Board of Health

CITY OF SALEM BOARD OF HEALTH MEETING MINUTES November 14, 2017 MEMBERS PRESENT: Paul Kirby, Chair, Dr. Jeremy Schiller, Mary Lauby, Nancy Crowder, Kerry Murphy EXCUSED: Beth Gerard, Council Liaison OTHERS PRESENT: Larry Ramdin, Health Agent, Suzanne Darmody, Public Health Nurse, Maureen Davis, Clerk of the Board, Kimberly Waller, Salem State University TOPIC DISCUSSION/ACTION 1. Call to Order 7:01pm 2. Approval of Minutes K. Murphy motioned to approve minutes with correction on (October 10, 2017) page 3 of typo of “tics” corrected. N. Crowder 2nd. All in favor. Motion passed. 3. Chairperson Communications P. Kirby shared an email from Mary Wheeler regarding the syringe exchange program. There are currently no new funds available, but Healthy Streets will still go forward with the program for us using existing services. L. Ramdin said police department approval is a matter of courtesy and he does not anticipate any objections to the program. J. Schiller said he would like Narcan administration data, including the number of overdoses and deaths. We used to get that data because of the opioid coalition meetings, but there has been a shift in strategy now. There was a Town Hall meeting with mayors from a few communities. Report just came out last week. Still needs to meet with the directors of Peabody and Lynn to discuss the outcomes. Changing the whole focus from a reporting meeting to break up into interest groups to focus on destigmatization, awareness and treatment. L. Ramdin will send a letter to Chief Butler requesting data on Narcan administration and deaths. 4. Monthly Reports-Updates a. Public Health S. Darmody reported lots of flu clinics. She went out with Denny Nurse’s Report from Healthy Streets and Officer Vaillancourt to give flu shots to the homeless. The reported suspected mumps case was negative. P. Kirby asked how contagious are mumps. S. Darmody said it is spread by droplets of saliva and mucous membranes, much like a cold. K. Murphy asked if the mumps vaccination wears off.  S. Darmody said it can - every person is different. M. Lauby asked what is discussed at the Emergency Preparedness meetings. S. Darmody said they discuss many things, like funding, planning flu clinics, trainings, programs, i.e. Mary Wheeler has come to one of the meetings. L. Ramdin added they discuss common responses to how we are going to support each other in emergencies such as hurricanes, emergency dispensing, etc. We do site set up drills. Prepare for food and shelter response to winter storms, etc. Each different type of emergency requires a different response. Lyme season never stops. M. Lauby asked what is the flu season prediction. S. Darmody said there is a higher incidence than in the past couple of years. Tracking up a little faster than last year at this point. K. Murphy asked if they know if the vaccine matches whatever strain is out there. S. Darmody said she just saw that they were seeing A-strains. There are two A-strains in the vaccine, but they don’t know exactly which ones. H1N1 is an A-strain. Encouraging everyone to get the flu shot. Copy available at the BOH office b. Health Agent’s L. Ramdin reported on his site visit to Northwestern University on Report October 29-31 as part of their reaccreditation. In Orange County, California he moderated two sessions and presented on the use of the food code for non-environmental health professionals on the prevention of foodborne illness. It was both well attended and well received. It was a room full of epidemiologists and they now understand what we do on our side. The new hotel on Essex Street is not ready. We will issue a food permit for the first floor, but the roof and the basement are not ready. They wanted an inspection to get advice. No major issues. M. Lauby asked how we can begin to assess Councilor Famico’s noise complaint possibilities. L. Ramdin said we must first look at the surroundings – is it business or residential, wind direction, etc. For example, the hotel built housing around their evaporator units to buffer the noise. M. Lauby asked for an update on the Washington Street/Mill Hill hotel project - Hampton Inn. L. Ramdin reported the project is on hold for now due to design issues. Construction will begin soon on the old district court building. There will be residences on top, shops on street level and parking underground. Former Jimmy John’s on Lafayette Street will be a bakery. Still has some work to do. Mr. Crepe (former Melita Fiore) on Washington Street near main City Hall should be up and running in a couple of months. Village Tavern remodel – we had to make sure his kitchen could support the additional seats he added. It did.  Problem trash areas, such as dumping behind the Moose along the tracks and a few other places. We have a few cameras set up around town. Janet Mancini downloads the pictures and reviews them. We need to go over 1,500 pictures per location. We will ticket violators. The departments at the Annex are moving up the street across from City Hall in March. We are being taxed for time and resources right now. We have a week to get most of our files ready for digitizing. We are also getting trained on a new phone system. Asked the IT department to retain the direct lines for the inspectors and the entire office because we need to have those for contact. It is a great phone system. L. Ramdin has to write a letter to the building inspector because the Red Lion Smoke Shop downstairs from our new location across from City Hall has a smoking room which can put people in the offices upstairs at risk for health issues such as asthma and other respiratory issues related to secondhand smoke, including predisposition to cancer. They should have a better ventilation system. The Public Health Committee proposed sliding scales for certificates of fitness fees for first, second and third inspections done on the same day. That would not work because each inspection is unique, so he asked to have that section stripped and they did. Another section was about the director of inspectional services deeming someplace a problem property and he had them add in “or the Board of Health agent” because the certificate of fitness ordinance is a Board of Health ordinance. We are the ones empowered to enforce it. Copy available at the BOH office c. Administrative Reports were distributed showing the number of temporary permits Report issued vs cost of overtime for fiscal years 2016, 2017 and 2018 (thus far). J. Schiller stated it is a very strong bargaining chip for the budget for next year. L. Ramdin asked for an additional $2,000.00 from free cash for overtime. It’s on the council agenda for Thursday and he has no reason to doubt that it won’t be granted. N. Crowder wondered if that will be enough to get us through June. J. Schiller said we lowered the fee dramatically, anticipating the number of food permits would go up and they went up 600%, which really is a boom for the City. That was the whole point of doing it. It’s more exciting because there’s more stuff going on. We should be requesting the budget increase based on these numbers. P. Kirby suggested at the next meeting we consider a draft letter to the Mayor. M. Lauby said the letter will also serve as an update for the Mayor on the status of the permits since lowering the fees. Copy available at the BOH office d. City Council Beth Gerard not present. Liaison Updates  N. Crowder motioned to accept the reports. M. Lauby 2nd. All in favor. Motion passed. 5. Board of Health Program Planning & city health status discussion a. Continue discussions with Dr. Kimberly Waller suggested, with regard to budget talks, we think Kimberly Waller, Salem about cost-effective ways to utilize all departments to accomplish State University, on how common goals. best to approach She looked up data about health and social issues in Salem. It was a health/social issues lot of work, but she now has some sense of what’s out there and would like to help us prioritize issues. She sent P. Kirby the new PowerPoint document about data review she showed at the meeting. She proposes a 3 to 5-year strategy with both short and long-term goals to give the city a compass to better health. We should compare what other cities have done or are doing. It was a lot more challenging to find data online specifically for Salem. M. Lauby stated that L. Ramdin had sent the Board some data. L. Ramdin said there is data out there. K. Waller said it would be great to pool data on our website so it would be easier for people to find. She found that in Essex County, mental illness and substance abuse mortality is greater than in both MA and nationally. There is data for gateway cities. Cities apply to be a gateway city – state funding is available to those cities. Salem is one of 28 gateway cities. Compared to the other gateway cities, Salem did not do well with obesity, asthma, cardiovascular disease and high school education attainment. K. Waller did some interviews with Clark University, North Shore Medical Center and City Connects. There is lots of data on the opioid crisis. Homelessness is an issue. Transient homeless a bigger issue. N. Crowder spoke of scattered sites for homeless families too large for other shelters. Landlords rent apartments to agencies for larger families to be able to stay together. Homeless data is skewed because some homeless families were housed in shelters in Peabody. We need cross sector collaboration with schools, North Shore Medical Center, Salem State University, etc. P. Kirby suggested as a next step, each member can take a close look and pick out an area they could each individually pursue and maybe get a grant to do. Without funding it is hard to do anything. L. Ramdin said that is why he has requested a public health programs specialist to look at how we address these things and what is our role as a Board of Health and what projects we can work around this. M. Lauby feels health disparities are not included in the data, so she is not ready to decide her priority. K. Murphy is meeting with K. Waller and will share that data with her  as far as health disparities. J. Schiller said this is a great start to help us with the vision of the Board. N. Crowder feels we are months away from being able to decide. She would like the staff to be part of deciding the priorities. K. Waller suggested next steps to have interviews with councilors, etc., to see what they feel are top issues. She also feels we need to find out if other gateway cities were using grants or existing budgets to get things done. She thinks by May, June or July we should be able to decide priorities and plans. K. Murphy said Mass in Motion’s community health assessment must be done by December. L. Ramdin said he provided a foundation with the Salem-specific community health assessment a couple of months ago. N. Crowder would love to have the newly elected Latino councilor-at- large and school committee members be part of the data gathering process. L. Ramdin said there are a lot of unsaid things that we do and we are aware of the consequences of those. For example, residents of rental housing are afraid to complain and lose their housing or have problems with immigration, so they live in sub-standard conditions. He feels the committee’s new certificate of fitness policy for a three- year cycle of inspections will address these issues. N. Crowder said homeless program system is working, but not great. M. Lauby feels we would be better prepared to handle other issues. K. Waller said what is the criteria for prioritizing issues – perceptions and high visibility? She can help coordinate, dig deeper into issues. She teaches at Salem State University and will be able to utilize interns from her health policy class in the fall to help compile data. M. Lauby requested another data dive. She will email our data to K. Waller to compile. 6. New Business / Scheduling of future - K. Waller to return in December. agenda items - Draft a budget letter to the Mayor. L. Ramdin asked to include the need for a program specialist who could also help and work with K. Waller. 7. MEETING ADJOURNED: M. Lauby motioned to adjourn the meeting. K. Murphy 2nd. All in favor. Motion passed. 9:20pm Respectfully submitted, Maureen Davis Clerk of the Board Next regularly scheduled meeting is Tuesday, December 12, 2017 at 7:00pm At City Hall Annex, 120 Washington Street, Room 313, Salem, MA