Board of Health

CITY OF SALEM BOARD OF HEALTH MEETING MINUTES May 7, 2019 MEMBERS PRESENT: Dr. Jeremy Schiller, Chair, Paul Kirby, Kerry Murphy, Geraldine Yuhas, Datanis Elias OTHERS PRESENT: David Greenbaum, Health Agent, Suzanne Darmody, Public Health Nurse, Maureen Davis, Clerk of the Board, Beth Gerard, City Council Liaison, John Femino, resident TOPIC DISCUSSION/ACTION 1. Call to Order 7:00pm 2. Discussion of Possible Body Works D. Greenbaum referenced the Arlington Body Works regulation that was Regulation part of the meeting packet. He said the Board can review it and decide if they want to move forward with a regulation for Salem. J. Schiller said penalties should be concrete so there is no room for discussion if there is a violation. We will put this item on the agenda for discussion at next month’s meeting. G. Yuhas asked if body works establishments need a permit in Salem now. D. Greenbaum said no, the Department of Professional Licensure oversees them now. He will research other communities’ regulations. 3. Review of Health Department Fee D. Greenbaum feels we need to review fees, especially for Halloween time. Schedule We need to decide what defines a true pop-up. The vendors for the food truck festival should be paying for our staff overtime, just as they do for police, etc. He said the fees aren’t set to create a revenue stream, they are set to offset our cost. He will research other communities’ fees. He believes the camp fee of $10.00 is set by state law, but he will check. Certainly, between the amount of time S. Darmody puts into them and the liability, a fee of $100.00 for a summer camp would certainly be warranted. J. Schiller said this is another agenda item to revisit next month. 4. Approval of Minutes K. Murphy motioned to approve the minutes. G. Yuhas 2nd. All in (March 12, 2019) favor. Motion passed. 5. Chairperson Communications We didn’t meet last month. J. Schiller asked D. Greenbaum to update the Board on the ISD Task Force meetings. D. Greenbaum distributed the presentation from MAPC from the last Task Force meeting on May 1st. They presented four models. Two that try to create a level of an inspectional services. The following are his thoughts and opinions on each: Concept #1 - Unified inspections. Would take the sanitarians and move them to the purview of the Building Commissioner. Not a model he would necessarily favor. J. Schiller noticed there would be no oversight by the Department of Health. Concept #2 - Status quo. No real change. The illustrative example doesn’t match up. The only way this model would work is if the ISD Director was the Health Agent. Concept #3 - Branches off into two divisions - Health and Building. All inspections would still go to the purview of the Building Commissioner with a liaison to the Health Department. K. Murphy felt this model made the least sense because the ISD Director would oversee both the Health Director and the Building Commissioner. D. Greenbaum believes this would be a violation of state law for the building code because the Building Commissioner must report to the person who appointed him, which would be the Mayor. That would not be the case with this model. The illustrative concept is from Lynn. Lynn’s model is crumbling. Lynn’s public health division is a shell because the whole health structure is only the Health Director and one Public Health Nurse. They contract out their food inspections. He is not a big fan of it. Lynn will need special legislation to go back to a more traditional model. They found it was cumbersome to coordinate public health because the inspectors and others sit in different locations. Concept #4 - Integrated public health. This is the ultimate wish list where things basically stay the same, only we would get some additional staffing. The additional positions, such as the Health and Wellness Coordinator, are ones he would love to have within our department, however he is a realist and doesn’t anticipate that happening. He realizes there are not unlimited resources. Some of the positions may not necessarily mean hiring new staff, it may mean that somebody gets a promotion. K. Murphy said he seemed to like concept #4. He said yes, either concept #4 or the status quo model, clearly. J. Schiller asked what the budget would have to be to have a model like that over what we have now. D. Greenbaum said if we promote an Environmental Health Manager, his wish would be to make our part-time sanitarian into a full-time sanitarian, so there would be an increase of only about 50% of the salary. The salaries for sanitarians are contract negotiated and are collective bargaining positions, so the salaries are what they are. There will be no negotiating of salaries. There would be a total increase in salaries of about $100-125K. K. Murphy said Mass in Motion should have been part of the Health Department from the beginning. The Community Health Manager could write grants that fund programs and positions. D. Greenbaum said grants are not sustainable, so we would need to figure out how we could fund or sustain the programs when the grants run out. He said the Mayor feels the Health and Wellness Coordinator would be cannibalized by inspections and so would not be housed in the Health Department, but rather at the Community Life Center (senior center). There would still be some collaboration, but they would not be a staff member of the Health Department. All members disagree with that notion. K. Murphy said the whole point of all of this was to have more public health in the Health Department, but if you’re going to add these positions and put them somewhere else offsite, then that’s not public health. J. Schiller said if the reason for looking into getting this changed is to increase the focus on public health, he feels the best model for that focus is D. Greenbaum’s wish list model. D. Greenbaum feels that the effect of putting the Health and Wellness Coordinator somewhere else is that nothing changes. Having that person in-house would give us the opportunity to do more public health  programming that the Mayor wants us to do. To him, having grant work sustainable is the goal. The last meeting of the MAPC is tentatively scheduled for June 5th, at which time they will provide their recommendations and final report. D. Greenbaum inquired to MAPC at the Task Force meeting as to why out of the 11 communities listed in the local health departments review, seven had ISD models and four did not. He feels it should have been more 50/50. He said a lot of communities that didn’t have ISDs had them at one time and went back. For example, Framingham had a horrible experience for a year and a half due to lack of oversight and also because the Building Commissioner refused to report to the Board of Health because they didn’t appoint him. D. Greenbaum said Boards of Health were designed to work autonomously. J. Schiller asked if MAHB has weighed in on the idea. He feels they are a very important body and we should know their informed opinion. Their opinion should weigh in heavily with the Task Force. D. Greenbaum said he spoke with MAHB’s staff attorney and she was going to speak with MAPC the next day. She said she was going to tell them she was concerned about loss of Board authority and oversight over the staff. She didn’t offer a concrete opinion, but she has her concerns 6. Monthly Reports-Updates about what happens when a Board loses its authority. a. Public Health Nurse’s Report B. Gerard asked about the news report about getting another MMR vaccine for measles. S. Darmody said it depends if you’ve had enough doses. You can safely get a titer done if you are not sure. There were 60 cases investigated, but only one confirmed and that was on the news that the person had traveled a lot. These are the most cases we’ve had since 1994. New York has a massive outbreak. D. Greenbaum updated the Board that the City of Gloucester put out a press release around measles and prevention of disease that their public health nurse shared with all the other nurses in the surrounding 15 communities and said we could use it carte blanche. He will be forwarding it to the Mayor’s office for approval to be sent out to the press. Copy available at the BOH office. b. Health Agent’s Report S. Darmody began training to become certified for the North Shore Mother Visiting Partnership. She attended a two-day, intense training last week that she found very interesting and informative. It was called Newborn Behavioral Observation. It is more focused on the infant and how to help facilitate bonding with the parent by pointing out the behaviors and abilities of the newborn to give the parents more confidence. D. Greenbaum informed the Board about his budget requests. The only line-item increase he requested was $3,400.00 for rodent control. He also asked to have Janet Mancini moved from part-time sanitarian to full-time using the money already in the budget from the additional clerk position, as well as moving money from the part-time salary line to the full-time salary line. He is cautiously optimistic about the budget. He is in the process of working with Recycling Works, a state-wide assistance program, to get us information about recycling resources aimed at getting the haulers and their customers to implement the mandatory  recycling. We will have some information going out to haulers this week or next week at the latest. On April 22nd he hosted a meeting, like a meet and greet, with the food establishments at the Annex to provide updates to the food code and to introduce himself and the staff. Received mostly positive feedback. He told them we have an open-door policy and we want to work collaboratively with them. He asked them to view us as a resource and not the enemy. He reminded them that we are, however, an enforcement body and if we have to enforce regulations we will, but our goal is to achieve compliance and not to take punitive action unless absolutely necessary. He and S. Darmody had a table at the health fair at the middle school. They focused on what the Board of Health does and handed out printed pens and drawstring backpacks. They will also have a table at a health fair coming up on Thursday, May 9th at Salem High School. The focus will be on the vaping issue. K. Murphy asked if we have heard about a vape shop going into the old Salem Laundromat. We have not heard anything about it yet. G. Yuhas asked about an email Board members received about getting certified for emergency preparedness training. D. Greenbaum will check to see if it is still a requirement for members and will let the Board know. We are updating our emergency dispensing site plans. We have a contractor that works with the EP grant. Copy available at the BOH office. c. Administrative Report Copy available at the BOH office. d. City Council Liaison Updates There is a proposed new ordinance to address the Municipal and Religious Overlay issue with the abandoned buildings that failed this week. Hopefully this proposal will pass. At the last Council meeting they unanimously approved to sell 5 Broad Street, but there is no mechanism for the proposal without a zoning change. We continue to be challenged by affordable housing. ATG went back online with their recreational. No complaints, except bikes in Harmony Grove Cemetery. She is hoping they will get their budget books soon. P. Kirby motioned to approve the reports. G. Yuhas 2nd. All in favor. Motion passed. 7. New Business/Scheduling of Future J. Schiller said the hospital is a huge resource. We may be able to partner Agenda Items with hospital staff and work collaboratively to accomplish the goal of expanding public health. The hospital is always looking to get involved with community health. He will look into it and try to get some contacts. D. Greenbaum said he would love to get involved in that. It would be awesome to have that kind of collaboration with the hospital. Years ago, Union Hospital actually paid half of the public health nurse’s salary in Saugus. K. Murphy said the hospital is funding her position right now, but they are not going to continue. They are paying 100% of her salary. She said she can help with the hospital, too because they have been trying to get someone from the hospital to join the Salem for All Ages Committee.  B. Gerard said an ICU nurse at the hospital approached her about addressing the Board regarding safe injection sites and she suggested he contact D. Greenbaum to get on the Board agenda. S. Darmody said she also spoke to some UMass Boston nursing students. One worked in ICU and another worked in the ER. They told her they see a lot related to the opioid crisis. D. Greenbaum asked what the Board’s position is on safe injection sites. J. Schiller said he only knows from the news reports that the data is very favorable. He is for what the data supports. D. Greenbaum said he is on the same page. It would be a radical move to do something like that but he thinks, if it’s feasible, it could solve a lot of problems such as overdoses, access to clean needles and recovery services, etc. P. Kirby said he would like to have Narcan training for the Board. D. Greenbaum said he will speak with Mary Wheeler from Healthy Streets to set up training. D. Greenbaum said there are standing orders throughout the Commonwealth that pharmacies are supposed to have Narcan available. He and S. Darmody will survey the pharmacies in town to see if they have it available, and if not, why not. They will make sure the pharmacies are aware of the order and work with them to try to get the Narcan available. J. Schiller wants to come up with an agenda about what we are going to do with public health. G. Yuhas has been reappointed to the Board. MEETING ADJOURNED: K. Murphy motioned to adjourn. P. Kirby 2nd. All in favor. Motion passed. 8:14pm Respectfully submitted, Maureen Davis Clerk of the Board Next regularly scheduled meeting is Tuesday, June 11, 2019 at 7:00pm At City Hall Annex, 98 Washington Street, 1st Floor, Salem, MA