Board of Health

City of East Orange EAST ORANGE BOARD OF HEALTH NEW JERSEY REGULAR MEETING East Orange Department of Health & Human Services 143 New Street East Orange, New Jersey 07017 DECEMBER 20, 2016 MEETING MINUTES Meeting call to Order @ 5:45PM Board President Christine Harris read the following Sunshine Law: This meeting, which conforms to the provisions of the Open Public Meeting Act, Chapter 231, and Public Law of 1975 is a regular meeting of the City of East Orange Board of Health. Notices have been filed with our official newspaper, with the City Clerk and posted on regular bulletin boards. The public is permitted to participate at this meeting. After the roll call, it was determined there was a quorum to convene the meeting. Board Members Present: Christine Harris, President Tobbia M. Corbitt Horace H. Henry Reverend Jean Maurice Board Members Absent: Attorney Ryan Linder Rosemarie Brown Mayoral Staff/Health Department Staff/Animal Control: Victor Kuteyi, Health Officer Diashana Coleman, Administrative Clerk, Department of Health Chesney Blue, WIC Coordinator Karen LaRussa, RN, Health Educator Ibrahim Small, Aide to Mayor Lester E. Taylor, III Guest Speakers: None Public in attendance: Ms. Chidek, intern, Kean University, Masters in Public Administration, Concentration: Healthcare Administration. Approval of November 22, 2016 Meeting Minutes Updated subject to corrections approval will take place at the January 2017 meeting. Announcements The announcement of the appointment of Ms. LaDonna Johns, Esq. as the new Director of HHS which will be confirmed by City Council in January 2017. President Harris announced Board Member Rosemarie Brown resigned effective Tuesday, December 20, 2016, for personal reasons. President Harris e-mailed her City Council pg. 1 City of East Orange EAST ORANGE BOARD OF HEALTH NEW JERSEY REGULAR MEETING East Orange Department of Health & Human Services 143 New Street East Orange, New Jersey 07017 DECEMBER 20, 2016 MEETING MINUTES representatives to inform them of the resignation and requested another appointment be made. She also stated that Ms. Brown will be missed and Ms. Brown stated to her that she hopes to be reinstated in the future when she comes back to East Orange. Updates: Staff HO Kuteyi stated Ms. Diesha Talmadge, clinical assistant, began working on December 5, 2016 in the nursing division to help the nursing manager; he proposed to Director Johns that the clinic change from walk-in to appointment only; and the possibility of instituting fees- for-service. HO Kuteyi stated Director Johns met with all division heads and she was provided with what was done for 2016 as well as informed of the goals for 2017. Ms. Talmadge is in school obtaining her bachelors’ degree in nursing; she has worked as a medical assistant in doctor’s offices; and she is educated and knowledgeable about billing and coding. HO Kuteyi stated Ms. Talmadge will be an asset as the clinic transitions to fee- for-service because she has experience with health insurance companies, Medicaid and Medicare. Fee for Service Proposal President Harris asked HO Kuteyi why the transition to a fee for services. He stated there are a lot of services being paid such as, chest x-rays and STD tests which they feel is costly to the city and the implementation of fees will help to decrease those cost. Additionally, he stated some health departments have set up a system for people with and without health insurance where they can get services. President Harris asked if a sliding scale will be included for people that do not have Medicaid. HO Kuteyi stated yes, they are looking into sliding scale for people that are not insured, as well as, organizations that assist with software for billing and coding, but they are first concentrating on having the staff well- grounded before the organization is brought in to help with the software issue. Board Member Horace asked HO Kuteyi if they are going to have an assessment officer. HO Kuteyi stated yes, they will have someone to check on the patient financial background and their ability to pay. President Harris commented that if it will be set up like a medical office. HO Kuteyi stated yes for medical and dental also. Board Member Horace asked about the population being served. HO Kuteyi stated in the past the set-up was well-grounded with a variety of residents being served but fizzled out in recent years, however, they are working towards restructuring and attracting more citizens to use the services. Board Member Henry commented with the new billing system, employing additional staff and implementing new services there is a cost recovery meaning the BOH wants to know if there is enough clientele to sustain and justify the new initiatives at the Health Department because that information will be asked in regards to the proposals. Also, he commented to HO Kuteyi the initiatives are a good idea. pg. 2 City of East Orange EAST ORANGE BOARD OF HEALTH NEW JERSEY REGULAR MEETING East Orange Department of Health & Human Services 143 New Street East Orange, New Jersey 07017 DECEMBER 20, 2016 MEETING MINUTES HO Kuteyi stated they are looking into partnering with East Orange General Hospital for patient referrals to provide services they do not provide such as dental services. Board Member Henry commented that the partnership will be for primary care services therefore people do not have to always go to the hospital and the health department can accommodate people’s needs. HO Kuteyi stated they are hoping that people will come to the Health Department to receive minor services such as blood pressure testing or employment evaluation instead of going to the hospital for those services. School-Based Medical Services Board Member Maurice commented that in the Newark school system the Jewish Renaissance Group is in many of the schools and they provide doctors, dentists, mental health counselors which provide various services. Additionally, he inquired if the Health Department can work closely with the school district to provide these services to children in need too. HO Kuteyi stated that he is going to speak with the Director Johns about meeting with the new Superintendent about arranging services for the school district. He also commented in the past the school district was very autonomous and they did not partner, however, the Health Department worked with them if the school nurses reached out to them. Nurse Karen commented that Jewish Renaissance provides school-based services in Newark. And, Cicely Tyson is set-up to provide similar services in their medical suite area which may be a matter of making contact with Jewish Renaissance health care service program to bring in the services to the school system. Furthermore, she cited the school near Branch Brook Park, is a good model to look at because they have medical, dental and other services set-up as well as, various hours including late nights to accommodate the population served. Board Member Corbitt inquired who would initiate the request through the school district since Cicely Tyson is the practical location in place, who would implement the request and where would the dialogue be entertained for it to happen. Nurse Karen responded that an RFP would have to be written and then it would be a matter of who responds with the best bid. She also cited that East Orange Primary Care, Jewish Renaissance and East Orange General Hospital can be contacted to see if they are interested in taking on such a project. Board Member Rev. Maurice suggested East Orange School District (EOSD) Student Services as a good start too. Board Member Mrs. Corbitt inquired why this hasn’t taken place; who needs to initiate the dialogue for the services to happen and who needs to stimulate the conversation for implementation, such as, the BOH, City Council, or Board of Education. HO Kuteyi suggested a meeting of the minds between Director Johns, Superintendent of the Schools and Board of Education where they can come to an agreement to bring to City Council. Mrs. Corbitt reiterated who will initiate the dialogue to Director Johns on this matter. HO Kuteyi replied that the initial dialogue can begin between Nurse Karen, Director Johns and himself regarding this matter to move it forward. President Harris asked how long has the medical suite been in existence at Cicely Tyson. Nurse Karen commented the medical suite area was built when the new building came into existence but stated she does not know why it is not pg. 3 City of East Orange EAST ORANGE BOARD OF HEALTH NEW JERSEY REGULAR MEETING East Orange Department of Health & Human Services 143 New Street East Orange, New Jersey 07017 DECEMBER 20, 2016 MEETING MINUTES fully used. Rev. Maurice commented on the set-up and population serviced within Newark with the Jewish Renaissance is similar to the needs of the children in East Orange. Nurse Karen stated the services which Jewish Renaissance provided are comprehensive, for the entire family. President Harris asked if the services would only be for East Orange residents. Nurse Karen stated yes, the services would only be for East Orange resident just as the services provided by Jewish Renaissance are only for Newark residents. President Harris inquired if the services are funded or a fee for service model. Nurse Karen stated she would find out but it may be funded. President Harris commented school-based clinic is a great idea particularly for the students and the adults can remain using the health department services. Nurse Karen commented they can work along with the school nurses to receive referrals for other services. Mrs. Corbitt stated with the implementation of these services healthcare issues do not have to be comprised for families without health insurance or can’t afford with the services being provided through the school which is a great idea. Furthermore, it’s a matter of seeing how it can work for East Orange especially with the city continuing to collaborate with different entities and coming into different pockets of funding source the BOH needs to see where this can fit in with the financial investments in the city. Ms. Blue inquired if the East Orange School District has a Director of School Nurses or a Director of Health. Nurse Karen responded there is a Director of Health. Ms. Blue suggested that would be the person to also include in meetings about the initiative. Nurse Karen commented the meetings will have to be multi-tiered for the best results. HO Kuteyi stated that by talking to the superintendent it can also trickle down to the schools. President Harris asked if the school have behavioral psychiatric/psychological services? HO Kuteyi stated EOGH has huge mental health department which is prepared and might be willing to help to provide those services. Health Department and EOGH collaboration President Harris asked HO Kuteyi if he had the opportunity to reach out and talk to EOGH staff, physicians or administrators regarding Health Department collaborations. HO Kuteyi stated he will be meeting with Executive Director Story at EOGH. Brookhaven patient issue HO Kuteyi stated a letter was sent to the Mayor’s office regarding the updates on the findings of the Brookhaven patient issue. Proposed health agenda for 2017 President Harris asked HO Kuteyi to present his goals for 2017.  HO Kuteyi stated he spoke with someone from EOGH about the needs assessment which is under review. He stated he intends to use it to help with the community health improvement plan with the hope it will assist with accreditation moving forward to be able to set-up preventive measures.  Food handler’s training program write-up almost completed and ready for implementation in early 2017 pg. 4 City of East Orange EAST ORANGE BOARD OF HEALTH NEW JERSEY REGULAR MEETING East Orange Department of Health & Human Services 143 New Street East Orange, New Jersey 07017 DECEMBER 20, 2016 MEETING MINUTES  Ordinance for the Mercantile License needs to be reviewed so it can be implemented early 2017.  Tobacco ordinance-HO Kuteyi indicated Ms. Blumenfeld did not forward the information, however, he will reach out to her so the process can begin on the 2 ordinances.  Part-time ACO-a person was interviewed and expressed interest and their information was forwarded to the HR department. President Harris stated the ACO issue is a very delicate issue because of their animal advocacy, which is not disclosed until after hired , and can cause problems, therefore, it is recommended that anyone who comes in for an interview should have a background check of their references and personal history of animal advocacy. Animal Control Update: Ms. Coleman stated Animal Control will be moved under Public Safety in January or February 2017, which was voted on in the November 2016 council meeting. President Harris asked if the animal shelters will also go under Public Safety. HO Kuteyi stated they also will be under Public Safety. Reverend Maurice asked why AC will be moved under Public Safety. Ms. Coleman responded they may feel it is better able to be managed by Public Safety because of the Police and the term ACO’s fall under Public Safety along with Fire & OEM. Additionally, a lot of the night-time calls are dispatched to the Police Department, however, there is minor health aspect which involves the health department and essentially the State of New Jersey. HO Kuteyi stated in the past he received many of the AC calls at night from the Police Department and he dispatched them to the ACO’s. Mr. Henry commented the health department will still have to be involved in the epidemiology aspect of the animal shelter. President Harris suggested a process and procedure to be formulated regarding the public health aspect of the animal shelter. President Harris asked for clarification regarding when the animal shelter will be transferred under the management of Public Safety. HO Kuteyi and Ms. Coleman stated the move will be in February 2017. Additionally, Ms. Coleman stated at the November City Council meeting there was an issue in the language of the ordinance which Council Liaison Brent was not aware of regarding the process and the issue pertaining to the ordinance is going to be revisited prior to the move taking place, however, the first reading of the ordinance did take place, but there were issues when the second reading took place which are being worked on. Food display issue HO Kuteyi has proposed an Ordinance for proper displaying of food in front of stores and on the street. He cited the example of Shoprite improperly displaying food at different times of the day and night. President Harris asked if he found this problem at other stores in the city. HO Kuteyi stated when he goes to other Shoprite’s in the area they do not have food displayed outside. Mr. Henry commented about the water being displayed, outside of Shoprite, in the warmer temperatures produces a pg. 5 City of East Orange EAST ORANGE BOARD OF HEALTH NEW JERSEY REGULAR MEETING East Orange Department of Health & Human Services 143 New Street East Orange, New Jersey 07017 DECEMBER 20, 2016 MEETING MINUTES chemical reaction between the plastic and sunlight. HO Kuteyi commented he has spoken to Shoprite managers regarding supervision of the products. President Harris asked if there was an ordinance which addressed the issue. HO Kuteyi stated there is not an ordinance which addresses the issue of outside food management and supervision. Mr. Henry commented that actions can be taken administratively to address these issues and concerns. Ms. Corbitt asked for clarification of the chemical reaction between sunlight and plastic. Mr. Henry explained the chemical reaction between sunlight and plastic impacts the water. HO Kuteyi added water is a universal solvent which dissolves anything with time and if the water is in high temperatures a certain amount of PCB’s is dissolving into the water. Mr. Henry added many of the waters on display are not pure water and the chemical reaction with plastic is harmful and has a cumulative effect. He added this is a public health issue that needs to be addressed. President Harris added the degradation between the plastics and chemical is very harmful and the Health Department will have to be vigilant in addressing the issue. She also added the product display outside of Shoprite is unsightly. HO Kuteyi added it doesn’t look good and that is why they are working to have an ordinance to address the issue. President Harris commented the outside display is in contrast to the positive changes which are inside the store. Mr. Henry added the food which is displayed in the front entrance of the store needs to be temperature controlled. He asked HO Kuteyi if there is a ticketing system for these violations. HO Kuteyi stated they have been taken to court a few times for violations. Mr. Henry commented on the conditions of food storage prior to being donated to food pantries. He cited as a food safety auditor he encountered unsafe conditions of donated food. President Harris inquired about the state law regarding donated food. Mr. Henry stated he is going to look into the regulations on this matter. HO Kuteyi added many of the churches receive government assistance for their food pantries. Mr. Henry added they receive help from the government, however, who are the government vendors because some places which donate food it is improperly stored, temperature abuses and even expired. President Harris suggested to HO Kuteyi to look into state legislation on how food banks are regulated particularly in terms of what is accepted and not accepted. HO Kuteyi commented that most food banks they inspect in East Orange are churches, however, it is the end point of the donation process. Nurse Karen added at the North Jersey Food Bank in Hillside from observation looks very controlled, clean and certificates were displayed from the Union County Health Department. Mr. Henry commented to also keep in mind the food donated to the North Jersey Food Bank originates from other places. Mrs. Corbitt asked if the North Jersey Food Bank donations originate from the local supermarket or from the company’s distributor. HO Kuteyi commented he did not know who distributes the donations to the North Jersey Food Bank. Mr. Henry added the food donations are from the local supermarkets and are pulled from the shelves pg. 6 City of East Orange EAST ORANGE BOARD OF HEALTH NEW JERSEY REGULAR MEETING East Orange Department of Health & Human Services 143 New Street East Orange, New Jersey 07017 DECEMBER 20, 2016 MEETING MINUTES not the rendering plants. Ms. Blue added that regulations are more for the food pantry and not the stores or donors. Additionally, she cited some states tried to regulate the donations, however, it became a big social issue where people did not want to make donations. Ms. Blue stated she understood Mr. Henry’s concern regarding food storage of donations, however, many larger, sophisticated food banks monitor and have a process to weed out bad food. BOH Goals for 2017 Ordinances on Tobacco Control President Harris stated she wants the BOH to develop an Ordinance for e-cigarettes and pass an Ordinance to increase the age of purchase of tobacco, e-cigarettes and paraphernalia to the age of 21. And, according to the statistics cited from both Ms. Blumenfeld from GASP and the Commissioner of Health, if the age is increased to age 21, a person’s longevity is increased because they tend to change their smoking habits when they graduate from college therefore they are more productive citizens and lessens healthcare costs. President Harris stated the BOH started discussing e-cigarettes when they became more noticeable in the public a couple of years ago, but delayed action pending federal government regulations on the matter. President Harris stated e-cigarettes are an issue that the BOH can revisit in 2017. President Harris also addressed acquiring funding and more education on lead prevention in 2017. President Harris inquired about the HPV work Dr. Betush is conducting in the City of East Orange. Nurse Karen stated Dr. Betush is approaching the medical providers as well as community outreach through awareness so that more people will go to their providers and ask for the HPV series immunization for their children at an age- appropriate level. Nurse Karen added with the help of HO Kuteyi she would like to start the awareness at a younger age so when the children are age appropriate the parent and physician so the families are not trying to initiate the HPV series at age 18. Basically, starting earlier with prevention and education just like with lead awareness also East Orange is a target area because of the high HPV levels. Rodent Baiting Issue President Harris asked HO Kuteyi if it was routine for inspectors to go out and bate properties prior to any ground disturbance occurring. HO Kuteyi explained the bating process. He also stated the construction workers have to have an exterminator working with them on the projects and anytime there is construction work going on in East Orange and they apply for a permit, the Health Department contacts the contractor whom contacts the exterminator. Then, the exterminator and HO Kuteyi pg. 7 City of East Orange EAST ORANGE BOARD OF HEALTH NEW JERSEY REGULAR MEETING East Orange Department of Health & Human Services 143 New Street East Orange, New Jersey 07017 DECEMBER 20, 2016 MEETING MINUTES discuss how the bating will be taking place including surrounding homes, however, when they are not informed it present a problem for the Health Department. He cited the example of not being informed about the demolition project which was taking place at Columbian School on Springdale Avenue, where he had to inform the construction company the area has to be properly protected due to the high-levels of lead, asbestos and danger to the surrounding community. Additionally, he informed them that all work would have to be halted until the following Monday where he can monitor those details of the demolition project. President Harris asked about the primary party who ensures contractors are following safe procedures. HO Kuteyi stated the contractor receives the permit from Property Maintenance, however, they do not deal with the health issues. And, when they are informed about the construction projects they meet with the contractors to discuss public and environmental health issues. Mr. Henry suggested reiterating to Property Maintenance that contractors do not begin projects until the Health Department is notified so either HO Kuteyi or other health officers can monitor the project. Mrs. Corbitt suggested the process take place interdepartmentally prior to the contractor receiving the permit. HO Kuteyi added for new business a site plan should be sent to the Health Department and they visit the site to see where everything will be placed, then approval granted before the permit will be issued to the contractor. President Harris asked if this is still the process. HO Kuteyi stated they are not always informed of business being constructed. Mr. Henry suggested the issue to be addressed to the Director to ensure the proper process is being followed and documented. Reverend Maurice asked about the building on Grove Street and Springdale Avenue. HO Kuteyi stated the residents in the area complained about the construction in the area in the past because of the vermin and he had to speak to the contractor about placing black boxes in the area to deal with the issue. Closing Comments President Harris suggested that the different city boards should come together to discuss what is taking place within their various areas to increase cooperation and understanding which can help to alleviate some of the difficulties that arise from not understanding and knowing which aggravates some of the health issues. She added this can be proposed to the Director Johns particularly since the city is moving in a progressive manner which would be an excellent start for 2017. Mrs. Corbitt asked if an amplified system can be purchased for easier transcription. HO Kuteyi suggested looking into a digital recorder which can be used from the computer. pg. 8 City of East Orange EAST ORANGE BOARD OF HEALTH NEW JERSEY REGULAR MEETING East Orange Department of Health & Human Services 143 New Street East Orange, New Jersey 07017 DECEMBER 20, 2016 MEETING MINUTES President Harris thanked everyone for a wonderful year and wished everyone a Happy Holiday season. Adjournment Board President Harris requested a motion to adjourn the meeting. Motion made by board member Henry and seconded by board member Corbitt. The Meeting was adjourned at 7:22 pm. Submitted by, Sala S. Small Recording Clerk pg. 9