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MEETING PACKET MAY 2012 CITY OF SALE"N4, MASSACFIUSL?TTS 130 -uzi)()i� 120 WAM[INGTON STREr:','I',4.71 Public Health (978) 741-1800f`\X(978) 745-0343 KIMBFRLI�'Y DRISCOLL Ininiclin(asalem.com LARRY RANIDIN,W,/RF'I IS,(:I R C11-1-S NOTICE OF MEETING You are hereby notified that the Salem Board qf Health will hold its regularly scheduled meeting Tuesday, May 8, 2012 at 7.00 PM City Hall Annex, 120 Washington St. Room 311 MEETING AGENDA 1. Call to order -< Cl> r- rn 2. Approval of Minutes from April 10, 2012 1 3. Chairperson Announcements D F W 4 '0 4. Public Health Announcements/Reports/Updates a. Health Agent • b. Administrative NJ c. Council Liaison 5. 40 Circle Hill.Rd project-Request for discussion of conditions set by the Board on June 15, 2009 6. Hearing for Sunny Comer Tobacco Violations 7. Joyce Redford, Tobacco Control Coordinator-Draft of Tobacco Regulations 90 X 9, 8. Miscellaneous 9. Adjournment Larry Rarridin Health Agent cc: Mayor Kimberley Driscoll, Board of Health, City Councilors Next regularly scheduled meeting is June 12, 2012 at 7prn at City Hall Annex, 120 in 0 Washington Street Room 311 Know your rights under the open meeting law MGL Chapter 39 Section 23B and City C Ordinance section 2-2028 through 2-2033 • Health Agent Report April 2012 Announcements • The Public Health Nurse position interviews have been conducted we have selected a candidate and her start date is May 14 • David Greenbaum successfully completed Massachusetts Systems Inspector training and is now a Licensed Systems Inspector • Delilah Castro has successfully completed all 18 FDA online Food Safety training courses Environmental Health Staff attended MHOA training that discussed updates from the Division of Community Sanitation Elizabeth Gagakis inspected 48 Derby Street, accompanied by Larry Ramdin and Delilah Castro and violations corrected, court advised that corrections were made and the complaint against the owner was dismissed • Other Activities Inspections Certificate of Fitness Inspections —42 Certificate of Fitness Re-inspections — 3 Court Hearings — 1 Food Service Inspections —29 Food Service Re-inspections — 16 Housing Inspections — 10 Housing Re-inspections — 3 Meetings —2 Rodent Inspections —2 Seminars — 5 Trash Inspections- 3 Phone calls- 483 • using in nonsmoking areas— age restriction on this product— open and closed chambers— 2. Secession sign— example, "for help quitting smoking go to" 3. Include 18 plus ID sign 4. Permit required • 5. No permit renewal if outstanding fines exist 6. Capping and reducing tobacco permit numbers in the city 7. A minimum cigar packaging size and price—minimum$2.50 single or minimum 4 per pack for$2.50 - 8. Ban blunt wraps 9. Ban coupon redemption 10. Ban self-service displays 11. Ban commercial roll your own machines 12. Vending machines ban 13 Health care facility and pharmacy ban on sale of tobacco 14. Ban educational institute from sale of tobacco 15. Add suspension to fine 16. Tolling period—36 months 17. Change shall/may in regulations Motion by Dr. Lucas to have Joyce Redford draft a new tobacco and nicotine control delivery policy for our next monthly meeting. 2"d G Sullivan; Motion passed unanimously 6. Miscellaneous Transfer Station- an appeal was filed by the condo association • off of First St; a hearing is scheduled for some time in May. 7. MEETING ADJOURNED: 9:15pm Respectfully submitted, Heather Lyons-Paul Clerk of the Board Next regularly scheduled meeting is May 8, 2012 at 7pm At City Hall Annex, 120 Washington Street,Room 311 Salem. • • Health Agent Report April 2012 Announcements • The Public Health Nurse position interviews have been conducted we have selected a candidate and her start date is May 14 • David Greenbaum successfully completed Massachusetts Systems Inspector training and is now a Licensed Systems Inspector • Delilah Castro has successfully completed all 18 FDA online Food Safety training courses • Environmental Health Staff attended MHOA training that discussed updates from the Division of Community Sanitation • Elizabeth Gagakis inspected 48 Derby Street, accompanied by Larry Ramdin and Delilah Castro and violations corrected, court advised that corrections were made and the complaint against the owner was dismissed Other Activities Inspections Certificate of Fitness Inspections —42 Certificate of Fitness Re-inspections — 3 Court Hearings — 1 Food Service Inspections —29 Food Service Re-inspections — 16 Housing Inspections — 10 Housing Re-inspections — 3 Meetings — 2 Rodent Inspections — 2 Seminars — 5 Trash Inspections- 3 Phone calls- 483 • I • • Administration Monthly Report April-12 Burial Permits @ $25.00 $1,100.00 Permits $2,310.00 Certificate of Fitness@$50.00 $1,900.00 Fines Total Monies Collected = $5,310.00 Annual Budget Expended Available Balance Total Salary/Longevity $344,000.00 $259,977.85 $84,022.15 Annual Budget Expended Available Balance Non-Personnel $19,600.00 $14,474.04 $5,125.96 cOttYttYanwealtb Of ftlao0arbuatto STATE RECLAMATION AND MOSQUITO CONTROL BOARD �ee1�� e yjf�r� NORTHEAST MASSACHUSETTS MOSQUITO CONTROL AND WETLANDS MANAGEMENT DISTRICT 5'a1 • 261 Northern Boulevard,Plum Islands Newburyport,MA 01950 Phone:(978)463-6630/Fax:(978)463-6631 dNubA�® www.northeastmassmosquito.com Jack A.Card,Jr.:Director Commissioners William Mehaffey,Jr.:Operations Manager John W.Morris,CHO:Chair Emily D.W.Sullivan: Wetlands Project Coordinator Vincent J.Russo,MD,MPH: Vice Chair Esteban Cuebas-Incle:Ph.D:Entomologist Sharon Cameron,RS,MPA Robyn A.Januszewski:Biologist Peter Mirandi,RS,MPH DISTRICT BULLETIN: 2 May 2012 Greetings and Happy New(Mosquito) Year! For those of us at Northeast Massachusetts Mosquito Control, this week marks the start of our surveillance season and thus, the start of a new mosquito season! In all of the District's thirty-two cities and towns our surveillance traps have all been set out, activated, carbon-dioxide tanks attached, "stinky" water added, and"All Systems Are GO"! We begin visiting each of our traps this week (Monday and Wednesday mornings) and continue twice every week collections until the beginning of October. All that is collected, even the occasional adult mosquito, as was the case on Monday (30 April), is removed and identified. •Although we start our adult mosquito surveillance early, when compared to all other Massachusetts mosquito control agencies, we are ready to collect and prepare responses if an adult emergence occurs earlier than usual; this was our fear earlier this spring after the short stretches of summer-like temperatures in mid March and mid- April (e.g.,this was the second warmest April on record!). Furthermore, an early start allows us to test our traps and equipment to insure they are in optimal working order when the mosquitoes do come out in earnest. On the subject of the spring, it has been one of the more unusual springs in recent memory. And this spring comes off the heels of an unusually mild and dry winter. And while we have had rain of some abundance last week, the District is still experiencing a drought. The ground is extremely dry and there is relatively very little standing water remaining. Trees and shrubs will suck up whatever water that remains as their leaves completely unfurl and expand. The consequence is that there is presently relatively little water for abundant mosquito development. This means that the "explosive" emergence of adult mosquitoes that occurs in May through early June,the so-called "Spring Brood", may not be very explosive and more like a"paper-bag pop"! If residents live near areas of poor drainage and seemingly perpetual standing water, a"minor" explosion of mosquitoes may result. If we begin to get steady rain for several days, and the temperatures continue to gradually warm, the Spring Brood explosion will occur but later into the spring. A similar scenario has been seen for mosquitoes developing in salt marshes. High-run tides that flood the upper reaches of the marsh have resulted in hatching and development of larvae. However, the extreme • dryness of the soil has led to many salt marsh pools drying up with no further mosquito development. In some cases, the salt marsh flooding has been so extensive that in areas have remained flooded for several days - Committed to a partnership of the principles of mosquito control and wetland management- resulting in fish reaching the upper stretches of marsh and consuming nearly all the developing larvae. We have projected to aerial salt marsh larviciding operations several times this spring but we have ultimately canceled for lack of larvae. Instead, we have identified only small pockets of salt-marsh"breeding" and have •treated these areas with the bacterial larviciding agent,Bacillus thuringiensis israelensis or"BTI". Aedes sollicitans(bugguide.net) Ae. cantator(bu,gguide.net) Y�i SL M o s' t1 i '♦ . .r (Both are Salt-marsh mosquitoes) Aedes vexans (www.cirrusima eg com) Culex pipiens (www.cdc.p_ov;PHIL:4464) 3 t V 9 ■�,a. IIF�� Y (A"Spring brood"species) (The principal vector of West Nile Virus in NE MA) What about the mosquitoes we saw flying about in March? These are mosquitoes that emerged at the end of last summer and hibernated all winter in sewers, catch basins, culverts, and basements. These mosquitoes are the "Winter Brood" and are usually no more than a minor annoyance; they have no role in public health. At the first hint of warm weather, they flew out and began searching for a bloodmeal to eventually lay eggs to start this year's generation. Most of these are now probably dead. Another group of hibernating mosquitoes emerging now are of concern because these are the principal vectors of West Nile virus (WNV); these mosquitoes (Culex pipiens and Cx. restuans) are suspected to harbor and maintain the virus through the winter When infected hibernating Culex mosquitoes emerge, they bite and infect birds and the WNV cycle of mosquito-to-bird-to- mosquito ("enzootic cycle") begins again. If more infected Culex mosquitoes survived the winter, then the enzootic cycle may start earlier. With more infected birds serving as sources to more biting mosquitoes, there is more virus "circulating" and the risks of infection to people becomes greater. What this means for us is that •infections to people may occur earlier this summer, as early as late June and early July rather than August into September as usual. Therefore, with our early-season surveillance in place, we can monitor any unusual population increases and plan any operational responses if they become necessary. •As in the recent past, we submit our mosquito samples ("pools")to the MA Department of Public Health (MDPH) to test for the presence of viruses by Friday of each week; testing by MDPH will not commence until mid-June. Because we do our surveillance trappings twice a week and time is needed to identify and process the specimens, we cannot submit our pools for testing not earlier than Thursdays of each week. MDPH will start the testing process possibly as early as Thursdays,but more likely will begin on Fridays; the testing may take anywhere from twenty-four to forty-eight hours. Your Board of Health, as well as NE MA Mosquito Control, will be informed of any infected pools from your community; we will then be in contact with your Board to discuss the next options which can range from additional trappings to a town-wide operation response. Parameters that come into play when planning our recommendations include when during the summer viruses are detected, mosquito population dynamics, history of virus in your and in adjacent communities, and weather conditions. If your Board is informed of infected pools on a Friday or weekend, we recommend that a representative of your Board be designated as the "contact"person to whom we can discuss options if decisions are needed to be made quickly. During the summer, we are "on call" on evenings and weekends so that if the situation requires fast decisions and responses, we are already ready to discuss and even take action(s)! Being ready for whatever the season holds is the goal for what we are working towards, and your help to reach this goal is greatly appreciated. To have in place both the required IPM (Integrated Pest Management)plans with regards to schools and parks, as well as the notification process for the public, makes for a smooth and controlled response in battling mosquitoes and viruses. A reminder, our annual workshop for health agents and Board of Health members to discuss mosquitoes/ arboviruses issues in northeast MA will be held again in Endicott Park in Danvers, on Wednesday 16 May 0 2012, from 9 until 11:30 am. We hope to see you there! • 11- DeIULIS BROTHERS 0. ► AILCONSTRUCTION CO., INC. April 19, 2012 10. Larry Ramdin,Health Agent ► Salem Board of Health 120 Washington Street, 41h Floor Salem, Massachusetts 01970 ► RE: 40 Circle Hill Road Three Lot Subdivision Building excellence Dear Mr. Ramdin: since 1958 I am writing to request to be placed on the agenda for the May 8, 2012 meeting of the Board of ► Health to discuss two of the conditions,numbers 3 and 13,on the enclosed June 15, 2009 letter to the ► Salem Planning Board. - 10. 10. ► Since permitting this project,we have had to focus solely on our core construction business, which is commercial building, and have not been able to devote any resources to starting this development ► project. We are currently in negotiations with Kenneth Steadman, a site developer and contractor who is better suited and who will be able to start this project in a short period of time. He is now ► close to completing work on his Witch Hill subdivision and is poised to move his equipment over to this location,which is only a few hundred yards away. • j Our agreement is conditioned on us delivering him a shovel ready project. He has indicated that the aforementioned conditions would delay his ability to start construction and would require additional ► expense that he is not willing to incur. Therefore, it is my hope to review these conditions with the Board of Health to determine if they are necessary, and if not,possibly modify or eliminate them 10. altogether. As for Condition No. 3,we do not have a 21E Report and have not undertaken any such survey of the property. We have owned this land since the mid 1960's and it has never been disturbed. The property is bordered by City owned park land and other single family residences. This area was ► never subject to any form of industrial use and we do not believe a 21E Report is necessary or even j required. Similarly,we do not believe Condition No. 13 is relevant, since our plans do not provide for any formal drainage system;there will be no underground or above ground collection or storage. ► With the approval of the City Engineer and the Planning Board,we have adopted a country style ► drainage plan where the surface water is directed to grassy areas where it is recharged back into the ground. ► Thank you for your assistance in bringing this before the Board. I will be present on May 8th to ► discuss this matter further and answer any questions. j /Sincerely, - • ► Patrick Delulis Vice President ' ♦ 31 Collins Street Terrace, Lynn, MA 01902-2205 ♦ 781-595-8677 ♦ FAX 781-593-7840 ► General,Construction . Construction Management . Member A.G.C. . o • CIT'Y OF SALEM, MASSACHUSETfS BOARD OF HIS..-1LT1i • �' 120�J1ISHING'f(.)N STRL;ET',4"i F1,00R TEL. (978) 741-1800 KINMERLEY DRISCOLL FAY(978) 745-0343 MAYOR i)Gu.-.rNBALIM S,,\J.r.M.(70,%4 DA.V1D GRI'.F5Ni3AUM RECEIVED AC"I'IN(, HI::A.IXIi A(,i N'I JUN 2 2 2009 June 15, 2009 De1u4is Charles Puleo, Chairman Salem Planning ng Board 120 Washington Street Salem, Massachusetts 01970 Dear Mr. Puleo: At its meeting on June 9, 2009, the Salem Board of Health voted to approve the Preliminary Subdivision Plan for 40 Circle Hill Road, presented by Patrick Delulis, with the following conditions: 1. The individual presenting the plan to the Board of Health must • notify the Health Agent of the name, address, and telephone number of the project(site) manager who will be on site and directly responsible for the construction of the project. 2. If a DEP tracking number is issued for this site under the Massachusetts Contingency Plan, no structure shall be constructed until the Licensed Site Professional responsible for the site meets the DEP standards for the proposed use. 3. The developer will give the Health Agent a copy of the 21 E report. 4. The developer shall adhere to a drainage plan as approved by the City Engineer. 5. The developer shall employ a licensed pesticide applicator to exterminate the area prior to construction, demolition, and/or blasting and shall send a copy of the exterminator's invoice to the Health Agent. 6. The developer shall maintain the area free from rodents throughout construction. 7. The developer shall submit to the Health Agent a written plan for • dust control and street sweeping which will occur during construction. 8. The developer shall submit to the Health Agent a written plan for containment and removal of debris, vegetative waste, and unacceptable excavation material generated during demolition and/or construction. 9. The Fire Department must approve the plan regarding access for fire fighting. 10. Noise levels from the resultant establishment(s) generated by operations, including but not limited to refrigeration and heating, shall not increase the broadband sound level by more than 10 dB(A) above the ambient leveis measured at the property line. 11. The developer shall disclose in writing to the Health Agent the origin of any fill material needed for the project. 12. The resultant establishment shall dispose of all waste materials resulting from its operation in an environmentally sound manner as described to the Board of health. 13. The drainage system for this project must be reviewed and approved by the Northeast Mosquito Control and Wetlands Management District. 14. The developer shall notify the Health Agent when the project is complete for final inspection and confirmation that above conditions have been met. If I may be of any assistance to your Board, please call me. Sincerely you s, �F0 tth�Bo f Health, David a nbau Acting Health Agent CC: Patrick Delulis, C/O Delulis Brothers Construction Co., Inc. i CITY OF SALEM BOARD OF HEALTH MEETING MINUTES • July 24, 2012 DRAFT MEMBERS PRESENT: Dr. Barbara Poremba, Chairperson; Gayle Sullivan; Robert Dionne; Dr. Larissa Lucas OTHERS PRESENT: Larry Ramdin, Health Agent; Council Liaison Thomas Furey MEMBERS EXCUSED: Martin Fair TOPIC DISCUSSION/ACTION 1. Call to Order 7:OOpm 2. Minutes of Last Meeting Accepted with corrections (July 10, 2012) 3. Chairperson Announcements Board of Health retreat will be held Sept 22"1 from 9-3PM at the Public Health Museum located on the grounds of Tewksbury State Hospital. We will begin by having a private tour of the museum before working on revising our mission, objectives and short/long term goals. 4. DiscussionNote on New DJ Wilson submitted a document regarding the concerns of the Tobacco Control Salem business owners from the public hearing on July 10, 2012 •Regulations (document was submitted as part of the record). The Board carefully reviewed and discussed the proposed regulations. In Section P. #4, "sale to a minor occurred" was changed to "any sale occurred". Councilor Furey supports the proposed regulations. Motion by G. Sullivan to accept the Tobacco Control Regulation to be effective on Sept 12012 except for cigar sales restrictions will be effective February 4, 2012. 2"d Larissa Lucas Motion approved unanimously. 5. MEETING ADJOURNED: 7:35pm Respectfully submitted, Heather Lyons-Paul Clerk of the Board Next regularly scheduled meeting is September 11, 2012 at 7pm At City Hall Annex, 120 Washington Street,Room 311 Salem. • i CITY OF SALEM BOARD OF HEALTH MEETING MINUTES • July 10, 2012 DRAFT MEMBERS PRESENT: Dr. Barbara Poremba, Chairperson, ,Gayle Sullivan, Robert Dionne &Dr. Larissa Lucas OTHERS PRESENT: Larry Ramdin Health Agent, Justina Polvere, Public Health Nurse MEMBERS EXCUSED: Martin Fair, Councilor Liaison Thomas Furey TOPIC DISCUSSION/ACTION 1. Call to Order 7:06pm 2. Minutes of Last Meeting Dr. Lucas motioned to approve G. Sullivan 2nd approved (June 190, 2012) unanimously 3. Chairperson Announcements Save the day. There will be a retreat for all BOH members and staff on Saturday September 22, 2012, location TBA. A. Health Agent Report Larry Ramdin will be training along with his inspectors to follow FDA standardized program for food establishment inspections. Dogs as of now will not be allowed in food establishments and patios unless they are a service dog. A letter to.be sent to all • establishments about the dog/animal enforcement. B. Public Health Nurse Accepted into the Record Report C. Administrative Accepted into the Record Report D. City Council Liaison None Presented Updates R. Dionne motioned to except the reports Dr. Lucas 2nd approved unanimously 5. Public Hearing— Regulations#22 Tobacco Dr. Poremba, Chairperson, announced the opening of the public and Nicotine sales hearing and advised the audience to allow everyone to speak without interruption. A 3 minute limit was given to comment about • the proposed regulations and Joyce Redford and DJ Wilson will be available to advise the board and address questions the Board and the audience may have at the end of the comment section of the hearing. Dildar Hussain - Globe Gas Station 200 Canal Street -Opposed banning of single sales of cigars under $2.50 Derek Arnold, Witch Dr.109 Lafayette Street—Opposed banning :- blunt wraps ; Guenevere Blanchard—Ben&Jerry's 60 Washington St—Asked if the Board can look into ban smoking within 20 feet of food Establishments. Mike Allen - Red Lion Smoke Shop—Asked if adding a lock out • devise to his cigar room would put him in compliance with these new regulations. —In favor Dianne Night- Director of North East tobacco free community partnership, 1 Canal St Lawrence MA- In favor Steve Ryan, Stoughton MA New England Convenience Store Association-Opposed 2 parts of proposed regulation—The banning of single sales of cigars under$2.50 &the cap on Tobacco Sales Permits allowed in the city. Both parts of the regulation are putting restrictions on small businesses in Salem thus making it harder for them to thrive in this economy. Joyce Redford—Director of the North Shore Cape Ann Tobacco Collaborative will address the concerns about the regulations so far. The reason for banning the sale of single cigars under $2.50 is not to encourage additional smoking but to detour young people from smoking. There were recently 3 cases of single sales of Black and Mild's to minors in Salem. Some of these individual cigars are between .59 & .75 cents and also geared towards our youth. The cap on tobacco permits is a public health issue when you have an inordinate amount of outlets and accessibility where these products can be sold. Also a ban at pharmacy would increase sales for local businesses. DJ Wilson - MA Municipal Association—Explained to the Board that a city wide buffer zone is hard to enforce. Danvers has a buffer zone of no smoking within 15-20 feet of a building and it's not being enforced because you have to chase down individuals and by the time the inspectors get there, they are gone. Joyce Redford can provide information for establishments including signage. In regards to the single sales of cigars; Boston has banned single sales of cigars and mini packs under$2.50 and it's working there since February 2012: Blunt wraps are an issue because they are sold for $1 or less and are geared towards children. "Roll your own" machines will no longer be an issue because the federal government is passing a bill that includes a ban the use of these machines unless you're a manufacturer. Just the clarify the capping issue; the successor of the establishment will get the tobacco permit. Mike Lash—28 Balcomb St. Mike's Museum LLC—Asked the Board to give everyone a fair amount of time to comment on the proposed regulation. PC Nicolas - Witch Doctor- 109 Lafayette St - Opposed on banning blunt wraps Closed 7:45pm • 6. Miscellaneous A Special Meeting will be held July 24, 2012 to vote on the Tobacco Regulations Permits allowed in the city. Both parts of the regulation are putting restrictions on small businesses in Salem thus making it harder for them to thrive in this economy. Joyce Redford—Director of the North Shore Cape Ann Tobacco Collaborative will address the concerns about the regulations so far. The reason for banning the sale of single cigars under$2.50 is not to encourage additional smoking but to detour young people from smoking. There were recently 3 cases of single sales of Black and Mild's to minors in Salem. Some of these individual cigars are between.59 & .75 cents and also geared towards our youth. The cap on tobacco permits is a public health issue when you have an inordinate amount of outlets and accessibility where these products t can be sold. Also a ban at pharmacy would increase sales for local businesses. DJ Wilson - MA Municipal Association—Explained to the Board that a city wide buffer zone is hard to enforce. Danvers has a buffer zone of no smoking within 15-20 feet of a building and it's not being enforced because you have to chase down individuals and by the time the inspectors get there, they are gone. Joyce Redford can provide information for establishments including signage. In regards to the single sales of cigars; Boston has banned single sales of cigars and mini packs under$2.50 and it's working there since February 2012. Blunt wraps are an issue because they are sold for $1 or less and are geared towards children. "Roll your own" machines will no longer be an issue because the federal government is passing a bill that includes a ban the use of these machines unless you're a manufacturer. Just the clarify the capping issue; the successor of the establishment will get the tobacco permit. Mike Lash—28 Balcomb St. Mike's Museum LLC—Asked the Board to give everyone a fair amount of time to comment on the proposed regulation. PC Nicolas - Witch Doctor- 109 Lafayette St - Opposed on banning blunt wraps Closed 7:45pm 6. Miscellaneous A Special Meeting will be held July 24, 2012 to vote on the Tobacco Regulations s 7. MEETING ADJOURNED: 7:50pm Respectfully submitted, 19eather Lyons-Paul Clerk of the Board Next regularly scheduled meeting is September 11, 2012 at 7pm At City Hall Annex, 120 Washington Street,Room 311 Salem. • • j • Health Agent Report July/August 2012 Announcements • Household Hazardous Waste day will be held on October 6, 2012 from 8:00 am- 12:00 pm at the Salem High School. The hazardous waste collection day is a shared with the City of Beverly. • The City went "live" (again) on MAVEN on September 13. Justina Polvere and Larry Ramdin are Maven certified. • The Salem Board of Health was awarded a$2,500 grant by the Food and Drug Administration(FDA) to support the voluntary program Standards assessment and meeting of program standard efforts. • Delilah Castro has completed her probationary period as is confirmed as a full- time Sanitarian with the Salem board of Health • Sara Lee an MPH intern is working on a capstone project with the Salem Board of Health, she will be developing public health outreach articles for the Board of Health utilizing social media as the medium for dissemination • The Board of Health Tobacco regulations became effective on September 1. Joyce j Redford has met with each tobacco vendor and discussed the regulations. • Staff attended a meeting with the Salem REACT team to work on providing grab and go kits for senior citizens • Kayla Lugo student intern was assigned to the Board of Health offices for the month of August, she assisted the staff in clerical duties, this enabled us to reduce the backlog in filing and allowed Heather Lyons-Pauls to attend to outstanding paperwork • Administrative hearings were held with 2 Salem restaurants to discuss ongoing sanitary violations and discuss strategies for serving safe food at the establishments Meetings and Trainings • David Greenbaum, Elizabeth Gagakis and Larry Ramdin attended Lead Determinator recertification on August 9. The program discussed the Lead law, Lead determination processes and enforcement requirements if lead is discovered in the dwelling unit. • Staff attended a NERAC sheltering exercise in Middleton , where they learned how to set up an emergency shelter Significant Communication or Complaints from Residents • We have received several complaints of rat sightings in Salem, we are baiting and trapping the storm drains and providing information to residents on actions they can take to protect their properties from rodents • ® Mosquito spraying was conducted in the Gallows Hill and Witchcraft heights neighborhood that is bounded by Highland Avenue and Boston Street to the Peabody and Lynn lines. There has been a significant finding of positive West Nile virus pools in Peabody border and in keeping with its charge to protect the Public Health the decision was made to spray the area to reduce the risk of infection from West Nile Virus. The 2012 mosquito season is extremely troubling as it has been the most active in recent years to date there have been 13 human West Nile Cases and 3EEE cases; 2 WNV and 3 EEE animal cases. Other Public Health Information Other Activities Inspections Certificate of Fitness Inspections — 87 Certificate of Fitness Re-inspections — 14 Court Hearings — 5 Food Service Inspections — 77 Food Service Re-inspections — 17 Housing Inspections — 23 Housing Re-inspections — 8 Beach sampling - 69 Meetings — 4 Rodent Inspections — 13 Nuisance Complaints- 1 Seminars — 2 Trash Inspections- 29 Phone calls- 654 the most active in recent years to date there have been 13 human West Nile Cases and 3EEE cases, 2 WNV and 3 EEE animal cases. Other Public Health Information Other Activities Inspections Certificate of Fitness Inspections — 87 Certificate of Fitness Re-inspections — 14 Court Hearings — 5 Food Service Inspections — 77 Food Service Re-inspections — 17 Housing Inspections — 23 Housing Re-inspections — 8 Beach sampling - 69 Meetings — 4 Rodent Inspections — 13 Nuisance Complaints- 1 Seminars — 2 Trash Inspections- 29 Phone calls- 654 R a t; Interm u nicipa greement as Authorized by M.G. L. Chapter 40 Healthby and between the North Shore Shared Public - -s Program Communities Marblehead,(Salem , Beverly, Danvers, Lynn, Nahant, Peabody, and Swampscott) AGREEMENT TO JOINTLY PROVIDE PUBLIC HEALTH SERVICES THIS AGREEMENT is entered into by and between the municipalities of Beverly, Danvers, Lynn, Marblehead, Nahant, Peabody, Salem, and Swampscott, in • Massachusetts (hereinafter referred to individually as "Municipality" or collectively as "Municipalities"), as members of the North Shore Shared Public Health Services Program PURSUANT TO the terms and obligations of the Massachusetts Department of Public Health (MDPH) District Incentive Grant Implementation Funding Award, the Request for Responses for the Implementation Grants, attached as Appendix A and incorporated herein, and in order to embody the intention of the Municipalities to cooperate in promoting well-planned regional efforts in the provision of public health services; and, WHEREAS, the Municipalities desire to create a North Shore Shared Public Health Services Program ("Program") for the purpose of jointly providing local public health services and a regional initiative addressing indoor air quality issues through smoke-free housing campaigns and awareness programs for asthma triggers, as well as and sharing in the cost of providing such services, as supported by the multi-year Massachusetts Department of Public Health District Incentive Grant Implementation Funds Award; and, WHEREAS, Pursuant to the terms of the MDPH District Incentive Grant, • execution of an inter-municipal agreement is required, each Municipality has obtained d authorization for this joint undertaking pursuant to M.G.L. C.40, §4A by a vote of its • respective Board of Selectmen or a vote of its respective City Council with approval by its Chief Executive Officer, or as required by special legislative act, as attested to by certified copies thereof contained in Appendix B. ; In addition, the Boards of Health of each Municipality have reviewed this Agreement and voted to recommend approval. NOW, THEREFORE, the Municipalities, in mutual consideration of the covenants contained herein, intending to be legally bound thereby, agree under seal as follows: 1. Term The term of this Agreement shall be five (5) years, commencing upon the date of the last Municipality executes this Agreement and shall expire on the same day and month of the year 2017, unless earlier terminated as set forth herein. The Agreement shall be renewed only through vote and approval of Municipalities' respective Boards of Selectmen, City Councils, and Chief Executive Officers "Governing Body". 2. Program There shall be established a program to be known as the North Shore Shared Public Health Services Program ("Program"). 3. Duties • The Program may perform all the duties required of local boards of health by Massachusetts law and specifically those necessary to accomplish the goals of the Program Plan (attached as Appendix D) including indoor air quality initiatives (smoke-free housing and asthma trigger awareness campaigns), as well as the provision of environmental health inspection services (optional services available to each Municipality) and any other services required by local boards of health as agreed to by the Municipalities through the Steering Committee. Notwithstanding the provisions of this Agreement, the Municipalities shall retain separate Boards of Health which shall retain their own legal authority and autonomy as provided by law. 4. Lead Municipality The City of Salem shall act as the Lead Municipality and, as such, shall contract or employ and provide Program staff, shall provide reasonable physical accommodations for Program staff and operations as necessary, notwithstanding any local restrictions on contractor's use of City resources, and shall perform all duties and provide all services consistent with the terms of the Implementation NORTH SHORE SHARED PUBLIC HEALTH SERVICES PROGRAM 2 of 124242 Intermunicipal Agreement under M.G.L. Chapter 40 j • authorization for this joint undertaking pursuant to M.G.L. C.40, §4A by a vote of its - respective Board of Selectmen or a vote of its respective City Council with approval by its Chief Executive Officer, or as required by special legislative act, as attested to by certified copies thereof contained in Appendix B. ; In addition, the Boards of Health of each Municipality have reviewed this Agreement and voted to recommend approval. NOW, THEREFORE, the Municipalities, in mutual consideration of the covenants contained herein, intending to be legally bound thereby, agree under seal as follows: 1. Term The term of this Agreement shall be five (5) years, commencing upon the date of the last Municipality executes this Agreement and shall expire on the same day and month of the year 2017, unless earlier terminated as set forth herein. The Agreement shall be renewed only through vote and approval of Municipalities' respective Boards of Selectmen, City Councils, and Chief Executive Officers "Governing Body". 2. Program There shall be established a program to be known as the North Shore Shared Public Health Services Program ("Program"). • 3. Duties The Program may perform all the duties required of local boards of health by Massachusetts law and specifically those necessary to accomplish the goals of the Program Plan (attached as Appendix D) including indoor air quality initiatives (smoke-free housing and asthma trigger awareness campaigns), as well as the provision of environmental health inspection services (optional services available to each Municipality) and any other services required by local boards of health as agreed to by the Municipalities through the Steering Committee. Notwithstanding the provisions of this Agreement, the Municipalities shall retain separate Boards of Health which shall retain their own legal authority and autonomy as provided by law. 4. Lead Municipality The City of Salem shall act as the Lead Municipality and, as such, shall contract or employ and provide Program staff, shall provide reasonable physical accommodations for Program staff and operations as necessary, notwithstanding any local restrictions on contractor's use of City resources, and shall perform all • duties and provide all services consistent with the terms of the Implementation NORTH SHORE SHARED PUBLIC HEALTH SERVICES PROGRAM 2 of 124242- Intermunicipal Agreement under M.G.L. Chapter 40 Funds Award Agreement with MDPH (Attached as Appendix A). In addition, the • Lead Municipality shall perform the following duties: • Maintain accurate and comprehensive records of services performed, costs incurred and reimbursements and contributions received; • Perform annual audits; • Issue quarterly financial statements and services reports to all participants; • Contract a program coordinator through the search and recommendation of a hiring committee to the Purchasing Authority. The hiring committee will consist of no fewer than three (3) Steering Committee members; • Enter into contracts for goods and services; • Prepare a proposed budget for review and approval by the Steering Committee. 5. Steering Committee The Program shall be governed by a steering committee ("Steering Committee") comprised of one (1) representative from each Municipality who shall be either a Health Department Director or Health Agent managing local public health. In the event the position of Director or Health Agent is vacant, the Municipality shall substitute a Board of Health member or member of their local Health Department staff to serve until the position of Director or Health Agent is filled. The Steering Committee is hereby established through this Agreement and shall be further delineated through bylaws to be approved by majority vote of members of the Steering Committee. The Steering Committee shall direct the establishment of polices, programs and procedures and prepare an annual operating budget and cost assessment schedule applicable to the Municipalities for approval by the Municipalities. 6. Program Coordinator The Program Coordinator shall be responsible for administration of the Program Plan (attached as Appendix D) as consistent with policies and performance standards adopted by the Steering Committee and in compliance with the grant award terms. The Program Coordinator shall serve as a liaison to all municipal departments in each of the Municipalities and shall be responsible for the following duties: distributing reports and training schedules, and coordinating directly with each Municipality's representative in order to accomplish the goals of the Program. • NORTH SHORE SHARED PUBLIC HEALTH SERVICES PROGRAM 3 of 1242 -2 Intermunicipal Agreement under M.G.L. Chapter 40 1 7. Fiduciary Responsibility • The budget for the Program is initially established through the adoption of the Program Plan through the contract with MDPH for the grant award, attached as Appendix D and as hereafter agreed to by the Steering Committee and approved by the appropriate Municipal authorities. A simple majority vote of the Steering Committee shall be necessary to approve a request to reallocate funds within the budget, provided however, the total budget amount shall not increase or decrease. Upon approval by the Steering Committee of a budget modification, the Steering Committee shall present such modification to MDPH for review, during the term of the MDPH grant, and final approval. All other future grant funds unrelated to the DIG Implementation fund shall follow budget guidelines as provided by the grantor and as agreed upon by a majority of the Steering Committee members. 8. Budget Assessments MDPH has awarded Implementation Funds up to $325,000 across four(4) grant years. No budget assessments are written into the Program Plan (attached as Appendix D) or project budget as of Grant Year 1. The terms of the DIG Implementation Funds specify that grant funds are to be used to augment and enhance public health service delivery and that such funds shall not be used to • offset budget reductions to local public health departments. Any financial commitments, in excess of the DIG or other grants, of the Municipalities a party to this Agreement is subject to appropriation under their respective budgets and shall not exceed the amounts so validly appropriated. Apportionment of any associated costs may be assessed on a per capita basis or other basis as agreed to by the Municipalities through the Steering Committee. Failure to obtain approval for any such assessment by the Municipality shall affect the level of services provided to the subject Municipality. 9. Fee Structure Each Municipality may retain and establish their own fee schedules and shall be entitled to collect any environmental health services fees or fines assessed. 10. Other Municipal Services This Agreement applies only to those public health services statutorily and customarily rendered by local health departments under Massachusetts law. The Municipalities may, by amendment hereto, add or remove associated services to be delivered by the Program based solely on unanimous consent of the Municipalities as parties to this Agreement, but only after the passage of sixty (60) days following a request from the Steering Committee. • NORTH SHORE SHARED PUBLIC HEALTH SERVICES PROGRAM 4 of 124:212 Intermunicipal Agreement under M.G.L. Chapter 40 UVU1 UCIJG. UPU I QI. PI V VA1 Uy 11 M JLUU1111 VV111111111GG V1 a VUUyGt 11IVUnIVQUVI I, the Steering Committee shall present such modification to MDPH for review, during the term of the MDPH grant, and final approval. All other future grant funds unrelated to the DIG Implementation fund shall follow budget guidelines as provided by the grantor and as agreed upon by a majority of the Steering Committee members. 8. Budget Assessments MDPH has awarded Implementation Funds up to $325,000 across four(4) grant years. No budget assessments are written into the Program Plan (attached as Appendix D) or project budget as of Grant Year 1. The terms of the DIG Implementation Funds specify that grant funds are to be used to augment and enhance public health service delivery and that such funds shall not be used to offset budget reductions to local public health departments. Any financial commitments, in excess of the DIG or other grants, of the Municipalities a party to this Agreement is subject to appropriation under their respective budgets and shall not exceed the amounts so validly appropriated. Apportionment of any associated costs may be assessed on a per capita basis or other basis as agreed to by the Municipalities through the Steering Committee. Failure to obtain approval for any such assessment by the Municipality shall affect the level of services provided to the subject Municipality. 9. Fee Structure Each Municipality may retain and establish their own fee schedules and shall be entitled to collect any environmental health services fees or fines assessed. 10. Other Municipal Services This Agreement applies only to those public health services statutorily and 9 pp Y customarily rendered by local health departments under Massachusetts law. The " Municipalities may, by amendment hereto, add or remove associated services to be delivered by the Program based solely on unanimous consent of the Municipalities as parties to this Agreement, but only after the passage of sixty _ (60) days following a request from the Steering Committee. NORTH SHORE SHARED PUBLIC HEALTH SERVICES PROGRAM 4 of 124212 • Intermunicipal Agreement under M.G.L pter 40 l • 11.EMPLOYEES An employee of any one Municipality, a party to this Agreement, who performs services, pursuant to this Agreement on behalf of another Municipality, a party to this Agreement, shall be deemed to remain an employee of the employee's hiring Municipality and shall retain all accrued benefits and shall be subject to standard personnel practices of such Municipality. 12.Indemnification The Municipalities shall hold each other and the City of Salem harmless from any and all claims related to employment or employee benefits, collectively bargained or otherwise, made by persons under their employ or contract prior to the commencement of operations of the Program and arising from the establishment thereof. Each party to this Agreement shall be liable for the acts and omissions of its own employees and agents in the performance of their obligations under this Agreement to the extent provided by law. By entering into this Agreement, none of the Municipalities have waived any governmental immunity or limitation of damages which may be extended to them by operation of law. Each party shall indemnify and hold harmless the other parties to t his Agreement from and against any claim arising from or in connection with the performance of services • provided pursuant to t his Agreement, to the extent the indemnifier would otherwise be liable under a direct claim pursuant to M.G.L. c.-258. 13. Termination Any Municipality, by approval of its Governing Body, may withdraw from and terminate its participation in this Agreement with the provision of at least one (1) year written notice to the other Municipalities. Such termination shall take effect at the close of the next full grant year following notification. Termination shall not relieve the terminating Municipality from any obligations of indemnification that may have arisen hereunder prior to such termination, nor from any financial obligations that by prior agreement extend beyond the termination date. Upon termination, the Steering Committee shall prepare a full statement of outstanding unpaid financial obligations under this Agreement and present the same to the terminating Municipality for payment within thirty (30) days thereafter. Upon receipt of a notice to terminate, the remaining Municipalities shall jointly consider whether to: a) Continue with the Agreement as written, b) Continue under an amended agreement subject to MDPH approval, or c) Dissolve this Agreement in a manner and on a date agreeable to all Municipalities, in which case each Municipality shall thereafter be solely responsible for the provision of public health services within its corporate NORTH SHORE SHARED PUBLIC HEALTH SERVICES PROGRAM 5 of 12422 Intermunicipal Agreement under M.G.L. Chapter 40 jurisdiction and may forfeit MDPH DIG Implementation Funds as well as • other possible future grants applied for through the Program. 14. Assignment The Municipalities may not, individually or jointly, assign or transfer any of their rights or interests in or to this Agreement, or delegate any of their obligations hereunder, without the prior written consent of all of the other Municipalities. 15. Amendment This Agreement may be amended only in a writing signed by all Municipalities duly authorized thereunto at any time by vote of the governing bodies of the Municipalities. MDPH shall be promptly notified of any amendment to this agreement. The addition of non-grant funded communities to the Program shall be considered an amendment to this Agreement and shall require the same approvals as specified above. 16. Severability If any provision of this Agreement is held by a court of appropriate jurisdiction to be invalid, illegal or unenforceable, or if any such term is so held when applied to any particular circumstance, such invalidity, illegality or unenforceability shall not • affect any other provision of this Agreement, or affect the application of such provision to any other circumstances, and the remaining provisions hereof shall not be affected and shall remain in full force and effect. 17. Waiver The obligations and conditions set forth in this Agreement may be waived only by a writing signed by the Municipality waiving such obligation or condition. Forbearance by a Municipality shall not be construed as a waiver, nor limit the remedies that would otherwise be available to that Municipality under this Agreement or applicable law. No waiver of any breach or default shall constitute or be deemed evidence of a waiver of any subsequent breach or default. 18. Governing Law This Agreement shall be governed by, construed, and enforced in accordance with the laws of the Commonwealth of Massachusetts. 19. Headings The paragraph headings herein are used for convenience only, are not part of this Agreement and shall not affect the interpretation of this Agreement. • NORTH SHORE SHARED PUBLIC HEALTH SERVICES PROGRAM 6 of 121 P1 2 Intermunicipal Agreement under M.G.L. Chapter 40 jurisdiction and may forfeit MDPH DIG Implementation Funds as well as • other possible future grants applied for through the Program. 14. Assignment The Municipalities may not, individually or jointly, assign or transfer any of their rights or interests in or to this Agreement, or delegate any of their obligations hereunder, without the prior written consent of all of the other Municipalities. 15. Amendment This Agreement may be amended only in a writing signed by all Municipalities duly authorized thereunto at any time by vote of the governing bodies of the Municipalities. MDPH shall be promptly notified of any amendment to this agreement. The addition of non-grant funded communities to the Program shall be considered an amendment to this Agreement and shall require the same approvals as specified above. 16. Severability If any provision of this Agreement is held by a court of appropriate jurisdiction to be invalid, illegal or unenforceable, or if any such term is so held when applied to any particular circumstance, such invalidity, illegality or unenforceability shall not • affect any other provision of this Agreement, or affect the application of such provision to any other circumstances, and the remaining provisions hereof shall not be affected and shall remain in full force and effect. 17. Waiver - The obligations and conditions set forth in this Agreement may be waived only by a writing signed by the Municipality waiving such obligation or condition. Forbearance by a Municipality shall not be construed as a waiver, nor limit the remedies that would otherwise be available to that Municipality under this Agreement or applicable law. No waiver of any breach or default shall constitute or be deemed evidence of a waiver of any subsequent breach or default. 18. Governing Law This Agreement shall be governed by, construed, and enforced in accordance with the laws of the Commonwealth of Massachusetts. 19. Headings The paragraph headings herein are used for convenience only, are not part of this Agreement and shall not affect the interpretation of this Agreement. NORTH SHORE SHARED PUBLIC HEALTH SERVICES PROGRAM 6 of 12422 Intermunicipal Agreement under M.G.L. Chapter 40 l • 20. Notices Any notice permitted or required hereunder to be given or served on any Municipality shall be in writing signed in the name of or on behalf of the Municipality giving or serving the same. Notice shall be deemed to have been received at the time of actual receipt of any hand delivery, upon the date of verified delivery by courier of package delivery service, or three (3) business days after the date of any properly addressed notice sent by mail as set forth below: For: City of Salem The Honorable Mayor Kimberly Driscoll 93 Washington Street Salem, Massachusetts 01970 For: City of Beverly The Honorable Mayor William F. Scanlon 191 Cabot Street Beverly, Massachusetts 01915 • For: Town of Danvers Mr. Wayne Marquis Town Manager 1 Sylvan Street Danvers, Massachusetts 01923 For: City of Lynn The Honorable Mayor Judith Flanagan Kennedy 3 City Hall Square Lynn, Massachusetts 01901 For: Town of Marblehead Mr. Jeffrey Chelgren Town Administrator 188 Washington Street Marblehead, Massachusetts 01945 For: Town of Nahant Mr. Andrew Bisignani Town Administrator . 334 Nahant Road NORTH SHORE SHARED PUBLIC HEALTH SERVICES PROGRAM 7 of 124242 Intermunicipal Agreement under M.G.L. Chapter 40 J Nahant, Massachusetts 01908 • For: City of Peabody The Honorable Mayor Edward A. Bettencourt, Jr. 24 Lowell Street Peabody, Massachusetts 01960 For: Town of Swampscott Mr. Thomas G. Younger Town Administrator 22 Monument Avenue Swampscott, Massachusetts 01907 21. Complete Agreement This Agreement constitutes the entire agreement between the Municipalities concerning the subject matter hereof, superseding all prior agreements and n runderstandings ma a or offered u derstandin s. An other agreements o d , 9 Y 9 whether oral or written between the Municipalities concerning the subject matter P 9 J hereof that are not contained in this agreement and its amendments are hereby • declared invalid. WITNESS OUR HANDS AND SEALS as of the dates here written. For the City of Salem By its Authorized Governing Body: X SIGNATURE NAME TITLE DATE For the City of Beverly • NORTH SHORE SHARED PUBLIC HEALTH SERVICES PROGRAM 8 of 124242 Intermunicipal Agreement under M.G.L. Chapter 40 R 20. Notices Any notice permitted or required hereunder to-be given or served on any Municipality shall be in writing signed in the name of or on behalf of the Municipality giving or serving the same. Notice shall be deemed to have been received at the time of actual receipt of any hand delivery, upon the date of verified delivery by courier of package delivery service, or three (3) business ' days after the date of any properly addressed notice sent by mail as set forth below: For: City of Salem The Honorable Mayor Kimberly Driscoll 93 Washington Street Salem, Massachusetts 01970 For: City of Beverly The Honorable Mayor William F. Scanlon 191 Cabot Street Beverly, Massachusetts 01915 For: Town of Danvers Mr. Wayne Marquis iTown Manager 1 Sylvan Street Danvers, Massachusetts 01923 For: City of Lynn The Honorable Mayor Judith Flanagan Kennedy 3 City Hall Square Lynn, Massachusetts 01901 For: Town of Marblehead Mr. Jeffrey Chelgren Town Administrator 188 Washington Street Marblehead, Massachusetts 01945 For: Town of Nahant Mr. Andrew Bisignani Town Administrator 334 Nahant Road • I NORTH SHORE SHARED PUBLIC HEALTH SERVICES PROGRAM 7 of 124242- Intermunicipal Agreement under M.G.L. Chapter 40 • X SIGNATURE NAME TITLE DATE For the City of Peabody By its Authorized Governing Body: x SIGNATURE NAME TITLE DATE For the Town of Swampscott By its Authorized Governing Body NORTH SHORE SHARED PUBLIC HEALTH SERVICES PROGRAM 11 of 12424-2 Intermunicipal Agreement under M.G.L. Chapter 40 X •SIGNATURE NAME TITLE DATE NORTH SHORE SHARED PUBLIC HEALTH SERVICES PROGRAM 12 of 12 24-2 Intermunicipal Agreement under M.G.L. Chapter 40 r X SIGNATURE NAME TITLE DATE IENORTH SHORE SHARED PUBLIC HEALTH SERVICES PROGRAM 12 of 124242 nicipal Agreement under M.G.L. Chapter 40 • By its Authorized Governing Body X SIGNATURE NAME TITLE DATE i • II For the Town of Danvers By its Authorized Governing Body: X SIGNATURE NAME TITLE DATE For the City of Lynn • By its Authorized Governing Body NORTH SHORE SHARED PUBLIC HEALTH SERVICES PROGRAM 9 of 1242-1-2 Intermunicipal Agreement under M.G.L. Chapter 40 J X •SIGNATURE NAME TITLE DATE • For the Town of Marblehead By its Authorized Governing Body: X SIGNATURE NAME TITLE DATE For the Town of Nahant By its Authorized Governing Body • NORTH SHORE SHARED PUBLIC HEALTH SERVICES PROGRAM 10 of 124212 Intermunicipal Agreement under M.G.L. Chapter 40 X SIGNATURE • NAME TITLE S DATE • For the Town of Marblehead By its Authorized Governing Body: X SIGNATURE NAME TITLE DATE For the Town of Nahant By its Authorized Governing Body i I NORTH SHORE SHARED PUBLIC HEALTH SERVICES PROGRAM 10 of 12424-2 Intermunicipal Agreement under M.G.L. Chapter 40 WNV and EEE Summary by County, as of 9/10/2012 Animal -`County �� ' � Towns at Human.Cases~, . Towns at High Risk' Cases Barns#able, Berkshire Pittsfield 1 WNV Acushnet, Freetown, New Bedford, Bristol $` "` Easton, Raynham, Taunton Norton, Rehoboth Dukes w. Boxford, Groveland, Methuen, Newbury, Essex Georgetown Rowley, Saugus, West Newbury 1 EEE Franklin" " Orange Erving, New Salem, Warwick, Wendell 1 EEE Holyoke, Ludlow, Palmer, Springfield, Hampden,_ Chicopee West Springfield 1 WNV 2 WNV Amherst, Granby, Pelham, South Hadley, Hampshire Belchertown Ware 1 EEE Arlington, Belmont, Everett, Hopkinton, r Lexington, Malden, Medford, Melrose, Middlesex':,.' ' Cambridge Newton, Somerville, Watertown 9 WNV, 1 EEE Nantucket.._ Norfolk -- Brookline, Canton Halifax, Plympton, Bridgewater, Carver, East Bridgewater, Rochester, West Hanson, Kingston, Lakeville, Plymouth'' ' Bridgewater Mattapoisett, Middleborough, Pembroke 2 EEE Suffolk, Boston Chelsea Winthrop Revere 11 WNV a. Auburn, Grafton, Northborough, Petersham, Phillipston, Shrewsbury, Athol, Royalston, Southborough, Templeton, Upton, Worcester. Westborough Worcester 1 EEE, 1WNV 13 WNV 2 WNV 3 EEE 4 EEE On 9/7/12, 210 communities still at remote or low risk were raised to moderate risk * in addition, one horse from NY state was probably exposed to EEE in Plymouth county I` I' • Giardia: Case #1:The source of this illness has not been identified. The case is not a food handler and does not work in a daycare. Case has no close contacts that are ill. None of the close contacts work in a daycare or are food handlers. Case fully recovered. Hepatitis C: Case#1:This case did not have symptoms but has been involved with intravenous drug use. Health education was given in detail on the prevention of infecting others. Offered support as needed. Case is currently being followed by PCP. Case#2-11- 10 chronic cases; no public health follow up needed Group A Strep: Case#1:This case is lost to follow-up. Some information was obtained from infection control regarding case's drug history use. Otherwise, no other information has been obtained because physician is lost to follow-up as well. Group B Strep: Case #1:This is a post radiation Cancer survivor with a history of a mastectomy. Case has had similar infections in the past. Case was treated and no longer has evidence of infection. Case is unemployed (is not a food handler or healthcare worker). Case#2:This infection was found when the case was in-patient. Case was discharged, and fully recovered with no further evidence of infection. Case is not a food handler or a healthcare worker. Case#3: This is a post radiation Cancer survivor with a history of a mastectomy, lymphadenectomy, and recurrent cellulitis in the left arm. Case has been treated with antibiotics and no longer has evidence of infection. Case is unemployed (is not a food handler or healthcare worker). Yersinia: Case #1: Unable to identify cause of this illness. This case is not a food handler. This case does attend a daycare. After interviewing daycare owner it is has been determined that there have been no other sick persons at this daycare. Case fully recovered. Lyme: r - r t 12 Cases. No public health follow up needed. • Babesiosis: Case#1:This case has had a history of tick bites on many different occasions. Case does a lot of outdoor activities while traveling throughout New England where exposure to ticks is prominent. Health education on prevention of tick bites was given in detail. Case has a co- infection of Lyme disease and is being followed by PCP. Shigella: Case#1:This case is not a food hander and is not employed in any supervised care setting. Case is no longer exhibiting symptoms and has fully recovered. Cause of this infection has not been identified. Vibrio: Case#1:This case is believed to have contracted the Vibrio organism during a trip where there was swimming in a spring-fed pond. The case had acquired minor scrapes and cuts while tubing in the pond,which later became infected. The case did not consume any seafood products in the 7 days prior to onset of symptoms. Case has fully recovered after being on antibiotic treatment. TB: Case#1: Case discharged from DOT; now self-administering meds. Once weekly med refill/house visit by PHN 4 cases are new arrivals—all 4 referred to the NSPHPC; 3 were skin tested (4t"case had a previous positive skin test overseas) 12 Cases. No public health follow up needed. Babesiosis: Case#1:This case has had a history of tick bites on many different occasions. Case does a lot of outdoor activities while traveling throughout New England where exposure to ticks is prominent. Health education on prevention of tick bites was given in detail. Case has a co- infection of Lyme disease and is being followed by PCP. Shigella: Case#1:This case is not a food hander and is not employed in any supervised care setting. Case is no longer exhibiting symptoms and has fully recovered. Cause of this infection has not been identified. Vibrio: Case#1:This case is believed to have contracted the Vibrio organism during a trip where there was swimming in a spring-fed pond. The case had acquired minor scrapes and cuts while tubing in the pond,which later became infected. The case did not consume any seafood products in the 7 days prior to onset of symptoms. Case has fully recovered after being on antibiotic treatment. • TB: Case #1: Case discharged from DOT; now self-administering meds. Once weekly med refill/house visit by PHN 4 cases are new arrivals—all 4 referred to the NSPHPC;3 were skin tested (4th case had a previous positive skin test overseas) • i t • Case #3:This case was seen and treated in the hospital. The case is not a food handler and does not work in a daycare. Case has no close contacts that are ill. None of the close contacts work in a daycare or are food handlers. Case has fully recovered according to hospitalist- unable to reach case or case's family. Case #4:The case was seen in the hospital and treated. The case is not a food handler and does not work in a daycare. Case has no close contacts that are ill. None of the close contacts work in a daycare or are food handlers. Case has fully recovered. Salmonella: The following 6 cases are part of a "Cluster" of Salmonella cases Case#1:This case has been identified as a possible source of the outbreak. Case is a food handler and the cases place of employment was fully inspected by David Greenbaum, with the aid of the Food Protection Program (FPP)at DPH. All employees were tested at the place of employment and the case is the only one whose test came back positive. Case did work during her incubation period because she was asymptomatic. Case is currently excluded from food handling duties until two negative stool samples are produced. No other employees have been sick. No close contacts have been ill. No close contacts are food handlers (besides co-workers) and no contacts work at a daycare. This case is currently being followed by MDPH; case now resides in another location. Case#2:This case ate at the suspect restaurant that was investigated. Case is not a food handler. No close contacts have been ill. None of the close contacts work in a daycare or are food handlers. Case fully recovered. Case#3: Case did not eat at suspect restaurant but lab results showed a matching strand of Salmonella. Case fully recovered. Case is not a food handler and does not work in a daycare. Case has no close contacts that are ill. None of the close contacts work in a daycare or are food handlers. Case#4: Case ate at the suspect restaurant that is currently being investigated. Case is a food handler and worked during incubation period. No sick employees and no sick customers have been noted. As soon as the Board of Health was notified of the diagnosis,this case was excluded from work until 2 negative stool samples were produced. No close contacts have been ill. None of the close contacts work in a daycare or are food handlers. Case#5: Case ate at the suspect restaurant that is currently being investigated. Case is not a food handler and does not work in a daycare. None of the close contacts have been ill. None of • the close contacts work in a daycare or are food handlers. Case fully recovered. t Case#6: Case ate at the suspect restaurant that is currently being investigated. Case is not a • food handler and does not work in a daycare. None of the close contacts have been ill. None of the close contacts work in a daycare or are food handlers. Case fully recovered. ------- End Cluster Case#7:This case is not related to the cluster. After thorough investigation the source of the illness has not been identified. The case is a food handler and did work during the incubation period. As soon as the Board of Health was notified of this diagnosis the case was excluded from work until the case produced a negative stool sample. There have been no sick employees or customers identified. Case does not work in a daycare. None of the close contacts have been ill. None of the close contacts work in a daycare or are food handlers. Case is fully recovered. Case#8:This case is lost to follow up. Pertussis: Case#1: It is suspect that this case became ill after contact with another infected person. All close contacts have received prophylaxis. Case hasn't completed her immunization schedule due to age. Case fully recovered. • Human Granulocytic Anaplasmosis(Ehrlichiosis): Case#1:The lab results show this is an old infection. Case did not have any symptoms related to this illness. No treatment was recommended by PCP. No evidence of any other tick-borne illnesses was found. Health education on prevention of tick bites was given in detail. Case #2: The lab results show this is an old infection. Case did not have any symptoms related to this illness. No treatment was recommended by PCP. No evidence of any other tick-borne illnesses was found. Health education on prevention of tick bites was given in detail. Case #3:The lab results show this is an old infection. Case did not have any symptoms related to this illness. No evidence of any other tick-borne illnesses was found. Case is an avid runner in the Salem woods. Health education on prevention of tick bites was given in detail. Case#4: Lab results show an old infection. No evidence of any other tick-borne illnesses was found. Case was treated with an antibiotic and has fully recovered. Case#5: Lab results show an old infection. Case is currently being investigated. • f' • Case#6: Case ate at the suspect restaurant that is currently being investigated. Case is not a food handler and does not work in a daycare. None of the close contacts have been ill. None of the close contacts work in a daycare or are food handlers. Case fully recovered. ------- End Cluster Case#7:This case is not related to the cluster. After thorough investigation the source of the illness has not been identified. The case is a food handler and did work during the incubation period. As soon as the Board of Health was notified of this diagnosis the case was excluded from work until the case produced a negative stool sample. There have been no sick employees or customers identified. Case does not work in a daycare. None of the close contacts have been ill. None of the close contacts work in a daycare or are food handlers. Case is fully recovered. Case#8:This case is lost to follow up. Pertussis: Case#1: It is suspect that this case became ill after contact with another infected person. All close contacts have received prophylaxis. Case hasn't completed her immunization schedule due to age. Case fully recovered. Human Granulocytic Anaplasmosis(Ehrlichiosis): Case#1:The lab results show this is an old infection. Case did not have any symptoms related to this illness. No treatment was recommended by PCP. No evidence of any other tick-borne illnesses was found. Health education on prevention of tick bites was given in detail. Case#2: The lab results show this is an old infection. Case did not have any symptoms related to this illness. No treatment was recommended by PCP. No evidence of any other tick-borne illnesses was found. Health education on prevention of tick bites was given in detail. Case#3:The lab results show this is an old infection. Case did not have any symptoms related to this illness. No evidence of any other tick-borne illnesses was found. Case is an avid runner in the Salem woods. Health education on prevention of tick bites was given in detail. Case #4: Lab results show an old infection. No evidence of any other tick-borne illnesses was found. Case was treated with an antibiotic and has fully recovered. Case #5: Lab results show an old infection. Case is currently being investigated. i • • Attended August's MAPHN meeting in Tewksbury—viewed a presentation given by Esteban Cuebas-Incle PhD., Entomologist, on ticks and mosquitos and disease prevention • Fit Tested with an N95 mask at Quadrant Health Strategies on August 14th, 2012 • Attended Medicare Reimbursement Training for the 2012-2013 Flu Season- *MassHealth is participating in the flu vaccine reimbursement project this year effective September 1, 2012. • Met with Ann Kelley (RN at Lifebridge)to discuss the 2012 flu clinic • Completed MAVEN training given by Deven Smith-Clarke of MDPH • Met with Melissa Wilson program coordinator NSPHDIG (North Shore Public Health District Incentive Grant)-discussed the PHN role and what areas could improve or change. -Working with Melissa on ways to adjust schedule in order to include more health promotion time • Met with Chief David Cody to discuss 2012/13 flu clinics • David Greenbaum and I met with Joann Sanchez, clinical liaison for Peabody Glen and Essex Park in Beverly, and Teresa Burns, marketing director of Essex Park,to discuss the "Grab &Go" • emergency project -They have confirmed their support and interest in aiding us with this this project -David Greenbaum and I were asked to present and speak about "Grab &Go" at their meeting at Peabody Glenn on October 25th,which is held for many health professionals • David Greenbaum and I solicited Salem Five on the "Grab & Go" project for donations of bags -Awaiting their response • Attended "Legal Nuts and Bolts of Isolation and Quarantine" at Tewksbury Hospital- networked with Attorneys and Health Educators of DPH;gained knowledge on the legal-side of disease investigation • Met with John Grullon of VOCES, and Carol MacGown of Salem Housing Authority regarding upcoming flu clinics/blood pressure clinics ■ Met with Nurse Nancy at Lydia Pinkham -Met with Bill Woolley of the Salem Council on Aging regarding the October flu clinic, and • setting up blood pressure clinics I 1 yf r -Met Keith Willa from "On Point"to discuss being a part of the program • Monthly Report of Communicable Disease July-September 2012 Disease Reported #Of Cases New Carry Over Discharged campylobacter 3 2 1 3 Salmonella 8 8 0 7 Pertussis 1 1 0 1 HGA 5 4 1 4 Giardia 1 1 0 1 Hep C 11 1 0 11 Group A Strep 1 1 0 1 Group B Strep 3 3 0 2 Yersinia 1 1 0 1 Lyme 12 0 0 12 • Babesiosis 1 1 0 1 Shigella 1 1 0 1 Vibrio 1 1 0 1 Tuberculosis 5 4 1 4 Summary of Communicable Diseases for September 2012 Campylobacteriosis: Case#1:The following information was obtained from case's PCP (case was not able to be reached). The case is not a food handler and does not work in a daycare. Case has no close contacts that are ill. None of the close contacts work in a daycare or are food handlers. Case has fully recovered. Case#2:This case is a food-handler and was removed from work as soon as the BOH was notified of this diagnosis. Case submitted a negative stool sample and then returned to work. Case did not work during infectious period. Cause of this infection has not been identified. Case • has fully recovered. i •Met Keith Willa from "On Point"to discuss being a part of the program • Monthly Report of Communicable Disease July-September 2012 ffDiseaseported #Of Cases New Carry Over Discharged cter 3 2 1 3 8 8 0 7 Pertussis 1 1 0 1 HGA 5 4 1 4 Giardia 1 1 0 1 Hep C 11 1 0 11 Group A Strep 1 1 0 1 Group B Strep 3 3 0 2 Yersinia 1 1 0 1 Lyme 12 0 0 12 • Babesiosis 1 1 0 1 Shigella 1 1 0 1 Vibrio 1 1 0 1 Tuberculosis 5 4 1 4 Summary of Communicable Diseases for September 2012 Campylobacteriosis: Case#1:The following information was obtained from case's PCP (case was not able to be reached). The case is not a food handler and does not work in a daycare. Case has no close contacts that are ill. None of the close contacts work in a daycare or are food handlers. Case has fully recovered. Case#2:This case is a food-handler and was removed from work as soon as the BOH was notified of this diagnosis. Case submitted a negative stool sample and then returned to work. Case did not work during infectious period. Cause of this infection has not been identified. Case • has fully recovered. i • 1USTINA POLVERE SALEM BOARD OF HEALTH PUBLIC HEALTH NURSE PUBLIC HEALTH NURSE REPORT SEPTEMBER 2012 Reporting from July 91h-September 181h 2012 Salem Board of Health "GO LIVE" on MAVEN September 13, 2012 Disease Prevention • Investigated 32 reportable diseases and reported case information to MDPH • In contact with North Shore Pulmonary Clinic on current active cases, as well as 4 New Arrivals • and their contacts • Weekly medication refill for active TB case discharged from DOT; currently self-administering medications •Skin tested 2 case contacts of an active TB case;this was a re-test measure done 8-12 weeks after initial testing •Conducted two rounds of stool sampling for 48 food handlers: identified suspect cause of salmonella outbreak •Assisted owners/managers of three food establishments in the distribution and signing of "Food Employee Reporting Agreement Forms." * I have attached this to my report • Excluded 3 food handlers diagnosed with a foodborne illness from employment until negative stool samples were obtained • 1 Health Promotion • -Attended Salem's Farmers Market and offered information on health topics and conducted blood pressure screenings. Some of the topics covered: sun safety, hypertension, nutrition / healthy eating,tick borne diseases, mosquitos, and rabies -Attended Salem Council on Aging's First Annual Wellness Fair for seniors and provided seniors with information on: heat safety, diabetes, hypertension, and tick borne diseases Meetings/Clinics • House visit of 4 new arrivals: skin tested 3 people/4 referrals given to North Shore Pulmonary Public Health Clinic -Met on two different occasions with members of North Shore REACT, NSES, Boards of Health, Salem Police, and Salem Council on Aging on an Emergency Preparedness Project for seniors called "Grab & GO": The goal is to put together emergency kits for seniors that they can take with them in the event of an emergency. We have a target date for mid-October at the Senior Center on the day of the annual flu clinic. The goal is to have 500 prepared "Grab & Go" bags to hand out to seniors that day. Other goals are being discussed now. • • Attended NS REACT meeting with David Greenbaum-discussed emergency preparedness for seniors and current seniors at risk • Attended North Shore Cape Ann Emergency Preparedness Coalition-viewed a presentation on extreme heat planning, discussed flu clinic planning,and community issues. • Home visit of a Salem resident with David Greenbaum-checked on living status/offered services; will be checking back with him in a month -Inspected Schooner Summer Camp with Elizabeth Gagakis- permitted to open for 2012 season • Met with Peabody's PHN —gained knowledge and training from her on PHN position; flu clinic planning • Met with a new resident of Salem: referred her to numerous resources and gave support to her as needed -Met with restaurant owner involved in salmonella outbreak on 5 different occasions regarding food safety, disease prevention, and employee health safety • David Greenbaum and I met with two other restaurant owners on similar issues • Health Promotion -Attended Salem's Farmers Market and offered information on health topics and conducted blood pressure screenings. Some of the topics covered: sun safety, hypertension, nutrition/ healthy eating,tick borne diseases, mosquitos,and rabies -Attended Salem Council on Aging's First Annual Wellness Fair for seniors and provided seniors with information on: heat safety, diabetes, hypertension, and tick borne diseases Meetings/Clinics • House visit of 4 new arrivals: skin tested 3 people/4 referrals given to North Shore Pulmonary Public Health Clinic -Met on two different occasions with members of North Shore REACT, NSES, Boards of Health, Salem Police, and Salem Council on Aging on an Emergency Preparedness Project for seniors called "Grab &GO": The goal is to put together emergency kits for seniors that they can take with them in the event of an emergency. We have a target date for mid-October at the Senior Center on the day of the annual flu clinic. The goal is to have 500 prepared "Grab & Go" bags to • hand out to seniors that day. Other goais are being discussed now. •Attended NS REACT meeting with David Greenbaum-discussed emergency preparedness for seniors and current seniors at risk •Attended North Shore Cape Ann Emergency Preparedness Coalition-viewed a presentation on extreme heat planning, discussed flu clinic planning,and community issues. • Home visit of a Salem resident with David Greenbaum-checked on living status/offered services;will be checking back with him in a month -Inspected Schooner Summer Camp with Elizabeth Gagakis-permitted to open for 2012 season • Met with Peabody's PHN—gained knowledge and training from her on PHN position;flu clinic planning • Met with a new resident of Salem: referred her to numerous resources and gave support to her as needed •Met with restaurant owner involved in salmonella outbreak on 5 different occasions regarding food safety,disease prevention, and employee health safety • • David Greenbaum and I met with two other restaurant owners on similar issues Food Employee Reporting Agreement Preventing Transmission of.Diseases through Food by Infected Food Employees The purpose of this agreement is to ensure that Food Employees and Applicants who have received a conditional offer of employment notify the Person in Charge when they experience any of the conditions listed so that the Person in Charge can take appropriate steps to preclude the transmission of foodborne illness. I AGREE TO REPORT TO THE PERSON IN CHARGE: SYMPTOMS 1. Diarrhea 2. Fever 3. Vomiting 4. Jaundice 5. Sore throat with fever 6. Lesions containing pus on the hand,wrist,or an exposed body part (such as boils and infected wounds, however small) MEDICAL DIAGNOSIS Whenever diagnosed as being ill with Salmonella Typhi (typhoid fever), Shigella spp. (shigellosis), Escherichia coli 0157:H7, hepatitis A virus, Entamoeba histolytica, Campy/obacter spp., V:brio cholera spp., Cryptosporidium parvum, Giardia lamblia, Hemolytic Uremic Syndrome, Salmonella spp. (non-typhi), Yersinia enterocolitica,or Cyclospora cayetanensis. PAST MEDICAL DIAGNOSIS Have you ever been diagnosed as being ill with one of the diseases listed above? If you have,what was the date of the diagnosis? HIGH-DISK CONDITIONS 1. Exposure to or suspicion of causing any confirmed outbreak of typhoid fever,shigellosis, E. coli 0157:H7 infection,or hepatitis A 2. A household member diagnosed with typhoid fever,shigellosis, illness due to E. coli 0157:H7,or hepatitis A 3. A household member attending or working in a setting experiencing a confirmed outbreak of typhoid fever,shigellosis,E. coli 0157:H7 infection,or hepatitis A I have read (or had explained to me)and understand the requirements concerning my responsibilities under 105 CMR 590/1999 Food Code and this agreement to comply with the reporting requirements specified above involving symptoms, diagnoses, and high-risk conditions specified. I also understand that should I experience one of the above symptoms or high-risk conditions, or should I be diagnosed with one of the above illnesses, I may be asked to change my job or to stop working altogether until such symptoms or illnesses have resolved. understand that failure to comply with the terms of this agreement could lead to action by the food establishment or the food regulatory authority that may jeopardize my employment and may involve legal action against me. Applicant or Food Employee Name(please print) Signature of Applicant or Food Employee Date • Signature of Permit Holder or Representative Date This is a model form created by MA Dept.of Public Health which is offered as a tool for industry to use to aid in compliance with 105 CMR 590.003(C)and Food Code 2-201.11 The use of this form is voluntary and is not required by state regulation. Revised:5/8/2001 Administration Monthly Report July and August 2012 Burial Permits @$25.00 $1,500.00 Permits $2,585.00 Certificate of Fitness@$50.00 $3,200.00 Copies $14.50 Fines $725.00 Total Monies Collected = $8,024.50 Annual Budget Expended Available Balance Total Salary/Longevity $363,600.00 $34,796.46 $328,803.51 Annual Budget Expended Available Balance Non-Personnel $19,600.00 $5,624.28 $13,975.72 ftc hhzlw c� SEP ' 20 s i is wil eon oo sq�E �2 Fyn 110A my As �— jM�� Y2„�xca Heather Lyons From: Joyce Redford <putitout@lynnma.gov> Sent: Tuesday, September 11, 2012 7:12 PM To: Larry Ramdin; Heather Lyons Subject: Training Sunny Corner attended and completed the Tobacco Control training on 9/11/2012 In attendance: Thomas Truong Lan Pham Chan Le Thank you, 30gee Joyce Redford,M.Ed.,Director North Shore/Cape Ann Tobacco Alcohol Policy Program 3 City Hall Square,Rm# 103 Lynn,MA 01901 781-586-6821 • www.makesmokinghistoa.org • 1 Voluntary National Retail Food Regulatory Program Standards—January 2011 • Voluntary National Retail Food Regulatory Program Standards U.S. Department of Health and Human Services Food and Drug Administration Center for Food Safety and Applied Nutrition • Voluntary National Retail Food Regulatory Program Standards—January 2011 • INTRODUCTION Achieving national uniformity among regulatory programs responsible for retail food protection in the United States has long been a subject of debate among the industry, regulators and consumers. Adoption of the FDA Food Code at the state, local and tribal level has been a keystone in the effort to promote greater uniformity. However, a missing piece has been a set of widely recognized standards for regulatory programs that administer the Food Code. To meet this need FDA has developed the"Voluntary National Retail Food Regulatory Program Standards" (Program Standards)through ideas and input from federal, state, and local regulatory officials, industry,trade and professional associations, academia and consumers on what constitutes a highly effective and responsive retail food regulatory program. In March of 1996, the FDA hosted a meeting to explore ways in which its retail food protection program could be improved. Participants in the meeting included FDA Retail Food Specialists, FDA headquarters personnel, state and local regulatory officials from the six FDA regions, the president of the Association of Food &Drug Officials, and industry representatives. Following that meeting, FDA established a National Retail Food Team comprised of the Regional Retail Food Specialists, CFSAN personnel and • other FDA personnel directly involved in retail food protection. A Retail Food Program Steering Committee was established and tasked with leading the team to respond to the direction given by the participants in the meeting, i.e. providing national leadership, being equal partners,being responsive,providing communication and promoting uniformity. The Steering Committee was charged with developing a five-year operational plan for FDA's retail food program. The Steering Committee was also charged with ensuring the operational plan was in keeping with the goals and mission of the President's Food Safety Initiative. FDA solicited input from the regulatory community, industry and consumers in developing the plan. The resulting Operational Plan charted the future of the National Retail Food Program and prompted a reassessment of the respective roles of all stakeholders and how best to achieve program uniformity. From the goals established in that first Operational Plan,two basic principles emerged on which to build a new foundation for the retail program: 9 Promote active managerial control of the risk factors most commonly associated with foodborne illness in food establishments, and • Establish a recommended framework for retail food regulatory programs within which the active managerial control of the risk factors can best be realized. These principles led to the drafting of standards that encourage voluntary participation by the regulatory agencies at the state, local, and tribal level. The Program Standards were L. Voluntary National Retail Food Regulatory Program Standards—January 2011 developed with input obtained through a series of meetings over a two-year period tincluding: the 1996 stakeholders meeting, FDA Regional Seminars, meetings with state officials hosted by the Retail Food Specialists, and six Grassroots Meetings held around the country in 1997. Valuable input from industry associations, associations of regulatory officials, and others was also obtained. The Program Standards were provided to the Conference for Food Protection for further input and to achieve broad consensus among all stakeholders. In developing the Program Standards, FDA recognized that the ultimate goal of all retail food regulatory programs is to reduce or eliminate the occurrence of illnesses and deaths from food produced at the retail level and that there are different approaches toward achieving that goal. Federal, state, local, and tribal agencies continue to employ a variety of mechanisms with differing levels of sophistication in their attempt to ensure food safety at retail. While the Program Standards represent the effective, focused food safety program to which we ultimately aspire,they begin by providing a foundation and system upon which all regulatory programs can build through a continuous improvement process. The Standards encourage regulatory agencies to improve and build upon existing programs. Further, the Standards provide a framework designed to accommodate both traditional and emerging approaches to food safety. The Program Standards are intended to reinforce proper sanitation(good retail practices) and operational and environmental prerequisite programs while encouraging regulatory agencies and industry to focus on the • factors that cause and contribute to foodborne illness, with the ultimate goal of reducing the occurrence of those factors. PURPOSE The Program Standards serve as a guide to regulatory retail food program managers in the design and management of a retail food regulatory program and provide a means of recognition for those programs that meet these standards. Program managers and administrators may establish additional requirements to meet individual program needs. The Program Standards are designed to help food regulatory programs enhance the services they provide to the public. When applied in the intended manner,the Program Standards should: • Identify program areas where an agency can have the greatest impact on retail food safety • Promote wider application of effective risk-factor intervention strategies • Assist in identifying program areas most in need of additional attention • Provide information needed to justify maintenance or increase in program budgets • Lead to innovations in program implementation and administration • Improve industry and consumer confidence in food protection programs by enhancing uniformity within and between regulatory agencies • Voluntary National Retail Food Regulatory Program Standards—January 2011 Each Standard has one or more corresponding worksheets, forms and guidance • documents. The Retail Food Program Resource Disk contains all the worksheets, forms and step-by-step guidance documents necessary to collect data for a self-assessment or to perform a verification audit. The Disk can be obtained from any FDA Regional Food Specialist [LINK]. Regulatory agencies may use existing, available records or may choose to develop and use alternate forms and worksheets that capture the same information. SCOPE The Program Standards apply to the operation and management of a retail food regulatory program that is focused on the reduction of risk factors known to cause or contribute to foodborne illness and to the promotion of active managerial control of these risk factors. The results of a self-assessment against the Standards may be used to evaluate the effectiveness of food safety interventions implemented within a jurisdiction. The Standards also provide a procedure for establishing a database on the occurrence of risk factors that may be used to track the results of regulatory and industry efforts over time. NEW DEVELOPMENTS The Program Standards were pilot tested in each of the five FDA regions in 1999. Each • regulatory participant reported the results at the 2000 Conference for Food Protection. Improvements to the Standards were incorporated into the January 2001 version based on input from the pilot participants. Further refinements to the Standards were made in subsequent drafts leading up to the endorsement of the March 2002 version of the Program Standards by the 2002 Conference for Food Protection. Subsequent changes and enhancements have been made following concurrence of the stakeholders at the biennial meetings of the Conference for Food Protection. In maintaining these standards, FDA intends to allow for and encourage new and innovative approaches to the reduction of factors that are known to cause foodborne illness. Program managers and other health professionals participating in this voluntary program who have demonstrated means or methods other than those described here may submit those to FDA for consideration and inclusion in the Program Standards. Improvements to future versions of the Standards will be made through a process that includes the Conference for Food Protection to allow for constant program enhancement and promotion of national uniformity. IMPACT ON PROGRAM RESOURCES During pilot testing of the Program Standards in 1991, some jurisdictions reported that the self-assessment process was time consuming and could significantly impact an agency's resources. Collection, analysis, and management of information for the • database Occurrence of Risk Factor Studies were of special concern. However, participating jurisdictions also indicated that the resource commitment was worthwhile Voluntary National Retail Food Regulatory Program Standards—January 2011 and that the results of the self-assessment were expected to benefit their retail food • protection program. Advance planning is recommended before beginning the data collection process in order to use resources efficiently. In addition, changes to the Standards now allow jurisdictions to use routine inspection data for analysis on the occurrence of risk factors, significantly reducing the resource requirements for separate data collection. It is further recommended that jurisdictions not attempt to make program enhancements during the self-assessment process. A better approach is to use the self-assessment to identify program needs and then establish program priorities and plans to address those needs as resources become available. COMMENTS AND INQUIRIES To promote uniform and reasonable application of these Standards, interested persons are invited to submit comments and inquiries to their FDA Regional Retail Food Specialist or to the Retail Food Protection Team in the FDA Center for Food Safety and Applied Nutrition. LINK to FDA Retail Food Specialists Directory] • I