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MEETING PACKET APRIL 2014 BOARD I IV N CFFY 01-�' SALEM, M,,�Ssi\("Fiusi ­11's 120 WASHING ON STREET,4"' Ff,()()Iz PubficHealth Ti"Il.". (978) 741-1800 FAX (978) 745-0343 KIMBERLEN DRISCOLL han-idin @ salem.com MAN"OR LARRYIZANIDIN,RS/Rkll IS,CI K),(T-FS NOTICE OF MEETING You are hereby notified that the Salem Board of Health will hold its regularly scheduled meeting Tuesday April 8, 2014 at 7.00 PM City Hall Annex 120 Washington St.3"d Floor Room 312 MEETING AGENDA r_1 C= 1. Call to order 2. Approval of Minutes 3. Chairperson Announcements > o 4. Public Health Announcements/Reports/Updates > NJ a. Health Agent 00 b. PHN Report c. Administrative d. Council Liaison 5. Short and Long Term Goals This notice posted on "Official Bulletin Bo2rdso 6. Miscellaneous City Hall, Salem,.Mass. on q, el at fln accordance/with MGL Chap. 30A, 7. Adjournment Sections 18-25. Larry Ramdin Health Agent cc: Mayor Kimberley Driscoll, Board-of Health, City Councilors Next regularly scheduled meeting is May 13, 2014 at 7pm at City Hall Annex, 120 Washington Street Room 312. Know your rights under the open meeting law MGL chapter 3" ss. 18-25 and City Ordinance section 2-2028 through 2-2033 CITY OF SALEM BOARD OF HEALTH MEETING MINUTES March 11, 2014 EMBERS PRESENT: Dr. Barbara Poremba Chair Gayle Sullivan Dr. Shama Alam&Dr. Danielle Ledoux OTHERS PRESENT: Larry Ramdin Health, Agent, Suzanne Doty, Public Health Nurse, Joyce Redford, Director of NSCATAPP &Peter King, Tobacco Control Inspector MEMBERS EXCUSED: Martin Fair TOPIC DISCUSSION/ACTION 1. Call to Order 7:05pm 2. Minutes of Last Meeting G. Sullivan motioned to except the minutes with (February 11, 2014) corrections, 2nd Dr. Ledoux; Unanimously approved 3. Chairperson Announcements Larry received congratulations from the BOH for being selected as a Fellow of Local Public Health Institute. 4. Monthly Reports-Updates • A. B. Health Agent Report Approved; copy available at the BOH An additional clerk was requested in the budget and is fully supported by the BOH. Dr. Poremba would like to see more local events in the Healthy Salem Calendar, not just the national awareness event. B. Public Health Nurse's Approved; copy available at the BOH Report S. Doty is getting trained to fit test N-95 masks. C. Administrative Report Approved; copy available at the BOH Dr. Poremba asked for a spreadsheet showing permit fees collected by health department for the last few years D. City Council Liaison Updates Not present 5. New Business A. Communications - Dr. Poremba asked J. Redford if the owner of Salem Grill Letter from AttY requesting. La Monica re uestin Z Chicken attended the recommended class after his BOH reconsider its revocation of the permit was suspended in November 2013. Joyce explained tobacco permit of Grill Z Chicken 105 the class was given by the state and she could not find a Lafayette Street. copy of the attendance sheet; if he had attended he would • have received a certificate after the training. Dr. Alam asked J. Redford if we needed any additional language regarding suspension language in our regulation; explained it is clearly stated and why it is not necessary. The Board discussed the request for the hearing to reconsider the revocation of the Tobacco Permit. Motion by Dr. Alam to deny request to reconsider revocation of tobacco permit of Grill Z Chicken; 2nd Dr. Ledoux. Motion approved unanimously • 6. Short and long term goals 1. Increase tobacco purchasing age to 21 years. BOH discussed letter from Lester Hartman, MD to increase tobacco purchasing age to 21 years and presented communities who have done so including Needham, Arlington, Dover, Dedham, Ashland, Sharon, Canton, Wellesley, Brookline, Belmont, Watertown, Westwood, Walpole, Sudbury, Scituate and Hudson. The Board discussed pros and cons of this. Salem BOH would like more information and to explore if there is regional interest in enforcing a higher age limit for purchasing tobacco so youth are not going to neighboring cities and towns to purchase tobacco. The Board asked L. Ramdin to write a letter to Lester Hartman inviting him to the next meeting April or May to discuss this issue. One challenge is Joyce Redford explained that this is not a DPH priority and that they may not pay for compliance checks for teenagers 18 years and over. She will look into this. 2. Increase in heroin use and deaths in Salem and across • Massachusetts. An opiate overdose reduction plan is being developed with Lynn, Salem and Beverly Police/Fire Departments. The antidote is the nasal spray, Narcan, which will be provided to these first responders. The Board would like to know if there is any plan to educate the public on signs/symptoms of overdose and if people who live with addicts may be provided with this life-saving antidote. Gayle Sullivan is knowledgeable of a number of overdoses in the young adult population and is an Y gu p p advocate of making Narcan more available to the families of addicts. She will work how the BOH may provide public health education on this. 7. MEETING ADJOURNED: 9:00pm Respectfully submitted, Heather Lyons-Paul Clerk of the Board • Next regularly scheduled meeting is April 8, 2014 at 7pm At City Hall Annex, 120 Washington Street,Room 311 Salem. w.".. C , ,.� ; t€"«. 5.:ir'�S, c >c''x.� 7 v s ,. 4 f.,•R - .,. t rs "�#"ir. zt,^ r. .'" Ft t"'ry r ca t T 3 '+ x r,`++ `:" i':. as tiSts^ Health Agent report April 2014 Announcements The Point clean-up day has been scheduled for May 31, in addition to the clean-up activities there will be information on how to prepare to exercise and some basic exercises, indoor(pot) gardening, and blood pressure screening. Community Outreach Larry Ramdin attended the Point Vision and Action plan launch. The main highlights that the Health department will be involved with are in the areas of safety, housing, and civic pride and engagement. Larry Ramdin is engaged in discussions with Lorri Long of the Salem Hospital to identify partnerships that the SHA and Salem BOH can collaborate on to improve the health of Salem. Public Health Highlights • Larry Ramdin and Suzanne Doty responded to a call from the police department of a unhealthy property, where an occupant had expired. We went to the home and noted 37 animal cages with animals, animal bedding strewn on the floor and other accumulations of trash and debris. Due to the sensitive nature of the situation given the death of the occupant. We worked with the family who were still resident in the home. David Greenbaum followed up on the case. The animals were either relocated to a farm or taken by the MSPCA. The cleanup of the property is ongoing. • Ugly Mug Diner, located at 120 Washington Street, has been issued a Food Establishment permit. • Plan review for Okea grill is in process. They are relocating to a new site on Jefferson Avenue. Meetings and Trainings • Staff attended the annual Community Sanitation Seminar hosted by MHOA. The seminar discussed housing, camps and recreational water issues. • Delilah Castro completed classroom Lead Determinator training hosted the Childhood Lead Poisoning Prevention Program. Her field work has been scheduled for May 14 after which she will be a Certified Lead Determinator. 4 � -•.� " '� r x, s ,fir �� - �"s - ,"� T, � „�.,w;..� c Mw � e � _ .z:� .t-,✓n Inspections Item Monthly Total YTD 2013 Total Certificate of Fitness 34 176 577 Inspection Certificate of Fitness 1 9 29 reinspection Food Inspection 32 131 377 Food Re-inspections 26 86 227 Retail Food 6 18 55 Inspections i Retail Food 0 4 27 reinspection General Nuisance 3 6 9 Inspections Food— 0 1 2 Administrative Hearings Housing Inspections 8 69 233 Housing re- 3 21 40 inspections Rodent Complaints 2 2 39 Court Hearings 1 2 10 MN,5�-, ,,,�z , ,?� .'P.,,,,� & '": _ r r- Trash Inspections 21 52 146 Orders served by 0 2 2 Constable Tanning Inspections 0 1 1 Body Art 0 1 1 Swimming pools 0 2 30 Lead Determination 0 1 4 Total 132 585 1770 • Suzanne Doty RN, BSN Salem Board of Health Public Health Nurse Public Health Nurse Report Reporting on March12, 2014-April 8, 2014 Disease Prevention • Investigated reportable diseases and reported case information to MDPH. • In contact with North Shore Pulmonary Clinic and MGH pulmonary clinic on current active tuberculosis cases. • Currently awaiting confirmation from Emergency Preparedness consultant for date to hold class for N95 fit test training. • Because of ongoing discussions with the MDPH TB program we were able to secure 80 doses of Tuberculin PPD. 60 doses are being provided to the Lifebridge Shelter as requested and 10 doses the Lydia Pinkham Memorial. Since these organizations are likely to care for an at risk population, this allows them to screen for Tuberculosis • infection and promotes the detection needed to treat possible infectious and latent patients. Health Promotion • Participated in Head Start Health Fair on March 27tn'provided information on smoking cessation, healthy nutrition and childhood immunizations. • Drafted list of websites to include on the Healthy Salem page. • Discussed health promotion planning with Lorri DeFrancesco of Salem Housing Authority we will begin holding clinics this spring at Salem Housing Authority sites. • Collaborated with the Healthy Agent Larry Ramdin on Program Planning to discuss most prevalent diseases and causes of disease in Salem, Massachusetts in order to plan programs and collaborations appropriate for Salem's population. • Updated the Salem Board of Health Facebook and Twitter pages with links and information on Diabetes Alert day which included a free diabetes risk assessment and on World Autism Awareness day. • Prepared poster presentation for Salem High School Health Fair on April 17tn , the focus will be on Sun Safety and healthy eating habits. Meetings/Training • Received mandatory training from MDPH for proper vaccine storage,handling and management on March 17tn i • On March 19th,attended North Shore Shared Public Health Services Program meeting • with Coordinator Heather Luciani and public health nurses from surrounding participating towns to discuss planning for Asthma reduction in our communities, and as a result of this meeting, a collaboration meeting with the Salem Family Health Center is in the process of being scheduled. • On March 20"',attended MHOA meeting on Bio Recovery:Hoarding and Crime Scene clean up. • On March 26`h, accompanied Senior Health Inspector,David Greenbaum, on a requested apartment inspection due to health concerns of the tenant. • On March 26th, attended North Shore/Cape Ann Emergency Preparedness Coalition meeting. • On March 27th, attended Salem REACT meeting at the Salem Police Department. • On April 7"', attending a week long Tuberculosis Intensive Workshop at the Rutgers Institute in Newark, New Jersey. Monthly Report of Communicable Disease March Disease #Of Cases New Carry Over . Discharged Running total Total for 2013 Reported for 2014 Tuberculosis 3 0 3 0 4 2 • (Active) Latent 5 5 0 5 21 44 Tuberculosis* Malaria 0 0 0 0 1 0 Calicivirus/No 0 0 0 0 1 0 rovirus Group B 0 0 0 0 1 2 Streptococcus Meningitis 0 0 0 0 2 0 Hepatitis C* 1 1 0 1 3 37 Influenza* 2 2 0 2 16 62 Lyme 0 0 0 0 0 8 Disease* Campylobacte 0 0 0 0 0 15 riosis Giardiasis 0 0 0 0 0 2 Shigellosis 0 0 0 0 0 2 Group A 0 0 0 0 0 1 Streptococcus • Streptococcus 0 0 0 0 0 1 • Pneuomoniae West Nile 0 0 0 0 0 1 Salmonellosis 0 0 0 0 0 3 Legionellosis 0 0 0 0 0 1 Vibrio 0 0 0 0 0 1 Haemophilus 0 0 0 0 0 1 Influenzae Enterovirus 0 0 0 0 0 1 Pertussis 0 0 0 0 0 2 Hansen's 0 0 0 0 0 1 Disease Total 11 8 3 8 49 187 *Notifications only, LBOH not required to follow up or investigate per DPH. Summary of Current Communicable Diseases TB: Case#1: Case continuing with DOT visits daily, compliant and feeling well. • Case#2: Case continues to be seen for DOT once per week, very compliant and feeling well. Case#3: Case moved to Salem in early February and has been on DOT visits since November. Daily DOT visits began in Salem upon notification of arrival on Monday February P. Patients DOT appointments are on Mondays, Wednesdays and Fridays. Continues to be compliant with all medications, using medication box properly and is attending all appointments. 1 Case of probable LTBI reported in February, sputum culture still pending to rule out active TB and the patient is continuing to be seen by NSMC pulmonary clinic. Follow up chest CT is ordered for late May when culture results should be complete. *Received verbal notification from an Epidemiologist at the Massachusetts Department of Public Health of possible exposures at North Shore Medical Center to Brucellosis. The source case was reported to the appropriate community of their residence, which was not Salem. NSMCs infection control department handled the treatment of the persons at risk for exposure in collaboration with the state and no investigation is required by the health department. 0k, Health Dept. Clerical Report FY 2 Burial Permits Permits Plan Reviews Certificate of Copies / Fines Revenue Permit Fees $25 Fitness $50 July-13 $750.00 $2,085.00 $0.00 $2,400.00 $1,100.00 $6,335.00 'Food Service Est. <25seats s140 August $675.00 $655.00 $0.00 $1,900.00 $0.00 $3,230.00 25-99 seats $28o >99 seats $420 September $425.00 $640.00 $0.00 $1,450.00 $0.00 $2,515.00 Retail Food <i000sq' $70 October $900.00 $925.00 $0.00 $1,775.00 $1,200.00 $4,800.00 1000-10,000 $280 >10,000 $420 November $600.00 $815.00 $180.00 $2,300.00 $1,100.00 $4,995.00 Temp.Food 1-3 days s3oo December $300.00 $34,605.00 $0.00 $1,025.00 $0.00 $35,930.00 4-7days $600 >7days s January-14 Example of>7 day temp food permit. $750.00 $24,167.00 $0.00 $300.00 $0.00 $25,217.00 14(da s)divided bY 7=2 x$600=$1200 February $950.00 $2,770.00 $540.00 $1,700.00 $425.00 $6,385.00 Frozen Desserts $25 March $1,375.00 $2,110.00 $450.00 $2,700.00 $1,207.00 $7,842.00 Mobile Food $210 April Plan Reviews New s18o May Remodel s90 June catering $25 per event)$200 catering kitchen Body Art Est. $315 Total Body Art Practitioner 135 7 24 .00 5 2.00 9 9 15 55 .00 03 6 725.00 68 772.00 1 170.00 0 $ $ , Review Plans s18o Fiscal Year Budget 2014 Suntan Est. $140 Rec.Day Camp s10 Salary Startinq Ending Expenses Ext.Paint Removal s35 Full Time $341,259.00 $116,908.84 Startinq Ending Transport Off.Subst. slo5 Part Time $15,997.00 $894.63 $18,850.00 $7,116.17 Tobacco Vendors $135 Overtime $2,000.00 $734.17 Swimming Pools Seasonal $140 Balance $359,256.00 $118,537.64 Health Clinic Revolving Account Annual$210 Nonprofit$40 ,$14,178 28 Title V Review $18o Well Application s18o Disposal works s225/i8o