Board of Health

CITY OF SALEM BOARD OF HEALTH MEETING MINUTES January 9, 2018 MEMBERS PRESENT: Paul Kirby, Chair, Dr. Jeremy Schiller, Mary Lauby, Nancy Crowder, Kerry Murphy OTHERS PRESENT: Larry Ramdin, Health Agent, Suzanne Darmody, Public Health Nurse, Maureen Davis, Clerk of the Board, Beth Gerard, City Council Liaison, Dr. Kimberly Waller, Salem State University TOPIC DISCUSSION/ACTION 1. Call to Order 7:04pm 2. Minutes of Last Meeting J. Schiller motioned to approve minutes. K. Murphy 2nd. All in (December 12, 2017) favor. Motion passed. 3. Chairperson Announcements Nancy Crowder’s friend, Geri Yuhas, is still interested in replacing Nancy on the Board. L. Ramdin said any interested person should submit a letter of interest with their resume to the Mayor. 4. Monthly Reports-Updates a. Public Health S. Darmody just received a report that the flu season will be bad this year Nurse’s Report vs. the past two years. This year’s flu shot will only be about 32% effective toward the H3N2 strain that is showing up this year. Flu cases are higher in the Northeast compared to the rest of the state. It is better to have some protection than none, so she is encouraging people to get the flu vaccine. Good hand washing helps. Keep distance from people who are sick. J. Schiller said he is starting to see some severe cases. P. Kirby asked about the table top training referenced in S. Darmody’s report. L. Ramdin said he and S. Darmody presented a simulation of a salmonella case for inspectional staff training purposes. They learned a lot. Planning to have a series of in-service training sessions with the staff. Copy available at the BOH office. b. Health Agent’s P. Kirby noted that garbage and recycling throughout the City seemed out Report of control over the last couple of weeks. L. Ramdin said the snow was part of the problem. It was forecasted we would get 8-10 inches, but we got 17 inches. The Engineering Dept. manages the contract with the trash company. No health issues regarding the trash at this time. The LEAP for Education students who met with Larry said they would distribute flyers as part of their project to educate people on proper trash  disposal and rules. N. Crowder said the city-wide phone messages helped to keep citizens updated about trash and recycling delays and schedule changes. P. Kirby stated that marijuana regulations came out. L. Ramdin sent it to the Board electronically. Very lengthy. Concerned about edibles and how they are going to be marketed and what the local powers are around regulations. Gave a hand-out about second-hand marijuana smoke and its impact on individuals, along with a schedule of the public hearings. M. Lauby asked if the initial measure had a provision that you couldn’t control or regulate edibles. L. Ramdin said not to his knowledge – you cannot prevent consumption of edibles. Denver requires that a marijuana leaf be stamped on any edibles so it is clearly marked as containing marijuana. J. Schiller said ER physicians noted a 30% increase in ER visits for marijuana intoxication. He pointed out there is no lethal dose of marijuana. L. Ramdin said other states that have legalized have seen an increase in calls to poison control centers for overconsumption of edibles. There is a hearing for the draft marijuana regulations on February 7th at North Shore Community College in Danvers. P. Kirby suggested members look at the regulations and forward any issues of concern to L. Ramdin who will gather and circulate to members. J. Schiller said we could look at any regulations that involve the Board of Health and Health Department. L. Ramdin said we need to concern ourselves with the safety of this product. We also need to look into onsite consumption and how it impacts surrounding buildings/spaces. The Health Dept. and all other City offices at 120 Washington Street will move across the street from City Hall in March. L. Ramdin said the SSU Expect students did an excellent presentation on opiates. They did a video which included interviews with nurses at the health center, Officer Vaillancourt, our outreach police officer, and Denny from Healthy Streets who goes out with him on door knocks. They also did a demonstration on administering Narcan. He will share the presentation with the Board. Asthma Awareness Day is going to be on May 1st at the State House. L. Ramdin joined the board of the Asthma Action Partnership. Copy available at the BOH office. c. Administrative J. Schiller asked about revenue this year vs. last year. Report P. Kirby noted the handouts from a previous meeting which compared permits, costs, etc. He noted that revenue from the Health Dept. goes into the general fund and is therefore irrelevant to the budgeting. B. Gerard said income from the general fund offsets taxes. M. Lauby said the concern is if revenue is going down, that would be punishing.  L. Ramdin pointed out that decreased fees = increased business = increased demands and workload for the Department. M. Davis thanked N. Crowder for pointing out the discrepancy in the burial permits for October at last month’s meeting. Indeed, online burial permits were not included in the total. Updated, corrected reports were emailed to members. Copy available at the BOH office. d. City Council B. Gerard said the plastic bag reduction went into effect January 1st and Liaison Updates she has not heard many complaints. Paper bags being used by most stores. The smaller tourist shops are having the biggest issue. Councilor Lovely asked that the matter be brought to Ordinances, Licenses and Legal Affairs to review, but for now the reduction is in effect. A lot of promotion was done. Coastwatch did a fantastic job with posters and bags. One of the requirements was that bags had to be larger than 4 mils, but they are really difficult to find. That’s why OLLA will revisit the issue. J. Schiller asked what was going on with alternative Salem-oriented bags people could buy. Marblehead had a design logo and distributed reusable bags throughout their shops. People really liked it. B. Gerard said Salem Recycles also did some outreach promotion with posters, etc. There was a grant to give out some bags, but it ran out. People say paper bags break down too easily, but they can double up. B. Gerard said the Council will be finishing up marijuana zoning. There was a joint public hearing with the Planning Board and they just sent their recommendations to the Council. They will review them and either send it back to Committee or vote on it on Thursday night. Initially the Mayor’s office was recommending not having it in the B5 (downtown) zone, but the argument was made that it was like a package store and if it’s being treated like a package store it should be in B5. People in residential neighborhoods that have mixed zoning could potentially have a pot shop next door to them. Recommended that B1 will be by special permit. R1 (residential) will be a no. There is not much talk about cultivation. P. Kirby asked if there are limits to the number of licenses we can issue. B. Gerard said MA General Law states it can be up to 20% of package store licenses, so that would mean up to five licenses in Salem. ATG (Alternative Therapies Group) - medical gets first offer. N. Crowder moved to approve the reports. M. Lauby 2nd. All in favor. Motion passed. 5. Reorganization of the Board P. Kirby said he has enjoyed being the Chair and has learned a lot. It is time-consuming, but he is willing to serve again. M. Lauby gave high praise and appreciation to him for the outstanding job he has done and for the trust and respect he has earned from all. All present agreed. M. Lauby motioned to nominate P. Kirby as Chair. N. Crowder 2nd. All in favor. Motion passed.  N. Crowder motioned to nominate M. Davis to remain as Clerk of the Board. K. Murphy 2nd. All in favor. Motion passed. 6. Discussion of the Health With regard to the review of the budget letter to the Mayor, a new full- Department’s budget request for time inspector will be needed due to increased Certificate of Fitness next year inspections from the new ordinance, as well as increased pop-ups. L. Ramdin will get Certificate of Fitness number details to P. Kirby, but roughly 9,400 apartments need to be inspected. Each inspection takes a half hour or more of the inspector’s time. N. Crowder asked if we need three permanent people as opposed to catching up. M. Lauby said the argument is creating permanent salary positions, not just the need for overtime which costs more because we have to pay the inspectors time and a half. L. Ramdin pointed out that See, Click, Fix has also increased the workload for the Department. J. Schiller said the trajectory, based on the shared vision with the Mayor, is successful, but as M. Lauby said, now we have to pay for it. L. Ramdin will go over his projections and send the math and rationale to M. Lauby who offered to rework the language. J. Schiller asked B. Gerard if she thought a meeting with the Mayor would be more effective than just a letter. She agreed a meeting would be better. J. Schiller said we can present the letter to the Mayor at the meeting. L. Ramdin feels the Mayor is receptive to a meeting. He met with her and she is willing to go to Council to make the current part-time inspector position a full-time position. L. Ramdin said inspectional services (building and health) is a good business model, but is not a good functional model. The Health Dept. is the only department with jurisdiction to enforce the state sanitary code. M. Lauby asked what we would lose with an inspectional services department. L. Ramdin said there would be no oversight or guidance. M. Lauby feels the integrity of the Department would be tampered with and the vision of public health of the City would be affected. L. Ramdin said the Mayor wants to discuss the idea of an inspectional services department with the Board. M. Lauby said she understands the Mayor wants greater cohesion with departments, but feels it is more of a ripping apart. K. Waller said she can give us info on other cities using the inspectional services model. N. Crowder asked if that would mean the City would not have a Health Agent. L. Ramdin said maybe not. L. Ramdin said there are different skill sets, knowledge base, regulatory responsibilities, etc. for building inspectors and health inspectors. P. Kirby said the Mayor has been actively advocating for the idea of an inspectional services model as a policy goal, but there is an immediate term with the Department and we need to work it out.  P. Kirby asked if a different department can take on Certificates of Fitness to take the pressure off the Department. L. Ramdin said no, because the Health Dept. is empowered to enforce the state sanitary code. M. Lauby asked if the Health Agent is required to do inspections, or to oversee the health and well-being of the City. L. Ramdin said it is not a requirement for him to do inspections, but the quality of the work coming out of the Department would suffer without a Health Agent. J. Schiller asked if the meeting with the Mayor should be private. The meeting should be with the Mayor and the Board, but not a quorum. He feels the meeting should take place in the next couple of weeks, but definitely before L. Ramdin submits his budget. We should present a detailed letter to her at the meeting. Budget meetings with the Mayor are in March/April. L. Ramdin feels he should not attend, but he will ask for guidance from Vickie Caldwell. B. Gerard suggested that perhaps the Finance Director should be at the meeting. P. Kirby will set up the meeting and contact Board members to see who can attend. L. Ramdin reminded members that at his meeting with the Mayor she indicated she is very much aware that she needs to provide more resources to public health. 7. Board of Health program planning & city health status discussion a. Discussion of Tabled review/discussion of health report due to time constraints. Sarah Corley’s community health report b. Kimberly Waller - K. Waller will get us some background on inspectional services models. Salem-specific M. Lauby suggested we discuss the model issue at a later date, after the data presentation budget meeting with the Mayor. 8. New Business / Scheduling of • Mary Wheeler, syringe exchange program updates future agenda items • Kimberly Waller, inspectional services models • Personal use of marijuana 9. MEETING ADJOURNED: K. Murphy motioned to adjourn the meeting. M. Lauby 2nd. All in favor. Motion passed. 8:48pm Respectfully submitted, Maureen Davis Clerk of the Board Next regularly scheduled meeting is Tuesday, February 13, 2018 at 7:00pm At City Hall Annex, 120 Washington Street, Room 313, Salem, MA