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HomeMy Public PortalAbout20231218 - Board of Health - Agenda PacketNOTICE OF MEETING HOPKINTON HEALTH DEPARTMENT Date: Time: 5:30 p.m. Location: Senior Center 28 Mayhew Street (Arts & Craft Room) AGENDA https://us02web.zoom.us/i /87828089522?pwd=WTIkYVhKcEp5aWQ 1T1IsVGoOdmhYUTO9 Meeting ID: 878 2808 9522 Passcode: 717992 Plastic Bags Discussion/Peggy Barton - Request to Approve the Hearing Meeting Minutes of October 30, 2023-(Pg. 4-5) Request to Approve the Board's November 27, 2023 Meeting Minutes-(Pg. 6-12) Director's Reimbursement(s) and Approval of MEHA Seminar & MHOA Membership Payments- • USPS • Mileage • MEHA • MHOA $130.55 $41.27 $100.00 S 60.00 $331.82 BOH Future Meetings-(Pg. 20) Request Support for VaxCare Agreement-(Pg. 21-29) Department's Annual Town Report Narrative for FY2023 Review & Approval-(Pg. 30-32) Records Digitization Update/IT Manager - Department's FY'24 NOVEMBER Budget Summary - Strategic Plan Meeting Update PFAS Update Public Health Nurse Report-(Pg. 35-36) Director's Report-(Pg. 37-38) Note: The listed matters are those reasonably anticipated by the Board to be discussed at the meeting. Not all items may in fact be discussed and other items not listed may also be brought up for discussion only to the extent permitted by law. Unless an agenda item is a posted Public Hearing, the matter may be considered earlier than the indicated time if there are last minute cancellation(s) or other unforeseen events which cause the Board to move more quickly through the agenda. Iri9pki,nt9n Agenda Item 1 message Nidia LaRoche <nlaroche@hopkintonma.gov> Peggy Barton <goodiegumdrops@gmail.com> Fri, Dec 8, 2023 at 10:11 AM To: Shaun McAuliffe <SMcAuliffe@hopkintonma.gov>, nlaroche@hopkintonma.gov, Bryan Besso <bryanb@hopkintonma.gov>, Simone Carter <scarter@hopkintonma.gov>, kobika@hopkintonma.gov Board of Health Dear Shaun and Board members, As suggested by the Board, I'm submitting a request that we discuss the dilemma of Plastic Bags being distributed in Hopkinton, despite the Bag Ban. CVS in particular shells out hundreds a day. If their excuse is that they are "reusable", I would defy that; that designation should lie not just in the gauge, but in the INTENT; if people are having them automatically foisted upon them, they have no intention of saving and reusing them, thus they are DE FACTO single use! You know they'll be tossed in the trash as soon as they get home. Only if you intentionally purchase a reusable bag can it be considered truly multi -use. This legal loophole is a brazen violation of the spirit of the law, seems corporate finagling. Also in Price Chopper, in the produce section, we've all seen the reams of bags being torn off by the thousands. This is at stunning variance with the ban. There are other alternatives: Offer small paper bags by the vegetable stands; along with a rack selling reusable bags right in that section. This should appeal to the store's zeal to reap more profit! People may initially object, but we've seen how quickly they adapt, and many now bring their own bags as a matter of course, and could also bring their own empty bread bags etc. for their produce. Regarding "recycling" of bags or any plastic; it's growing knowledge that recycling is a sham: 95% of plastic NEVER GETS RECYCLED, and ends up in landfills, incinerators, and oceans in whales' stomachs and turtles' mouths. Until people are willing, or mandated, to make changes in their daily practices, this planet is doomed. Whichever meeting date that's convenient for you is fine with me. Thank you for your consideration! Peggy Barton (I'll attach a few relevant links re. the plastic plague.) PLASTIC SOUP: e 1 The Issue Bogus solutions RECYCLING MYTH Over the last few years, multinational companies set goals for plastic waste management derived by single -use packaging. These goals are all similar; McDonald's, Procter & Gamble, Unilever, Coca-Cola and other major companies all promise that by 2025 or 2030, their packaging will consist of 100% of renewable, compostable, or recycled materials. What these companies fail to mention is that plastic productio grow by 40% in the next ten years and that they want to profit from this development.. PLASTIC= SOUP! THE PROCESS OF RECYCLING PLASTIC IS A MYTH The problem with recycling plastic is that it doesn't really happen. For example, plastic litter is not separated during collection in The Netherlands. It can't be used to make the same products again; for example, food packaging that is recycled cannot be used again as food packaging. Until recently, some of the western world's plastic waste was exported to China to be recycled. China, however, no longer wants our plastic rubbish. The flow of rubbish has shifted to other Asian countries, but they, too, are beginning to implement restrictions or are closing their borders to foreign plastic waste. Countries need to deal with their own plastic waste. In theory, all plastic can be used again. The suggestion, however, that the issue of plastic pollution can be solved through recycling is a myth. In reality, only 9% of all plastic in use worldwide is recycled, and the majority of this recycled plastic is of inferior quality. The process of recycling is, for the time being, downcycling, which results in an undiminished use of new or 'virgin' plastic. ALLIANCE TO END PLASTIC WASTE At the beginning of 2019, 30 of the world's top industrial companies formed a partnership, the Alliance to end Plastic Waste (AEPW). During the formation of this alliance, these companies agreed to invest 1 billion dollars in combatting plastic pollution. One of the ways in which the Alliance supposedly does this is through the promotion of more and better recycling, especially in countries which, at present, lack the necessary infrastructure. Oil and gas industry giants such as Shell, ExxonMobil, and Dow are amongst the AEPW, but these same companies profit from the use of cheap shale gas as raw material for plastic, and they invest tens of billions of dollars in new plastic factories. On the one hand, these industry giants act as if plastic pollution can be combatted by recycling. On the other, by swamping the market with virgin plastic,' BOARD OF HEALTH Town of Hopkinton, Massachusetts Hopkinton Senior Center 28 Mayhew -Great Room Monday, October 30, 2023 at 6:00 p.m. Public Hearing MINUTES Members Present: Also Present: Absent: Late Arrival(s): Early Dismissal: Chairman, Dr. Richard Jacobs Shaun McAuliffe, Health Director Vice Chairman, Nasiba Mannan Regina Miloslaysky Chairman Jacobs called to order the Public Hearing at 6:40 p.m. by announcing the following: The Board of Health welcomes the public to the Hopkinton Health Department's Public Hearing on the Biosafety Regulation; the hearing is televised. Chairman Jacobs broadcasted the Purpose of the hearing and the Order and Conduct for the hearing. Chairman Jacobs recited a copy of the legal notice to the public. Mr. McAuliffe acknowledged that no public comments had been submitted to the Department for this hearing. Mr. McAuliffe acknowledged that only Public Health Nurse Simone Carter was present in the audience between 6:00 p.m. and 6:40 p.m. (the start of the public hearing). Chairman Jacobs provided a brief summary of the newly drafted BioSafety regulation and noted that the City of Cambridge's BioSafety Regulation had been used as a template for the Hopkinton Health Department and that the Hopkinton Health Department had consulted with representatives from the City of Cambridge on the regulation. Chairman Jacobs noted that several "housekeeping" issues had been identified during the final review of the regulation and that the final review had been completed after the hearing notice was posted. A motion to consider the edited version of the BioSafety regulation was provided by Member Miloslaysky. Chairman Jacobs seconded the motion. Member Miloslaysky voted to proceed with the review of the edited version. Chairman Jacobs seconded. In summary, both voted to review the edited version. Mr. McAuliffe reviewed the list of edits. Upon completing the review (copies of the edited copy were available to the public), Member Miloslaysky motioned to adopt the edited version of the BioSafety regulation. Chairman Jacobs seconded. Both voted to adopt the edited version of the BioSafety regulation for consideration and later vote. Chairman Jacobs inquired as to whether the audience or anyone on the live feed had submitted or voiced any comments about the edited regulation. None were voiced or noted by the representative from HCAM. The representative from HCAM noted that the only inquiry that had been received was BOH October 30, 2023 Minutes -PUBLIC HEARING Page -4 related to the revised starting time of the hearing. After waiting 20 minutes, the full scheduled time of the hearing, Chairman Jacobs motioned to close the public hearing at 7:00 p.m. Member Miloslaysky seconded. Chairman Jacobs motioned to approve and Member Miloslaysky voted in favor of the new regulation. Chairman Jacobs motioned to approve the BioSafety regulation. Member Miloslaysky seconded. Member Miloslaysky and Chairman Jacobs were both in favor. ADJOURN: Chairman Jacobs motioned to adjourn the Board of Health Public Hearing Meeting at 7:05 p.m. Member Miloslaysky seconded. Member Miloslaysky and Chairman Jacobs were in favor of closing the hearing. Respectfully Submitted, Shaun McAuliffe Health Director BOH October 30, 2023 Minutes -PUBLIC HEARING Page 2 HEALTH DEPARTMENT Town of Hopkinton, Massachusetts Monday, November 27, 2023 MINUTES Members Present: Chairman Richard Jacobs, Vice Chairman Nasiba Mannan and Regina Miloslaysky Also Present: Shaun McAuliffe, Health Director; Simone Carter, Public Health Nurse Absent: Late Arrival(s): Early Dismissal: Mode of Participation: In Person and Virtual The meeting was called to order at 5:32 p.m. by Chairman Jacobs. Public Comment- Members of the community are invited to share ideas, state opinions or ask questions Peggy Barton and Diane Hayward from the Sustainable Green Committee presented their plastic bag from CVS and grocery product bag concerns and asked what kind of remedy the Board would suggest Chairman Jacobs informed Ms. Barton and Ms. Hayward that unfortunately, under the open meeting law a discussion of said topic would not be allowed. Ms. LaRoche explained that since the topic is not on the agenda the topic can't be discussed nor a vote would be able to be taken. She further explained the procedure as to how Ms. Barton and Ms. Hayward would be able to officially have their concerns addressed. Both Ms. Barton and Ms. Hayward understood the procedure and will submit their request to come before the Board in writing. Mary Ellen Gambon from the Hopkinton Independent joined the meeting virtually at 5:44 p.m. Request to Approve the Meeting Minutes of October 16 , 2023 Ms. LaRoche requested approval of the Board's meeting minutes of October 16, 2023. Ms. Miloslaysy motioned to approve the minutes of October 16, 2023, as presented. Vice Chairman Mannan seconded. Roll Call: Chairman Jacobs Yes, Vice Chairman Mannan Yes and Ms. Miloslaysky Yes. Director's Reimbursement for Quarterly Meeting and Mileage to MHOA Conference MHOA Quarterly Meeting MHOA October Conference $25.00 5100.88 $125.88 BOH November 27, 2023 -MEETING Minutes Page 1 Ms. LaRoche requested approval for Mr. McAuliffe's MHOA Quarterly meeting fee and mileage and for the MHOA October Conference mileage to be reimbursed in the amount of $125.88 Ms. Miloslaysky motioned to approve the Director's reimbursements, as requested and detailed by Ms. LaRoche, in the total amount of $125.88. Roll Call: Chairman Jacobs Yes, Vice Chairman Mannan Yes and Ms. Miloslaysky Yes. Records Digitization Update/IT Manager Ms. LaRoche informed the Board that the first shipment of 10 boxes was completed last week. In the coming days the IT department will be working with the vendor to try to improve the scanning procedure for the next round of boxes that are slated to be shipped out in a couple of weeks. She also mentioned that in the next couple of months the IT department will have a better cost measure to determine if it would be feasible to have the rest of the files scanned by the department. Ms. LaRoche voiced that everything is going very well and she is very happy with the progress. Department's FY' 24 OCTOBER Budget Summary Ms. LaRoche offered the department's October 2023 budget expense summary and stated that for the month of October the department's expenditures were a total of $10, 788 which leaves a balance in the operating budget of $59, 312.09 to be expended by June 30, 2024. Chairman Jacobs asked what kind of expenses attributed to the $8,505.61 expense. Mr. McAuliffe and Nurse Carter replied that the purchase of vaccines makes up that expense. FY'25 Draft Budget Discussion Mr. McAuliffe informed the Board that for the proposed FY '25 budget the total operating expenses is projected to be $99,000 with the bulk of the increase of $10,140 focused on the medical services item line to purchase vaccines. He commented that his meeting with the senior leadership supported a 4.3% increase after he pointed out the gifts, revenues and grants that the department has brought in for the town, with those additional revenue counted the increase is actually 2.1%. Ms. LaRoche stated that the proposed FY25 budget will come before the Board for their approval after completing its cycle through the appropriation committee. Strategic Plan Meeting of October 24, 2023 Update/Vice Chairman Mannan Mr. McAuliffe presented to the Board a synopsis of the strategic plan's first meeting of the advisory group. He voiced that the following department were present: • Town Manager's • South Asian Circle • Nursing Department • Resident(s) • Youth & Family Services • Fire Department BOH November 27, 2023 -MEETING Minutes Rage 2- 10,1 .11 • Senior Center • Representative from the Board • Department Staff and Director • Advisory (MAPC) Representatives The following department were not present: 6 School Department 9 Police Department • Chamber of Commerce Introductions were made and discussion proceeded to explain and inform the advisory group why they were invited, selected, the department's strategic plan outline and input of any kind that they would like to share with the group in regards to the department and community goals. He said that they engaged in break out sessions to voice any pressing issues associated with the department, comments and ideas they thought needed to be addressed. Mr. McAuliffe said that having this meeting with the advisory group will enable them to be lined up with the Stakeholders meeting once that is introduced. He stated that everybody found it very productive, constructive and exciting. The next internal meeting will be on December 6th and will focus on the next strategic meeting and the survey that will be sent out to the community He noted that this also puts the department in alignment with the Select Board's objectives and goals. Vice Chairman Mannan noted that when they broke into groups the South Asian Circle and the Fire Department were part of her group and that is where she became aware that the residents of Legacy Farms have a huge communications and cultural issue as to when to call for help. Nurse Carter noted that during her group discussions the takeaway was that the department does an enormous amount of work under the radar and that the department does not sell themselves. PFAS Update Mr. McAuliffe stated that he believes that the EPA will be adopting the more aggressive 4 ppt PFAS standard across the board. The aggressive 4 ppt ruling does not cover private drinking wells and noted that the EPA and DEP's website have conflicting information on their website stating that if a private well tests above 20 ppt the property will be considered a hazard waste area and in another section of their website it states that DEP will not consider the property a hazard waste site if the count is higher than 20 ppt. He has addressed this with EPA & DEP and they have not responded. Mr. McAuliffe stated that we need DEP and EPA's guidance as to how to move forward with this and how the enforcement and education of different water standards will be addressed to the private well owners. Vaccination Discussion Mr. McAuliffe said that on the administrative side, one of the biggest challenges, that he faces, as a director, is that the State has a set of goals that the local boards of health need to accomplish which one of those goals is to provide an array of vaccines to the public (RSV, Shingrex, Flu, Covid..etc). BOH November 27, 2023 -MEETING Minutes Page 3 Because the department has to buy vaccines in the open market and the ancillary kits the cost would be approximately over $200,000. Under the current vaccine registration system the claims are sent out; however, the system does not allow to correct any errors that the registered person has entered in a timely manner; therefore, creating a cost decrease to the reimbursements that are needed to purchase more vaccines. In addition, during a clinic the staff needs to verify each individual line text to confirm that the information inputted is correct; by staff conducting these validations on clinic runs it is extremely time consuming and not as efficient as it should be. Mr. McAuliffe said that he and Nurse Carter conducted an audit process and the finding facts are the following: • The department can't go back to make corrections • The system takes too long to process and/or find out that a claim(s) is/have been rejected • The department has been waiting over 3.5 weeks for a request that was placed for: 1. the number of shots that were administered 2. claims that were reimbursed and rejected for calendars years 2020, 2021, 2022, 2023 and to date still do not have the data. Through conversation with the point person of the current system it was discovered that the claims processing group sent this task to another group to be conducted and to date we are still waiting for the data. Mr. McAuliffe stated that after discussing the additional services needed from the organization it was concluded that they would provide those services at additional cost. He said that he and the Town Manager both agree that trying to carry a $200,000 expense across two fiscal years is not feasible, especially when the department will still need to purchase another $200,000 of vaccines. He noted that a solution was needed and said that Nurse Carter and Nurse Mauro step in to find a solution. Nurse Carter said that they have found a group (VaxCare) and are still in discussion with them and have brought the idea of State beta testing to the DPH. She explained that VaxCare shows up, provides the software, computers and vaccine to process each claim. Each claim is in a medical inventory tracking format which confirms the registrant's medical information in real-time; therefore, eliminating any errors on the spot. Due to the fact that VaxCare is providing the vaccine they are vested in their service that they provide. Nurse Carter noted that she believes that this is a win -win proposal by increasing the department services and getting a little cost back to off -set our budget. Mr. McAuliffe noted that he has discussed VaxCare and State beta testing with DPH and they have voiced their support. He also indicated that he will reach out to North Attleboro on Wednesday and will also contact out of state communities who are using VaxCare for their comments and experience. BOH November 27, 2023 -MEETING Minutes Page 4 The Board thanked and voiced their support for their presentation of VaxCare. Public Health Nurse Report Public Health Nurse updated the Board on the following: Disease Surveillance New Dashboards rolled out per DPH—will reflect rates of RSV, influenza, and Covid. May be accessed tiers: Regional EMS Opioid Incidence Dashboard may be accessed Community Outreach 6 Narcan/Risk Reduction --2nd Tuesday of each month in Library • Vaccination clinics successful • Wellness and BP Clinics / Senior Center Outreach weekly at Senior Center -these programs are growing as demand grows • To date 572 vaccines have been delivered. We anticipated another 50 doses to be administered over the next month. Partnering in Education/Preceptor Hosted 2 nursing students from Worcester State University Nursing Program who participated in VFC clinics and Senior programming Upcoming • Vaxcare • Healthy Brain Initiative Program Planning • Website/Messaging • Strategic Planning per Health Director Snap shot of Public Health Nursing Services October 2023 BOH November 27, 2023 -MEETING Minutes Page -5 We had 70 client encounters in October (excluding vaccination clinics) Count of What is the purpose of the encounter? Risk reduction. Educ... Medical, Health Pro... - Medical Medical. Health Pro... Behavioral Health Education Health Promotion/Di... Director's Report The Director updated the Board with the following: Food, Pool and Housing Inspections 1. The Department had received several food and business complaints related to improper temperature control of a food product, distribution of expired food, unpermitted food distribution and illegally operating apartment rentals (no heat or smoke detectors). The Director addressed the temperature control complaint, met with the Store Director and observed all cold holding to be compliant. The complaint against the food pantry was unfounded as they are permitted to distribute out of code (food beyond its use by date). A vendor was observed to be "delivering food" to the rear of the CVS Pharmacy. The Department is working to identify the source of the food that is being distributed. The housing case remains open. Inspectors from the municipality have been dispatched to the home to assess whether the repairs were completed without proper permits and inspections. The owner had been issued a cease and desist letter. Well and Septic 1. The discharge from the Legacy Farms treatment plant was determined by the MDEP to be out of regulatory compliance. The MDEP issued a notice of non-compliance to the owner. The owner and operator have been ordered by the MDEP to bring the plant into compliance. Arbovirus / Mosquito Control 1. The Arbovirus season has ended. Last week's frost should have killed the majority of adult mosquitos. Based on the presence of EEE positive water bodies to the southwest of Hopkinton this Summer and Fall, the Department will be engaging the Central Massachusetts Mosquito Control Project to treat our swamps and water bodies with an organic larvicide next Spring. Allergen 1. The Hopkinton Independent has interviewed Reese Robledo, her family and the Director about the playground allergen signage. Fox25 may interview her before December. The signage for BOH November 27, 2023 -MEETING Minutes Page -6 ej•Il EMC park has been approved. The MDPH/APHC will assist the Health Department in taking this program statewide. Our intern will be developing additional program content. MDPH Work 1. The Health Department is distributing COVID-19 test kits again to the public at no cost. Additional kits have been delivered to PJB. 2. The Department is auditing the MDPH's insurance claim processor (refer to vaccination discussion) 3. The Department started working with the school district to recover food from the free breakfast and lunch program. Recovered food has been delivered to PJB. 4. We resubmitted our annual Opioid Disbursement Report to the Commonwealth. Though Y&F Services and Health cannot access the settlement money until we go to town meeting, the town has received more than $45,000 to date. 5. The Director is working with UMass, Tufts and Tick Report staff to collect deer blood and deer ticks for disease surveillance. As a reminder, residents from Hopkinton are eligible to receive 0 to $15 tick testing from TickReport.com. 6. The Director and our intern, Nora Connors, are coordinating refugee/shelter aid for the PHEP 4AB communities. ADIOURN: Ms. Miloslaysky motioned to adjourn the Board of Health Meeting at 6:45 p.m. Chairman Jacobs seconded. Chairman Jacobs Yes, Vice Chairman Mannan-Yes and Ms. Miloslaysky Yes. Respectfully Submitted Nidia LaRoche Administrative Assistant BOH November 27, 2023 -MEETING Minutes Page -7 P • 1I NOV 2 2023 :Z13144Y3iFEDSTATES PO'rri.IE Erari E'. ..-02KINTON 5 C=DAR ST NOPKITT0' MA 3174.8-9908 (856)275-8777 11/21/2023 09:46 AM product 0ty Jilt Price Price 'M Express 1 -Da :l $130.55 Haverhill, l'A 3:-3:35 We,ght: 42 Ai 7 3 oz Signature Requested Scheduled De; l i ve -v .J to Wed 11/:2/2023 35:00 PM Money Back Cuarir v:ee Tracking #; EI640192203[l; Insurance $0.00 Up to $100.03 1 r_1 uded Total $130 55 grand iota1 ;redi t Card Rern r Card Name: 1;i over - Account #: )t)(X><)(K);){KuH1(3142 Approval #: 021412P Transaction #: 495 AID: A0000i)G1523310 AL: Discover PIN: Not Recui••c:5 $1.1C1.55 $130.55 Chip Save this re:eip1 3S evidence of insurance. For i '.1r 'rrlat l oo on filing an i nsuran:e claim go to https://www.uscs-con/help/cl.aims.11tm or c<;i 1 80W-222-1811 Text your trackrn lulilotr to 28777 (2USPS) to get the latest cstat,r5. Standard Message and Data rates ray a :l y. You may also visit www.usps.c n USPS Tracking or call 1-803-222-1811. Previ ;tw yo_ - Mall Track_ yo 1r- ?aCKageS for FREE 4 https://iWorib liverv.usps.com All salt I:nai of st'mps and postage. Refund 'for oa:al:ee:1\rervices only. arlk ycu ta:- vox ,1 iness. /Tel'I us oboJt yo_<- e>:pJ-ience. Go o: https://p;:stalaxperieryce,com/Pos or skan this ccde with your rnolti l e device, or ca' 1 1-300-410-7420. JFN: 2436V4-074 ; - teoei pt # \840-!'01i0))8-1-845439,-/ Vehicle Mileage Log for F 65.5 cents as of 7/1/2022 DATE 12/8/2023 7 Locations in Framingham a nd PJB Picki ng up donated strollers for PJB and Ref. Sha un McAuliffe DESTINATION PURPOSE BOH Chairperson & Health Director's Signatue: Total: MILES 0 .655 AMOUNT 63 .00 63.00 $0.655 $0 .655 $41.27 $0.00 $41.27 2/5/23, 1:12 PM Town of Hopkinton, MA Mail - [MEHA] Invoice 30700 for order 30700 from December 5, 2023 Shaun McAuliffe <smcauliffe©hopkintonma.gov> [MEHA] Invoice 30700 for order 30700 from December 5, 2023 1 message MEHA <admin@maeha.org> Reply -To: MEHA <contact@maeha.org> To: smcauliffe@hopkintonma.gov MASSACHUSETTS ENVIRONMENTAL HEALTH ASSOCIATION Invoice for order 30700 Billing Address Shaun McAuliffe Town of Hopkinton Health Department 18 Main Street Hopkinton, MA 01748 Title 5 Seminar Ticket 2024 Member Customer Details Tue, Dec 5, 2023 at 1:11 PM Remit to: P.0 Box 385, Dedham, MA, 02027 Order Date: December 5, 2023 1 $100.00 Subtotal: $100.00 Payment method: Pay via check Total: $100.00 • Email: smcauliffe@hopkintonma.gov • Phone: 508-497-9725 ps://mail.google.com/mail/u/0/?ik=863ae0fae3&view=pt&search=a II&permthid=thread-f:1784466513731077067&simpl=msa-f:1784466513731077067 1/1 12/5/23, 1:12 PM Checkout - MEHA Product Total Title 5 Seminar Ticket 2024 Member MEHA Title 5 Seminar 2024 February 21, 2024 @ 8:30 am - 4:00 pm Ticket ID MT5S2024-15-HEA4DK Attendee First Name Attendee Last Name Attendee Email Attendee Place of Work Acknowledgements Security Code Subtotal: Payment method: Total: Shaun McAuliffe smcauliffe@hopkintonma.gov Hopkinton Health Department I understand that if I am unable to attend this training, I must notify MEHA by emailing admin@maeha.org no later than February 13, 2024 to be eligible for a refund., I understand that registration fees are nonrefundable after February 13, 2024., I understand that, for cancellations received after February 13, 2024, I will be responsible for payment of the registration fee., I understand that if I am not in attendance at the seminar on February 21, 2024, will still be responsible for payment of the registration fee. ac7bc60b05 $100.00 $100.00 Pay via check $100.00 https://maeha.org/checkout/order-received/30700/?key=wc_order_NOJYCofCAJ8mx 2/4 /5/23, 1:12 PM Checkout - MEHA YOUR TICKETS Title 5 Seminar Ticket 2024 Member - $100.00 Billing address Shaun McAuliffe Town of Hopkinton Health Department 18 Main Street Hopkinton, MA 01748 �% 508-497-9725 smcauliffe@hopkintonma.gov My Cart ittps://maeha.org/checkout/order-received/30700/?key=wc_order_NOJYCofCAJ8mx 3/4 F at n Fwd: MHOA Membership Application - Confirmation 1 message Nidia LaRoche <nlaroche@hopkintonma.gov> Shaun McAuliffe <smcauliffe@hopkintonma.gov> Tue, Dec 12, 2023 at 12:30 PM To: Nidia LaRoche <nlaroche@hopkintonma.gov> My MHOA renewal Forwarded message From: Massachusetts Health Officers Association <dhalley@mhoa.com> Date: Tue, Dec 12, 2023 at 12:29 PM Subject: MHOA Membership Application - Confirmation To: <smcauliffe@hopkintonma.gov> SErrs, 1!►1VI..�Ll.O� ( `I ( .A , t Thank you for renewing your membership with the Massachusetts Health Officers Association! RECEIVED DEC 12 2023 TOWN OF HOPKINTON Please remember, if you selected to 'Pay by Check via Mail', to make checks payable to the MHOA and send with printed email confirmation to: Massachusetts Health Officers Association C/O Berkshire Bank PO Box 911 Worcester, MA 01613-0911 INVOICE Shaun McAuliffe Town of Hopkinton 18 Main Street, 3rd Floor Hopkinton, MA 01748 Charges Invoice #: 5149 Date: 12/12/2023 Charges: $60.00 Payments: $0.00 Balance: $60.00 12/12/2023 - 2024 MHOA Membership Renewal $60.00 Payments 12/12/2023 - Manual payment via Check - (Pending) $0.00 Completed Form Details Paidthru First Last Email Title Work phone Mobile phone Region Designations Healthdept Sectortype Billingaddress1 Billingcity Billingstate Billingzip Billingnation Membership Total ©2023 MHOA Executive Director Teresa Kett 12/31/2023 Shaun McAuliffe smcauliffe@hopkintonma.gov Health Director (508) 497-9725 6176868785 Region 4A MPH, RS Town of Hopkinton Public 18 Main Street, 3rd Floor Hopkinton MA 01748 US Regular Member $60 $60.00 EMAIL ADVERTISE 1 DISCLAIMER As of 11/23/22 MHOA's New Check Remittance address is: Massachusetts Health Officers Association C/O Berkshire Bank PO Box 911 Worcester, MA 01613-0911 Public Health Pre^•.rni Prurrotr. Proice.t Shaun McAuliffe, RS, MPH Health Director Town of Hopkinton 18 Main Street Hopkinton, MA 01748 (508) 497-9725 All email messages and attached content sent from and to this email account are public records unless qualified as an exemption under the Massachusetts Public Records Law. Visit us online at www.hopkintonma.gov. . i q 2o.?q January su Mo Tu We Th Fr Sa 2 3 4 5 6 7 8 9 10 11 12 13 14 I 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 3:0 11:• 17:0 25:0 February Su Mo Tu We Th Fr Sa 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18I 20 21 22 23 24 25 26 27 28 29 2:0 9:• 16:4) 24:0 ilsi. L7' • Hec: dai March su Mo Tu We Th Fr Sa 1 2 4 5 6 7 8 9 11 12 13 14 15 16 18 19 20 21 22 23 25 26 27 28 29 30 3:® 10:• 17:0 25:0 THIS TERMS OF SERVICE AGREEMENT (together with all Exhibits, this "Agreement"), made this 06/22/2023, (the "Effective Date") is entered into by VaxCare, LLC, a Florida limited liability company located at 3113 Lawton Road, Suite 250, Orlando, Florida 32803 ("VaxCare") and Family Practice and Internal Medicine of New Have County, LLC or (doing business as Family Practice and Internal Medicine of New Have County, LLC) located at 205 Main St, East Haven, CT 06512 ("Administrator"). BACKGROUND WHEREAS, VaxCare is a health care information and technology company that provides inventory management and dispensing solutions for vaccines, allowing vaccination of the CDC -recommended schedule of all ages across multiple immunizing specialties, including but not limited to pediatrics, family practice, internal medicine, and public health departments (the "VaxCare Services"). WHEREAS, Administrator desires to contract with VaxCare to perform the VaxCare Services, and VaxCare wishes to contract with Administrator for Administrator to administer vaccines on behalf of VaxCare (the "Administrator Services," and together with the VaxCare Services, the "Services"). NOW, THEREFORE, in consideration of the representations, warranties, covenants, and agreements contained in this Agreement, and for other valuable consideration, the sufficiency of which is hereby acknowledged, the parties hereto agree as follows: 1. Definitions Capitalized terms used herein shall have the definitions set forth on Exhibit A. 2. Licensing and Compliance 2a. Health Care Professional Services Provider. Administrator represents, warrants, and covenants that Administrator is, and will remain for the duration of the Term, either (i) a physician or other health care professional Licensed in the jurisdiction in which Services are to be provided hereunder; or (ii) an entity that employs or contracts with such individuals; or (iii) a public health department. 2b. Mass Immunizer Provider. VaxCare represents, warrants, and covenants that VaxCare is, and will remain for the duration of the Term, enrolled as a "mass immunizer" provider under the Medicare Program. 2c. Compliance with Law. 2c(i). Administrator covenants that all Vaccinations under the terms of this Agreement shall comply with all applicable Laws, including, but not limited to, the guidelines promulgated by the CDC and/or the Advisory Committee on Immunization Practices. Administrator represents that Administrator and its Vaccinators are authorized by Law to provide Vaccinations under the terms of this Agreement. Administrator represents, warrants and covenants that it and its Vaccinators are fully Licensed and shall remain fully Licensed throughout the Term. Administrator agrees to immediately cease the use of VaxCare Services and notify VaxCare in writing if any applicable License is revoked, canceled, suspended or otherwise limited in a way that would impact Administrator's ability to perform the Administrator Services in accordance with this Agreement. Administrator covenants that the Vaccinations shall be administered only at the Locations registered with VaxCare, which may be updated from time to time in accordance with this Agreement. 2c(ii). Each party to this Agreement shall strictly abide by all applicable Laws, including, without limitation, with respect to the confidentiality of patient information, HIPAA and all state equivalents thereto. Each party acknowledges that it is a covered entity under HIPAA and shall comply with requirements applicable thereto. Each party further acknowledges that the other party may use and disclose any information obtained under this Agreement, including without limitation Patient information and Administrator information, as permitted by HIPAA or for any other purpose not prohibited by law, including without limitation de -identifying such information and selling or otherwise disclosing such de -identified information. 2c(iii). Each of the parties expressly understands, agrees and covenants that no payment shall be made at any time, directly or indirectly, by either party to any physician or other person or entity as an inducement or remuneration for the referral or admission of a patient to the other party, and neither party shall take any action in violation of any applicable fraud and abuse laws, including, without limitation, 42 U.S.C. § 1395u(b)(6) (prohibition against assignment of Medicare Program payments); 42 U.S.C. § 1395nn (the Stark law limitation on certain physician referrals); 42 U.S.C. § 1396a(a)(32) (prohibition against assignment of Medicaid payments); or 42 U.S.C. §1320a -7b (criminal penalties for acts involving federal health care programs; prohibition on kickbacks), as any of the foregoing may be amended from time to time. 2c(iv). Each party represents and warrants that it is not an Excluded Provider. Each party shall notify the other party within five (5) days in writing after it receives notice that the notifying party is an Excluded Provider, or if it is aware of any threatened, proposed, or actual exclusion from any Federal Healthcare Program. The party receiving the notice shall have the right to terminate this Agreement at any time after learning that notifying party or any of its employees or contractors is an Excluded Provider. 2c(v). If there is any conflict between the terms of this Agreement and any Law, the provisions of the Law shall supersede this Agreement. 3. VaxCare's Obligations Subject to the terms of this Agreement, VaxCare hereby retains Administrator to provide Vaccinations on behalf of VaxCare, utilizing the VaxCare Services. To facilitate the implementation of the VaxCare Services, commencing on the Go -Live Date, VaxCare shall: 3a. Existing Non -Flu Inventory. Reimburse Administrator for the transfer to VaxCare's consignment inventory of Administrator's existing non -flu vaccine inventory, excluding Public Vaccines, as it exists on the Go -Live Date at the prices listed in the Vaccine Fee Schedule in Exhibit B. Payment terms shall be as mutually agreed in the Purchase Order based on Administrator's monthly VaxCare Vaccine usage. 3b. Existing Flu Inventory. With respect to influenza vaccines Administrator has on -hand upon Go -Live Date, VaxCare will not transfer these inluenza vaccines to VaxCare's consignment inventory. Rather, VaxCare shall reimburse Administrator for the administration of these influenza vaccines at the prices listed in the Purchase Order pricing in Exhibit B. Administrator shall be responsible for returning any unused influenza vaccines at the Go -Live Date in accordance with Section 4i. 3c. VaxCare Vaccine Planning & Delivery. Provide Administrator access to VaxCare Vaccine by arranging for delivery of VaxCare Vaccine to Administrator from a designated third party that has been approved by VaxCare. VaxCare reserves the right, in its sole and absolute discretion, to modify the Vaccine Portfolio immediately upon notice to Administrator via email or the VaxCare Site. Nothing in this Agreement shall be deemed or read to entitle Administrator to administer any particular number of VaxCare Vaccines. 3d. VaxCare Hub. Provide Administrator with a VaxCare Hub device(s) per terms and conditions of Exhibit C. 3e. Training. Provide reasonably necessary set-up, training and support to implement the VaxCare Services. 3f. On-line Tools. Provide online reports to Administrator via the VaxCare Site to allow Administrator to monitor activity under the VaxCare Services, including, but not limited to, reports associated with inventory, Vaccinations, and Administrator Compensation. 3g. Standing Orders. Provide Administrator with Standing Orders prior to the Go- Live Date and during the Term. To VaxCare's knowledge, the Standing Orders comply with all applicable Laws; provided, however, that it shall be Administrator's sole responsibility to ensure that all Vaccinations are administered in full compliance with all applicable Laws. If Administrator or VaxCare believes the Standing Orders or the Program Materials do not comply with all applicable Laws, the parties agree to notify one another and Administrator shall immediately cease the VaxCare Services until the conflict has been resolved. 3h. Administrator Compensation. Provide Administrator Compensation to Administrator in accordance with Section 5. 3i. Customer Support. Provide VaxCare Services customer support to Administrator via phone, email, chat and the VaxCare Site. 3j. VaxCare Vaccine Returns & Processing. Provide support to Administrator when Administrator returns VaxCare Vaccine in accordance with Sections 4h -4j. 4. Administrator's Obligations Commencing on the Go -Live Date, Administrator shall, and shall cause its employees and contractors to, perform the Administrator Services, and utilize the VaxCare Services, solely in accordance with this Agreement, including without limitation to: 4a. Handling VaxCare Vaccine and Public Vaccine. Conduct Storage and Handling as specified in the VaxCare Vaccine or Public Vaccine package insert, which can be found at www.immunize.org/packageinserts/. 4b. Ordering & Delivery. 4b(i).VaxCare Vaccine. Inform VaxCare of Administrator's regular office hours for purpose of scheduling VaxCare Vaccine delivery and immediately notify VaxCare of any changes to those office hours. Administrator shall accept all orders placed by Administrator under Section 3b and processed by VaxCare. In the event the VaxCare Vaccine is received in an unusable condition, Administrator shall contact VaxCare to process the return in accordance with Section 4j. Administrator shall record its VaxCare Vaccine inventory in the VaxCare Hub upon acceptance of delivery. 4b(ii).Public Vaccines. Arrange for the order and delivery of Public Vaccines according to the requirements of the applicable public program and Administrator's usual practices. Administrator shall record its Public Vaccine inventory in the VaxCare Hub upon acceptance of delivery. VaxCare shall not order and/or deliver Public Vaccines. 4c. Inventory Counts. Conduct weekly counts of existing VaxCare Vaccine and Public Vaccine inventory and record the results in VaxCare Hub (such process, the "Inventory Count"). VaxCare will charge Administrator, and Administrator shall pay, the Vaccine Fee for all doses of VaxCare Vaccine provided to Administrator and not accounted for during the Inventory Count. 4d. Training/Guidelines. Implement the VaxCare Services in accordance with the training and guidelines provided by VaxCare. 4e. Consent Forms, Notice of Privacy Practices and Acknowledgment for Pharmacy Benefit Plans. For any Patient receiving a Vaccination covered under a pharmacy benefit plan, obtain a Patient signature for the Consent Form and provide Patient with the Notice of Privacy Practices and Acknowledgment. Such Vaccinations are typically covered by, but not limited to, Medicare Part D benefit plans for shingles and Tdap vaccines. Administrator shall verify all information on the Consent Form. The parties shall work together to develop mutually agreed upon written operational processes to ensure Administrator collects the Consent Forms from and provides the Notice of Privacy Practices and Acknowledgments to Patients in a mariner satisfactory to VaxCare and in compliance with Law, which process shall include at a minimum that Administrator must submit to VaxCare all Consent Forms for a given calendar year prior to December 31 of that calendar year. If Administrator fails to provide VaxCare with a signed Consent Form in connection with a Vaccination covered under pharmacy benefit plans, VaxCare may charge Administrator, and Administrator shall pay, the Vaccine Fee for any related VaxCare Vaccine. 4f. Compliance with Law; Notice of Privacy Practices. Ensure that Administrator and all Vaccinators conduct Patient counseling and Vaccinations in accordance with all applicable Law, Standing Orders, VISs, applicable public program and FDA requirements for VaxCare Vaccine and Public Vaccine, or as otherwise ordered by an appropriately Licensed health care professional affiliated with Administrator. In addition, Administrator shall ensure that its Notice of Privacy Practices, including an acknowledgment that Administrator may share protected health information with third parties as permitted by HIPAA, is furnished to each Vaccination patient. 4g. Billing for Conforming Vaccinations. Not collect any co -payments or other amounts from a Patient, or bill a Patient's insurance plan, including, without limitation, for Administration and Vaccine CPT Codes, for Conforming Vaccinations. Administrator further agrees to provide to VaxCare all Patient information necessary for VaxCare to bill for Conforming Vaccinations provided to Patients and agrees that VaxCare shall be entitled to any and all reimbursement or payments for any and all charges associated with Conforming Vaccinations, including, without limitation, fees for Administration and Vaccine CPT Codes. 4h. Expired VaxCare Vaccine and Public Vaccine. Ensure VaxCare Vaccines and Public Vaccines are not administered after the applicable expiration date, as determined by the applicable manufacturer and applicable Laws. Any expired VaxCare Vaccine may be returned to VaxCare without Administrator being charged the Vaccine Fee, as long as the VaxCare Vaccine is in a form accepted by the VaxCare Vaccine manufacturer for return and are returned within 30 days of expiration date. Partially used or uncapped vials or syringes shall not be returned to VaxCare. All shipments of expired VaxCare Vaccine shall be coordinated between both parties. Expired Public Vaccine may not be returned to VaxCare, and is the responsibility of Adminsitrator. 4i. Unused Influenza (Flu) Vaccine —Administrator shall return unused influenza VaxCare Vaccine to VaxCare each Flu Season by the date communicated to Administrator by VaxCare in a form acceptable by the manufacturer in order to avoid being charged the Vaccine Fee. Partially used and uncapped vials or syringes shall not be returned to VaxCare and will be charged the Vaccine Fee. Administrator may only return up to twenty-five percent (25%) of each presentation of unused influenza VaxCare Vaccine that VaxCare shipped to Administrator each Flu Season. Any presentation of influenza vaccine returned and/or unused over 25% of the presentation of influenza vaccine shipments delivered to Administrator will be charge the Vaccine Fee in Exhibit B. With respect to unused influenza vaccine that was not supplied/shipped by VaxCare through the VaxCare Services but were instead purchased pursuant to Section 3b, then the Administrator shall be responsible for returning these unused influenza vaccines directly back to the manufacturer for credit. 4j. VaxCareVaccines Shipped in Error or Outside Temperature Storage and Handling Guidelines. If Administrator receives any VaxCare Vaccine shipped in error or outside the temperature recommended in the Storage and Handling guidelines, Administrator must accept the VaxCare Vaccine, contact VaxCare and follow return instructions. If Administrator follows return instructions from VaxCare, Administrator will not be charged the Vaccine Fee. 4k. Additional Services or Equipment Rental. Adhere to the terms of this Agreement for any additional services or equipment rental (such as VaxCare Hub devices) that Administrator has agreed to utilize in Exhibit C. 41. Hold Harmless. Except as set forth in Section 5b(ii), in no event, including non-payment by VaxCare, insolvency or breach of this Agreement, seek compensation, remuneration, or reimbursement from, or have any recourse against any Patient or any Patient's health plan. 4m. Special Rule for RHCs and FQHCs. For any period of time during the Term that Administrator participates in the Medicare Program as an RHC or FQHC, be in compliance with all Laws applicable to Administrator's status, including, but not limited to, 42 C.F.R. Parts 405, Subpart X and 491, Subpart A. Without limiting the generality of the foregoing, with respect to all vaccines furnished by VaxCare pursuant to this Agreement, Administrator acknowledges and agrees that if participating in the Medicare Program as an RHC or FQHC, Administrator shall not include costs related to any vaccines or administration, in any claims for health insurance payment, nor its CMS cost reports, nor the accompanying worksheets. Administrator is responsible for confirming and using current and correct documentation. 4n. Registration. Register with VaxCare, in a manner directed by VaxCare, each location where VaxCare Services will be provided. VaxCare shall assign a unique Health Identification Number to each such location, and VaxCare Services may be used only at a location so -registered. 40. Opted -Out Physicians/Practitioners: For any Medicare -eligible patient with whom Administrator has entered into a private contract and "opted -out" of Medicare pursuant to 42 C.F.R Subpart 405.400, and for whom Administrator has ordered a Vaccination under this Agreement, Administrator acknowledges and agrees that s/he (i) is not eligible for payment for administration to Medicare beneficiaries, and hereby waives any right to such payment, (ii) shall assist VaxCare with its submission of claims for VaxCare Vaccine and/or Public Vaccine used in Medicare patient administration as reasonably requested by VaxCare (including, but only upon the specific request of VaxCare, submitting separate no -charge claims), and (iii) is and shall remain in compliance with all applicable requirements of such regulations. 5. Administrator Compensation 5a. Administrator Compensation. The Administrator Compensation shown in Exhibit D may be changed by VaxCare with 30 day advanced notification to Administrator outlining the new compensation amount(s) and stating the reason for the change, which may include, but is not limited to, change in VaxCare Vaccine costs, change in payor reimbursement to VaxCare, or a change in Law. 5b. Conforming Vaccinations. VaxCare shall only be required to provide the Administrator Compensation to the Administrator for Vaccinations that meet each of the following specific criteria: 5b(i). Check -In Patient. Administrator collects all material information necessary to administer the Vaccination, including, but not limited to, Patient and guardian demographic and payment information. 5b(ii). Accepted Insurance. Administrator verifies that Patient's insurance is on the Accepted Insurance List. If Patient's insurance is not on the Accepted Insurance List, then Administrator may directly bill the Patient or the Patient's applicable health plan for any Vaccinations in accordance with Administrator's standard billing practices, and retain all related collections for Administrator's own benefit and accounts. 5b(iii). Verify Patient Insurance Coverage. Administrator verifies active insurance coverage via an "Eligible" response from VaxCare's electronic verification system. 1. Except for Patients whose eligible insurance is Medicaid, for verifications receiving an "Eligible with Possible Patient Responsibility" response, Administrator must collect valid credit card information from Patient so that VaxCare may collect any patient responsibility associated with the Vaccinations. a. Except for Patients whose eligible insurance is Medicaid, if Administrator does not collect valid credit card information from Patient, then VaxCare may directly bill Patient for Patient Responsibility. b. For the avoidance of doubt, VaxCare shall not bill or otherwise attempt to collect any amounts from a Patient whose eligible insurance is Medicaid. 2. If Administrator chooses to administer VaxCare Vaccine and/or Public Vaccine to a Patient for which an insurance verification indicates "Not Available", VaxCare will submit the claim to the Patient's health plan. If the health plan pays the claim as in - network, the Vaccination will be deemed a Conforming Vaccination. If the health plan denies the claim or processes the claim as out -of -network, is the Vaccination will be deemed a Non -Conforming Vaccination. 5b(iv). Check -Out. Administrator "checks out" the VaxCare Vaccine or Public Vaccine on VaxCare Hub within twenty-four (24) hours of Vaccination. 5b(v). Vaccination. The Vaccination is administered to the Patient during the Term in compliance with this Agreement and applicable Law. 5c. Non -Conforming Vaccinations. VaxCare will not provide any Administrator Compensation to Administrator for Non -Conforming Vaccinations. For Non -Conforming Vaccinations, Administrator shall be permitted to directly bill the Patient or the Patient's applicable health plan in accordance with Administrator's standard billing practices, and may retain all related collections for Administrator's own benefit and accounts. VaxCare will charge Administrator, and Administrator shall pay, the Vaccine Fee for all administered Non - Conforming Vaccinations related to VaxCare Vaccine. 5d. Inventory Audit. VaxCare shall be entitled to conduct VaxCare Vaccine and Public Vaccine inventory audits from time to time, at its sole discretion. Administrator shall provide VaxCare access to such inventory within five (5) business days of any request by VaxCare for such access. If Administrator fails to grant VaxCare access to such inventory or perform an internal inventory audit within the time period required by this Section 5d, all VaxCare Vaccine that VaxCare's records show are located at Administrator's site shall be deemed not accounted for and Administrator shall be charged, and shall pay, the Vaccine Fee for all such VaxCare Vaccine. 5e. Reconciliation of Payments to Administrator. VaxCare shall make available to Administrator reports that reconcile all credits and debits associated with the use of the VaxCare Services once per month on a date to occur on or around the 15th of each month. 5f(i). Compensation Due to Administrator. The Administrator Compensation shall be the net difference of all amounts due to the Administrator under the terms of this Agreement for the respective period, less all amounts due to VaxCare under the terms of this Agreement. 5f(ii). Amount Due to VaxCare. If the sum of all activity occurring since the last reconciliation yields an amount due to VaxCare, VaxCare may, but is not required to, present an invoice to the Administrator requesting payment of such amount. If such an invoice is presented, that amount is due and payable under the terms of this Agreement, and the Administrator shall pay the amount due within thirty (30) days of the date of the invoice. If VaxCare, in its sole discretion, does not present such an invoice, VaxCare may apply the amount due by Administrator to Administrator Compensation earned by Administrator. Additionally, VaxCare may suspend VaxCare Vaccine delivery immediately if an amount due to VaxCare from the Administrator remains unpaid for more than thirty (30) days. Failure by Administrator to pay any amount due within thirty (30) days of receiving an invoice constitutes a breach of this Agreement and VaxCare shall have the option to terminate this Agreement for cause immediately. 5g. Payment of Administrator Compensation. Administrator is required to enroll with VaxCare's 3rd party electronic payment platform. VaxCare pays all Administrator Compensation through this electronic payment platform. 6. Term and Termination 6a. Term. This Agreement shall be binding from and after the Effective Date and until this Agreement is terminated pursuant to this Section 6 (the "Term"). 6b. Notice of Termination. Notwithstanding anything to the contrary in this Agreement, either party may terminate this Agreement without cause upon thirty (30) days' prior written notice delivered to the other party. The termination date shall be the date that is thirty (30) days after the delivery of the notice to the other party. 6c. Termination for Breach. A non -breaching party may immediately terminate this Agreement for cause if the breaching party fails to cure a breach to the reasonable satisfaction of the non -breaching party within thirty (30) days of receiving written notice from the non - breaching party specifying the breach with particularity. 6d. Administrator Responsibilities Following Notice of Termination. Upon notice of termination of this Agreement, Administrator shall: 6d(i). Additional Vaccinations. Have the right to continue to provide Vaccinations under the terms of this Agreement until the termination date. 6d(ii). Unused VaxCare Vaccine. Either purchase or return, at VaxCare's discretion, any unused VaxCare Vaccine shipped to Administrator prior to the termination notice date at the applicable Vaccine Fee set forth in Exhibit B. Administrator shall not be charged a Vaccine Fee for any unused VaxCare Vaccine returned to VaxCare by the termination date in a shipping manner reasonably acceptable to VaxCare and in a form accepted by the VaxCare Vaccine manufacturer for VaxCare Vaccine returns. 6d(iii). Expired VaxCare Vaccine. Return all expired VaxCare Vaccine to VaxCare in a shipping manner reasonably acceptable to VaxCare and in a form accepted by the VaxCare Vaccine manufacturer for VaxCare Vaccine returns. VaxCare shall not charge Administrator a Vaccine Fee for any VaxCare Vaccine that expires prior to the termination date and is properly returned under the terms of this Agreement. 6d(iv). Unaccounted for VaxCare Vaccine. Be charged, and pay, a Vaccine Fee, as shown in Exhibit B for any unaccounted for VaxCare Vaccine (i.e., that are neither purchased nor returned). 6d(v). Termination of the Trademark License. Promptly (but in any event within 10 calendar days) discontinue all uses of the VaxCare Licensed Marks, as the Trademark License granted to Administrator in this Agreement shall immediately terminate upon termination of this Agreement. Administrator further agrees that the promises and acknowledgements of 8a and 8b, and this Section 6d(v) of this Agreement shall survive and remain in effect after termination. 6e. VaxCare's Responsibilities Following Termination. Upon termination of this Agreement, VaxCare shall handle all returns authorized under Section 6d, and make all payments due to Administrator under the terms of this Agreement. All amounts due to Administrator, if any, shall be paid by VaxCare within thirty (30) days of the termination date. 7. Miscellaneous Terms 7a. Consignment Provisions. VaxCare agrees to consign and deliver to Administrator, and to replenish as requested, a mutually agreeable inventory of VaxCare Vaccine for use by Administrator as permitted and contemplated hereunder. VaxCare may change the items available for the VaxCare Vaccine inventory at any time. VaxCare and Administrator intend that this Agreement be treated as a "true" consignment of goods in accordance with the applicable provisions of the Uniform Commercial Code, as adopted in Florida (the "UCC"). Administrator expressly disclaims and waives any title to or claim of ownership in the VaxCare Vaccine inventory; provided, however, to the extent that delivery of VaxCare Vaccine inventory on consignment to Administrator is (contrary to the intent of the parties) deemed to transfer any title to or ownership interest in the VaxCare Vaccine inventory to Administrator, Administrator hereby grants to VaxCare a purchase money security interest of first priority in all of Administrator's right, title and interest in and to the VaxCare Vaccine inventory now or hereafter delivered to Administrator by VaxCare (whether deemed inventory or raw materials under the UCC). Administrator hereby expressly authorizes VaxCare to file such financing statement or statements (and any related amendments or extensions thereof), in such form and in such jurisdictions, as VaxCare may deem necessary to perfect its rights as consignor, secured party, or both. 7b. Professional Practice. Administrator shall have complete authority over all aspects of his or her Professional Practice, and nothing in this Agreement shall limit the exercise of independent professional judgment of any physician or health care professional. If a court of competent jurisdiction or authorized federal or state agency finally determines any act by VaxCare herein to be unauthorized Professional Practice, VaxCare's requirement to perform such shall be waived and unenforceable. 7c. No Intellectual Property Rights. The parties agree and acknowledge that, except as specifically set forth in Section 8 or elsewhere herein, no license to or transfer of title to any intellectual property is effected by this Agreement. 7d. Confidentiality and Non -Disclosure. Administrator acknowledges that in the performing of Administrator's duties under this Agreement, Administrator will have access to and be entrusted with valuable, confidential information of VaxCare, including, but not limited to, VaxCare's policies and procedures, Administrator Compensation, or Program Materials related to any VaxCare Services. During the Term of this Agreement and for a period of one (1) year following the termination of this Agreement for any reason or until such time as the information no longer constitutes Proprietary Information, Administrator shall retain in strict confidence such information and all information and data relating to VaxCare's business, development plans, programs, documentation, Trade Secrets, systems, and know how ("Proprietary Information"), and shall not, unless required by Law, disclose such Proprietary Information to any third party without VaxCare's prior written consent. Proprietary Information shall not include information which: was is, becomes known to Administrator from a third party through no fault of Administrator; is learned by Administrator from a third party legally entitled to disclose such information; or is required to be disclosed to a third party under applicable Law, provided that Administrator shall first notify VaxCare as soon as reasonably practicable prior to disclosure (unless to do so would be prohibited by Law) and provide VaxCare with the opportunity to review such Proprietary Information and to contest such required release prior to the disclosure. Failure to comply with this Section 7d shall be deemed a material breach of this Agreement and shall entitle VaxCare to immediately terminate this Agreement, without limiting any of the other rights and remedies available to VaxCare at law or in equity, including the right to seek an injunction to prohibit disclosure of VaxCare's Proprietary Information. 7e. Non -Compete. During the Term of this Agreement and for a period of one (1) year following the termination of this Agreement, Administrator shall not individually or jointly, directly or indirectly, whether as employer, employee, operator, agent, contractor, owner, stockholder, investor, partner, or otherwise, engage in any business that owns or develops proprietary technology platforms and/or solutions that are the same or similar to those of VaxCare and that competes with the business of VaxCare; provided, however, nothing in this Agreement shall be deemed or construed to prohibit Administrator from operating a physician or other health care professional practice in the field of public health care services, family medicine, internal medicine, pediatrics or directly administering vaccines or providing any other medical or other health care services that may be performed by a primary care physician or public health department from time to time. The restrictions set forth herein shall be considered independent covenants and the existence of any claims by Administrator against VaxCare, including, without limitation, a claim for breach of this Agreement, shall not constitute a defense to enforcement of the restrictions set forth in this Section 7e. 7f. Indemnification by VaxCare. VaxCare shall indemnify and hold Administrator harmless from and against any and all judgments, costs, liability, or expense (including reasonable attorneys' fees and expenses) arising out of any grossly negligent action or omission by VaxCare under this Agreement. This section shall survive the termination of this Agreement for any reason. 7g. Indemnification by Administrator. Administrator shall indemnify and hold VaxCare harmless from and against any and all judgments, costs, liability, or expense (including reasonable attorneys' fees and expenses) arising out of any action or omission by Administrator, including, but not limited to, a breach by Administrator of its obligations hereunder, the failure of Administrator to properly administer Vaccinations, the failure of Administrator to ensure Administrator and Vaccinators are properly Licensed, or any fraud or misrepresentation by Administrator. This section shall survive the termination of this Agreement for any reason. 7h. Governing Law, Venue and Jurisdiction. This Agreement shall be governed by, and construed in accordance with, the laws of the State of Florida, excluding its conflicts of laws rules. If for any reason whatsoever the arbitration requirement set forth in Section 7i of this Agreement is deemed invalid or if a party seeks to enforce any resulting arbitration award, any such suit, action, counterclaim, or proceeding arising out of or relating to this Agreement must be brought solely in the courts of the State of Florida located in Orlando, Florida or in the United States District Court for the Middle District of Florida, located in Orlando Florida. The parties irrevocably submit to the exclusive jurisdiction of such courts and any appellate courts thereof for the purpose of any such suit, action, counterclaim or proceeding or judgment (it being understood that such consent to the exclusive jurisdiction of such courts waives any right to submit any disputes hereunder to any courts other than those above). Notwithstanding anything to the contrary herein, VaxCare shall enforce the contractual restrictions set forth in Section 7e herein in a court of competent jurisdiction in any state in which Administrator has committed a breach. 7i. Arbitration. Any controversy or claim arising out of or relating to this Agreement, or the breach thereof, shall be settled by arbitration administered by the American Arbitration Association in accordance with its Commercial Arbitration Rules, and judgment on the award rendered by the arbitrator(s) may be entered in any court described in Section 7h. VaxCare shall be entitled to attorneys' fees as part of any judgment awarded it due to the breach of this Agreement by Administrator. 7j. WAIVER OF JURY TRIAL & CLASS ACTION. THE PARTIES UNCONDITIONALLY AND IRREVOCABLY WAIVE ANY RIGHT TO A TRIAL BY JURY, TO THE MAXIMUM EXTENT ALLOWED BY LAW, FOR ANY CLAIM OR ACTION ARISING OUT OF OR RELATED TO THIS AGREEMENT. NEITHER ADMINISTRATOR NOR VAXCARE SHALL BE ENTITLED TO JOIN OR CONSOLIDATE CLAIMS BY OR AGAINST OTHER INDIVIDUALS OR ENTITIES, OR BRING ANY CLAIMS AS A REPRESENTATIVE MEMBER OF A CLASS OR IN A PRIVATE ATTORNEY GENERAL CAPACITY ARISING OUT OF OR RELATED TO THIS AGREEMENT. THUS, ANY CONTROVERSY OR CLAIM ARISING OUT OF OR RELATING TO THIS AGREEMENT, OR THE BREACH THEREOF, SHALL BE DETERMINED ON AN INDIVIDUAL BASIS. 7k. No Warranty. The parties understand, acknowledge, and agree that no warranty of merchantability or fitness for a particular purpose shall apply to the Services, nor to the VaxCare Vaccines and/or Public Vaccines except to the extent provided by the applicable manufacturer. VaxCare shall not be liable for any use of the Services by Administrator or for any loss, claim, damage or liability of any kind or nature which may arise from the use, handling or storage of the VaxCare Vaccines and Public Vaccines by Administrator. 71. Changes to Terms of Service. From Time to Time, VaxCare may change the terms of service set forth in this Agreement. Any such changed terms of service will be made available to Provider at least 30 days before it is effective. Your continued use of the VaxCare Services will constitute your acceptance of the revised terms of service and this Agreement. 8. Rights to Use VaxCare Trademarks 8a. Grant of Trademark License. VaxCare hereby grants to Administrator, and Administrator hereby accepts, a limited, non-exclusive, non -transferable license (the 'Trademark License") during the Term to use the following logos and any other marks as may be periodically added to this license by VaxCare (together, the "VaxCare Licensed Marks"), in connection with materials provided by VaxCare to Administrator for use in providing the Administrator Services at the Location(s): „,R vaxcare and 8b. Terms of Use. Administrator shall ensure that all activities carried out by Administrator under the VaxCare Licensed Marks shall be of a nature and quality consistent with the high quality and reputation of VaxCare and VaxCare's trademarks. Administrator acknowledges that VaxCare is the sole and exclusive owner of the VaxCare Licensed Marks, and that VaxCare may make all decisions involving the VaxCare Licensed Marks' use, registration, and enforcement. Exhibit A: Definitions 1 a. "Administrator” is as defined in the introductory paragraph of this Agreement and shall include any affiliates and successors in interest of Administrator. lb. "Administrator Compensation" means the financial payment set forth on Exhibit D that VaxCare pays to Administrator in accordance with Section 5 of this Agreement. lc. "Accepted Insurance(s)" means the commercial and government health plans included on the "Accepted Insurance List" provided on the VaxCare Site. The Accepted Insurance List is the product of ongoing negotiations between VaxCare and various third parties and is subject to change. ld "Administration and Vaccine CPT® Codes" means the claims associated with purchasing and administering vaccines that are submitted by a provider to a payer for purposes of reimbursement. Administration and Vaccine CPT® Codes follow the annual guidelines set forth by the American Medical Association. CPT® is registered trademark of the American Medical Association. le. "Administrator Services" shall have the meaning set forth in the Background of this Agreement. 1f. "CDC" means the United States Centers for Disease Control and Prevention. lg. "CMS" means the United States Centers for Medicare and Medicaid Services. 1 h. "Conforming Vaccination" means a Vaccination that meets each of the criteria set forth in Section 5b. "Consent Form" means an electronic or paper form used to collect Patient demographic and payment information and claims assignment in connection with the receipt of one or more Vaccinations covered under Medicare Part D specialty pharmacy benefits (e.g., shingles and Tdap vaccines). The content of the form shall be determined by VaxCare, as it reasonably determines what is necessary to comply with applicable Laws and billing requirements. A copy of VaxCare's blank consent form is available at the VaxCare Site and is attached hereto as Exhibit E. 1j. "DEA" means the United States Drug Enforcement Administration. 1 k. "Excluded Provider" means a person or entity that is currently excluded, debarred or otherwise ineligible for participation in a federal health care program, such as Medicare and Medicaid, pursuant to Sections 1128 and/or 1156 of the Social Security Act. 11. "FDA" means the United States Food and Drug Administration. 1 m. "Flu Season" means the recurring period of August — May during which VaxCare will provide influenza VaxCare Vaccine to Administrator. 1 m. "FQHC" means an entity that participates in the Medicare Program as a Federally Qualified Health Center pursuant to 42 C.F.R. Part 491, Subpart A. 1 n. "Go -Live Date" means the date that the VaxCare Services becomes live and operational at Administrator's site and Administrator's existing inventory, excluding Public Vaccines, becomes consigned to VaxCare. lo. "HIPAA" and "HITECH" means Health Insurance Portability and Accountability Act of 1996, as amended, including by, but not limited to, Section XIII of the American Recovery and Reinvestment Act of 2009 known as the Health Information Technology for Economic and Clinical Health Act, and any and all regulations promulgated thereunder as may be applicable at any particular time, including the 2013 HIPAA regulation amendments. 1 p. "Law" means any statute, law, ordinance, regulation, standard (including standard of care), rule, code, order, constitution, treaty, common law, judgment, decree, other requirement or rule of law of any governmental authority or regulatory body, including, but not limited to, the DEA, CDC, CMS, and FDA, whether currently in effect or enacted on a later date during the Term. lq. "License" means any and all applicable licenses, registrations, or certifications required by Law necessary for Administrator, or Administrator's employees or contractors, or VaxCare, as applicable, to perform its or their respective duties under this Agreement in each and every jurisdiction applicable to the performance of such duties. Such Licenses include, but are not limited to, those issued by any applicable state department of health, state medical board, the DEA and any other similar governmental authority or regulatory body. lr. "Licensed" means having all applicable Licenses in good standing. 1 s. "Location" refers to a location of the Administrator registered with VaxCare pursuant to Section 4n. As stated in Section 4n, VaxCare Services may only be used at registered Location(s). 1 t. "Medicaid" means the federal and state health insurance program established under Title XIX of the Social Security Act (42 U.S.C. 1396 et seq.) and administered by CMS and states, including managed care plans funded by Medicaid. 1 u. "Medicare Program" means the federal health insurance program established under Section XVIII of the Social Security Act (42 U.S.C. 1395 et seq.) and administered by CMS, including managed care plans funded by Medicare (such as Medicare Part C (Medicare Advantage) and Medicare Part D plans). lv. "Non -Conforming Vaccination" means a Vaccination that does not meet all of the criteria set forth in Section 5b for a Conforming Vaccination. lw. "Notice of Privacy Practices" means the VaxCare Notice of Privacy Practices, which can be found at: https://s.vaxcare.com/resources/portalforms/awarenessformsNaxCare.Privacy.Policy.081513.pdf and are attached hereto as Exhibit F. lx. "Patient" means an individual receiving a Vaccination in conjunction with the VaxCare Services. ly. "Professional Practice" means the practice of medicine or other health care profession as authorized by the applicable License(s). lz. "Program Materials" means the materials developed by VaxCare and which VaxCare deems, in its sole discretion, necessary to effectively implement the VaxCare Services, including, but not limited to, equipment, tray carriers, door sensors, other medical supplies, marketing materials, and educational materials, of which the Consent Form and Notice of Privacy Practices are attached hereto and incorporated by reference as Exhibit E and Exhibit F, respectively. 1 aa. "Public Vaccines" means vaccine products supplied by a federal or state government program and ordered by Administrator from such program. lbb. "RHC" means an entity that participates in the Medicare Program as a Rural Health Clinic pursuant to 42 C.F.R. Part 491, Subpart A. lcc. "Services" shall have the meaning set forth in the Background of this Agreement. ldd. "Standing Orders" means the standing orders, policies, and procedures developed by VaxCare for Administrators providing Vaccinations to Patients in one or more VaxCare Services, including, but not limited to, those relating to Patient or guardian pre - administration counseling, the administration of VaxCare Vaccine and Public Vaccine within the licensure specified by the FDA, and the administration of VaxCare Vaccine and Public Vaccine according to current applicable CDC recommendations. VaxCare reserves the right to update Standing Orders for each VaxCare Vaccine and Public Vaccine from time to time at its sole discretion. lee. "Storage and Handling" means the standard protocols associated with receiving, storing, and managing VaxCare Vaccine and Public Vaccine in the VaxCare Services. lff. "Trademark License" means the license granted to Administrator to use the VaxCare Licensed Marks pursuant to Section 7c and Section 8 of this Agreement. 1 gg. "Trade Secrets" shall mean any information obtained from or through VaxCare which: (i) is not commonly known by or available to the public; (ii) derives economic value, actual or potential, from not being generally known to, and not being readily ascertainable by proper means to, other persons who can obtain economic value from its disclosure or use; and (iii) is the subject of efforts that are reasonable under the circumstances to maintain its secrecy. 1 hh. "Vaccination" means the administration of VaxCare Vaccine or Public Vaccine by Administrator or a Vaccinator. 1 ii. "Vaccinator" means any employee or contractor of Administrator permitted by Administrator to administer VaxCare Vaccine or Public Vaccine to Patients. 1jj. "Vaccine Fee" means the cost for each dose of VaxCare Vaccine as set forth in Exhibit B that is (i) charged by VaxCare to Administrator in certain situations as set forth in this Agreement, or (ii) paid by VaxCare to Administrator in certain situations as set forth in this Agreement (e.g., purchasing pre-existing inventory or inventory at termination). VaxCare shall update Exhibit B quarterly to reflect changes in the underlying cost of VaxCare Vaccine. 1 kk. "Vaccine Portfolio" means the subset of VaxCare Vaccine from Exhibit B that VaxCare makes available to Administrator. 111. "VaxCare" is as defined in the introductory paragraph of this Agreement and shall include any affiliate of VaxCare providing Services in accordance with Law, and any successors in interest of VaxCare. lmm. "VaxCare Hub" means VaxCare's proprietary system used in VaxCare's inventory and billing processes, accessed through VaxCare's proprietary hardware tablet provided by VaxCare in accordance with Exhibit C. 1 nn. "VaxCare Licensed Marks" shall mean the trademarks described in Section 8 of this Agreement. loo. "VaxCare Services" is defined in the Background and, more specifically, means VaxCare's proprietary comprehensive business model with respect to the Services. 1 pp. "VaxCare Site" means the online technology and resources that VaxCare provides Administrator to access and conduct the VaxCare Services utilizing an Administrator log -in at https://www.vaxcare.com. 1qq. "VaxCare Vaccine" means one or more of the products listed in Exhibit B, to the extent available to VaxCare and provided by VaxCare, or purchased by VaxCare pursuant to Section 3a. For the avoidance of doubt, the products listed in Exhibit B do not constitute "VaxCare Vaccine" if purchased under Section 3b or if provided by a federal or state government program and ordered by Administrator from such program; in such case, the vaccines shall be considered "Public Vaccines." 1 rr. "VIS" means the vaccine information sheets published by the CDC, which can be found at https://www.cdc.gov/vaccines/pubs/vis/. Exhibit C: Rental Terms and Conditions In connection with the Services, Administrator may choose to rent the equipment below provided and owned by VaxCare. The rental of equipment will be governed by the terms set forth herein. 1. Equipment Subject to This Contract. Administrator shall rent VaxHub at a price of $20 per month per VaxHub. 2. Own Cost. Administrator shall keep and maintain the rented equipment during the terms of the rental at Administrator's own cost and expense and shall keep the equipment in a good state of repair, normal wear and tear excepted. 3. Lost, Stolen, or Damaged Equipment. Administrator shall pay VaxCare full compensation for replacement and/or repair of any equipment which is not returned because it is lost or stolen or which is damaged due to Administrator's negligence. The cost of replacement for all equipment will be as follows: a) VaxHub replacement cost is $1,000.00 b) Mobile Hub cost is $500.00 4. Own and Specific Location Use. Administrator shall not remove the equipment from the address of Administrator or the location shown herein as the place of use of the equipment without prior written approval of VaxCare. 5. Delivery by VaxCare. The equipment shall be delivered to Administrator and returned to VaxCare at VaxCare's expense. 6. No Encumbrances. Administrator shall not pledge or encumber the rented equipment in any way. 7. Equipment Guarantee. VaxCare makes no warranty of any kind regarding the rented equipment, except that VaxCare shall replace the equipment with identical or similar equipment if the equipment fails to operate in accordance with the manufacturer's specifications and operation instructions. Such replacement shall be made as soon as practicable after Administrator returns the non- conforming equipment. BOARD OF HEALTH Fiscal Year 2023 The Board of Health is composed of three elected members who serve overlapping three-year terms. The members include Chairman Richard Jacobs, Vice -Chairman Nasiba Mannan who was elected as member in May of 2023 and member Regina Miloslaysky. Shaun McAuliffe, R.S., has been the Director of the Department since July 31, 2017. Simone Carter, RN, BSN has been the Public Health Nurse since August 16, 2021. Our per -diem base nurses, Kasey Mauro and Emilia Muanya have served the community and department since 2020. Nidia Ruberti LaRoche has been the full-time Administrative Assistant since January 3, 2014. Kelechi Obika has been the Health Services Agent since March 29, 2021. Bryan Besso, RT(R), has been the part-time Health Agent for the Department's environmental services for over 20 years. The mission of the Health Department is extensive and works under the direction of the Board of Health, below are just a few, and includes: • promotion of community wellness, • enforcement of federal, state and local regulations that promote public and environmental health, and 6 community education. A complete regulatory list of our responsibilities may be found at: https://www.mahb.org/wp-contentluploads/2015/12/MAHB-updated-Manual-of-Laws-and-Rem tions-6.17.16-1.r df Our agency licenses funeral directors and issues burial permits, licenses and inspects food establishments, mobile food trucks, temporary events, caterers, daycares that serve food, schools, pools, beaches, camps, trash and septage haulers, septic systems, septic installers, portable toilets vendors, body art practitioners, tobacco establishments and retailers and the installation of wells and septic systems, just to name a few. For Fiscal Year 2023 the Department reviewed, conducted inspections and issued the following number of Permits: Subsurface Wastewater Disposal Systems 55 Swimming Pools 5 Failed Septic Systems 5 Beach 1 Septic Installers 38 Tobacco Establishments 7 Septage Haulers 26 Food Establishments 68 Trash Haulers 12 Funeral Directors 2 Title 5 Reports 103 Deaths (for year 2023) 65 Building Plan Permit Reviews 117 Portable Toilets 3 Wells 16 Body Art Practitioners 2 Camps 1 Soil Testing 25 BOARD OF HEALTH Fiscal Year 2023 On -Site Sewage Disposal Systems The department reviews engineered plans for subsurface wastewater disposal systems. The Agent witnesses soil testing for new system construction and issues permits for construction, repair and replacement. The department also reviews building department plans to verify that the building modifications will not negatively impact the on -site septic system. In addition to the permitting and plan review, the department issues Septic installer's licenses, reviews and maintains septage pump records and permits. The Septage Haulers and Trash Haulers permits are also issued by the department. The office conducts inspections on all permits issued to ensure that Title 5 standards and local regulations are met for all on -site sewage disposal systems. Failing septic systems are investigated, and corrective action is planned to ensure the protection of public health. Community Septic Management Loan Program Financial assistance is available to homeowners through a Community Septic Management Loan Program (CSMLP) administered by the department. This loan program was established in 1999 and offers low -interest loans at 2% to Hopkinton residents to correct their failing septic systems. Loan funding is supplied by the Massachusetts Water Pollution Abatement Trust (WPAT) through the Department of Environmental Protection. Any town resident seeking more information about this Loan Program should contact the office at (508) 497-9725. Water Wells and Quality Our office reviews private well installation/deepening/Hydrofracking plans for drinking water and irrigation wells, witnesses the water quantity testing to ensure that an adequate water supply is met, and reviews comprehensive analytical reports for potential contaminants on all new private wells. Prior to the transfer of ownership of the property and if the testing has not been conducted within the last five (5) years, Town regulations require comprehensive water quality testing at homes that are supplied by a private well; copies of test reports should be submitted to the office. The department recommends that residents test their wells at least every five years for bacteria and chemicals in order to verify the quality of their drinking water. The Department is assisting the DPW and Town Leadership with the current PFAS issue. Mosquito Control The Town participates in the Central Massachusetts Mosquito Control Project (CMMCP), a program that monitors mosquito activity, tests for the presence of infected mosquitoes, and performs activities to reduce the mosquito population, such as spraying limited areas, larviciding (organic), reducing mosquito -breeding areas, and responding to resident's complaints. Information for residents on the project is available at cmmcp(a�cmmco.orq. The residential mosquito treatment service is free to residents and performed at night, when the human biting mosquitoes are active. We worked closely with the CMMCP to mitigate the risk around the playing fields, schools, Town Common and other Spring and Summer event areas. We also engaged the CMMCP to provide Hopkinton residents free beaver dam management. BOARD OF HEALTH Fiscal Year 2023 Disease Prevention Hopkinton's Public Health Nursing department continues to lead the Commonwealth in vaccination and other nursing services. We operated flu and COVID-19 vaccination clinics for each age group. We operated in and outdoor clinics utilizing our per diem nurses, nursing students from Worcester State's nursing program, high school volunteers and the Hopkinton Fire Department. Hopkinton continues to have one of the highest vaccination rates in the Commonwealth. The Health Department has funded our COVID-19 efforts with outside grants. We continue to secure grant funded test kits, face coverings and nursing supplies to stock our schools, the food pantry, senior center, municipal offices and other public buildings. The Department completed and submitted over 2,705 Communicable and Infectious Disease reports to the MDPH. Cases of the following were managed by the Department: Babesiosis, Norovirus, Campylobacter, Giardiasis, Hepatitis A, B and C, HGA, Influenza, Lyme, COVID-19, Salmonella, Shiga Toxin Producing Organism, Tuberculosis and Varicella. The Health Director is the Burial Agent for the Town. The department utilizes data from the permitting process and from the Department of Public Health to track disease trends within the Town and establish interventions that will improve wellness. In 2022, 10 residents died from COVID-19. Two adults died of suicide and another two died from drug overdoses. Food Establishment Permitting and Inspections All permanent food establishments are required to be permitted by the department, and must be inspected, at a minimum, two times per year. Temporary food establishments, such as those associated with the Boston Marathon, PolyArts Festival and the Farmers Market, are also permitted and inspected. Follow-up inspections occur when violations are noted, and to ensure compliance with the Food Code including the food allergy notice requirements. The office investigates all complaints received regarding food services or food products; a total of 19 complaint inspections were conducted. A total of 103 routine inspections were performed in 2022. We adopted a digital inspection system for food service, retail and housing inspections. Recreational Swimming and Camps for Children and Bathing Beaches All swimming pools, camps and public beaches must be inspected and permitted by the agency prior to use. A comprehensive camp inspection was conducted, and permits issued for the one recreational camp for children that operated in the summer of 2022. During the swimming season, the Department sampled the water at Sandy Beach on a weekly basis. The results of this testing are reviewed by the Department and an annual report forwarded to the Commonwealth of Massachusetts Department of Public Health. Respectively submitted, Dr. Richard Jacobs, Chairman Nasiba Mannan, Vice Chairman Regina Miloslaysky, Member Shaun McAuliffe, Health Department Director Nidia LaRoche <nlaroche@hopkintonma.gov> Re: Scanning and digitization Initiative Update 1 message Josh Grossetti <jgrossetti@hopkintonma.gov> To: Richard Jacobs <bohchair@hopkintonma.gov>, Shaun McAuliffe <smcauliffe@hopkintonma.gov>, Nidia LaRoche <nlaroche@hopkintonma.gov> Cc: Lucas Ferreira <Ferreira@hopkintonma.gov> Hi all, Fri, Dec 8, 2023 at 8:53 AM We're progressing with the vendor to set up jobs and workflows for the initial ten boxes they are scanning for us. The first pass box scan for review is expected in the upcoming weeks before the new year. Additionally, our on -premise scanner is now operational with fully licensed scan software. We've streamlined the process with barcode separator pages for efficient bulk scanning. Below is a link to example files from 2023, demonstrating the quality of scans. These are some of the dated files that will be indexed with more detail and not part of the "bulk" pre -2023 file. Ignore the file names for now; they'll be renamed for readability during processing into the EDMS. Some files, like 106 Saddle Hill, include larger 11x17 documents. Just wanted you to see this progress and the quality of the scans. https://drive.google.com/drive/folders/1zq-FbQ6De4xiU6kNc-pS PN R4dzFRRI4b?usp=shari ng IT will continue to keep you posted on progress. Thanks, Josh On Mon, Nov 20, 2023 at 3:27 PM Josh Grossetti <jgrossetti@hopkintonma.gov> wrote: Hi all, I'm confirming that our scanning vendor has picked up the first shipment of 10 boxes to be digitized! Even though these have just been picked up, we are already working with the vendor on how we can improve on the next 'round - namely, by Hopkinton doing a little more pre - work and also utilizing barcode labels to help streamline the process. A sub -component of that is we may start to scan files dated in the year of 2023 here internally, on premise. Additionally, I expect we'll start to have the hierarchy structure built out soon - and so can also talk about how new documents can be digitally ingested into the new system, and perhaps bypass even having to physically go into a manilla folder. I will continue to keep you all updated. Coincidentally, Nidia stopped by Fruit Street earlier today, and so is already aware that those 10 boxes have shipped out. If there is a need for any documents that have been shipped out, please send an email to both Lucas and I, and we will work with the vendor to have them digitize that folder as quickly as possible. Regards, -Josh On Fri, Oct 20, 2023 at 1:08 PM Josh Grossetti <jgrossetti@hopkintonma.gov> wrote: Hi all, I'm writing with a quick update on the scanning and digitization initiative for the Health Department files. While we have an agreed upon understanding of how we will file and tag the documents, we've been working with our laserfiche electronic document management system partners to ensure we have the proper settings, structure, and processes in place to support this. We have also been working with the scanning company to ensure the requirements are met, and to work through the logistics of the process. We are close to having the first "beta run" of boxes sent out, and I expect that will happen by the middle of November, if not sooner. I will continue to keep you updated on progress, and welcome any feedback or questions you have in the meantime. Thanks again to all of you for your continued collaboration and support on this project! -Josh Joshua Grossetti Director of Information Technology Town of Hopkinton 18 Main Street Hopkinton, MA 01748 Phone: 508-497-9756 Email: jgrossetti@hopkintonma.gov Web: www.hopkintonma.gov Joshua Grossetti Director of Information Technology Town of Hopkinton 18 Main Street Hopkinton, MA 01748 Phone: 508-497-9756 Email: jgrossetti@hopkintonma.gov Web: www.hopkintonma.gov Joshua Grossetti Director of Information Technology Town of Hopkinton 18 Main Street Hopkinton, MA 01748 FISCA L YEAR 2024 BUDGET APPROVED 1005111 511100 511400 Total 1005112 530970 579900 571200 558900 571300 To tal Grand To tal Total Ex cl. Salaries Salaries & Wages Salaries Hourly Wages (Overtime) Sala ries & Wages Bo H EXPENSES MEDICAL SERVICES M ISC OTHER CHARG ES & EXPENSES CONFERENCES & TRAININGS M ISC OTHER SUPPLIES M ILEAGE Bo H EXPENSES FINA NCE! FY2024Ex pense Budget-BO H B udget Year Jul Aug Sep Oct Nov 385,194.24 5,000 .00 390,194 .24 0.00 0 .00 0 .00 0 .00 Actual Dec Jan Fab Mar Apr May Budget Remai ning Jun Year T otal Year 0 .00 0 .00', 5,000.00 Comm ents 0 .00 0 .00 0 .00 0 .00 0.00 0.00 0 .00 0 .00 0.00 5,000.00 64,860.00 52 .17 272.96 8,050 .61 3,475 .32 16,000.00 14,520 .0 604 .83 191.78 3,500.00 650.00 1,600 .00 1,442 .45 25.00 2,000.00 37 .87 126.85 46.34 1,000.00 690.17 100 .88 87,360 .00 14,572 .1 687.87 1,999 .81 10,788 .0 3,839 .32 0.00 0 .00 0 .00 0 .00 0 .00 0.00 0.00 11,851 .06 15,316.61 3,717.45 211.06 791 .05 31,887.23 477,554.24',14,572.1 687.87 1,999.81 10,788.0 3,839.32 0 .00 53,008.94 683 .39 (217.45) 1,788.94 208.95 55,472.77 Oper ating Expense Balance 0 .00 0.00 0 .00 0 .00 0.00 0 .00 31,887.23 60,472 .77 92,3600014,572.1 687.87 1,999 .81 10,788.0 3,839.32 0 .00 0.00 0.00 0.00 0.00 0 .00 0.00 31,887 .23 60,472 .77 Hopkinton Public Health Nursing Hopkinton Health Department Public Health Nursing Report as of 12.18.2023 December 2023 Disease Surveillance RSV, influenza, and Covid. May be accessed Regional EMS Opioid Incidence Dashboard may be accessed here Community Outreach • Narcan/Risk Reduction --2nd Tuesday of each month in Library • Vaccination clinics successful • Wellness and BP Clinics / Senior Center Outreach weekly at Senior Center —these programs are growing as demand grows • To date 613 vaccines have been delivered. We anticipated another 25-50 doses to be administered over the next month. • Regional Outreach ongoing to assist our neighboring communities. For more info click Partnering in Education/Preceptor Hosted 2 nursing students from Worcester State University Nursing Program who participated in VFC clinics and Senior programming Upcoming • Vaxcare—see Director's Report —we are ready to roll -out the program • Healthy Brain Initiative Program Planning • Website/Messaging—Winter newsletter here • Strategic Planning per Health Director Snap shot of Public Health Nursing Services November 2023 Count TB screening and M... Skin/wound follow up MAVEN/MIIS Records BP/Wellness Check... 12 Vic, Referral to services 5.3% Immunization 2 Director's Report December 18, 2023 Food, Pool and Housing Inspections - 1. The Department received a housing complaint related to an illegal apartment. The Department, Building Department and Fire Prevention Office are scheduled to investigate the complaint and take appropriate regulatory action. The Department has two illegal home kitchens to follow up on before the end of the month. We are awaiting confirmation on one restaurant closure and the possibility of a new restaurant moving in. More to follow. Well and Septic - 1. The operator provided the MDEP a response to the notice of non-compliance. I am awaiting a response from the MDEP. We intend to inventory and map the private wells in Hopkinton. The MDEP has requested the documentation and we believe that we have interns that are willing to work with us on the project. The MDEP has requested that we consider mapping the irrigation wells that exist in the community. That is a task that we will table for the future. Arbovirus / Mosquito Control / Ticks 1. The MDPH has recommended that all communities join a mosquito control district. Hopkinton is part of the Central Mass Mosquito Control Project. In addition to mosquito control work, they are providing us assistance with beaver control, stormwater runoff and NPDES compliance. 2. Whereas EEE was identified in several communities to the southwest of us at the end of the season, there is a concern that EEE could be an issue next year. We intend to work with the Mosquito Control Project to treat our swamp areas with an organic larvicide in the spring. 3. The Health Director has been sampling deer at the check station for ticks. He has also been obtaining blood samples. The ticks and blood are sent to UMass and Tufts for disease and vaccination research. We are one of four communities to assist the universities. Allergen - 1. The Academic Public Health Corp. of the MDPH met with the Director on 12/13/2023 to build an educational campaign around the topic of Playground Allergens. This topic was introduced to the Department through a Hopkins student, Reese Robledo. We are still working on a network news spot to highlight her work. MDPH Work - 1. The Health Department is distributing COVID-19 test kits again to the public at no cost. Additional kits have been delivered to PJB. 2. The Department has received written consent from the MDPH to proceed with a vaccine provider. We hope to pilot a project with the MDEP in January. 3. The Department continues to work with the Middle School to recover food from the free breakfast and lunch program. Recovered food is delivered to PJB. We intend to expand the program to all of the schools in the district. 4. MAHB announced that the new state budget removes the need for Youth and Family Services and the Health Department to receive Town Meeting authorization to access the opioid reimbursement funding. Once we receive further information on the process, we will create a restricted account and transfer the current and all future funds to the account. Youth and Family Services and the Department will develop programming that compliments the work that Youth and Family Services is already providing. 5. The Department entered into a contract with the MDPH that allows participating Departments to receive direct electronic grant funding from the MDPH. 6. The Director and our intern, Nora Connors, are coordinating refugee/shelter aid for the PHEP 4AB communities. She will continue to document the food quantities that have been recovered and assist the Department with other programming. PJB - 1. The Department has secured strollers and clothing for PJB. We wanted to acknowledge the great work that the school district is doing for the Project. Miscellaneous - 1. Kelechi passed the Sanitarian Exam. I believe that I can speak on his behalf when I say that he never wants to take the exam again. r8 A