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 October 17, 2023 MEETING MINUTES Meeting Call to Order – 5:37 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. Zoom Communication ID: 867 5391 1200 Meeting Link: https://us02web.zoom.us/j/86753911200?pwd=bEdNZG9neDFVcmlLdUNxN3pjR3RhZz09 After the roll call, it was determined there was a quorum to convene the meeting. Board Members Present: Christine Harris, President Tobbia M. Corbitt, Vice-President Deanna Phillips Angela Jones-Williams - absent Dr. Tonya X. Cook Council Liaison: Mustafa Al-M. Brent - absent Board of Health Counsel: Attorney Emeka Madubuogo - absent Health Department Staff: Yvonne Blake, Acting HHS Director Health Officer Vincent DeFilippo, Orange Mayoral Staff: Jada Braime-Butler 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 October 17, 2023 Guests: None Public in attendance: None Approval of September 19, 2023, Meeting Minutes: Approved Unanimously President’s Announcement A Board of Health meeting is scheduled with Mayor Green on October 23rd to discuss health department issues. Director Bladke Updates: Dental Clinic Dir. Blake asked for guidance on how to get the dental clinic up and running. Dr. Cook explained that the area where the dental clinic was housed could have been more conducive to an effective clinic. The clinic, as it stands, would most likely not pass a State inspection, and we would have to wait until we can remodel or relocate into a new building. Dr. Cook stated we want to provide as many comprehensive services to the community as possible, and a dental program will undoubtedly be one of them. Still, she doesn’t see how the current space can be repurposed to accommodate new dental equipment, especially with the other outstanding structural issues plaguing the building. President Harris asked if the grant funding could be applied to the dental clinic renovations. HO DeFilippo stated that 50% of the cost of structural renovations could be paid for using the grant funding. Requisitions & Purchase Orders Dir. Blake stated she is trying to catch up with their requisitions and POs. Dir. Blake shared they fell behind because her staff managing that process had to go on medical leave, and she could not get permission to have them processed remotely. We are now ensuring these bills are paid for the items we need. Dir. Blake reminded the Board that Finance would close down some accounts around late November. President Harris asked how much money has been spent from the NJACCHO grant. Dir. Blake stated we hadn’t gotten any bills yet; however, they have repaired the first and second-floor restrooms and are moving forward with FileBank. President Harris asked if WinWam was also operational within the department. Dir. Blake stated she still plans to retain WinWam’s services but noted there were issues having a contract drawn up with Dell so that we can tailor WinWam for use with our current software. 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 October 17, 2023 Technology Dir. Blake mentioned that during their crisis shutdown, Mr. Ankrah could not support the medical team, so she spoke with Al Holmes of IT to ascertain the cost of acquiring laptops, desktops, and cell phones to update the staff’s IT equipment. The equipment would be utilized either daily or for emergency purposes. Ms. Braime-Butler suggested that we be mindful of the amount of equipment we order since there are continued fees associated with some equipment, such as cell phones. Mr. Ankrah shared that the equipment would be required for the clinics and other divisions to utilize during outreach efforts. Dr. Cook suggested that a more accurate number be provided for the amount of equipment we order, which may assist in justifying a large order. Dir. Blake shared they are also installing a new generator to provide power in a blackout. President Harris asked if the IT work was completed at the Grove Street location. Dir. Blake stated the IT Department has begun the work for the LHCHH offices, but it is not yet completed. President Harris asked if the LHCHH program could function without the completed IT work. Dir. Blake stated they are functioning with the help of Ms. Hagler and her team. Homelessness Program President Harris stated she heard a homeless program would be in place where the lead program was evacuated on the second floor. Dir. Blake concurred, stating she met with Mr. Blakely, who is heading up that program and will conduct outreach in addition to three staff members. The program will receive calls or complaints, and they'll go out to assist. Those in need will not be coming directly to the HD for resources. HO DeFilippo Updates: Grant Spending HO DeFilippo shared the HD needs to spend approximately $270,000 a month before June of 2024 from the awarded funds. President Harris asked if we had spent any of the funding. HO DeFilippo stated we had not spent any funds but offered suggestions for the funding for HD renovations. Department Renovations HO DeFilippo stated that in addition to the bathroom renovations, they have ordered new counters and are repainting the Office of Vital Statistics. They will also be painting the second floor of the HD and have a list of other renovations that will be addressed, such as getting new air conditioners, secure cabinets, and doors for the Nursing Division. Dir. Blake shared they are also installing a new generator to provide power in a blackout. This will ensure that items 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 October 17, 2023 such as vaccines will still be kept at temperature in the event the primary source of power is lost. Chief REHS Updates: Environmental Inspections Mr. Henry shared that the Environmental Health Division continues to investigate constituent complaints. We have received 309 complaints for the year, with 46 complaints resolved and closed. We try to close out our complaints with a short enough turnaround time rather than having them lingering. Most of our complaints involve mold with mold issues, which has been a big problem within the City. Once we intervene, we get compliance from mainly, if not all, the landlords, property owners, and property managers to rectify these issues. Another major complaint involves pests such as insects and rodents. Mainly, we are finding that bedbugs are increasing in other places. Some residents are picking up furniture that has been discarded without knowing the items have been infested with bedbugs. This has been a major proponent in their spread. President Harris asked if the bedbug infestation has to be addressed in an entire dwelling. Mr. Henry stated that the entire apartment or dwelling must be addressed when mitigating a bedbug infestation because they migrate. So, you must concentrate your efforts within a certain radius, just like we do for mosquito control. So far to date, we have done over 200 inspections, with 193 of those being satisfactory. Thirteen conditional placards were given, and two establishments were closed. In addition, 31 still needed to be posted. Sometimes, we do spot-check inspections to ensure continued compliance from our establishments. Water Shutoffs Water shutoffs are a significant concern affecting tenants. We intervened in 29 water restoration shutoffs. Many landlords and property owners are not paying the water/utility bills even though tenants are paying rent. We offer a service by collaborating with the EO Water Commission to provide 10-day water restorations for tenants who are elderly, children, or health-compromised residents. The 10-day period allows the landlord or owner to make payment arrangements with the Water Commission. The restoration can only be done once a year. After a collaborative meeting with the Water Commission, they have begun applying lien tax liens to people's property. This new measure has made property owners leery of not paying their water bills. Dir. Blake shared that most of these individuals who owe an astronomical amount of money are not the average homeowners in this community. We're talking about water bills in the tens of thousands. These are not the average people living in their homes and struggling to pay 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 October 17, 2023 their bills. These people own many properties and need to pay their full share. And the dilemma that is plaguing the Administration is when the water is shut off, the tenants suffer. We have to figure out how we are going to navigate this. Dir. Blake shared that she spoke with Tony Jackson, the Chief of Staff, who has an idea that may mitigate this issue. Hopefully, we will get an opportunity to implement his plan. President Harris asked if the Water Commission had something in place that signals when the bills become astronomical. Dir. Blake reiterated that these are mainly apartment buildings and that the tenants would be affected by the shutoffs, which leaves the Commission in a bind. WIC Updates: Telephone System Repairs Ms. Braime-Butler inquired about the status of the WIC division’s main number. She shared that she has received several calls from constituents trying to get in contact with someone in the WIC office, and they've been told just to keep trying several times, even when they come in person. Ms. Blue stated their phone system has not been working correctly since 2021, which has been communicated to the Administration. Ms. Blue stated she and her staff have been using cell phones to communicate with constituents, but sometimes it can be difficult with the cell phone since we don't have one central number for the program. So, she usually gives out the receptionist’s cell phone number, and people can call and text it or email us. The email address is wic@eastorange-nj.gov, and people could reach out that way and receive a quick response to their inquiries. President Harris remarked that she was under the impression they were already working on WIC’s telephone system. VP Corbitt concurred, stating that was a conversation had months ago, with Ms. Blue stating for some time that their phone system had been compromised. Ms. Blue shared that everyone assumes we're not picking up. The phones just really don't work right now. Sometimes, calls come through, but we cannot click over if we are on another line due to a lack of an adequate call waiting system. Ms. Blue stated that she looked at the call log today, and they received 300 calls with only four lines. So, of course, some constituents will fail to get through. Ms. Braime-Butler asked Ms. Blue to email herself and Ms. Pearson, who assists in ensuring the wiring systems are up to date, as a possible solution to the phone issues. Clientele Increase Ms. Blue shared that there has been an increase in WIC clients statewide, leading to an increase in our clientele. We do not have the staffing to take care of all these clients. This is a statewide issue and is not only affecting our operations. We are having a shortage of WIC 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 October 17, 2023 nutritionists to come on because the salaries are low, and the job can be stressful. We are also in the process of uploading benefits to our clientele’s accounts, which are done manually. We hit a snag with the threats of a possible shutdown, causing a stall in the USDA’s ability to get things through. President Harris asked how many of the influx of patients are relevant to East Orange. Ms. Blue stated at least 70-75% of her clientele are East Orange residents. And this is from a caseload of about 5,000 people, which is a significant increase. Before COVID, we had about low 4,000. Since COVID-19, especially since June of this year, everyone has gotten more clients into their clinics because of the rising cost of food and the new immigrant population. So that's why there has been an influx. We went from statewide 126,000 people before COVID-19 to over 160,000. So that's a big jump. And currently, statewide, we just don't have the infrastructure to handle all these people right now, to be honest. We need better technology; we need more staffing. Those are the two things that are an issue. And honestly, we need more bilingual staff too. We have a meeting with the State because many WIC directors face the same challenges. President Harris asked how many of the influx of patients are relevant to East Orange. Ms. Blue stated at least 70-75% of her clientele are East Orange residents. President Harris complimented Ms. Blue on the tremendous job she and her team are doing despite the staffing and phone system issues. Nurse Karen LaRusso Updates: Outreach and Education Nurse LaRusso shared that she and her team did a tremendous job with outreach and education, with over 25 community outreach and education sessions completed this year. Add all the pieces from the other teams available at the HD. Nurse LaRusso contacted many community groups and advisory boards, such as the Cancer Coalition, CareWell Health, Isaiah House, and YMCA. We are concentrating on strengthening grants to improve the local public health capacity. Some of the projects we've been working on are mental health and hepatitis, which Ms. Hagler’s team is also managing a piece of the work. So, we will try to ensure that data is reported because it's essential for us to put all the pieces together so people can see an accurate profile of everything we're doing. We can receive the appropriate credit or recognition for how many services we have here in East Orange that work for the community. We've also tackled mental health this year, starting at the beginning of the year with Imani Baptist Church, helping them assemble a program with the Mental Health Association of Essex and Morris, a critical faction to assemble people and resources. We did a lot of lead poisoning outreach at the beginning of the year. Nurse LaRusso shared that Mr. Salaam's program is based on a demo program she and Mr. Henry conducted years ago, where East Orange was invited to receive funding to assist residents with home repairs. So, it's a compliment to us 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 October 17, 2023 here in the City to see it go from a demo into a full-fledged program. Nurse LaRusso remarked we need to improve in our efforts to restart our intern program. We have received many inquiries from students, but it has been challenging to bring them in because of the recent changes. So, hopefully, that's one thing that we'll return to. Nurse LaRusso shared that many previous interns have asked about you or are looking for references. So, it's very much encouraging. Nurse LaRusso reiterated the importance of having interns because the children and the adult students were very impressed and learned many good skills they can utilize in public health. President Harris remarked that it's an excellent program and that Nurse LaRusso did phenomenally well. Unfortunately, it fell by the wayside, particularly during the pandemic, but hopefully, she will use her expertise to start it again. Nurse LaRusso shared she has also been assigned to a task that she used to do back in the eighties and the early nineties: wellness visits for community people. Referrals have been coming in for people who seem to be struggling. Still, in the forefront, they need somebody to assess their wellness or health, ensure they're getting the proper healthcare, ensure their environment is appropriate, and work on both facets. So, we've been working with Mr. Henry on some of them. We're trying to crack a case involving several people in one apartment building. It's nice to be able to do that in the community and help them understand the resources and services we offer outside of COVID. President Harris asked if Nurse LaRusso would need additional staff to help facilitate this process. Nurse LaRusso concurred and stated she has completed three home visits with Ms. Sheila Jeudy, who assists with providing resources, and a few with Ms. Keless, a new social worker under the umbrella of the Health Department’s Homelessness Program. President Harris asked if there was an approximation of your patient load for the wellness program. Nurse LaRusso explained as this is a new service, the caseload has been sporadic, with the cases being referred to her by Director Blake. Rodent Demonstration Program Nurse LaRusso shared that she and Mr. Henry have been working on a rodent demonstration program for a while. There was an excellent brochure that we're using, but also a project that involves the Rutgers Master Gardner and the 4H Club, which has a garden behind the library. Nurse LaRusso shared that she participated in a session with them and hopefully will remain in touch so that they can help us with the demo project. They anticipate including the Main Street corridor towards ShopRite with the new buildings, which may provide additional feeding grounds. Gardening Projects Nurse LaRusso stated that she and Mr. Henry discussed utilizing our kids at the library in the 4H Garden Club. There are additional programs for children interested in Cicely Tyson’s 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 October 17, 2023 garden project. So, we're looking to combine those resources and try to get the kids onto Main Street and work with the City entity so they can see how vital the coordination recognition is to both beautify and make it worthwhile to use plants that'll help repel the rodents. We did a lot of lead poisoning outreach at the beginning of the year. Mr. Salaam's program is based on a demo program I did years ago where East Orange was invited to get a pot of money and then help people do the repairs in their homes. So, it's a compliment to us here in the City to see it go from a demo project to, it's been a few years, but at least it made its maturity into a full- fledged program. Breast Cancer Awareness President Harris asked if there would be any activities in support of Breast Cancer Month. Nurse LaRusso shared that she attempted to obtain the mobile mammogram clinic; however, their program has been on a hiatus for the last two years as the mobile unit has been out of service. They're getting another resource to replace the van, including new imaging techniques and equipment. So, it's going to take some rebuilding. We’ve asked them if they can send some of the information before their relaunch so that we can build up an interest. President Harris asked how the new equipment was being provided. Nurse LaRusso stated the van is a part of UMDNJ and Rutgers, so she is unsure of the upgrades' details. Nurse LaRusso stated she has kept in contact with the young lady managing the program and was advised she is moving into a new role but has shared the information with her successor. They're getting another resource to replace the van, including new imaging techniques and equipment. So, it's going to take some rebuilding. We’ve asked them if they can send some of the information before their relaunch so that we can garner interest. Open Discussion: Meeting to Discuss HD Issues President Harris stated that a meeting between the Board and the Administration was scheduled for the following Monday via Zoom. President Harris sent an email containing a brief overview of some of the issues the Board wanted to discuss. President Harris asked that all Board members arrange their schedules so they could be present for this meeting. Since we asked for it, it is incumbent upon us to be there and be presented in force. President Harris shared that she asked if the Mayor could meet one-on-one with herself if he were unavailable to meet with the entire Board. But expressed hope that the meeting request would be accepted for all Board members to attend. CareWell Health President Harris asked VP Corbitt if she spoke with the Administration at CareWell Health regarding the issues brought up in a previous meeting. VP Corbitt shared that she has yet to have an opportunity to address the issues with the Administration as she has 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 October 17, 2023 been inundated with so many other things that have demanded her time. She reiterated that while this is a priority, she has had to prioritize other items. President Harris asked if VP Corbitt had received a patient satisfaction survey from the hospital. VP Corbitt stated she had not, but she still had the pictures on her phone. President Harris suggested that she contact the hospital when she has an opportunity to ask for a survey, as she is sure that VP Corbitt is one of many to raise those issues. HD Staff Introductions President Harris shared that she has invited all of the HD divisions' managers and supervisors to gauge what is occurring within the department. Substance Abuse Debbie Haggler introduced herself as the clinical supervisor for the Drug Abuse Division. Ms. Hagler shared she has been with the department for 30-plus years. Our division has been running for 50 years this year. So, we've been in operation for a long time. We're an outpatient adult treatment services program. Patients have to have a primary opiate use disorder. Currently, we have about 150 patients, but we also do case management and referrals because we get at least 20 calls per week from people who need counseling or referrals to treatment. Sometimes, we receive calls from parents who have children with alcohol abuse issues and have to educate them. We then counsel them and refer them out because our program, again, is primarily for opiate use. We have gender-specific groups and women; we run an intensive outpatient program for our medication-assisted patients. We offer both methadone and suboxone at our site prescribed for that. All our patients who come into treatment have a medical and psych evaluation. We make referrals and do extensive case management and follow-up with our patients. We have education and prevention groups that run every week. Intensive groups run three times per week for our patient population. We do outreach in the community and outreaches to service providers, sometimes churches, community centers, and individuals who may need referrals for substance use services and treatment. We make those referrals to them and direct them where they need to be. We assist providers in making appropriate referrals or offer them treatment services with us. We do education if someone calls in the community and says, we want to know something about substance use. For example, our counselors went out in June, and they did education in the high school because we were asked to come and do an overview of how to become a counselor and then what are the challenges and issues that children may face in the community, or their parents may face and how to get treatment services. So, anyone who calls will go out to do education. So, people have a better understanding of substance use disorders and what people need so that we can hopefully reduce the stigma about addiction treatment services and addictions and help people 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 October 17, 2023 understand how to help their loved ones who may need assistance and to get people back on track and to meet their potential. President Harris asked if Ms. Hagler had encountered anyone recovering from the use of the zombie drug. Ms. Hagler shared the zombie drug is challenging because it is not an opiate, which renders Narcan ineffective. But Narcan is still provided in case the individual has overdosed on other substances such as fentanyl. Narcan has been beneficial in the community. And then with patients who are overdosing from opiates, if somebody is available to do that. We give out Narcan kits and instructions to all of our patients. We've had a few patients who have said people who are not in treatment that they've known have overdosed, and they've used their kits on people outside and been able to get them assistance to go to the hospital, which is what you want. We want to have less death, mainly due to overdose, and more treatment and not a cure, but stability. President Harris asked if they keep statistics on how many patients are seen, how many times patients have used Narcan, and their frequency over a period of time. Ms. Hagler shared that within the last year, they have had a report of maybe three to five of our patients using it on someone else outside of the program. Our patients collect it because we educate them. So, they have kits, and they've used them on individuals. Luckily, we've not used that within the program itself. President Harris remarked that it is a wonderful program and thanked the program for 50 years of service. Health Education Cedra Starks shared her educational credentials and stated she is the Health Educator, CHEZ, and has been with the department for two years. Ms. Starks stated that she does content development, such as infographics, fact sheets, and public health advisories. Ms. Starks frequently collaborates with the multiple HD divisions to ensure advisories are going out, especially with cold flu RSV and COVID-19. We are still just ensuring that the approach is not COVID-only. A lot of respiratory illnesses go around, as well as policy reviews. We reviewed the COVID policy for staff members of the City recently. We updated that because there hadn't been an update for quite some time, especially since the public health emergency is over- tailoring health promotion messages to meet health literacy standards for East Orange demographics as we are considered an asylum City now. Ms. Starks shared that she realized many individuals speak Creole and Spanish during her outreach, so she ensured languages were translated and available to those populations. Hence, they're able to engage with us. Ms. Starks shared that she could access the digital sign outside the HD and updates the health messaging accordingly. Ms. Starks also distributes educational information from state and federal public health agencies. She also has access to the libraries for NIH & CDC, to which both entities send us free material frequently—also ensuring that the information is current, relevant, and aligned with state and federal guidance. President Harris 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 October 17, 2023 asked how Ms. Stark’s efforts align with Nurse LaRusso’s. Ms. Starks stated her efforts are separate from Nurse LaRusso’s, but they have plans for future collaborations. VP Corbitt remarked that her explanation was comprehensive and stated she was a welcome addition to Nurse LaRusso. VP Corbitt stated Nurse LaRusso is a wealth of education and looks forward to seeing the fruits of their collaborative efforts. Nursing Division Robert Ankrah introduced himself and stated he was the supervisor of the Nursing Division. Nurse Ankrah shared the Nursing Division runs two primary clinics: the VFC clinic, which is the children's clinic, and the 317 clinic, which is the adult clinic. With the VFC clinic, we cater to children with or without insurance. Adults are also covered under the 317 clinic regardless of insurance status. The children's clinic offers mandatory vaccines for schools. To ensure the children in our community receive their vaccinations for school, we partnered with the Board of Education Enrollment Center. When the schools reopened, we met the families there and offered vaccines to children in need. This allowed us to publicize our division so that parents are aware of the services we offer. Our services for the VFC program are federally funded and free for children who are East Orange residents. President Harris asked if Nuse Ankrah was referring to the COVID vaccinations. He shared these are not COVID vaccinations but the preliminary vaccines the school district requires for children to attend school, such as Hepatitis B, HPV, etc. Nuse Ankrah also shared the HD coordinates with the school nurses for audits. The audits allow us to access the student’s charts to ensure each child has up-to-date immunizations. Now, with the adult clinic, we provide STD tests such as chlamydia, gonorrhea, and syphilis, but they pay a $20 service fee. We also do TB & PPD implants. So, when children and adults have a positive test result, we refer them to the CareWell Health Medical Center for X-rays. We do physicals, too, for employees who are East Orange residents, both insured and uninsured. In addition to our regular functions, we assist with the COVID outreach program. Via the COVID program, we recently distributed about 600 free at-home COVID test kits to senior buildings. Next month, we are partnering with our local community pharmacies, including ShopRite, to go to senior buildings to provide flu, COVID-19, and shingles vaccines. The services are also provided to our uninsured or underinsured residents. President Harris asked about their publication efforts for the services they provide. Nurse Ankara stated his colleague Dr. Kamara manages that aspect of the program alongside the Health Educators. President Harris remarked that the Nursing Team is doing a tremendous amount of work and thanked them for their excellent service. 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 October 17, 2023 At the conclusion of Board business, President Harris adjourned the meeting at 7:49 pm. Respectfully submitted, Jo-Ann Lowe Board Clerk pg. 12