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MEETING PACKET DECEMBER 2016 CITY OF SALEM MASSACHUSETTS BOARD OF HEALTH 120 WASHINGTON STREET,4"i FLOOR Prevent.ablcH Protect, TEL. (978) 741-1800 FAX(978) 745-0343 KIMBERLEY DRiscoLL Iramdin@salem.com Li1RRY RAMDIN,RS/KERB,CIIO,CP- MAYOR HEM.-ni AGENT NOTICE OF MEETING You are hereby notified that the Salem Board of Health will hold its regularly scheduled meeting Tuesday December 13, 2016 at 7.30 PM Council on Aging Pfloor S Broad Street MEETING AGENDA 1. Call to order 2. Approval of Minutes < c� cy, o 3. Chairperson Communications m O© 4. Public Health Announcements/Reports/Updates M zt a. PHN Report -NSMC working group update M -0 b. Health Agent c. Administrative v _ d. Council Liaison Updates 5. Discussion on temporary food permitting process and fee schedule 6. Discussion on banning smoking in public parks and beaches 7. The impact on legalization of Marijuana will have on the department 8. New Business/Scheduling of future agenda items • Items that could not be anticipated prior to the posting of the agenda Larry Ramdin Health Agent cc: Mayor Kimberley Driscoll, Board of Health, City Councilors Next regularly scheduled meeting is January 10, 2017 at 7:00pm at City Hall Annex, 120 Washington Street 3ro Floor Room 313. Know your rights under the open meeting law MGL chapter 30A ss 18-25 and City Ordinance section 2-M8 through 2-2033 This notice posted on "Offi �(etirL oard � City Hall, Salem, Mass. on I ZZUU1l at 3'`4/ PH in accordance with MGL Chats.30A, CITY OF SALEM BOARD OF HEALTH MEETING MINUTES November 15, 2016 DRAFT MEMBERS PRESENT: Paul Kirby, Chair, Mary Lauby, Jeremy Schiller &Janet Greene OTHERS PRESENT: Larry Ramdin, Health Agent, Suzanne Doty, Public Health Nurse &Heather Lyons-Paul Clerk of the Board EXCUSED: Nancy Crowder TOPIC DISCUSSION/ACTION 1. Call to Order 7:00pm 2. Minutes of Last Meeting J. Greene motioned to amend to the minutes.M. Lauby 2"d (October 18, 2016) Discussion about amendments. J. Greene would like to elaborate on the discussions about food permitting issues and closing of establishments. J. Greene restated her original motion to say: Janet Greene continues to have concerns about the process of closing operations of a food establishments and would like to continue discussing this at a future Board meeting for clarification on what the Board's role should be with this procedure going forward. M. Lauby 2"d All in favor. Motion passed. Dr. Schiller Motioned to accept the minutes of the meeting with corrections. P. Kirby 2"d All in Favor. Motion passed. 3. Chairperson Announcements *P. Kirby met with Mary Lauby last week. Mary suggested to Paul about having a separate meeting to discuss plans, strategies of the board, and meeting with the staff. Mary asked if staff would come to the meeting to talk about their jobs in the department. Larry will talk with the staff to set up a time to meet with the Board. He will also work on small presentations to present to the Board monthly about how the department is running. * P. Kirby had conversations with the Mayor over emails about food establishment trends that are happening now. She believes it would be useful to have a task force meeting to talk about new trends in food establishments and regulatory issues around them. J. Greene would like these meetings to have open discussions that are not didactic. The Board agrees that this is a great idea and is looking forward to starting these discussions. Larry would like to note that he is open to discussions on this topic and is willing to work with the owners and new establishments coming in to the city. He's also having discussions with the Chamber about this. 4. Monthly Reports-Updates • A. Public Health S. Doty updated the Board on the flu clinics. More shots have been Nurse's Report given this year at clinics than in the past. The clinic at DPS had a very positive response and she will continue to do this yearly. Copy available at the BOH office B. Health Agent's Overdose awareness committee meetings have been focusing on de- Report stigmatization. A grass roots movement in Salem has started to focus on this issue to make more people aware of the epidemic. Copy available at the BOH office • C. Administrative Discussion about how the report is set up. Report Copy available at the BOH office Dr. Schiller motioned to accept the reports. J Greene 2"d All in favor. Motion passed. D. City Council None present Liaison Updates 5. 2013 Food Code L. Ramdin explaining FDA process. Food establishments want this Discussion on adopting to happen since they are being trained under the 2013 code already. code L Ramdin asked the Board to adopt the 2013 code so the department is in compliance with the FDA grant program. Effective date of April 1, 2017 M. Lauby motioned to adopt 2013, in addition to the provisions set forth on 105 CMR 590.001(18) through 590.018, the Salem Board of Health hereby adopts and incorporates by reference the 2013 Food Code (not including Annex 1-8) as amended by the Supplement to the 2013 food code ("2013 food code") published by the United States Department of Public Health and Human Services, Public Health Service, Food and Drug Is Administration,Washington DC 20204 provided, however, that the Salem Board of Health does not adopt those provisions of the 2013 Food Code which are specifically stricken or modified by 105 CMR 590.000. This adoption will become effective April 1, 2017. 2"d Dr. Schiller. Discussion, asked to have this well publicized. All in favor. Motion passed. No one from the public showed for comment. Discussion on what 6. Board of Health Tobacco cities and towns have adopted the flavor restriction. Regulations Update— Dr. Schiller motioned to approve the final draft for the tobacco comment review and vote regulation 24 changes including the highlighted areas that were amended. 2nd M. Lauby Discussion: J. Green asked if is this regulation separate from institutions like nursing homes? L Ramdin responded, it will not impact them. There is a separate regulation for workplace smoking band and nursing homes and private clubs are exempt. All in Favor Motion passed. M. Lauby motioned that the effective date be for March 1, 2017. Dr. Schiller 2"d All in favor. Motion passed * Janet Greene led a discussion on transparency. Her goal was to 7. Transparency encouraging share a value that she would like feedback on. Open meeting law discussion at meeting restricts us from meeting outside a posted public meeting. The goal of this is not for more than 2 members meet without posting an agenda. Minutes need to be filled with more information to represent the tone of the meetings. Reports from members meeting with citizen and city staff on topics related to the Board of Health need to be brought to the meetings. Members going to other meeting to represent the Board, needs to be reported back to the Board at a next meeting. If agreements or disagreements happened at our meetings that need to be extended to the next meeting, that should be represented in the minutes. We should be able to have open discussions and conflict resolutions. If we are passionate on a view, we should feel safe to be passionate about it at the meetings. * P. Kirby responded with requesting Heather, the Clerk of the Board,to add more information in the minutes. Also, he welcomes all members to share their points of view on everything that's discussed at the meetings. * Dr. Schiller will also look into Roberts Rules about minute taking and reporting back information from meetings had by individual members outside the Board meetings. * M. Lauby added that the minutes are currently more detailed than she is used to and is satisfied with the way they are being taken. * J. Greene brought up that she feels members are not reporting everything that's being discussed outside the meetings to the Board. * Dr. Schiller also added that it's the purview of the Chair to make sure that the members that are representing the Board are reporting back to the Board on discussions that will affect any decisions that the Board might have to make. * P. Kirby added that if he failed to do that he apologizes if he neglected that duty. * M. Lauby added that the open meeting law is not about the minutes. It is there to prevent people from going off in secret and making decisions that affect the public. The minutes aren't about the public being able to read the details of a discussion they were not at or for members to know every detail that they missed. She is in agreement with Dr. Schiller that less is more. * Dr. Schiller said that it can have negative consequences if parts of a discussion are not represented; that, can have an impact on the public who won't there at that meeting. In conclusion P. Kirby requested to have more details in these minutes to review at next month's meeting. J. Greene motioned to bring item#8 to the next meeting. M. 8. Discussion of recent food Lauby 2"d All in favor Motion passed service permitting issues 9. New Business/ Scheduling of future *Discussion of recent food service permitting issues agenda items *Banning smoking in beaches and public parks *L. Ramdin will bring information about department functions on marijuana legalization and how it will impact the department. �10. MEETING ADJOURNED: J. Greene motioned to adjourn the meeting. 2"d Dr. Schiller All in favor. Motion passed. Adjourned at 9:50pm Respectfully submitted, 0 Heather Lyons-Paul Clerk of the Board Next regularly scheduled meeting is December 13, 2016 at 7pm At City Hall Annex, 120 Washington Street,Room 313 Salem. • Suzanne Doty RN BSN Salem Board of Health Public Health Nurse Public Health Nurse Report Reporting on November 2nd, 2016 through December 6th°2016 Disease Prevention and Health Promotion • Investigated reportable diseases and reported case information to MDPH. • Coordinating follow up with North Shore Pulmonary Clinic on 1 current active tuberculosis cases. • Held several flu clinics throughout the month including: -Clinics for the Fire department(4 clinics, 1 per shift), a total of 27 doses were given. -Clinic for Department of Public Service, 12 doses were given. - 6 additional doses have been given by appointment this month • Collaborated with Public Health Nurses in surrounding towns to help staff clinics. • All necessary documentation of administered flu shots was organized and sent for insurance billing. • Continually inputting flu doses and clinic information into the Massachusetts Immunization Information System(MIIS) for up to date vaccine records and better continuity of care between clinics and providers. • Added several posts to the Board of Health Facebook page including the Walk for Opiate Awareness flyer, information and a link to the Recovering in Salem series on SATV, shared the Salem Police Departments post regarding availability of free Thanksgiving meals in the area and posted a link to the Center for Disease Controls website for Food Safety around the holidays. s Meetings/Trainings • Continued modules and Working on Wellness webinars, the beginning steps of creating a program on wellness for city employees. The Wellness committee is scheduled to meet December 7th, 2016 and Wellness Survey results were sent to all employees. • Attended the Hidden in Plain Sight train-the-trainer at the Salem Police Department. Attendees were taught how to set up a display of a"typical teenage bedroom"which included numerous objects that raise concern of substance abuse, though not always easily identifiable. • Attended the Salem Overdose and Substance Abuse Awareness Coalition on November 81h for ongoing efforts to increase prevention and awareness of substance abuse. • Attended the Emergency Preparedness meeting on November 16th for continued collaboration for emergency preparedness with our region. • Attended the Northeast Chapter Massachusetts Public Health Nurses meeting on November 18t"which included a lecture by Richard Pollack, an entomologist, who spoke about pest identification and managing pest problems with bed bugs, head lice, spiders, ticks, and other insects. • Attended a meeting with the North Shore public health nurses where we debriefed about our flu clinics, discussed on going plans and collaboration needs such as trainings for camps in the spring and discussing the deliverables of the Emergency Preparedness coalition. Monthly Report of Communicable Diseases: November 2016 Disease New Carry Over Discharged/ Total#Of Running Total for Total for Reported Cases this Total for 2015 2014 Closed Month 2016 Tuberculosis 0 1 0 1 5 4 5 i (Active) Latent 0 0 0 0 28 5 31 Tuberculosis* Arbovirus* 0 0 0 0 0 i 0 0 Babesiosis 0 0 0 0 1 1 0 Calicivirus/No 0 0 0 0 0 1 1 rovirus Campylobacte 1 0 1 1 14 11 10 riosis Chikungunya 0 0 0 0 0 0 1 Dengue* 0 0 0 0 1 0 0 �hrlichiosis 0 0 0 0 0 0 1 Enterovirus 0 0 0 0 0 1 0 Giardiasis 0 5 2 0 Group A 0 0 0 0 0 4 2 Streptococcus Group B* 0 0 0 0 1 7 6 Streptococcus Human 0 0 0 0 2 1 0 Granulocytic Anaplasmosis Haemophilus 0 0 0 0 1 1 0 Influenzae Hansen's 0 0 0 0 0 0 0 Disease Hepatitis A 0 0 0 0 0 0 0 epatitis B* 0 0 0 0 8 0 2 Monthly Report of Communicable Diseases: November 2016 Hepatitis C* 9 0 9 9 54 29 37 fluenza* 0 0 0 0 17 29 27 Legionellosis 1 0 1 1 1 1 0 Lyme 0 0 0 0 27** 2 7 Disease* Malaria 0 0 0 0 1 0 1 Measles 0 0 0 0 1 0 0 Meningitis 0 0 0 0 0 0 2 Mumps 0 0 0 0 2 0 0 Pertussis 0 0 0 0 0 1 2 Rocky 0 0 0 0 1 0 0 Mountain Spotted Fever Salmonellosis 0 0 0 0 10 6 3 higatoxin 0 0 0 0 0 0 1 Producing Organism Shigellosis 0 0 0 0 3 0 4 Streptococcus 1 0 1 1 8 3 2 Pneumoniae* Varicella* 0 0 0 0 1 0 3 Vibrio 0 0 0 0 1 0 - 0 West Nile 0 0 0 0 0 0 0 Yersoniosis 0 0 0 0 0 1 0 Zika Virus 0 0 0 0 1 0 0 Infection Total 12 1 12 13 203 98 148 • November 2016 *Notifications only, LBOH not required to follow up or investigate per DPH. •**Total reflects cases that have also been reported as suspect cases. All Communicable disease totals above are subject to change in the event that the follow-up investigation results in the revocation of the diagnosis. Summary of Current Communicable Diseases Active Tuberculosis: Case 1:DOT started 6/6/16. 3 contacts had TB Skin Tests administered. 1 contact has been referred for further follow up. Second round of contact testing completed, no further follow up for contacts required. Campylobacteriosis: Case 1: This case was diagnosed and treated as outpatient, they are not a food handler nor work in a care setting. No close contacts are ill. Case has recovered and no further follow up is required. Lengionellosis: Case 1: This case was diagnosed with pneumonia and followed by the infectious disease specialist, due to other chronic medical diagnoses this case was not able to recall some information however did remember going in a hot tub out of state, this information was reported to the Department of Public health. The case is recovering at home and has no ill •contacts.No further follow up required, case is closed. Zika Virus Infection: 27 cases of Zika Virus Infection previously listed as cases have been revoked after lab tests. In the month of November, there was no new cases of testing and 1 revoked case. Confirmed Case(June 2016): Case not pregnant at time of diagnosis. Case traveled to Dominican Republic and reported symptoms of fever and rash. • Health Dept. Clerical Report FY 2016 Burial Permits Permits Plan Reviews Certificate of Copies / Fines Revenue Permit Fees $25 Fitness $50 ,JUI �t} food Service Est. <25 seats $140 Y- $475.00 $2,210.00 $1,950.00 $4,635.00 August $700.00 $985.00 $1,500.00 $3,185.00 25-99 seats s28o >gg seats $420 September $1,475.00 $2,165.00 $4,300.00 $300.00 $8,240.00 Retail Food <i000sq' $70 October $475.00 $3,415.00 $2,150.00 $6,040.00 loon lo,000 s28o >10,000 s420 November $500.00 $7,785.00 $2,150.00 $150.00 I $10,585.00 temp. Food 3 days s3oo December $0.00 4-7 days shoo I>7 days $ January-1 5 Example of>7 day tempfood permit: $0. 00 14(da s)divided b Y 7=z xs600=$1200 February $0.00 Frozen Desserts $25 March $0.00 Mobile Food $210 April $o.00 Ap Plan Reviews New s18o May $0.00 1Remodel sgo June Catering $25perevent/$zoo $0.00 catering kitchen Body Art Est. $315 Total $3,625.00 $16,560.00 $0.00 $12,050.00 $450.00 $32,685.00 Body Art Practitioner 135 Review Plans $18o Fiscal Year Budget 2017 suntan Est. $140 Rec.Day Camp $10 Salary Starting Ending Expenses Ext.Paint Removal s35 Full Time $362,039.00 $218,716.31 Starting Ending Transport Off.Subst. s1o5 Part Time $28,306.00 $18,126.62 $16,500.00 $8,574.16 Tobacco Vendors $135 Overtime $2,000.00 $932.71 Swimming Poo fs Seasonal $140 Balance $392,345.00 $237,775.64 Health Clinic Revolving Account Annual$uo Nonprofit$40 $7,910.67 Title V Review $180 Well Application $180 • Disposal works $22S11 l� CITY OF SALEM, MASSACHUSETTS Kimberley Driscoll Mayor December 12, 2016 Salem Board of Health 120 Washington Street Salem, Massachusetts 01970 Dear Board members, 'I In early November, I had a brief exchange with Board Chairman Paul Kirby about the growing innovation and creativity happening within the food industry in Salem and how best we might be able to support these efforts. Part of that effort most certainly might include the topic of temporary food permit fees and I encourage you to consider a reduction in this fee at your next meeting. At present, • Salem's current temporary food permit fee, at $300, is higher than any nearby municipality and negatively impacts short term `pop up' style events, as well as festivals, fairs and markets. I would recommend a much lower fee, closer to the current City of Boston structure, which is $30 for the first day; $5 for any additional days,up to 14 days. In addition to addressing the current fee issue, I think anything we can do to make it easier for those interested in undertaking creative food innovations in our community would be welcome. Actions such as making the temporary food permit application process simple and creating `How To' and "FAQ" guides will help us communicate with food industry entrepreneurs in Salem that we value and welcome their creative endeavors, while also ensuring that public health and safety standards are adequately met. Ideally, I would like us to create an environment that not only allows these types of events, but actually works to make it easy for those interested in undertaking this type of creative food innovation in our community. I hope to attend your meeting on Dec. 13'to engage in a dialogue on this topic. I know that you will give these requests all the thoughtful deliberation that you have brought to bear on all the multitude of issues you have ably addressed over the years. I deeply appreciate all of your service on this volunteer board and the expertise and insight you bring to its work. Very truly yours, • Kimberley Driscoll Mayor Salem City Hall •93 Washington Street•Salem, MA•01970-3592 •p: 978.745.9595 •f: 978.744.9327