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 March 19, 2019 MEETING MINUTES Meeting Call to Order – 5:35 PM 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 Deanna Phillips Angela Jones-Williams Board of Health Counsel: Attorney Joseph Campbell, Attorney assigned to the Board of Health Health Department Staff: Dr. Monique Griffith, Director of Health and Human Services Victor Kuteyi, Health Officer Karen Johnson-LaRussa, Nurse, Community Health Educator Hazel Lucas, HIV Coordinator Health Department Interns: Marie Michelle LaPlante, Intern, Montclair State University-Public Health-BS Mamadi Sajawu, Intern, Rutgers University-Public Health-BS Mayoral Staff: Ms. Baldwin, Office of the Mayor Public in attendance: None Approval of February 19, 2019 Meeting Minutes: Unanimous approval. Announcements President Harris: • President Harris attended the NJEHA’s Annual Educational Conference and Exhibition, in Atlantic City, NJ on Monday March 4th. The guest speaker Maude Barlow, from 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 March 19, 2019 MEETING MINUTES Council of Canadians, presentation focused on the theme; “Our Shared Water Crisis and What We Can Do About It”. Ms. Barlow explained how water is being used as leverage for bargaining and negotiations. The event was very well attended. An informational booklet was shared amongst meeting attendees. • Extensive discussions were held regarding Pulse EMS service requesting 4 BLS vehicles to service East Orange. Statistics did not support a 4th vehicle as indicated by data submitted by OEM (15,000 call over the year). Director Griffith concurred that the number responded to by the 4th vehicle was insufficient to warrant having 4, but there was a rationale for having 3. Director Griffith surmised, if the work was evenly distributed by all 3 ambulance they could efficiently manage the load. Director Griffith concurred with the BOH, that operating with only 2 ambulances would drastically increase wait times. • President Harris requested Board members assess minutes from the Homelessness Meeting to prepare for the creation of an MOU outline. Dr. Griffith, Director - Updates: Director Griffith informed the Board that Naiima Fauntleroy of our Grants Division, is continuing the search for a grant to finance a Mobile Health Unit (to manage persons with mental health issues). Director Griffith also envisions approaching diverse agencies such as Robert Wood Johnson Foundation, American Psychological Association, Psychiatric Associations and Saint Barnabas to develop a coalition sharing resources addressing mental illness. Director Griffith disclosed that last year, EO General lost their credentialing for operating a mental health crisis unit but continues to provide limited mental health service and therefore endorses the justification for East Orange establishing its own mobile unit to effectively respond to mental health issues of our residents. Clara Maas is operating a mental illness crisis unit. President Harris inquired if Director Griffith had a chance to reach out to the VA Hospital to understand what resources they can provide. Director Griffith stated that she had not, but it is on her agenda. Director Griffith received some documentation from language vendors to review possible costs and of utilizing the service. Language Lines offer phone services for 240 languages and the capability of video conferencing for American Sign Language at a rate of $1.70 per call, which she feels is reasonable. Presently we do not have statistics on the number of patients needing interpreting services, however it is evident the service is needed due to the number of non-English speaking clients accompanied by relatives acting as interpreters. Nurse LaRussa indicated that the Police Department also uses Language Line for translation services and we should review the possibility of merging to their existing contract. Director Griffith stated she is working with legal and procurement to ascertain the Health Department’s ability to merge with the existing contract or would we need to create a separate contract. Director Griffith disclosed she currently has individuals gathering data to assist with the homelessness initiative, to better understand the matter. Director Griffith is working with different organizations that service mentally ill and homeless populations to evaluate if this is a true issue or if organizations are lacking support. Director Griffith has an employee working aggressively on gathering data to assist the Board in creating the MOU. Director Griffith’s objective is to ensure we are addressing exact issues prior to presenting evidence-based strategies to the community stakeholders. 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 March 19, 2019 MEETING MINUTES Director Griffith announced the CACFP/Nutrition Program is in the process of transitioning from the Health Department to the Recreation Department, indicating that the process began quite some time ago, and the ruling was recently made by the State, to dissolve the CACFP number under the Health Department and consolidate the two programs. The state will be terminating the program under the Health Department and transfer all sites to the Recreation Department, as of April 30th or possibly May 2019. Trustee Phillips asked what would happen to the sites and the staff currently employed within the Nutrition Program once our CACFP number is terminated. Director Griffith explained that those cites would be required to reapply for the program under the Recreation Department and normally when a grant is terminated the employees would be terminated as well. However, she is looking to reevaluate skills to ascertain where those employees will fit, since the Health Department needs reinforcement in other areas. Director Griffith believes the CFCAP doesn’t encompass the Nutrition Division, it’s a grant under the division and she is trying to reevaluate and restructure the division to determine how we might be able to maintain a Nutrition Division in the absence of the CFCAP program. Further discussion involved the rationale for removing the CACFP Program from the Health Department to the Recreation Department, the abruptness and rapidity of deciding the program conversion and the exclusion of Health Department directorship from the discussion process. Mr. Kuteyi, Health Officer – Updates: HO Kuteyi mentioned that the HIV division has a new employee, La’Nae Grant. Ms. Grant is a member of the NJCRI Newark Committee, which is another group working with HIV; she has credentials in counselling and she will be an asset to the program. HO Kuteyi was unable to procure a video of the projected building of an exercise station in Haire Park. Director Griffith stated she has access to the link and will remit to the BOH. HO Kuteyi assured the Board that the Health Department has sustained most grants acquired since 2018. A new grant was obtained for the Lead Division (Lead Reduction Grant). The grant imparts a healthy homes certificate upon owners who comply with lead regulations. HO Kuteyi conveyed the Medication Assisted Treatment Outreach Program grant for Substance Abuse concluded in June 2018. HO Kuteyi reported that he and Ms. Blue WIC Coordinator, preferred the office space at 7 Glenwood Ave as it provides a more welcoming environment for the WIC clientele. It is also the location of the Lead Program operation. At this point we are waiting for the legal department to assess the expense of renovating and renting this space. Director Griffith stated the perception is that 7 Glenwood would be more cost effective than the location where WIC is currently housed. Ms. Chesney is determining which funds in the grant can be utilized towards its housing and reporting that information to legal in preparation for negotiations. HO Kuteyi stated that Nurse LaRussa’s students gave a presentation on the importance of proper oral hygiene to WIC’s clients. He also shared that Ms. Gayle dental assistant, resigned last month and did not apply for the $15,000 grant for the 2018-2019 year. HO Kuteyi, was advised by the grantors to reapply for the grant in June 2019. We are also in the process of attempting to increase grant funding to expand the Dental Division’s staffing. Vice-President Henry asked how Ms. Gayle’s absence has affected the program. HO Kuteyi responded stating that calls are routed to the Nursing Department where Ms. Syeda schedules appointments. HO Kuteyi reviews all requisitions, approves them and orders supplies. Board member Corbitt asked about the number of dental assistants in the department and HO Kuteyi replied, currently none since Ms. Gayle’s departure. We had been operating with one but previously under Ms. Evans directorship, we had two dental assistants. President Harris asked if 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 March 19, 2019 MEETING MINUTES the new grant will allow us to have two? Director Griffith explained that staffing depends on grant funding received. Director Griffith commended Ms. Gayle for providing support above and beyond her role and imparted the rarity in finding a dental assistant that would provide that level of support especially at her pay rate. Director Griffith hopes to receive additional funding to procure an office manager who will manage the administrative part in addition to a dental assistant. If approved, the dental assistant will be paid at their appropriate rate and an office manager would provide continuity for the dentists and oversee the office itself. The goal is for there to be more support. HO Kuteyi stated that the grant only covers the dental outreach program, while the City pays the salaries of dental assistants. Health Department Staff: Hazel Lucas, HIV Program – Updates: President Harris asked Ms. Lucas to discuss her role as Coordinator of the HIV Program. Ms. Lucas communicated her functions included: ensuring the program is running smoothly, to conduct community outreach in various locales throughout the state, provide education about HIV, and to perform rapid testing on clientele. Community outreach affords her team an opportunity to engage populations in discussions about HIV/AIDS prevention and treatment. They make referrals for the necessities of life such as: food, shelter, clothing, and to healthcare specialists. They also supply condoms and discuss various methods of protection. Ms. Hazel stated her team encounters persons whom have not participated in HIV testing for a decade or more and stated that many clients regard their current sexual partner’s scarcity of testing as an indication of health. This thinking is dangerous, and is the reason so much emphasis is placed on education. President Harris asked if Ms. Hazel works with La’Nae Grant, the new HIV Tester. Ms. Hazel stated that she does and mentioned La’Nae has ties to the LGBTQ Community and also serves on a Board at Robert Wood Johnson representing that community. President Harris asked if the addition of Ms. Grant to her team is a direct result of her petitioning the State for additional funding. Ms. Hazel responded, yes it was and remarked her enthusiasm of including a person who identifies with the LGBTQ community to her team. Ms. Lucas revealed the State awarded the program an additional $2,000 for supplies, which are needed to assist clients in maintaining safe sex practices. Ms. Lucas detailed supplies typically consist of condoms, lubricants, etc. Ms. Lucas noted as of July 1st, 2019, the program’s grant funding will increase to $209,000 for the year, covering salaries and everything needed. Further discussion included: the continued rise of HIV among the African American Community; new strains of HIV resistant to anti-viral medications; the perception that HIV is no longer life threatening; and, the damage to internal organs resulting from the Truvada which is being prescribed as a prevention method for those engaging in risky sexual behavior. Trustee Jones-Williams asked if education is provided in addition to the literature. Ms. Lucas stated they provide on-site, individualized, counseling depending on the nature of behaviors and client needs during the testing/counseling session which can last between 30-45 minutes. Ms. Lucas spoke on HIV Division’s community initiative for referring those suffering from mental illnesses or sexual addictions. The HIV Division is also equipped with 3-D displays to demonstrate the effects of HIV on the body. Ms. Lucas wishes more parents were more accepting of them clarifying misconceptions about HIV, because many parents assume that their children are not engaging in sexual behaviors due to their age but that is not always the case. 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 March 19, 2019 MEETING MINUTES President Harris indicated that Nurse LaRussa and her students have several presentations throughout the schools to educate minors. Vice-President Henry questioned how the HIV Division manages communicating with those whom have engaged in sexual behavior with an HIV affected client. Ms. Hazel reported that, her Division has been able to effectively manage those calls based on the lists provided by the client. Ms. Lucas detailed a recent situation, where the client was HIV+ and had given them a list of 200 persons with whom they had a sexual encounter. Due to the considerable number of contacts they were obligated to submit the list to the State. The State was tasked with contacting everyone on the list; unfortunately, they were unable to reach some of the contacts as their information had changed. Ms. Lucas also warned although people are made aware of their positive status, due to the confidentiality clause if people refuse treatment there is no recourse. At that point the HIV Division will have to alert the State, should a person who has testing positive during the 1st round of testing, refuses to receive the results of the secondary confirmatory test which further confirms the positive status. Vice-President Henry questioned if the Health Department was aware of any cases of children being born with HIV. Ms. Lucas explained that more recently children the State has mandated automatic HIV testing for all newborns, even without the parent’s consent. The State gives reversal anti-viral drugs to any new-born children whose parents are HIV+. President Harris asked what happens if the mother ops to breast-feed. Ms. Hazel stated it is recommended that mothers who are HIV+ not breast-feed their children due to the ability to pass the virus to their baby. Ms. Hazel suggested that even with babies being on the reversal medication, the mother still should not breast feed. Nurse LaRussa Updates: Nurse LaRussa informed the Board, her students have 3 upcoming presentations on substance abuse diabetes, domestic violence, prostate cancer and dental. Her students are also continuing to work with Cicely Tyson Elementary on their annual Health Fair. At the Tyson middle and high schools, they will be focusing on hygiene, dental care and assist with the topic of natural herbal medications that the school nurses were asked to present this year. Nurse LaRussa announced she attended a meeting with the Meet, Move and Mingle Committee for a pre-event taking place Friday, May 3rd, 2019 at Bowser school from 6pm - 8pm and the main event in September. Nurse LaRussa introduced 2 of her students Marie Michelle LaPlante and Mamadi Sajawu. President Harris queried if the students would be offering a presentation from the students performing tobacco-based auditing from UMDNJ. Nurse LaRussa believes the information obtained from the student’s audits may be skewed and thought it would be more helpful if the Health Inspectors, along with herself, a nurse and the students, could audit stores selling tobacco and maybe get more community based information. President Harris offered the interns an opportunity to speak to the Board. Marie Michelle LaPlante stated that interning has afforded her with an opportunity to acquire a lot of knowledge. Nurse LaRussa commended Ms. Marie for her dedication and eagerness to learn and contribute to the team. Mamadi Sajawu stated that his experience with the team has been very informative and educating and has been a major motivator in pushing himself to work harder. Mamadi shared that he is from Gambia, West Africa; completed 3 years of public health college; and, following graduation was employed by the local hospital for three years where his focus was on vaccine immunizations for pregnant women and children under 5 years of age, health education, environmental inspections. Mamadi commented that the workload is very different in his country where resources are limited, and prevention is a chief focus. 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 March 19, 2019 MEETING MINUTES Attorney Campbell Updates: Attorney Campbell remarked with the help of HO Kuteyi the mold ordinance was presented to at the last Health Committee Meeting. The mold ordinance requires revisions, due to verbiage stipulating the BOH’s passing of ordinances; which ties into the unresolved autonomy issue. There is no State statute for mold remediation in rental properties nor is it State regulated in terms of certifications and licensing. HO Kuteyi discussed the entire mold remediation process from the beginning with tenant notification to the landlord and/or the Health Department to the end results with documentation/report from the contractor if needed; and the need for credentialed mole remediation contractors. Attorney Campbell recommended that the Health Department establish guidelines for performance and define what comprises a qualified individual in the statute of the ordinance. Director Griffith suggested we use the EPA certified program as a guideline in creating expectations for remediation which HO Kuteyi agreed. Attorney Campbell cited we still have an outstanding Body Art Ordinance; however, one currently exists as a State statute or code that regulates businesses within the Body, Art, Piercings, industry. HO Kuteyi reminded the BOH of an existing ordinance that requires all businesses, operating within the City of East Orange, must register and pay licensing fees; therefore, being subject to inspection by Public Officers. HO Kuteyi shared the ordinance could be utilized to impose an inspection fee on those industries. Director Griffith added, the inspection fee would be similar to immunization audits, where the fee covers efforts by the staff to perform those inspections. Ms. Baldwin Updates: President Harris inquired if Ms. Baldwin had any updates on the planned conference, with City Officials, by legal experts to discuss issues related to recreational marijuana or e-cigs. The event was postponed due to conflicting schedules, but the subject will be revisited. President Harris affirmed the Boards concerns surrounding the usage of e-cigs, its harmful effect and the current trend of targeting young people. HO Kuteyi indicated that the e-cig ordinance had not been passed. Ms. Baldwin shared with HO Kuteyi circumstances surrounding discovery of mold at Housing Authority properties. Ms. Baldwin stated State Health Inspectors are inspecting the homes due to resident complaints and declaring mold infestations. An extended discussion ensued. HO Kuteyi stated upon notification of complaints, the Health Department inspects those locations and contacts Property Maintenance in an interdepartmental collaborative effort and requested that Ms. Baldwin continue to remit any constituent complaints received about the Housing Authority to him via email. In response to Vice President Henry’s question, HO Kuteyi stated that mold itself is visibly identifiable, however, mold spores which are airborne are not. In certain scenarios, the Health Department has outsourced the identification of mold spores to result in the remediation. HO Kuteyi stated the absence of a mold statue, means tenants can’t legally sue landlords for the presence of mold. However, NJ also says, if a tenant discovers mold in their home, they can either hold the rent or deduct funds from the 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 March 19, 2019 MEETING MINUTES rent to remediate this issue. Director Griffith acknowledged the importance of maintaining interdepartmental communication since Building’s codes will account for the moisture which generates mold (a Health Department issue). President Harris praised HO Kuteyi for working diligently to ensure a task force was formed between the various departments. HO Kuteyi reiterated the task force is comprised of Planning, Property Maintenance, and the Health Department. HO Kuteyi noted those departments communicate potential issues and come together to resolve them as a team. Upon discovering a severe situation, the person or persons affected will be removed from the home; allowing the homeowners time to remediate the issue. Open Discussion: President Harris asked members for their feedback on the Homelessness Meeting Minutes that provide contextual points that can be used as an outline in creating a MOU. As this is a public health concern, the BOH will take the initiative and work with community stakeholders. Director Griffith identified numerous organizations throughout East Orange are currently assisting various populations perceived as homeless and offering their own programs and support. The MOU would allow us to formally create a coalition between the Health Department, Boarding Homes, and any additional entities that may not have enough resources and extend support where needed. Director Griffith shared these organization’s lack of resources has possibly resulted in a lack of oversight of that population during daytime or weekend hours. The lack of oversight may be the cause of panhandling and disruption of services operated by our stakeholders and eliciting the perception of having a higher number of homeless individuals. Trustee Jones-Williams indicated she researched and observed the healthcare provided to Boarding Home residents and was made aware that residents are posed with a curfew and not allowed admittance if they are unable to meet curfew or provide advance notification for the delay. Trustee Jones-Williams stated this creates a cause for alarm as the facility should always be aware of its client’s whereabouts. Trustee Jones-Williams suggested the BOH also review the facilities in addition to the shelters and boarding homes to ensure they are keeping track of their participants. Ms. Baldwin asked if the MOU is geared towards specific populations of homelessness? Director Griffith stated the data collection phase should allow us to evaluate distinctive characteristics of the population we are aiming to address. Director Griffith declared it is possible some residents may be homeless due to having an undiagnosed or untreated illness or possess deficient resources. Ms. Baldwin affirmed many persons coming to constituent services are homeless, but they are employed. So, they are working but are not earning enough income to afford housing. President Harris asked if we were privy to anyone renting singular rooms in private homes. Ms. Baldwin acknowledged we do come across these types of rentals, but they are illegal. Ms. Baldwin stated we often discover these illegal rentals following a constituent complaint. Trustee Corbitt mentioned younger residents also face homelessness once they advance beyond the foster care age requirements. President Harris concurred she felt young populations were not considered when reading the Homelessness Meeting Minutes. Director Griffith 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 March 19, 2019 MEETING MINUTES shared she is in the process of collecting data from organizations whom are already assisting those populations. Vice-President Henry suggested obtaining current data will aid the BOH in focusing on the categories of populations we need to address. Director Griffith will furnish the BOH with copies of the collected data to support a formulation of concepts for the board. Trustee Corbitt asked what we are classifying as data during the collection phase. Director Griffith expounded upon the two types of data collection qualitative and quantitative. Director Griffith has not been apprised of the types of data the community stakeholders possess but we are interested in procuring it to facilitate an MOU. Trustee Corbitt communicated an upcoming event for the Historical Society of East Orange. The theme of the event is, “Preserving the Past for the Present to Prepare for the Future”. The Historical Society is preparing to create an MOU to address re-development in East Orange and how that impacts historic buildings throughout East Orange. Trustee Jones-Williams revealed her participation in the “Adopt-A-Nursing Home” Organization. The program selects a different nursing home each week and interviews its residents. Upon conducting the interview, permission is gained from family members to publish the information. Trustee Jones- Williams shared a plethora of history and knowledge can be discovered from the residents. At the conclusion of Board business, President Harris adjourned the meeting at 7:40 pm. Respectfully submitted, Jo-Ann Mills Board Clerk pg. 8