September 15, 2025 – Board of Health – Video & Transcript

September 15, 2025 - Board of Health

Autoscroll:

Jonathan Storer: Was September 15. 2025 it's hybrid meeting in person or via zoom. one may watch or participate remotely with the meeting link. We found that wayland.us public body meeting information. virtual in person and hybrid. Pursuant to chapter two of the acts of 2025. This meeting will be conducted in person and via remote means. in accordance with applicable law. This meeting way may be recorded which will be made available to the public on WayCAM as soon after the meeting is back and do a roll call. Brett Mortis here. Katie stiff here. Genevieve Anna here. John store here. Unknown: perfect. Thank you.
We have a public comment first. one way online. and I'll Lindsay is going to join us as a part of the agenda at seven o'clock. Jonathan Storer: So they're not don't see any public comment online. Unknown: Okay? So. Abby. do you have public money? Abigail Charest: Sure. Should I go now or Well. no. you're part Unknown: of the agenda. Okay. yep. so we're ready to get started with the with the first agenda Jonathan Storer: item. No. it's first agenda is review and comment on subject design plans for Wayland High School. Drafted by is it? Ty Tyne bond with guest town engineer. Abby Charest. Abigail Charest: Hi. how are you? You can Unknown: come up a little closer. because sometimes it's hard to get
Abigail Charest: well. I hope to be a little bit farther along on this project. But the engineer that I usually work with has appendix burst. and he's been in the hospital. so we're a little bit farther behind than I had wanted to be. but we did get out into the field and did some test bits and do the soil evaluation test with Darren. and we have those results on the top of The third page here. talking about design standards for the leach fields and how much we'll have to have the additional reserve areas associated. But again. so we're still looking at the high school treatment plant. It's been offline for a long time. When we looked at the flows. they were lower than 10.000 gallons a day. So we've been looking at designing something under Title Five. It is in the zone two. so we'd have to do some additional nitrogen removal. which means we need an IA system. We've looked at a couple of IA systems. We looked at an and Nitro. But because we had so many more examples of the amphidrome system being used in schools. we felt like That was the best one to go with. We felt that some of the operations difficulties with the treatment plant previously were due to those variable flows from the school. and that. since am for drum could demonstrate more of a background with the schools. we felt more comfortable with that technology. I did text in since we just were chatting in the office. we're a little bit concerned about the probability of finding someone Unknown: to do O and M operation in MA. Operation. oh. sorry. Abigail Charest: Operation. operation maintenance. because these types of systems are often used on the cape because they are specific to nitrogen sensitive areas. But White Water has people. and there is a company called Unknown: Lewis. Oh. okay. Abigail Charest: so there's. there's some people around. So we'll be continuing to look at that and get you. you know. further design drawings and specifications. So I just want to give you an update. let you know that still working on this. and see if you have any questions so far. Also. just to say that please think about how you want to go through review and design of this. It if this was a treatment plant. we have previously been out requests for qualifications and gotten engineering firms. and that's why we use tie and bond. That's how we found them. So if this was a treatment plant. we would just go out to bid for construction. Uh. on this with the time bond design. with having me reviewed it. um. but since it's going through the board here. you guys would be normally send it out for additional review. You just think about if the town has had me review it and time bond design. and if you want to send Julia Junghanns: it. that would be for. like. an example of a peer review we've had done on some other projects recently. for for some larger systems where some of the dosing might be looked at. or mounting calculations and things like that that we would typically have another set of eyes look at. you know. from a peer review consultant sometimes. and then staff. I mean. we do the review in house. And then. you know. the board has been involved with this design. because we're changing from. you know. having the wastewater facility on site to the conventional system with alternative technology. So. you know. typically for residential projects. the board isn't typically involved. but because of those intricacies of this change where we have been involved. because there's a variance. you know. to use those different flow so. so that's. you know. part of but staff would also be reviewed with a design and feedback.
Unknown: So we usually would send it out for additional review. depending on. you know. what we end up with for Abigail Charest: flow them. so 8000 gallons. Yeah. on the other hand. this is a town project. so the town's already paid for the design. And to have. as opposed to having. like a commercial development come in with something. then you want to have that with you. Unknown: so we almost wouldn't need to. in this case. just because you've already. sort of. Abigail Charest: it's been through the town engineer as Unknown: well. which is you. but do you do septic design reviews? Abigail Charest: I mean. I have. you Unknown: have. yeah. okay. yeah. because I didn't know if you had the like for pressure dosing or mounding. or any of those types Abigail Charest: of things. More specifically than we're looking at the technologies and goals of the IA systems. yeah. and working with full towns to do. like a comprehensive stuff. Unknown: once we get a little further on. we'll have. you know. better idea for. you know. if there was additional review needed. you know. if we felt like we wanted that. but we'll work together. Jonathan Storer: And then. after it's built. is there testing to make sure that we meet the requirements for
Abigail Charest: nitrogen the there's operation and maintenance Julia Junghanns: of it. It depends which approval is is used for the and we're not sure which approval is used yet. We did. you know. Darren. I took a quick look at it. because each technology has different types of approvals that change all the time. So once we have an idea which one is being used. then there's a whole set of different rules and parameters for testing and whatnot that we would look at to figure out what would be needed for the long term O and M operation and maintenance.
Unknown: We haven't seen new amped around go in in quite some time. So. you know. it's something that we would look at. I mean. we will get all of them when they come through. But for a system this size. it might be new territory for us. You know. what's at the middle school? The Middle School. I think is a bio clear. okay. that's right. yeah. Abigail Charest: yes. I asked them to look at that as I my initial assumption would be that I would rather have a consistent technology throughout town. but time Bond did not.
Unknown: Why did they have a reason why this passed towards their mental Jonathan Storer: system? I'll find there's a large system for an assisted living housing development in Carlisle that's they've been dealing with nitrogen problems for the last couple of years. And I'll find out what the system Unknown: is. So it's not meeting the parameter correct. Jonathan Storer: and the they must have test or somewhere in the leaching field. and it's all. it's always coming up too high. Oh. wow. Okay. so once it's built. it's pretty expensive to try to. Unknown: right? Yeah. And. Abigail Charest: Yeah. luckily. the soils were pretty good out there. Sandy. It was a little bit of fill at the top that we have to pick out and remove a buck Jonathan Storer: once we got what is the I haven't walked over there. What is the land there now? Is it just open space? Is it woods or Abigail Charest: it's open space? There is sort of a hill area that the leaching fields are on. and then it kind of slopes down to baseball field. and then the football practice field. And as you go towards the football practice the groundwater gets higher and higher. but we're able to position this up on that mounted area. Jonathan Storer: And will the land be able to be utilized for anything after the fields are in. Abigail Charest: um. nothing that you could build on. but kids would be able to run around on Jonathan Storer: it. yep. okay. I didn't know how what it's going to be peppered with test pits or. you know. the spots that you can test. or what it would look like. Abigail Charest: I think they use it for frisbee. Ultimate Frisbee first to golf. yeah. Jonathan Storer: because it's not flat. yeah.
Unknown: yeah. that's so that's important regarding the nitrogen removal. because it is so close to the town wells. you know. So I'm sure that Ty and bond will be looking at that closely. yeah. to figure out what the best I mean. they're saying. yeah. good. wrong at this point. So yeah. Jonathan Storer: then maybe any system. I mean. do you when you purchase a system like that. Is it based on your gallons per day. and is it. is it that you err on the to be a little larger versus. yeah. and could systems be expanded if they needed to be okay? So it depends Abigail Charest: on the system. I don't know if an extended. but I'll look into that. But usually you err on the side of making sure you can cover up peak flows. although the Title Five is usually the peak flows. And then some of the systems can also be expanded. or additional filters can be added. I mean. Jonathan Storer: with these systems. that's really the pre treatment is going to be the secret. That's right. it's in its success.
Unknown: So probably maybe the next month or so. Abigail Charest: we'll hear from you again. Yeah. they're saying that we'll submit something by the day. Oh. okay. yeah. is there Unknown: like a deadline that you're trying Abigail Charest: to meet? I would like to start construction after baseball season.
Unknown: Are they? Oh. because it's right next to the baseball field. So then. just out of curiosity. I might be getting hit. But yeah. what will happen to the wastewater units that are in the building and any components that have been Abigail Charest: we'll need to use some of the electricity and some of the wiring for the instrumentation. but we'll also do some demo inside that building and take out some of the and we actually will have to wait until after July 1 together. position to go um. right after that. and trying to timeline the construction so that we're doing the fields in the summer. And if we have to do some of the treatment by the treatment plant. we can do that rather than McCall that we just start. I don't
Jonathan Storer: remember what type of leaching field will it be? Is it just like a big stone in black bed? Or. yeah. yes. it would Unknown: be pressure desk. right? This one. yes. because of the gallons per day I would. I believe it has. right. yeah. but it would still be. well. it's pressure. dose. Abigail Charest: it's pressure. yeah. yeah. show it. yeah. a little horse man over here. Yeah?
It's dose for another reason to like to have multiple reasons. Finally. they've seen it made it it's also Unknown: uphill. right? Sure that makes sense. I
Awesome. That's up there. I think thank you very happy.
We are a few minutes early. I don't know if you want to
go over some of the health director updates. We do have Lindsay here. but I don't know if she's sound prepared. or you should just stick to the seven o'clock time. Maybe
I could talk about mosquitoes from the health director on the Oh. she hasn't helped see that.
Hi. Lindsay. hi. How are you? I don't know. I don't camera option. For some reason I can see all of you and I'm here. But okay. I just found the link on the website Julia. so I don't know if there's a different link. I need to participate via video.
That was probably my fault. No. no. it's fine. I mean. I see the meeting link. but I don't know. Do
promote to panelist. Can you do that? Oh. yeah. did it work?
It says she'll be rejoining. Okay. yes. here I am. Okay. Oh. perfect. You're Hired. right? All right. we just get rid of that little box. Perfect. Thank you.
All right. okay. great. sorry to not be able to be in person. Well. thanks for joining. Yeah. we do appreciate it. Yes. absolutely. absolutely and again. apologies I couldn't be there in person. juggling kids schedules and all the things in the evening. but happy to be here and Julie. I figured I'd just go over the annual report. and certainly I'm happy to answer any questions that folks have. That's great. I'm just going to hand out a fresh coffee so everyone has it great. sure. So for those of who I haven't met. I'm Lindsay steinstep. the executive director at hrs Human Relations Service. the community mental health agency that serves West and Wayland and Wellesley. And I thought I would just review our FY 25 year and then again. answer any questions you all have. Our visits for Wayland residents were up this past year fairly significantly. We did just over 1100 clinical hours for Wayland residents. And I should back up and say. we see. you know. children all the way through. seniors in the community. and actually have recently made a push to ensure that seniors in all three of the towns that we serve are aware that we take Medicare and. you know. welcome them to access services through us as well. And I think some of that marketing has been useful because we've gotten sort of an influx of intakes from the senior community. which is great. but certainly. you know. most of our referrals come through the public school system or other residents who use services at hrs before. So the visit count was up from FY 24 and FY 24 just to go back. we did 864 clinical visits. So again. fy 25 we did 11 192 we did 30 consultation hours to the public school to sort of small groups or individuals within the public school system. I do some of those. My colleague. Alan Wyatt does some of those. And then Dr Luke Baker sirode Does some of the consultations as well. and certainly we're available to add. subtract. change consultation schedule as needed throughout the year. So many. some of you may remember that in years past. if there's been a tragic loss in a school community or something like that. we're always happy to come and support a school community. Or administrator as the need arises. But these consultations that I'm reviewing now. the 30 we did in FY 25 are just sort of our standard consultations that that we continue to do year to year. and in terms of our intake program. just in general. we had 31 new Wayland resident clients in FY 25 and then 52 sort of unique clients all together. So the difference there being that the 52 includes clients who have been at hrs for more than a year. So for example. children. you know. often we're doing long term work. generally. But kids. adolescents. may have seen the same therapist from FY 24 into FY 25 but we did 31 new intakes for Wayland residents in FY 2510 of those were kids under the age of 1112. Of them were between the ages of 12 and 18. and then nine of them were 19 plus. so sort of a range in terms of age. far and away. the sort of diagnostic category that we see the most of is anxiety. That may not surprise many of you. though anxiety is sort of a large umbrella. So there are. you know. plenty of diagnostic labels that would fall under that. but just for the purposes of a broad overview. that's certainly the primary issue that folks who come to seek our services are struggling with generally. And then actually right behind that was ADHD this past year. and then just under that. depression. usually depression. or historically. I should say. depression and anxiety have been sort of neck and neck. or closer together than the numbers show this past year. which is just interesting. You know. on a larger scale. as we think about what residents are contending with when it comes to mental health issues. and let's see. what else can I share in terms of referrals out so in the report. I go over that we. you know. one of our sort of big agency wide pushes this past year has been to build up our clinical staff just to ensure that we have the clinical capacity to serve as many residents as we can. We are a organization of roughly 35 total employees. so 25 you know. clinical staff. So we're never going to be able to meet the mental health needs of all of Wayland in any year. of course. but certainly. we want to make sure that we see as many as we can who are appropriate for care at hrs. And so this past year. we welcomed five trainees. which represented the largest training class that we've ever had. And these trainees are. I should mention. you know. late stage doctoral students or social work fellows who have graduated from their program and are just accruing hours towards their own independent licensure. So it's not. you know. I hesitate to use the word trainee. because usually people feel like that's sort of a real entry level clinician. And these clinicians have a lot of clinical experience already under their belt. and are supervised. It's a two year program that we have so welcoming that larger class of trainees last year. and again. they're still with us this year for the second year. really helped us to increase our clinical capacity. which I think is one of the reasons that the numbers were up this past year. just in terms of visits. And it also helps us to refer out fewer cases. of course. So you know. there are cases that we're going to refer out. even if we did have capacity because they're not appropriate for care at hrs. they might be looking for specialized treatment. They might have an insurance that we don't take. something like that. but so for so. we referred out 20 Wayland residents this past year. and nine of those were not appropriate for care at hrs. They had an insurance retake and needed to use their insurance or they were seeking specialized treatment of some kind. The other refer out cases were either folks who called at a time that we didn't have capacity to see them. they may have had a particular time that they needed to be seen. Some children and adolescents. you know. really don't have a lot of availability. and our after school evening hours go certainly the fastest throughout the year. So but if we do refer out. we refer Wayland residents to folks in the community that either a staff member. a clinical staff member. has recommended. knows. sometimes it's somebody who's worked at hrs in the past. So it's a really well vetted list. So I always mentioned that because I think that's another great service hrs can offer to the community is kind of a personalized. really well vetted referral system. So we're more than happy to work with any Wayland resident to get connected to mental health treatment and and we're going to the INT. Team. the clinicians who are on that team are going to stick with any resident until they find a provider if we can't see them that they are satisfied with. So as much as they want to continue to reach out to us. if they're having difficulty. we're going to stick with them and make sure that they get connected as well. But overall. our referral numbers are down. and the number of Wayland residents you know. seen in house has gone up in the last couple of years. and just again for reference. and this is all in the report. But in FY 23 we saw 677 residents. as I said. In FY 24 864 and then just over 1100 this past fiscal year. So it's going up. So Right?
And what else can I share? Let me pause and then not inundate you with numbers and ask if people have particular questions. either from the report or just about hrs currently. in general. happy to do my best.
I was wondering you under the diagnosis breakdown. There's one that just had. is a NA is that just somebody that saw referral. but there is no real diagnosis with it. So the diagnostic breakdown actually. and I can look into what that is. that this is actually all of the cases seen. and that could just be. somehow the coding it could be. let's see. you know. couples is in there. The way that that information got coded in our system. whatever the diagnostic category was. just didn't fall into one of these categories. So I will look into that. I don't know exactly it should be an other. I would assume. But that's just an error in our sort of the way our operations manager who collects the data from our electronic health record system.
it got code. okay. yeah. Was there any. any. any other. like. really severe cases that would be like. stand out in terms of. like. very. very severe depression or any. anything. or has it been. like. more or less manageable? You know. I would say it's manageable. HMS is not an acute care facility. So if we're working with a resident. or a resident's been referred. or we hear about an individual you know through the school system who's struggling. you know. to a great degree. essentially. when they present to us. we're likely going to recommend a higher level of care than outpatient treatment. We do come across these cases and help the folks in the school system you know work with individuals. if they're school aged. who you know can be really struggling with a pretty severe depressive episode. But again. if they come to us seeking treatment and they're in the midst of it. we're we're likely to recommend either going to the hospital just to assess for safety reasons and liability reasons. or a higher level of care if it's already sort of identified that it's really severe. That being said. we have a psychiatrist on staff who's trained as a child and adult analyst. and he. you know. certainly has a tremendous amount of experience. and as long as somebody is in treatment. in therapy at hrs. they can access medication management through us. So. you know. we certainly see folks who are struggling with a severe depression. but I would say overall. our clientele are able to function. you know. for the most part. day to day. whether they're school aged or within The adult population. Thank you. Yeah. absolutely. Other questions. I
Julia Junghanns: do appreciate the information. as we had talked about. you know. previously. when we fell shut hope was here. She's actually left the town and no longer working here. unfortunately. Unknown: So yeah. but some more information. And you know. we can pull that into our annual report that is due the end of this month. And so. you know. we've been working busily on our draft. and no so we appreciate your coming in. I don't know if any other folks have questions. but we do have some time as we have scheduled. Yeah. Absolutely. And we were happy to add one of the things. just for others on the call that Michelle was interested in. was referral source data. So we were. we started gathering that this past fiscal year upon request. And. you know. it's interesting to see. it's always a sensitive thing to figure out how to gather. you know. more data. right? But also be sensitive to folks calling to seek mental health treatment and not be. you know. asking too many questions for our own data gathering purposes. Within that first call. we want to make sure that they feel comfortable giving information. And for some people. it may be sensitive how they learned about hrs or from whom. and and the data. as you can see in the chart. sort of supports what we thought. 28 you know. referrals from the public school district. but a couple from the Senior Center. which was great to see. And then. you know. and this is self report. So. so the clients themselves who presented are giving us that information. 12 self referred. four from family members. five from community and then six from PCPs. which was higher than anticipated. But we we always try to connect with local PCPs. just to make sure they're aware about us and our services. We have a longer standing relationship with Western pediatrics and many residents of the three towns we serve. you know. are seen there. so they know about us. But there are others who have become more familiar Framingham peds and others. a couple providers in in Wayland as well. So that's good to see that that primary care providers of kids are referring to us and staying connected to us as well. and certainly. as we train new staff and social work fellows and postdoc fellows. we make sure that they're reaching back out to those pediatricians or primary care offices with permission. of course. from the patients. just to coordinate care in an ongoing way. and we gather the information about who their primary care provider is right at the beginning. when they're when they're signing registration paperwork and getting getting up and going in treatment. So I think that was the. one of the main. you know. pieces of data that Michelle was interested in. and then also just getting a sense of the total number of Wayland residents and scene versus just new intakes. We used to just report on that and then yes. the specific consultations happening year to year. I think Julia. that was mostly the data that we added
to mentioned it. I had another question when Sure so from referral to appointment time. what's that access like? That's a great question. So usually we are we have an intake meeting on Thursdays every week. and if a case is assigned. they're going to hear from that clinician. We really require that that clinician. that the case has been assigned. to get in touch with the individual or family the next day. because our goal is that that individual would be seen the following week. right? So it's a Thursday. they're. you know. likely we've assigned them to a time that the clinician has given to us as available when we make the match. But usually those aren't going to be Friday. even if the case is assigned Friday. So I would say the longest number of business days would be six. right? If it's if a Friday was looked for and they were going to be given that time the following Friday. but assuming no other scheduling issues get in the way it would be seen the following week. Yeah. So you know. between two and six business days they should be seen. That being said. I can get you the exact answer now that we have an electronic health record system. and it's likely that the average would show a longer amount of time. And of course. just the way averages work. That's because. you know. sometimes the clinician will call the next day after case is assigned. And of course. the child or adolescent has something in place. you know. an activity or something that following week. at a time that they had told the intake team they do have available and will it just gets pushed out. So I often find that it's easier to kind of explain our system than state what our electronic record system would say is the average. But certainly. if you're interested in what that says. I'm happy to get that data. But if there are no other scheduling issues. we're if we're assigning the case that clinician has the availability the following week in their schedule to see the person. Thank you. and I should say. maybe you asked about first contact. So we assigned cases on Thursday. if a Wayland resident calls hrs. they're going to get a call back from a member of the intake team within 24 hours of their call. Um. and that's we know during business hours. So we don't our phone is answered all the time. because we have an answering service on on the weekends in case there's something urgent clinically going on. but if it's during the weekly call back within 24 hours. and then a senior clinician on the intake team will take information and present the case at the intake meeting that occurs once a week on Thursdays. So again. it's variable based on the day that somebody calls. but a resident will always get a call back from one of those people within 24 hours of calling initially. So that's the other variable that can sort of depending on the day that they call and how many days until the intake meeting. It's can consider change. You know. how quickly the turnaround happens in terms of first visit. But one of the benefits of having senior clinicians staff the intake team. is that they're also in gathering information about what a resident is looking for in terms of treatment. They're also assessing. you know. acuity and whether or not there would be any problem waiting until that first appointment. So they're not going to have somebody who's in great distress. And really. you know. their sense is that they won't be able to function well until that next appointment. They're not just going to say. just sit tight. There are clinicians. and are also going to figure out how to get the resident what they need in the interim so they would only be waiting for an appointment if that was clinically appropriate to do. So.
I just had a question on. Looks like it's page two. I'm just trying to figure out. you know. where you talk about FY 25 clinical hours to town residents. non school. But then below that. you know the hours are referencing counseling to children and families. So the non school language. and I should take that out. but remember last year when we were talking about kind of the origin of the contract with the Wayland Board of Health and the work that we did in schools. Initially. when the contract was created. we were helping the Wayland school in part. we were doing some outpatient work. but we were also helping Wayland. the Wayland public school system service. IEPs. particularly the counseling goals written into IEPs because the school district didn't have enough counseling staff to service all of the counseling needs within Student IEPs that existed. So some of this funding helped to support that. So I'm a clinician at hrs. for example. if I got assigned a Wayland school case. that's what we would call it. Then that would mean that I would be meeting with a child who attends the Wayland public school. you know. weekly for counseling. I wouldn't be with them in the summer. because. again. the counseling need was written into their individualized education plan. and I was servicing that need for the district that those sort of school based counseling hours being covered within this contract ended. you know. I think over 10 years ago now. and we encouraged that piece of the work to end. School districts have hired more clinical staff now. It's better to have those counseling needs met by an in house clinician. In House meeting within the school district they can better coordinate the care. That's just the model that school districts have adopted. So it certainly makes more sense for a kid to be seen on an outpatient basis at hrs if a clinical need arises and they're referred. usually schools think you know of referring kids who don't just need counseling support to get through the school day or be functioning in school. but they could really benefit from talking to someone outside of school. So we haven't done any of those in school hours in a long time. but. but I think that language was sort of written into the report template. really. to differentiate between outpatient clinical hours done at hrs to provide therapy for Wayland residents and the School Based counseling hours that we provided historically. But we're kind of counseling hours to service kids IEPs. Does that clarify? I think so. I just. and I remember we talked about that before it was just. you know. mainly trying to identify. you know
Julia Junghanns: how people are getting note. how people are aware of your services. And you know is that generally. through the school system and different relationships. you know at the school that are through your services that are provided. Unknown: Potentially. yes. certainly. So you know. the vast majority of referrals to us came through the public school district this past fiscal year. but there are other residents who you know. family. friends. neighbors. things like that. You know. other folks in the community who have sought services. Do you know refer some residents. And as I said. we did some marketing work with the senior centers in all of the towns and and they referred a couple of patients. So. so. and then. you know. also PC piece in the area as well. So. but again. the vast majority of people refer to us came through the public school district.
Quiet buddy.
yeah. non school. It's just old language to differentiate between just traditional outpatient clinical hours. and I'll be
done in just a couple minutes. Couple minutes. Five minutes. What time are you holding down? What time are you going? Five minutes. Okay. thank you. Oh. how long is time? How many minutes do we have. like this. like this thing? How many minutes do we have now? How many one second. I'm gonna bring him out there anyway.
You know. one of the basis is the questions that we have before to try and identify. you know. how people know their services outside of the school center? Yeah. and. you know. I think she explained that they have done some. you know. informational. I don't know exactly. some type of outreach. I think. to. you know. Senior Center. but it seems like. you know. I'm not. The school is still. you know. really the part where it says non school in life. that to me. just just a little bit hard to grasp that I'd like to remove that from this. because it doesn't really match up with what's actually. all right. sorry about that. No. that's okay. Um. I was just trying to figure out. you know. when people look at the support. how they. you know. look at that section and feel like it's services that are not being provided to the schools. And I understand what you're explaining to us. which makes sense. because I know we've talked about that before. but it seems like the report should probably be a little different. you know. in the way it's described. I would think. you know. updating the language. Maybe just update the language a little bit so that it's. I
Julia Junghanns: don't know exactly what the language should be. but. you know. non school. to me. is sort of misleading. because it is school work that's being done for families in the school system. Unknown: No. it's not. That's not what that that section means. So I think perhaps removing non school will help clinical hours to town residents. The 1100 92 is clinical hours of outpatient therapeutic services provided to Wayland residents. period. nothing to do with school. That's just outpatient clinical services provided consultation hours to school staff. Consultation is another service we provide and for all of the towns that we serve West and Wayland and Wellesley. We do consultation work with folks in the school administrators. principals. vice principals. the guidance team. special educators. etc. to help support the work that they do. We provide a unique clinical perspective as outpatient providers. but are also very familiar with the school system and can help them think about difficult cases in a new way. family systems issues in a new way. That's just the 30 hours that we did. So if you see in the school services section. so general services. maybe. if you look at that section. general non school services. the counseling to children and families. 1100 92 that's clinical hours provided to Wayland residents. nothing to do with school and similarly. the intake and referral services the 51 hours that's work that our intake team is doing with Wayland residents across the lifespan who are seeking mental health treatment. the school services that we have. Provider. just the consultation. and then we didn't do any last year. but any urgent psychiatric evaluations.
Julia Junghanns: I think we're maybe talking about two different things. because I'm looking at it from a different a different perspective. potentially. where are people finding out about hrs? Are they finding out about hrs in the school setting. not necessarily related to any IEP in the school? That's what I'm sort of. you know. right? Unknown: So you're on. you're wondering about the referral source data. So if you look at the last page. the chart on the last page. referral source data is. at least for anybody who accessed care through us. You're wanting to know how they found out about us. And so in 28 of the cases. someone within the school district at some level. Sorry. the last page. If there are four pages in the report. I believe it's on page four and then it's in the right hand column. Referral source.
Okay. looks like it's clear. Yeah. I'm sorry. Go right ahead. Continue. please. Oh. that's okay. So. so this is just a new section of data that we added to the report this past fiscal year because Michelle was curious about just your question. Julia. where are people? Where are people who are presenting for treatment at hrs. finding out about hrs. And in 28 it was the cases the the school district. Someone in the school district told them about us. Six of the cases. they found out about us through a primary care provider. Five through a friend or community for family member. And then. you know. in 12 cases. they self refer. meaning that's just what they indicated. right? So this data is a little bit complicated to get. You know. I wouldn't. I think it's. it's helpful in some ways. But again. individuals who are presenting to treatment. we can ask them. sort of for this information. how did you learn about us? And then the data is. what is it? Some may choose not to give us that information. but those that did gave us the information in this section.
And as I said. just as we expected. there are a large amount of people who find out about us through the public school district. If you think about families within the district who have children. They could be presenting to hrs for couples. treatment parent guidance. you know. treatment for themselves. but learn about a community health agency through the school district at some point. whether it's back to school night. something like that. So we imagined before even presenting this referral source data. that many of the referrals came somehow through the school district. But as you can see. there are the senior center PCPs in the community. friends family also referred Wayland residents to hrs as well. Am I better answering your question now about sort of how people learn about hrs and our services? Yes. that is helpful. Okay.
I asked one more question. Sorry. So if you had 52 unique clients in fiscal year. 2025 what was the number for 2024 Do you know? I'm just wondering if it's typical. the hours that were the clinical hours. if that's like typical. because. if you like. just. do I just divide the number of hours by the number of people. which probably isn't like accurate. is like 23 hours? Is that kind of typical in a year? You know? So that services? Yes. I mean. certainly there is no real typical. you know. So exactly. you can't really divide it and get a sense of what is average. but because we work with children and families. it is longer term work. We're not doing short term work for the most part. Some people may come for five to 10 sessions and feel better and move along. But you know. when we're working with children. if you get a new child case. the evaluation alone is between three and five sessions. because you're meeting with parents initially. then meeting with the child for three to five sessions. and then having parents back to give some feedback and make a treatment plan from there. So the number of sessions. certainly. you know. is greater. I would say overall for a child case. So you were asking the number of unique Wayland residents that were seen in FY 24 overall. And I can pull that up just from last year's report. Really quickly. It's. it's. I believe this year's is higher than last year's. you know. in that category as well. given that would be my guess anyway. that. given that the clinical hours are up. but it sounds like you're wondering about sort of average number of sessions that an individual is in treatment overall. And if that's possible to determine. or if this is sort of a normal number of sessions for that number of residents. yes. yeah. So I think that the number of clinical hours being up does correlate with us being able to serve more residents than we did last fiscal year and the fiscal year prior. Certainly I don't think it's always that correlation is not always. you know. completely straight line. because it depends on the type of treatment needed. age of the client. etc. But there will be a correlation between those two numbers the vast majority of the time. and I'll just look and see if I can get that quickly. The total number of unique clients from last year's report is I think
what I just found is the number of new cases assigned in FY 24
which was 17 in 24 compared to 31 this year. So that was certainly up as well. And I'll
look right now and continue. Can take other questions as I do this. if there are any. I
think that's. I think that's great that you take the time and go through set multiple sessions to talk to parents and everything. I think that's like. that's awesome instead of or like. Yeah. that's really great that taking the time to go through multiple sessions. I'm glad you think so. Yeah. certainly it feels like best practice to us and working with kids and families and well. it's going to result in more visit. It's. I personally would never begin treatment with a child without doing a thorough. you know. history. gathering a full history from parents. understanding their concerns. And then also. even after. you know. you need to meet with a child. I would say at least three times to you know. even get a sense of who they are and whether continuing on in therapy will be useful for the child. I always like to reach out to any school providers during that initial evaluation who might be involved as well. You just need to gather all that data at first so it can't happen.
I'm any other questions.
Thank you so much for your time. Yes. I'm not finding that figure. I my guess is that the number is high 30s or in the 40s of total unique residency in last year. if the number of new cases was 17. I think we just started reporting some of this new data within this fiscal year and maybe in the mid year report from last year that I could probably find as well. anyway. But yeah. that's my guess. So certainly that number was lower last year as well the total number of residents seen within the year. given this account. thank you. Lindsay. we appreciate your Absolutely. Yes. Thank you very much for the support from the board. It's really critical to the work we do and to make sure that all Wayland residents you know can have their mental health needs serve. regardless of their ability to pay. I think is really critical and valuable to the community. So thank you for supporting the work that we do in the way that you do. and if other questions come up. don't hesitate to reach out. Happy to come back. hopefully next time in person. Thanks for tolerating my son's questions about mid Yeah. Appreciate it. Okay. thanks. everybody. That's
not five minutes. How many is five minutes?
So I don't know if everyone had a chance to look at the annual report. but I printed out a copy of it. just a case that we can it's a draft. obviously. this is the full report
for the whole department. We're still working on gathering some information. but it's. there's quite a bit of it that's already done. The nursing section is not done yet. So there's a few things that would be added. But in general. it's. you know. similar to prior years.
See if anything's our septic permits are up from the past couple of years. We went from 109 to 116 in FY 25 well testing was up a little bit
new construction. I
Not as many title fives. but it's hard to track those. because. you know. when we do a permit. it's good for a few years. So people may not actually do that work in the same year that they pull apartment. So you know. it runs over a few years. so you can sort of see the trends for the past few years for any
septic comments.
But we are up on building approval reviews. We had 280 this year and last year we had 207 uh.
So we're so we're the volume is sort of slowly increasing. I mean. that's what the numbers show for this fiscal year. I mean. we still have some time to go for our preliminary numbers for FY 26 I don't know where we're at right now. you know. But FY 25 ends. you know. So it starts on July one. and it's confusing. It starts on July one of 24 and runs to June 30 of 25 so it's a little bit. you know. you have to kind of go back in time to remember what we did at that time. Um. but in the in the end. it works out. you know. So now we're in the next fiscal year. I don't know how it lines up with. you know. where We're at with numbers to compare with preliminary but I
the areas in red we're still working on. but some of it is our Communicable Disease Information. and some of it is. you know. the public health nursing section. Um
hrs is not in here yet because I did not have their report last week when I was updating this. Um.
some of our large projects. Charena Farms subdivision. Veritas Christian Academy development project. Saint Anne's 40 bean development. did you see the new one? Which one was that? And race road? Oh. that's going to be. yeah. we're. we're just sort of hearing about that. but we will. I mean. that's huge. That's a huge project. But Darren. I believe. did soil testing up there recently the Coptic charge. yeah. there were plans online somewhere that I saw. yeah. so that'll be another. you know. those large projects can be very time consuming for us to look at the septic design plans. and when they want to phase it too. they're going to right? So another complicated. phased project where there'll be pressure dosing. mounting calculations. probably a hydro geo review. which potentially could also be for the high school septic system. You know. some of those things we can look at. but we generally don't look at hyper geo reviews. And so we'll have to probably have a consultant look at some of those components. but they can be time consuming. especially if they're a Phase project
that the the church that's on rice Road. yes. the Coptic Jonathan Storer: Church. it's. it's kind of residences in Unknown: it too. So the church is getting demolished. Jonathan Storer: or in phases. They're going to build a new church before they take down the old one.
Unknown: Yeah. I think they they have a fin recently. Yes. they did. because I remember. Were hearing about something recently. Julia Junghanns: We've been talking about it at. you know. just land use meetings with town staff. Just initially. they had come in and explained what they were planning on. And then. you know. we talk about it again. And then we hear about. you know. different phases the project. when they're going to other. you know. like site plan review or zba. I can't remember which one they may have been at recently. but they haven't made it to us yet. but we did do soil testing. Jonathan Storer: So what struck me is they were utilizing every bit of that piece of property. yeah. yeah. between parking lot or athletic court or housing or whatever it was all. Unknown: Yeah. that'll be very busy and on rice road. I
anything in red is the old stuff from last year. so it has to be. I mean. I think we've done a lot. so we'll be fine with meeting the deadline of September 30. but they would tell you that if you don't submit your annual report. your board Beat this man disbanded. which is pretty extreme. We've always submitted it useless to say it
oh and China rose got the sushi. So that is going to go specs. yeah. actually. they did hire a consultant. and they went through that process. I guess I should. I haven't talked more about recently. but I will find Out.
Jonathan Storer: What has Veritas been doing lately is that just charging along. or I haven't heard or read anything Unknown: recently. they were working on building permit reviews.
Jonathan Storer: That's the last time they got all through conservation.
Unknown: I don't know if they have a comment with them. does it conservation just take so long? So yeah. sure. they've actually completed their process. yeah. with conservation. But if they're working on the building application. I would think they have something.
Wow. So at the end of the report. we've got an FY. well. that should be FY 26 FY 26 focus areas. These are just things that you know we're continuing. that we're still working on. I don't know if the board has any feedback or thoughts about areas that the board might feel important or of interest to focus on. In addition to some of these things that I have already plugged in.
we do feel like it's a very important goal to get our Building reviews and eventually our septic reviews respond. open. go.
although we have a new IT director. which isn't good. but the one of the IT staff recently resigned. so that'll be difficult. But you know. things happen. People leave. and I'm sure that we will find someone. but it might be a little cumbersome to pick up where we left off. which. you know. we were making some good progression on that. but we're very eager to get our building reviews on Open Gov. You know. we feel like it will be a really good move to have. you know. a more streamlined process for residents in the application process. and so we're anticipating that happening. And then. you know. we'll work on septic reviews. But that's. you know. that's down pike. I mean. I think the building part would be most of interest to people you know. that are. I think it's a bit of a struggle to get through that process. It's a little disjointed right now. where it's. you know. some is on open go. some isn't some paper. some is online. So. you know. I look forward to seeing that get all opened up. Jonathan Storer: And have you found anyone to replace Michelle? Yet Unknown: we have. which is great news. We went through some interviews with some really good applicants. And you know. we had two rounds of interviews. Heather joined us. myself. the HR director and Heather. and we expect Laura Carter to start with us on September 22 she's coming from a job where she has a job share between Concord and Maynard as the public health nurse. and she's a nurse practitioner. We're very excited. and think she'll be great fit. So as in frantically working on some logistics and planning for flu clinics Julia Junghanns: and. you know. just getting some dates set. you know. the locations and the times and strategizing some staffing and whatnot. On. So when she walks in here. there's some work that's already done. because it's going to be busy. We have vaccine already. so people are calling about clinics. and we have flu vaccine. and we have Unknown: high dose and regular we will be getting some covid vaccine as well. So we'll do some covid clinics. but not right away. because. like. here. make it a little crazy. but we can. We'll work on that too. So. but yes. I'm very excited. It's been a little stressful. Jonathan Storer: Well. you've been wearing multiple hats for a little bit. Julia Junghanns: yeah. I mean. it's. you know. plus anticipating. you know. what happens if we don't have someone and. I mean. I felt like we would. because we had some really good candidates. and. you know. I felt like. you know. we would get someone in here. So that was good part. but then going through that process. it always takes longer than you expect. you know. and and HR really did help us along. but it just always. you know. people on vacation. or you know this or that. and people have to get give notice. You know. I mean. it's a process so.
Unknown: but finally.
does she want to come meet us? Or. yeah. I am sure she will.
So didn't skip a little bit over here. but
that's. you know. basically the update on flu clinic planning. The two dates that we have are October 15 and October 22 three to 7pm
you know. we like to have a couple on Wednesdays. because those are the early release days for school. and that way we can try to capture Julia Junghanns: kids and families where we can the 15th is probably going to be the senior clinic we haven't you sent out any registration or sign ups yet that will be coming. You know. we have to get the because Unknown: it's all online now. You know. you register online. and so once we have those registration links ready. we will do some advertising. But those are the two clinics that we've set up so far. which will be in this room in the town building and so
On. budget updates.
Tom is very. very closely looking at the budget for FY 27 and they also already looked at our non salary budget. Everyone's not just us. everyone's non salary budget to see where you can shave out. you know. some costs that potentially could be cut from our budget. And so we've done that. We haven't heard Julia Junghanns: about formal budget planning. I think they're having some big meetings about how to approach these concerns for an override. And you know. there's a proposal that I think the Select Board is reviewing. I don't know if they're reviewing that tonight. I think there have any hearing on property on West plain street. So
Unknown: there were some proposals that I think were being provided by the town manager and the finance director. and so they're looking for some direction from the Select Board on which way to go and whether they need to go to ask for override from Tom meeting next spring. So that's that. That's what's going on there. It's. I don't know exactly what will happen. but we'll see. I'll keep everyone in the loop of any new information I have. Heather. our school nurse leader. is. has been. you know. working on the. you know. preschool meetings with the school nurses. and we've been in touch. you know. a number of times she's been handling all that. So very thankful for all of her help getting everyone ready. To start the school year. and. you know. they're in full swing now. That was a couple weeks ago. So very thankful that. you know. she was able to step in and and handle that without any. you know. big bumps in the road. I haven't heard of any. anything crazy going on. I'm just going to knock on the table. but
mosquito surveillance. excuse me. We did have testing done last week. and there were no positives. They are doing testing again. today or tomorrow. it is possible we could have a positive mosquito for West Nile. At this point. the populations are much lower than they were because it's been so cool at night. and so I don't know that there would be any need to have additional measures taken. as far as. like. you know. considering canceling programs or things like that. This time of year. if it's cool at night. the populations really start plummeting. And when I say that. I mean of the mosquitoes themselves and their activity. they're much slower moving. Julia Junghanns: Warm days. they're still out there. There's no There's no obliteration of all mosquitoes at this point. You know that would be after the first heavy cross. but people should still be. you know. protecting themselves using bug spray. and you know. trying to avoid peak mosquito hours. especially you know. senior citizens or people with immunocompromised systems Unknown: underlying health issues. potentially. you know. West Nile could be a risk for those those populations. but we will find out more when I get results back from our mosquito control project. which hopefully will be maybe tomorrow. maybe Wednesday or Thursday. but that will be probably the last time they do testing this year.
Are they testing for West Nile and Tripoli? So they they look at the populations and the types of mosquitoes. So if they found they do have some light traps. which would be where they would find mosquitoes that could potentially carry Tripoli. Um.
Julia Junghanns: I know that it's much. much less likely here. because we don't have Cedar swamps. but I know they're looking at what types of mosquitoes they find. So I can ask Laura about that when they do their next testing. But typically. the mosquitoes that would carry that disease would be a certain species. So they would. you know. look at what the trap collects. and determine if there was any mosquitoes that could potentially be carrying that he didn't mention that. But I can ask. you know. out of you know. knowledge. you know. we don't get an actual print out of a report. So it's like. you know. it's basically. um. whether there's positives or not. And then sometimes the mosquito. some species. they will tell us that. oh. there's a lot of these types of species. so maybe we'll test for that. so that type of thing. So. but I can ask more about that. It's interesting to know. you know.
Jonathan Storer: where are the closest cedar swamps. Unknown: Sudbury.
Jonathan Storer: And do you know what kind of mosquitoes carry? Unknown: Tripoli I do. although I haven't heard this season. and I think it might be off the radar for a lot of towns. because we haven't really heard of of that many problems with Tripoli being carried in mosquitoes to see Jonathan Storer: Asian tiger mosquito or which one carries Unknown: don't think it's that mosquito. It's you'll see it in Melena is one of them. Jonathan Storer: I just. I don't. didn't have any idea how far they travel. and I Googled it. It Some don't travel Unknown: very far that we put right on the route 20 corner. and they stay over there. Yeah. no. it is possible. you know. because obviously mosquitoes travel and and Jonathan Storer: they sometimes ride the wind. is what? Yes. Google says. that's for sure. Julia Junghanns: They do. Do. and so. you know. but there's a lot of science involved with it too. that I probably am not aware of right now as to potentially why this. you know. is happening where we're seeing more West Nile than triple E mosquitoes carry. you know. plus we've had West Nile cases in humans. and so that elevates it who are at a high risk right now. for for West Nile. although. as I mentioned. as the nights cool. it becomes. you know. less concerning. I mean. it's still a risk where people should. you know. put back on protect themselves. but
Unknown: the populations start really going down. but. you know. people are still outside and should wear bug spray long sleeves. you know. spray deed. all over again. spray deed is the best thing that is. I'm sure there's a lot of reasons not to UD use deed. but it is good to prevent mosquitoes. you know. so lots of garlic. you know. staying away from areas where there's a lot of foliage. where the mosquito sort of gather. and swampy wetland areas. Things like that. especially at dusk or early morning. Um. the update on 195 main street at the old DEP W site.
Julia Junghanns: They are doing a little bit more work. I did watch the last meeting that they had. and the PFAS numbers were even higher from additional testing that they had done in the groundwater monitoring wells. and so they were going to look more closely towards where the septic system leach field is at the Middle School as a potential suspect source for PFAS. So that's being still looked at. I'm not sure where that's going to go. because. according to Unknown: Ben Gould. it's not something that is really fixable by digging the soil out. Julia Junghanns: You know. I don't know exactly what the solution would be. But I think you know this. the town will still have to do something to satisfy the state's non compliance letter for having this PFAS in water. in in the zone too. So that's. that's basically what's going on. I don't have anything new on that
Unknown: 10 short drive we are. We did have information coming from someone regarding concerning housing conditions. and so we're going to initiate an inspection at the property. Initially. it's. you know. basically requesting an inspection. So I will let the board know how that goes and what happens next.
General business. Oh. there was the MWRA connection. I had shared the letter that went out in the end of August regarding the emergency connection to the MWRA. I don't know exactly where that stands as of today. as far as the repair of piping at the happy follow wells So. but the good news is we had the ability to connect and use the butter from MWRA. Um. general business. Oh. one more thing. We do have some events coming up that are part of National Recovery Month. There's a whole calendar of events that was put together by Olivia do for who is our regional substance use prevention coordinator. and each town in our seven town collaborate. Collaborative has. you know. different events going on. and so this. I believe. is on the town's website. where each day there's something going on. And we also have a survey. which is to help us under understand what potentially the opioid needs are in our community. It's. you know. easy to take the survey by a link on this handout. This was also put together by a. Olivia do for who has been doing a great job. you know. on prevention work. and this was. you know. one of the things that they wanted to try and identify what people think the needs are in each community out of our seven Tom collaborative. yeah.
general business. there's a stack of bills. which we apologize for. Patty had gotten behind with vacations and things like that. So if there's any questions. please let me know I'm happy to answer them. Or you could always stop in if you wanted to. you know. in the office. And then we do have one set of minutes that are ready. May 12. Did everyone have a chance to look at them. or have a copy here? Okay. so then we would just need to someone would need to make a motion to approve the minutes. a motion to approve the minutes from May 12. Yes. I second the motion.
What do we do now? Need to take a vote. yeah. and I
don't remember what we say. So basically. you know each person votes. and you go around asking each person if they vote yes. Jonathan Storer: Okay. Genevieve and on. do you vote yes? Or how do you vote yes? Brent mortis. Unknown: yes. Jonathan Storer: Katie step. yeah. And John story. yes. Unknown: excellent. Thank you.
We don't have June. but we're working on that. so that should be ready next
time I thought you were gonna say. I know you know. you just That's right. I forgot Robert. Yeah.
any other questions or concerns or I will definitely bring Laura in to one of our board meetings so you can meet her and welcome her to Wayland. and you know she'll be working with Heather Yates and our fabulous nursing team that we have that's been running smoothly as you know. so far this school year. which is very happy about. yeah. isn't there something else you want to announce? What I
Jonathan Storer: don't know? I just noticed something Unknown: that I got engaged. Congratulations. Thank you. Yeah. thank you. Couple weeks ago. few weeks ago. thank you.
So I mean. I don't think there's anything else someone needs to make a motion to close. I make a motion to close the meeting.
Second. just go around again. Jonathan Storer: Jen. you have an on? Yes? John store. yes.
Unknown: Brett mortis. yes. Katie stuff. yeah. great. Thank you. All right. if you.