MEETING PACKET MAY 2014 Health Agent report May 2014
Announcements
The Mayor has submitted the name of Paul Kirby to the city Council for confirmation as a
Board of Health member. The appointment has been heard and will come back for final vote on
June 12, 2014.
Larry Ramdin Health Agent was inducted as a Fellow of the Local Public Health Institute on
May 19, 2014
The Electronic death registration system will go live on August 1, 2014. We will opt in to e-
burial permitting which allows for auto processing of burial permits and will allow for
processing of burial permits outside of normal business hours.
Delilah Castro , Sanitarian, has completed her Lead Determinator training and has been certified
as a Code Enforcement Lead Determinator
Community Outreach
The Point Clean-up day was well attended and was supported by the Health Department, The
Mayor's Office, Engineering Department, Department of Public Works, Northshore CDC, Point
• Neighborhood Association, Salem YMCA, Salem Cyberspace, Latino/Hispanic Coalition, The
On-point program, Salem Police Department and Salem Family Health Center. The program
involved a clean-up of the streets removing trash, planting flowers in Mary Jane Lee Park e-
waste collection, and white goods collection, Councilor Heather Famico participated in the
clean-up activities. The Health Department also hosted a blood pressure screening clinic and
provided informational materials on hypertension, diabetes, stroke signs, drug overdose
recognition and other drug prevention materials. After the clean-up a celebration was held at the
lot across from Mary Jane Lee park, plant seeds and pots for indoor gardening was provided,
raffles for recycling bins, YMCA passes and Summer camp registration were held and prizes
awarded to residents. Refreshments were donated by local businesses.
Public Health Highlights
A food permit was issued for the Clam Shack at the Salem Willows
We are beginning to receive rodent complaints as the ambient air temperature increases. The
complaints are below what we have received in past
The Department is crafting a Keeping of Animals regulation for submission to the Board; this is
being done in response complaints about backyard farming in the city. The Department has been
receiving several inquiries/comments from the public on the issue.
. One septic system was abandoned and the house has connected to the sewer system
a
Meetings and Trainings
The entire Health Department Team attended the MEHA annual meeting that discussed the
electronic death registration system and green burials.
Inspections
Item Monthly Total YTD 2013 Total
Certificate of Fitness 52 228 577
Inspection
Certificate of Fitness 2 11 29
reinspection
Food Inspection 29 160 377
Food Re-inspections 14 100 227
Retail Food 2 20 55
Inspections
Retail Food 3 7 27
reinspection
General Nuisance 2 8 9
Inspections
Food— 0 1 2
Administrative
• Hearings
s
Housing Inspections 18 87 233
Housing re- 6 27 40
inspections
Rodent Complaints 5 7 39
Court Hearings 0 2 10
Trash Inspections 10 62 146
Orders served by 0 2 2
Constable
Tanning Inspections 0 1 1
Body Art 0 1 1
•
Swimming pools 12 14 30
Lead Determination 0 1 4
Septic Abandonment 1 1 0
Septic System Plan 0 0 1
Review
Soil Evaluation 0 0 1
Percolation tests 0 0 1
Total 156 741 1770
•
• Suzanne Doty RN, BSN
Salem Board of Health
Public Health Nurse
Public Health Nurse Report
Reporting on April 9, 2014-May 13, 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.
• In contact with NSMC Infection Control department for prevention of disease within the
hospital.
• Accompanied Larry Ramdin and David Greenbaum on a housing inspections due to an
animal farming/hoarding report.
• Mailed all camp inspection packets to summer camps for completion and appointment
set up, included the current guidelines for Christians Law.
• Received notification of a new arrival through immigration and set up appointment for
• tuberculin PPD testing and initiated referral to NSMC Pulmonary Clinic.
Health Promotion
• Participated in Salem High School Health Fair on April 171", provided information on sun
safety and healthy eating habits.
• Updated the Salem Board of Health Facebook and Twitter pages with links and
information for National Stroke Awareness Month.
Meetings/Trainings
• From April 7'hto 111"attended a week long Tuberculosis Intensive Workshop at the
Rutgers Institute in Newark,New Jersey. This workshop included lectures and group
activities for investing active tuberculosis patient contacts, medication regimens and side
effects, Multi-Drug Resistant cases, epidemiology, Tuberculosis and drug addiction and
several others.
• From April 14t"to 16'h attended MEMA Incident Command System 300 course at Logan
Airport Fire Headquarters.
• On May I", attended the Annual Massachusetts Association of Public Health Nurses
Conference which included lectures on Tick Bourne Disease, information on the Measles
cases in Framingham, MA and a presentation called The Active Shooter which was to
better prepare us to deal with an active shooter situation and to raise awareness of
• behaviors that represent pre-incident indicators and characteristics of active shooters.
• On May 61h, attended lecture on Immunization Updates by MDPH at Northern Essex
• Community College.
• Completed training on May 8t"with Emergency Preparedness consultant for N95 fit
testing.
Monthly Report of Communicable Diseases
April
Disease #Of Cases New Carry Over Discharged Running total Total for 2013
Reported for 2014
Tuberculosis 3 0 3 0 4 2
(Active)
Latent 4 4 0 4 25 44
Tuberculosis*
Malaria 0 0 0 0 1 0
Calicivirus/No 0 0 0 0 1 0
rovirus
Group B 1 1 0 1 2 2
Streptococcus
Meningitis 0 0 0 0 2 0
• Hepatitis C* 2 2 0 2 5 37
Influenza* 4 4 0 4 20 62
Lyme 0 0 0 0 0 8
Disease*
Campylobacte 1 1 0 1 1 15
riosis
Giardiasis 0 0 0 0 0 2
Shigellosis 0 0 0 0 0 2
Group A 1 1 0 1 1 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 1 1 0 1 1 2
Hansen's 0 0 0 0 0 1
Disease
Total 17 14 3 9 63 187
*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, using daily medication box, 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 3`d. Patients DOT
appointments are 3 times weekly. Continues to be compliant with all medications, using daily 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 scan is ordered for late
May when culture results should be complete.
Campylobacteriosis:
A voice message was left for case without response and then the phone number was no longer in service
the following day. A letter was mailed to the home but there has been no response for several weeks. This
case has been deemed lost to follow-up and it closed at this time.
Pertussis:
This person was not previously immunized due to medical contraindications. They stated they missed
most days of work, which is in an outdoor setting, during the infectious period and did not seek medical
attention until after the period infectiousness was over. All close household contacts have been
immunized. No further action is needed from the LBOH, case is closed.
Group B Streptococcus:
This case presented to the hospital with respiratory issues and was later diagnosed with the Group B
Streptococcus infection in the blood. They were treated with antibiotics in the hospital and returned home
with visiting nursing care within one week and continued on an antibiotic regimen. No further action is
needed from the LBOH, case is closed.
• Group A Streptococcus:
Case presented at the hospital with cardiac issues, blood cultured drawn on the day of admission were
negative, 2 days later another set of blood cultures were drawn which grew the Group A Streptococcus.
Unfortunately, due to multiple medical complications, the patient expired while hospitalized. While
investigating this case, I worked closely with the Infection Control nurses at NSMC and the assigned
epidemiologist at MDPH who deemed this a hospital acquired(nosocomial) infection. MDPH has
provided protocols and procedures which are being implemented at NSMC. No further investigation by
the LBOH is needed at this time.
•
•
Health Dept. Clerical Report FY 2014
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Burial Permits Certificate of H
$25 Permits Plan Reviews Fitness $50 Copies/ Fines � Revenue Permit Fees
s
JUI 3 + Food Service <z5 seats $140
Y- $750.00 $2,085.00 $0.00 $2,400.00 $1,100'00 � $6,335.00
August $675.00 $655.00 $0.00 $1,900.00 $0.00 $3,230.00 �5-g9 seats: $280' " >gg seats $420
�: Retail Food <l000s $ o
September $425.00 $640.00 $0.00 $1,450.00 $0.00 ; $2,515.00 q�
October $900.00 $925.00 $0.00 $1,775.00 $1,200.00 ;5 $4,800.00 1000-10,000 $28o >10,000 $420
November ' Tem Food;;: i- ,da s $300.
$600.00 $815.00 $180.00 $2,300.00 $1,100.00 $4,995.00 F 3 y
December $300.00 $34,605.00 $0.00 $1,025.00 $0.00 $35,930.00 47days: $600 >7ddys $
a : Example of 5j day temp food�perm�t.
January-14 $750.00 $24,167.00 $0.00 $300.00 $0.00 $25,217.00 14(da s)dividedb 7 2z.8606=81200
4�4,
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 $1,150.00 $2,900.00 $1,700.00 , . $5,750.00 Plan Reviews New;'' $18o
May Remodel 490 '
4.
June Catering $25 perevent/$zoo
-;' catering kitchen
t - 77
. ix
+ ., "+v rp s,.. ,to ,.as k .fa .*.,Ry .«,.m.+,. .er nEaa " ;:'+za+ r af.u.r,' uy�s Ito?„i•€a° ,? ."`'' ,. Body Art Est. $315
Total $7,875.001 $71,672.001 $1,170.001 $17,250.001 $5,032.00 �Iv $102,999.00 Body Art Practitioner 135
Review Plans $180
Fiscal Year Budget 2014 Suntan Est. $140
Rec.Day Camp $10
Salary Starting Ending Expenses Ext.Paint Removal $35
Full Time $341,259.00 $90,957.48 Starting Ending Transport Off.Subst. $105
Part Time $15,997.00 -$392.87 $18,850.00 $3,244.46 Tobacco Vendors $135
Overtime $2,000.00 $566.55 Swimming Poo Seasonal $140
Balance $359,256.00 $91,131.16 Health Clinic Revolving Account Annual$210 Nonprofit$4o
$14,178.28 Title V Review $i8o
Well Application $180
• Disposal works $225/
CITY OF SALEM
BOARD OF HEALTH
MEETING MINUTES
April 15, 2014
DRAFT
IREMBERS PRESENT: Dr. Barbara Poremba Chair Martin Fair Dr. Shama Alam & Gayle Sullivan
> � Y
OTHERS PRESENT: Larry Ramdin Health Agent, Council Liaison Beth Gerard & Suzanne Doty, Public Health
Nurse
MEMBERS EXCUSED: Dr. Danielle Ledoux
TOPIC DISCUSSION/ACTION
1. Call to Order 7:1 Opm
2. Minutes of Last Meeting G Sullivan motioned to approved minutes with corrections.
(March 11, 2014) 2nd Dr. Alam. Approved unanimously
3. Chairperson Announcements Dr. Poremba would like the following information added to the
website: EPA Radon information&the Board of Health standard
list of conditions for developments.
4. Monthly Reports-Updates
A. Health Agent Report *Due to the increased use of opiates, Governor Patrick has declared a
public health emergency in the Commonwealth. The office will post
educational information on opiate overdose recognition and
prevention.
*There will be a splash pad built at Mary Jane Lee Park on Prince St.
Splash pads do not fall under the Public Health Codes. The Park and
Recreation Department will consult with L. Ramdin about the care
and maintenance of the splash pad prior to installation and use.
*Dr. Poremba would like to look into having an emergency
dispensing site drill this year. L Ramdin will be having a table top
drill with all Salem participants. Another suggestion was to do a site
set up drill with MRC volunteers. This year we are using Real Opt
computer program that estimates the amount of volunteers and
people needed in an emergency for the DPH drill requirements.
*The budget report for FY 2015 was submitted to the Mayor with
another clerk added to the budget. The Mayor still has to approve
this request before it goes to City Council.
A. Public Health Approved unanimously—Copy available in BOH office
Nurse's Report
B. Administrative Approved unanimously— Copy available in BOH office
Report
C. City Council *Councilor Garrard informed the Board of trash on Balcomb St & 8
Liaison Updates Bayview Circle. L Ramdin replied that the department is already
attending to these complaints.
- +'r *Councilor Gerrard spoke with Councilor Todd Siegel; Chair of the
Public Health, Safety and Environment committee, about the request
to reduce the size of the Board. No date has been set for a hearing on
the Board's request.
*Dr. Poremba indicated that there is a need for a description of
differences between the Board of Health and the Board of Health
Department - L Ramdin has an organizational chart that the Board
had previously accepted that will explain this. The board requests
that the work department be referred to as the Health Department in
order to avoid confusion between it and the supervisory Board of
Health.
5. New Business
A. Short and long term goals
Substance abuse-
The office, as part of the MAOPC Grant, will provide information on
our website about opiate dependency. The information will be
available in the office and offered to businesses for display in their
establishments.
Smoking Free Housing-
The Salem Housing Authority's smoke free housing is in process
will take about 1.5 years to complete.
21+initiative-
L. Ramdin notified the Board that Peabody and Beverly are not
interested in hearing about the 2 1+ initiative. Some believe that this
should be done statewide. L. Ramdin will invite The Boards of
Health from the North Shore to come to next month's meeting to hear
about this issue. The Board also discussed smoke free zones such as
beaches &parks &requiring smokers to have individual ashtrays to
reduce littering.
6. Misc. Meetings afe being held to discuss urban farming. Draft guidelines
and regulations on keeping of animals will be developed for the
Board to consider.
7. MEETING ADJOURNED: 8:45pm
Respectfully submitted,
Heather Lyons-Paul
Clerk of the Board
Next regularly scheduled meeting is May 13, 2014 at 7pm
At City Hall Annex, 120 Washington Street,Room 311 Salem.