MEETING PACKET MAY 2015 CITY OF SALEM, MASSACHUSETTS
BOARD OF HEALTH
120 WASHINGTON STREET,4"�t FLOOR PablicHealth
TEL. (978) 741-1800 FAX(978) 745-0343 Prevent.Promote.Protect,
KIMBERLEY DRISCOLL lramdin@salem.com
LARRY RAMDIN,RS/I2EFiS,CI-IO,CP-FS
MAYOR HEALTI-i AGENT
NOTICE OF MEETING
AMENDED
You are hereby notified that the Salem Board of Health will hold its regularly scheduled meeting
Tuesday May19, 2015 at 7.00 PM
Council on Aging S Broad Street Salem MA
MEETING AGENDA
1. Call to order
2. Approval of Minutes
3. Chairperson Communications
r--
4. Public Health Announcements/Reports/Updates
:xz-
a. PHN Report
b. Health Agent
C. Administrative 7D
5. Continuance of nuisance complaint 69 Orchard Street C cn
6. Council Liaison Updates
7. New Business/Scheduling of future agenda items
Larry Ramdin
Health Agent
cc: Mayor Kimberley Driscoll, Board of Health, City Councilors
Next regularly scheduled meeting is June 9, 2015 at 7pm at City Hall Annex, 120
Washington Street 3rd Floor Room 313.
Know your rights under the open meeting law MGL chapter 3" ss 18-25 and City
Ordinance section 2-2028 through 2-2033
This notice posted on "Offilif Ulf tin Board"
City Hall, Salem, Mass. on Ar 2015
at 4-'54 Pll� in accordance with MGL Chap. 30A,
Sections 18-25.
CITY OF SALEM
BOARD OF HEALTH
MEETING MINUTES
• April 14, 2015
DRAFT
MEMBERS PRESENT: Dr. Shama Alam (Chair), Mark Danderson, Janet Greene, Paul Kirby, & Dr. Danielle
Ledoux
OTHERS PRESENT: Suzanne Doty, Public Health Nurse, Vickie Caldwell,Assistant City Solicitor, Councilor
Beth Gerard, City Council Liaison, Heather Lyons-Paul, Clerk of the Board, &Larry Ramdin,Health Agent
TOPIC DISCUSSION/ACTION
1. Call to Order 7:04pm
2.Minutes of Last Meeting P Kirby motioned to accept the minutes. J. Greene 2nd All
(April 14,2015) in favor-Motion Passed
3. Chairperson Announcements Dr. Alam shared a letter from the Mayor stating that Spaulding
North Shore is closing and that the city is looking for members to
form a task force and a health round table. Dr. Alam asked if
anyone was interested. M. Danderson will volunteer as well as
Dr. Alam. Meeting are once a month. Dr. Ledoux will be an
alternate if M. Danderson is unavailable.
4.Monthly Reports-Updates
A. Public Health Nurse's ➢ DPH has not changed their policy for distributing PPD.
Report ➢ Copy available at the BOH office
B. Health Agent's Report ➢ The home rule petition for the Board's reduction from 7 to 5
was approved by City Council and will be forwarded to the
legislature for approval. Approval is dependent on how soon
they can get it into their calendar, given that they are in the
middle of the state budget process.
➢ Cherry Street history of trash issues discussed. Arrangements
were made with the property owner to start the cleanup
process but it has not been working so far. The Chair
recognized Councilor Turiel. He added the community and the
city met about this property and the matter is being address at
this time.
➢ L. Ramdin advised the Board that interviews for the Sanitarian
Position where held and Jeffrey Barosy was selected and he
accepted the offer with a tentative start date of April 27, 2015.
➢ Copy available at the BOH office
C. Administrative ➢ There are still budget restraints from the Finance Department
Report but they have been relaxed so bills under$500 can be paid
without prior approval from their department.
➢ Copy available at the BOH office
Dr Ledoux motioned to approve the reports 2"d P Kirby
All in favor-Motion passed
D. City Council Liaison ➢ The Board reduction vote passed unanimously. There was
Updates positive discussion around this topic. Dr. Alam received a lot
of positive feedback as well.
➢ Home Rule Petition will go back to Council after approval by
the legislator and then the city ordinances will be updated to
reflect the change. Larry will inform the former Board
members about this topic.
➢ A letter from Mayor's office stated that Pan Am Railways
will be spraying herbicide along the railway on May 12, 2015
5. Ex. Session: Purpose 1
Dr.Ledoux motioned to go into executive session purpose 1,
per MGL Ch30A S21 (a)(1): To discuss the reputation,
character,physical condition or mental health,rather than
professional competence, of an individual, or to discuss the
discipline or dismissal of, or complaints or charges brought
against, a public officer, employee,staff member or
individual. P.Kirby 2"d All in favor-Motioned passed
Roll call: Dr.Danielle Ledoux,Dr. Shama Alam,Janet
Greene,Mark Danderson & Paul Kirby; All in favor
6. Continuance of Nuisance
complaint 69 Orchard Street L. Ramdin read into record the inspection report done on April
14, 2015 from Sr. Sanitarian David Greenbaum and Sanitarian
Elizabeth Gagakis. The inspection report from The Animal
Control Officer Don Famico's from April 13, 2015 was read into
record. And a letter to the Board from Councilor Josh Turiel
from April 14, 2015was read into record. The Board also received
a email from Michelle Conway stating that she would not be
attending tonight's meeting.
Copies available at the Board of Health office.
Dr. Ledoux asked Mr. Ramdin how the department would address
the noise complaint.
The Air pollution regulations include noise. The department staff
did not find evidence of noise issue.
P Kirby suggested to the Board that we as a Board should think
about nuisance law and how to proceed with a public vs private
health threat. He asked Vickie Caldwell to provide a letter from
the city solicitor's office that explains this process.
P.Kirby motioned that we request the City Solicitor's office
prepare for the Board of Health a memorandum addressing
the legal issues around whether a nuisance must pose a
general threat to public health verses a specific threat to the
health of an individual. 2"d M.Anderson All in favor—
Motion passed
A proposed letter from Chair, Dr. Shama Alam, addressed to both
parties, was read into record on this public health nuisance
complaint.
Deliberations and vote will be done at the Board of Health
meeting on May 12, 2015.
Dr. Alam recognized Councilor Legault. He sincerely
I ,
complimented the Board on their deliberations.
Dr.Ledoux motioned to accept letter from Dr.Alam and
defer the vote until the next meeting.P. Kirby 2"d All in Favor
-Motion passed.
7.New Business/Scheduling of future ➢ Continuance of nuisance complaint
agenda items ➢ Spaulding North Shore closing discussion
➢ Opiate discussion -Active working group
8. MEETING ADJOURNED: Dr.Ledoux motioned to adjourn.P. Kirby 2"d
All in favor-Motion passed
9:45pm
Respectfully submitted,
Heather Lyons-Paul
Clerk of the Board
Next regularly scheduled meeting is May 12, 2015 at 7pm
At City Hall Annex, 120 Washington Street,Room 313 Salem.
•
Health Agent report May 2015
Announcements
• The City has changed its trash collection contractor to Waste Management. The previous
contractor had many issues where they were unable to effectively collect trash on a
timely basis.
• The City of Salem, Lynn and the Town of Swampscott was awarded a$100 000 grant to
develop implement and support underage drinking prevention strategies. The Grant will
be managed by the City of Lynn Health Department.
Community Outreach
• The Salem Board of Health facilitated a training on Additions for the Police Department
through the MAOPC program
• The Northshore Shared Public Health Services will be providing posters for use art parks
and wooded areas on ticks and how to conduct a tick check
Public Health Highlights
• Illegal dumping continues to be an issue and we are monitoring on of the sites, A site on
Harmony Grove Road was cleaned up by the DPW and Sherriff's Community Service
Team. We will take action to the fullest extent of our authority against anyone found to
be illegally dumping
• Jeffrey Barosy completed Housing Public Health Inspector training.
Meetings and Trainings
• Larry Ramdin attended the Massachusetts Asthma Prevention Partnership meeting where
the discussions was around upstream strategies to reduce asthma exposure and treatment
• David Greenbaum participated in the"Community Collaboration and Hoarding: Clearing
a Path to Success"conference held at North Shore Elder Services. David was a panelist
discussing the Board of Health role in the collaborative process in dealing with hoarding
cases.
1
Inspections
Item Monthly Total YTD 2014 Total
Certificate of Fitness 36 195 559
Inspection
Certificate of Fitness 0 3 17
reinspection
Food Inspection 18 76 384
Food Re-inspections 4 18 124
Retail Food 3 7 23
Inspections
Retail Food 0 1 7
reinspection
General Nuisance 12 15 14
Inspections
Food— 0 0 1
Administrative
Hearings
Housing Inspections 12 79 183
Housing re- 2 12 39
inspections
Rodent Complaints 4 5 23
Court 0 5 10
Hearings/filings
Trash Inspections 9 41 218
Orders served by 0 0 2
Constable
Tanning Inspections 0 1 1
Body Art 0 0 1
Swimming pools 16 16 23
Bathing Beach 0 0 100
Inspection/testing
Lead Determination 0 0 1
Septic Abandonment 0 0 1
Septic System Plan 0 0 1
Review
Soil Evaluation 0 0 1
Percolation tests 0 0 2
Total 112 476 1737
Suzanne Doty RN, BSN
Salem Board of Health
Public Health Nurse
Public Health Nurse Report
Reporting on April 1 Oth 2015 to May 6`h 2015
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.
Health Promotion
• Updated the Salem Board of Health Facebook and Twitter pages with information on The
MRC Shelter training we held and on World Hand Hygiene Day.
• Posted an MRC recruitment notice on the Salem Patch regarding our sheltering table top
and reached out to the Salem Volunteers group with information about the MRC to post
in their newsletter.
• Mailed all summer camps an application letter and packet to begin process for this
summers inspections.
• Met with the camp director of the Lynch Van Otterloo YMCA on April 13th to discuss
this upcoming season and help them prepare for inspection this summer.
• Inspected and licensed the Boys and Girls club camp at the Collins Middle School in
order to qualify them for children's vouchers at their new location; I plan to follow up
closer to the opening of camp.
• Provided all camps that accept vouchers with a letter for MDPH stating if they are in
good standing and expected to receive a license this year. This is a new mandatory letter
that is required to be provided by the local board of health and included in the camps
application packets in order to qualify each camp to accept vouchers for kids that's need
financial support.
• Placed a request for state-supplied flu vaccine for school aged children in hope to have
free flu clinics within the schools next flu season.
• Reviewed and approved new tattoo artist applications.
Meetings/Trainings
• Participated in the MAOPC Salem working group meeting on April 21"where we
discussed the current situation regarding opioid abuse and overdoses and planned a
training on addiction at the Salem Police department which will take place on May 131h
• Hosted an Emergency Dispensing Site training on April 22"a, in attendance were many
key people who are part our EDS plan as well as MRC volunteers and interested
members from other towns.
• Hosted a Sheltering Table Top training with EDS site walk through on April 21"for all
MRC members and new recruits as well as members of our EDS plan where we
discussed scenarios and challenges that can be faced while operating a shelter.
• Attended the Northeast chapter of the Massachusetts Public Health Nurses association
meeting at Tewksbury hospital on April 1 Oth which included updates from neighboring
towns on current issues and a presentation from MDPH on Maven(the online disease
surveillance site).
• Attended the Adult Immunization Conference on April 141h which focused on promoting
the HPV vaccines as more a an cancer prevention vaccine than STD as well as a break
out session on disease surveillance, reporting and control of vaccine preventable diseases
given by two of the epidemiologists we work with closely from DPH and the after
Plenary "When There is No Vaccine:Lessons from the Ebola Response"
• Attended the yearly DPH Community Sanitation Seminar on April 15th which included
updates and information for this upcoming camp season.
Monthly Report of Communicable Diseases
March 2015
Disease New Carry Over Discharged Total#Of Running Total for
Reported Cases this Total for 2014
Month 2015
Tuberculosis 0 1 1 1 2 5
(Active)
Latent 0 0 0 0 2 31
Tuberculosis*
Calicivirus/No 0 0 0 0 1 1
rovirus
Campylobacte 2 0 2 2 3 10
riosis
Chikungunya 0 0 0 0 0 1
Ehrlichiosis 0 0 0 0 0 1
Enterovirus 0 0 0 0 0 0
Giardiasis 0 0 0 0 1 0
Group A 2 0 2 2 2 2
Streptococcus
Group B 0 0 0 0 4 6
Streptococcus
Haemophilus 1 0 1 1 1 0
Influenzae
Hansen's 0 0 0 0 0 0
Disease
Hepatitis B* 0 0 0 0 0 2
Hepatitis C* 5 0 5 5 9 37
Influenza* 8 0 8 8 29 27
Legionellosis 0 0 0 0 0 0
Lyme 0 0 0 0 0 7
Disease*
Malaria 0 0 0 0 0 1
Meningitis 0 0 0 0 0 2
Pertussis 0 0 0 0 0 2
Salmonellosis 0 0 0 0 2 3
Shigatoxin 0 0 0 0 0 1
Producing
Organism
Shigellosis 0 0 0 0 0 4
Streptococcus 0 0 0 0 0 2
Pneumoniae
Varicella* 0 0 0 0 0 3
Vibrio 0 0 0 0 0 0
West Nile 0 0 0 0 0 0
Yersoniosis 1 0 1 1 1 0
Total 19 1 20 20 57 148
*Notifications only, LBOH not required to follow up or investigate per DPH.
Summary of Current Communicable Diseases
TB:
Case#1: Patient was being seen for DOT once per month. They continued to consistently follow their
regime by using a daily medication box; they are very compliant with appointments and feeling well.
They were seen by their doctor in mid-April after some follow up testing and upon negative findings
treatment was discontinued because there was no longer evidence of disease. Upon confirmation with the
hospital and MDPH, this case has been closed.
Campylobacteriosis:
Case#1: This case was reported by a lab from an outpatient appointment, I was able to reach the clinician
who stated that the patient was treated and recovering. I was unable to reach this patient by phone several
times and mailed a letter. At this time this case has been lost to follow up and closed.
Case#2: This patient was seen by their primary care physician and started on antibiotics. They had not
left home for several weeks and did not remember eating anything from outside the home. They currently
live alone but no close contacts are showing any similar symptoms. They are retired and do not attend any
day programs. Teaching was done regarding hand washing and food preparation. There is no further
follow up required and this case is now closed.
Group A Streptococcus:
Case#1: This patient had a knee injury and with an aspiration in the knee was found to have the Group A
Streptococcus infection and received antibiotics while inpatient at the hospital. The patient's house hold
contacts have not been sick recently and do not have Varicella at this time; all children have gotten the
vaccine. We ask about Varicella because people who currently have Varicella are more susceptible to
contracting GAS. This patient was recovering and discharged. There is no further follow up required and
this case is now closed.
Case#2: This case was followed up by an MDPH epidemiologist and Tracy Giarla, the Marblehead
Public Health Nurse, while I was out of the office. This patient had gotten surgery about 6 weeks prior to
presenting to the hospital with signs and symptoms of infection. Per the surgeon, it is unlikely that the
wound is likely the source of the infection. The patient is currently being treated with antibiotics and still
inpatient. All follow up has been completed regarding contacts and surveillance. There is no further
follow up necessary but local public health and this case is now closed.
Haemophilus Influenzae:
Case#1: This patient was originally thought to have meningitis. With the epidemiologist, we discovered
that this person lived in group home and attended a day care. We followed up with all contacts and
facilities. The final lab result came back at Haemophilus Influenzae without a type(not H13). In this case
prophylaxis was not required per the epidemiologists from MDPH. According to the hospital this patient
was responding well to treatment. There is no further follow up required and this case is now closed
Yersoniosis:
Case#1: This patient had been sick for several weeks before seeking treatment. They currently work in an
administrative job and they do not have any close contacts that have become ill. Upon seeing their doctor
they tried to think of how they could have caught Yersoniosis, they did not recently travel or eat from any
restaurants during the incubation period they could remember. They drink tap water when they were out
of state several weeks before the incubation period. There is no further follow up required and the case is
closed.
Health Dept. Clerical Report FY 2
Burial Permits Certificate of
Permits Plan Reviews Copies / Fines Revenue Permit Fees
$25 Fitness $50
July-14 $450.00 $815.00 $850.00 $2,115.00 'Food Service Est. <25seats s14o
August $900.00 $2,415.00 $1,950.00 $5,265.00 25-99seats $28o >99seats $42o
September $775.00 $1,000.00 $180.00 $950.00 $200.00 1 $3,105.00 Retail Food <i000sq' s7o
October $625.00 $1,804.00 $1,350.00 $7.00 $3,786.00 1000-10,000 $28o >10,000 $420
November $675.00 $0.00 $90.00 $1,700.00 $2,465.00 Temp.Food 1-3 days s3oo
December $850.00 $50,095.00 $3,450.00 $54,395.00 4-7days s600 >7days $
January-15 Example of>7 day temp food permit.
$725.00 $2,670.00 $180.00 $650.00 $800.00 $5,025.00 14(da s)divided b 7=2 x$600=$1200
February $675.00 $5,895.00 $1,550.00 $100.00 $8,220.00 Frozen Desserts $25
March $1,500.00 $2,635.00 $1,350.00 $5,485.00 Mobile Food s210
April $975.00 $2,235.00 $3,100.00 $100.00 $6,410.00 Plan Reviews New $180
May $0.00 Remodel sgo
June Catering $25 per eventl$2oo
$0.00 catering kitchen
Body Art Est. $315
Total $8,150.00 $69,564.00 $450.00 $16,900.00 $1,207.00 $96,271.00 Body Art Practitioner 135
Tobacco Vendors $135
Fiscal Year Budget 2015 Suntan Est. s140
Rec.Day Camp $10
Salary Startinq Ending Expenses Ext.Paint Removal $35
Full Time $341,229.00 $71,483.25 Starting Ending Transport Off.Subst. slo5
Part Time $15,997.00 $9,184.50 $17,050.00 $7,134.55
Overtime $2,000.00 $367.59 'Swimming Pools Seasonal $140
Balance $359,226.00 $81,035.34 Health Clinic Revolving Account 'Annual$2zo Nonprofit$40
$11,688.22 Title V Review s18o
Well Application s18o
Disposal works $22S118o