Board of Health

City of Nashua Division of Public Health & Community Services 18 Mulberry Street, Nashua, NH 03060 BOARD OF HEALTH MEETING June 11, 2014 12:30 PM AGENDA 1. Call to Order 2. Approve minutes from May 2014 3. Vote on requested expenditure for recognition gifts 4. Discussion regarding recognition ceremony dates and BOH vacation month 5. Department Reports for May 2014: a. Community Services a. Public Health Network Services (EP & SMP) b. Community Education c. Program Coordinator/CHIP d. Healthy Homes b. Community Health c. Environmental Health d. Welfare 6. Public Comments 7. Adjourn – Next Meeting - TBD  City of Nashua Division of Public Health & Community Services 18 Mulberry Street, Nashua, NH 03060 BOARD OF HEALTH MEETING May 14, 2014 12:30 PM 18 Mulberry Street, 2nd floor Nashua, NH 03060 MEETING MINUTES BOH Members Present: Dr. Anthony Storace Dr. Thomas Astolfi Dr. Chuck Cappetta Board members were given an agenda and copies of the department reports, as well as an orientation binder. Mayor Donnalee Lozeau attended to offer a few words of thanks and support to the new Board members. Meeting was called to order at 12:35 pm. Minutes: Dr. Astolfi made a motion to accept the April 2014 minutes. Dr. Storace seconded the motion. The Motion passed. Orientation Orientation led by Kerran. Department Managers and Program Coordinators summarized their departments’ roles and responsibilities within the division. Dr. Astolfi posed the question of whether Environmental Health conducts water testing to Heidi Peek. Water testing kits are available for home testing, but are submitted by the resident to NH DHHS. The Environmental Health Department does not conduct drinking water tests. 1 Dr. Cappetta asked about ticks and differentiation between types. Members of the public are able to bring in ticks for species determination and information. Dr. Storace asked Beverly Doolan what is the percentage of grant funding versus city funding for the Division. Kerran replied that she believed it was 47%. After seeing the Tree Streets PlaceMaps, Dr. Cappetta suggested sharing them with the local PTAs. In response to the Healthy Homes presentation, Dr. Cappetta proposed to speak with pediatricians at Dartmouth Hitchcock to increase lead screening rates among two-year-olds. Sue Myers gave a brief update on MERS: two cases in the United States (FL and IN). No sustained person-to-person transmission thus far. The Division has held a webinar and conference call with its medical partners for educational and planning purposes, as well as having provided a FAQ for them. Public Comments None Dr. Astolfi made a motion to adjourn. Dr. Cappetta seconded the motion. The Motion passed. Meeting adjourned at 1:35 pm. In accordance with the 2014 Board of Health Meeting Schedule, the next meeting will be on Wednesday, June 11, 2014 12:30-1:30 pm. 2  Board of Health • May 2014 Division of Public Health and Community Services Melissa Whalen, Community Health Educator Communications/Marketing  Coordination of printed promotional items for regional distribution of marketing materials for the STD/HIV/HCV program  HIV testing Day, Lyme Disease Awareness, MERS-CoV FAQs, Annual Conference and Immunization Information posted onto the city website  Promotion of Annual Conference on 5/29/14 o Wrote and distributed press release for Annual Conference  rd 3 GNPH quarterly newsletter – distributed on 5/6/14  Developed FAQs newsletter on MERS-CoV for distribution to local and regional partners  Developing press release template for MERS-CoV to prepare for a case in New Hampshire or the Greater Nashua Region Events/Community Partners  Attended the second Healthy Living Advisory Group (HLAG) at the YMCA of Greater Nashua to help inform their plans to roll out the Diabetes Prevention Program, 5/21/14  Attended the CHA Advisory Board meeting on 5/9/14  Attended “MisLEAD” documentary held for providers and residents on lead poisoning awareness and best practices  Attended “Disaster Epidemiology” Lunch and Learn held at DPHCS, 5/27/14 Community Health Assessment  Assisted with the planning of the Greater Nashua Public Health Annual Conference on May 29th  Working to write the chapter on Weight, Nutrition and Obesity Accreditation  Working intermittently to gather documents to inform where the division currently stands regarding Domain 3 “Inform and Educate about Public Health Issues and Functions” New Hampshire Public Health Association (NHPHA)  Attended the NHPHA Communications Committee Meeting on 5/16/14. Planning for the marketing campaign of the first “Get your Rear in Gear” 5k Trail Run, promoting colon cancer awareness. To be held in Hopkinton, NH on 9/27/14.  May 2014 Board of Health Report Greater Nashua Healthy Homes Program Amy Moutenot, Program Coordinator The Healthy Homes Program addresses multiple diseases and injuries in the home. The program takes a comprehensive approach to these actives by focusing on housing- related hazards in a coordinated fashion, rather than addressing a single hazard at a time. This program is grant funded through the U.S. Department of Housing and Urban Development Program and will be funded for the next three years. This month we’ve continued to monitor the blood lead levels of children in the Greater Nashua area. Currently there are twelve cases of elevated blood lead levels in the Greater Nashua region. This month we were notified by the state that a childcare center in Milford had a lead issue and was ordered to close until lead remediation was completed. We contacted the parents of all children who were enrolled and set up a two day screening event at the local ambulance center. All the children who came tested below three and we gave them information to share with their pediatricians about further testing. The childcare center event showed us that we need to be more proactive in the region about lead screening. We are working with Southern New Hampshire Services Childcare Resources and Referral group to get into more childcare centers to hold screening events. This upcoming month launches our participation in Nashua’s Summer Fun events. We have our outreach items and are ready to take our message to the masses. Our strategic planning meetings are held at 9:30 on the second Tuesday of the month at 18 Mulberry Street. All are invited to attend.  New Hampshire Department of Health and Human Services Community Health Department Board of Health Report Community Health Department Program Statistics May 2014 PROGRAM May May May FY YTD 2012 2013 2014 2013 FY 2014 Communicable Disease Surveillance & Investigation Communicable Disease 19 10 16 62 78 Investigations Tuberculosis High-risk Latent TB Infection 4 1 0 18 15 Latent TB infection 4 7 3 34 65 Active Cases Reported 0 0 0 3 1 Suspect Active Case Reported 0 0 0 0 7 Ongoing Case Investigated 1 14 12 20 25 (High-risk +Active) Skin Test performed 37 30 0 201 151 STD/HIV Clinic Number of Client Visits 2 0 33 112 288 Recorded HIV/STD Dual Test Performed 0 0 5 12 52 STD Only Test Performed 0 0 9 19 66 Hepatitis A/B Vaccines 0 0 0 1 6 Administered Positive Chlamydia Tests 0 0 3 5 13 Reported Positive Syphilis Tests 0 0 0 2 2 Positive Hepatitis C Tests 0 0 2 15 17 Reported Clinic + Outreach Reactive HIV Tests Reported 0 0 0 0 1 Clinic + Outreach Positive Gonorrhea Tests 0 0 1 0 3 Reported Clinic HIV Tests 0 0 11 33 90 High Risk/Targeted Clients 0 0 5/4 31 67/10 Immunization Children 39 57 16 283 286 Adults 69 56 45 415 446 Seasonal Flu Vaccine 0 0 0 73 121 (Children) Seasonal Flu Vaccine (Adults) 0 0 13 1,108 1084 Children vaccinated with Flu 0 0 0 1,385 1,055 Vaccine in schools Childhood Lead Poisoning Prevention New Cases Reported 0 0 0 7 8 Ongoing Case Management 3 8 10 8 16 Screening Completed Using 53 3 7 56 25 LeadCare Analyzer HIV Prevention/Outreach HCV Tests Performed 0 0 6 34 29 Van/Street Outreach Contacts 40 0 15 182 168 HIV Tests Performed 7 0 4 77 44 Communicable Disease Program Highlights Reportable Diseases, Nashua, NH January 2014 REPORTABLE DISEASE May 2013: May 2014: May 2014 CATEGORY Number of Number of Number of Cases Reportable Reportable Investigated Diseases Diseases (Including Confirmed, (Confirmed, Probable, (Confirmed, Probable, Probable, Suspect and Suspect) Suspect) “Not a Case”) Foodborne/Waterborne 5 3 3 Latent Tuberculosis Infection 3 3 Tuberculosis Disease (active 0 0 case) Vaccine Preventable 2 4 4 Vectorborne 0 0 0 Other (Strep A/B, HUS, HIV) 3 1 1 STD/HIV Program Highlights National Hepatitis Testing Day was recognized on May 19th. The Community Health Department provided Hepatitis C testing free of charge from 4:00-7:00 pm. Four individuals were tested. The Oraquik kits were supplied by the NH Department of Health and Human Services. Submitted by: Betty Wendt, PHN Lead/Healthy Homes Program Highlights Leads screenings were held in Milford on May 27th and May 28th for children who may have experienced exposure to lead. Seven children participated. No confirmed blood lead levels were identified. Submitted by: Theresa Calope-Yaklin, PHN Communicable Disease Program Highlights Several conference calls were held with NH DHHS regarding Middle Eastern Respiratory Syndrome, including its impact on New Hampshire. The Community Health staff has provided phlebotomy for asymptomatic contacts that have identified exposure during flights. Submitted by Betty Wendt, PHN Immunizations Highlights NCHD is partnering with the NH Immunization Program in providing assessments and education at physician practices in the region. Submitted by Christine Caron, PHN TB Program Highlight The public health staff continues to provide directly-observed therapy for two active TB cases and three clients with latent TB infection. Submitted by: Theresa Calope-Yaklin, PHN Other Updates  The Community Health Department Manager developed a Fact Sheet with key points related to Middle Eastern Respiratory Syndrome for the medical partners within the community.  Community Health Department staff provided representation at the Low Flow O2 Exercise at Nashua High School South  The Community Health Department Manager provided a presentation on the Access to Care Workgroup at the Annual Public Health Conference held at Nashua Community College.  Interviews have been completed with applicants for the per diem public health nurse position. The recommendations have been provided to the Human Resources Department.  Plans are underway for National HIV Testing Day which is held on June 27th. The Department has an opportunity to work with Nicole Drake, a student intern from UNH, to plan activities for the event. Respectfully Submitted by, Susan Myers, RN, MEd Manager, Community Health Department  City of Nashua Division of Public Health & Community Services Environmental Health Department Board of Health Report-May 2014-FY 2014 FOOD SERVICE EHS II-HP EHS I-AT EHS I-AH ETC. TOTAL Routine Inspections 24 29 50 106 Re-inspections 1 1 2 Site Visits 12 3 17 32 Change of Ownership 1 1 2 Inspections Pre-Licensing 2 1 1 4 Inspections Plan Reviews 1 4 2 7 Temporary Plan 4 4 8 Reviews Complaints 2 2 4 Recall Response 3 3 Establishment: Food 3 4 1 8 Service Meetings Food Samples 4 4 Collected Emergency Responses:  April Torhan responded to a small fire at Nashua Soup Kitchen  Howard Price responded to a sprinkler discharge at Texas BBQ at Pheasant Lane Mall  Howard Price responded to fire suppression system discharge at Burger King in Pheasant Lane Mall Temporary Closures: Rincon Colombiano remained closed for month of May, but property owner and restaurant owner making progress in building and facility. Educational Presentations:  April Torhan and Amanda Hyde provided food safety training to volunteers of St. Philip Greek Orthodox Church prior to their annual Food Festival  Amanda Hyde provided safe food handling in homes presentation at Nashua Senior Center Staff attended planning meetings with food service facility owners, Chamber of Commerce and Great American Downtown staff, and other City department representatives to discuss Downtown Dinner & Movie series, Downtown Music Festival and potential new Farmers Market. Number annual licenses issued 56 th New license holders (5): Nashua Little League 7 Street, Moochie’s Macarons, Craft Beer Cellar, Tilted Kilt, Red Sauce Ristorante Number annual licenses renewed 51 Number temporary licenses issued 3 PUBLIC POOLS/SPAS EHS II-HP EHS I-AT EHS I-AH Total Routine Inspections 6 4 15 25 Site Visits 1 1 1 3 Samples Collected Complaints Temporary Closures Number annual licenses issued/renewed 11 New license holders : 0 ARBOVIRAL SURVEILLANCE/CONTROL Rene Beaudoin and Heidi Peek attended annual NE EEE Conference sponsored by CDC and NH DHHS. EDUCATIONAL PRESENTATIONS  Heidi Peek provided education on Lyme Disease, WNV and EEE for Park s and Recreation staff with Ross Dugas from Risk, who provided education on bee stings, poison ivy and proper disposal of found syringes.  Rene Beaudoin and Heidi Peek attended NHHOA Spring Workshop on Septic Systems. RABIES CONTROL Number of Type of sample(s), Date delivered to Negative or sample(s) feline, canine, etc. NH DHHS PHL Positive 1 Canine 5/22/2014 Negative 1 Canine 5/9/2014 Negative Number of animal bite or non-bite exposure Dog Cat Ferret reports processed: 8 2 INCIDENT RESPONSE TEAM  Rene Beaudoin and Heidi Peek attended monthly IRT meeting.  Heidi Peek and Rene Beaudoin participated in MERS webinars. LAND USE Address Brief Description Amanda Hyde 18 Birch Ridge Rd. Test Pit Amanda Hyde 54 Farmwood Dr. Test Pit Amanda Hyde 67 Farmwood Dr. Test Pit Amanda Hyde 9 Countryside Dr. Plan Review April Torhan 3 Covey Road Bed Bottom April Torhan 24 Birch Ridge Trail Bed Bottom Howard Price 12 Sunrise Trail Bed Bottom Howard Price 84 Pilgrim Circle Bed Bottom Howard Price 25 Ridgefield Rd. Bed Bottom HOUSING ASSESSMENTS-0 Department Address Partner Brief Description Representative Agency(ies) INSTITUTIONAL INSPECTIONS Department Type of inspection (Child Name of Facility/Address Representative Care, Foster Home, School, USDA) Howard Price School-Follow-up Nashua High School South GENERAL COMPLAINTS Type of Complaint EHS II-HP EHS I-AT EHS I-AH ETC. Solid Waste Animals 2 Vector 1 Hazardous Materials Residential Swimming Pools/Spas 1 Air Quality Other EMERGENCY PREPAREDNESS  Rene Beaudoin and Heidi Peek participated in EP’s O2 Functional Exercise.  Rene Beaudoin and Heidi Peek attended LEPC meeting. OTHER Heidi Peek attended first Annual CHA/CHIP/PHEP Meeting. Respectfully submitted, Heidi E. Peek Health Officer/Environmental Health Manager 4 June 2014  City of Nashua Division of Public Health & Community Services 18 Mulberry Street, Nashua, NH 03060 603-589-4560 Memorandum To: Honorable Donnalee Lozeau, Mayor Board of Aldermen John Griffin, CFO Kerran Vigroux, Director DPHCS From: Robert Mack, City Welfare Officer Date: June 3, 2014 RE: Welfare Statistics – May 2014 [FY2014] The following is a summary for the month of May 2014 in the City Welfare Department. Expense figures for May 2013 as compared to May 2014: Type of May 2013 May 2014 Assistance FY2013 FY2014 Shelter: $43,687.51 $38,850.75 Medical: $3,955.86 $4,330.26 Utilities: $4,462.55 $2,669.32 Food/Maintenance: $1,172.46 $292.40 Maintenance: - $172.96 Burial / Cremation: $750.00 $750.00 Transportation: $900.00 $0.00 Total expense: $54,928.39 $47,065.69 Statistics for May 2013 as compared to May 2014: May 2013 May 2014 FY2013 FY2014 Number of Contacts: 762 653 Number of New Applications: 151 119 Number of Interviews: 273 222 Number of Cases: 152 112 Number who received Assistance: 211 133 Percentage who received aid: 77% 60% Number of vouchers issued during the calendar month of May 2013 compared to May 2014: Voucher Type May 2013 May 2014 FY2013 FY2014 Shelter: 98 68 Medical: 48 39 Utility: 41 20 Food: 10 10 Maintenance: 16 13 Burial: 1 0 Total vouchers: 214 150 The Nashua Welfare Department assisted 3 families in emergency shelter placements and referred 4 families and 2 individuals to public shelters/homeless outreach during the month of May. As of the date of this report, the Welfare Department has expended $545,698.23 out of the FY 2014 budget of $650,000.00 for General Assistance. The Welfare Department continues to work with social service agencies in the community and to provide assistance in accordance with RSA165 and the City of Nashua Welfare Guidelines to those who are in need and unable to support themselves.