Board of Health

CITY OF SALEM BOARD OF HEALTH MEETING MINUTES February 11, 2020 MEMBERS PRESENT: Paul Kirby, Geraldine Yuhas, Sara Moore EXCUSED: Dr. Jeremy Schiller, Datanis Elias OTHERS PRESENT: David Greenbaum, Health Agent, Suzanne Darmody, Public Health Nurse, Maureen Davis, Clerk of the Board, Patti Morsillo, City Council Liaison, Joyce Redford, NSCATAPP, SSU students (observing) TOPIC DISCUSSION/ACTION 1. Call to Order 7:00pm G. Yuhas motioned to take the agenda out of order. S. Moore 2 nd. All in favor. Motion passed. 2. Approval of Minutes S. Moore motioned to approve the minutes. G. Yuhas 2 nd. All in favor. (January 14, 2020) Motion passed. 3. Chairperson Communications P. Kirby chaired the meeting in J. Schiller’s absence. No communications. 4. Monthly Reports-Updates a. Public Health S. Darmody reported that the World Health Organization gave the new Nurse’s Report Coronavirus disease a name; COVID-19. She will be meeting with the other public health nurses tomorrow to go over their pandemic plans and update and create a regionalized plan. There will be a community baby shower at the public library on Saturday, 2/29/20. She will have a display about the mother visiting program. Copy available at the BOH office. G. Yuhas motioned to take the agenda out of order again. S. Moore 2nd. All in favor. Motion passed. 5. Kimberly Waller – K. Waller shared a PowerPoint presentation from her Salem State Health Discussion of Vaping Care Studies Policy class. The presentation provided definitions related to vaping, along with data on price, equipment and supplies, hospitalization for lung injuries/infections and deaths. Vitamin E acetate, when inhaled, seems to be the main issue. The U.S. Surgeon General has deemed e-cigarette use among youth an epidemic. The U.S. is the largest market for vape products. Juul is the biggest company. Online sales of vape products provides easy access for youth and allows the purchase of flavors and offers many different product choices. The products are inexpensive, and they don’t need to prove their age to make a purchase. After the ban in MA, sales in NH increased and they started offering discounts to MA residents to keep the sales there. P. Morsillo asked is there have been any studies that vaping helps to quit 1|Page  smoking. D. Greenbaum said yes, but it is still a nicotine addiction. Studies show that boys use e-cigarettes more than girls. Teen e-cigarette users are more likely to start smoking cigarettes. Teens don’t see it as ingesting nicotine, they think they are just vaping for the flavors. Vaping devices are easy for teens to hide because they are small and don’t smell. “Dripping” is a new practice among high school students where they place e-liquid drops directly onto the heating coils to create a thicker vapor, improve the flavor and produce a stronger throat hit. Students don’t think vaping is dangerous. It is accessible and affordable, and they are attracted to the flavors. The more options and varieties that are available, the more likely teens will utilize it. Providence, RI was the first city in the U.S. to limit price promotions so vape and cigarette products can’t be discounted. They also restricted and enforced flavor restrictions and they saw a reduction in both vaping and the use of e-cigarettes. 6. Joyce Redford of NSCATAPP – J. Redford introduced herself and explained that NSCATAPP was formed Tobacco Control Update and in 1993 and is a collaborative of 16 North Shore Cape Ann communities. Discussion of Proposed Regulation On January 17th the DPH held a public hearing after they enacted the immediate vape ban. We need to draw a clearer line between CBD and tobacco for the new regulation. There is a new State regulation regarding civil violations, aka 21D tickets. The new fees for violations have increased to $1,000.00 fine for a 1st violation, $2,000.00 fine for a 2nd violation and $5,000.00 fine for a 3rd and subsequent violation. Boards of health and police departments can enforce it. As soon as the emergency ban was lifted on December 11th, the Governor immediately enacted the flavor restriction on all vapor products with the exception of tobacco flavored products. The industry is trying to conceal flavors with names that don’t sound like a flavor, like blue instead of blueberry or blonde instead of banana. Flavors are dangerous because they cover up any bad tastes. J. Redford encourages everyone to watch a 15-minute video titled, “Black Lives, Black Lungs”, which shows how the industry has historically targeted a specific population. June 1, 2020 is the deadline for no flavored tobacco in any form, including menthol and mint, in MA. The only benefit to an adult-only establishment at this point is that they can carry liquid nicotine with nicotine milligrams over 35 milligrams per milliliter. So Juul can’t be sold in any convenience store or gas station in MA, it can only be sold in adult-only establishments. We have seen a large increase in middle school kids, 6th and 7th graders, who have started using disposable “puff bars”. Peabody, Danvers and Lynn police have information about a young adult driving around providing students with puff bars which they then re-sell to their peers. Kids are selling a “hit” or a “draw”, which brings on a lot of other health issues since they are sharing a device. If the person in the car does not have the flavor the youth wants, this young adult has also been known to take the youth to their home to get the flavor. This is so alarming 2|Page  on so many levels. The police are investigating it as criminal. There has been an increase in middle school suspensions for vaping. This causes an attendance issue and the student is then home vaping unsupervised. There is not a program for middle school students. We recognize this is a big gap in service and we are trying to find ways to fill that gap. As she discussed with the Board in the past, she would like us to consider a retiring cap on tobacco stores. Once a store closes, the permit goes back to the City and will not be reissued, so there would be one less store in the City and over time there will be less and less stores. S. Moore said we have discussed the retiring cap a few times before and asked when we will change the regulation to include it. D. Greenbaum said we don’t want to update the regulation piece-mail, so when we are ready to update it the retiring cap will be included in it. P. Kirby asked J. Redford when we should update the regulation. She said they will be sending out a template of the regulation so we can update ours after the template is provided. With the regulation, we can’t go less than the State, but we can go more. We will make all the updates that the State has and then add to it. The tobacco industry is trying to come up with all kinds of new nicotine products such as toothpicks, gels, water, etc. We could include no smoking in private clubs in our regulation. Salem was the first community to adopt the totally smoke-free workplace regulation for restaurants and bars in 2003. The State followed suit in 2004. Smoking bars are not allowed in Salem and the current regulation does not allow for a variance, so any change would require a public hearing. D. Greenbaum reported that someone went to the Mayor about opening a hookah lounge. He explained to them what the regulation says and said he wouldn’t speak for the Board, but told them it would be a high hurdle to get over with this proactive and forethinking Board because it would set the City back and there would also be a coalition that would come out against it. He told him if he wanted to be on the agenda, it would be in March and he should email him if he wanted to come before the Board. As of yet he has not received an email. This person currently has approval to open his retail store, but he hasn’t done that yet either. He has a hookah lounge in Methuen. J. Redford distributed a sheet with reports of violence at hookah bars, such as stabbings and shootings. Hookah is a water pipe, or a bong, and is popular at late-night clubs. Anything can be used in the liquid that is then inhaled. She said she will be at our meeting in March. She believes the Salem Youth Commission will be there, too. 7. Monthly Reports-Updates (Continued) b. Health Agent’s Report D. Greenbaum said he is hoping the e-cigarette buyback program at the high school will be up and running in the next couple of weeks. If it gets positive reviews, he hopes to expand it to other places and to all age groups throughout the City. J. Redford said if it is successful, she feels other communities will likely do the same. 3|Page  S. Moore asked if anyone will be collecting data about the buyback program. D. Greenbaum said the nurse practitioner at the teen center will do pre and post surveys with the kids. D. Greenbaum talked about the Healing Communities study with Boston Medical Center. A grant-funded coalition coordinator will be a Health Department employee. The goal of the study is to achieve a 40% reduction in opioid overdose deaths. It is a huge undertaking. P. Kirby asked who is involved in the grant. D. Greenbaum said himself, S. Darmody, Healthy Streets, police, Lifebridge, Salem Partnership, NS Community Health, NSMC and residents. D. Greenbaum reported we have an issue with a resident that has trash and debris all over the yard. He has been cited and ordered to clean it. He has requested a hearing. He will be at the March meeting for a hearing. Copy available at the BOH office. c. Administrative Report D. Greenbaum said it is budget season. His budget should be coming to him soon. Again, he will be requesting the part-time position be full-time. P. Kirby asked if there was anything the Board could do to help. D. Greenbaum said once he gets the budget, they can talk more about some documentation to support his request. Copy available at the BOH office. d. Council Liaison Updates P. Morsillo said hopefully we will have a new accessory dwelling unit ordinance to look at, this time with financial incentives for low-income. We are still waiting on the inclusionary zoning ordinance. The two religious reuse proposals going through for St. James school and Immaculate Conception are very affordable, which is great. D. Greenbaum said people need to understand that affordable does not mean low-income. It can mean market rate, which can still be expensive. S. Moore asked what the Board can do to help with housing. She said we had talked about the Board writing a letter that housing is a public health issue. P. Morsillo said she would love the support of the Board and will keep us posted. She will be having an order on Thursday to invite the police Community Impact Unit to speak at the public health and safety committee to educate everybody on what they do. They do so much for the community. P. Morsillo reported that two largest teachers’ unions spoke out against active shooter drills. The League of Women Voters did a lot of study into it and about the emotional impact it has on kids, which can be devastating in some cases. These drills are done twice a year, and somebody is making a lot of money on them. The schools have actually dropped some fire drills to have the active shooter drills. She asked if the Board wanted to get involved. She said the School Committee makes the decision but the Board could still provide some support. D. Greenbaum said a lot of communities a number of years ago signed onto a letter about gun violence in schools. It was about gun violence as a public health issue. He thinks this issue would fall under the same realm and the Board could support action against it. 4|Page  MA Health Officers Association is putting on a half-day training on workplace violence next month. He will be attending and will send most of the staff as well. S. Moore motioned to approve the reports. G. Yuhas 2 nd. All in favor. Motion passed. 8. New Business/Scheduling of Future - Hearing for trash order Agenda Items MEETING ADJOURNED: G. Yuhas motioned to adjourn. S. Moore 2 nd. All in favor. Motion passed. 8:42pm Respectfully submitted, Maureen Davis Clerk of the Board Next regularly scheduled meeting is Tuesday, March 10, 2020 at 7:00pm At City Hall Annex, 98 Washington Street, 1st Floor, Salem, MA 5|Page