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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.