Board of Health

CITY OF SALEM BOARD OF HEALTH MEETING MINUTES July 11, 2017 MEMBERS PRESENT: Chairman Paul Kirby, Dr. Jeremy Schiller, Nancy Crowder, Mary Lauby, Kerry Murphy EXCUSED: Council Liaison Beth Gerard OTHERS PRESENT: Elizabeth Gagakis, Senior Sanitarian, Suzanne Doty, Public Health Nurse, Maureen Davis, Clerk of the Board, Mary Wheeler, Director, Healthy Streets, Denny, Outreach, Healthy Streets, Josh, Intern for Healthy Streets from MA College of Pharmacy, Diane Wolf, Owner, Lobster Shanty and Ugly Mug Diner TOPIC DISCUSSION/ACTION 1. Call to Order 7:00pm 2. Approval of Minutes N. Crowder motioned to accept minutes as written. (June 13, 2017) K. Murphy 2nd. All in favor. Motion passed. 3. Chairperson Announcements No meeting in August. 4. Monthly Reports-Updates A. Public Health S. Doty reported lots of camp inspections in June. This year all the Nurse’s Report YMCA camps have a nurse, including the Marblehead Y and Children’s Island. J. Schiller pointed out there were much more flu cases than last year, even though it was reported that the vaccine was good. Perhaps less people are being vaccinated? K. Murphy asked if there is data on the number of people in Salem who got the vaccine. S. Doty said not yet because doctor’s offices are still reporting. Salem State camp issue is all set. It seemed to be a transition period for them. They have structured differently for next year. P. Kirby inquired as to how many hours it takes to inspect a camp. E. Gagakis and S. Doty said it varies, but usually about three hours. There is a 4 to 5-page check list for camps, including such items as CORIs, SORIs, immunization records, physicals, plans and policies in place, medication logs, etc. M. Lauby asked how the City staff wellness programs are going. S. Doty announced that nutritionist Diane Dube will be speaking at a meeting for all employees on July 26th at 4:30pm at 120 Washington Street, Room 313. M. Lauby asked what the Public Health Nurses meetings entail. S. Doty said they discuss what they see on MAVEN, reportable diseases, camps, vaccine clinic dates, etc. Copy available at the BOH office  B. Health Agent’s E. Gagakis reported the department has been busy with the Farmers’ Report Market, camp inspections, pools, beach testing. Mosquito control program did not put on any meetings for us this year. No positive pools for anything. Last year the mosquitoes were mostly bird- biters, not human-biters. Beach testing - we test 11 beaches weekly mid-June to Labor Day. Children’s Island has three beaches and one more semi-private beach that test themselves bi-weekly, as long as they don’t have any failures for 2 or 3 years. Had a really high failure for beach testing at one beach. High bacterial content. Had not had a test come back that high in years. It was fine the next week. It was a beach off a neighborhood, not a beach people would sit and swim at. P. Kirby offered his thanks for the quick response to the Salem State situation. P. Kirby asked about the proposal for late night food trucks. E. Gagakis said it would be for people to get a bite to eat after the bars close. Possible sites Riley Plaza and the city lot by Speedway. We would need to inspect and permit them. Could be a strain on the department for nights and weekends. Zoning prohibits food trucks at this time. H. Famico asked if we get an inspector for the Certificates of Fitness ordinance, could they help with food trucks? E. Gagakis said they could if they are trained in food inspections. Copy available at the BOH office C. Administrative J. Schiller again requested that we show the number of temporary Report pop-up permits @ $300 in 2015 and 2016 to compare to the number of permits now @ $35. M. Davis will include in next report. P. Kirby offered his appreciation to the inspectors for their work on nights and weekends for pop-ups. J. Schiller offered for the official record based on the Salem State complaints that were levied on Facebook, that the proper channel of communication should there be a complaint about the department should really be with the Board of Health. M. Lauby said it is really annoying, especially for someone in a leadership role. Copy available at the BOH office J. Schiller motioned to approve the reports. M. Lauby 2nd. All in favor. Motion passed. 5. Mary Wheeler, Healthy Streets M. Wheeler brought items given out at the needle exchange Continued discussion on program, including syringes and other safe injection items. allowing Needle Exchange P. Kirby said the state DPH funds needle exchange programs. programs M. Wheeler said in the last 30 days, the Supreme Court in MA has ruled in favor of syringe distribution, so anyone can set up a syringe exchange service without any approval of city or town officials, as long as they are not selling syringes, but still requires BOH approval. Five people a day are dying from drug use in MA. Syringe exchange service allows users access to help and education and helps to decrease the spread of Hepatitis C and continue to decrease the spread of HIV among injection drug users and more Narcan programs. Healthy Streets has subcontracted with Salem Police through a DMH grant. Officer Vaillancourt does overdose follow-ups, also called doorknocks, with Denny from Healthy Streets. Currently collect used syringes, but they can’t give them back clean ones. J. Schiller asked about what happened in Barnstable. M. Wheeler said that was in Hyannis and was a satellite program of the Provincetown program. The city councilors sued ASGCC in supreme court and lost. The BOH approved it, and the city councilors did not. Governor Baker ruled no longer need community approval, just BOH approval for a DPH funded program. J. Schiller asked about any negative impacts on needle exchange programs and the health impact. M. Wheeler states over the last 20+ years, data shows syringe service programs don’t increase crime, they reduce rates of overdose and spread of infection, increase feelings of self-respect and empowerment of users. M. Wheeler said people have a “not in my back yard” kind of attitude about the programs. Public injection is blamed on the program, but that happens anyway – with or without a program. Healthy Streets does overdose doorknocks in surrounding communities. Officer Vaillancourt and Denny pick up syringes. M. Lauby was interested in home visits and asked how many users take up offers for their help. M. Wheeler said they feed them, give them a safe place to rest, even rub their sore feet if need be and try to steer them toward treatment, counseling, etc. They have a drop-in center in Lynn and mobile services either by car or on-foot. Hepatitis C cases are five times higher in MA than other states in the country, mostly from sharing other injection items, such as water, cotton, containers, etc. Infection is usually not from sharing needles. N. Crowder asked if we can stipulate no drop-in center without BOH approval. M. Wheeler said yes. P. Kirby said Chief Butler emailed Larry Ramdin to say she is all for the program, but prefers 1 for 1 exchange vs. 5 for 1. M. Wheeler prefers not to have 1 for 1 because she feels it increases needle sharing and reuse. In Lynn, the police dept. suggested 1 for 1, but Healthy Streets has a voucher program with the pharmacy so users can get 10 needles, but no other items. Healthy Streets gives out sharps containers and kits with clean injection items. H. Famico asked how they establish mobile unit locations. M. Wheeler said it would not be anywhere residential. Most likely would be a van with no signage on it. Not looking to advertise it. Denny pointed out it is embarrassing for users to do needle exchange. He pointed out that people are desperate in their situations and will use whatever, whenever. P. Kirby asked M. Wheeler if she has talked with Chief Butler about the 1 for 1 vs. 1 for 5 exchanges. M. Wheeler said not yet, but she spoke to Lt. King. She will speak to Chief Butler. M. Lauby asked if users are using every day, how is 1 for 1 helpful. M. Wheeler said, “exactly”. J. Schiller asked if it is proven that if you give someone an alcohol swab and a clean needle they will use it. M. Wheeler said yes, educate them and they will take care of themselves. P. Kirby asked what Salem’s program would be. M. Wheeler said probably a mobile unit, 1-2 days a week, plus home visits, aka “doorknocks”. Home delivery and pick-ups. M. Lauby asked if Healthy Streets reports data. M. Wheeler said yes, they report to DPH all the time. M. Wheeler said there is no syringe statute in MA. K. Murphy asked if we could approve the program and talk details later. M. Wheeler said we could specify it’s approved, but we want reports. P. Kirby suggested that based on the reports, we as a board could revoke it. N. Crowder liked the idea of just saying we approve it. J. Schiller said it’s a no-brainer to approve it. There could be a lot of backlash, but we could respond that we approved it based on the data presented. P. Kirby asked M. Wheeler to confirm that we can’t start until DPH gives the go-ahead. M. Wheeler said yes. M. Wheeler had previously provided a template of a letter to Kevin Cranston at DPH requesting a syringe exchange service. L. Ramdin would need to send the letter. P. Kirby asked how quickly could you start the program. M. Wheeler said as soon as she receives a letter from DPH. Usually about a month. M. Lauby asked M. Wheeler if DPH RFR doesn’t come for a year, do you currently have funding to serve Salem? M. Wheeler said yes. M. Lauby motioned to approve a syringe service program to be established in Salem, with a vendor to be approved by the Salem Department of Health, with data and ongoing reporting to be provided to the Board of Health at the Board of Health’s request. N. Crowder 2nd. All in favor. Motion passed. 6. Ward 2 City Councilor, H. Famico passed out packets to members. Heather Famico Noise: She would like to establish an acceptable sound level for the ambient a. Sound level limits on noise downtown. non-residential HVAC She put into committee at the council to establish an ordinance and other large surrounding ambient noise to add levels. Every ordinance change mechanical units in the requires two city council passages. The BOH could require it to be a downtown part of inspections. Noise levels are currently not included in food b. Non-residential establishment inspections. trash/recycling storage The licensing board has been exploring setting up sound levels for dimensions and pick-up outdoor entertaining. requirements The sounds downtown are affecting sleep and quality of life. Ambient noise levels are hard to check during the day due to all the other noise downtown. Showed emails with the Health Dept. since January requesting help. H. Famico said she and Larry Ramdin went to the roof of the mall to listen to the HVAC unit and he agreed it was loud. He said he would do a measurement the next week. She never heard back. He did tell her volume was discussed and they are required to control noise. H. Famico started contacting the state to see what else can be done. Would like to imbed HVAC sound levels to requirements to include noise reduction around units, not just coverings for aesthetics. D. Wolf, owner of two restaurants downtown, would like to see all commercial buildings required, not just restaurants. J. Schiller asked under which office would sound level inspections be done. D. Wolf said this issue has been discussed since 2009, with the question of which department would be responsible for enforcement. E. Gagakis said we inspect residential units for complaints or Certificates of Fitness, but we do not inspect commercial buildings. H. Famico says the DEP is responsible for addressing noise complaints, therefore the BOH is responsible. J. Schiller would like to hear from Larry about his follow-up and whether there is a potential health code violation or a noise violation. P. Kirby will speak with Larry about this issue upon his return. P. Kirby agreed the ambient noise is loud, especially at the Essex mall. We will work on this issue. H. Famico asked that the Board let the City Solicitor know there is interest in the subject, and not just for outdoor music. Trash: At next council meeting, at second passages on zoning that now recycling has to be shown on site plans. No requirement within the city of dimensions for trash storage. Just says adequacy of trash storage. Currently recycling is not mandatory for properties that are not part of the City contract. No BOH regulations requiring recycling area. Sometimes trash is picked up at 5:00am – there is noise downtown  until 1:30am, then very early trash pick-ups. Showed several photos of overflowing trash. Sometimes restaurants get blamed for overflows of trash they have no control of – maybe the landlord is not handling the situation. H. Famico would like to define what “adequate” is. She showed a plan with a very small, parking space sized, trash area for a 61-unit housing structure – far from adequate. P. Kirby asked if he could send some of her photos to the state for their tool kit that will work together with the City to solve the issue. D. Wolf feels training for overflow recycling would be helpful, i.e. box breakdown, etc. The state, as part of the tool kit, will provide training for businesses. Composting by restaurants would also help. Some are already composting. H. Famico would appreciate a continuation of this topic and any updates. 7. Board of Health program M. Lauby has an idea, but she would like to speak to Larry Ramdin planning & city health status and Paul Kirby about it first before she presents. discussion CDC’s Healthy 2020 has the outline of everything that matters. Would like to talk about considering the possibility of inviting centers of community programs to come in and talk to us and educate us so we can talk about priorities. K. Murphy said Mass in Motion is doing a community health assessment that will be done by December. 8. New Business/Scheduling of As discussed, the Board will not be meeting in August. future agenda items MEETING ADJOURNED: J. Schiller motioned to adjourn the meeting. N. Crowder 2nd. All in favor. Motion passed. 9:14pm Respectfully submitted, Maureen Davis Clerk of the Board of Health Next regularly scheduled meeting is September 12, 2017 at 7:00pm at City Hall Annex, 120 Washington Street, 3rd floor, Room 313