Board of Health

EAST ORANGE BOARD OF HEALTH City of East Orange REGULAR MEETING East Orange Department of Health & Human Services NEW JERSEY 143 New Street East Orange, New Jersey 07017 September 20, 2022 MEETING MINUTES Meeting Call to Order – 5:40 PM Board Vice-President Horace Henry 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. Zoom Communication ID: 815 8876 4961 Meeting Link: https://us02web.zoom.us/j/81588764961?pwd=aUZRbFBVeUJHZThxeDBiUkxYK2Zsdz09 After the roll call, it was determined there was a quorum to convene the meeting. Board Members Present: Christine Harris, President - absent Horace H. Henry, Vice President Tobbia M. Corbitt Deanna Phillips Angela Jones-Williams Dr. Tonya X. Cook Council Liaison: Tameika Garrett-Ward Board of Health Counsel: Attorney Javonna Baker Health Department Staff: Yvonne Blake, Acting HHS Director Lia Hodges, Manager Mayoral Staff: None Guests: None pg. 1  EAST ORANGE BOARD OF HEALTH City of East Orange REGULAR MEETING East Orange Department of Health & Human Services NEW JERSEY 143 New Street East Orange, New Jersey 07017 September 20, 2022 Public in attendance: None Approval of July 19, 2022, Meeting Minutes: Approved Unanimously Vice-President Henry Announcements: New Director & Staff Welcome Vice-President Henry welcomed and congratulated Ms. Yvonne Blake on her recent appointment as Acting Director of Health and Human Services and her staff member Lia Hodges. They are both in attendance at this meeting. NJLM Vice-President Henry reminded the Board about the upcoming annual League of Municipalities Conference in Atlantic City, which runs from November 15-17. The conference features many informative sessions that board members can attend. Vice-President Henry reminded board members to make the required provisions through the health department if they plan to attend. Director Blake Updates: Welcome Director Blake said it is a pleasure meeting everyone and knowing we have a functioning BOH overseeing this department. Director Blake mentioned how needed the BOH was and hoped they could collaborate to achieve the appropriate goals for our community. Dental Program Director Blake announced her efforts to revive the dental program. She will apply for a small grant and hopes to be qualified to receive the award by next year. We also have a meeting scheduled for Thursday, September 22nd, with Dr. Barden and Dr. Barrett, our former dentist, to discuss how we will move forward and put the dental clinic back together. This discussion will include assessing our current dental equipment and what new equipment will be needed. We have most of what was purchased, so we are not going to dig too deep into the City's pockets. However, we will need an x-ray machine and perhaps a new dental chair. pg. 2  EAST ORANGE BOARD OF HEALTH City of East Orange REGULAR MEETING East Orange Department of Health & Human Services NEW JERSEY 143 New Street East Orange, New Jersey 07017 September 20, 2022 Ms. Blake and her team spoke with the dental assistant who was here before the clinic was closed, and she is excited about coming back and being a part of the team. So that was good news. Another significant interest is to bring our dental services back to the school system. Director Blake reached out to Deborah Harvest, an administrator with the EO school district, to facilitate the process of bringing our services to the schools. Director Blake mentioned our dental clinic used to provide dental exams and make referrals when needed in the past. And it is needed once again. We will also provide the children with a letter identifying current and potential dental problems and recommendations for going to their dentist or our clinic. Environmental Health Health Officer Director Blake shared they currently do not have a health officer. So, we are utilizing the services of Vinny, the Health Officer from the Orange Health Department. The current agreement states we pay him approximately $1,000 per visit. So, we drafted an MOU to amend the terms of the agreement to contract his services monthly, which would be cheaper than paying him per visit. We are waiting on the MOU we drafted to be reviewed by the business administrator, Mr. Steplight, and our legal liaison before its execution. Currently, Vinny is providing needed services for the department; however, Director Blake expressed concern regarding the lack of an internal health officer. Director Blake shared they are in the process of scheduling interviews for the Health Officer position in the coming weeks. BOH members were invited to participate in the interview process. Environmental Staff We also need a senior inspector and a part-time inspector for the evening. So hopefully, we can move in that direction. Director Blake stated that 350 businesses manage food in our community. And as you know, we only have two and a half inspectors. So, we cannot allow the food in this community to not be supervised in some way. Looking also at the food trucks, they have a license to operate in East Orange. Director Blake advised the inspectors to ensure the food trucks are operating with licenses and to proper safety standards. We need to know where the food is coming from, where the food is prepped, etc. We must get a little handle on that. But, again, with two and a half inspectors, achieving this is challenging and potentially dangerous for residents. Vice-President Henry concurred, stating that they are not only concentrating on food hygiene, food safety, and constituent complaints. Vice-President Henry wished the HD luck finding qualified candidates to fill these positions and hoped the administration could find a speedy pg. 3  EAST ORANGE BOARD OF HEALTH City of East Orange REGULAR MEETING East Orange Department of Health & Human Services NEW JERSEY 143 New Street East Orange, New Jersey 07017 September 20, 2022 resolution to address this issue. EO is too large a community for us to operate with such a minuscule staff. Director Blake shared she spoke to the business administrator, and he is open to giving us what we need because it is a liability for us if we give the license out and we are not doing a proper follow-up. Annual Inspections One of the difficulties the REHS' are having relates to annual inspections. For example, if a school or restaurant inspection occurred in October of 2021, by the code, they cannot inspect the facility again until October 2022. Except for cases where a complaint has been lodged against a facility, they have to come back annually in October. Director Blake advised the inspectors that she is uncomfortable with schools only being inspected yearly. You are talking about a school, the cafeteria, and hundreds of children. One inspection is not enough. So hopefully, the Board will support us in putting together an ordinance that says they have to check at least three times a year. The ideal inspection times would be August, Christmas vacation, and Easter vacation. Vice-President Henry asked if the ordinance requires inspectors to perform school inspections three times a year. Director Blake stated the ordinance was drafted long ago and only requires annual inspections. Lead Hazard Program Updates: Program Extension Director Blake advised that she requested an extension from the federal government for our Lead Hazard Control and Healthy Homes program. This program receives federal grant funding for the remediation of homes where lead is present. In the contract terms, we specified the number of homes we would remediate annually. However, due to COVID and other factors, we could not meet that quota. We could not do it because we could not get into people's houses because of covid. So therefore, we fell short in our numbers. So, we asked for an extension. They received our first letter, but today we had to send them a specific letter asking for just the extension. So that went out today. And hopefully, that will give us the time we need to get about 40 to 45 houses abated. Lia stated they denied our first three requests, even though it was a covid matter. So, this is our fourth request. We brought Mr. Steplight in, so we understand that it is not so much of us losing money; it is more about being realistic about what we can do with our staffing. The program needs a second inspector, and we also need assistance from another program to address that EBL, the elevated blood levels. pg. 4  EAST ORANGE BOARD OF HEALTH City of East Orange REGULAR MEETING East Orange Department of Health & Human Services NEW JERSEY 143 New Street East Orange, New Jersey 07017 September 20, 2022 So, we are at a little bit of a riff in the road right now because we initially had forty-two units to cover over the period. Then, the feds offered us additional money, which upped the number of houses in our quota. That put us behind the eight ball simply because you have one inspector who is a program coordinator, and you are asking him to do 110 units without a proper system in place. The State is refusing to give him access to that system. Although we have an internal program that could give him access, that is also direct. It is also causing the inability to complete the requirements successfully. So, we have a few things that are roadblocks for us, and we do not want to lose a grant. So that is why we have now asked for this fourth extension. And we believe, after speaking yesterday with the grant overseer, that we will get this extension, but this is the only one they will grant us. Vice-President Henry asked if the extension would be indefinite. Lia stated it would not be. They are going to cap it. So, what was said to all, Director Blake, Mr. Steplight, and Mr. Salaam, instead of us asking for 12 months, let us be a little more willing to bend and give to them and ask them for nine months. And we will work in tandem with our part-time inspector in the evening. Mr. Salam is willing to do so. So, he is splitting his day with us. He will give us morning, and he will also give us night so that we can cover more territory. Lead Hazard Staff We'll soon post for a part-time inspector and a part-time receptionist in that area. Vice- President Henry asked if they are also looking to hire a full-time inspector for the lead program. Lia explained the grant only allows us one more inspector. So, we, what we did was that we decided to get two part-time. And then Mr. Salaam would continue as our full-time staff. So, we at least have three people versus two. Upcoming Lead Abatements Dir. Blake shared we have six potential lead abatements scheduled to begin on October 3rd. Two are definite. And the other four are pending. We had an abatement scheduled today; however, we had to push it back because the contractor did not follow our protocol and process properly. So, we did reach out to him and just let him know that he has to follow the City's process and protocol. And that just pushed us back. VP Henry asked if this was sufficient time for everything to be in place. Dir. Blake stated yes, we only need five days to prep to move the family for the temporary stay. So, the scope of work should be able to be completed within that time. Major Program Roadblocks The primary issue there is the Childhood Lead (CL) and the Lead Hazard (LH) program. These programs are supposed to work in conjunction with each other. The Childhood Lead program should provide information to the Lead Hazard program for homes where the children tested positive for EBLs. The LH program can then offer lead remediation services to those residents. pg. 5  EAST ORANGE BOARD OF HEALTH City of East Orange REGULAR MEETING East Orange Department of Health & Human Services NEW JERSEY 143 New Street East Orange, New Jersey 07017 September 20, 2022 However, the CL program is not sharing the information siting HIPPA laws. Because of the lack of shared information, we have to knock on every door to see if we can offer services. If we can get the list that the Childhood Lead coordinator receives from the State divulging the names of children in the State of New Jersey who tested positive for lead, we would go to those houses and start the process. The coordinator is on vacation right now, but when she returns, Ms. Blake will ask her to show the HIPAA laws stating that she cannot provide us with that information. So, it is impacting the grant that we have for the lead abatement. We tried to access the State's system, but we were denied. VP Henry stated the law she is speaking of is technically not HIPAA; it is Regulation 8-51. However, the information does not deny Mr. Salaam, a lead inspector risk assessor. The State does confirm that all lead inspectors and risk assessors can access it and nurses in case management. Dir. Blake confirmed he is still currently licensed. However, for us to have received the grant for the lead hazard control program, which they requested, was predicated on their sharing that information. For whatever reason, a conversation must have gone forth. And now the State refuses to give Mr. Salam that program the necessary information. So, unfortunately, the truth is that the Childhood Lead program is preventing us from achieving our numbers. We could lose the grant if we did not get what we needed. VP Henry added it is a pity that you do not have a resident health officer. A health officer would help because the health officer is the HD's technical CEO. But then, the director is more on the administrative side, and the health officer is the technical person responsible for all the technical programs. So, this again underscores the urgency of having a health officer in place. Dir. Blake asked if the health officer is permitted to provide that information to our Lead Hazard coordinator. VP Henry concurred. Quarterly Audit Ms. Blake shared that the HD is in the process of a quarterly audit. That is due to the State. It is usually an audit that the State does, but now they just keep pushing things to all the different agencies to do it for themselves. So, we have this audit that we have to send as soon as we can put it together. The audit is requesting information as far back as fifteen quarters. Other Health Department Staff Dir. Blake revealed multiple requests by employees for transfers. She asked the staff to explain why they wished to be transferred from the Childhood Lead program. There currently seem to be issues stemming from harassment and intimidation. And it is, and it is not good at all. We spoke to the HR director, who asked that we refer them to her, and she would manage it. Dir. Blake stated she takes harassment claims seriously and will be recommending training for all pg. 6  EAST ORANGE BOARD OF HEALTH City of East Orange REGULAR MEETING East Orange Department of Health & Human Services NEW JERSEY 143 New Street East Orange, New Jersey 07017 September 20, 2022 managers. VP Henry thanked Dir. Blake for being observant and mindful of what needs to be done. From a management and leadership standpoint, we have to ensure that our staff are comfortable and as much as possible and give them whatever it takes to perform their job. Dir. Blake stated she is looking to increase the salaries for HD positions. She added to ask someone, particularly a health officer or inspectors, to come here for 95,000 is absurd. Even in the substance abuse field, employers offer $10 to $20,000 more than we do. So, we must think logically, will we continue to hold onto the best at the current salaries. While the staff may love this City and their community, they must eat, pay their bills, and care for their own families. Nursing Updates: Staffing Dir. Blake revealed, they are waiting for the business administrator to approve the hire of a nursing supervisor. As soon as we receive the approval, we can onboard our nursing supervisor, making life much easier for the nurses. Much, much more manageable. Also, there are some salary adjustments we must review. The medical field is very competitive. We asked Mr. Steplight about increasing the salaries for these positions so that we can become competitive enough to get the best and hold onto the best. Mr. Steplight advised it was best to wait until the union contracts had been passed before proceeding. Dir. Blake stated she might also hire additional nursing staff as there is a shortage in that area. We are looking for one nurse to help with the pediatrics, the STD, and STI, and one to deal with the vaccinations, immunization, HIV, and PrEP. We also need a specialist nurse in substance abuse. Unfortunately, these nurses are harder to come by as they must have a minimum of three years in a treatment facility and a BSRN. Substance Abuse Updates: Building Conditions Dir. Blake shared they are still waiting for the inspection of the elevator. Substance Abuse currently has a conditional license with the building. In the 38 years, the program has been in operation, we have never received a conditional license. The conditional license is not due to a program error but the building owner who has not kept the facilities, particularly the elevator, in working condition. Last week the elevator was out of order. With the elevator out of order, transporting supplies and medication up multiple flights of stairs has been difficult. However, we are still doing pg. 7  EAST ORANGE BOARD OF HEALTH City of East Orange REGULAR MEETING East Orange Department of Health & Human Services NEW JERSEY 143 New Street East Orange, New Jersey 07017 September 20, 2022 everything we need to comply with the State to ensure everyone gets their medication daily because of the severe need. Dir. Blake shared she sent a follow-up email to Dr. Gandhi, who owns the building, to let him know that while both elevators are working, we have not seen the inspection placard. The State's asking me for evidence that the elevator has been fixed and is up to code. So, an email was sent to Dr. Gandhi asking for this information. We are again holding onto his rental payment as these are consistent, ongoing issues with the building. Medication Pump Dir. Blake shared they require a medication dispensing pump that costs approximately $8,000. The one we have is old, and the requirements for measuring the meds are stringent. So, the staff has been measuring manually, but we do this for 150-200 people daily. We must ensure the measurements are accurate to comply with State and Federal regulations. There are constant assessments done by the DEA, Medicaid, and Medicare, and they come in to check our books to see if the billing is correct. Unfortunately, we lack funding as the majority is being sent to relieve towns in South Jersey. VP Henry asked if we are held to these assessment stipulations in East Orange. Dir. Blake concurred, stating that even though we are in EO, we are still held to these stipulations by the agencies mentioned earlier and other State and Federal agencies such as the Attorney General, Damas, and the Department of Health and Addiction Services. EVOLVE Software We're also updating our software to include electronic record-keeping. It is expensive for record-keeping and billing. However, we met with Net Smart today, and from that conversation, we realized we could also use the record-keeping software for HIV, STD PrEP, and pediatrics. The program costs roughly $153,000, but we can add up to fifty-five users. So, we are in the negotiating stage, and we requested a breakdown of the exact cost so the figures can be submitted to Mr. Steplight and the Board in our next meeting. VP Henry asked if the $153,000 was a one-time fee or an annual cost. Dir. Blake stated that $153,000 is the program's initial cost, and maintenance fees will be charged monthly. Dr. Cook asked what the name of the record-keeping software was. Dir. Blake shared that the software is called EVOLVE. Dr. Cook stated since the department has many divisions, we should also include dental in the electronic record-keeping since the program is being resurrected. Dir. Blake concurred, stating that is why she selected a program that functions with up to fifty-five users, so we can allow multiple divisions to use the services. Vital Statistics Updates: Copy Machine pg. 8  EAST ORANGE BOARD OF HEALTH City of East Orange REGULAR MEETING East Orange Department of Health & Human Services NEW JERSEY 143 New Street East Orange, New Jersey 07017 September 20, 2022 Dir. Blake shared she ordered a new copy machine for Vital Statistics as they need one urgently. The current copier is making streaks down the center of the page, which can cause their documents, such as birth certificates, marriage licenses, etc., to become void. And we have to pay for each page we use, including voided pages. So that is extremely costly because the State tracks every page. The registrar, Ms. Cynthia, stated they had ordered copiers in the past only or them to be redirected to other divisions by previous directors. Dir. Blake advised the new machine should be arriving in the coming weeks. Digitalization of Records Vital Statistics has records they cannot touch because the material they were printed on is old and delicate. So, therefore, we need to begin the process of digitalizing the records. Dir. Blake stated she would share a proposal that should outline the cost and how the digitalization process works. Outside Kiosk We are thinking about obtaining three kiosks and placing them outside. This will allow individuals to receive services at the kiosks, mainly when the staff is busy helping other clients. Ms. Cynthia sent Dir. Blake, a proposal for this free service. Once the proposal is reviewed, we will share it with the Board and appropriate parties. Weights & Measures Updates: Director Blake stated she wants to promote the current assistant Superintendent of W&M to the Superintendent position. He will also need to be trained in measuring cannabis products. Once we open dispensaries, he will be tasked with checking the weight and measure of the cannabis they are serving and seeing if those weight machines are correct. Dir. Blake stated the cannabis training might be located in Atlantic City, but David will provide her with the information. WIC Updates: Relocation Lia shared the WIC division is operating in an unsafe space. We pay close to $10,000 monthly for rent without proper safety precautions for staff and amenities. As a result, some unsavory individuals hang around the building even into the late hours, when staff may still be working. There is a lack of quality security to ensure the safety of staff and clientele, primarily women. They also have issues with the HVAC system, and the heat and air conditioners are not working correctly. Chesney concurred, stating the issues in the building are severe, and a move is needed urgently. pg. 9  EAST ORANGE BOARD OF HEALTH City of East Orange REGULAR MEETING East Orange Department of Health & Human Services NEW JERSEY 143 New Street East Orange, New Jersey 07017 September 20, 2022 The staff cannot service their clients to the best of their abilities based on their environment. Lia shared she has gone to two locations to scope out a potential new environment for the staff and has advised Mr. Steplight of the same. They are in an office space with about thirteen offices and four bathrooms. So, we need something as compatible. We tried making arrangements with both 7 Glenwood Avenue and EO General before they transitioned into CareWell Health. But rents are high everywhere, so we are looking into a nearby facility in the hopes that it will provide us with a safe and affordable environment for the WIC program. We will need about three months to relocate the staff as the program requires, we notify the State before moving. VP Henry inquired about the status of the renovations in the new building. Lia shared that a pipe burst in the building, which caused flooding. This set back the renovation process. We do not have a timeline for when the renovations will be completed in that space. VP Henry commended Dir. Blake and her staff and stated they have the Board's support in these endeavors. Outreach Chesney shared she and her staff are receiving a lot of outreach requests. So, we are trying to ensure that we are out in the community doing outreach. We do an excellent outreach in Orange monthly, capturing many people from the Orange area, especially bilingual residents, with the interfaith food pantry organization. They do a food drive and diaper giveaway once a month. So, we have been going to that, and that is working well. And we will try to head out to some other outreach events throughout the fall before it gets too cold. VP Henry asked if, apart from the matter of building safety, they are reaching their program goals. Chesney concurred, stating the program continues to grow statewide. WIC is continuing to grow. So, we are doing well in that regard. Attorney Baker Updates: Cannabis Ordinance VP Henry asked if there are any updates regarding the cannabis ordinance. Attorney Baker stated there are no updates at this time. Barbershop, Nail Salon, and Cosmetology Ordinance Vice-President Henry asked if there were any updates regarding these items. Attorney Baker shared that the ordinances were brought up right before Dr. Griffith left, so there has been no movement. But now that we have Director Blake here, we may have some updated information by our next meeting. pg. 10  EAST ORANGE BOARD OF HEALTH City of East Orange REGULAR MEETING East Orange Department of Health & Human Services NEW JERSEY 143 New Street East Orange, New Jersey 07017 September 20, 2022 Open Discussion: The Apothecarium Dispensary Visit Vice-President Henry stated the City and BOH are interested in what other municipalities are managing dispensaries in their community to understand better what to expect when we open dispensaries in EO. A tour of The Apothecarium Dispensary in Maplewood, NJ, was scheduled for BOH members this Summer to facilitate this process. Vice-President Henry asked board members to share their experiences during their tour of the Apothecarium Dispensary. Trustee Corbitt shared she found the tour very informative. The facility is very consumer friendly. Trustee Corbitt stated the facility caters to both recreational and medicinal clientele. The person who gave us the tour was very energetic and informative in explaining everything. Trustee Jones-Williams shared she could not open her notes from her phone but stated the hiring process enthused her. She shared that the facility actively hires a certain percentage of staff residing in the community they serve. This hiring practice is a part of their business formula, which allows them to give back to the community. They also hire people who were previously incarcerated for marijuana offenses. So, they try to employ those types of people, which is good. The Apothecarium provides excellent customer service and assists those looking to purchase cannabis products. So, for example, if someone comes in and does not know what type of cannabis product they want to use, the staff will direct them to the appropriate product based on their needs. During the tour, they learned there are different types of marijuana. So, for every type purchased, they have a little reading about all the types and brands they are and their usage. They shared the types we could use if we had specific issues, such as trouble concentrating or being relaxed. So, we came in thinking this is not something we would want in our community. But the tour was enlightening and gave us a different perspective on cannabis and its multiple uses. All cannabis sales are controlled. The dispensary keeps records on who they sell to and are knowledgeable about their clientele. Trustee Jones-Williams shared the dispensary has separate parts of the building to serve its recreational and medicinal clientele. So, one side is pg. 11  EAST ORANGE BOARD OF HEALTH City of East Orange REGULAR MEETING East Orange Department of Health & Human Services NEW JERSEY 143 New Street East Orange, New Jersey 07017 September 20, 2022 strictly for recreational, and the other side is strictly for medicinal. So those with medicinal prescriptions can only be seen seven or eight to a specific time. And then, they open to the general public, where recreational users can also come in and purchase their product. Trustee Jones-Williams shared she liked that the facility does not mix the two populations. Trustee Jones-Williams stated she would try to have her notes prepared for the next BOH meeting. At the conclusion of Board business, Vice-President Henry adjourned the meeting at 6:57 pm. Respectfully submitted, Jo-Ann Mills Board Clerk pg. 12