Board of Health

CITY OF SALEM BOARD OF HEALTH MEETING MINUTES July 10, 2018 MEMBERS PRESENT: Paul Kirby, Chair, Kerry Murphy, Geraldine Yuhas EXCUSED: Dr. Jeremy Schiller, Beth Gerard, City Council Liaison OTHERS PRESENT: Larry Ramdin, Health Agent, Suzanne Darmody, Public Health Nurse, Maureen Davis, Clerk of the Board, Mayor Kimberley Driscoll, Kimberly Waller, Salem State University, Patricia Gozemba, Co-Chair, SAFE (Salem Alliance For the Environment), Stan Franzeen and Cindy Keegan, David Rowand, SAFE Board Members, Ward 7 Councilor Stephen Dibble, Salem residents Richard Stafford (Sierra Club member), Claudia Paraschiv, Alex Lacey, Joanne Scott, Attorney Edward Moriarty, Datanis Elias, Esq. TOPIC DISCUSSION/ACTION 1. Call to Order 7:03pm G. Yuhas motioned to take item #3 out of order. K. Murphy 2nd. All in favor. Motion passed. 2. Patricia Gozemba, SAFE - P. Gozemba said in 2016 National Grid reported there were 62 gas leaks Discussion of signing on to in Salem. Using the same standards used by National Grid, SAFE, along natural gas infrastructure letter with Gas Safety Inc., detected 232 gas leaks in City of Salem streets. We to Governor Baker are concerned about gas and its impact on climate change and also for safety and health reasons. There are a lot of dead and dying trees in Salem near the identified gas leaks. Trees are kind of the lungs of the universe and we want to preserve and increase the urban canopy with trees. Last year Salem got an urban forestry grant for $30,000.00 to plant new trees to replace those lost by the ill-effects of the gas leaks. Methane gas is leaking. A low estimate of 60% to as high as 80% of gas in the pipes in MA is fracked gas. Fracked gas is different from natural gas - it has harmful chemicals, which are carcinogens, and they certainly cause asthma. They are concerned about the safety and health of the residents in Salem. They are advocating for safety and caution. P. Gozemba said SAFE is requesting the Board sign on to a draft letter about gas infrastructure, started by the Sierra Club, to Governor Charlie Baker and also to send a copy of the Salem letter to all others listed on her handout sheet, which included members of the Sierra Club, Mayor Driscoll, State Rep. Paul Tucker, Senator Joan Lovely, Salem City Councilors, herself and Salem SAFE. 67 other communities in MA already signed on to the letter, representing 34% of the MA population. For some reason, the State wants 50% of communities signed on before taking action - we are now at 34%. Salem City Councilor Steve Dibble thanked the Board for taking up the issue. He requested the Board take action now and perhaps even look further into this issue and warn residents of the dangers and what they can do to reduce their intake of these gases - turn on their exhaust fans and  open a window. His family owned an oil company for many years and dug natural gas wells in PA and NY state and his dad has been lobbying for about 15-20 years to stop fracking in NY state - to not allow it to happen. A huge number of chemicals and by-products are being put into the pipes with natural gas and they are coming our way to Salem. He has a huge problem with it. People from PA are dying because of it. These chemicals are now in our kitchens and we are inhaling them - benzene, radon and many others. P. Gozemba pointed out that they are not anti-gas, but just wants us to be safe and think of future generations. There is not enough safety of new gas pipelines. Chemicals being emitted from the pipelines don’t just stay near the pipeline - the emissions travel. There is also an economic concern as we are all paying for all these gas leaks. There is an estimate there are 16,000 gas leaks in the state of MA. The gas leaked is worth approximately $90 million. We are all paying for that in our gas bills. G. Yuhas moved to sign tonight to approve sending out the letter to the Governor. K. Murphy 2nd. All in favor. Motion passed. P. Gozemba said Dr. Brita Lundberg, who is recognized as one of the state’s leading experts, will be invited to give a presentation in the future and the public will be invited. P. Gozemba can provide a map of the gas leaks in Salem and a map of the condition of the trees in Salem. She will send P. Kirby a link for the map. She thanked the Board. 3. Discussion on Inspectional Mayor Driscoll said K. Waller has done much excellent work for the Services with Mayor Driscoll Board on investigating Inspectional Services models. P. Kirby said K. Murphy also took an active role, assisting K. Waller with the interviews. The Mayor sees these models as opportunities to balance municipal assets we have and would like to look further into the potential benefits of linking like services within the City. Salem has a lot of needs. We need to better understand what our health and wellness needs are in Salem. We need to collect data to identify our needs and we have a lot of non-profit organizations that can help. We don’t have a human services approach to governing. She feels the maintenance work that needs to be done, such as inspections, gets prioritized at the expense of some of the other health and wellness needs that happen in our community. There are benefits to inspectional services. For example, fire prevention, building and health department staff are often in the same places. Maybe we can reframe some of the ways we are doing the work. She just wanted to start the dialog with the Board of Health. We need to invest in how we are delivering services. There might be value in separating out some of the inspectional work. Let’s look into what the benefits/drawbacks of an IS model are. It would have to be approved by the City Council. There are lots of different Inspectional Services models, not just one. K. Murphy visited with Chelsea to check out their IS model. She met with both the IS person and the Health Director. IS felt there was a lack of communication among departments. The Health Director thought there was a lack of oversight and felt there was a risk to public health because things were not being reported as they should, so there was a reduced emphasis on public health because of their IS model. Chelsea seemed to have a database where the building and health departments could both access info. Mayor Driscoll said that when she was there, the IS department was running like a top in Chelsea. Their model may have flaws, but our current model also has flaws. We need to increase our health & human services component with resource allocation. We could be digging deeper into opioids, homelessness, etc. K. Waller went to Lynn and asked them the pros and cons of their current IS model. They stated the one-stop shopping for residents was great. The head of the IS division was overseeing all three departments, health, facilities and inspectional services, saw some cost savings and felt coordination was enhanced. The health promotion office did not feel the same way - they did not feel like they had as much emphasis as the inspectional did. They thought it was helpful for the sanitary inspections, but felt they needed more direction with restaurant inspections. Mayor Driscoll feels we just need to figure out a model that works for us. She doesn’t want us to look at it like she is looking to take something away from the Health Department, but rather that she is trying to allow us to be able to have the time to provide more health & human services components. There are a lot of things we’re not getting to right now, even with added resources being put forward in the Department. She wants to have further conversation and if there is a willingness, dig a little deeper and develop a model that works for us. G. Yuhas said as a new Board member she was shocked to see what the Health Department is responsible for. She asked why they are doing the rental inspections for Air BnBs. L. Ramdin said it’s being done by us because it requires a special skill set by trained inspectors in the Health Department. P. Kirby said there is a big concern about training and certification and feels that could suffer under an IS model. K. Waller said better communication and possibly better management were the only transitional issues with the models they saw. P. Kirby said there is still a concern about the funding if it is only going to come from efficiency savings. Mayor Driscoll stated she increases salaries every year for the Health Department - it is not a flat budget. K. Waller spoke of how Worcester does proactive work around health promotion and health & human services. Mayor Driscoll said coalitions work best and we need to put assets and resources that we do have to provide better services. We could play a role as a convener with non-profit organizations. We can’t really do it alone. She feels it is a worthwhile conversation to have with the Board of Health and she would like to have a more formal exploration. J. Scott, the former Salem Health Agent and current Executive Director for the Salem Boys & Girls Club, said the Health Department has such a broad range of responsibilities. She said she really appreciates the Board members tremendously. The Building and Health Departments only intersect in housing inspections. Food inspections are completely different than structural inspections - different skill sets are required. It is about prevention, and it is often hard to prove that someone doesn’t get sick because of what the Health Department is doing. Mayor Driscoll said the Home Rule Petition is needed to have an IS department. More internal discussions with existing internal staff and the Solicitor are needed. K. Waller said a State Commission of local and regional public health just released a report to make recommendations to local Boards of Health across MA that will emphasis more health and social. They want to look at the structure and staffing of Health Departments and how Boards of Health work with Health Departments in cities and towns. Attorney E. Moriarty said legislation is critical. The general law has been in effect for over 100 years giving Boards of Health specific responsibilities. There should be a substantial respect for the general law that sets forth public health that delegates to cities and towns. The Board of Health would have to give up its authority and delegate it to someone else. He feels the Mayor is playing both judge and jury in saying that our current system is not working and we need a new system. MA was a national leader in public health when they enacted the statute to provide authority that delegated it from the State to cities and towns to protect the public health. He spoke to the Mayor and asked, isn’t it possible Salem is great because the Board and Department are great? He said it is not credible for the Mayor to suggest we will have better health or that we could focus more carefully and more clearly on issues, like homelessness, mental health, opiates, etc. if we relieve the Board of Health of this onerous task, which he guesses is an assumption that they are not doing it very well or doing it very efficiently. He said an IS Department is not a benefit to the Board of Health. He said he respectfully disagreed with the Mayor on the subject of funding levels, stating that funding hasn’t been anything other than level at best, and sometimes reduced, for the Health Department. He doesn’t feel that structure and function would guarantee a better health condition in the community. He asked how Worcester is in any way a comparative to Salem since Worcester is the second largest city in the Commonwealth. K. Murphy agrees with the Mayor that there needs to be more of a focus on public health issues, but the IS model she saw was not overwhelmingly positive and she wants to make sure there would be a way to monitor both sides of the public health spectrum if there was restructuring. G. Yuhas praised all the work the Health Department and S. Darmody does and feels they are terribly overworked. She feels we need to have a meeting to talk about ideas, but not at a Board meeting. Mayor Driscoll said she did not come in with a proposal, she came to have a conversation about the possibilities of restructuring. She said this idea is not a reflection of any staff - people are working hard and doing great work, but we are a busy, hot, active city with a lot going on. She is just interested in what is actually going to work for our community. L. Ramdin said we could put together an internal working group within departments.  K. Waller said the State Commission was formed because the State is recognizing that MA is falling behind other states in health promotion. She acknowledged the scope and volume of the Health Department’s responsibilities. G. Yuhas motioned to take item #7 out of order. K. Murphy 2nd. All in favor. Motion passed. 4. Continued Discussion of P. Kirby said Councilor Gerard was in Boston and not able to attend the Polystyrene meeting, but he asked her to text him the latest info, which was that Councilor Milo did not want to take the issue up in her committee, Public Health, Safety, and Environment, but recommended it to Councilor Dibble’s committee, Community Development. C. Paraschiv said polystyrene is not just Styrofoam - it includes plastic utensils, take-out containers, cups, straws, etc. - all #6 plastics - the current suggested ban is only for expanded polystyrene. L. Ramdin said OLLA is the place for any change in legislation in the City. P. Kirby said there are budgetary and financial impacts to the School Department. L. Ramdin said any changes we make will not be going to trash or compost because food contaminates the recycling. G. Yuhas said soon recycling will soon be down to only #1 and #2. She feels we will have to open our own recycling plants. C. Paraschiv wondered how we can balance the health implications with the budgetary implications. It would be best to move straight to compost. L. Ramdin believes City Council is the right place for this issue. While the Board is in support of the issue, he feels the advocates need to build a grassroots movement. Even if a Council member chooses not to bring the subject up, the advocates can show up at the open session at the beginning of Council meetings and bring the subject up. He recommended they get their councilor to draft the ordinance and discuss with the City Solicitor to make sure it meets all the legal requirements, then go before Council. It’s a long process. P. Kirby said he personally supports the ban as a policy. Maybe a letter to Council from the Board to encourage discussions and recommend a ban. Model municipal legislation would be helpful. 80% of students in Salem are using polystyrene trays every day - that is a lot of waste. P. Kirby suggested we continue discussion at the September meeting. He will gather information from the advocates in preparation. C. Paraschiv will provide information from the Cambridge model - it is a large city that did a good job and managed to ban polystyrene even in schools and restaurants. L. Ramdin said we need to show cause to Council and prove that the positives outweigh the negatives. Try to get a Council member, perhaps Councilor Gerard, to introduce it to Council.  G. Yuhas motioned to continue discussion in September. K. Murphy 2nd. All in favor. Motion passed. 5. Approval of Minutes K. Murphy motioned to approve the minutes. G. Yuhas 2nd. All in (June 12, 2018) favor. Motion passed. 6. Chairperson Communications P. Kirby distributed a Salem Syringe Service Program Update he received from Mary Wheeler of Healthy Streets. The program appears to be working well. S. Darmody said the Community Impact Unit of the Police Department is doing a great job and are really involved in the homeless community and people out on the streets who may have been the people discarding needles in the past. L. Ramdin said Healthy Streets is using the needle distribution to build a rapport with the users to gain their trust so they can guide them toward services. He reminded everyone that every police cruiser in Salem has a sharps container so they can dispose of sharps as they come across them. 7. Monthly Reports a. Public Health S. Darmody reported that the Farmers’ Market has started. It is every Nurse’s Report Thursday from 3-7pm. She provided information on sun safety, ticks and mosquitoes, blood pressure screenings and handouts and passed out pedometers to promote activity. Jeffrey in our office did two foodborne illness inspections in June in response to complaints. S. Darmody has done a couple of food histories in response to complaints and the inspectors follow up with inspections. L. Ramdin said the establishments in Salem are aware that the Health Department has expectations and know what they need to do. Camps will all be finalized next week. Copy available at the BOH office. b. Health Agent’s L. Ramdin would like to ask the Board to take action and adopt a zero- Report tolerance policy for bulk items left out on the sidewalk, but with inspector discretion allowed. P. Kirby said we could call it an “enhanced enforcement” policy. K. Murphy asked if there is a way we can put it out to the media first to give a general warning. L. Ramdin said if the Board supports it we can move forward and he will plan to put something out as a press release about enhanced enforcement. G. Yuhas motioned that the Board will support enhanced enforcement for illegally dumped materials and items placed on curbside for collection without making the appropriate arrangements for collection. K. Murphy 2nd. All in favor. Motion passed.  L. Ramdin reported that he just came back from the NEHA Conference. There were discussions about movements to go back to paper straws. There was also talk around the country of going into recyclables and compostables. Life Alive was having issues with building management. He had to get them all together to work it out. Still having issues with Celia’s Restaurant - the problems are due to lack of managerial control. They were required to hire a food safety consultant to train staff in food safety and handling. Letters are going out soon to all the registered owners of rental units to turn in applications for a Certificate of Fitness. P. Kirby asked about finalizing the solid waste regulation. L. Ramdin said they were waiting for the new fiscal year to get a PO to do the summary that has to go in the paper. Once the summary is posted, he will notify Paul to come in and sign the regulation, then it will be filed with DEP before the effective date. L. Ramdin said we will be purchasing a new vaccine refrigerator to comply with the guidelines/requirements of the Dept. of Public Health. Copy available at the BOH office. c. Administrative No comments/questions. Report Copy available at the BOH office. d. City Council B. Gerard not present. Liaison Updates G. Yuhas motioned to approve the reports. K. Murphy 2nd. All in favor. Motion passed. 8. New Business/Scheduling of - Continue discussion of polystyrene Future Agenda Items 9. MEETING ADJOURNED: K. Murphy motioned to adjourn the meeting. G. Yuhas 2nd. All in favor. Motion passed. 9:27pm Respectfully submitted, Maureen Davis Clerk of the Board Next regularly scheduled meeting is Tuesday, September 11, 2018 at 7:00pm At City Hall Annex, 98 Washington Street, 1st Floor, Salem, MA