is there a way to identify Fentanyl laced products? KCP — there is color assay test which goes along with the 5 -panel quick screen. KCP — does not know the cost of the test but it used in the field and emergency room. DB — this is the leading cause of death among young people KCP — it is a designer drug that sole purpose is to get you addicted KCP — selling is now done by cell phones and all done by errojis which has made enforcing the laws that much harder KCP — the One Pill Can Kill presentation is going out to schools to help raise awareness KCP — DEA has put a lot of work into the One Pill Can Kill campaign. DB — looking forward to hearing updates on the program with regards to our allocation of funds. Water Quality Review Committee DB — asked John for update JK — group is not meeting until 8/25 DB — there is a mound/sandpit across from the Captain's Golf Course that looks like it is being refurbished Health and Human Services/ COA PH - during our last meeting there was a great deal of interest in the new watershed regulations that became effective in July. People want information and they do not know what to say to a potential buyer. We have a meeting scheduled to work on this next week. DB — I am not surprised, and I am looking forward to a statement being made by the town that you can paraphrase without going out on a limb. DB — I was surprised that the letter was not included in the package at Thursday's meeting. Were we expecting that an announcement was going to go out? KCP — next meeting is on Thursday where these items will be reviewed, and the joint meeting will be the following Monday. JK — Mark Nelson is working on the supporting presentation Recycling Commission AA — recycling commission last met on July 18th and they have not met since that time so there is no additional update. DB — on the Wastewater Committee we continue to meet and will make a presentation to the Selectmen which will make an update on policy and how we are proceeding with these items. This will include a statement to the public and a commitment by the town to address these issues one way or another. There will be more to review during the next meeting. DB — I would encourage you/Amy to ask any questions that you have during those meetings or bring into perspective what the Board of Health issues are, what are the capacities we are in enforcing I/A Systems. AVH — will everyone be able to make the meeting on the 26"'? All responded yes. AVH — the meeting start time is 6:00 PM however the agenda has not been published DB — confirmed this is a joint meeting 10. Matters not reasonable anticipated by the Chair None. 11. Items for next agenda - Using Hawaii as an example — what is our local fire plan from the human perspective, can we put this on a future agenda based on draughts and some fire activity at Nickerson. What is our plan for turning off our power grid if required? Should we request a letter from Eversource for the plan, but we should ask the fire department first. Amy will check with fire and provide an update. - Warning systems for alerting Brewster residence - Wildfire prevention plan, for example -controlled burns 12. Next meeting: September 6, 2023 N:\Health\from Shari\MSWORK FOLDERS\MEETINGS\SOH\Augl623m.doc Noted. Informational items noted. Meeting adjourned at 7:42 PM. *Accompanying documents in packet: Agenda, Opioid information, informational items N:1Hea1th\from Shaii\MSWORK FOLDERS\MEETINGS\BOH\Aug1623m.doc