Board of Health

CITY OF SALEM BOARD OF HEALTH MEETING MINUTES September 11, 2018 MEMBERS PRESENT: Paul Kirby, Chair, Dr. Jeremy Schiller, Kerry Murphy, Geraldine Yuhas ABSENT: Beth Gerard, City Council Liaison OTHERS PRESENT: Elizabeth Gagakis, Acting Health Agent, Suzanne Darmody, Public Health Nurse, Maureen Davis, Clerk of the Board, Mayor Kimberley Driscoll, Joanne Scott, Attorney Ed Moriarty TOPIC DISCUSSION/ACTION 1. Call to Order 7:03pm G. Yuhas motioned to take the meeting out of order. K. Murphy 2nd. All in favor. Motion passed. 2. Approval of Minutes K. Murphy motioned to approve the minutes. J. Schiller 2nd. All in (July 10, 2018) favor. Motion passed. 3. Chairperson Communications Datanis (Dee) Elias has been approved to be on the Board. She will be nominated before the City Council on 9/26/18. P. Kirby will try to attend the Council meeting. Patti Kelleher, the Preservation Planner with the City, requested a temporary closure of the Charter Street Cemetery. This item will be on the October agenda and the Board will vote on it. P. Kirby acknowledged that L. Gagakis is doing a great job as Acting Health Agent. 4. Monthly Reports-Updates a. Public Health S. Darmody reported a sharp increase in the latent tuberculosis numbers Nurse’s Report between July 3rd and August 29th. The State tuberculosis office said the City of Lynn got a grant to test everyone so that’s why the numbers were so high. The CDC recommends FluMist for ages 2-49. Per the Advisory Committee on Immunization Practices (ACIP), previous years showed no significant effectiveness against Influenza A from FluMist. Providers may choose to give FluMist this year for whom it is appropriate. Our employee flu clinic will be held in the City Hall Annex on 9/27/18. There will be another flu clinic on 10/2/18 at the new Community Life Center on Bridge Street. Copy available at the BOH office.  b. Health Agent’s J. Schiller asked if the Board gets beach testing results. Report E. Gagakis said we receive results weekly, for 12 weeks, until Labor Day. She said the reports go to the Health Agent, but we can forward them to the Board. E. Gagakis reported that most of the plan reviews are new owners of existing establishments. With regard to the noise complaint of Kokeshi’s rooftop air conditioning unit by abutting neighbors; Kokeshi is ordering a muffler. There only needs to be a small noise reduction. Copy available at the BOH office. c. Administrative M. Davis noted the large increase in Certificate of Fitness income - more Report than double the amount collected the previous month. It is due to the updated inspections ordinance. P. Kirby said he sees two administrative issues at this time; first, we still need to fill the contracted inspector position and second, we need to have coverage for S. Darmody’s maternity leave. S. Darmody said she will reach out to local nurses for coverage and also Lisa Cammarata from Human Resources to set up how we will pay for the coverage. There will need to be MAVEN coverage for reported communicable diseases, such as foodborne illness follow-up and also coverage for tuberculosis cases, especially those requiring D.O.T. She estimates there will need to be coverage for approximately 10 hours per week. Copy available at the BOH office. d. City Council B. Gerard not present. Liaison Updates K. Murphy motioned to approve the reports. J. Schiller 2nd. All in favor. Motion passed. 5. Mayor Driscoll - Discussion on P. Kirby said since this is an on-going, long-term discussion, at this time Inspectional Services Model the Board is in an information receiving mode. Mayor Driscoll noted that previous discussions were about coming up with additional details and concepts. She passed out organizational charts for both the existing structures and the proposed Health and Wellness Department and Inspectional Services Department. She proposes investing in an inspectional services model that groups inspectors to streamline the operations around inspectional work in order to build more opportunities for public health. This is a special act process so we would have to go get special legislation to do this. The process could take several months. We would fund a Director of Public Health and a Health & Wellness Coordinator so we could look at public health prevention. There would need to be clear communication and protocols between what might be happening that could end up coming before the Board of Health, for example, foodborne illness. J. Schiller asked what town is using the model successfully. Mayor Driscoll said it was working well in Chelsea, but there are many other communities. K. Murphy said when she visited Chelsea, the Inspectional Services side thought everything was great, but the Health Agent did not and talked about a lack of communication between departments. She suggested we could set it up to ensure better communication. Mayor Driscoll said she thought it worked great when she was in Chelsea. She said she can get J. Schiller a list of communities. G. Yuhas said she likes the idea of ISD, but only because at this time we don’t work enough with the elderly. She said if the building department and the health department were on the same floor it would make more sense. Mayor Driscoll said we would be investing in a more efficient system. She feels we are missing out on huge grant opportunities. P. Kirby asked Mayor Driscoll who would be the grant writer with the proposed plan. She said it would be the Director of Public Health. Mayor Driscoll said there are many areas that we could improve upon. For example, the homeless coalition could use a boost. J. Schiller said when Larry Ramdin was Health Agent he was concerned that someone would be overseeing inspections they weren’t qualified to do themselves. P. Kirby noted that according to MA general law, the Board is still responsible. Mayor Driscoll said the Health Department is the only department with a Board. P. Kirby asked how the Special Act Home Rule Petition works. Mayor Driscoll said it is a way for cities to carve out exceptions to MA general law. It would require a majority vote of the City Council. She doesn’t want to hire someone now who doesn’t have the skillset required for an ISD. J. Scott asked P. Kirby to reconsider the idea of ISDs. She said prevention of disease is the Board’s #1 priority. The Board should stand up to what it believes is right. She feels it’s not necessary to make things so complicated as it seems to be from the organizational charts. She also feels that those who seem to be in favor of ISDs may be influenced by politics. Sanitarians are agents of the Board. Models work if personalities work; it’s all about personalities. There is nothing more important than health and she feels very strongly about this subject. She has such respect for the Board of Health and wants the Board to maintain its authority and feels it is of the utmost importance. She said the Board is lucky to have the MAHB as an advisor and their whole job is to help the Board keep its authority. P. Kirby thanked J. Scott for her passion and said if the subject comes to a public hearing he would encourage her to attend, and also to write a letter to the Board expressing her views on the subject. P. Kirby said he would like to involve the staff in the decision-making process. K. Murphy and G. Yuhas agreed. Mayor Driscoll thought a working task force would be better. K. Murphy asked if an ISD model passes, is it set in stone or can we make changes to it as we go. Mayor Driscoll said any changes would require another Home Rule Petition. She said she will have to ask the City Solicitor if we can operate like an ISD without a Home Rule Petition as a pilot program.  J. Schiller said we need to hire a Health Agent. The Board’s opinion of ISD models should matter to the City Council. We need to know what kind of degrees and training are required of a Director of Public Health compared to that of a Health Agent because the salary would be different and they would need specific skillsets. Mayor Driscoll said there would be shifting of responsibilities, powers and authorities. G. Yuhas said she doesn’t want to put off hiring, but just let those interviewed know there is a possibility of an ISD in the future. P. Kirby said his strong preference is to move forward on hiring a Health Agent. G. Yuhas agreed and added that we need to be up front. S. Darmody said the department has lots of questions about how an ISD would work with regard to camps, pools, body art, etc. She would be happy to be part of a working group. P. Kirby asked who the working task force group would consist of. Mayor Driscoll said Board members, but not a quorum - only two members, plus the City Solicitor, city staff, such as the Building Inspector, and perhaps a public health consultant from the BU School of Public Health. Mayor Driscoll stated that her staff would do the administrative work to put together the task force. Mayor Driscoll said it would also be helpful for the Board to put together an internal working group to keep moving forward. It would be a way to gather information in a constructive way that would allow the Board to make a decision or recommendation. It would not be a public meeting. J. Schiller motioned, based on the discussion on Inspectional Services Model, to form a working group composed of two Board members and selected members of the City. G. Yuhas 2nd. All in favor. Motion passed. 6. Health Agent Hiring Discussion The hiring committee met on 9/10/18. There were seven candidates in total. The committee agreed they would like to interview four of the candidates. P. Kirby reported he asked the City Solicitor if the full Board could see all the resumes. The answer was no; the committee needs to do that. J. Schiller asked if the other members could at least be given the names of the candidates. The answer was no; they can only be told of the finalists. P. Kirby sent emails to Board members asking that they send any questions they have for the candidates to Lisa Cammarata, who will compile them and have them available to the committee for use at the interviews. After the interviews, the committee will narrow the candidates to one or two and the Board will interview those finalists in an open meeting. G. Yuhas feels we should finish the process we started and hire a Health Agent and tell them what’s happening at the interviews. J. Schiller agreed that transparency is the only way forward. He asked E. Gagakis how long she would be willing to serve as the Acting Health Agent. She said she is happy to serve, but noted that it took two to three  years to hire a new Health Agent last time and that is too long. 7. New Business/Scheduling of Presentation by SAFE on gas leaks and health Future Agenda Items K. Murphy mentioned that the first community meal at Saltonstall is on Wednesday, 9/12/18. MEETING ADJOURNED: G. Yuhas motioned to adjourn. J. Schiller 2nd. All in favor. Motion passed. 8:38pm Respectfully submitted, Maureen Davis Clerk of the Board Next regularly scheduled meeting is Tuesday, October 9, 2018 at 7:00pm At City Hall Annex, 98 Washington Street, 1st Floor, Salem, MA