MEETING PACKET SEPTEMBER 2016 e +
CITY OF SALEM, MASSACHUSETTS
BOARD OF HEALTH
120 WASHINGTON STREET,4nl FLOOR PuNcHeaRb
Prevent.Promote.Protect.
j TEL. (978)741-1800 FAx(978)745-0343
KIMBERLEY DRISCOLL lramdin@salem.com
LARRY RAMDIIV,RS/REIiS,CI-IO,CP-F:
MAYOR HEALTH AGENT
NOTICE OF MEETING
You are hereby notified that the Salem Board of Health will hold its regularly scheduled meeting
Tuesday September 13, 2016 at 7.•00 PM
City Hall Annex 120 Washington Street 3rd Floor Room 313
2
MEETING AGENDA
1. Call to order
M fn
2. Approval of Minutes
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3. Chairperson Communications .0
3
4. Public Health Announcements/Reports/Updates
a. PHN Report
b. Health Agent
c. Administrative
d. Council Liaison Updates
• 5. Board of Health tobacco regulation update-public comment
6. New Business/Scheduling of future agenda items
• Discussion on rescheduling of November's Board of Health meeting
• 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 October 11,2016 at 7:00pm at City Hall Annear, 120
Washington Street 3'd 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
This notice posted on "Official Bulletin Board"
City Hall, Salem, Mass. on SEP 0 8 2016
. at (ti.'/9?H in accordance with MGL Chap. 30A,
Sections 18-25.
CITY OF SALEM
BOARD OF HEALTH
MEETING MINUTES
• July 19, 2016
DRAFT
MEMBERS PRESENT: Dr. Shama Alam, Chair,Nancy Crowder, Paul Kirby, &Jeremy Schiller
OTHERS PRESENT: Larry Ramdin, Health Agent, Erica Rimpila, Public Health Nurse&Heather Lyons-Paul
Clerk of the Board, Joyce Redford Dir. NSTACP, DJ Wilson Tobacco Control Dir., &Asst. City Solicitor Victoria
Caldwell
EXCUSED: Janet Greene
TOPIC DISCUSSION/ACTION
1. Call to Order 7:00pm
2. Minutes of Last Meeting Dr. Schiller motioned to approve minutes. P. Kirby
(June 14,2016) 2°d All in favor. Motion passed.
3. Chairperson Announcements Mary Lauby, new Board Member will be confirmed at the
next City Council meeting.
Conflict of interest certifications for applicable members
are due to City Clerk.
4.Monthly Reports-Updates
A. Public Health Nurse's Report * Food borne illness update. Case is closed
* ZIKA Virus update
Copy available at the BOH office
B. Health Agent's Report * The Board congratulated Larry Ramdin on assuming
the post of Vice President for Region 9 of the NEHA.
* 2013 FDA Food Code training will be starting soon.
The Board will need to adopt the 2013 FDA code. L.
Ramdin will provide the Board with a draft.
* Board of Health permit fee structure is being revised
* Trash issue discussion about bulk item pick-up
* Rodent discussion
* Opiate discussion
Copy available at the BOH office
C. Administrative Report * Larry will provide more info on how the budget works
at the October Board meeting.
Copy available at the BOH office
N. Crowder motioned to accept the reports.Dr.
Schiller 2nd All in favor. Motion passed.
D. City Council Liaison Updates *State Rep. Paul Tucker updated Councilor Gerard on
home rule petition.
*New member will be on agenda for the next City
Council meeting.
*Plastic bag initiative will be on September's committee
meeting.
5. Tobacco regulations draft * The Board will move forward with the previous edits to
discussion with Joyce Redford,DJ section 4 b, suspension language.
Wilson&Victoria Caldwell on * L. Ramdin will post a public hearing notice in the
flavor suspension and suspension Salem News and send businesses notification.
language update continuation *Voting on accepting the updated regulations will be
done in a separate meeting so that written comments can
be accepted up to 2 weeks after the public hearing is
closed.
* Chair proposed to have a special meeting for the public
hearing. The Board decided to have the public hearing at
the regularly scheduled meeting in September.
P.Kirby motioned to accept the draft regulation and
bring it to the next regularly scheduled Board meeting
for a public hearing.Dr. Schiller 2°d.All in favor.
6. Organization of the Board Election of new chair. Dr. Shama will step down as chair
after this meeting is concluded due to her resignation
from the Board.
Dr,Schiller motioned to nominated Paul Kirby, N.
Crowder 2nd
Discussion:
P. Kirby accepted the nomination.
All in favor. Chair abstained. Motion passed
Discussion on Roberts Rules of motions and abstention of
votes. The Assistant City Solicitor was contacted to
confirm vote interpretation.
7. Structural racism in structural Asked to move this topic until the October meeting.
government, requested be Board Mayor Driscoll has recently started an inclusion meeting
member Nancy Crowded to discuss this topic. N. Crowder would like a Board
member or Larry to contact her about this topic.
8. New Business/Scheduling of future Public Hearing on updates to Tobacco Regulations-
agenda items September meeting
Budget discussion—October's meeting
Racism in structural government October's meeting
9. MEETING ADJOURNED: Dr.Schiller motioned to adjourn the meeting. 2nd N
Crowder All in favor.Motion passed
9:00pm
Respectfully submitted,
Heather Lyons-Paul
Clerk of the Board
Next regularly scheduled meeting is September 13, 2016 at 7pm
0 At City Hall Annex, 120 Washington Stree4 Room 313 Salem.
I
Health Agent report July/August 2016
Announcements/Updates
• Elizabeth Gagakis has returned from maternity leave and resumed duties as Senior
Sanitarian
• Erica Rimpila last as Salem Public Health Nurse was on August 19
• Suzanne Doty has returned as the Salem Public Health Nurse on August 19.
• Nikeeta Patel, MPH student Walden university is doing her practicum with us in
September and October, she will be assisting in several projects during her internship
Community Outreach
• The Board of Health and Overdose Coalition participated in the national Night out
Activities on Salem Common
• The Board of Health participated in the Salem overdose awareness day that was held in
Derby Square, Old Town Hall on August 31
Meetings and Trainings
• Meeting with AJ King management to discuss relocation of baking operations
• Meeting with Steve Feldman and staff to discuss new restaurant concept
• Jeffrey Barosy is completing his Foundations of Local Public Health Course graduation
slated for September 14, 2016
Environmental Health Activities
• New Food Permits were issued to Notch Brewing Derby Street, Celias' Congress Street,
Flatbreads Pizza, Derby Street and Richdale, Lafayette Street
• Renovation work at Dominos Pizza, Canal and Washington Street has been completed
and they were allowed to re-open.
• The department has been dealing with several trash complaints most related to placement
of bulk items on sidewalk.
• Rodent issues continue and the budget fr FY 17 has been almost expended. We will be
asking council to appropriate supplementary funds to cover rodent control expenses for
the rest of FY 17
• Beach Sampling has come to an end and during the season, no Salem beaches exceeded
the microbiological limits that would have led to closure
Inspections
Item Monthly Total YTD 2015 Total
Certificate of Fitness 103 339 534
Inspection
Certificate of Fitness 9 30 4
re-inspection
Food Inspection 12 92 263
Food Re-inspections 1 27 55
Retail Food 0 13 18
Inspections
Retail Food 0 10 1
re-inspection
General Nuisance 13 9 25
Inspections
Food— 0 2 0
Administrative
Hearings
Housing Inspections 15 70 181
Housing re- 10 22 37
inspections
Rodent Complaints 6 22 19
Court 0 3 7
Hearings/filings
Trash Inspections 127 301 138
Orders served by 0 3 7
Constable
Tanning Inspections 0 0 7
Body Art 0 0 1
Swimming pools 1 9 17
Bathing Beach 79 108 106
Inspection/testing
Recreational Camps 1 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 377 1112 1433
Erica Rimpila RN BSN BA
Suzanne Doty RN BSN
Salem Board of Health
Public Health Nurse
Public Health Nurse Report
Reporting on July 13th, 2016 to September 6, 2016
Disease Prevention and Health Promotion
• Investigated reportable diseases and reported case information to MDPH.
• Coordinating follow up with North Shore Pulmonary Clinic on 2 current active
tuberculosis cases. Coordinating follow up with BMC TB Pulmonary Clinic on 1 current
active tuberculosis case.
Meetings/Trainings
Erica Rimpila RN:
• On July 13th attended Local Public Health Institute training in Devens. The training
focused on Camps and Housing Regulations.
• On July 20"participated in the Local Public Health Institute webinar. The webinar group
• discussed the role of the Public Health Nurse and Hoarding.
• On July 26`h attended North Shore Nurses Meeting. Discussed retaining flu vaccination
and other medical records and responses to outbreaks.
• On July 27th attending Hoarding Task Force at the Salem Police Station. Focused on
senior hoarding concerns and discussed Well Check program.
• On August 3rd inspected Schooner Day Camp.
• On August 9th attended the Vaccine Reimbursement Program update. Received
information on billing guidelines.
Suzanne Doty RN:
• August 19th Suzanne Doty RN started as Public Health Nurse, hand off report given by
Erica Rimpila RN.
• On August 31"completed modules and participated in Working On Wellness webinar,
the beginning steps of creating a program on wellness for city employees.
Monthly Report of Communicable Diseases: August 2016
Disease New Carry Over Discharged/ Total#Of Running Total for Total for
Reported Closed Cases this Total for 2015 2014
Month 2016
berculosis 1 3 3 4 5 4 5
(Active)
Latent 5 0 4 5 25 Se_ 31
berculosis*
Arbovirus* 0 0 0 0 0 0 0
Babesiosis 1 0 1 1 1 1 0
Calicivirus/No 0 0 0 0 0 1 1
rovirus
Campylobacte 2 0 2 2 10 11 10
nosis
Chikungunya 0 0 0 0 0 0 1
Dengue* 0 0 0 0 1 0 0
Ehrlichiosis 0 0 0 0 0 0 1
Enterovirus 0 0 0 0 0 1 0
Giardiasis 0 0 0 0 3 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
aplasmosis
aemophilus 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
Hepatitis B* 0 0 0 0 8 0 2
Hepatitis C* 4 0 4 4 40 29 37
Influenza* 0 0 0 0 16 29 27
Legionellosis 0 0 0 0 0 1 0
Lyme 6 0 6 6 25** 2 7
Disease*
Malaria 0 0 0 0 0 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
ountain
potted Fever
Salmonellosis 0 0 . 0 0 7 1 6 3
Shigatoxin 0 0 0 0 0 0 1
Producing
Organism
Shigellosis 0 0 0 0 1 0 4
Streptococcus 0 0 0 0 7 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 2 2 2 3 0 0
Infection
Total 19 5 22 24 162 98 148
August 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: Case's completion of treatment was August 2nd 2016. Case is closed.
Case 2: Continuing to provide Directly Observed Therapy for case. Case's expected completion
of treatment is August 17th, 2016.No new updates.
Case 3:DOT started 6/6/16. 3 contacts had TB Skin Tests administered. 1 contact has been
referred for further follow up.
Case 4: A Suspect case was reported and admitted to Lemuel Shattuck Hospital where
Tuberculosis was ruled out with negative sputum cultures. This case is now revoked.
Suspect LTBI Arrival:Follow up requested by DPH regarding to refugee who will be arriving in Salem
whom had a positive PPD test and negative chest x-ray prior to departure. Referral to pulmonary clinic
completed and appointment scheduled for patient.
•
i
Babesiosis:
Case confirmed by primary care physician and also treated for Lyme disease however, this case
was unable to be personally reached for several weeks and has been lost to follow-up.
Campylobacter:
Case 1: Case denies work as food handler or in daycare setting. Case does not suspect food. Case
is closed.
Case 2: Diagnosis revoked by lab, no follow up necessary per DPH.
Hepatitis A(Suspect):
Case was diagnosed while inpatient at a hospital in another town, they were asymptomatic and
per DPH no further follow up is required due to likelihood of a false positive or previous
infection. Case is retired and not a food handler or health care worker. After consulting with
DPH, all necessary data has been collected and this is case is now closed.
Zika Virus Infection:
21 cases of Zika Virus Infection previously listed as cases have been revoked after lab tests
(including 2 negative results in August as explained below).
Case 1: (Contact) Symptomatic partner trying to conceive. Partner also traveled and is
asymptomatic. Approved for testing and advised of 6 month delay for conception. Final test
results are negative.
Case 2: (Contact)case meets criteria for lab testing due to travel and pregnancy. Case does not
report symptoms. Blood test results are negative and the case was revoked.
Confirmed Case(June 2016): Case not pregnant at time of diagnosis. Case traveled to
Dominican Republic and reported symptoms of fever and rash.
XI
Health Dept. Clerical Report FY 2
Burial Permits Permits Plan Reviews Certificate of Copies/ Fines Revenue Permit Fees
$25 Fitness $50
July-16 $475.00 $775.00 $1,300.00 $200.00' $2,750.00 Food Service Est. <25seats $140
August $875.00 $1,065.00 $1,500.00 $3,440.00 2599seats s280 >ggseats s420
September $0.00 Retail Food <i000sq' s7o
October $0.00 1000-10,000 $28o >lo,000 $420
November $0.00 Tema Food 13 days s3oo
December $0.00 4-7days $hoo >7days $
January-17 Example of>7 day temp food permit.
: $0.00 _i4(da s)divided by 7--z x$600=$I2oo
February $0.00 Frozen Desserts $25
March $0.00 Mobile Food $210
Plan Reviews New $180
April $0.00
May $0.00
Remodel s90
,June Catering s25Pereventl$200
'r $0.00 catering kitchen
Body Art Est. $315
Total $1,350.00 $1,840.00 $0.00 $2,800.00 $200.00 $6,190.00 Body Art Practitioner 135
Review Plans s18o
Fiscal Year Budget 2014 Suntan Est. $140
Rec.Day Camp $10
Salary Starting Ending Expenses Ext.Paint Removal s35
Full Time $357,223.00 $333,617.76 Startina Ending Transport Off.Subst. sio5
Part Time $16,545.00 $15,741.25 $18,300.00 $17,509.22 Tobacco Vendors $135
Overtime $2,000.00 $1,471.89 Swimming Pools Seasonal $140
Balance $375,768.00 $350,830.90 Health Clinic Revolving Account Annual$210 Nonprofit$40
$17,137.61 Title V Review s18o
Well Application $18o
Disposal works s225/18o