Nashoba Board of Health

ASHBY ANNUAL REPORT 1999

Nashoba Associated Boards of Health continues to serve the local Board of Health in meeting the challenges of environmental and public health needs in Ashby. In 1999 particular efforts were made to improve service in the Environmental Division while adjusting to changes in the Nursing Division created by national trends in health care. We look forward to continuing our work with Ashby's Board of Health. Included in highlights of 1999 are the following:

Continued active professional relationship with Massachusetts Association of Health Boards (MAHB), the only statewide professional association representing Ashby and other local Nashoba boards, as an elected member of the Executive Committee of MAHB. Participated in MAHB’s Advanced Certification Program. Distributed complementary copies of MAHB’s Guidebook for Massachusetts Boards of Health to members through informal raffle at Board meeting.

Pilot project for home health nursing staff to more effectively and efficiently maintain patient records through use of palm-held computers. Use daily downloaded data for scheduling, chart maintenance, and records access. Database refreshed daily by uploading at day’s end.

Introduced project for verification of home care aide visits through a telephone response system to increase efficiency, accountability, and reduce "paperwork" for both visit and office staff.

Provided health education programs in collaboration with the Ashby Council on Aging.

Collaborated with the North Middlesex Regional School District, Massachusetts Department of Public Health (DPH), and Harvard School of Public Health concerning local communicable disease issue.

Collaborated with Montachusett Home Care around elders at risk and other safety issues.

Responded to and assessed mental health concerns through crisis intervention and teamwork with other community resources including Herbert Lipton.

In role as DPH depot, distributed immunizations and preventive disease information to the medical community.
Continued unique and acclaimed Dental Program in Local Schools.

Provided assistance to Ashby for tobacco control efforts through Department of Public Health grant award.

Reviewed 38 Title 5 state mandated private Septic System Inspections (121 since 3/95, 76% passed) for Ashby Board of Health. Received, reviewed, and filed these 135 state mandated (but unfunded) Title 5 inspections in 1999. Corresponded with inspectors regarding deficiencies; referred deficient inspections to Ashby of Health for enforcement action.

Initiated computer generated septic system permits as initial step in development of database for local board and general public access.

Utilized voice mail, message paging, and cellular phone access to field staff in Environmental Division to facilitate improved communication while freeing up Secretarial time for Title 5 research, data entry, and other tasks.

Two additional Environmental staff members achieved status of Registered Sanitarian by passing rigorous exam.

Improved utility of Nashoba web page to include improved staff contributions to content and local Boards' access to Nashoba administrative business. (See nashoba.org homepage).

Sustained level local funding of Nashoba for eleventh year in a row! (30%+ growth re: Consumer Price Index would have increased local assessment by $2850)

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

Annotated Statistics

Town of Ashby

Environmental Health Department

Environmental Information Responses

Ashby Office (days) 95

The Nashoba sanitarian is available for the public twice a week at the Ashby Board of Health Office.

Nashoba Office 12

This number reflects miscellaneous meetings held at Nashoba's Ayer office for Ashby residents

Food Service Licenses 11

Nashoba annually mails out and receives application from both restaurants and retail food businesses. Licenses are renewed for existing facilities. Plans are submitted and reviewed prior to initial licensing.

Food Service Inspections 18

All licensees are inspected at a minimum twice a year. Where deficiencies are found, a re-inspection is scheduled to insure compliance. When a complaint from the public is received an inspection is also conducted. During this inspection health factors of food handlers is also investigated, and where appropriate medical consultation and laboratory testing may be required.

Beach/Camp/School Inspections 6

Camps are inspected at least annually at opening for compliance with State Sanitary Code, Chapter IV, 105CMR430.00. Public swimming beaches are sampled for water quality every other week during the summer and more often if a problem is suspected.

Housing & Nuisance Investigations 4

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

Septic System Test Applications 51

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

Septic System Lot Tests 209

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

Septic System Plan Applications 26

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

Septic System Plan Reviews 83

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

Septic System Permit Applications 43

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

Septic System Inspections 103

Nashoba Sanitarian is called to construction site at various phases of construction to witness & verify that system is built according to plans.

Septic System Consultations 19

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

Well Permits 37

Water Quality/Well Consultations 63

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

Rabies Clinics - Animals Immunized 24

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

Nashoba Nursing Service

Nursing Visits 238

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

Physical Therapy Visits 38

Occupational Therapy Visits 18

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

Medical Social Service Visits 6

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

Home Health Aide Visits 246

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

Local Well Adult, Support Groups, & Other Clinic

Patients Seen 240

Dental Health Department

Nashoba Program (Historically Funded Through Environmental Assessment)

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

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

Students Eligible 369

Students Participating 222

Referred to Dentist 22

Nashoba's Certified Hygienists also provide classroom instruction of cleaning and maintaining health teeth to all children in these grades.

Number of Programs 18

Students Participating 360

Fluoride Rinse Grant Program (State Supplied Materials, Nashoba Administered, Local Volunteers)

Nashoba's certified Hygienists secure the dental materials for this program through a grant application to the Massachusetts Department o Public Health.

Students Participating 234