November 16, 2017: The “gift of presence” for hospice veterans

Belmont Citizen-Herald — November 16, 2017

It was cold that day. The day before Christmas in the Midwest usually is. The black hearse wound its way down the narrow lane to the grave site. A veteran was gone, to be buried with full military honors in a national cemetery in rural Iowa.

The bugler raised his instrument. Taps echoed through the trees and rolled over row upon row of headstones. The 15-member military Honor Guard from Fort Leavenworth (Kansas) fired its 21-gun salute. The head of the Honor Guard solemnly took the flag, having been removed from the casket and properly folded. He delivered it to. . .

No-one.  Nobody was there.  No family. No friend.  No neighbor or colleague or former roommate.

And the head of the Honor Guard that day, Belmont High graduate Bill McEvoy, realized right then and there that this was not the way the world should be.

The image from that lonely rural cemetery remained seared in McEvoy’s mind over the years. When he retired, McEvoy decided it was time for him to pull out that memory and finally act on it.  He began to volunteer at the Veteran’s Administration hospital in Bedford (MA).  He quickly became involved with the No Veteran Dies Alone program.  He’s volunteered there ever since, more than eight years now.

The program is directed toward veterans in hospice care at Bedford’s VA hospital. (No Veteran Dies Alone is a national program through many VA hospitals.)  Some veterans are in the hospice care beds at the Bedford hospital.  Others are admitted for hospice care, but remain in the general population. The vast majority of veterans McEvoy has worked with are Vietnam veterans or older.

The No Veteran Dies Alone program, McEvoy says, has two components to it.  The first component involves “socialization visits.”  Through this part of the program, a volunteer sits with the veteran. Sometimes they talk; other times they listen to music.  As a volunteer, he may read poetry or do nothing at all other than to hold the person’s hand.  The point, he says, is simply to “be there. To get to know them.” What you provide, McEvoy says, is the “gift of presence.”

The second program component is directed toward veterans determined by the VA medical team to be “actively dying.”  Sometimes these veterans don’t have anyone. Sometimes, it has been a long process and the family simply needs the ability to take a break. Sometimes geographic distance makes a family’s presence impossible. McEvoy’s role through No Veteran Dies Alone, he says, is to “stand in the place for those who aren’t there.”

That’s not to say he’s present whenever someone passes.  He eventually learned, however, that “it is not so important to be there at the end of the journey, as it is important to walk with them along the way.”

“Be sure to emphasize,” McEvoy urged me when we sat down together, “that the story is not about me. It is only about the veterans.” In fact, he says, there are no limits on who can be a No Veteran Dies Alone volunteer.  “Every volunteer has their own reasons for being there. Anyone can do it. All you need is a good heart, a capacity for understanding, and the ability to be a good listener.”

One need not stand in a cold Iowa cemetery on the day before Christmas to appreciate the importance of the No Veteran Dies Alone program.  Persons who might want to volunteer for No Veteran Dies Alone should call Laurel Holland, 781-687-3074.  Persons who know a veteran they would like to receive hospice care through the VA hospital should call Karen Budnick, 781-983-9170.


August 31, 2017: Cell phones are the new “bouncing balls”

August 31, 2017: Belmont Citizen-Herald

As our kids head back to school this week, let’s think again about the safety implications of mixing cars with kids walking to school.

Some lessons you just never forget. I’ve been taught since I was a young driver to “beware the bouncing ball.” I will always carry the memories of those afternoons practicing driving around our neighborhood, gripping the wheel of our family car, my instructor at my side. My mother would lecture (sometimes, perhaps, in louder tones than others), “bouncing balls, and the children who chase them, are the bane of the driver. Watch for them. Notice them.”

The numbers today tell us about a different type of “bouncing ball.” These numbers warn that it is perhaps the teenager that is most at risk as a pedestrian.  According to one report, “Teens on the Move,” every hour of every day a teenage pedestrian in the United States is killed or injured.  According to this study, “while teens account for one-third of children in the United States, they make up two-thirds of the pedestrian fatalities.”

Safe Kids, an organization dedicated to improving pedestrian safety, agrees.  Safe Kids attributes the problem to “distracted walking.”  Safe Kids reports that by the end of 2015, 88% of high school students owned cell phones, up from 45% just ten years earlier.  This trend has safety implications for students walking to and from school.  Safe Kids collected more than 34,000 observations of students crossing streets in school zones.  It found that “one-in-five high school students, and one-in-eight middle school students, were observed crossing the street while distracted by phones, headphones and other mobile devices.”  Indeed, according to Safe Kids, from 2013 to 2016, distracted walking increased from one-in-five to more than one-in-four among high school students, and increased from one-in-eight to one-in-six middle school students.  In today’s world, in other words, cell phones are the new “bouncing ball.” As my mother would have said “watch for them; notice them.”

It is not just street crossings, however, that merit increased attention as our kids go back to school.  Driveways can be deadly as well.  In the United States, 50 children are backed over every week because a driver could not see them.  Every vehicle, I am told, has what is called its “blind zone,” that area behind the vehicle where the driver cannot see even when looking back and properly using his or her rear and side view mirrors.  The larger the vehicle, the larger the blind zone.

Driveways are often made even more dangerous to kids walking to school by bushes and other shrubberies that line the driveway or sit close to the sidewalk and impede sight lines.  In addition, cars like our Prius hybrid are so quiet, they can “sneak up” on pedestrians, both young and old, without being heard.  Situations where the driver cannot see the pedestrian, and the pedestrian can neither see nor hear a car backing out of the driveway, will daily present the potential for tragedy without the exercise of utmost care.

Unlike the teenage dangers of distracted walking, backing out of driveways poses the most danger to younger children.  According to KidsAndCars, a national safety organization, “children do not understand the danger of the slow moving vehicle; they believe if they see the vehicle, the driver can see them.”  The need to protect our kids from our cars, in other words, arises before one’s car ever hits the streets.

Kids, welcome back to school. I hope you find the year both fun and interesting.  Here’s hoping, also, that we all take seriously our responsibilities, as both drivers and pedestrians, to keep the school year safe as well.

March 9, 2017: Marijuana regulation: Opinions need to surface early

March 9, 2017: Belmont Citizen-Herald

Belmont will soon face the complex task of deciding how to regulate local marijuana dispensaries within the community.  Under “Question 4,” approved by Massachusetts voters in November of 2016, the recreational use of marijuana was legalized in Massachusetts.  While the state legislature is now considering amendments to the marijuana statute, legislators who are involved with that process say that no major changes will be made to the intent of what voters approved. The new statute gives the authority, and the responsibility, to develop local regulations to the town’s Board of Health.

Despite the flux that is present at the state level, Belmont residents should be thinking even now about what types of local regulation they might wish.  On the one hand, it might seem that since marijuana is now legal, the town could not prohibit its sale within town borders.  That conclusion, however, may well be wrong.  Not long ago, for example, Belmont was still a “dry” town, even though the consumption of alcohol has been legal for some time.  In contrast, David Alper, chair of the Belmont Board of Health, has said, rightly so in my opinion, that the Board will consider the fact that a majority of Belmont voters approved Question 4.  The community, in other words, has already expressed its preference.

Some topics are outside the scope of local regulation. The licensing of marijuana dispensaries, for example, is within state control.  Belmont, therefore, would not have the authority to require background checks of owners/operators or to require local ownership of marijuana facilities.  In contrast, governing the location of marijuana dispensaries is clearly within the town’s control.  We presumably would not want such stores to be close to schools, day care centers or parks. One question is whether we wish to limit marijuana dispensaries to one part of town, or whether we should allow them throughout town. For example, like liquor sales, we might want each major business center to have at least one sales location.

Local regulation of marijuana dispensaries will have some (but not all) aspects of the regulation of both alcohol and cigarettes. The form of marijuana sales, however, makes the issue of local regulation complex almost beyond belief.  In some ways, the sale could be like that of tea, where a customer can ask the proprietor to mix and match different types, flavors or potencies of the product.  However, marijuana can also be mixed with candy, with food, or with baked goods.  On-site consumption of marijuana is allowed (e.g., sitting down to eat on-site).  Each type of sale presents its own issues.

Some aspects of local regulation are very traditional zoning-type issues, including fencing, lighting and hours of operation.  Other aspects might not be traditional at all. Should there be regulation of trash disposal, security, and days of operation?  Would it even be legal to require local businesses to display information on the potential adverse consequences of using marijuana (e.g., impaired driving)?

Belmont could do nothing, but that would not be wise.  In the face of local inaction, the state would step in to regulate. Belmont would have to accept what the state decides.

In short, Belmont is facing major decisions on whether and how to regulate the local sale of marijuana.  People will have strong opinions. The Board of Health not only deserves to hear those opinions, but is striving to solicit those opinions.  Belmont residents should work with the Board to help craft marijuana decisions, not simply wait to respond to regulations, once published, on a straight up-or-down reject-or-approve manner.  When opportunities arise for public input, this topic of the local regulation of marijuana dispensaries deserves everyone’s attention and involvement.

February 9, 2017: Belmont’s drought response: Increasingly ‘too late’

February 9, 2017: Belmont Citizen-Herald

While the poor quality of water that Belmont dumps into the Mystic River has gained considerable attention in recent years, the quantity of water in Belmont, not merely the quality, should also be of concern.  In five of the last seven months of 2016, the northeast region of Massachusetts, the region of which Belmont is a part, has been subject to a Drought Warning by the state.  In the state’s system of drought classifications, Drought Warning is just one step down from a Drought Emergency.

Under a Drought Warning, Belmont is not under the threat of mandatory water conservation measures.  Mandatory state restrictions on water use, such as a ban on watering one’s lawn, can only be imposed when the drought becomes a Drought Emergency.

Nonetheless, according to Belmont resident Julia Blatt, executive director of the Massachusetts Rivers Alliance, Belmont should take the Drought Warning seriously even during these winter months.  People have been poorly conditioned by other warning systems, Blatt believes.  For example, when one hears a winter storm warning issued, the caution is about a storm that will occur in the future.  In contrast, Blatt says, a Drought Warning is not a prediction of a future event.  The Drought Warning under which Belmont has been placed means that the drought is here today.

By the time a Drought Warning has been issued, in other words, it is largely too late for people most effectively to respond.  The adverse impacts of the drought are not coming, they have already arrived.  In addition, Blatt says, those adverse effects cannot be alleviated simply through a few rain storms.  It takes months of wet weather for the impacts of a drought to be undone.  Moreover, she continues, hard rain storms are not generally helpful in ending drought conditions.  Big storms result in rain water quickly draining into the streets, being funneled into streams and rivers through stormwater pipes, and eventually flowing into the ocean.  In contrast, lots of snow could help.  Snow can melt slowly, soak into the ground, and help replenish ground water and drinking water sources.

Belmont residents are in no danger of turning their kitchen faucet on and not having water come out.  That, however, is not an entirely crazy notion.  Cambridge, for example, was forced last fall to begin to buy water from the Mass Water Resources Authority because of the decline in water levels in the city’s own reservoir. That need to purchase MWRA water not only imposed substantial costs on Cambridge residents, but also reduced available water supplies to other MWRA communities (of which Belmont is one).

I realize that as I write today, snow is on the ground and the Super Bowl (and, even more importantly, the coming start to baseball’s Spring Training) are more on peoples’ minds than things like restrictions on watering one’s lawn.  In fact, however, that is precisely the point.  The longer the Belmont community postpones its responses to the existence of drought conditions in Massachusetts, the more likely two things will occur.  First, the restrictions that may eventually be imposed will need to be more severe.  Second, even those more severe restrictions will be a less effective response to the drought conditions since it will increasingly be “too late.”

Through its water department, the town should be taking an aggressive response to the drought that has befallen Belmont (and many other parts of Massachusetts).  At the least, community education regarding ways to implement water conservation, even during these cold weather months, would be an important beneficial response to dry summer weather.  Waiting until the summer months to respond to continuing dry weather will be too late.

October 20, 2016: Child care: addressing children’s well-being in local planning

October 20, 2016: Belmont Citizen-Herald

A public input meeting on the renovation of the PQ playground, over behind the VFW Hall and the tennis courts, brought together an eclectic group of folks recently in the Butler School cafeteria.  Groups that were represented in the gathering involved not only parents and abutters, but also child care providers who regularly use that playground.

Belmont has a particular need for playground facilities.  According to data published each year by the Kids Count Data Center, Belmont has the highest penetration of young children in our region. While 14.3% of Belmont’s population is age 9 or younger, the next highest penetrations are Arlington (12.4%) and Lexington (11.5%). Watertown (9.5%) and Waltham (8.9%) fall further behind.  The need for playground facilities is not the only need presented by this segment of our community.  Adequate child care is an important resource needed by these families as well.

Adequate child care requires a sufficient supply of child care facilities.  While Massachusetts overall has one of the highest rates of child care facilities in the nation, Middlesex County does not reflect that performance.  Only three counties in Massachusetts have fewer child care facilities per 1,000 children than does Middlesex. In addition, while Massachusetts nearly doubled the number of child care facilities per 1,000 children in recent years, Middlesex County’s rate remained constant. Data for individual communities is not reported.

Adequate child care also requires a sufficient diversity in the types of facilities offered.  Massachusetts, for example, has a shortage of slots available in family child care homes.  Fewer than one-in-five (17%) of all child care spaces in Massachusetts can be found in licensed family child care homes.

This shortage has substantial cost implications to families with children.  In Massachusetts, while the annual cost for an infant in a family care home is $10,679, the cost for an infant in a child care center is $17,082 (2015 dollars).  Similarly, while the cost of a family care home for a four year old is $10,012, the cost for a four year old in a center is $12,796.

Belmont places restrictive zoning regulations on family day care providers.  In Belmont, family day care providers must receive a special permit before they can operate.  No consideration is given to the number of children being cared for in the home. The zoning by-law frequently pits the interests of families, particularly young families, who are faced with the need for two-incomes (and thus regular child care) against the concerns of neighbors about noise and traffic (at times of drop-off and pick-up).  Those who object to family day care providers often argue that such homes are like any other “commercial” enterprise in a residential neighborhood.

Belmont should follow the guidance of the American Planning Association on child care facilities.  APA states that “there is increasing recognition given to the importance of including children’s well-being in our planning practice.”  In addition, APA continues, “child care is seen as a critical support for working parents and their employers.”  The APA says that “just as roads, sewer and water are needed for housing and business development, so, too is child care.”

Progress has been made.  In some places, small family day care providers have been exempted from zoning regulations entirely.  In other places, child care has been made mandatory in new large housing developments.  Whether from the perspective of dual income families, the perspective of promoting economic development, or the perspective of providing for long-term child development benefits, Belmont would be well-served to examine how its planning and zoning supports local child care.  A multi-stakeholder study group reporting to the Board of Selectmen would be a good start.

September 8, 2016: As school year begins, “keep kids in motion”

September 8, 2016: Belmont Citizen-Herald

As the summer months wind down and school hours again take up much of the day for our community’s school-age children, one increasingly difficult task facing parents is to promote healthy living by our kids.  Healthy living involves not simply healthy eating, according to Be Well Belmont, but involves efforts to “keep kids in motion.”

Both the message and the messenger deserve public attention.

Be Well Belmont is a project of the Belmont Food Collaborative.  The effort, according to Suzanne Johannet, an M.D. and the BFC board chair, is based on the observation that unhealthy living imposes costs, both governmental and societal.  Be Well Belmont is pursuing several major “themes,” Johannet says, including both obesity prevention and mental health.  Youth services, Johannet says, is an important aspect of both of these themes.

Be Well Belmont is part of a larger network of community-based health initiatives.  It joins sister efforts such as Live Well Watertown and Shape-up Somerville.  In most states, Johannet observes, the activities of these efforts would be undertaken by the county public health department.  However, she says, Massachusetts has never had strong county governments and county health departments are non-existent.

Accordingly, Johannet says, local grassroots efforts are supported through regional networks called Community Health Network Areas. Belmont is part of CHNA (pronounced, Chuh-NAW) 17, which also includes Somerville, Cambridge, Watertown, Arlington and Waltham.  Funding is provided to the CHNA when regulatory actions such as hospital consolidations are approved by state regulators.

Be Well Belmont began in late 2015 by pulling together more than 70 community leaders, ranging from the school superintendent, to the library director, to the police chief and a host of community volunteers, business people and clergy, not as policymakers but rather as idea generators and community role models.  The evening’s conversation was charged with identifying “gaps in community wellness activities.”

One resulting objective of the Be Well Belmont organization was to “keep kids in motion.”  The U.S. Department of Health and Human Services recommends that young people aged 6 – 17 participate in 60 minutes of physical activity daily.  Such activity, HHS says, not only helps build healthier bodies for our kids, but also helps improve academic performance, including grades, attentiveness in the classroom and ability to concentrate on tasks.

Paying particular attention to keeping kids in motion is important both by gender and by age.  Engaging in physical activity declines as young people grow older, the U.S. Centers for Disease Control and Prevention report.  The CDC’s Youth Risk Behavior Surveillance study noted that by high school, only 29% percent of high school students had participated in at least 60 minutes per day of physical activity on each of the seven days before the survey. Young females were half as likely as young males to have engaged in such activity (17.7% vs. 36.6%).

The Be Well Belmont efforts are part of a growing campaign to keep kids physically active outside of the classroom in the face of video games, television, and other screen time attractions.  For example, physical activity might beneficially be viewed as part of each child’s daily regime as much as daily homework is.

As the summer days of bicycles and camps turn into days of classrooms and nights of homework, it is important to keep kids in motion.  From walking to school to hoola hoops to bikes; from backyards to houses of worship; from friends to family to neighbors, renewing our community’s commitment at the beginning of this school year to help our kids stay healthy by helping them to stay physically active is one promise we should make and keep.