Town of Bolton, MA - Board of Health 2005 Annual Report

Mark Sprague, Chairman............................. 2006

Andrea Gilbert............................................. 2007

Christopher Rogers ..................................... 2008

The Board of Health continued to maintain its focus on public health and safety issues during 2005, reviewing Title V inspections, septic system and well permits, food service inspections, nuisance investigations, and nursing services. The Board of Health has been active in discussion and recommendations regarding public water supplies, beaver related issues, animal control, waste treatment plants, ground contamination, and preliminary review of subdivision plans, the majority of which is ongoing. The Board of Health completed review and updating of well and septic regulations, with a focus on improving regulations around shared septic systems.

This year, the Board of Health received applications for 58 septic permit tests; 52 permits for new construction, 22 permits for repairs/upgrades to septic disposal systems, and 32 well permits were issued. Housing and nuisance investigations totaled 30 and 18 food inspections were performed. The Board continues its vigilance with regard to septic disposal systems, wells, food service inspections, and housing and nuisance complaints.

In the coming year, the Board of Health hopes to continue to work closely with other Town Boards, Committees and Commissions, improve public awareness of public health issues through the Town's newspaper and web site, and continue its review of existing rules, regulations, and offsets. As the town approaches 5000 inhabitants, the Board of Health will be creating regulations covering livestock and manure disposal. We wish to thank Administrative Assistant, Andrea Schnepf, and Nashoba Associated Boards of Health Sanitarian, Bill Brookings, for their hard work and assistance on behalf of the Board.

Financial Statement

July 1, 2004 to June 30, 2005

Appropriated $2,425.00

Expended Advertising $ 76.64

Dues 100.00 $ 739.24

Unexpended balance returned to general fund $1,685.76

Nashoba Associated Boards of Health

Appropriated $7,202.00

Herbert Lipton Mental Health

Appropriated $1,000.00

Unexpended balance returned to general fund $1,000.00

Landfill Expenses

Appropriated $8,650.00

Expended Monitoring Wells $4,500.00

Unexpended balance returned to general fund $4,150.00

NASHOBA ASSOCIATED BOARDS OF HEALTH

Nashoba Associated Boards of Health continues to serve the local Board of Health in meeting the challenges of environmental and public health needs in Bolton. In addition to the day-to-day public health work conducted for Bolton we also provide the following services:

Maintaining Nashoba’s internet web site to provide information for the public. (See nashoba.org)

Through our involvement in the Bioterrorism Regional Coalition we are keeping the Bolton Board of Health up-to-date on matters of emergency preparedness planning. We are currently working on the Emergency Dispensing Site plan for Bolton.

Response to the West Nile Encephalitis (WNV) surveillance effort through coordination with Massachusetts Department of Public Health (MDPH), through the collection of suspected bird samples, submittal to the MDPH lab, and follow-up when the lab results were obtained.

Response to health related impacts of beavers through coordination with the local Board of Health in the issuance of the necessary permits.

Response to state-mandated changes in regulations requiring more frequent beach sampling through sample collection, submittal for analysis, and follow-up when results were obtained.

We look forward to continuing our work with Bolton's Board of Health. Included in the day-to-day work of Nashoba in 2005 were the following:

Through membership in the Association, Bolton benefited from the services of Nashoba staff including: Registered Sanitarians, Certified Health Officers, Registered Nurses, Nutritionists, Registered Physical & Occupational Therapists, Licensed Social Workers, Certified Home Health Aides, and Registered Dental Hygienists.

Nashoba Nursing Service is the regional vaccine depot for MDPH. As such it is a valuable resource for the regular distribution of vaccines to physicians in the area, provides regular public immunization clinics, and is positioned and equipped to provide for larger scale immunizations should MDPH require them.

Reviewed 75 Title 5 state-mandated private Septic System Inspections for Bolton Board of Health. Received, reviewed, and filed these state-mandated (but unfunded) Title 5 inspections. Corresponded with inspectors regarding deficiencies; referred deficient inspections to Bolton Board of Health for enforcement action.

By the Bolton Board of Health’s continued participation in the Association, you can shape your future local public health programs and share in the benefits of quality service at a reasonable cost!

Environmental Health Department

Environmental Information Responses

Bolton Office (days)............................................................ 97

The Nashoba sanitarian is available for the public on Fridays between 8-9:00 a.m. at the Bolton Town Hall.This does not reflect the daily calls handled by the three Nashoba secretaries during daily business hours.

Food Service Licenses & Inspections................................... 18*

Nashoba annually mails out and receives applications from both restaurants and retail food businesses. Licenses are renewed for existing facilities. Plans are submitted and reviewed prior to initial licensing. All licensees are inspected at a minimum twice a year. Where deficiencies are found, a re-inspection is scheduled to insure compliance. When a complaint from the public is received, an inspection is also conducted. During this inspection health factors of food handlers is also investigated, and, where appropriate, medical consultation and laboratory testing may be required. *Drop in inspections due to the relocation of the Bolton Fair to Lancaster.

Beach/Camp/School Inspections.......................................... 35

Camps are inspected at least annually at opening for compliance with State Sanitary Code, Chapter IV, 105 CMR 430.00. Public swimming beaches are sampled for water quality every week during the summer and more often if a problem is suspected.

Housing & Nuisance Investigations....................................... 30

Nashoba, as agent for the local Board of Health, inspects dwellings for conformance with State Sanitary Code, 105 CMR 410.00, issues orders for correction, and re-inspects for compliance. Similarly, complaints from residents concerning unsanitary conditions or pollution events are investigated.

Septic System Test Applications.......................................... 40

Applications from residents proposing to build or upgrade a septic system are accepted, a file created, and testing dates are coordinated with the applicant’s engineer.

Septic System Lot Tests.................................................... 354

Nashoba sanitarian witnesses soil evaluations, deep hole tests, and, usually on a separate date, percolation tests conducted by the applicant’s engineer, which serve as the basis of the design of the septic system.

Septic System Plan Applications.......................................... 58

Detailed plans created by engineers hired by residents proposing to build or upgrade a septic system are received, filed, and routed to the Nashoba sanitarian for review.

Septic System Plan Reviews ............................................. 180

Engineered plans are reviewed according to state code, Title 5, and local Board of Health regulations, and review forms are created and sent to the engineer for revision. Subsequent re-submittals by the engineer are also reviewed.

Septic System Permit Applications (new lots)....................... 52

Septic System Permit Applications (upgrades)...................... 22

Applicant approved plan submittals and Board of Health requirements are incorporated into a permit to construct the septic system.

Septic System Construction Inspections............................. 157

Nashoba Sanitarian is called to construction sites at various phases of construction to witness and verify that the system is built according to plans.

Septic System Consultations.............................................. 194

During all phases of application, design, and construction the Nashoba Sanitarian is called upon for legal details and interpretation.

Well Permits........................................................................ 32

Water Quality/Well Consultations....................................... 127

Private wells are regulated solely by local Board of Health regulations, The Nashoba Sanitarian assists the Board of Health by reviewing well plans, securing well water samples, and interpreting water quality test results.

Rabies Clinics - Animals Immunized..................................... 22

Nashoba arranges for local clinics with cooperating veterinarians, arranging for dates and locations, placing ads in local newspapers, and sending home flyers through local schools. In addition, since the recent raccoon rabies epizootic, Nashoba has arranged for delivery of over 500 animal specimens to the State lab in Boston for analysis and has counseled possible exposure victims to seek medical assistance.

Nashoba Nursing Service

Nursing Visits.................................................................... 142

Nashoba’s Certified Home Health Registered Nurses visit patients at home under their physician’s orders to provide an assessment of physical, psychological, and nutritional needs. Skills include teaching/supervision of medications, wound care, ostomy care, IV therapy on a 24-hour basis, catheter care, case management and referral to other services as needed.

Rehabilitative Therapy Visits.............................................. 126

Nashoba Therapists provide skilled therapeutic interventions through assessment, treatment and education. Their integration of client, caregiver, and medical outcomes aims at attaining maximum functional independence.

Medical Social Service Visits................................................. 4

Nashoba Social Workers provide short-term assistance to patients at home for counseling and referral to community resources.

Home Health Aide Visits...................................................... 44

Nashoba’s Certified Home Care Aides provide assistance with bathing dressing, exercises and meal preparation.

Local Well Adult, Support Groups, & Other Clinic Visits.. ………..25

Visits include well adult clinics, and immunization, cholesterol, exercise, mental health and bereavement clinics.

Number of patients who received Flu Shots that live in Bolton ………23

Number of patients who received Pneumovax Vaccine...... …………….1

Number of patients who attended Well Adult Clinics from Bolton..1

Communicable Disease

Communicable Disease Reporting & Control and Nashoba’s Nursing Service & Environmental

Health Department work together to meet the local Board of Health’s responsibilities under the law to do the following:

Investigate and control the spread of communicable diseases within Bolton (Massachusetts General Law Chapter 111, Section 6, 7, and 92-116). Nashoba works with the Massachusetts Department of Public Health (MDPH) in this area.

Receive and process reports from physicians concerning cases of diseases “dangerous to the public health” as defined by MDPH (MGL Chap111, Sec6)

Notify MDPH Division of Epidemiology and Immunization within 24 hours of receiving notice of any case “dangerous to the public health”.

Receive reports and undertake follow-up as necessary regarding certain food borne and waterborne diseases and diseases being monitored by the MDPH.

Receives reports, investigates and conducts follow-up on all incidences involving positive rabies results.

Number of Communicable Disease cases investigated....... 2

Communicable Disease Number of Cases

Lyme Disease............................... 1

Tuberculosis ................................ 1

Dental Health Department

Examination, Cleaning & Fluoride - Grades K, 2 & 4

Nashoba’s Registered Dental Hygienists, operating out of the school nurse’s office and records, provide these services to those children whose parents have given written consent.

Students Eligible................................................................ 225

Students Participating......................................................... 114

Referred to Dentist.............................................................. 11

Instruction - Grades K, 1 & 5

Nashoba’s Registered Dental Hygienists also provide classroom instruction of cleaning and maintaining healthy teeth to all children in these grades.

Number of Programs........................................................... 13

Students Participating ........................................................ 241