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HomeMy WebLinkAbout2022-01-27 Board of Health Minutes North Andover Board of Health Meeting Minutes Thursday—January 27,2022 7:00 p.m. 120 Main Street,Board of Select Room Live broadcast can be heard on www.northandovercam.org Present: Joseph McCarthy,Dr.Patrick Scanlon,Michelle Davis,Brian LaGrasse,Stephen Casey Jr,Carolyn Lam and Toni Wolfenden I. CALL TO ORDER The meeting called to order at 7:00 pm. II. PLEDGE OF ALLEGIANCE III. NEW BUSINESS A. 2022 Board of Health Schedule—tabled till next meeting IV. COMMUNICATIONS,ANNOUNCEMENTS,AND DISCUSSION A. Brian LaGrasse—Covid19 updates and statistics See Appendix A There has been a worldwide holiday spike due to the omicron variant. It is extremely transmissible however it is less severe than the delta variant. The state epidemiologist Dr.Katie Brown stated that the omicron variant seems to be more in the throat than the nasal passage which causes transmissibility to be higher. The variant arrived in the United States around Thanksgiving which was the perfect storm and perfect time to transmit throughout the entire nation. This caused the biggest spike seen since the beginning of the pandemic. Currently, it has since receded and the numbers are back down to under 100 active cases in North Andover. The town is at a 16%positivity rate. The numbers are on the decline. Testing is holding strong,which is good. Lawrence General Hospital and Merrimack College still do testing. Hospitalizations are down to 2500 across the state which is down from 3144 last week. In the future,the Commonwealth of Massachusetts will be separating out patients being hospitalized due to COVID-19 and those being admitted with incidental COVID-19. The state will also be categorizing the COVID-19 deaths with more detail. People who test at home do not have to submit the results to the local government. Brian LaGrasse recommends for people who test at home to follow up with a PCR test to confirm positive results. If someone tests positive on at home,do not go out before the PCR test,isolate,get tested then wait for results. If towns people call the health department or the school department,the results will be placed on a master list and are tracked,they become part of the town data however,it is not part of the states. The School Committee require all students to wear masks in schools. This mandate has been extended to February 281,2022. It is in the process of being discussed and reviewed because the numbers are going down and the student immunization rate is at 80%. The Department of Education is no longer implementing"Test to Stay". The school department is now starting an optional test at home program. It is for students and staff. Massachusetts Water Resource Authority(MWRA)has been doing ongoing sampling of wastewater 2022 North Andover Board of Health Meeting Page 1 of 3 Board of Health Members:Joseph McCarthy,Chairman;Michelle Davis,RN,Clerk/Member;Daphnee Alva-LaFleur,Member; Dr.Patrick Scanlon,DO,Town Physician/Member;Max Tilson MD,Member, Health Department Staff:Brian LaGrasse,Health Director;Stephen Casey Jr.,Health Inspector;Caroline Ibbitson,Public Health Nurse;Toni K.Wolfenden,Health Department Assistant for concentrations of COVID-19. This is an indicator of the trends. The concentrations are going down dramatically,which is a clear sign that the numbers are decreasing. Vaccination rates are up. As a town,76%of the towns people are fully vaccinated with 85%partially. Greater Lawrence Family Health Clinic will be conducting a COVID-19 vaccination clinic today at NAHS. Joe McCarthy discusses natural immunity with Brian LaGrasse and Dr.Patrick Scanlon. The draft of the new Animal Regulations has been tabled till a future meeting. The Community Health Improvement Assessment and Plans for the Towns of Andover and North Andover(See Appendix B.) has been included for the board to review. The towns have partnered together because we have similar populations and combining the outreach,and data collection can help cut cost. The next step is to go to bid for a Request for Proposal(RFP). Any company can put in a bid. After the bids are received,a company will be chosen to do the assessment. These projects are in-depth,estimated completion date is one year. The plan will give data and community input about what residents think they need and want. Programs and outreach will be created from the data results. It will give a blueprint on what we can do most effectively moving forward as a public health department. Earlier this week,there was an oil spill on Foster Street. An estimation of seven to eight hundred gallons of oil was released into Mosquito Brook. Department of Environmental Protection runs point on hazmat. They have been notified.An emergency response crew came out. Whoever is the responsible party will get a Notice to Responsible Party(NRP). They are in charge of the cleanup under supervision from the state.DEP has the Massachusetts Contingency Plan(MCP)for any type of hazmat release. The MCP must be followed completely. It is very complicated,in-depth process to complete the cleanup. Clean Harbors has been hired for the cleanup process. The cleanup is ongoing. Brian has not received any reports at this time. Patrick Scanlon—explains that the COVID-19 vaccine was designed to prevent serious illness and death with a secondary benefit of not overwhelming the health care system. The vaccine is twofold:to protect you and to protect others. It is a public health issue and as citizens of this country we should abide by and care for other citizens that are around us. Joseph McCarthy asks if an antibody test would show results if a person had the virus a year or more ago which Patrick explains that you do not know. The question is what is the level of function of those antibodies that are being tested? An antigen test does not test the strength of those antibodies. Someone who got infected early in the pandemic,where critically ill and recovered,had much more remaining and longer antibody response after their recovery than somebody who had mild illness. When a new virus enters the population,it is unclear how the populous will react. Today,with vaccine and the population having some natural immunity, we are moving past pandemic and now becoming endemic. Brian LaGrasse explains that masks are a mitigating factor and they play some role in reducing transmission of COVID-19. Patrick explains about 3 weeks ago the hospitals were being backlogged with patients. There are much less people taking up ICU beds and ventilators from COVID-19. Test kits can be ordered through USPS.com. To find your vaccine record to go to myvaxrecords.mass.gov. Carolyn Lam—The Town of North Andover has flu vaccine available. If interested call the health department 978-688-9540. Carolyn has ordered one hundred Moderna booster shots. When the vaccine arrives booster clinics will be set up at the senior center. Vaccination clinics will also be set up for school age children. The state has done away with contract tracing. The health department has partnered with the school nurses to work with the school age population. It is being switched from a more active participation to surveillance and monitoring clusters which is shifting from pandemic to endemic. The isolation and quarantine guidance as changed by the Commonwealth of Massachusetts. Isolation and quarantine time lines are down to five days. Isolation for people who have tested positive,on day six through ten,people can go out with a mask on if symptoms have resolved. Quarantine is for people who have been exposed. That person needs to wear a mask for five days and get tested if symptomatic. It is recommended to get tested after day five. The PCR test can show the virus for up to ninety days. This has caused issues in the hospitals. If a patient needs to be transferred to a rehabilitation facility,however,they are still testing positive can result in delays. Stephen Casey—COVID-19 Isolation&Quarantine Flow Chart. See Appendix C. V. ADJOURNMENT MOTION made by Michelle Davis.Dr.Patrick Scanlon seconded,all in favor,motion approved.The meeting adjourned at 8:14 pm. North Andover Board of Health Meeting Minutes Thursday—January 27,2022 7:00 p.m. 120 Main Street,Board of Select Room Live broadcast can be heard on www.northandovercam.org Prepared bjL Toni K. Wolfenden, Health Dept.Assistant Reviewed by: All Board of Health Members&Brian LaGrasse,Health Director &3.med : Z�12z vouaeu*o- MichgLlo'Davis, Clerk of the Board Date Signed Documents Used at Meeting: Agenda COVED 19—Case Numbers and Statistics Community Health Improvement Assessment and Plans for the Towns of Andover and North Andover Isolation&Quarantine Flow Chart 2022 North Andover Board of Health Meeting Page 3 of 3 Board of Health Members:Joseph McCarthy,Chairman;Michelle Davis,RN,Clerk/Member;Daphnee Alva-LaFleur,Member; Dr.Patrick Scanlon,DO,Town Physician/Member;Max Tilson MD,Member, Health Department Staff:Brian LaGrasse,Health Director;Stephen Casey Jr.,Health Inspector;Caroline Ibbitson,Public Health Nurse;Toni K.Wolfenden,Health Department Assistant North Andover Board of Health Meeting Agenda Thursday,January 27, 2022 7:00 pm 120 Main Street Board of Select Room Live broadcast can be heard on www.northandoverma.gov I. CALL TO ORDER II. NEW BUSINESS A. 2022 BOH Meeting Schedule III. COMMUNICATIONS,ANNOUNCEMENTS,AND DISCUSSIONS A. COVID19-Updates IV. ADJOURNMENT 2022 North Andover Board of Health Meeting-Meeting Agenda Page 1 of 1 Note: The Board of Health reserves the right to take items out of order and to discuss and/or vote on items that are not listed on the agenda. Board of Health Members: Joseph McCarthy,Chairman;Michelle Davis,RN,Clerk/Member;Daphnee Alva-LaFleur,Member; Dr.Patrick Scanlon,D.O.Town Physician/Member;Dr.Max Tilson,MD,Member Health Department Staff:Brian LaGrasse, Health Director;Stephen Casey,Public Health Inspector;Caroline Ibbitson,RN,Public Health Nurse;Toni K.Wolfenden, Health Department Assistant. Date Total Number of Cases Total Active Cases Deaths 1i20i2022 6211 171' 98 5 day isolation/active cases (not 10 days as of 12/30121) Cases by age North Andover Vaccination Rates I Vaccination Status ............—............_....................................................................................-_........................._....._............;................_......._................._............._........-----._---------------......................---.._...._......_._.. - .._..:..................................................................................................,................................-._..__..._............_......._............. Age #of Positive Cases %Population Partially Vaccinated %Population Fully Vaccinated Vaccinated NOT Vaccinated .................................................................................:.....................................................................................................................................................................................................................................................................................---.................................................................................................................................................._............................................................ 0-4 8 5-11 [ 12 57% 48% _..........................-......-.� ..-.._..-.--...._...._......-- t...__._......._..__. _-....._..._...._................ ---....._..._..?.._ _-_......................................................................_.._..___......................._�_..._ 12-15 9 ! 88% 79% Breakthrough cases typically account for between 25-45%of daily totals. _._._._._.................._............----- _.......- - _.. ..................................................................... __...... ........................................................................................._.—_...................._ 16-19 16 __-F.._--•- 70% 64% Immunity does decrease over time and it is estimated to be down to 35% ...._....._...__.......................................... .........._........_.. -..-.._................................................................. ........ ..................................................... ....... _ ....... ............ .. - ---......... ... -- -- 20-29 25 90% 77% after 6 months.A booster brings it back up to over 95%effective. ...........-----.-.........................._....—.-.._....----......................._.. ____...........:.............. __.......... .............................-............._.................-,-._......._................... .................--..__._.._..L .................................--— 30 49 55 92% 84% Once you are vaccinated,your body has antibodies and your Immune _................__................................................._.................................................................................................,......................................... .............................;........................................................................_..._............................—.._...................._....................._.._..._...................................................................... 50-64 28 94% 86% system is ready to fight the virus so if you do contract it,your body can 65-74 9 >95% >95% fight off infection much easier and quicker,which dramatically reduces .............._...............................................-..........._......_.....-._...-_........-......._....-__.-._..-_r_.-_.........._.._......._..._......_......_.._......_..__......._.._.................._.L__...__..._............._........_...---............_..-.---._.._............i..........-..-.......-........ -__..................................................._......................_ - 75+ € 7 >95% - >95% j your chance for severe symptoms and hospitilization. t--.........--------_---------- ---........_._.-...._._. ......._..._.....:......_—................. -. .........................--_........... TOTAL 171 84% 76% 10.02%of breakthrough cases end up in the hospital. NA Household Cluster% 24% Cases linked to household or congregate living transmission. NA Percent Positive Testing Rate: 20.41% Percent of positive tests over 14 days NA 14 Day Incidence Rate: 237.5 Incidence rate is the number of new cases per 100K people. Rates are used to compare data between areas with different population sizes NA 7 Day Incidence Rate: 155.6 NA rate taken over the last 7 days NA Two week Testing Number 5,297 Number of tests given over 14 days to NA residents,including higher ed Total#Vaccinated in MA: 5.16M People are fully vaccinated in MA Hospitalizations in MA: 3,144 COVID-19 hospital patients in MA(462 in ICU,280 Intubated patients) Items to Note: 1.The weekly case totals have declined and our 7-day incidence rate has gone down to 155 from 257. Our daily average is down to 47 new cases per day. We had a high of 97 cases one day this week with a low of 7 cases. 2.We are hoping the post holiday spike has peaked and our munbers will keep declining. 3.The CDC and MADPH have changed their isolation and quarantine recommendations. 4.You can look at DPH's new recommendations here 5.The new isolation period of 5 days and has been reflected in the 2022 dashboards. 6. You can order free at home test kits from USPS,4 tests per household. htt[)s://soecial,usos.com/testkits 7.You can also now access your digital vaccination card here. Omicron Variant: 1.This variant is the dominant strain here in MA and accounts for 95%of the samples tested by the state. 2.All 3 vaccines and the boosters are effective against Omicron. Vaccine Info: https://www.mass.gov/covid-19-vaccine The BEST DEFENSE against the virus and any variant is getting vaccinated! Vaccines are very effective at keeping you out of the hospital if you contract the virus. Please remember that FULLY VACCINATED individuals DO NOT have to QUARANTINE if considered a close contact. Indoor sports tend to have a lot more close contact quarantines than other activities. 5.1%of fully vaccinated people in MA have contracted the virus. 0.09%of vaccinated people have gone to the hospital with symptoms. 0.02%of vaccinated individuals have passed away from covid. As of 1/8,5.1 M people are vaccinated in MA with 262,060 breakthrough cases.Of those cases,4,553 were hospitalized and 1,054 resulted in death. The Department of Public Health(DPH)released breakthrough data showing that 97%of COVI D breakthrough cases in Massachusetts have not resulted in hospitalization or death.Unvaccinated individuals are five times more likely to contract COVID than fully vaccinated individuals and 31 times more likely to contract COVID than individuals who have a booster. Testing: If you have been exposed or are a close contact,get tested. It is still free and easy. https://www.mass.gov/info-details/find-a-covid-1 9-test Monoclonal Antibody Treatment for COVID-19: Massachusetts has several public sites administering monoclonal antibody treatment,therapies that have shown to be effective in reducing severity of disease and keeping COVID-19-positive individuals from being hospitalized. Referral from a health care provider is required for treatment,which is provided at no cost to the patient and offered regardless of immigration status or health insurance. Patients should discuss with their health care providers whether monoclonal antibody treatment is right for them. For more info see the press release here: https://www.masr.aov/`news/baker-polito-administration-announces-state-supported-monoclonal-antibody-tr atm nt-sit s-in-ma sa h c tts Booster Doses: Reminder:CDC COVID-19 Booster Recommendations include 12 to 15 years of age. 12-17-year olds can get a Pfizer booster.People 18+can get any booster. The CDC expanded COVID-19 booster recommendations to 12 to 15-year-olds.Information is available on the booster shots webpage and the Clinical Considerations webpage. In Massachusetts,following the updated recommendations and guidance from the CDC,MDPH announced that all adolescents ages 16 and 17 are able get their Pfizer COVID booster if they are at least 6 months post their initial Pfizer vaccination series.Adolescents ages 16 and 17 are able to receive the Pfizer COVID-19 booster from more than 500 locations including retail pharmacies,primary care practices,regional collaboratives, community health centers,hospital systems,state-supported vaccination sites and mobile clinics. Visit www.mass.gov/covidl9booster for more information. *Active cases are now based on a 5 day isolation period. The 2021 dashboards were based on a 10 day active case load Date Active Cases 7/8 0 7/15 4 North Andover Active COVID-19 Cases by Week - - 7/22 11 7/29 32 500 8/6 20 480 _ 457 460 ._ 8/12 47 440 _.. _. 8/19 58 420 400 — _ 376- 8/26 62 380 - 9/2 82 360 _...—.__..__ _— __ _ _. 322 9/9 88 340 __�___� _. _. 320 9/16 107 300 9/23 103 z 280 9/30 105 N 260 _.____ ._. ______-__._ _ 236 240 _ 240 _..... _.__....._ ._ . ..._.._. _ __.. _204 10/7 71 220 10/14 61 200 : _ _ ------ — �� 171 180 10/21 70 — 160 �:w_.� 128 133 10/28 91 140 —.. --._. ..___. 112 120 107 103 105 96 107 11/4 96 100 82 88 91 62 71 70 11/11 112 80 _. __47 58 61 _ 11/18 107 60 .. _. 32 ..20. 11/25 128 20 0 4 11 12/2 133 0 12/9 204 ^�oti��,y� ��o e�^��� ��06 o�ti ono tee- ��0� ���o �o�^o�^a^o\��^o\�� ^�a^^�.^^\w^���h ���L ^�a 4�o 0�o�4�50 �o \^\�oPti 12/16 236 12/23 240 Date 12/30 457 **1/7 and later represents 5 day data instead of 1/6 322 10 day due to change in isolation guidance 1/13 376 1/20/22 171 1/27 Date Percent Positivity 7/29 2.48 _ 8/6 2.95 NA 14-Day Percent Positivity of Tests 8/12 2.42 20.7^ 8/19 3.68 21.0 2o.a1 20.0 8/26 4.69 19.0 9/2 4.13 18.0 9/9 2.81 17.0 _ _v_ - 16.0 -- _.._ 9/16 2.48 15.0 14.0 __-__ 9/23 2.31 __.,.. _ _.__.._. _._.. .. 2- 13.0 9/30 2.44 12.0 10/7 2.6 d 11.0 ___ 10.0 10/14 1.84 a 9.0 -- 10/21 1.74 8.0 7.0 5:93, ..____ _ __ �_ _ ___.____ _ W _ 10/28 2.7 6.0 4.69413 4.434.655.11 11/4 3.22 5.0 _-- 3.68 _. 322 4.0 2.48295 2.81 . 2.42 2.482.312.44 2.6 2.7 2.42 11/11 2.42 3.0 1.841.74 2.14 2:99 11/18 2.14 2.0 1.0 11/25 2.99 0.0 HME 12/2 4.43 ��ti° ��°°�^�°��°e�0° °�� °\° ° �°\,bo °\1,°\�'.°\�°^,\o ^ .�\�°^�y`'���ti^� e \�° 12/9 4.65 12/16 5.11 Date 12/23 5.93 12/30 8.28 1/6 16.04 1/13 20.79 1/20 20.41 1/27 Date 14 Day Avg Incidence rate 7/29 6.4 8/6 9 - 8/12 8.5 8/19 14.1 14-Day North Andover Average Incidence Rate 8/26 21 250 - 237.5 9/2 19.6 227.1 9/9 22.4 9/16 29.2 9/23 27.4 200 9/30 30.4 10/7 29.2 10/14 17.5 rr 150 137.5 L) U 10/21 16.7 10/28 24.5 11/4 27.1 a 100 11/11 30.4 0 78.3 11/18 32.3 64.4 65.3 51.9 11/25 34.4 41.7 50 30.4 29.2 30.4 32.3 34.4 12/2 41.7 29.2 27.4 24.5 27.1 21 19.6 22.4 1/16 51.96.4 1117,116,7 12/16 64.4 12/23 65.3 41�1 41", e 4P 41 lb", 19^o 4 o�,4o ^off 1/6 137.5 Date 1/13 227.1 1/20 237.5 -- - ------- -- - 1/27 Date 7 Day Avg Incidence Rate 9/9 25 9/16 33.1 9/23 36.4 9/30 29.2 7-Day North Andover Average Incidence Rate 10/7 20.8 400.0 10/14 17.9 10/21 16.7 Yo 0 10/28 31.6 300.0 257.4 m 11/4 35.3 11/11 38.6 190.1 200.0 159.4 155.6 11/18 39.6 a) 11/25 36.7 c 86.7 12/2 52 , 100.0 66 69.3 12/9 66 > 25 33.136.429.2 31.63 5.33 8.639.63 6.7 52 m 20.817.916.7 12/16 69.3 11 Its-1 OEM milli 12/23 86.7 .0 ono o\,�0 0\�3 0\00�o��o\,��o\�,o\�������\,�,�\,���\�`'������\o ti��o ti�oo 12/30 159.4 1/6 190.1 Date 1/13 257.4 1/20 155.6 1/27 Date 2 Week Tests R 9/9 4167 9/16 5727 9/23 5716 9/30 5972 Total Tests Administered in NA over 14 Days 10/7 5549 8,000 -- -- - ----- - 10/14 4946 _ 7046 10/21 4650 z 5972 5959 5843 10/28 4377 6,000 -- 5727 5716 5549 4946 4994 4916 11/4 4103 N '167 4650 4377 4103 4360 4262 11/11 5959 = 3885 11/18 7046 E 4,000 11/25 5386 N 12/2 4262 0 2,000 12/9 4994 , 12/16 5843 Ev.> „ ... 12/23 5246 Z 0 12/30 4360 \� \,�0 \�3 \60 No\, O\^ moo � '. o\�,L� 1�\o �N\,�. NN\�� ^^\yh ��\'L 0\ I�\ � �^,y� �\�o \�o 1/6 3885 1/13 4916 Date 1/20 5297 1/27 I � ! 1 f ? 1 � I , 1 i fI 1 r 1 , 1 1 s 1 j f , , 1 1 I ( i 1/20 3144 462 280 1/27 Hospitalizations, ICU and Intubated Patients in Massachusetts Hospitilizations ICU ® Intubated 4000 3180 3144 3000 Z. 2524 m 1954 6 2000 1636 E 1473 c 1239 0 F-- 989 1000 -- _._ ... .... 565 595 622 675 606 618 657 439 571 567 532 528 509 527 1"62 375 378 387 416 484 264 319 17317 519 8 32 9°48 1°70 1599 1E93 1797 116956 1 100 1592 1483 1`�79 1°75 1483 147q 1367 158�4 20 09 26 49 184 242 243 259 278 280 0Lm 7/29 8/5 8/12 8/19 8/26 9/2 919 9/16 9/23 9/30 1017 10/14 10/21 10/28 11/4 11/11 11/18 11/25 12/2 12/9 12/16 12/23 12/30 1/6 1/13 1/20 1/27 Date 0-9 0 10-19 0 North Andover Deaths by Age 20-29 0 30 29 30-39 0 30 27 40-49 2 50-59 3 60-69 7 20 70-79 27 80-89 30 E 90 + 29 _-. z 10 7 2 3 0 0 0 .__----_ --------___._-. 0 0 ------ 0-9 10-19 20-29 30-39 40-49 50-59 60-69 70-79 80-89 90+ Age ;max s 5Y( M- AMR, Ah AS Alk Submitted on October 4, 2021 by Abby Atkins, MSW, Managing Director aatkins@hria.org 617-279-2254 Health Resources in Action Advancing Public Health and Medical Researcl, Health Resources in Action (HRiA) is pleased to submit this proposal to the Towns of North Andover and Andover to conduct a Community Needs Assessment(CNA) and develop Community Health Implementation Plan (CHIP) and Monitoring and Evaluation (M&E) Plans.This proposed process aims to engage stakeholders, provide an updated portrait of the area's health, assets, and needs, and develop a plan for addressing these concerns in a sustainable, collaborative way. HRiA considers this proposed scope of work a starting point for discussion and is happy to discuss how these components can most effectively meet the needs of North Andover,Andover and their communities. HRiA Organizational Background and Experience HRiA is a national 501(c)3 non-profit with expertise in developing, implementing, and evaluating solutions for clients who share a vision of improving population health. Founded in 1957, our mission is to help people live healthier lives and create healthy communities through prevention, health promotion, policy,and research. For over 60 years we have worked with foundations, state and local government, health care providers, and community-based organizations to improve population health and reduce health inequities. Our core services include research and evaluation; capacity building assistance; and grant making.Across these core services,we are committed to advancing health equity and racial justice. As a non-profit public health organization, HRiA envisions a world where all people attain and experience optimal health and well-being,yet we recognize that persistent health disparities stem from historical and contemporary social and racial inequities.To achieve our vision of health equity,we explicitly(though not exclusively) lead with race to ensure that all our efforts advance or consider racial equity; and, we support communities, clients, and partners to do the same. In our work,we bring consultative expertise to develop, implement,and evaluate solutions that address health inequities at their root causes in order to more equitably and sustainably promote and improve population health. At HRiA, we have developed our own health equity framework—centered on racial equity—that guides both our internal policies and processes, as well as our work with communities, partners, and clients (Figure 1).This framework lifts up three foundational components to operationalize and advance health equity.Together with our clients, we: 1. Challenge assumptions and narratives about what promotes and hinders health:To understand and address why certain health outcomes and disparities exist, we constantly reflect upon and address the social, economic,and physical determinants of health that shape the conditions in which people live, as well as the historical and contemporary injustices and systemic oppression that create and perpetuate these conditions. 2. Create and sustain authentic and diverse stakeholder engagement:To advance health equity and ensure solutions are appropriate and collectively owned,we consider ways to create and sustain authentic engagement of diverse stakeholders, including communities, sectors, leaders, and other individuals; furthermore, we continuously consider who should be engaged as part of the conversation,and modify approaches wherever possible. 3. Strengthen capacity to correct power imbalances and address inequities:To transform policies and embedded practices that can perpetuate inequities,we critically reflect upon the distribution of power in strategic approaches and decision-making and aim to shift and correct these power dynamics through capacity building and collaborative partnerships. 2 Figure 1: HRiA's Health Equity Framework HRiA Health Equity Framework EXTERNAL APPROACHES Disrupt external inequities and injustices COMMUNITY ENGAGEMENT DATA COMMUNICATIONS CHALLENGE / ENGAGE BUILD 4 INTERNAL APPROACHES Develop and strengthen equitable internal policies/ practices,and build staff capacity F allenge assumptions and Strengthen capacity to narrativesabout what Create and sustain authentic correct power imbalances motes and hinders health and diverse engagement and address inequities tWIh Rasp—n Moon^ HRiA has extensive experience conducting formal community health assessments to identify the needs and strengths of a particular community to improve its health status, inform funding decisions and collaborative work, and help prioritize program development and implementation. HRiA believes that systematic assessment and planning are good health care and public health practice and should be used to inform development of initiatives,guide revisions or expansion of existing programs, and help align and coordinate efforts across various groups with similar goals. HRiA's work in community health assessments and planning processes helps identify the strengths and needs of a community to improve the health of residents, inform funding decisions, and prioritize program development areas and implementation strategies. HRiA has conducted over 80 community-based assessments and planning processes throughout the U.S., including projects undertaken to assist health care institutions, health departments, health centers, community collaboratives, and philanthropic foundations to comply with regulatory requirements and ensure that community health planning and investment strategies are informed by data.The map below(Figure 2) highlights the assessment and planning work that HRiA has conducted across the United States over the last several years. 3 Figure 2. Map Showing Locations of HRiA Assessment and Planning Work WA Vr MT ND ME OR MN p ID SD WI NY M WY MI Cr Fi NE IA PA -NJ NV OH _DE UT !L- IN CO WV CA MD KS MO KY VA �DC TN NC N OK AZ M AR SC MS AL GA !', Assessment Projects L_j Planning Projects Tx L . Assessment&Planning Projects AK FL" oCi Q,oO H trMN wIM mepchal.n1 The following projects demonstrate specific experience and expertise that HRiA can offer to the towns of North Andover and Andover. In all of these studies, HRiA worked closely with the institutions—and their partners where appropriate—in an engaged process that included both qualitative and quantitative data collection.The goals have been to not only fulfill the IRS mandate but also present results so they are comprehensive, action- oriented, and can inform future planning and initiative development. HRiA has conducted numerous needs assessments and community health improvement plans for communities similar to North Andover and Andover.These include: • Boston, MA (http://www.bostonCNA.org/articles/category/reports/) • Cambridge, MA(https://www.cambridgepublichealth.org/policy-practice/public-health- accreditation/assessment.php ) • Austin,TX(https://www.austintexas.gov/sites/default/files/files/Health/CHA- CHIP/2018 Travis County CHIP FINAL 9.12.18.pdf) • Winchester, MA(https://www.Luinchester.us/513/Needs-Assessment) • Issaquah, WA(https://www.issaguahwa.gov/DocumentCenter/View/4604/Issaquah-CNA-2017?bidld=) Proposed Approach HRiA proposes an approach that works closely with the Towns of Andover and North Andover throughout the project to ensure an effective and efficient process.The intent of the proposed approach is to work 4 collaboratively,when appropriate,to develop an assessment and plan specific to the needs of each town.This approach is intended to align with the evolution of the National Association of County and City Health Officials (NACCHO's) Mobilizing for Action through Planning and Partnerships(MAPP)framework.The proposed project is to be conducted in three phases over a timeline of twelve months, starting in January 2022 and concluding in December 2022 (Figure 3). Due to the COVID-19 pandemic, HRiA provided costs to conduct all activities virtually. Pending guidance from state and local health departments, HRiA will adjust the work plan and budget to include in-person activities when appropriate. Costs for in-person activities have been provided. Figure 3. Timeline and Milestones Phase III: Monitoring and Evaluation Phase 1:Community Needs Assessment(CNA) Planning(M&E) Partner Engagement: CNA Presentation Final Draft and Community AdvisoryQualitative and Prioritization Data of Assessment CNA Draft and Final Collection Results Committee Report Final CHIP ME Plan Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Doc 2022 M.22 Analysis and Planning Secondary Data Community Development of Sessions and Document Health CNA Report Review Survey Phase II:Community Health Improvement Plan (CHIP) In recognition of the need to be in alignment with PHAB requirements for accreditation, HRiA will ensure that our assessment and planning processes meet those requirements. 1. Project Management and Partner Engagement(Ongoing) HRiA believes in actively engaging the client and project partners in regular project updates. We recommend check-in conference calls every other month (approximately 60 minutes in length) with the project leads from Andover and North Andover, any other key individuals (e.g., members of the Community Advisory Committee), and the HRiA team to provide updates on the project, ensure the process has open communication,and allow space to discuss opportunities and challenges as they arise. Engagement of Community Advisory Committee To ensure that community voice is present throughout the community needs assessment process, HRiA proposes engaging a Community Advisory Committee (CAC)for this project. Examples of individuals that could be engaged for the CAC include key community leaders (e.g., religious leaders, members of local government), stakeholders from target populations (e.g., leaders of cultural organizations, small business owners), and local experts from any topics of interest(e.g.,transportation, health care, aging).The CAC will be engaged to ensure that the needs assessment's approach, methods, and data collection tools are culturally relevant and reflective of community needs and interest. 5 While the specific role of the CAC can be decided on at project start, examples of potential activities include review of data collection tools (e.g., focus group guides), identification of target segments for qualitative data collection, review, and prioritization of key findings from the assessment, and participation in the planning and implementation process. At the beginning of the project, HRiA will hold a kick-off meeting with North Andover and Andover project staff and their project Community Advisory Committee to discuss the overall CNA-CHIP project approach and timeline. Consistent with best practices for community health improvement', HRiA recommends that members of the CAC participate in this kick-off meeting to advise on the overall approach. In addition to discussing the overall project approach,this kick-off meeting will also be used to identify specific topics of interest to delve deeply into through the CNA qualitative data collection and secondary data review. Phase 1: Community Needs Assessment HRiA will conduct a CNA that identifies the key health needs and assets of the North Andover and Andover communities, building off and expanding upon any past work conducted by the Towns and their partners to identify trends or differences in sub-population groups.The CNA will be structured to meet the requirements of a Comprehensive Community Health Assessment as part of the PHAB Accreditation process. In summary, HRiA proposes the following methods for the components of the CNA: • Engagement of Community Advisory Committee • Secondary data review: provide guidance on the review and analysis of social, economic, and health indicators for the area • Quantitative data collection: community health survey • Qualitative data collection: o Individual or small group key informant discussions with a range of stakeholders and community leaders, conducted by telephone o Focus groups conducted with a variety of audience segments, including but not limited to different racial or ethnic groups,age groups,or issue groups, conducted virtually For each of these activities, HRiA will document(via meeting minutes and notes)any planning meetings and/or decision-making processes in alignment with requirements for PHAB accreditation.These will be shared with Andover and North Andover 1. Secondary Data Review(January-April) HRiA will manage the collection of secondary data sources and indicators for the Assessment. HRiA's staff will oversee compiling, reviewing, synthesizing, and analyzing secondary data relevant to the target communities. The secondary data will incorporate a social determinants of health perspective by examining the multitude of upstream social and economic issues that have an impact on health (e.g., unemployment, education, and housing).Where available,data will be examined by race/ethnicity to understand the ongoing impact that systemic racism has had on individuals and community health and wellbeing. HRiA will create all graphs,tables, maps, and other data visualizations needed for the primary CNA report and appendices. 2. Qualitative Data Collection-Key Informant Interviews& Focus Groups(February-May) 1 Association for Community Health Improvement(ACHI)Community Health Assessment Toolkit: https://www.healthVcommu nities.org/resources/community-health-assessment-toolkit 6 While existing quantitative and survey data provide benchmarks on key indicators as well as insight on the magnitude and severity of specific risk factors and health outcomes, it may not tell the whole story. Qualitative data can engage community members, leaders, and organizations in the CNA process to provide insight into the risk and protective factors that have an impact on the health of the community, identify where there are gaps in services, programs, and policies, and elicit feedback on what the community views as the biggest needs to address. A cross-section of key informants and focus group participants will be engaged in this process. HRiA recommends approaching community engagement through a health equity lens to continue to build relationships and community buy-in and maximize the success of implementation resulting from the CNA process. Identification of interviewees and focus group segments will be informed by input from the CAC. HRiA recommends inviting participants for the interviews and focus groups from traditionally under-served populations and vulnerable groups in order to capture often unheard voices.Authentic and direct engagement of community members will add to the overall understanding of community strengths and needs. For example, HRiA has conducted assessments across the country that have included representation from the following sectors: local non-profit community-based organizations,the faith community, parents,youth, elders, neighborhood program planners, health center staff, members of specific racial, ethnic, or cultural groups, school officials, business owners, elected officials,and other formal and informal community leaders. During the qualitative data collection, HRiA will probe on specific issues including those that emerged during the kick-off discussion and any other issues of interest identified by the Towns or by the CAC. For example, qualitative data collection can gather information on specific disease topics (e.g., mental health, addiction, diabetes), related social needs(e.g.,food insecurity),social and other context (e.g.,the COVID-19 pandemic;the ongoing national movement for racial justice), specific health care or social service utilization patterns (e.g., use of local food banks or urgent care centers), and specific populations. HRiA proposes conducting 20 interviews with key stakeholders and 10 resident discussions with residents in the Andover and North Andover communities. Conducting the resident discussions in languages other than English can be discussed at project start. HRiA will work with project leadership,the CAC, and local stakeholders to identify interviewees and focus group segments. Interviews. Interviews of 30-60 minutes will be conducted by telephone or video. A semi-structured interview guide will be used to guide the discussions and will include questions related to the community assets and opportunities in Andover and North Andover, as well as prioritization of community needs. Interviewees could represent a wide range of organizations from different sectors including health care providers, local government, education, human services, housing,transportation, community-based organizations, and faith- based organizations. Resident Discussions. Resident discussions of 3-6 participants for a duration of 60-90 minutes will be conducted by video in place of in-person focus groups.The resident discussion format will encourage group-based qualitative data collection in a manageable and productive manner apt for a virtual format.A semi-structured guide will be used to guide the discussions and will include questions related to the community assets and opportunities in North Andover and Andover, as well as prioritization of community needs. Resident discussions can explore residents' priorities for community needs to be addressed,the strengths of their community that can be leveraged, and areas that are ripe for future action. Resident discussions can also explore the specific challenges and barriers that residents encounter in seeking services as well as what factors have supported their efforts. Resident discussions can be with populations segmented by different characteristics including age group, race/ethnicity,town of residence, health care utilization, parental status, language spoken, or other important 7 characteristics. HMA's practice is to provide stipends to community-based organizations for recruiting participants ($150/organization) and to resident discussion participants for their participation ($35 in cash or gift card/participant). 3. Quantitative Data Collection—Community Survey(February-April) To gather quantitative data that has not been included in secondary sources, HRiA proposes conducting an online community survey of Andover and North Andover residents.This survey will focus on the health-related issues, social determinants of health, and service and programming priorities among residents and would include questions to provide information on social context and root causes of inequities. HRiA recommends approaching the development, distribution; and analysis of the survey through a health and racial equity lens to ensure that appropriate demographic information is gathered,that the survey reaches diverse populations,and that the results are analyzed by subgroups as feasible.Analysis can also be conducted to distinguish between findings between the two focus communities. To minimize the burden placed on community organizations engaged to support survey dissemination and on respondents themselves and increase the likelihood of response, HRiA recommends aligning this process with the community survey conducted by Lawrence General Hospital as part of their Community Health Needs Assessment process. Data from this survey could be analyzed in a way to look at North Andover or Andover respondents only, with the potential to add questions specific for Andover and North Andover residents. This scope assumes that HRiA would develop the survey in English but can discuss additional languages to meet the needs of Andover and North Andover.There would be an additional$2,000 fee to cover translation, pilot testing and programming for the surveys in additional languages. HRiA would program the survey into an online link for dissemination. HRiA would then work with the Towns and the CAC to disseminate the survey to community networks.The email link could be promoted on professional and personal list serves in the community, sent to organizational rosters, and be advertised in the local newspaper, website, or via social media (e.g., an advertisement on Facebook only for users from the two communities). HRiA will provide technical assistance on survey dissemination,with an eye towards strategies to reach diverse populations and the organizations that serve them. However, it is assumed in this scope that the Towns and their stakeholders will conduct most of the marketing work for disseminating the online survey. It should be noted that the online methods of survey administration do not use probability sampling and thus produce samples that may not be representative of the town.These survey methods, however, can help engage the community and still elicit important feedback for the assessment. 4. CNA Presentation and Prioritization of Assessment Results(June) Once the assessment is drafted, HRiA will develop a PowerPoint presentation on key findings for presentation at the Community Health Implementation Plan (CHIP) kick-off and prioritization meeting. Priorities are used as the basis for developing goals, objectives,strategies and action plans to implement the CHIP. HRiA will facilitate a prioritization process that allows for the identification for shared or overlapping priorities, as well as priorities that may be town specific. The prioritization process takes place once a health assessment has been conducted and key themes/strategic issues/significant health issues have been identified for the community.The process considers priorities to be "strategic issues". When synthesizing the data from all the Community Needs Assessment, HRiA refers to potential priorities as"key themes" or"key health issues"that emerged from the data gathering. Identifying a set of 3-5 priorities is important for focusing the health improvement planning efforts to best take advantage of the resources available to make the improvements needed on the health of the community. Numerous key 8 themes/health issues/strategic issues may be identified as part of an assessment-as many as 10-15. The prioritization process narrows that larger list to a manageable set of priorities- priorities that partners can reach consensus on and commit to planning efforts around. There are several methods for reaching consensus on priorities. HRiA utilizes a rating tool where each key theme/health issue/strategic issue is rated against a set of agreed upon criteria. Participants cast votes for their top-rated issues, and the highest voted 3-5 issues are then agreed to be the Priorities for health improvement planning. The PowerPoint slide deck from the assessment key themes and prioritization session will be available for North Andover and Andover to use in any additional presentations to stakeholders such as hospital leadership, community leaders, and policymakers. This scope assumes that project leads from North Andover and Andover are responsible for presenting the CNA to town leadership and obtaining any necessary approvals. S. Analysis and Development of Draft and Final CNA Report(July-August) Data from these tasks will be analyzed to provide a portrait of the two target communities,their needs and assets,current infrastructure, and strategic opportunities for the future.The qualitative data gathered during the CNA will be analyzed thematically, as HRiA team members examine and code notes for similarities and differences across responses. Extracted themes will be summarized, highlighting community and sub-group priority concerns and perceived assets.The aggregate secondary data will be integrated with the qualitative information. HRiA anticipates that the CNA report will be organized by topic and will focus on the themes that emerged across the community, noting specific differences by demographic sub-population where appropriate. The goal will be to build off past work, identify trends and changes, and drill-down into the data to identify specific, action-oriented findings. The CNA report will include an introduction; methodology;findings from all the data collection activities by key theme/topic area; and a final section discussing key issues and larger strategic directions to consider when moving forward with a planning process. A draft assessment report will first be submitted to Andover and North Andover for review.This step will provide an opportunity for key stakeholders to give additional input into the information being gathered for the report. Based on this feedback, HRiA will finalize the report. HRiA aims for the final assessment report to be salient to multiple audiences, written in lay language, and be visually interesting.To this end,we suggest that the final report be no more than 50-60 pages (without appendices) and focus on the main findings from this work.Any additional information that is important for Andover or North Andover but not critical for the main report will be provided in an appendix. once the final report is reviewed and approved, HRiA will develop up to eight(8), 1-page data infographic sheets (four(4) per town) detailing key findings on prioritized topics selected by the two communities.These infographics can be used for public dissemination and communication. The final report will be delivered as a Microsoft Word document including a table of contents, main report,and appendices (including infographic sheets). The Towns of North Andover and Andover may provide logo(s)/artwork for use on the cover page if desired. HRiA can provide an estimate for graphic design services to develop a more elaborately illustrated and formatted final document at Andover and North Andover's request. HRiA will also provide a PowerPoint presentation for Andover and North Andover's use in presenting the assessment to their Boards, Leadership, and other key groups. Phase 2:Community Health Improvement Plan (CHIP) 9 Following the completion of the community needs assessment,the work will move into development of a community health improvement plan. 1. CHIP Kick-Off and Preplanning Meetings(August) HRiA will conduct a virtual 90-minute meeting with Andover and North Andover project staff and their project CAC to kick off the planning process and discuss current/emerging initiatives from the recently completed Community Needs Assessment(CNA). During the Kick-Off Meeting, HRiA will review the CHIP process, define outcomes, deliverables, project timeline,the roles and responsibilities for leadership and participants in the planning process, and scheduling for the proposed prioritization process and planning session. HRiA will also develop content and conduct a 1-1.5-hour virtual pre-planning session for all participants of the upcoming CHIP planning session. This session will cover the identified priorities and relevant data to support the priorities chosen. The CHIP planning process and session expectations will also be covered. This meeting provides a foundation for participants and allows more time for priority group planning during the CHIP session. This meeting will be recorded and shared with any invitees who are unable to attend the live virtual meeting. Deliverables for CHIP Kick-off and Pre-Planning • Agenda (Word document), presentation (PowerPoint document), and prioritization worksheet(Word document) for the Prioritization Meeting • Documented outcomes of Prioritization,Meeting(Word document) • Agenda (Word document), presentation (PowerPoint document)for Pre-Planning Meeting • Link to recording of the Preplanning Meeting 2. CHIP Planning Sessions (August—September) HRiA's planning process aims to be both inclusive and focused. The goal is to engage a representative group of stakeholders to ensure support and buy-in as well as develop a plan that is actionable and will meet the needs of the Towns of North Andover and Andover. HRiA's facilitated approach permits in-depth conversation, ensures feedback from multiple points of view, and allows participants to have input on all elements of the plan. The CHIP will be a 5-year plan to address health issues that are prioritized as most appropriate for North Andover and Andover to address. The plan will focus on developing goals and measurable objectives for the communities' recommended initiatives,selecting strategies (including identifying what is already being implemented by others), developing outcome indicators and targets aligned with community planning processes, and determining which community partners will help facilitate implementation. To this end, HRiA will design and facilitate four virtual sessions with stakeholders,to develop the CHIP that is in alignment with current initiatives,the CHNA, and other identified priorities in the community. HRiA will then facilitate conversations in work groups, one for each priority area, capturing key elements on flip charts to develop the following plan components during this working meeting: • Goals for each of the priority areas • Measurable objectives for each of the goals(approximately 3-4 per goal) • Outcome indicators for each objective (baseline,target, and data sources) • Strategies to meet each of the objectives,with annual timeline benchmarks • Potential Partners/Resources 10 Between sessions,working group participants will provide feedback on the plan components drafted for all priority areas. Preplanning Session Orientation and Planning Overview 1.5 hours Session 1 Draft Goal Statements 1.5 hours Session 2 Finalize Goal Statements, Draft Objective Statements 2.5 hours Session 3 Finalize Objectives, Brainstorm Strategies 2.5 hours Session 4 Finalize Strategies 1 2 hours For the purposes of this proposal, HRiA has provided cost options for HRiA staff members to facilitate work groups for four(4) potential priority areas, and one (1)staff to coordinate logistics, materials and technology. Deliverables for CHIP Planning Session • Agenda (Word document), presentation (PowerPoint document),and any handouts (Word document) for CHIP Planning Session • Summary notes and outcomes of priority area discussions (Word documents) 3. Draft and Final CHIP Report(October—November) The CHIP report will synthesize the outcomes from the planning session, identify or refine the indicators that may be helpful in tracking the success of the CHIP,and outline how organizations and agencies in Andover and North Andover can work together to focus on common priorities. HRiA aims for the final CHIP report to be salient to multiple audiences, with a focus on the main findings, written in lay language.To this end, the final document will clearly articulate the health priorities and provide a "roadmap" of goals, objectives, and strategies for how to achieve these priorities. From the collaborative, interactive nature of the CHIP process, it would also be expected that this plan would have support and buy-in from a range of stakeholders.The CHIP will ideally become a living document as key leaders involved in this CHIP process secure commitments from stakeholders for CHIP implementation. Upon receipt of each draft, North Andover and Andover project leadership and the CAC will disseminate the CHIP to the appropriate subject matter experts (SME's) and other reviewers for their input. North Andover and Andover project leadership will identify and assign a team of subject matter experts (SMEs) and/or epidemiologists (EPIs)to do the following review and refinement of the planning session outcomes as part of each feedback/review cycle: • Refine strategies for evidence-base and feasibility • Add to partners and resources list • Identify current, relevant plans for CHIP alignment • Identify appropriate baselines,targets and data sources for outcome indicators for each defined objective (data table) For each feedback/review cycle, project leadership will identify one point person for each priority area to collect and organize feedback from the multiple reviewers into one submission to HRiA. For the purposes of this proposal, HRiA has budgeted for two (2) review/feedback cycles. Following each electronic review and feedback cycle, HRiA will incorporate recommended changes into a revised and ultimately final draft of the CHIP. HRiA 11 will be happy to conduct additional review/feedback cycles at the client's request for a mutually agreed upon cost. The drafts and final report will be delivered as Microsoft Word documents including a table of contents, main report,and appendices. The main body of the report will be formatted with headings, written narrative, and tables containing the plan components. The client may provide logo(s)/artwork for use on the cover page if desired. HRiA can provide an estimate for graphic design services to develop a more elaborately illustrated and formatted final document at the client's request. HRiA will also develop a PowerPoint presentation for use in communicating the CHIP to the community and other stakeholders. Deliverables for Draft and Final CHIP Report • First Draft of the 2022 Community Health Improvement Plan (Word document) • Instructions for review/feedback cycles (emails) • Second Draft of the 2022 Community Health Improvement Plan (Word document) • Final 2021 Community Health Improvement Plan (Word document) • CHIP presentation (PowerPoint) 4. CHIP Year 1 Action Planning& Report Development(December) HRiA will design and facilitate virtual planning sessions,working with a diverse group of stakeholders to: • Identify which objectives and/or strategies will be implemented in Year 1 of the CHIP Action Plan. • Develop the components of the Action Plan that include specific activities to accomplish strategies, target dates, resources available and/or required, lead person/organization, potential partners, and anticipated product or result. For the purpose of this proposal, HRiA would provide facilitators for a three,two-hour virtual planning sessions, one facilitator for each of the priority area work groups. HRiA will use the work outputs of the action planning sessions, as well as input from Andover and North Andover leadership,to develop a draft Year One Action Plan to include:goals, objectives,strategies from the CHIP, and the Action Plan components for the Year 1 strategies(specific activities,target dates, resources available and/or required, lead person/organization, potential partners,and anticipated product or result).The goal of the Year One Action Plan will be to provide a realistic blueprint of activities and action steps that can be implemented and tracked as well as indicate roles and responsibilities to which organizations can be held accountable. Upon receipt of the draft, North Andover and Andover leadership will disseminate the plan to the appropriate reviewers/subject matter experts for their input. Project leadership will then collect/organize feedback from the multiple reviewers into one submission to HRiA. HRiA recommends conducting one (1) review and feedback cycle. Following the feedback cycle, HRiA will incorporate recommended changes into a revised/final draft of the Action Plan. The draft and final report will be delivered as a Microsoft Word document including a table of contents, main report, and appendices.The report will contain minimal narrative.The client may provide logos)/artwork for use on the cover page if desired. 12 Deliverables for Year 1 Action Plan t • Agendas and materials for Action Planning Sessions (Word and PowerPoint documents). • Recommendations for set-up, logistics, and supplies/materials required for session. • Draft of the Year 1 Action Plan (Word document) • Final Year 1 Action Plan (Word document) Phase 3. Monitoring and Evaluation Plan . The goal of the monitoring and evaluation will be to provide Andover and North Andover with an actionable plan to monitor the implementation of the CHIP, identify and address any challenges that may arise, and to identify and celebrate successes from implementation. 1. Monitoring and Evaluation Plan(December) Following the completion of the CHIP, HRiA will create a standalone monitoring and evaluation plan to measure the progress-and impact of the programs and initiatives selected for implementation. HRiA will work with North Andover and Andover to identify relevant tools and success measures. HRiA will work with project leads from North Andover and Andover to identify relevant partners,timelines, and reporting mechanism to facilitate use of the monitoring and evaluation plan. 13 Isolation & Quarantine Flow Chart December 29, 2021 Isolation is for persons who test positive. Name: (Quarantine is for persons who are close contacts of a positive person. Isolation (for people who test positive) Test Positive or Leave [solation Isolate for 5 Have any Yes,or there symptom onset & Mask for 5 Release on date. whichever Days- symptoms Were never any Dav 11 DAYS 0 to 5 resolved:? Days is (first. symptoms DAYS 6 to 10 DAY 0 Remain in isolation until 24 hours after No - symptoms resolved, then «year mask around others througgh Day 10 Quarantine (for close contacts/people exposed) Identified as a Close Have you RLcommend Leave Quarantine if no Contact to a Positive Quarantine for 5 rccei,�cd a Dav PC'R Test on Rcicasc on Case Date of last booster shot,or �, UAL S to {r atfter M Symptoms or Negative Day I I liecotne fully - PCR Al ear :Mask for exposure is Day 0 After day i. vaccinated leave quarantine Days within the last and wear inask DAYS 6 to 10 6 months'' through day 10 «`ear a mask Recommend Fnd mask use around others PCR Test on on Day I I for 10 days or after Day 5 Identified as a Close Contact to a Positive Case Date of last exposure is Day 0 BOARD OF HEALTH - 2022 Community&Economic Development • HEALTH Main DEPARTMENT MEETING SCHEDULE Streetr. MA 01845 TOWN OF NORTH ANDOVER, MASSACHUSETTS MEETING TIME& MEETING AGENDA MEETING DATE LOCATION DEADLINE All meeting dates are held on the unless otherwise indicated,all All requests to be on the agenda 4th Thursday ofeach month at meetings will be held in the must be submitted 7:00 p.m.,unless otherwise notified.* Second Floor Selectman's IN WRITING-10 business Meeting Room at Town days prior to the meeting date. HaR 120 Main Street See dates indicated below. January 27,2022 See above January 13,2022 *March 3,2022 See above February 16,2022 March 24,2022 See above March 10,2022 April 28,2022 See above April 14,2022 May 26,2022 See above May 12,2022 June 23,2022 See above June 09,2022 July 28,2022 See above July 14,2022 August 25,2022 See above August 11,2022 September 22,2022 See above September 8,2022 October 27,2022 See above October 13,2022 *November 17,2022 See above November 3,2022 *December 15,2022 See above December 1,2022 **Please note that the regular monthly meetings of the Board of Health will be held at the Selectmen's MeetingRoom at 120 Main Street. Due to unforeseen scheduling conflicts,it may be possible that the meeting location will change. In the event of a meeting location change,a notice will be posted on the Town of North Andover Website under the Municipal Calendar Section and Public Notice Section. Please check with the Health Dept.Assistant at:978.688.9540 or e-mail at:healthdept@northandoverma.gov if you have any questions. i