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MEETING PACKET NOVEMBER 2016 CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH 120 WASHINGTON STREET,4"'FLOOR PubbTCHealth TEL. (978) 741-1800 FAx(978) 745-0343 Prevent.Premote.Protect. KIMBERLEY DRISCOLL lramdin@salem.com MAYOR LARRY RAMDIN,RS/REH:S,CHO,CP-F HEALTH AGENT NOTICE OF MEETING You are hereby notified that the Salem Board of Health will hold its regularly scheduled meeting Tuesday November 15 2016 at 7.•30 PM Council on Aging]"floor S Broad Street MEETING AGENDA 1. Call to order 2. Approval of Minutes 3. Chairperson Communications 4. Public Health Announcements/Reports/Updates a. PHN Report -NSMC working group update b. Health Agent c. Administrative d. Council Liaison Updates r7 . 5. 2013 Food Code discussion on adopting code � a 6. Board of Health tobacco regulation update—comment review and vote 'CZt.,Z. AR 7. Transparency/encouraging discussion at meetings 3 ,� 8. Discussion of Recent Food Service Permitting Issues L`' 9. New Business/Scheduling of future agenda items • Items that could not be anticipated prior to the posting of the agenda This notice posted on "Offici I Bulletin�v/�' Larry Ramdin City Hail, Salem, ma,s. on /14U `a, Health Agent at3Yy /Im in accordance with MGL Chap. 30A, Sections 18-25. cc: Mayor Kimberley Driscoll, Board of Health, City Councilors Next regularly scheduled meeting is December 13, 2016 at 7:00pm at City Hall Annex, 120 Washington Street Yd Floor Room 313. Know your rights under the open meeting law MGL chapter 30A ss. 18-25 and City Ordinance section 2-2028 through 2-2033 CITY OF SALEM BOARD OF HEALTH MEETING MINUTES October 18, 2016 DRAFT MEMBERS PRESENT: Chairman Paul Kirby, Mary Lauby&Janet Greene OTHERS PRESENT: Larry Ramdin, Health Agent, Suzanne Doty, Public Health Nurse, Janet Orta, Sanitarian & Heather Lyons-Paul, Clerk of the Board EXCUSED: Nancy Crowder & Jeremy Schiller I TOPIC DISCUSSION/ACTION 1. Call to Order 7:00pm 2. Minutes of Last Meeting J. Greene motion'e'&16 approve mmu,a§. P.Kirby 2"d All in favor. (September 11, 2016) Motion passed, 3. Chairperson Announcements *Welcome Mary Lauby. Backgf6fr"und; has lived"!�Salem for 10 years, &NAhas been Working on sexual avid domestic violence��ssues and public +W( tfkin at UNH'tesearchin sexual and relationship violence Policy." s , �g � g p and stocking:» . *Postponing net nth's meeting,,tto November 15'ha� *Larry Ramdn introducedaJanice Oita, Sanitarian and new hire. , Graduated fromF,Fitchburg,Stat with a BS in Earth Science and worked in the enV�r en research field. NA � . 4. Monthly Reports-Updates '�$�N ..+4tyW fly J' •p' 7 A. Public Healthy " .,Greene impressed with Peabody s Board of Health thank you letter Nurse's Report for S Doty in respeinse to the vaccination clinic she helped with. Copy available at the BOH office �b w B. Health Agent's Ce tificate of Fitness ordinance change coming up at City Council Report s sooin. Some additions will include, short term rental inspections and w . . �'requiring inspection after 3 years. Larry will provide the Board with a w� +c raft. Copy available at the BOH office C. Administrative Copy available at the BOH office Report J. Greene motioned to accept the reports. M. Lauby 2"d All in favor. Motion passed. J. Greene motioned to take the agenda out of order and call on Bambolina after the reports. 2"d All in favor. Motion passed D. City Council Not present Liaison Updates 5. Tobacco regulation P. Kirby suggested postponing the vote until we have more members update—Discussion and present at our meeting. vote M. Lauby motioned to table the tobacco regulation vote. J. Greene 2"d All in favor. Motion passed. P. Kirby quickly went over draft with Mary Lauby. No flavored tobacco products with exception to adult only shops. This will not affect E-Cigarette sales. Suspension language discussion. M. Lauby motion to continue discussion at the next Board meeting. 2"d J. Greene All in favor. Motion passed J. Greene Motion to table foodcode discussion until the next 6. Food Code 2013 discussion Board meeting. 2"d M Lauby AU in favor. Motion passed *P. Kirby began the=discussion byscommenting that The Board of 7. Bambolina/Rover Health does su ort!local businesses Board encourages a Bagels—menu expansion constant and op n'low of information between the department staff discussion with Larry and business owne s�,so that the staff can provide guidance and Leibowitz and Tim assistances with any�changes th a Salem business owners might Haigh have to'their food establishment. � ' * Rove Bagels? that was�operaating out of Bambolina, was shut down because the department wa§Ii6hinf6rmed of what was believed to be a significant•,change to how th6415 siness was being operated. Rover r � Bagels was allowed toc�ntuiue per�ting for the weekend once a ��ternporary foodpermit application"s filled out and submitted. � *lP.� irby asked$L;afy Ramdin'to provide a more specified definition of v�1f t is considered a significant change, in hopes that it will clarify � g g � p to Salem establishment owners what permits might need to be pulled an Bd�what dlsoussions,need to be had with the department. oth Larry Ramdin and Larry Leibowitz had a discussion in Mr. Ra' di?'s office before the Board meeting. With the information Mr. Leibowiiiprovided, Rover Bagel was allowed to continue its operationk, der Bambolina's permit. *Mr. Leibowitz assured the Board and Mr. Ramdin that he will *N continue to keep an open dialog about any changes to their ' businesses. He also informed the Board that both Tim Haigh and self have started construction on a new restaurant close to h, ambolina and will be in communication with Mr. Ramdin about the progress they are making there. 8. New Business /Scheduling of Continuation of discussion and vote on tobacco regulation update future agenda items Food Code 2013 discussion 9. MEETING ADJOURNED: M. Lauby motioned to adjourn the meeting. 2"d J Greene All in favor. Motion passed 9:20pm Respectfully submitted, Heather Lyons-Paul Clerk of the Board Next regularly scheduled meeting is November 15, 2016 at 7.30pm At Council on Aging S Broad Street, ISM floor+ N. s tt p "'folkaN Yr':.YV ds i Health Agent report November 2016 Announcements/Updates • I will be proceeding on vacation from December 19—January 9, 2017. Elizabeth Gagakis will be dealing with administrative and inspection concerns during this time Local Health Directors will be available for Emergency response and advising as well. • Janet Mancini, Part-Time Health Inspector, was awarded her Certified Food Manager certificate. • The inspection staff will be attending a training on December 14 to understand the processes involved with inspecting restaurants utilizing the 2013 Food Code Community Outreach • A training on the Hidden in Plain Sight program that depicts ways that drugs are stored in a bedroom was hosted by the Salem overdose awareness and use reduction Coalition. The has been a general consensus that we should develop one of the kits so it can be utilized regionally as another educational tool for parents Meetings and Trainings • The environmental health team attended a Food Safety seminar hosted by the Massachusetts Environmental Health Association. The seminar discussed the adoption of the 2013 Food Code, answered question on specific code items, and addressed the review of equipment during a plan review and animals in Food establishments. • Larry Ramdin and Elizabeth Gagakis attended an update on the recently concluded Arbovirus season, its impact and there was a presentation by Dr. Alfred DeMaria State Epidemiologist on Arboviruses and tick-borne diseases. Environmental Health Activities • The number of rodent complaints has reduced significantly as the weather becomes cooler. • The issues with illegal dumping continue we will be installing cameras at identified hotspots. • The Department received a complaint of a dog in a Food establishment and child sitting on counter in food service area on Thanksgiving Day, video and photographic evidence was provided to support the complaint. A fine was issued to the facility i I • Inspections Item Monthly Total YTD 2015 Total Certificate of Fitness 48 472 534 Inspection Certificate of Fitness 2 37 4 re-inspection Food Inspection 12 235 263 Food Re-inspections 1 p 31 55 Retail Food 3 17 18 Inspections Retail Food 0 11 1 re-inspection General Nuisance 4 21 25 Inspections Food— 0 2 0 Administrative Hearings Housing Inspections 7 86 181 Housing re- 0 23 37 inspections Rodent Complaints 0 24 19 Court 0 3 7 Hearings/filings Trash Inspections 75 508 138 • • Item Monthly Total YTD 2015 Total Orders served by 0 3 7 Constable Tanning Inspections 0 0 7 Body Art 0 0 1 Swimmingpools 0 9 17 Bathing Beach 0 108 106 Inspection/testing Recreational Camps 0 6 12 Lead Determination 0 2 1 Septic Abandonment 0 0 0 Septic System Plan 0 0 0 Review Soil Evaluation 0 0 0 Percolation tests 0 0 0 Total 153 1572 1433 f Suzanne Doty RN BSN • Salem Board of Health Public Health Nurse Public Health Nurse Report Reporting on October 5th, 2016 through November l ', 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: -The Salem Council on Aging clinic on October 12'"with the assistance of Salem State University students, 60 doses of vaccine were given. -Salem City Employee Clinic on October 13'h, 65 doses of vaccine were given. -Two clinics for the Salem Police department on October 261h, 11 doses were given., -Clinics for the Fire department and Department of Public Works have been scheduled for early November. - 18 additional doses have been given by appointment, including 3 home visits for homebound residents. • Collaborated with Public Health Nurses in surrounding town to help staff clinics. Participated in Marblehead Flu Clinics on Oct 5`h and 17th, Beverly on October 18"'and Swampscott on October 19'h. • Added several posts to the Board of Health Facebook page including an article about Heroin and Fentanyl, and information regarding the Zika Virus and Flu season. Meetings/Trainings • Continued modules and Working On Wellness webinars,the beginning steps of creating a program on wellness for city employees. Held a wellness committee meeting on October 5, 2016 and environmental scans were completed for all locations. • Attended the Emergency Preparedness meeting on October 19'h for continued collaboration for emergency preparedness with our region. Monthly Report of Communicable Diseases: October 2016 Disease New Carry Over Discharged/ Total#Of Running :;T�otal'fornotal'fo ; Reported Cases this Total for 2015����,���K 2014` Closed Month 2016 � Tuberculosis 0 1 0 1 5 4 r 5 (Active) Latent 3 0 3 3 28 x 31 � Q Tuberculosis* = � Arbovirus* 0 0 0 0 0 0 `0 FRI abesiosis 0 0 0 0 w Calicivirus/No 0 0 0 0 0 rovirus Campylobacte 0 0 0 0 13 a riosis Chikungunya 0 0 0 0 0 r 0 € ArmT Dengue* 0 0 0 0 10 Ehrlichiosis 0 0 0 0 0 0 1 Enterovirus 0 0 0 0 0 1 0 T Giardiasis 0 5 x! Group A 0 0 0 0 0 t # 2 Streptococcus Group B* 0 0 0 0 1 Streptococcus ` Human 0 0 0 0 2 i"` 0Q -* Granulocytic ` Y Anaplasmosis Haemophilus 0 0 0 0 1 Influenzae Hansen's 0 0 0 0 0 Disease m t It Hepatitis A 0 0 0 0 00 Hepatitis B* 0 0 0 0 8 Hepatitis C* 2 0 2 2 54 , 9 37� Influenza* 1 0 1 1 17 9 kAr27 Legionellosis 0 0 0 0 0 f 0 Lyme 1 0 1 1 27** x V7 F Disease* 0,4 kx$ rk Malaria 1 0 1 1 1 1 ggi, a Measles 0 0 0 0 1 Meningitis 0 0 0 0 0 z Mumps 0 0 0 0 2 ��d � 0 Pertussis 0 0 0 0 01�,��1 f " 2 t Rocky 0 0 0 0 10 *0 Mountain '- � p Spotted Fever ' ' almonellosis 0 0 0 0 10R 3 Shigatoxin 0 0 0 0 07 q M Producing ` Organism Shigellosis 2 0 2 2 3 44� M. Streptococcus 0 0 0 0 7 Pneumoniae* x � Varicella* 0 0 0 0 1 0 4 # N 3 � , Vibrio 0 0 0 0 1 M' 0 West Nile 0 0 0 0 0 Yersoniosis 0 0 0 0 0 1 Or Zika Virus 0 0 0 0 1 y" r0 " " Ok Infection Total 10 1 10 11 191 4 �0 k t. October 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. Malaria: Case 1: This case is the same patient of case 2 of Shigellosis. They have recently immigrated from another country and were admitted to the hospital and diagnosed with both Shigellosis and Malaria with laboratory confirmation. Patient is not a food handler or in a care setting. Denies any sick contacts.They are being followed by their primary care and doing well.No further follow-up required. Shigellosis: Case 1: This case had recently traveled out of the country during the incubation period, per the ordering provider this infection originated there. This case does not work as a food handler or in a care setting and has since been treated and recovered. No further follow up required at this time. Case 2: This case had recently immigrated from another country and was admitted to the hospital and diagnosed with both Shigellosis and Malaria with laboratory confirmation. Patient is not a food handler or in a care setting. Denies any sick contacts. They are being followed by their primary care and doing well.No further follow-up required. Zika Virus Infection: 26 cases of Zika Virus Infection previously listed as cases have been revoked after lab tests. In the month of October, there was no new cases of testing or revoked cases. Confirmed Case(June 2016): Case not pregnant at time of diagnosis. Case traveled to Dominican Republic and reported symptoms of fever and rash. • • i r ROBERTS RULES CHEAT SHEET To: You say: Interrupt Second Debatable Amendable Vote Speaker Needed Needed Adjourn "I move that we adjourn" No Yes No No Majority Recess "I move that we recess until..." No Yes No Yes Majority Complain about noise, room "Point of privilege" Yes No No No Chair temp., etc. Decides Suspend further consideration of "1 move that we table it" No Yes No No Majority something End debate "I move the previousquestion" No Yes No No 2/3 Postpone consideration of "I move we postpone this matter No Yes Yes Yes Majority something until..." Amend a motion "I move that this motion be amended No Yes Yes Yes Majority b . " Introduce business (a primary "I move that..." No Yes Yes Yes Majority motion The above listed motions and points are listed in established order of precedence. When any one of them is pending, you may not introduce another that is listed below, but you may introduce another that is listed above it. To: You say: Interrupt Second Debatable Amendable Vote Needed S eaker Needed Object to procedure or "Point of order" Yes No No No Chair decides personal affront Request information "Point of information" Yes No No No None Ask for vote by actual count "I call for a division of the house" Must be done No No No None unless to verify voice vote before new someone motion objects Object to considering some "I object to consideration of this Yes No No No 2/3 undiplomatic or improper question" matter Take up matter previously "I move we take from the table..." Yes Yes No No Majority tabled Reconsider something "I move we now(or later) reconsider Yes Yes Only if original No Majority already disposed of our action relative to..." motion was debatable Consider something out of its "I move we suspend the rules and No Yes No No 2/3 scheduled order consider..." Vote on a ruling by the Chair "I appeal the Chair's decision" Yes Yes Yes No Majority The motions, points and proposals listed above have no established order of preference; any of them may be introduced at any time except when meeting is considering one of the top three matters listed from the first chart(Motion to Adjourn, Recess or Point of Privilege). Page 1 of 5 PROCEDURE FOR HANDLING A MAIN MOTION NOTE: Nothing goes to discussion without a motion being on the floor. Obtaining and assigning the floor A member raises hand when no one else has the floor • The chair recognizes the member by name How the Motion is Brought Before the Assembly • The member makes the motion: I move that (or "to') ... and resumes his seat. • Another member seconds the motion: I second the motion or 1 second it or second. • The chair states the motion: It is moved and seconded that... Are you ready for the question? Consideration of the Motion 1. Members can debate the motion. 2. Before speaking in debate, members obtain the floor. 3. The maker of the motion has first right to the floor if he claims it properly 4. Debate must be confined to the merits of the motion. 5. Debate can be closed only by order of the assembly (2/3 vote) or by the chair if no one seeks the floor for further debate. The chair puts the motion to a vote 1. The chair asks: Are you ready for the question? If no one rises to claim the floor, the chair proceeds to take the vote. 2. The chair says: The question is on the adoption of the motion that... As many as are in favor, say `Aye'. (Pause for response.) Those opposed, say 'Nay'. (Pause for response.) Those abstained please say `Aye'. The chair announces the result of the vote. 1. The ayes have it, the motion carries, and ... (indicating the effect of the vote) or 2. The nays have it and the motion fails WHEN DEBATING YOUR MOTIONS 1. Listen to the other side 2. Focus on issues, not personalities 3. Avoid questioning motives 4. Be polite Page 2 of 5 HOW TO ACCOMPLISH WHAT YOU WANT TO DO IN MEETINGS MAIN MOTION You want to propose a new idea or action for the group. • After recognition, make a main motion. • Member: "Madame Chairman, I move that " AMENDING A MOTION You want to change some of the wording that is being discussed. • After recognition, "Madame Chairman, I move that the motion be amended by adding the following words " • After recognition, "Madame Chairman, I move that the motion be amended by striking out the following words " • After recognition, "Madame Chairman, I move that the motion be amended by striking out the following words, , and adding in their place the following words " REFER TO A COMMITTEE You feel that an idea or proposal being discussed needs more study and investigation. SAfter recognition, "Madame Chairman, I move that the question be referred to a committee made up of members Smith, Jones and Brown." POSTPONE DEFINITELY You want the membership to have more time to consider the question under discussion and you want to postpone it to a definite time or day, and have it come up for further consideration. • After recognition, "Madame Chairman, I move to postpone the question until PREVIOUS QUESTION You think discussion has gone on for too long and you want to stop discussion and vote. • After recognition, "Madam President, I move the previous question." LIMIT DEBATE You think discussion is getting long, but you want to give a reasonable length of time for consideration of the question. • After recognition, "Madam President, I move to limit discussion to two minutes per • speaker." Page 3 of 5 POSTPONE INDEFINITELY You want to kill a motion that is being discussed. • After recognition, "Madam Moderator, I move to postpone the question indefinitely." POSTPONE INDEFINITELY You are against a motion just proposed and want to learn who is for and who is against the motion. • After recognition, "Madame President, I move to postpone the motion indefinitely." RECESS You want to take a break for a while. • After recognition, "Madame Moderator, I move to recess for ten minutes." ADJOURNMENT You want the meeting to end. • After recognition, "Madame Chairman, I move to adjourn." PERMISSION TO WITHDRAW A MOTION • You have made a motion and after discussion, are sorry you made it. • After recognition, "Madam President, I ask permission to withdraw my motion." CALL FOR ORDERS OF THE DAY At the beginning of the meeting, the agenda was adopted. The chairman is not following the order of the approved agenda. Without recognition, "Call for orders of the day." SUSPENDING THE RULES The agenda has been approved and as the meeting progressed, it became obvious that an item you are interested in will not come up before adjournment. • After recognition, "Madam Chairman, I move to suspend the rules and move item 5 to position 2." POINT OF PERSONAL PRIVILEGE The noise outside the meeting has become so great that you are having trouble hearing. • Without recognition, "Point of personal privilege." • Chairman: "State your point." • Member: "There is too much noise, I can't hear." Page 4 of 5 COMMITTEE OF THE WHOLE is You are going to propose a question that is likely to be controversial and you feel that some of the members will try to kill it by various maneuvers. Also you want to keep out visitors and the press. • After recognition, "Madame Chairman, I move that we go into a committee of the whole." POINT OF ORDER It is obvious that the meeting is not following proper rules. • Without recognition, "I rise to a point of order," or "Point of order." POINT OF INFORMATION You are wondering about some of the facts under discussion, such as the balance in the treasury when expenditures are being discussed. • Without recognition, "Point of information." POINT OF PARLIAMENTARY INQUIRY You are confused about some of the parliamentary rules. • Without recognition, "Point of parliamentary inquiry." • APPEAL FROM THE DECISION OF THE CHAIR Without recognition, "I appeal from the decision of the chair." Rule Classification and Requirements Class of Rule Requirements to Adopt Requirements to Suspend Charter Adopted by majority vote or Cannot be suspended as proved by law or governing authority Bylaws Adopted by membership Cannot be suspended Special Rules of Order Previous notice & 2/3 vote, 2/3 Vote or a majority of entire membership Standing Rules Majority vote Can be suspended for session by majority vote during a meeting Modified Roberts Rules of Adopted in bylaws 2/3 vote Order • Page 5 of 5