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HomeMy WebLinkAbout2022-05-26 Board of Health Minutes North Andover Board of Health Meeting Minutes Thursday—May 26, 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,Carolyn Lam,Toni Wolfenden and guest speaker-Ronald Beauregard I. CALL TO ORDER The meeting called to order at 7:05 pm. II. PLEDGE OF ALLEGIANCE III. APPROVAL OF MINUTES Meeting Minutes from March 24,2022 presented for signature. Motion made by Michelle Davis for approval,seconded by Dr.Patrick Scanlon,all in favor,minutes approved.(3-0-0) Meeting Minutes from April 28,2022 presented for signature. Motion made by Michelle Davis for approval,seconded by Dr.Patrick Scanlon,all in favor,minutes approved.(3-0-0) IV. OLD BUSINESS A. COVID-19 Updates—See Appendix A. Brian LaGrasse—There has been a small dip down in the overall numbers. For the past two weeks we have been hovering around 70-80 as opposed to a few weeks back North Andover was at 90-99. Variants are more transmissive than the original strains but they are not as lethal and the symptoms are less violent. Vaccinations and boosters reduce the chances of having severe symptoms or worse. Ages 5-12 can now receive boosters. Ages 50+can receive the second booster. There is evidence of waning immunity which is why boosters are encouraged. Booster clinics will be offered later this summer,before school starts. Last week,state hospitalizations were in the 800's. Currently,Massachusetts is still around this point. Half of the hospitalizations are incidental which means,patients do not actually know they have COVID-19, they are admitted into the hospital for something else and test positive. Unfortunately,North Andover had a death from the virus. This person was in their 90's and lived in a long care facility. Nursing homes are still having small clusters of COVID-19. The US post office is sending out eight more free tests. If interested go to usps.com. V. NEW BUSINESS A. Election of Board Positions Motion made by Dr.Patrick Scanlon to nominate Joseph McCarthy for position of Board of Health Chairman for one year,seconded by Michelle Davis,all in favor,Motion approved. (3-0-0) 2022 North Andover Board of Health Meeting Page 1 of 2 Board of Health Members:Joseph McCarthy,Chairman;Michelle Davis,RN,Clerk/Member;Dr.Patrick Scanlon,DO,Town Physician/Member;Health Department Staff:Brian LaGrasse,Health Director;Stephen Casey Jr.,Health Inspector;Carolyn Lam,Public Health Nurse;Toni K.Wolfenden,Health Department Assistant Motion made by Dr.Patrick Scanlon to nominate Michelle Davis for position of Board of Health Clerk for one year,seconded by Michelle Davis,all in favor,Motion approved.(3-0-0) B. Update of Board Vacancies—See Appendix B. The Board of Health is accepting applications for two new board members. If interested please go to: https://www.nordiandoverma.gov/board-and-committee-resources and fill out the Volunteer Form. C. Keeping of Animal Rules and Regulations Draft—See Appendix C. Public Hearing possibly for June Meeting. Draft regulations reviewed. D. Community Health Improvement Assessment—See Appendix D. RFP has been completed. Proposals have been solicited. An Application and proposal have been received from Health Resources in Action(HRIA). Abby Atkins from HRIA was interviewed to go over the proposal. Changes will be made to draft copy. This project is funded by the state and federal government. The assessment will help get the town detailed data on health disparities and equities,as well as the criteria that is needed to concentrate mostly on.An action plan is then put in place to tackle those specific issues. Brian discusses the Public Health Excellence Grant Program for Shared Services. VI. COMMUNICATIONS,ANNOUNCEMENTS,AND DISCUSSION A. Ronald Beauregard—Healthy Communities Tobacco Control Program—See Appendix E. Discussion about the tobacco control program. Massachusetts has the strongest tobacco regulations (105 CMR 665)in the country. The Massachusetts law uniforms all town and cities regulations. The regulations prohibit sales to people under the age of 21,all flavor tobacco,the sale of vape products with more than 35 mg of nicotine in stores other than adult only vape shops. The fines for any of the regulations under 105 CMR 665 is$1000 for the first offense. Ron has issued 14-15 fines,which is hard because he puts his heart and soul into education. In North Andover,compliance checks are conducted. There was one sale. Various stores are having a difficult time getting retail help which can result in the sales of cigarettes to minors. Ron suggests the stores promote compliance through reward and recommends merging the state regulations with local for uniformity. VII. CORRESPONDENCE/NEWSLETTERS VIII. ADJOURNMENT MOTION made by Michelle Davis to adjourn. Dr.Patrick Scanlon seconded and all in favor,motion approved.The meeting adjourned at 8:05 pm.(3-0-0) Prepared by: Toni K. Wolfenden, Health Dept.Assistant Reviewed bv: All Board of Health Members&Brian LaGrasse, Health Director S4.ned Michelle Davis, Clerk of the Board Date Signed Documents Used At Meeting: Agenda COVID19 statistics Volunteer Forms Draft—Keeping of Animals Rules and Regulations Draft—Community Health Improvement Assessment and Plans Tobacco Store List and Regulating the Sale and Use of Tobacco Products North Andover Board of Health Meeting Agenda Thursday,May 26, 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. PLEDGE OF ALLEGIANCE III. APPROVAL OF MEETING MINUTES A. March 24,2022 B. April 28,2022 IV. OLD BUSINESS A. COVID 19—Update V. NEW BUSINESS A. Elections of Board Positions B. Update on Board Vacancies VI. COMMUNICATIONS,ANNOUNCEMENTS,AND DISCUSSIONS A. Healthy Communities Tobacco Control Program—Ronald Beauregard VII. 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;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. i Date Total Number of Cases Total Active Cases Deaths 5/19/2022 7,232 74 95 Cases by age North Andover Vaccination Rates Vaccination Status .............................................................................a..............................................................................,................................................ ...............................,............................................................-................,............................................................................... Age #of Positive Cases :opulation Partially Vaccina Population Fully Vaccinate Vaccinated NOT Vaccinated ..............................................................................,.............._....................._.......................................;........................._....................................................,.................................._........................................_:............................................................................... 0-4 2 0 2 ..............................................................................,..............................................................................;........................................................................................................_.................................................................................................................................................................................................................. ..............................._•...-11.._. '..................................-4 ...............................62% .58%.............................. ................................ 2 ,. _. ;. ...... .:........ 12-15 ;. :. ;....... .....................................................................................................................................................�...................................... 16-19 7 71% 66% 5 2 ..............................................................................;..............................................................................................................................................................;.............................................................................................................................................................. 20-29 10 93% 79% 9 1 ............................................................................ ..;............................................................................................................................................................;............................................................................................................................................................................................................................................. 30-49 28 94% € 85% 25 3 ............................................,..............................................................................,...........................................................................................................................................................:............................................................................................................................... 50-64 13 95% 88% 11 2 ..............................................................................d..............................................................................,...............................................................................,.............................................................................. .... ................................................................................................................................................ ........... 65-74 8 >95% >95% 7 1 ...................:...............................................:................................................................................................................_....._............................................................................................................................................................................................................. 75+ 0 >95% >95% 0 0 ..............................................................................................................................................................................................___.....................................a..............................................................................„........................................................................................._._................................................................ TOTAL 74 86% 78% 61 13 82%of eligible North Andover residents(ages 5+)are fully vaccinated (78%of all North Andover residents). 53%of eligible(ages 12+)North Andover residents have received a booster(48%of all North Andover residents) ------ -.___.___.____._-_-- - --------_-__ _.____..________._.__- NA Household Cluster% 19% Cases linked to household or congregate living transmission. NA Percent Positive Testing Rate: 12.16% Percent of positive tests over 14 days i NA 14 Day Incidence Rate: 56.6 Incidence rate is the number of new cases per 100K people. Rates are used to compare data between areas with different population sizes i NA 7 Day Incidence Rate: 62.7 NA rate taken over the last 7 days i NA Two week Testing Number 2,040 Number of tests given over 14 days to NA residents, including higher ed _______ -___-_-_.-__ Total#Vaccinated in MA: 5AM People are fully vaccinated in MA Hospitalizations in MA: 866 COVID-19 hospital patients in MA(74 in ICU,26 Intubated patients) Items to Note: The weekly case totals have dipped down a little and our daily average is down to 19 new cases per day with a high of 36. Vaccinations reduce severity of symptoms and with very high vaccination rates in MA, hospitilzations have remained low. Vaccine Info: Vaccine is readily available and the best way to protect yourself hftps://www.mass.00v/covid-1 9-vaccine Testing: If you have been exposed or are a close contact,get tested. It is still free and easy. https://www.mass.aov/info-details/find-a-covid-1 9-test A regional testing site at Shriners Auditorium in Wilmington has opened up.You may make an appointment ahead of time or register onsite. Please click here for details and to make an appointment Date Active Cases 7/8 0 7/15 4 North Andover Active COVID-19 Cases by Week 7/22 11 7/29 32 i 500 8/6 20 480 —_� - __. 460 8/12 47 440 8/19 58 420 - _ 400 376 8/26 62 380 - - 9/2 82' 360 9/9 88` - - �322 _ 340 .. - � — _. 320 9/16 10T 300 -- 9/23 103 z 280 260 - _ __ 236.240 9/30 105 _. (D 240 — - -- 204 10/7 71 @ 220 - 10/14 61 - g 200 180 _. 10/21 70 160 26 _- - 133_ v _-- -- 1 . 10/28 91 140 _._-- 11/4 96 120 -91=96 99 E91-99 --- - __ 100 68 --70 74 11/11 112 80 —61 50 39 6] 11/18 107 60 32— — -. -29- 40 20-12=12._12 14 1 B 11/25 128 20 12/2 133 0 ^ Io�.�43 ti .o%CI S, � � `\Ib ��,�o\,Cl^�l ti\`b °j 12/9 204 _.. 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 99 2/3 68 2/10 50 2/17 32 2/24 20 3/3 12 _ 3/10 8 3/17 12 3/24 12 Date Percent Positivity 7/29 2.5 8/6 3 8/12 2.4 8/19 3.7 NA 14-Day Percent Positivity of Tests 21.0 -- - ----- .. 20.0 — 19.0 -- 18.0 17.0 16.0 15.0 14.0 - jc _-13.0 1216- 12.0 0 11.0 d 10.0 -- d 9.0 =- - 8.0 7.0 6.0 5.0 4.0 - 3.0 -- - 2.0 - - 1.0 0.0 °�^ °��� 10 ti, \^° \^� \�� �\� \�° \^1 \rye $1 0 11 \�" IP 4`1 \^� Date 1/27 17 2/3 12 2/10 8.6 2/17 5.7 2/24 3.9 3/3 3 3/10 2.2 3/17 1.4 3/24 1.8. 3/31 2.3 4/7 2.9 Date 14 Day Avg Incidence rate 7/29 6 8/6 9 8/12 9 8/19 14 14-Day North Andover Average Incidence Rate 250 —238 227 200 -- -- — 150 a) 150 _ - 138- _ — --- U C N U C Q 100 _ _ _ -89_ 78 cc 64 65 r 57 56.6 5250 41_ 42 25 27 30 32 34 31 28 29 18 17 20 13 8 5 6 9 12 15 17 _ _ _ _1_■_.___._._._■_�_1_ _ _ _ \irk o1 o\`���^�"^\'��I \�����ti�0 - 0 11115 �������\�o ����������o���� ������o�1��rx ��3���o���1�������� �� �������ti���� 0���ti���� Date 2/10 57 2/17 31 2/24 20 Date 7 Day Avg Incidence Rate 9/9 25 9/16 33 9/23 36 9/30 29 7-Day North Andover Average Incidence Rate 400.0 Y 1 0 300.0 - 257 m a m ' C 190 U 200.0 1.59 156 c 87 86 100.0 66-69-- - —61.. 43 50 69-63- Q' 31 35 39 40 37 52 32 29 @ 1817 2415 8 6 7 8 14 18 21 0 00 t O In N !;Z! CO M O (O M O !- Q O 1� M O 11- d' ` 'ct N M In N M N N a- _� - N N N N M T N N N - - N M -- � N C` d' -- N N 'f5 O O O T T T T N N N �- T �- N N N M m m M It qt M, to T T T T T T T T T Date 2/3 61 2/10 32 2/17 24 2/24 15 3/3 8 3/10 6 3/17 7 3/24 8 Date 2 Week Tests 9/9 4167 - - 9/16 5727 9/23 5716 9/30 5972 10/7 5549 Total Tests Administered in NA over 14 Days 8,000 a z 5959 5343 c 6,000 2 54650 4994 4916 N 4103 4262 4360 4226 .E 3885 3647 EE 4,000 27712453 H2O03184418281575169716781860 2,000 20181965188219782040 0 m _ E .. ,... ,., ,. a-., _, ,. ... ., .... _ .,• ..,,.. ..,:: . .. n. _: ,,, ,... 9 z 0 K 11P N\v , Date 2/17 2771 2/24 2453 3/3 2003 3/10 1844 3/17 1828 3/24 1575 3/31 1697 4/7 1878 4/14 1860 4/22 2018 4/28 1965 5/5 1882 5/12 1978 Do% Hos,lmn28ftM ICU Mabaw 7/29 176 39. 17 --- 8/5 264 55 19 - _ 8/12 375 85 32 Hospitalizations, ICU and Intubated Patients in Massachusetts ■571 ■ 150 ■82 4000 3180 31" 3000 2524 2521 -s a 1964 2000 1636 1661 E 1473 1239 c 1161 989 1000 — 657 1 _..._ _ . 796— 743 866 567 532 528 509 527 319 1242 78 387 416 484 462 396 512 383 384 431 547 14^ 14^ 14" 4' 14' 13^ 55 IT 9 161 49 184 243 259 278 60 237 2161 21121 15° 9'73 280 228 234 221 200 307 _. 83 79 75 83 74 67 84 74 63 6f31 4C20 2571 4�16 1'11 2C19 3C15 2:11 310 418 531 7�26 0 Is 10/14 1021 1028 11/4 11/11 11118 1125 122 12/9 12/16 1223 12/30 1B 1113 120 127 W 2110 2/17 224 313 3/10 3/17 324 3/31 4/7 4114 422 428 515 5112 5/19 Data 2/24 512 97 63 3/3 383 65 31 - 3/10 280 46 20 3/17 228 29 11 324 234 39 16 3131 221 32 11 _ 417 200 28 19 4/14 307 30 15 4/22 384 27 11 42B 431 31 10 5/5 547 45 18 5/12 743 57 31 5/19 866 74 26 - 0-9 p 10-19 0 North Andover Deaths by Age . .._...... 20-29 p 30-39 0 40 _-- 35 40-49 2 50-59 2 30 60-69 8 24 24 70-79 24 80-89 24 .n 20 --- --— - -- - 90 + 35 z - Total 95 10 _ 8 2 2 Updated: 5/19/22 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 B 10 COVID-19 Community Report Bor Report provided: May 18, 2022 Kit ID: KIT-47687 Greater Lawrence Sanitary District - Influent Composite Sampler Sample collection date: May 15, 2022 SARS-CoV-2 virus in wastewater Virus concentration Effective* virus concentration (copies per liter of sewage) i (copies per liter of sewage) 156443804 *Effective virus concentration value is derived by adjusting the raw virus concentration to account for dilution and other factors. Effective virus concentration over time Effective SARS-CoV-2 virus New cases in county concentration(copies/L of sewage) on sampling date 16,000,000 5,000 8,000,000 2,500 Not detected 0 Jun Aug Oct Dec Feb Apr Jun 2021 2022 —«— Effective SARS-CoV-2 virus concentration - 7-day rolling average of new cases in your county New cases in your county Overview of effective virus concentration levels State-level mean of samples AK (collected in the past 6 weeks) - lower higher WA MT ND MN WI MI NY ID WY SD IA IL ^'1iJ ., OH PA N) Color indicates effective virus concentration level OR NV CO NE MO KY WV MD DE Your state outlined in CA Az UT KS AR TN VA NC OC NM OK LA MS AL SC T% CA FL PR Copyright Biobot Analytics, Inc. Internal Kit ID: 3357.1 • Protocols:v4.1 - Analysis:v3 • Report: RT006 v1.1 1 B I O COVID-19 Community Report BOT Report provided: May 18, 2022 Kit ID: KIT-47687 Effective virus concentrations trend with new cases >5,000,000 Effective SARS-CoV-2 l,000,000 , virus concentration (copies/L of sewage) 100,000 to �� , •`�` 10,000 Your sample Not detected 1111 ua s III:of All other samples nationwide 0 1 5 10 20 40 80 160 collected in the past 6 weeks Average daily cases per 100K people in county for past 7 days Effective virus concentrations in comparison Your sample has higher concentration levels than 88% of all quantifiable samples collected in the past six weeks. Your sample Median nationwide sample(in past 6 wks) All other samples collected nationwide(in past 6 wks) I � # � Nat 1 300,000 600,000 900,000 1.200,000 1,500,000 >1,800,000 detected Effective SARS-CoV-2 virus concentration(copies/L of sewage) Learn more about Biobot's protocols and methodology by visiting http://www.biobot.io/covidl 9-report-notes Copyright Biobot Analytics, Inc. Internal Kit ID: 3357.1 Protocols: v4.1 • Analysis:v3 • Report: RT006 v1.1 2 B 10 COVID-19 Community Report BOT Report provided: May 19, 2022 Kit ID: KIT-47711 Greater Lawrence Sanitary District - Influent Composite Sampler Sample collection date: May 16, 2022 SARS-CoV-2 virus in wastewater Virus concentration Effective* virus concentration (copies per liter of sewage) (copies per of sewage) 1,994,597 818,718 'Effective virus concentration value is derived by adjusting the raw virus concentration to account for dilution and other factors. Effective virus concentration over time Effective SARS-CoV-2 virus New cases in county concentration(copies/L of sewage) on sampling date 16,000,000 5,000 8,000,000 2,500 Not detected 0 Jun Aug Oct Dec Feb Apr Jun 2021 2022 --o— Effective SARS-CoV-2 virus concentration 7-day rolling average of new cases in your county New cases in your county Overview of effective virus concentration levels State-level mean of samples (collected in the past 6 weeks) "'`d NH lower higher WA MT ND MN WI MI NY gmN%) Y~I ID WY 5D IA IL `-�Q[til OH PA NJ CT Color indicates effective virus concentration level OR NV Co NE Mo KY WV MD DE Your state outlined in CA AZ UT KS AR TN VA NC DC NM OK LA MS AL SC T% CA 0FL PR Copyright Biobot Analytics, Inc. Internal Kit ID: 3357.W • Protocols: v4.1 - Analysis:v3 • Report: RT006 v1.1 1 B I O COVID-19 Community Report BOT Report provided: May 19, 2022 Kit ID: KIT-47711 Effective virus concentrations trend with new cases >6,000,000 0 : Effective SARS-CoV-2 1,000,000 virus concentration ;" ` �e4 (copies/L of r i> 'mot sewage) 100,000 "a'.eY e`iP 9 ) ` s' 10,000 Your sample Not detected c ® 9 A : a 1; All other samples nationwide 0 1 5 10 20 40 80 160 collected in the past 6 weeks Average daily cases per 100K people in county for past 7 days Effective virus concentrations in comparison Your sample has higher concentration levels than 78% of all quantifiable samples collected in the past six weeks. Your sample Median nationwide sample(in past 6 wks) All other samples collected nationwide(in past 6 wks) i Not 1 300,000 600,000 900,000 1,200,000 1,500,000 >1,900,000 detected Effective SARS-CoV-2 virus concentration(copies/L of sewage) Learn more about Biobot's protocols and methodology by visiting http://www.biobot.io/covidl9-report-notes Copyright Biobot Analytics, Inc. Internal Kit ID: 3357.W • Protocols:v4.1 • Analysis:v3 • Report: RT006 v1.1 2 B 1 O COVID-19 Community Report BOT Report provided: May 21, 2022 Kit ID: KIT-47671 Greater Lawrence Sanitary District - Influent Composite Sampler Sample collection date: May 17, 2022 SARS-CoV-2 virus in wastewater Virus concentration Effective* virus concentration (copies per liter of sewage) (copies 1,902,599 864,314 "Effective virus concentration value is derived by adjusting the raw virus concentration to account for dilution and other factors. Effective virus concentration over time Effective SARS-CoV-2 virus New cases in county concentration(copies/L of sewage) on sampling date 16,000,000 5,000 8,000,000 2,500 Not detected 0 Jun Aug Oct Dec Feb Apr Jun 2021 2022 -+-Effective SARS-CoV-2 virus concentration 7-day rolling average of new cases in your county New cases in your county Overview of effective virus concentration levels State-level mean of samples AK (collected in the past 6 weeks) NH lower higher WA MT ND MN WI MI NY ID WY SO IA IL OH PA NJ Color indicates effective virus concentration level OR NV CO NE MO KY WV MD DE Your state outlined in CA AZ UT KS AR TN VA NC DC NM OK LA M5 AL SC TX GA FL PR Copyright Biobot Analytics, Inc. Internal Kit ID: 3357.E • Protocols: v4.1 • Analysis: v3 • Report: RT006 v1.1 1 BIO COVID-19 Community Report BOT Report provided: May 21, 2022 Kit ID: KIT-47671 Effective virus concentrations trend with new cases >6,000,000 m Effective t� SARS-CoV-2 1,000,000 virus concentration (copies/L of P # ► ���a sewage) 100,000 ct�o `� °u`� c e� •� c `e 10,000 a "' ��8 e Your sample Not detected - u All other samples nationwide 0 1 5 10 20 40 80 160 collected in the past 6 weeks Average daily cases per 100K people in county for past 7 days Effective virus concentrations in comparison Your sample has higher concentration levels than 79% of all quantifiable samples collected in the past six weeks. Your sample Median nationwide sample(in past 6 wks) All other samples collected nationwide(in past 6 wks) Not 1 300,000 600,000 900,000 1,200,000 1,500,000 >1,900,000 detected Effective SARS-CoV-2 virus concentration(copies/L of sewage) Learn more about Biobot's protocols and methodology by visiting http://www.biobot.io/covidl9-report-notes Copyright Biobot Analytics, Inc. Internal Kit ID: 3357.E • Protocols: v4.1 • Analysis: v3 • Report: RT006 v1.1 2 B I o COVID-19 Community Report 13oT Report provided: May 22, 2022 Kit ID: KIT-47699 Greater Lawrence Sanitary District - Influent Composite Sampler Sample collection date: May 18, 2022 SARS-CoV-2 virus in wastewater Virus concentration Effective*virus concentration (copies per liter of sewage) (copies per liter of sewage) 1,680,142 11433,495 *Effective virus concentration value is derived by adjusting the raw virus concentration to account for dilution and other factors. Effective virus concentration over time Effective SARS-CoV-2 virus New cases in county concentration(copies/L of sewage) on sampling date 16,000,000 5,000 8,000,000 2,500 Not detected 0 Jun Aug Oct Dec Feb Apr Jun 2021 2022 —+- Effective SARS-CoV-2 virus concentration - 7-day rolling average of new cases in your county New cases in your county Overview of effective virus concentration levels State-level mean of samples AK y (collected in the past 6 weeks) NH lower WA MT ND MN WI MI NV ' iMA ID WV SD IA IL ,II'm OH PA NJ CT Color indicates effective virus concentration level OR NV Co NE MO Kr WV MD OE Your state outlined in CA AZ UT KS AR TN VA NC DC NM OK LA MS AL SC TX GA H FL PR Copyright Biobot Analytics, Inc. Internal Kit ID: 3357.P • Protocols:v4.1 • Analysis: v3 - Report: RT006 v1.1 1 BIO COVID-19 Community Report BpT Report provided: May 22, 2022 Kit ID: KIT-47699 Effective virus concentrations trend with new cases >6,000,000 :_ Effective SARS-CoV-2 1,000,000 b 1�' virus concentration ` (copies/L of r 3k • sewage) 100,000 R m a t 10,000 e +a 8a 8 •i Your sample p Not detected M28 1118:8 .i All other samples nationwide 0 1 5 10 20 40 80 160 collected in the past 6 weeks Average daily cases per 100K people in county for past 7 days Effective virus concentrations in comparison Your sample has higher concentration levels than 91% of all quantifiable samples collected in the past six weeks. Yoursample Median nationwide sample(in past 6 wks) All other samples collected nationwide(in past 6 wks) Not 1 300,000 600,000 900,000 1,200,000 1,500,000 >1,900,000 detected Effective SARS-CoV-2 virus concentration(copies/L of sewage) Learn more about Biobot's protocols and methodology by visiting http://www.biobot.io/covidl 9-report-notes Copyright Biobot Analytics, Inc. Internal Kit ID: 3357.P • Protocols: v4.1 • Analysis:v3 • Report: RT006 v1.1 2 BIO COVID-19 Community Report BOT Report provided: May 25, 2022 Kit ID: KIT-47691 Greater Lawrence Sanitary District - Influent Composite Sampler Sample collection date: May 22, 2022 SARS-CoV-2 virus in wastewater Virus concentration concentration (copies per liter of sewage) (copies per liter2,217,402 1 ,261,763 *Effective virus concentration value is derived by adjusting the raw virus concentration to account for dilution and other factors. Effective virus concentration overtime Effective SARS-CoV-2 virus New cases in county concentration(copies/L of sewage) on sampling date 16,000,000 5,000 8,000,000 2,500 Not detected 0 Jun Aug Oct Dec Feb Apr Jun 2021 2022 —.—Effective SARS-CoV-2 virus concentration - 7-day rolling average of new cases in your county New cases in your county Overview of effective virus concentration levels State-level mean of samples AK (collected in the past 6 weeks) NW ,a lower higher WA MT ND MN WI MI NV ID WY SD IA IL �� IIIM_ii � OH PA NJ .-'�,,,, Color indicates effective virus concentration level OR NV CO NE MO KY WV MD DE Your state outlined in CA Az UT KS AR TN VA NC DC NM OK LA MS AL SC TX GA FL PR Copyright Biobot Analytics, Inc. Internal Kit ID: 3357.E - Protocols:v4.1 - Analysis: v3 - Report: RT006 v1.1 1 B 1 O COVID-19 Community Report BOT Report provided: May 25, 2022 Kit ID: KIT-47691 Effective virus concentrations trend with new cases >6,000,000 A Effective SARS-CoV-2 1,000,000 virus concentration + '� (copies/L of sewage) 100,000 • 10,000 • Your sample Not detected All other samples nationwide o 1 5 10 20 40 e0 160 collected in the past 6 weeks Average daily cases per 100K people in county for past 7 days Effective virus concentrations in comparison Your sample has higher concentration levels than 87% of all quantifiable samples collected in the past six weeks. Your sample Median nationwide sample(in past 6 wks) p All other samples collected nationwide(in past 6 wks) Not 1 300,000 600,000 900,000 1,200,000 1,500,000 1,800,000 >2,100,000 detected Effective SARS-CoV-2 virus concentration(copies/L of sewage) Learn more about Biobot's protocols and methodology by visiting httl2://www.biobot.io/covidl9-rel2ort-notes Copyright Biobot Analytics, Inc. Internal Kit ID: 3357.1- • Protocols:v4.1 - Analysis: v3 • Report: RT006 v1.1 2 4,14/2021 7123/2021 10/33d2021 2/8 2022 5;19,+2022 8.127 North Andover, MA 120 Main Street Phone:978-688-9500 Volunteer Form Good Government Starts with You Date Submitted: May 25,2022 Name: Home Address: North Andover Mailing Address: 7 North Andover Phone Number(s): Email Address: Current Occupation/Employer: Retired/RN Narrative: Have available time and interest to serve.Excellent computer skills.Worked most of professional career at Lawrence General Hospital in critical care.Past member of Sustainability Committee. Have extensive experience dealing with the elderly.Believe and love the Town of North Andover and would like to give back. Board(s)/Committee(s): _COUNCIL ON AGING Page 1/1 •`'i,'p `�" North Andover, MA 120 Main Street ► H Phone:978-688-9500 Volunteer Form Good Government Starts with You Date Submitted: May 20,2022 Name: Home Address: North Andover Mailing Address: North Andover Phone Number(s . Email Address: Current Occupation/Employer: Heath&Wellness Program Specialist/Lahey Hospital Narrative: I have 4 hours a week to serve on a committee after 6 pm and on the weekends if needed.I am a seasoned health and wellness professional.My work experience ranges from community health education programs to corporate health engagement programming and health care.I am committed to the health and well-being of my community and providing accessible and relevant opportunities for improved health to all residents. Board(s)/Committee(s): BOARD OF HEALTH Page 1/1 North Andover, MA :3'•:.. 120 Main Street Phone:978-688-9500 r Volunteer Form Good Government Starts with You Date Submitted: May 20,2022 Name: Home Address: North Andover MA 01845 Mailing Address: North Andover MA 01845 Phone Number(s): tA Email Address: Current Occupation/Employer: Physician MGB Narrative: Able to attend monthly meetings. Board certified physician(internal medicine and cardiovascular disease). 27 years at Pentucket Medical Associates.Recently semi-retired. Board(s)/Committee(s): BOARD OF HEALTH Page 1/1 North Andover, MA 120 Main Street Phone: 978-688-9500 Volunteer Form Good Government Starts with You Date Submitted: May 19,2022 Name:4NOWWAMP Home Address: north andover Mailing Address: IN I north andover Phone Number(s): Email Address- Current Occupation/Employer: Beth Israel Lahey Health Beverly Campus Narrative: Registered nurse with masters in leadership.Almost 20 years experience as a nurse and 13 years working as public health nurse at state facility. Board(s)/Committee(s): BOARD OF HEALTH Page 1/1 North Andover, MA 120 Main Street Phone:978-688-9500 r Volunteer Form Good Government Starts with You Date Submitted: May 20,2022 Name: Home Address: NORTH ANDOVER,MA 01845 Mailing Address: 41 NORTH ANDOVER,MA 01845 Phone Number(s): Email Address: Current Occupation/Employer: Registered Nurse,Boston Children's Hospital Narrative: I have been a resident of North Andover for 20 yrs.In the last 2 yrs I have participated in vaccine administration of Covid and Flu vaccines.My 41 yr career has included 2.5yrs adult surgical inpatients, 13ys pediatric burn care,25yrs in Newborn ICU. I work 2-3 12hr shifts/wk and have weekday time available. Board(s)/Committee(s): BOARD OF HEALTH Page 1/1 North Andover, MA 120 Main Street Phone:978-688-9500 Volunteer Form Good Government Starts with You Date Submitted: May 21,2022 Name: Home Address: NORTH ANDOVER,MA 01845 Mailing Address: NORTH ANDOVER,MA 01845 Phone Number(s): Email Address: Current Occupation/Employer: Recovery Centers of America Narrative: MS,MS Env.Eng.,MS CPM, MPH North Andover,Massachusetts,United States Summary � I am a result-driven leader passionate about developing imp Tementing programs that increase efficiency and save money while preserving human values.An expert at identifying potential risks and correcting them quickly with sound technical knowledge,and meticulous execution.Recognized for my strong organization and communication skills.Presently in the midst of entering the battle to fight addiction. Experience Residential Support Specialist Recovery Centers of America Jun 2021 -Present(1 year+) On the frontlines of the public health battle over the substance use disorder epidemic. Teamed with a nurse,provide direct patient care,and participate in the therapeutic milieu.I establish therapeutic relationships with patients while maintaining professional boundaries.By identifying patient behaviors that may contribute to the development of a crisis,I utilize non-verbal and verbal techniques to de-escalate these budding crisis situations.I lead and participate in the planning and implementation of patient groups.Perform active milieu assessment while assigned to checks,particularly attuned to safety concerns. Owner visionary ThinkTank Strategies Oct 2020-Oct 2021 (1 year 1 month) Page 114 North Andover, MA 120 Main Street Phone:978-688-9500 Volunteer Form Good Government Starts with You Our goal is to guide our client's needs in strategic research and planning by utilizing the strengths of �� qualitative and quantitative data and the power of ,coupled with the uniquely diverse skill set of our team,enables clear,accurate analyse Data Analyst TOWN OF NORTH READING A May 2017-Sep 2017(5 months) In concert with the North Reading School Department,analyzed data obtained from a survey administered by the North Reading Youth Services Department concerning drug and alcohol use among the middle and high school age.Compared res t t experience regarding the same. Results were reported to North Reading Board of Selectmen for consideration and possibility of future intervention. GED Math and Science Instructor MS,MS Env.Eng.,MS CPM,MPH-page 1 Notre Dame Education Center May 2011 -May 2012(1 year 1 month) Tutored adult bilingual learners who were working towards the GED. Journeyman International Brotherhood of Electrical Workers,Local 103(IBEW 103) Nov 1991 -Jul 2010(18 years 9 months) Performed duties as required of anyone in electrical construction on some of Boston's landmark projects. Served as Lead Project Liaison between the Equipment Vendor,Mitsubishi Heavy Industries and the General Contractor,Washington Group International,for the design,installation,and troubleshooting of the electrical equipment and systems for performance evaluation of the 1600 megawatt Excelon- Mystic Power Generation Station.Supervised the operations of 10 electricians and developed an overall design for interconnection of equipment used to perform air quality monitoring,vibration assessment, and fuel consumption.The information gathered was used to not only troubleshoot the existing equipment but also for the modification of future productions. Bridged the cultural and communication gap that existed between technical team members from Mitsubishi Heavy Industries,a Japanese concern,and engineering and technical team members from the Washington Group International and their subordinate contractors. Developed comprehensive,company-wide health and safety monitoring and outreach programs that Page 214 North Andover, MA 120 Main Street Phone:978-688-9500 Volunteer Form Good Government Starts with You lead to a renewed relationship with the Boston Edison Company,the primary procurer of services. Project Superintendent URS Corporation,An AECOM Company Dec 2007-Jan 2009(1 year 2 months) Served as a senior construction supervisor and field liaison monitored,directed,and documented the work of up to 20 subordinate supervisors and foremen at the 170 megawatt 129 million dollar Cogeneration Project at the Suncor Firebag oilsands construction site and 140 and 260 kV distribution system that was supported by 5 substations. Reviewed and provided reliable and consistent evaluation and analysis of project blueprints and worked with onsite contract and vendor personnel and home office engineering staff to troubleshoot and resolve various technical building construction issues resulting in numerous cost-and time-saving redesign initiatives specifically related to ground grid development,cable tray design,and pipe rack reconstruction Ensured adherence to corporate,contractor and governmental occupational health and safety requirements and developed materials and programs to support the programs. Leader on project wide environmental management committee Project Field Engineer URS Corporation,An AECOM Company May 2007-Sep 2007(5 months) ,MS Env.Eng.,MS CPM,MPH-page 2 Key team member responsible for cost management and quality oversight during the construction of US Route 7 in Brookfield,CT Managed project deliverables including project invoices,receivables and schedules ensuring that the project remained on budget and schedule Worked closely with vendors and contractors to co goals and requirements to make sure the project adhered to corporate and state mandated policies including occupational health and safety Conceived,developed and implemented project information and document management system to enable seamless integration of information between the contractor,the State of Connecticut,and the home office to expedite project schedule and enhance project quality control protocols Assistant General Superintendent Carlin Contracting Company Page 314 North Andover, MA , 120 Main Street Phone:978-688-9500 Volunteer Form Good Government Starts with You Aug 2005-Sep 2006(1 year 2 months) Directed electrical and startup operations for a 15 million gallon a day water treatment plant in Billerica, MA Effectively supervised and managed 18 employees and subcontractors,assigning work,managing project tasks,conducting quality control assessments,ensuring on-the-job safety,and resolving conflicts leading to the timely and efficient completion of construction and startup tasks to the satisfaction of the owner Directed 20 vendor relationships including coordinating activities,supervising operations, troubleshooting various equipment issues and installations,negotiating payment and evaluating vendor performance Initiated efforts that lead to dispute settlement between electrical and instrumentation contractor that created significant project delay. Responsible for estimating time,materials for projects including,inception,design, implementation and continuing operations erations phases Allocated resources including personnel,equipment,materials and vendors per budget constraints and maintained consistent on-time and on-budget project delivery Lead Electrician National Science Foundation(NSF) Oct 2003-Feb 2004(5 months) Led a team of 5 to 15 employees and directed an k under difficult conditions for the installation of electrical equipment in support of the National Science Foundation's research efforts in the South Pole for the United States Antarctic Program Researcher Construction Occupational Health Project University of Massachusetts Lowell � MS,MS Env.Eng.,MS CPM,MPH-page 3 Board(s)/Committee(s): BOARD OF HEALTH Page 414 5-25-22 DRAFT NORTH ANDOVER BOARD OF HEALTH KEEPING OF ANIMALS RULES AND REGULATIONS T LED .1 � 6 • • • r3 fi �-- LAKE COC HTCHF W ICK ATER _. Adopted and Effective June 23, 2022 J Section 1 -Authority The North Andover Board of Health adopted these Keeping of Animals Rules and Regulations under the authority granted by M.G.L. Chapter 111, Section 31. Section 2 - Purpose Whereas minimum standards for keeping of animal's protection of the public health, animal welfare, and the environment are considered necessary for the welfare of the community, these regulations have been adopted by the North Andover Board of Health on June 23, 2022 and are effective on June 23, 2022. Section 3 - Definitions Unless otherwise noted below, the following terms shall have the following definitions through this regulation. 3.1 Abutter: shall mean the owner of properties within 300' of the parcel(s) that is applying for the Keeping of Animals Permit as certified by The North Andover Assessor's Office. 3.2 Accessory Structure: A building or structure which is incidental to the primary or principal building on the same lot and which is devoted exclusively to an accessory or secondary use to the principal building. 3.3 Animal: shall mean the keeping and raising of livestock including horses, the keeping and raising of poultry, swine, cattle, and other domesticated animals used for food or farming purposes as defined in MGL Chapter 111. 3.4 Applicant: shall mean any person, on behalf of themselves, a business or corporation, who applies for a permit to keep one or more animals under this regulation within in the Town of North Andover. 3.5 Animal Shelters and Corrals: shall include all stables, coops, pens, piggeries, cages, and any other means of protecting and housing an animal from the environment or for containing an animal. 3.6 Board of Health: shall mean the North Andover Board of Health and appointed agents. 3.7 Cockerel: shall mean a young male chicken. 3.8 Coop: shall mean a small structure for housing live fowl. 3.9 Corral: shall mean any pen or enclosure for confining one or more animals. 3.10 Direct Abutter: shall mean owners or tenants of land that adjoins the side or rear lot lines of the resident property that is applying. 3.11 Domesticated Animal: shall mean animals of a species of vertebrates that have been domesticated by humans to live and breed in a tame condition and depend on humankind for survival. Domesticated animals shall include household pets such as dogs, cats, ferrets, pot-bellied pigs, domesticated or exotic birds, hamsters and mice, etc. 3.12 Dwelling: shall mean any building, shelter or structure used or intended for human habitation. 3.13 Exotic Animal: shall mean an animal that is not native to this region and or country. 3.14 Facility: shall mean the total accommodations to be used for the keeping and care of one or more animals, including but not limited to, land and any accessory or animal structures such as, but not limited to, a coop, barn and/or stable. 3.15 Feral Cats: shall mean a cat born to the wild, which is no longer domesticated or socialized to humans and has been abandoned or allowed to become free roaming. 3.16 Fencing: shall mean enclosure material installed for the purpose of privacy or livestock and/or animal containment. 3.17 Fowl: shall mean chickens, pigeons, doves, capons, hens, turkeys, pheasants, guinea fowl, ducks, roosters, and geese other than wild species. 3.18 Generally Acceptable Agricultural Practices: shall mean the applicant is consistent with the Massachusetts Department of Agriculture Resources Division of Animal Health's, Generally Acceptable Agricultural Practices. The following are some potential resources. https://www.mass.gov/orgs/massachusetts-department-of-ag riculturaI-resources https://www.nrcs.usda.gov/wps/portal/nrcs/site/ma/home/ https:Hmassacd.wordpress.com/ https:Hag.umass.edu/resources/agricture-resources 3.19 Hen: shall mean adult female chicken. 3.20 Household Pets: shall mean domesticated animals that are primarily kept indoors for non-agricultural purposes, including but not limited to dogs, cats, ferrets, pot-bellied pigs, domesticated or exotic birds, hamsters and mice, etc. 3.21 Keeping of Animals Permit: shall mean a permit issued by the North Andover Board of Health and appointed agents for the keeping or housing of one or more animals in accordance with the provisions of this regulation. 3.22 Livestock: shall mean animals kept for agricultural purposes, including but not limited to cattle, goats, sheep, swine, equines, camelids, poultry, and other fowl. For the purposes of this regulation, the definition of"livestock" shall not include roosters or cockerels. 3.23 Manure Management Plan: shell mean a plan for the handling of manure. This plan shall address cleaning, composting, storage, utilization, and removal of manure. 3.24 Nuisance: shall mean any condition including, but not limited to noise, offensive odor, attraction or breeding of insects, an environment supporting growth of vermin, presence of rodents, or any other condition having public health or environmental significance. 3.25 Permit: shall mean a permit that is issued by the North Andover Board of Health and appointed agents for the keeping of one or more animals in accordance with the provisions of this regulation. 3.26 Permit Applicant: shall mean any person, on behalf of themselves, a business or corporation, who applies for a permit to keep one or more animals under this regulation within in the Town of North Andover. 3.27 Permit Holder: shall mean any person who has received a permit issued by the Board of Health for the keeping of animals. 3.28 Pen: shall mean a structure for the keeping or housing one or more animals. 3.29 Person: shall mean a person, persons, association, partnership, trust, company, corporation, or other legal entity, owning property carrying on an activity regulated by this regulation. 3.30 Pest Management Plan: shall mean a plan, which adequately defines the measures that shall be taken by the owner to minimize the presence of rodents, insects, and pests, and to minimize the creation of odors and other nuisances. 3.31 Plot Plan: shall mean the plan that shows the dimensions of the lot and area where animals will be kept. A plot plan must also include the locations of the primary residence, all structures, fences, corrals, septic systems, private wells, and wetlands. A hand-drawn plot plan is acceptable so long as it is of sufficient detail and quality to allow for review by the North Andover Board of Health and appointed agents. 3.32 Poultry: shall mean the following but is not limited to, chickens, ducks, geese, guinea fowl, peafowl, pheasants, partridges, quail and turkey. 3.33 Rooster: shall mean adult male chicken. 3.34 Runoff: shall mean water from natural or unnatural sources that flows over the surface of the ground. 3.35 Stable: shall mean a building or structure used for the shelter and/or feeding of one or more animals. 3.36 Stall: shall mean a compartment in a stable used for the keeping of one or more animals. 3.37 Swine: shall mean livestock suck as pigs, hogs and boars but shall not include domesticated pigs kept primarily indoors as companion animals. 3.38 Town: shall mean the Town of North Andover. 3.39 Usable Area: shall mean land area suitable for the raising of animals such as pastures, fields, and wooded uplands. This area does not include wetlands, dwellings, or any other area(s) as may be restricted by town, state or federal law, regulations, or guidelines. 3.40 Vermin: shall mean various types of insects, bugs and rodents. 3.41 Wetland: shall mean land area or surface are so defined by Massachusetts Wetlands Protection Act, M.G.L. Chapter 131, Section 40, and regulations promulgates pursuant thereto at 310 CMR 10.00 and the North Andover Wetlands Protection Bylaw. Section 4 - General Requirements 4.1 All applications must be submitted to The North Andover Board of Health and shall meet the criteria set forth in this regulation. 4.2 All structures must comply with the setback requirements for the zoning district in which such structures are located as set forth in The North Andover Zoning Bylaw's (Chapter 195-4.2, Chapter 195-4.3, Chapter 195-4.4, Chapter 195-4.5, Chapter 4.6). Chart 195 attachment 3 (Table 2 summery of dimensional requirements) and Wetland Protection Chapter 190. 4.3 All Keeping of Animal Applications must meet all Zoning Requirements set forth in the North Andover Zoning Bylaw as summarized below in Table 1. TABLE 1 North Andover by law states: Agriculture, horticulture,floriculture,viticulture or silviculture. (1) Farming of field crops and row crops,truck gardens,orchards,plant nurseries,and greenhouses. (2) On any lot of at least three acres,the keeping of a total of not more than three of any kind or assortment of animals or birds,except chickens being kept,harbored, raised,or maintained as accessory to a residential single-family structure as defined in Subsection F(5),in addition to the household pets of a family living on such lot,and for each additional acre of lot size to five acres,the keeping of one additional animal or bird,but not the keeping of animals,birds,or pets of persons not resident on such lot. (3) On any lot of at least five acres,the keeping of any number of animals or birds regardless of ownership and the operation of equestrian riding academies,stables,stud farms,and poultry batteries. (4) The sale of products raised as a result of the above uses on the subject land. (5) The sale of products of agriculture, horticulture,floriculture,viticulture or silviculture as well as accessory or customary items,by any person who is primarily engaged in any of the above activities.The operation must be on at least 10 contiguous acres used primarily for any of these activities. (6) A single-family residence may keep a maximum of six hens. (a) Two-family residences,in addition to single-family residences,may keep six hens as long as hens are owned by the homeowner,who must reside in the property. (b) For lots of at least three acres,a single-family residence may keep a maximum of three hens per acre of lot size. (c) No roosters shall be permitted. (d) Such residence must maintain a minimum coop area of four-square feet per hen. (e) The owner of the hens must live in the residence. (f) Hens and coops are prohibited from the front yard of a residence, unless screened by a privacy fence of at least six feet in height. (g) No coop shall be located closer than 40 feet to any residential structure occupied by someone other than the hen owner,custodian,or keeper. (h) The hens shall be secured in a coop and contained in a fenced area on the property when out of the coop. (i) This use shall meet all current applicable state or Board of Health regulations regarding the raising of chickens. 4.4 All facilities used for the keeping of animal's shall be securely fenced as to prevent animals from escaping the location that is permitted for the keeping of animals. 4.5 Keeping of household pets are exempt from this regulation with the exception that the North Andover Board of Health and appointed agents may impose a permit requirement in situations where animals are kept in unreasonable numbers or in conductions that may result in a public health nuisance or hazard to the health and welfare of the Town of North Andover and its residents. Section 5— Permit Requirements 5.1 A permit to keep one or more animals shall be required for anyone keeping one or more animals as defined in this regulation. 5.2 Permits shall be required annually and expiration dates shall be set by the Board of Health permit and fee schedule. Permits shall last for one year unless revoked or suspended by the North Andover Board of Health or appointed agents. 5.3 Any violations of these regulations may result in enforcement actions that include but are not limited to, issuance of an Order to Correct, monetary fines, permit suspension or permit revocation. Section 6 -Application Requirements 6.1 Permit applicant must complete and submit. 6.1.1. Completed application. 6.1.2. Sketch or Certified Plot Plan of land. The plot plan shall include: • All property boundaries; • All principal and accessory structures, including but not limited to dwellings, coops, stables, fences, physical barriers, corrals and pens. • All utilities and appurtenances including septic systems; • All impervious areas such as driveways, walkways, etc. • All surface water, wetlands or water courses on the property and within 100' of all property boundaries; • Areas dedicated for animals shall be depicted on the plan; • Areas for storage of feed, waste, etc. shall be noted on the plot plan; and • Number and species of animals to be kept shall be noted on this plan. 6.1.3. Payment of Application Fee. Fees shall be set by the North Andover Board of Health Permit Fee Schedule. 6.1.4. Written plans of how the permit holder or operator will implement. • Manure and Waste Management Plan • Storage of Feed Plan • Pest Management Plan 6.1.5 New Applicants will be required to appear before the Board of Health and attend a Public Hearing for approval of their application. DO WE WANT TO HOLD PUBLIC HEARINGS FOR NEW APPLICANTS? 6.1.5 New applications will be required to submit a List of Abutters within 300' of the parcel(s) where the animals are proposed as certified by the North Andover Assessor's Office. (NOTE: This certified list shall not be more than 30 days old at the time of application submittal.) 6.1.6 New applications will be required to notify abutters by certified mail/certificate of mailing not less than seven (7) calendar days prior to the public hearing and proof of mailing presented at that hearing in the form of signed green cards." 6.1.7 New applications are also required to submit self-addressed stamped envelopes made out to each abutter. 6.1.8 Applications will need zoning clearance from the Building Department. 6.1.9 If the Applicant is not the property owner of the affected Lot, a written authorization to keep animals, from the Owner, must be provided to the Board of Health as part of the application. 6.2 The following will not be permitted: • The keeping of a rooster or roosters shall not be allowed; • Slaughtering operations of any animals shall not be allowed on any property not licensed by the Massachusetts Department of Public Health as a slaughter house; • The keeping of chickens or other agricultural animals inside a residential dwelling shall not be allowed; • Animals shall not be allowed to leave the property unattended or enter onto any abutting properties or private lands without written consent of the abutting property owner; • Permits are not transferrable. Section 7 - Construction 7.1 No person shall erect, occupy, use, rebuild, reconstruct, alter or structurally change a stable, accessory structure or corral without approval from but not limited to, the Board of Health, the Building Department, the Zoning Department and the Conservation Department. 7.2 All structures used for the housing of animals, storage of supplies and storage of waste must meet all Zoning and Conservation regulations. 7.3 All chicken coops must be raised no less than six inches (6") from the ground. 7.4 All stables, coops, or any other structures used for the housing of animals must be a minimum of one hundred feet (100') from any abutter's residential dwelling 7.5 All structures used for the storage of waste such as waste pits or receptacles that store any type of waste such as fecal matter, shavings and manure or urine related materials shall be located at a distance of at least one hundred feet (100) from any abutter's residential dwelling and least one hundred feet (100') from any wetland resource areas. Section 8—Standards of Care 8.1 Structures and areas used for the keeping of animals such as but not limited to, stables, coops, pens and corrals must be maintained in a clean and sanitary manner, free from decaying food, sources of filth, feces, stagnant water and insect or vermin infestation. 8.2 Structures used for the keeping of animals shall be of sufficient size and design to accommodate the number of animals housed in said structure. 8.3 Structures used for the keeping of animals shall be well ventilated and constructed of materials that will accommodate the animals in a safe and healthy manner and provide sufficient protection form the elements. 8.4 The permit holder is responsible to submit and implement a Manure and Waste Management Plan. A written Manure and Waste Management Plan shall be submitted with all permit applications. 8.5 The owner shall provide all necessary equipment, pits, receptacles and structures for the sanitary storage, management and disposal of all waste including but not limited to fecal matter, manure, shavings and manure or urine related materials that will control vermin, insects and odors. 8.6 The permit holder is responsible to submit and implement a Storage of Feed Plan. Food shall be stored in sealed, moisture proof and vermin proof containers. A written Storage of Feed Plan shall be submitted with all permit applications. 8.7 Animals must have access to fresh food and potable water. 8.8 Deceased animals shall be disposed of or incinerated at an appropriate facility and within a reasonable amount of time but in no event, more than forty-eight (48) hours after death. Storage of deceased animals shall be in such a way top prevent odors and the attraction of vermin. 8.9 Drainage or runoff containing fecal matter, manure, urine or animal waste shall not be discharged over the surface of the ground onto any neighboring property, public way or into any wetland resource area. 8.10 The Board of Health may allow composting of manure generated at the facility upon specific written approval of a Manure Management Plan which requests said permission. 8.11 The permit holder is responsible to submit and implement a Pest Management Plan for the facility and property. This plan requires approval by the Board of Health and will be performed by a licensed pest control company whenever required by law. A written Pest Management Plan shall be submitted with all permit applications. Section 9 - Enforcement and Penalties 9.1 Any violations of these regulations may result in a monetary fine and a written Order to Correct. 9.2 Any owner or person in charge of a facility covered by these regulations who does not comply with this regulation or an Order to Correct shall be issued a fine up to three- hundred dollars ($300). Each day or portion thereof in which a violation exists shall constitute a separate offense. Daily fines will continue to accrue until all violations are rectified and the property and facility is in full compliance with these regulations. 9.3 The North Andover Board of Health and appointed agents may suspend, revoke, or deny a permit if any permit holder or potential permit holder is found to be in violation of any of these regulations or is not in compliance with an Order to Correct. 9.3.1 Any permit holder who has had a permit to keep animals revoked, shall be ordered to remove all animals from the property within thirty (30) days or within a timeframe as determined by the Board of Health or appointed agents. 9.4 Should the Animal Control Officer, Animal Inspector or an authorized representative of the Town of North Andover take into custody, a loose or stray animal and the animal's owner is determined, the owner shall be responsible for any and all fees associated with the capture, transport and boarding of said animal. Section 10 — Right to a Hearing 10.1 Any person or persons whom feel aggrieved by a Board of Health Order to Correct, that has been served pursuant to any section of these regulations, may request a hearing before the North Andover Board of Health and appointed agents, by filing a written request to the Board of Health for a hearing within seven (7) calendar days from receipt of said Order. Section 11 -Variance 11.1 The Board of Health may hold a public hearing and grant a variance to any provision of these regulations when in its opinion, the strict enforcement would do manifest injustice and does not jeopardize public health or the environment. 11.2 Variance to any section of this regulation may be requested before the North Andover Board of Health by submitting a written request for a public hearing for the specific purpose of requesting said variance. The Board will notify you of your scheduled hearing date. 11.3 The written request shall include the following: • A public hearing request in writing which clearly states which section and clause of the regulations a variance is sought. • The applicant must state the reason why a variance is sought and the manifest injustice the regulation causes by being enforced. • The reasons why granting the variance will not impact public health or the environment and all mitigating strategies to eliminate any such risks. 11.4 Anyone seeking a variance must notify all abutters within three hundred feet (300) of their property limits. Abutter Notification is required for any Public Hearing. 11.5 A Certified Abutters list obtained from the North Andover Assessor's Office not more than thirty (30) prior to the scheduled Board of Health meeting date. 11.6 Notification to the abutters on the certified abutter list shall include the following: a) Date, Time and Place of Public Hearing; b) Person or Entity requesting the Public Hearing; c) Specific regulation that the variance is requested; 11.7 Applicant must notify abutters via certified mail and submit return receipt documentation and a copy of the letter sent via certified mail prior to the opening of the public hearing. 11.8 At the Board of Health Hearing all parties will be allowed to present their information and the Board will make a determination to either grant or deny the variance in full or in part. Section 12 —Severability 12.0 Each provision of these regulations shall be considered as separate to the extent that if any section, item, sentence, clause or phrase is determined to be invalid for any reason, the remainder of this regulation shall continue to remain in full force and effect. t r , CommunityI AM • • • Plans for • of • • and North A • • • Submitted on May 5, 2022, by Abby Atkins, MSW, Managing Director aatkins@hria.org 617-279-2254 Health Resources in Action rt"> Advancing Public Health and Medical Research 2 Boylston Street,4th Floor Health Resources in Action Boston,MA 02116 t` 617.451.0049 1 Fax:617.451.0062 Advancing Public Health and Medical Research HRiA.org May 5, 2022 Town of Andover Central Purchasing Department 36 Bartlet St.,Andover, MA 01810 Attn:Theresa Peznola, Health Resources in Action (HRiA) is pleased to submit this proposal to implement and manage the Community Health Assessment Project on behalf of the Town of Andover.This transmittal letter includes the required information laid out in the request for applications. Organization: Health Resources in Action Address: 2 Boylston Street,4th Floor, Boston, MA 02116 Primary Contact: Abby Atkins, MSW E-mail Address: aatkins@hria.org Phone Number: 617.279.2254 HRiA acknowledges the terms and conditions of this opportunity and that they will apply to any contract resulting from this proposal.This proposal response will be in effect for at least sixty(60) days from the submission of proposal or until it is formally withdrawn, or a contract is executed, or this RFP is cancelled from the date of submission. We are eager and excited about the opportunity to support the Town of Andover to better understand the social needs faced by the Andover and North Andover communities and close the gap between social needs and associated resources. With deep gratitude, Steven Ridini, EdD President and CEO Health Resources in Action (HRiA) is pleased to submit this proposal to the Towns of North Andover and Andover to conduct a Community Needs Assessments(CNA) and develop Community Health Implementation Plans (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 residents. 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 f i • C • • COMMUNIT�ENGAGEMENT DATA CHALLENGES ENGAGE BUILD i INTERNAL APPROACHES j Develop and strengthen equitable internal policies/ practices,and build staff capacity Challenge assumptions arid'1 [�Cr�eateStrengthen capacity to narratives about what sustain authentic correct power imbalances se engagement 'remotes and hinders health j and address inequities YWalth It-m Mtm 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. Locations of HRiA Assessment and Planning Work MT ND VT ME MN ID SD WI { WY MI RI NE IA PA N1 NV OH _DE UT IN CO MD CA KS MO KY VA DC NC TN AZ NM c �, pK ARk SC ` MS AL A LA i 4 Y A 4 �'r AK �p HI 0 C M.d•dM mapcliwl.iM HRiA has conducted numerous needs assessments and community health improvement plans for communities similar to North Andover and Andover. In all of these projects, HRiA worked closely with the communities—and their partners where appropriate—in an engaged process that included both qualitative and quantitative data collection with the goal of presenting results so they are comprehensive, action-oriented, and can inform future planning and initiative development.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.goy/sites/default/files/files/Health/CHA- CHIP/2018 Travis County CHIP FINAL 9.12.18.pdf) • Winchester, MA (https://www.winchester.us/513/Needs-Assessment) • Issaquah, WA(https•//www issaguahwa.gov/DocumentCenter/View/4604/Issaquah-CNA-2017?bidld= ) 4 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 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.1The proposed project is to be conducted in three phases over a timeline of twelve months, starting in July 2022 and concluding in June 2023 (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 I: Community Needs Assessments(CNAs) Planning(M&E) Partner Engagement: CNA Presentation Final Draft and CommunityAdvisoryQualitative and Prioritization Committee Data of Assessment CPA Draft and Final Reports Collection Results Final CHIPS M&E Plan AugJul '• Octs Dec '• Mar Apr May June 2023 Analysis and Planning Secondary Data Community Development of Sessions and Document Health CNAReports Review Survey Phase II: Community Health Improvement Plans (CHIPs) 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 week(twice monthly) (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), 1 We propose using an adapted MAPP process that reflects the direction of the updated MAPP process. However, it is important to note that the official update to the MAPP tools and process will not be released until Summer 2023. 5 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. 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. As there will be overlap in the goals and activities of the Towns' assessment and planning processes, HRiA proposes engaging one Advisory Committee that includes representation from both communities. Engagement of the CAC will emphasize opportunities for collaboration between North Andover and Andover,while still ensuring that each town has its own process that reflects its unique context and needs. 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 z Association for Community Health Improvement(ACHI) Community Health Assessment Toolkit: https://www healthycommunities org/resources/community-health-assessment-toolkit 6 1. Secondary Data Review (July-October) 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 reports and appendices. 2. Qualitative Data Collection -Key Informant Interviews&Focus Groups(August-November) 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, local health care providers, 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 (10 per community) and 10 resident discussions with residents in the Andover and North Andover communities (5 per community). 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. Opportunities to conduct overlapping data collection (e.g., an interview with a community-based organization that serves both communities) will be identified and discussed with project leadership and the CAC. 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 7 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 characteristics. HRiA'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). Analysis of collected qualitative data will be conducted in a manner that distinguishes between Andover and North Andover,though areas of overlap or potential opportunities for collaboration between the two communities will be highlighted. 3. Quantitative Data Collection—Community Survey(September-November) 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 will be conducted to distinguish findings between the two focus communities,though areas of overlap or potential opportunities for collaboration will be highlighted. 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 identifying any concurrent data collection efforts (e.g., other community survey efforts) and, where possible, identifying opportunities to align with those efforts. In the opportunity arises to coordinate with other initiatives, HRiA can adjust the budget accordingly. 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. 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.This scope also assumes that the Towns are responsible for entering data from any paper copies of survey responses that are collected. 8 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(December) Once the assessment is drafted, HRiA will develop PowerPoint presentations on key findings for each community for presentation at the Community Health Implementation Plan (CHIP) kick-off and prioritization meetings. 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 the CNAs, 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 for each community 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 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 decks 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 town 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. 5. Analysis and Development of Draft and Final CNA Report(December- February) HRiA will develop final assessment reports for both Andover and North Andover. Data from these tasks will be analyzed to provide a portrait of each 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 reports 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 reports 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 for that community. Draft assessment reports 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. 9 Based on this feedback, HRiA will finalize the report. HRiA aims for the final assessment reports to be salient to multiple audiences, written in lay language, and be visually interesting.To this end, we suggest that the final reports 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 pages 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) Following the completion of the community needs assessments,the work will move into development of two community health improvement plans. 1. CHIP Kick-Off,Capacity Building Sessions,and Preplanning Meetings (January 2023) HRiA will conduct two virtual 90-minute meeting (one with Andover and one with North Andover project staff and their project CAC) to kick off the planning processes and discuss current/emerging initiatives from the recently completed Community Needs Assessments (CNAs). During the Kick-Off Meetings, 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 planning sessions. Preparation is required to meaningfully engage diverse stakeholders in the development and implementation of a CHIP. Informed by the findings from the assessment and conversations with the Community Advisory Committee, HRiA will craft a set of capacity building sessions to prepare planning participants for the CHIP planning process. HRiA proposes to lead two, 2-hour interactive capacity building sessions to engage the planning participants. While the content of each session will be similar to build a common foundational experience across all participants, approaches and examples might vary slightly depending on the unique needs of participants and their respective community. Potential topics might include, but are not limited to: • Foundations in health and racial equity: Define health equity, racial equity, health inequities, structural racism, and other related concepts and frameworks. • Identifying root causes of inequities: Prioritize approaches that meaningfully address disparities and advance equity, uncover the root causes of inequities in our work, and explore the ways power perpetuates inequities. • Advancing health equity through systems change: Explore upstream and downstream approaches to health; and identify narratives and mental models that hold inequities in place, opportunities to shift relationships and power more equitably, and opportunities for structural change—through policies, practices,community engagement, and resource flows. • Power, privilege,and facilitating collective ownership and accountability: Recognize how intersecting social identities interact with systems and health outcomes, identify how power, oppression, and privilege intersect—along with opportunities for change, and explore individual, interpersonal, and institutional roles and responsibilities to advance health and racial equity. 10 Not all topics listed above will included in the two, 2-hour sessions; HRiA will work with the Community Advisory Committee to prioritize topics. HRiA will support the Community Advisory Committee to recruit and plan the logistics for each capacity building session. Once planned, HRiA will deliver these interactive capacity building sessions—with attention to building knowledge and skills, ensuring the actionability of learning, and creating a learning environment that encourages trust-and relationship-building. HRiA will also collect participant feedback for continuous quality improvement. HRiA will also develop content and conduct two 1-1.5-hour virtual pre-planning sessions for all participants of the upcoming CHIP planning sessions. These sessions will cover the identified priorities and relevant data to support the priorities chosen. The CHIP planning processes 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 sessions.This meeting will be recorded and shared with any invitees who are unable to attend the live virtual meeting. Deliverables for CHIP Kick-off, Capacity Building Sessions and Pre-Planning Meeting • Agenda (Word document) and presentation (PowerPoint document)for the Kick-Off Meetings • Documented outcomes of the Kick-Off Meetings (Word document) • Agenda (Word document) and presentation (PowerPoint document)for the Capacity Building Sessions • Agenda (Word document), presentation (PowerPoint document)for Pre-Planning Meetings • Link to recording of the Preplanning Meetings 2. CHIP Planning Sessions(February—March 2023) 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 plans that are 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 plans. The CHIPS will be 5-year plans to address health issues that are prioritized as most appropriate for North Andover and Andover to address. The plans 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 two separate processes, each comprised of four virtual sessions with stakeholders,to develop CHIPS that are in alignment with current initiatives,the respective CHNAs, and other identified priorities in the community. HRiA will then facilitate conversations in work groups, one for each priority area,capturing key elements 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 11 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 eight (8) potential priority areas, and two (2) 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 Sessions • Summary notes and outcomes of priority area discussions (Word documents) 3. Draft and Final CHIP Reports (April—May 2023) The CHIP reports will synthesize the outcomes from the planning sessions, identify or refine the indicators that may be helpful in tracking the success of the CHIPs, 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 reports to be salient to multiple audiences, with a focus on the main findings, written in lay language.To this end,the final documents 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 processes, it would also be expected that this plan would have support and buy-in from a range of stakeholders.The CHIPs will ideally become living documents as key leaders involved in this CHIP processes secure commitments from stakeholders for CHIP implementation. Upon receipt of each draft, North Andover and Andover project leadership and the CAC will disseminate the CHIPS to the appropriate subject matter experts (SMEs) 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 drafts of the CHIPS. HRiA will be happy to conduct additional review/feedback cycles at the client's request for a mutually agreed upon cost. 12 The drafts and final reports will be delivered as Microsoft Word documents including a table of contents, main report, and appendices. The main body of the reports 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 CHIPS to the community and other stakeholders. Deliverables for Draft and Final CHIP Reports • First Drafts of the 2022 Community Health Improvement Plans(Word document) • Instructions for review/feedback cycles(emails) • Second Drafts of the 2022 Community Health Improvement Plans (Word document) • Final 2021 Community Health Improvement Plans (Word document) • CHIP presentations (PowerPoint) 4. CHIP Year 1 Action Planning&Report Development(June 2023) 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 two CHIP Action Plans. • Develop the components of the two Action Plans 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 six(three per CHIP),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 draft Year One Action Plans to include: goals, objectives, strategies from the CHIPs, 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 Plans 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 plans 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 Plans. The draft and final reports will be delivered as a Microsoft Word document including a table of contents, main report, and appendices.The reports will contain minimal narrative.The client may provide logo(s)/artwork for use on the cover pages if desired. Deliverables for Year 1 Action Plans 13 • Agendas and materials for Action Planning Sessions (Word and PowerPoint documents). • Recommendations for set-up, logistics, and supplies/materials required for session. • Drafts of the Year 1 Action Plans (Word document) • Final Year 1 Action Plans (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. 14 HRiA Team The HRiA team for the Andover and North Andover's CNA-CHIP would be comprised of staff with a range of expertise in research,facilitation, and strategic planning. Meghan Guptill and Kevin Myers will co-lead a diverse team of staff,with support from senior advisors, Abby Atkins and Amanda Ayers. Ms. Guptill and Ms. Atkins will lead the assessment phase and play a key role in developing quantitative and qualitative methods and instruments, communicating work plans and timelines, and providing oversight to the assessment. Ms. Guptill and Ms. Atkins will work with staff from the Department of Strategic Planning and Organizational Effectiveness to inform and transition to the planning phase, in which Mr. Myers and Ms.Ayers will lead the development of the CHIP. Meghan Guptill, MPH, is a Senior Associate at HRiA. For this project, Ms. Guptill will serve as project co-lead. She has experience conducting both qualitative and quantitative research, and has supported data collection and asset mapping activities for community needs assessments around the country including in Massachusetts, Texas and Washington State. Ms. Guptill is skilled at synthesizing and analyzing data from multiple sources, including focus groups, interviews, and surveys, to identify salient themes and priorities. Previously,she served as the day-to-day project manager for a community needs assessment for the city of Winchester, MA. In that role, she provided project management, qualitative data collection and analysis, secondary data review, survey development, and report-writing. Ms. Guptill also has experience conducting research to support population health planning efforts; for example, she served as the project manager for an assessment of the early childhood and family mental health service landscape in New Hampshire. Ms. Guptill holds a master's degree in public health from Boston University School of Public Health and a bachelor's degree from Mount Holyoke College. Kevin Myers, MSPH, is a Director of Planning and Facilitation at HRiA. For this project, Mr. Myers will serve as project co-lead. Mr. Myers has over 10 years of public health experience including strategic planning, facilitation, community needs assessments, program management, grantmaking, capacity building assistance, and health and racial equity. Kevin provides tailored strategic planning services to coalitions, health departments, and hospitals on a wide range of health issues.While at HRiA, Mr. Myers co-developed and managed Working on Wellness, a $1.3 million grant program for businesses to implement worksite wellness initiatives. Kevin also provided strategic leadership to the Massachusetts Community Health and Healthy Aging Funds and served as a Program Officer for its inaugural awardees, representing a $10 million portfolio. Prior to joining HRiA, Kevin worked for the Massachusetts Department of Public Health and the U.S. Centers for Disease Control and Prevention. Kevin holds a Bachelor of Science degree in environmental engineering from Lehigh University and a Master of Science degree in public health from the University of North Carolina at Chapel Hill. Abby Atkins, MSW, is the Managing Director for Community Health Assessment at HRIA. For this project, Ms. Atkins will serve as a senior advisor. Ms. Atkins has over 25 years of experience in planning and conducting community-based research, community needs assessments, and evaluation projects and works with a wide range of public and private clients including hospitals, public health departments, school districts, nonprofits business and philanthropic entities. She has led or co-led over 30 community health needs assessments and planning processes. Ms. Atkins is the co-PI on a Robert Wood Johnson Foundation funded research project to evaluate hospital involvement in collaborative community health improvement processes. She leads diverse teams in data collection and analysis to inform planning, implementation and evaluation of small and large initiatives. Ms.Atkins holds a master's degree in social work(focus in community organization, social policy, and planning)from Boston College and a bachelor's degree from Connecticut College. Amanda Ayers, MPH, is the Managing Director of Strategic Planning&Organizational Effectiveness at HRiA. For this project, Ms. Ayers will serve as a senior advisor. Ms.Ayers has been working in the field of public health for nearly 25 years, and has expertise in strategic planning, evidence-based prevention, coalition development, 15 capacity building, and sustainability. Her work on CHA-CHIP and SIP planning in several states has broadened her skills in working with both large and small communities, health departments and non-profit hospitals. She has facilitated prioritization and rapid planning processes nationally, as well as working specifically in the areas of DoN planning and PHAB accreditation technical assistance. Ms.Ayers has an MPH from the University of Connecticut. 16 i 6 ZONING BYLAW REVIEW AND UPDATE j ANDOVER,MA i RFP No. 003/07-20/100 REFERENCES FORM Bidders Name:Health Resources in Action.Inc. Bidders Address: 2 Boylston St.41h Floor Boston,MA 02116 Bidder must provide references for similar type projects performed within the past three years.Attach additional pages if necessary. Reference: Boston CHA-CHIP Collaborative Contact:Magnolia Conteras,MSW.MBA(she/her) Address: Magnolia Contrerasna.dfci.harvard.edu Phone: 617-632-3462 Fax: Description and date of Project: 2019-2020&2022-2023 Community Health Assessment and Community Health Improvement Plans Reference: Connecticut Department of Public Health Contact:Sandra M Gill(she/her) Address: Sandra.M.Gillaa.ct.gov Phone: 860-509-7141 Fax: Description and date of Project: 2020 State Health Assessment and Improvement Plan Reference: City of Chelsea(MA) Contact:Alexander Train.AICP(he/him) Address: atr:ain@chelseama.gov Phone: 617-466-4192 Fax: Description and date of Project: 2022 Community engaged process to inform decision making on ARPA funds Reference: Contact: Address: Phone: Fax: Description and date of Project: 2021 Record # Applicant Name Company Name Address 1 62549 muneeb khan 10 Smoke Shop 100 ELM STREET, NORTH ANDOVER, MA 01845 *Adult Only* 2 60973 Christopher Buco McAloon's Liquors 535 CHICKERING ROAD, NORTH ANDOVER, MA 01845 3 60972 Christopher Buco Quic Pic 535 CHICKERING ROAD, NORTH ANDOVER, MA 01845 4 60911 Walid Bugazia Super Petroleum 79 CHICKERING ROAD, NORTH ANDOVER, MA 01845 Shetu, Inc.- DBA Richdale 5 49141 Mohammed Alam Dairy Stores 4 MAIN STREET, NORTH ANDOVER, MA 01845 6 54244 Samuel Ameen Sam's Mobil Mart 12 MASSACHUSETTS AVENUE, NORTH ANDOVER, MA 01845 KARLEN YEGOYAN (no 50661 longer in business) Kashmir Smoke 100 Elm Street, North Andover, MA 01845 Wine & Beer at the 350 WINTHROP AVENUE, Unit Wine and Beer at the Andovers, 7 49261 DHARMESH DAVE Andovers NORTH ANDOVER, MA 01845 8 49398 Jignashu Patel Richdale Convenience Store 75 CHICKERING ROAD, NORTH ANDOVER, MA 01845 9 48839 Michael Xenakis J&M Convenience Store 701 SALEM STREET, NORTH ANDOVER, MA 01845 10 48837 Michael Xenakis Mikes Market 220 MIDDLESEX STREET, NORTH ANDOVER, MA 01845 11 53577 Tina Truong A L Prime Energy 1725 TURNPIKE STREET, NORTH ANDOVER, MA 01845 12 49309 Nitesh Patel TOWN MART 260 WINTHROP AVENUE, NORTH ANDOVER, MA 01845 miroli Ilc, dba denrock wine 50 PETERS STREET, Unit Den Rock Wine and Spirits, NORTH 13 49276 vick jain &spirits ANDOVER, MA 01845 14 53564 John Gordon Market Basket 350 WINTHROP AVENUE, Unit 10B, NORTH ANDOVER, MA 01845 2 permits available 2 permits pending 786 Shell & Liquor Junction Town of North Andover Board of Health REGULATING THE SALE and USE OF TOBACCO PRODUCTS SECTION 1: STATEMENT OF PURPOSE WHEREAS there exists conclusive evidence that tobacco smoking causes cancer,respiratory and cardiac diseases,negative birth outcomes, irritations to the eyes,nose and throat[l]; WHEREAS the U.S. Department of Health and Human Services has concluded that nicotine is as addictive as cocaine or heroin[2] and the Surgeon General found that nicotine exposure during adolescence, a critical window for brain development,may have lasting adverse consequences for brain development,[3] and that it is an addiction to nicotine that keeps youth smoking past adolescence[4]; WHEREAS a Federal District Court found that Phillip Morris, RJ Reynolds and other leading cigarette manufacturers "spent billions of dollars every year on their marketing activities in order to encourage young people to try and then continue purchasing their cigarette products in order to provide the replacement smokers they need to survive" and that these companies were likely to continue targeting underage smokers[5]; WHEREAS more than 80 percent of all adult smokers begin smoking before the age of 18,more than 90 percent do so before leaving their teens, and more than 3.5 million middle and high school students smoke[6]; WHEREAS 18.1 percent of current smokers aged<18 years reported that they usually directly purchased their cigarettes from stores (i.e. convenience store,supermarket, or discount store) or gas stations, and among I I'grade males this rate was nearly 30 percent[7]; WHEREAS the Institute of Medicine(IOM) concludes that raising the minimum age of legal access to tobacco products to 21 will likely reduce tobacco initiation,particularly among adolescents 15 - 17,which would improve health across the lifespan and save lives[8]; Whereas cigars and cigarillos, can be sold in a single "dose;" enjoy a relatively low tax as compared to cigarettes; are available in fruit, candy and alcohol flavors; and are popular among youth[9]; WHEREAS research shows that increased cigar prices significantly decreased the probability of male adolescent cigar use and a 10%increase in cigar prices would reduce use by 3.4%[l0]; WHEREAS 59% of high school smokers in Massachusetts have tried flavored cigarettes or flavored cigars and 25.6% of them are current flavored tobacco product users;95.1 % of 12— 17-year old's who smoked cigars reported smoking cigar brands that were flavored[11]; 1 WHEREAS the Surgeon General found that exposure to tobacco marketing in stores and price discounting increase youth smoking[12]; WHEREAS the federal Family Smoking Prevention and Tobacco Control Act(FSPTCA), enacted in 2009,prohibited candy-and fruit-flavored cigarettes,[131 largely because these flavored products were marketed to youth and young adults,[141 and younger smokers were more likely to have tried these products than older smokers[15],neither federal nor Massachusetts laws restrict sales of flavored non-cigarette tobacco products, such as cigars, cigarillos, smokeless tobacco,hookah tobacco, and electronic devices and the nicotine solutions used in these devices; WHEREAS the U.S. Food and Drug Administration and the U.S. Surgeon General have stated that flavored tobacco products are considered to be"starter"products that help establish smoking habits that can lead to.long-tern addiction[16]; WHEREAS the U.S. Surgeon General recognized in his 2014 report that a complementary strategy to assist in eradicating tobacco-related death and disease is for local governments to ban categories of products from retail sale[17]; WHEREAS the U.S. Food and Drug Administration and the Tobacco Products Scientific Advisory Committee concluded that menthol flavored tobacco products increased nicotine dependence, decreased success in smoking cessation[18]; WHEREAS menthol makes it easier for youth to initiate tobacco use[191; WHEREAS the number of tobacco retail establishment permit holders in North Andover declined from 20 to 15 permit holders in 2019 and there has only been one adult only retail tobacco establishment permit that has been applied for; WHEREAS the U.S. Centers for Disease Control and Prevention has reported that the current use of electronic cigarettes, a product sold in dozens of flavors that appeal to youth, among middle and high school students tripled from 2013 to 2014[20]; WHEREAS 5.8% of Massachusetts youth currently use e-cigarettes and 15.9%have tried them[21]; WHEREAS the Massachusetts Department of Environmental Protection has classified liquid nicotine in any amount as an"acutely hazardous waste"[22]; WHEREAS in a lab analysis conducted by the FDA, electronic cigarette cartridges that were labeled as containing"no nicotine" actually had low levels of nicotine present in all cartridges tested, except for one [231 WHEREAS according to the CDC's youth risk behavior surveillance system, the percentage of high school students in Massachusetts who reported the use of cigars within the past 30 days was 10.8% in 2013[24]; 2 WHEREAS data from the National Youth Tobacco Survey indicate that more than two-fifths of U.S. middle and high school smokers report using flavored little cigars or flavored cigarettes[25]; WHEREAS the sale of tobacco products is incompatible with the mission of health care institutions because these products are detrimental to the public health and their presence in health care institutions undermine efforts to educate patients on the safe and effective use of medication, including cessation medication; WHEREAS educational institutions sell tobacco products to a younger population,who are particularly at risk for becoming smokers and such sale of tobacco products is incompatible with the mission of educational institutions that educate a younger population about social, environmental and health risks and harms; and WHEREAS the Massachusetts Supreme Judicial Court has held that " . . . [t]he right to engage in business must yield to the paramount right of goverment to protect the public health by any rational means"[26]. Now,therefore it is the intention of the North Andover Board of Health to regulate the sale of tobacco products. SECTION 2: DEFMTIONS For the purpose of this regulation, the following words shall have the following meanings: 2.1 ADULT-ONLY RETAIL TOBACCO ESTABLISHMENT: An establishment that does not share space with another business, that shall have a seperate public entrance,that does not sell food or alcohol, that does not have a restaurant license or lottery license,whose only purpose is to sell or offer for retail sale tobacco products and/or tobacco product paraphernalia, in which entry of persons under the age of 21 is prohibited at all times, and which maintains a valid permit for the retail sale of tobacco products as required to be issued by the North Andover Board of Health and any applicable state licenses. Entrance to the establishment must be secure so that access to the establishment is restricted to employees and to those 21 years of age and older. The establishment shall not allow anyone under 21 to work at the establishment. 2.2 BLUNT WRAP: Any tobacco product manufactured or packaged as a wrap or as a hollow tube made wholly or in part fiom tobacco that is designed or intended to be filled by the consumer with loose tobacco or other fillers. 2.3 BUSINESS AGENT: An individual who has been designated by the owner or operator of any establishment to be the manager or otherwise in charge of said establishment. 2.4 CHARACTERIZING FLAVOR: A distinguishable taste or aroma imparted or detectable either prior to or during consumption of a tobacco product or component part thereof, including,but not limited to, tastes or aromas relating to any fruit, chocolate, vanilla,honey, 3 candy, cocoa, dessert, alcoholic beverage, menthol, mint or wintergreen,herb or spice. "Characterizing flavor" does not include the taste or aroma of tobacco, additives, or flavorings that do not contribute to the distinguishable taste or aroma of the product or the provision of ingredient information. 2.5 CIGAR: Any roll of tobacco that is wrapped in leaf tobacco or in any substance containing tobacco with or without a tip or mouthpiece not otherwise defined as a cigarette under Massachusetts General Law, Chapter 64C, Section 1,Paragraph 1. 2.6 COMPONENT PART: Any element of a tobacco product, including, but not limited to, the tobacco, filter,paper, mouthpiece, heating element battery and/or electronic circuits but not including any constituent. 2.7 CONSTITUENT: Any ingredient,substance, chemical or compound, other than tobacco,water added to.a.tobacco product or reconstituted tobacco sheet that is added by the manufacturer to a tobacco product during the processing, manufacturing or packaging of the tobacco product, Such term shall include a smoke constituent from a tobacco product and a vapor or aerosolization constituent from a tobacco product. 2.8 DISTINGUISHABLE: Perceivable by either the sense of smell or taste. 2.9 EDUCATIONAL INSTITUTION: Any public or private college, school,professional school, scientific or technical institution,university or other institution furnishing a program of higher education. 2.10 ELECTRONIC CIGARETTE: Any electronic device composed of a mouthpiece, heating element, battery and/or electronic circuits that provides vapor of liquids,regardless of nicotine content, or relies on vaporization of any solid or liquid substance,regardless of nicotine content. This term shall include such devices whether they are manufactured as e-cigarettes, e-cigars, e-pipes or under any other product name. An electronic cigarette includes any component or part of an electronic cigarette,regardless of nicotine content,that rely on vaporization or aerosolization, including but not limited to,pods,vape juice containers and cartridges. 2.11 EMPLOYEE: Any individual who performs services for an employer. 2.12 EMPLOYER: Any individual,partnership, association, corporation, trust or other organized group of individuals, including North Andover or any agency thereof,which uses the services of one(1) or more employees. 2.13 ENCLOSED: A space bounded by walls,with or without windows or fenestrations, continuous from floor to ceiling and enclosed by one (1) or more doors, including but not limited to an office, function room or hallway. 2.14 FLAVORED TOBACCO PRODUCT: Any tobacco product or component part thereof that contains a constituent that has or produces a characterizing flavor. A public statement, claim or indicia made or disseminated by the manufacturer of a tobacco product, or by any 4 person authorized or permitted by the manufacturer to make or disseminate public statements concerning such tobacco product, that such tobacco product has or produces a characterizing flavor shall constitute presumptive evidence that the tobacco product is a flavored tobacco product. 2.15 HEALTH CARE INSTITUTION: An individual,partnership, association, corporation or trust or any person or group of persons that provides health care services and employs health care providers licensed, or subject to licensing,by the Massachusetts Department of Public Health under M.G.L. C. 112 or a retail establishment that provides pharmaceutical goods and services and subject to the provisions of 247 CMR 6.00. Health care institution includes, but is not limited to,hospitals, clinics,health centers,pharmacies, drug stores, doctor's offices and dentist's offices. 2.16 NON-RESIDENTLAL ROLL-YOUR-OWN(RYO)MACHINE: A mechanical device made available for use (including an individual who produces cigars, cigarettes, smokeless tobacco,pipe tobacco, or roll-your-awn tobacco solely for the individual's own personal consumption or use)that is capable of making cigarettes, cigars or other tobacco products. RYO machines located in private homes used for solely personal consumption are not Non-Residential RYO machines. 2.17 OUTDOOR SPACE: An outdoor area, open to the air at all times and cannot be enclosed by a wall or side covering. 2.18 PERMIT HOLDER: Any person engaged in the sale or distribution of tobacco products directly to consumers who applies for and receives a tobacco product sales permit or any person who is required to apply for a tobacco product sales permit pursuant to these regulations, or his or her business agent. 2.19 PERSON: An individual, employer, employee, retail store manager or owner, or the owner or operator of any establishment engaged in the sale or distribution of tobacco products directly to consumers. 2.20 RETAIL ESTABLISHMENT: Any establishment selling, goods,articles or personal services to the public,including but not limited to convenience stores, gas stations, grocery stores, department stores, barber shops, nail salons,hair salons and tanning salons. 2.21 SELF SERVICE DISPLAY: Any display from which customers may select a tobacco product without assistance fi-om an employee or store personnel, excluding vending machines. 2.22 SMOKING(or smoke): The lighting of a cigar, cigarette,pipe or other tobacco product or possessing a lighted cigar, cigarette,pipe or other tobacco or non-tobacco product designed to be combusted and inhaled. 2.23 SMOKING BAR: An establishment that primarily is engaged in the retail sale of tobacco products for consumption by customers on the premises and is required by Mass. General Law Ch. 270, Section 22 to maintain a valid permit to operate a smoking bar issued 5 by the Massachusetts Department of Revenue. "Smoking Bar"shall include,but not be limited to, those establishments that are commonly known as "cigar bars" and"hookah bars". 2.24 TOBACCO PRODUCT: Any product containing,made, or derived from tobacco or nicotine that is intended for human consumption,whether smoked, chewed, absorbed, dissolved,inhaled, snorted, sniffed, or ingested by any other means, including, but not limited to: cigarettes, cigars, little cigars, chewing tobacco,pipe tobacco, snuff or electronic cigarettes, electronic cigars, electronic pipes, electronic hookah,liquid nicotine, "e-liquids" or other similar products,regardless of nicotine content,that rely on vaporization or aerosolization. "Tobacco Product" includes any component or part of a tobacco product. "Tobacco Product"does not include any product that has been approved by the United States Food and Drug Administration either as a tobacco use cessation product or for other medical purposes and which is being marketed and sold or prescribed solely for the approved purpose. 2.25 TOBACCO PRODUCT SALES PERMIT: A permit issued by the Board of Health upon application and in accordance with Section 4 of these regulations. Approval and a Tobacco Product Sales Permit is required by any retail establishment or adult only tobacco retail establishment to sell any tobacco product in North Andover. Selling any tobacco product in North Andover without a valid Tobacco Product Sales Permit is a violation of these regulations and subject to enforcement. 2.26 VAPING PRODUCTS: 1) any product intended for human consumption by inhalation regardless of nicotine content,whether for one-time use or reusable,that relies on vaporization or aerosolization, including but not limited to electronic cigarettes, electronic cigars electronic cigarillos, electronic pipes, electronic vaping product delivery pens,hookah pens, and any other similar devices that rely on vaporization or aerosolization; and 2) any component,part, or accessory of a product or device defined in subsection 1), even if sold separately. "Vaping products" do not include any product that has been approved by the Federal Food and Drug Administration either as a tobacco use cessation product or for other medical purposes and which is being marketed and sold or prescribed solely for the approved purpose. 2.27 VENDING MACHINE: Any automated or mechanical self-service device,which upon insertion of money, tokens or any other form of payment, dispenses or makes cigarettes, any other tobacco product. SECTION 3: TOBACCO PRODUCT SALES TO PERSONS UNDER THE AGE OF 21 PROHIBITED -11 PROHIBITION UNDER TWENTY ONE YEARS OF AGE: No person shall sell or otherwise distribute tobacco products to persons under the age of 21. 6 3.2 REQUIRED SIGNAGE: In conformance with G.L. c. 270, § 7, a copy of Massachusetts General Laws, Chapter 270, Section 6,shall be posted conspicuously by the owner or other person in charge thereof in the shop or other place used to sell tobacco products at retail. The notice shall be made available fiom the North Andover Board of Health. The notice shall be at least 48 square inches and shall be posted conspicuously by the permit holder in the retail establishment or other place in such a manner so that it may be readily seen by a person standing at or approaching the cash register. The notice shall directly face the purchaser and shall not be obstructed from view or placed at a height of less than four(4)feet or greater than nine (9) feet from the floor. The notice shall also disclose current referral information about smoking cessation, as well as notice that the sale of tobacco products, to someone under the age of 21 is prohibited,and that the use of e-cigarettes is prohibited where smoking is prohibited in the Town of North Andover. 3.3 IDENTIFICATION: Each person selling or distributing tobacco products or nicotine delivery products shall verify the age of the purchaser by means of a valid government-issued photographic identification containing the bearer's date of birth that the purchaser is 21 years old or older. Verification is required for any person who appears to be under the age of 40. 3.4 FACE TO FACE SALES: All retail sales of tobacco products must be face-to-face between the seller and the buyer(except for the purchase of tobacco from vending machines) and all retail sales of tobacco products must occur at a location with a valid tobacco product sales Permit, SECTION 4: TOBACCO PRODUCT SALES PERMIT 4.1. No person shall sell or otherwise distribute tobacco products at retail within North Andover without first obtaining a Tobacco Product Sales Permit issued annually by the North Andover Board of Health. Only owners of establishments with a permanent, non-mobile location in North Andover are eligible to apply for a permit and sell tobacco products or products in North Andover. 4.2 As part of the Tobacco Product Sales Permit application process,the applicant will be provided with the North Andover Board of Health regulation. Each applicant is required to sign a statement declaring that the applicant has read said regulation and that the applicant is responsible for instructing any and all employees who will be responsible for tobacco product sales regarding federal, state and local laws regarding the sale of tobacco and this regulation. 4.3 Each applicant who sells tobacco is required to provide proof of a current tobacco sales license issued by the Massachusetts Department of Revenue before a Tobacco Product Sales Permit can be issued. 7 4.4 The fee for a Tobacco Product Sales Permit shall be in accordance with the most current Board of Health fee schedule. All such permits shall be renewed annually by June 30`' of every year, 4.5 A separate permit is required for each location where a retail establishment is selling tobacco products. 4.6 Each Tobacco Product Sales Permit shall be displayed at the retail establishment in a conspicuous place, 4.7 No Tobacco Product Sales Permit holder shall allow any employee to sell tobacco products until such employee reads this regulation and federal and state laws regarding the sale of tobacco and signs a statement, a copy of which will be placed on file in the office of the employer,that he/she has read the regulation and applicable state and federal laws. 4.8 A Tobacco Product Sales Permit is non-transferable 4.9 Issuance of a Tobacco Product Sales Permit shall be conditioned on an applicant's consent to unannounced,periodic inspections of his/her retail establishment to ensure compliance with this regulation. 4.10 Issuance and holding of a Tobacco Product Sales Permit shall be conditioned on an applicant's on-going compliance with current Massachusetts Department of Revenue requirements and policies including, but not limited to,minimum retail prices of tobacco products. 4.11 A Tobacco Product Sales Permit will not be renewed if the permit holder has failed to pay all fines issued and the time period to appeal the fines has expired and/or has not satisfied any outstanding permit suspensions. 4.12 An Adult-Only Retail Tobacco Establishment maybe issued a Tobacco Product Sales Permit authorizing the sale of flavored tobacco products or blunt wraps provided the Adult-Only Retail Tobacco Establishment meets with the following conditions: a) The business establishment does not share retail or business space with another business establishment.It has a separate public entrance from any other business establishment. The entrance is secured so that access is restricted to employees and individuals twenty one(21)years of age or older: b) It does not sell food,drinks, alcohol, lottery tickets, goods or services nor shall it hold a license to sell food, a restaurant license, an alcohol license, or a lottery license. c) No person under the age of twenty one (21)shall enter the premises or be employed by the establishrent. 8 d) It shall not be located within five hundred(500') feet of a retailer with a tobacco product sales permit, e) It shall hold all permits and licenses required by the Commonwealth of Massachusetts. 4.13 A Tobacco Product Sales Permit limited to the sale of natural tasting tobacco products that does not have a characterizing flavor may be issued to other retail establishments that meet the criteria of the North Andover Board of Health regulations and all state and federal laws pertinent to the sale of natural tasting tobacco products. 4.14 At any given time, there shall be no more than SIXTEEN (16) Tobacco Product Sales Permits issued in the Town of North Andover. This section shall only apply to permits newly issued after the effective date of this regulation. No renewal of an existing valid permit will be denied based on the permit capping requirements described herein. A valid existing permit shall not include any permit that has not been renewed within thirty (30) days of its expiration. Any such permit shall be treated as a New Permit. 415 At any given time there shall be no more than ONE (1) Tobacco Product Sales Permit issued to an Adult-Only Retail Tobacco Establishment. 4.16 A Tobacco Product Sales Permit shall not be issued to any new applicant for a retail establishment located within five hundred(500')feet of a public or private elementary or secondary school as measured by a straight line from the nearest point of the property line of the school to the nearest point of the property line of the site of the applicant's business premises. 4.17 A Tobacco Product Sales Permit shall not be issued to any new applicant for a retail establishment located within five hundred(500') feet of a retailer with a valid Tobacco Product Sales Permit as measured by a straight line from the nearest point of the property line of the retailer with a valid Tobacco Product Sales Permit to the nearest point of the property line of the site of the applicant's business premises. 4.18 Applicants who purchase or acquire an existing business that holds a valid Tobacco Product Sales Permit at the time of the sale or acquisition of said business must apply within sixty(60) days of such sale or acquisition for the permit held by the Current Permit Holder if the Applicant intends to sell tobacco products, as defined herein. Such applicant may choose to apply for a Tobacco Product Sales Permit for an Adult-Only Retail Tobacco Store if the Current Permit Holder possessed the same or if a Tobacco Product Sales Permit for an Adult-Only Retail Tobacco Store is available per subsection 4.15. SECTION 5: CIGAR SALES REGULATED: 5.1 No retailer,retail establishment, or other individual or entity shall sell or distribute or cause to be sold or distributed a cigar unless the cigar is contained in an original package of at least 9 four(4) cigars. A package of four or more cigars must be priced at the retail market price or at five ($5.00) dollars,whichever price is higher. 5.2 This Section shall not apply to: (a) The sale or distribution of any cigar having a retail price of two dollars and fifty cents ($2.50) or more. (b) A person or entity engaged in the business of selling or distributing cigars for commercial purposes to another person or entity engaged in the business of selling or distributing cigars for commercial purposes with the intent to sell or distribute outside the boundaries of North Andover. 5.3 The North Andover Board of Health may adjust from time to time the amounts specified in this Section to reflect changes in the applicable Consumer Price Index by amendment of this regulation. SECTION 6: THE SALE OF FLAVORED TOBACCO PRODUCTS PROHIBITED 6.1 No person shall sell or distribute or cause to be sold or distributed any flavored tobacco products except in smoking bars and adult-only retail tobacco establishments. SECTION 7: THE SALE OF 13LUNT'WRAPS 7.1 No person or entity shall sell or distribute blunt wraps within North Andover, except in adult-only retail tobacco establishments are permitted to sell or distribute blunt wraps. SECTION 8: FREE DISTRIBUTION AND COUPON REDEMPTION 8.1 No person shall: (a)Distribute, or cause to be distributed, any free samples of tobacco products. (b)Accept or redeem, offer to accept or redeem, or cause or hire any person to accept or redeem or offer to accept or redeem any coupon that provides any tobacco product, as defined herein, without charge or less than the listed or non-discounted price in exchange for the purchase of any other tobacco product. (c) Sell a tobacco product, as defined herein,to consumers through any multi pack discounts (e.g. "buy two get one free") or otherwise provide or distribute to consumers any tobacco product, as defined herein,without charge or for less than the listed non-discounted price in exchange for the purchase of any other tobacco product. 10 SECTION 9: OUT-OF-PACKAGE SALES 9.1 The sale or distribution of tobacco products as defined herein in any form other than an original factory-wrapped package is prohibited. No person may sell or cause to be sold or distribute or cause to be distributed, any cigarette package that contains fewer than twenty (20) cigarettes, including single cigarettes. (a) The sale or distribution of tobacco products, as defined herein, in any form other than an original factmy-wrapped package is prohibited, including the repackaging or dispensing of any tobacco product, as defined herein, for retail sale. No person may sell or cause to be sold or distribute or cause to be distributed any cigarette package that contains fewer than twenty (20) cigarettes, including single cigarettes. (b)Pursuant to the Governor's September 24, 2019 Public Health Emergency Order,no Permit holder shall sell Liquid Nicotine Containers. The North,Andover Board of Health may reconsider this prohibition at the time the Public Health Emergency has been deemed to be resolved. If the prohibition ends thereafter,the Permit holder who sells Liquid Nicotine Containers must comply with the provisions of 310 CMR 30.000, and must provide the North Andover Board of Health with a written plan for disposal of said product,including disposal plans for any breakage, spillage or expiration of the product. (e)All permit holders must comply with 940 CMR 21.05 which reads: "It shall be an unfair or deceptive act or practice for any person to sell or distribute nicotine in a liquid or gel substance in Massachusetts after March 15,2016 unless the liquid or gel product is contained in a child-resistant package that, at a minimum,meets the standard for special packaging as set forth in 15 U.S. C. §§1471 through 1476 and 16 CFR §1700 et. seq." (d)No permit holder shall refill a cartridge that is pre-filled and sealed by the manufacturer and not intended to be opened by the consumer or retailer. SECTION 10: SELF SERVICE DISPLAYS 10.1 All self service displays of tobacco products are prohibited. All humidors including, but not limited to, walk-in humidors must be locked. SECTION 11: TOBACCO VENDING MACHINES 11.1 All tobacco product vending machines are prohibited. SECTION 12: NON-RESIDENTIAL ROLL-YOUR-OWN WO)MACIRM 12.1 All Non-Residential Roll-Your-Own(RYO) Machines are prohibited. 11 SECTION 13: RESTRICTIONS ON THE SALE OF TOBACCO PRODUCTS AT HEALTH CARE INSTITUTIONS 13.1 No Health Care Institution located in the Town of North Andover shall sell or authorize the sale of tobacco products within its buildings, or facilities or on its grounds. G.L. c. 111, § 61A, as amended 2018 SECTION 14: PROHIBITION OF THE SALE OF TOBACCO PRODUCTS BY EDUCATIONAL INSTITUTIONS: 14.1 No educational institution located in the Town of North Andover shall sell or cause to be sold tobacco products. This includes all educational institutions as well as any retail establishments that operate on the property of an educational institution. SECTION 15: SALE OF ELECTRONIC CIGARETTES PROHIBITED: 15.1 Consistent with the Governor's September 24,2019 Declaration of a Public Health Emergency, no person shall sell, distribute,or cause to be sold or distributed any vaping products as defined herein. If the Public Health Emergency Ban has been deemed to be resolved or rescinded,the sale of electronic cigarettes and all vaping products or accessories will be restricted to only Adult-Only Tobacco Retail Establishments. SECTION 16: PROHIBITING SMOKING IN WORKPLACES AND PUBLIC PLACES 16.1 The Board of Health adopts the Massachusetts Smoke-Free Workplace by reference and any future revisions as a local regulation. G.L. c.270, §§ 21, 22. 16.2 Pursuant to G.L. c. 270, § 22 0), smoking is also hereby prohibited in the following locations: (a)Adult-Only Retail Tobacco Store; (b) Smoking bar; (c) Outdoor spaces of restaurants,bars,taverns and any other outdoor space where food and/or alcoholic beverages, and/or non-alcoholic beverages are sold to the public and served to the public, or otherwise consumed or carried by the public; (d)Within Twenty--Five (25) feet of a building entrance or enclosed space where smoking is prohibited. 16.3 The use of e-cigarettes or any vaping product is prohibited wherever smoking is prohibited. G. L. c. 270, §22 and North Andover Board of Health regulation§ 4.17.002. 12 SECTION 17: VIOLATION OF TERMS OF PERMIT AND REGULATIONS 17.1 It shall be the responsibility of the permit holder and/or his or her business agent to ensure compliance with all sections of this regulation pertaining to his or her distribution of tobacco products. The violator shall receive: (a)In the case of a first violation, a fine of Three Hundred($300) dollars; (b) In the case of a second violation within twenty-four(24) months of the date of the first violation, a fine of Three Hundred($300) dollars and the Tobacco Product Sales Permit may be suspended for Seven(7) consecutive business days. (c) In the case of a third violation within a twenty-four(24)month period, a fine of Three Hundred($300)dollars and the Tobacco Product Sales Permit may be suspended for Thirty(30) consecutive business days. (d) In the case of more than three violations within a twenty-four(24)month period, a fine of three hundred (300) dollars per additional violation and the Tobacco Product Sales Permit may be revoked. 17.2 Refusal to cooperate with inspections pursuant to this regulation shall result in the suspension of the Tobacco Product Sales Permit for Thirty(30) consecutive business days. 17.3 In addition to the monetary fines set above, any permit holder who engages in the sale or distribution of tobacco products directly to a consumer while his or her permit is suspended shall be subject to the suspension of all Board of Health issued permits for thirty (30) consecutive business days. 17.4 The North Andover Board of Health shall provide notice of their intent to suspend or revoke a Tobacco Product Sales Permit,which notice shall contain the reasons therefore and establish a time and date for a hearing which date shall be no earlier than seven(7) days after the date of said notice. The permit holder or its business agent shall have an opportunity to be heard at such hearing and shall be notified of the Board of Health's decision, and the reasons therefore in writing. After a hearing, the North Andover Board of Health may suspend or revoke the Tobacco Product Sales Permit if the Board finds that a violation of this regulation occurred. For purposes of such suspensions or revocations,the Board shall make the determination notwithstanding any separate criminal or non-criminal proceedings brought in court hereunder or under the Massachusetts General Laws for the same offense. All tobacco products shall be removed from the retail establishment upon suspension or revocation of the Tobacco Product Sales Permit. Failure to remove all tobacco products shall constitute a separate violation of this regulation. 13 SECTION 18: VIOLATIONS OF REGULATIONS 181 Whoever violates any provision of this regulation maybe penalized by the non-criminal method of disposition as provided in Massachusetts General Laws, Chapter 40, Section 21D or by filing a criminal complaint at the appropriate venue. Each day any violation exists shall be deemed to be a separate offense. 18.2 An individual or person who violates the provisions of G.L. c. 270, § 21 and 22 by smoking in a place where smoking is prohibited shall be subject to a civil penalty of$100 for each violation. G.L. c. 270, § 22(m)(2). Any individual or person who violates the provisions of Section 16.2 of these regulations shall be subject to a fine of$25.00. Each occurrence of a violation shall be a separate offense. 18.3 Enforcement of this regulation shall be by the North Andover Board of Health or its designated agent(s). Any resident who desires to register a complaint pursuant to the regulation may do so by contacting the North Andover Board of Health or its designated agent(s), and the Board may investigate. SECTION 19: OTHER APPLICABLE LAWS 19.1 This regulation shall not be interpreted or construed to permit smoking where it is otherwise restricted by other applicable health, safety and fire codes,regulations or statutes. SECTION 20 THROUGH 21 Reserved for future regulations, amendments, etc. SECTION 22: SEVERABILITY 221 If any provision of these regulations is declared invalid or unenforceable,the other provisions shall not be affected thereby but shall continue in full force and effect. SECTION 23: PREVIOUS REGULATION SUPERCEDED 23.1 This regulation supersedes the prior regulation titled"Regulations Affecting Smoking in Certain Places and Youth Access to Tobacco," as adopted with an effective date of September 1, 2015 and thereafter amended. 14 Effective Date: This regulation was adopted on October 24,2019. This regulation shall take effect on January 1, 2020. Signatures: -r J�- Av) Franczs' . MacMillan, M.D., Chazrxn n Date of Signature o ep cCa�thy, Clerk Date of Signature Michele Davis,R.N., Member Date of Signature Patrick Sc on,D.O.,Member Date of Signature Daphnee Alva-LaFluer,Member Date of Signature Latest Revision Date: October 24, 2019 15 [1] Center for Disease Control and Prevention,(CDC) (2012),Health Effects of Cigarette Smoking Fact Sheet. Retrieved from: http://www.cdc.gov/tobacco/data statistice/fact sheets/health effects/effects cig smoking/index.htm. [2] CDC(2010),How Tobacco Smoke Causes Disease: The Biology and Behavioral Basis for Smoking,-Attributable Disease. Retrieved from:http://www.cdc.gov/tobacco/data statistics/sgr/2010/. [3]U.S. Department of Health and Human Services.2014. The Health Consequences of Smoking—50 Years of Progress:A Report of the Surgeon General.Atlanta:U.S.National Center for Chronic Disease Prevention and Health Promotion,Office on Smoking and Health,p. 122. Retrieved from: http://www.surgeongencral.gov/library/reports/50-years-of-progress/full-report.pdf. [4] Jd. at Executive Summary p. 13.Retrieved from: http://www siugeongencral.gov/library/reports/50-years-of-progress/exec-summary.pdf [5]United States v. Phillip Morris,Inc.,RJ Reynolds Tobacco Co., et al.,449 RSupp.2d 1 (D.D.C. 2006) at Par.3301 and Pp. 1605-07. [6] SAMHSA, Calculated based on data in 2011 National Survey on Drug Use and Health and U. S. Department of Health and Human services(HHA). [7] CDC(2013)Youth Risk Behavior, Surveillance Summaries (MMWR 2014: 63 (No SS-04)). Retrieved from:www cdc.gov, [8] IOM(Institute of Medicine) 2015.Public Health Implications of Raising the Minimum Age of Legal Access to Tobacco Products. Washington DC: The National Academies Press,2015. [9] CDC (2009), Youth Risk Behavior, Surveillance Summaries(MMWR 2010: 59, 12,note 5). Retrieved from:http:www.edc.gov/mmwr/pdf/ss/ss5905.pdf [10]Ringel,J.,Wasserman,J.,&Andreyeva,T. (2005) Effects of Public Policy on Adolescents'Cigar Use: Evidence from the National Youth Tobacco Survey. American Journal of Public Health,95(6), 995-998, doi: 10.2105/AJPH.2003.030411 and cited in Cigar; Cigarillo and Little Cigar Use among Canadian Youth: Are We Underestimating the Magnitude of this Problem?, J.Prim.P.2011,Aug: 32(3-4):161-70. Retrieved from: wwwnebi.nim.gov/pubmed/21809109. [11] Massachusetts Department of Public Health,2015 Massachusetts Youth Health Survey(MYHS); Delneve CD et al., Tob Control,March 2014:Preference for flavored cigar brands among youth,young adults and adults in the USA. [12] U.S.Department of Health and Human Services. 2012.Preventing Tobacco Use Among Youth and Young Adults:A Report of the Surgeon General.Atlanta:U.S.National Center for Chronic Disease Prevention and Health Promotion,Office on Smoking and Health,p. 508-530, wwvvstngeorrgerreral.gov/libi•aiv/reports i-eeveiiting-vocttls-tobacco use/ull-report.pdf. [13] 21 U.S.C. §387g. 16 [14) Carpenter CM,Wayne OF,Pauly JL,et al.2005. "New Cigarette Brands with Flavors that Appeal to Youth:Tobacco Marketing Strategies."Health AfJ'airs.24(6): 1601-1610;Lewis M and Wackowski 0. 2006. "Dealing with an Innovative Industry:A Look at Flavored Cigarettes Promoted by Mainstream Brands."American Journal ofPublic Health. 96(2):244-251;Connolly GN.2004. "Sweet and Spicy Flavours:New Brands for Minorities and Youth"Tobacco Control. 13(3):211 212;U.S.Department of Health and Human Services.2012.Preventing Tobacco Use Among Youth and Young Adults:A Report of the Surgeon General.Atlanta:U.S.National Center for Chronic Disease Prevention and Health Promotion,Office on Smoking and Health,p. 537, wwwsut=onzerre►yl gov/Ii rrary/rgpor7 nreveltting yuth tobacco use(u11 report ndf [15]U.S.Department of Health and Human Services.2012.Preventing Tobacco Use Among Youth and Young Adults:A Report of the Surgeon General.Atlanta:U.S.National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health,p. 539, wmv sur eongeneral gov/librarv/report preventing youth tobacco use/fi_ rll re o t [16]Food and Drug Administration.2011.Fact Sheet:Flavored Tobacco Products, wwwfda Gov/downloads/TobaccoProducts/ProtectiregKidsfionrTobacco/FlavoredTobacco/UCM183214 U.S.Department of Health and Human Services.2012.Preventing Tobacco UseAmong Youth and Young Adults:A Report of the Surgeon General.Atlanta:U.S.National Center for Chronic Disease Prevention and Health Promotion,Office on Smoking and Health,p.539, wwwsurgeongerreral goy/library/reports/nreven tin g oottth tobacco use/full Mo i-t,pdf [17]See fn.3 atp. 85. [18]www.fda.gov/downtoads/Ucm361598.pdf. Https://tobacco,ucsfedu/tpsac-gave-fda-what-it-needs-to-ban-menthol [19]www.tobaccofreeAdds.org/assets/f"actshect/0390.pff [20] Centers for Disease Control&Prevention.2015."Tobacco Use Among Middle and High School Students—United States,2011 2014,"Morbidity and Mortality Weekly Report(M11IWR)64(14): 381 385; (21)Massachusetts Department of Public Health,2015 Massachusetts Youth Health Survey(MYHS) [22]310 CMR 30.136 (23]Food and Drug Administration,Summary of Results:Laboralmy Analysis of Electronic Cigarettes Conducted by FDA,available at:http:/Jwwwfda eovJnewsevents/publichealthfoquc&cm173146 htm. [24]See fn. 7. [25]King BA,Tynan MA,Dube SR,et al.2013."Flavored-Little-Cigar and Flavored-Cigarette Use Among U.S.Middle and High School Students."Journal ofAdolescentHealth. [Article in press], tivww.iahonline.arg&-icle/SI Q54-139X%28X3%2Q00415-1/y&tract. [261 Druzik et al v Board of Health of Haverhill,324 Mass.129 (1949). 17