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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