MEETING PACKET JANUARY 2016 Health Agent report January 2016
Announcements
• David Greenbaum, Senior Sanitarian has submitted his resignation effective February
19t', 2016. David leaves Salem after over 12 years of service to assume a position of
Health Director in another community. We thank him for his service to Salem and wish
him well in his new endeavors.
• Elizabeth Gagakis has advised us that she and her husband are expecting their first child
in late June.
• Roberta Cody,part-time Food Inspector has submitted her resignation effective March
4t'. Bobbi has accepted a position in another community that is more demanding on her
time.
Community Outreach
• Larry Ramdin met with Tim Haigh of Bambolina to discuss a planned Pig Roast on
Derby Street.
Meetings and Trainings
• Attended a Sheltering tabletop exercise in Beverly
• Attended the City Council/Senior Staff retreat
• Attended the Haunted Happenings planning meeting. The meeting will be held monthly
to discuss strategies in planning for Haunted Happenings
Inspections
Item Monthly Total YTD 2015 Total
Certificate of Fitness 40 40 534
Inspection
Certificate of Fitness 0 0 4
re-inspection
Food Inspection 15 15 263
Food Re-inspections 5 5 55
.f
Retail Food 0 0 18
Inspections
Retail Food 0 0 1
re-inspection
General Nuisance 0 0 25
Inspections
Food— 0 0 0
Administrative
Hearings
Housing Inspections 12 12 181
Housing re- 3 3 37
inspections
Rodent Complaints 0 0 19
Court 1 1 7
Hearings/filings
Trash Inspections 10 10 138
Orders served by 3 3 7
Constable
Tanning Inspections 0 0 7
Body Art 0 0 1
Swimming pools 0 0 17
Bathing Beach 0 0 106
Inspection/testing
Recreational Camps 0 0 12
i
i
Lead Determination 1 1 1
Septic Abandonment 0 0 0
Septic System Plan 0 0 0
Review
Soil Evaluation 0 0 0
Percolation tests 0 0 0
Total 90 90 1433
I� CITY OF SALEM
BOARD OF HEALTH
MEETING MINUTES
December 8, 2015
DRAFT
OMEMBERS PRESENT:, Dr. Shama Alam, Chair, Paul Kirby, Janet Greene, &Jeremy Schiller
OTHERS PRESENT: Larry Ramdin, Health Agent, Emily Rimpila, Public Health Nurse, &Heather Lyons-Paul
Clerk of the Board
TOPIC DISCUSSION/ACTION
1. Call to Order 7:00pm
2. Minutes of Last Meeting J Greene motioned to approve the minutes. 2"d Dr.
(Nov. 10, 2015) Schiller All in favor Motion passed
Reopen motioned
J Greene motioned to remove "retail" from topic
#6. P. Kirby 2"d All in favor Motion passed
3. Chairperson Announcements Dr. Alam attended NS Medical Center round table.
Mark Danderson had given his resignation to the Board
to the Mayor's Office and does not need to be included
in communications per the City Solicitor's office.
Dr. Alam had sent the Board a status update from State
Rep. Paul Tucker's office about the Home Rule
Petition.
4. Monthly Reports-Updates
A. Public Health Nurse's Report No Public Health Nurse's report
B. Health Agent's Report L. Ramdin introduced the New PHN Erica Rimpila.
Opiate Awareness meeting discussion
The Board asked for data on the BMI of students in the
Salem school system
Co
py available at the BOH office
Copy available at the BOH office
C. Administrative Report
No updates
D. City Council Liaison Updates
P. Kirby motioned to accept reports. 2"d J. Greene
All in favor. Motion Passed
5. Joyce Redford Director of North J. Redford was unable to attend this
Shore/Cape Ann Alcohol and Tobacco meeting. At least month's meeting there
Policy Program—Continued discussion was a discussion by the Board that there is
on program policy and procedures and not an overlap of violations with the FDA
roducts on the market tobacco program and the local Board of
Health regulation. The Board further
discussed that violations can be on both
FDA and city side but the FDA's violation
will not ee countea as a violation of the
Board of Health regulations. '
FDA program is strictly monetary so there
is no need to change our regulation or to
take a vote at this time.
This tobacco product presentation and .
compliance data overview discussion will
be continued to next month. Heather will
contact J. Redford to ask her to be at
January's meeting and will ask her to bring
an overview of pass-fail compliance data
for tobacco inspections and presentation of
products.
6. Shared Kitchen—Information on Discussion was had at the previous meeting
protocol and regulatory requirements with further discussion at this meeting about
making a motion to support the idea of
shared kitchens as long as they meet the
same standards of a Food Establishment.
P. Kirby motioned that we as a Board are
in favor of a shared kitchen, as long as
they meet the same standards as
permitted food establishments. Dr.
Schiller 2"d All in favor. Motion passed
7. Protocol for evaluating Health Agent
Discussion on the draft form for of the
health agent evaluation.
The discussion topics included .
* To include a different rating scale that is
more specific to the job description.
* Options were discussed on how to adopt
and whether to include a 360 review
* The time of year the evaluation should be
done, eg. from date of hire or at start of
fiscal year
* Biannual frequency
* Per OML, evaluation should be done in
Open meeting. Also The Board has the
option to appoint a member on their behalf
to do the evaluation so it can stay private.
L. Ramdin informed the Board that the City
is discussing using a tool to evaluate all
Department heads. The Board discussed
that Dr. Alam will share the evaluation tool
with key stakeholders in the City, including
the Mayor.
8. New Business/ Scheduling of future agenda items Protocols for evaluating Health Agent.
Tobacco product and compliance data overview
discussion with Redford.
Reorganization of the Board of Health.
will not be counted as a violation of the
Board of Health regulations.
FDA program is strictly monetary so there
is no need to change our regulation or to
take a vote at this time.
This tobacco product presentation and
compliance data overview discussion will
be continued to next month. Heather will
contact J. Redford to ask her to be at
January's meeting and will ask her to bring
an overview of pass-fail compliance data
for tobacco inspections and presentation of
products.
6. Shared Kitchen—Information on Discussion was had at the previous meeting
protocol and regulatory requirements with further discussion at this meeting about
making a motion to support the idea of
shared kitchens as long as they meet the
same standards of a Food Establishment.
P. Kirby motioned that we as a Board are
in favor of a shared kitchen, as long as
they meet the same standards as
permitted food establishments. Dr.
Schiller 2nd All in favor. Motion passed
7. Protocol for evaluating Health Agent
Discussion on the draft form for of the
health agent evaluation.
The discussion topics included
* To include a different rating scale that is
more specific to the job description.
* Options were discussed on how to adopt
and whether to include a 360 review
* The time of year the evaluation should be
done, eg. from date of hire or at start of
fiscal year
* Biannual frequency
* Per OML, evaluation should be done in
Open meeting. Also The Board has the
option to appoint a member on their behalf
to do the evaluation so it can stay private.
L. Ramdin informed the Board that the City
is discussing using a tool to evaluate all
Department heads. The Board discussed
that Dr. Alam will share the evaluation tool
with key stakeholders in the City, including
the Mayor.
8. New Business/ Scheduling of future agenda items Protocols for evaluating Health Agent.
. Tobacco product and compliance data overview
discussion with Redford.
Reorganization of the Board of Health.
V. 1V1EL+ 1 LV li ALJ V UKNEI): Y. Kirby motioned to adjourn the meeting.J
-•=` Greene 2nd
All in favor. Motion passed
8:26pm
Respectfully submitted,
I*
Heather Lyons-Paul
Clerk of the Board
Next regularly scheduled meeting is January 12, 2016 at 7pm
At City Hall Annex, 120 Washington Street,Room 313 Salem.
•
Erica Rimpila RN BSN BA
Salem Board of Health
Public Health Nurse
Public Health Nurse Report
Reporting on December 9`h 2015 to January 12th, 2016
Disease Prevention
• Suzanne Doty is currently covering MAVEN; she investigated reportable diseases and
reported case information to MDPH. All reported December disease cases have closed.
• On December 17`h observed Beverly tattoo parlor inspection completed by Beverly
Public Health Nurse.
• The DPH and CDC have advised that we will no longer doing Ebola monitoring.
Health Promotion
• Began directly observed therapy(DOT) for Tuberculosis case#1 of Salem resident.
DOT was previously provided by Lynn Public Health Nurse.
• North Shore Pulmonary Clinic is following up on 2 current active tuberculosis cases
Boston Medical Center TB Pulmonary Clinic is following up on 1 current active
tuberculosis case.
• Hosted two Influenza vaccine clinics at the Salem Police Department for city employees
on December 29`h. 15 flu shots were administered.
• Flu Shots are still available.
Meetings/Trainings
• Completed online orientation. Finished these modules: ICS 200, ICS 700, ICS 808,
MAVEN online module, Orientation to Local Public Health,Hoarding, Legal Nuts and
Bolts of Isolation and Quarantine, HHAN: Using the Health and Homeland Alert
Network.
• On December 171h received Vaccine Immunization Update 2015 Vaccine Storage&
Handling and Vaccines for Children(VFC)Compliance Training.
• On January 5th attended MEMA Sheltering Table Top Exercise. Discussions focused on
preparation for evacuation of a `Sending Community' `Pass-Through Community' and
`Hosting Community'.
• On January 7`h attended a Collaborative Meeting at the Salem Police Department
regarding a hoarding situation for a resident. Meeting members are looking into support
and services to provide a healthy living situation.
• On January 12`h attended meeting for Salem Overdose Prevention Committee.
• Upcoming Training: MAVEN in person training January 281h. Plan to cover MAVEN
after January 28th training requirements complete.
Monthly Report of Communicable Diseases
December 2015
Disease New Carry Over Discharged Total#Of Running Total for Total for;
Reported Cases this Total for 208 2014
Month 2016
Tuberculosis 0 3 0 3 3 4 5
(Active)
Latent 0 0 0 0 0 31�
Tuberculosis* V
Babesiosis 0 0 0 0 0 h Q
Calicivirus/No 0 0 0 0 0 11 t
rovirus
Campylobacte 2 0 0 2 0 11 10'
riosis
Chikungunya 0 0 0 0 0 0 l
Ehrlichiosis 0 0 0 0 0 0 1?
Enterovirus 0 0 0 0 0 1 0`
Giardiasis 1 0 0 1 0 2 0
Group A 1 0 0 1 0 4 2,
Streptococcus
Group B 0 0 0 0 0
Streptococcus
Human 0 0 0 0 0 1 0,
Granulocytic
Anaplasmosis
Haemophilus 0 0 0 0 0 4 01
Influenzae
Hansen's 0 0 0 0 0 0 0'
Disease
Hepatitis B* 0 0 0 0 0 0 2
Hepatitis C* 7 0 0 7 0 29 37
Influenza* 0 0 0 0 0 29 2T
Legionellosis 1 0 0 1 0 1, 0`
Lyme 0 0 0 0 0 2. la
Disease*
Malaria 0 0 0 0 0 0 1;
Monthly Report of Communicable Diseases
December 2015
Disease New Carry Over Discharged Total#Of Running 'afMAW n 'otal'�fo jt
Reported Cases this Total for
Month 2016 a - ' �. .
Tuberculosis 0 3 0 3 3
(Active) a ��, �
Latent 0 0 0 0 0 f+� :�r;
Tuberculosis* t
Babesiosis 0 0 0 0 0
Y. �s s ,
Caiicivirus/No 0 0 0 0 0 z s ` -
rovirus
Campylobacte 2 0 0 2 0
riosis
:; .
Chikungunya 0 0 0 0 0
x _
Ehrlichiosis 0 0 0 0 0 4 40 I ~'
4nterovirus 0 0 0 0 0 {9,:
'iard'asis 1 0 0 1 0
Group A 1 0 0 1 0 A_
Streptococcus
Group B 0 0 0 0 0
�:.�.
Streptococcus ; `
Human 0 0 0 0 0
s
Granulocytic z "
Anaplasmosis
Haemophilus 0 0 0 0 0
Influenzae x , r,
Hansen's 0 0 0 0 0
Disease
Hepatitis B* 0 0 0 0 0 11r121 #`
Hepatitis C* 7 0 0 7 0
Influenza* 0 0 0 0 0 " �1
Legionellosis 1 0 0 1 0 'y
Lyme 0 0 0 0 0 %
Disease* `'"
Malaria 0 0 0 0 0 ��,
Meningitis 0 0 0 0 0 0' 2
Pertussis 0 0 0 0 0 l F2
Salmonellosis 0 0 0 0 0 6' Y
Shigatoxin 0 0 0 0 0
Producing
Organism
Shigellosis 0 0 0 0 0 Oj
Streptococcus 1 0 0 1 0 3
Pneumoniae
Varicella* 0 0 0 0 0
Vibrio 0 0 0 0 0
West Nile 0 0 0 0 0
Yersoniosis 0 0 0 0 0 .1 0
Total 13 3 0 16 0 98 148'
December 2015
*Notifications only, LBOH not required to follow up or investigate per DPH.
Summary of Current Communicable Diseases
Active Tuberculosis:
Case 1: On 12/14/15 accompanied the Lynn Public Health Nurse to home of Salem resident with
Tuberculosis and observed Lynn Public Health Nurse provide Directly Observed Therapy(DOT)to
resident. Salem Public Health Nurse has since taken on this DOT case. Resident requires DOT 5 times a
week. Resident has 3 children and the spouse living in the household. 3 children and the spouse have not
tested positive but children are being treated prophylactically. Household contacts require an additional
TB Skin Test 2 months after initial TB Test per protocol. Resident has been compliant with medication
and appointments.
Case 2: This resident currently receives DOT through an outreach worker. Salem Public Health Nurse
will soon be assisting DOT with this case.
Case 3: This resident is almost complete with DOT.This resident currently receives DOT through an
outreach worker.
Giardiasis:
Case has no history of travel. Case does not work in food establishment; no implication for food safety. '
� I
I
Health Dept. Clerical Report FY 21,116
Burial Permits Certificate of
$25 Permits Plan Reviews Fitness $50 Copies / Fines Revenue Permit Fees
July-14 $475.00 $2,210.00 $1,950.00 $4,635.00 Food Service Est. <25Seats $140
August $700.00 $985.00 $1,500.00 $3,185.00 25-99seats $280 >99seats $420
September $1,475.00 $2,165.00 $4,300.00 $300.00 $8,240.00 Retail Food <i000sq' s7o
October $725.00 $3,295.00 $1,400.00 $5,420.00 1000-10,000 $28o >1o,000 $420
November $600.00 $2,384.14 $180.00 $1,400.00 $200.00 $4,764.14 Temp.Food 1-3 days s3oo
December $1,375.00 $52,268.00 $2,600.00 $56,243.00 4-7days s600 >7days $
Example of>7 day temp food permit:
January-15 $0.00 14(da s)divided b =2 xs600=$1200
February Frozen Desserts $2
$o.o0 5
March
Mobile Food 2
$0.00 s 10
April $0.00 Plan Reviews ' New $180
May $0.00 Remodel .$go
June
Catering
$25 per event)$2oo
$0.00 catering kitchen
Body Art Est. $315
Total $5,350.00 $63,307.14 $180.00 $13,150.00 $500.00 $82,487.14 Body Art Practitioner 135
Review Plans s18o
Fiscal Year Budget 2014 Suntan Est. $140
Rec.Day Camp $10
Salary Startinq Endinq Expenses Ext.Paint Removal s35
Full Time $357,223.00 $188,153.80 Startinq Ending Transport Off.Subst. s1o5
Part Time $16,545.00 $12,385.00 $18,300.00 $8,100.54 Tobacco Vendors $135
Overtime $2,000.00 $207.17 Swimming Pools Seasonal s14o
Balance $375,768.00 $200,745.97 Health Clinic Revolving Account Annual$210 Nonprofit$40
$5,720.09 Title V Review $180
Well Application s18o
Disposal works s225/18o
-C-1\_ The Commonwealth of Massachusetts
Wamwip Executive Office of Health and Human Services
Department of Public Health
U'F . William A. Hinton State Laboratory Institute
305 South Street, Jamaica Plain, MA 02130
CHARLES D.BAKER Bureau of Infectious Disease MARYLOU SUDDERS
GOVERNOR Tel: (617)983-6550 SECRETARY
KARYN E.POLITO Fax: (617)983-6925 MONICA BHAREL,MD,MPH
LIEUTENANT GOVERNOR Commissioner
www.mass.gov/dph
TO: Massachusetts Hospitals, Local Boards of Health
FROM: Patricia Kludt, MPH
Director, Epidemiology Program
DATE: December 29, 2015
RE: End of Ebola Monitoring of Travelers from West Africa
The Massachusetts Department of Public Health will no longer monitor travelers who leave West
Africa after December 29, 2015.
Guinea is the last country affected by the Ebola outbreak to be declared free of Ebola transmission.
On December 29, 2015,the World Health Organization (WHO) declared Guinea free of Ebola virus
transmission, 42 days having passed since the last patient with Ebola twice tested laboratory-
negative. Travelers entering the US from Guinea will continue to undergo exit screening before
leaving Guinea and be required to enter the US through one of three designated airports conducting
enhanced entry screening. Entry screening is overseen by the.Department of Homeland Security
and includes a temperature check and interview about travel history, symptoms and possible
exposure to Ebola. However, CDC no longer recommends active monitoring by local and state
health departments for travelers arriving in the US from Guinea. The country has now entered a 90-
day period of enhanced surveillance.
Since March 2014, West Africa has experienced the largest outbreak of Ebola in history, with
multiple countries affected. To date, 28,637 total, probable, and confirmed cases have been
identified. Over 15,000 of these were laboratory confirmed, and 11,315 deaths were recorded.
In response to the outbreak, CDC activated its Emergency Operations Center to coordinate
technical assistance and control activities with other U.S. government agencies, WHO, and other
domestic and international partners. Widespread transmission of Ebola in West Africa has been
controlled, although additional cases may continue to occur sporadically. However, because of
ongoing surveillance and strengthened response capacities, the affected countries now have the
experience and tools to rapidly identify any additional cases and to limit transmission.
ZIKA
Script for Salem Board of Health Department:
Practice enhanced travel precautions for the following locations: Caribbean, Pacific Islands,
South America, Central America and Cape Verde.
• Prevention: There is no vaccine to prevent Zika virus disease. Prevent Zika by avoiding
mosquito bites (see below). Prevent sexual transmission of Zika by using condoms or not having
sex with persons that have recently traveled to an area with an outbreak.
• Recommendations for women that are pregnant,planning pregnancy or are breastfeeding:
Talk with a physician prior to travel to and when returning from an area with an outbreak.
• Please understand that this remains a rapidly evolving situation and that new guidance will
continue to come out as more is learned about specific risks linked to Zika virus infection. You
should continue to remain alert for and follow the most up-to-date information. For the most
current information about the Zika virus visit one of the following websites:
o Salem Board of Health at www.salem.com/health
o Center for Disease Control at www.cdc.gov/zika
o Massachusetts Department of Public Health at
www.mass.gov/eohhs/gov/departments/dph/
Steps to prevent mosquito bites:
When traveling to countries where Zika virus or other viruses spread by mosquitoes are found,
take the following steps:
• Understand that mosquitoes that spread Zika virus bite mostly during the daytime.
• Cover exposed skin by wearing long-sleeved shirts, long pants,and hats.
• Stay in places with air conditioning or that use window and door screens.
• Sleep under a mosquito bed net if you are overseas or outside and are not able to protect yourself
from mosquito bites.
• Use insect repellent, follow product directions and reapply as directed.
• If you are also using sunscreen, apply sunscreen first and insect repellent second.
• If you have a baby or child:Follow instructions closely when using an insect repellent product.
After Travel:
• Talk to your health care provider if you develop a fever with a rash,joint pain, or red eyes. Tell
your health care provider about your travel.
• Persons with Guillain-Bane Syndrome(neurological disorder)should follow up with their health
care provider regarding recent travel.
• For males: If your partner is pregnant, either use condoms the right way every time you have
vaginal, anal,and oral(mouth-to-penis)sex or do not have sex during the pregnancy.
• For females:If you are pregnant or planning to get pregnant, discuss concerns with a physician.
You can use condoms the right way every time you have vaginal, anal, and oral(mouth-to-penis)
sex. Not having sex is the best way to be sure that you do not get sexually transmitted Zika
virus. All pregnant travelers returning from areas with ongoing Zika transmission can be tested
for Zika virus infection.
Information from:http:Hwww.cdc.gov/zika/prevention/index.html taken February 25th,2016,
http://www.health.gov.au/internet/main/publishing.nsf/Content/oho-zika-countries.htm taken February 25,
2016. MDPH Bureau of Infectious Disease Public Health Fact Sheet January 2016.
Created:02/25/16
Hi All:
I wanted to follow up regarding the Open Meeting and Public Record Laws issues that have
arisen with respect to the evaluation process. I had the opportunity to touch base with the
Attorney General's office this afternoon to seek some informal advice about how best to go
about evaluating an employee who is employed by a public body. Assistant Attorney General
Kevin Manganaro indicated to me that the only way around the process being public would be to
delegate it to one member of the Board. He indicated that forming a subcommittee, even without
a quorum of the Committee present, would be viewed as circumventing the law unless the
subcommittee meeting was posted and conducted as an open meeting.
As has already been discussed, individual board members' evaluations are public records, but
providing them to a single member delegated to conduct the evaluation outside of a public
meeting would keep the potential for any public records requests to a minimum.
Please feel free to give me a call if you would like to discuss this further.
Thanks.
Vickie
Appendix J. How Do the Open Meeting and Public Records Laws Affect the
Superintendent Evaluation Process?
The Attorney General has issued guidance in the form of responses to
frequently asked questions concerning superintendent evaluations
pursuant to the revised Open Meeting Law (c. 28, s. 18 2009).
1. May a public body perform an evaluation of an employee in
executive session?
No. Deliberations conducted for the explicit purpose of evaluating the
professional competency of an individual may not occur during an
executive session. See G.L. c.30A, s.21(a)(1). While conclusions
drawn from deliberations about professional competency may be part
of a deliberation for another executive session purpose, the evaluation
of professional competency, itself, must occur during open session.
For example, as part of the discussion in preparation for renegotiating
a superintendent's contract, a school committee may wish to consider
the results of an annual professional competency evaluation. The
S evaluation results may be considered as part of deliberations about
strategy held in executive session, however, only after deliberations
about professional competency were held during a previously
convened open session.
2. Are individual evaluations completed by members of public
bodies public records?
Yes. The Open Meeting Law carves out an exception from the Public
Records Law for "materials used in a performance evaluation of an
individual bearing on his professional competence," that were created
by members of a public body and used during a meeting. See G.L. c.
30A, s.22(e). Individual evaluations created and used by members of
a public body for the purpose of evaluating an employee are public
records. Comprehensive evaluations that aggregate the individual
public body members' evaluations are also public records if they are
used during the course of a meeting. However, evaluations conducted
by individuals who are not members of public bodies are not public
records. For example, the individual evaluations created by municipal
I
employees in response to a request for feedback on the town
administrator are not public records, provided the employees
completed the evaluations are not also members of the public body
tasked with evaluating the town administrator's professional
competency.
3. May the individual evaluations of an employee be aggregated
into a comprehensive evaluation?
Yes. Members of a public body may individually create evaluations,
and then submit them to an individual to aggregate into a master
evaluation document to be discussed at an open meeting. Ideally,
members of the public body should submit their evaluations for
compilation to someone who is not a member of the public body, for
example, an administrative assistant. If this is not a practical option,
then the chair or other designated public body member may compile
the evaluation. However, once the individual evaluations are
submitted for aggregation there should be no deliberation among
members of the public body regarding the content of the evaluations
outside of an open meeting, whether in person or over email.
4. May a public body discuss issues relative to the salary of a
public employee in executive session?
It depends. Discussions of salary issues may only occur in executive
session as part of a contract negotiation. See G.L. c.30A, s.21 (a)(2),
(3). Other discussions related to salary, such as a discussion about
whether an employee's job performance merits a bonus or salary
increase, must be conducted in open session.