Board of Health

CITY OF SALEM BOARD OF HEALTH MEETING MINUTES December 13, 2022 MEMBERS PRESENT: Jeremy Schiller, Chair, Paul Kirby, Geraldine Yuhas, Datanis Elias, Sara Moore, MEMBERS EXCUSED: OTHERS PRESENT: David Greenbaum, Health Agent, Suzanne Darmody, Public Health Nurse, Mark Blanchard, Tomb Gallery Tattoo TOPIC DISCUSSION/ACTION 1. Call to Order 7:01pm 2. Approval of Minutes S. Moore motioned to approve the minutes. P. Kirby 2 nd. (November 8, 2022) Roll call vote: J. Schiller - yes P. Kirby – yes G. Yuhas - yes S. Moore – yes D. Elias – yes Motion passed by a vote of 5 to 0. 3. Mark Blanchard – Request for a Mr. Blanchard appeared before the Board to request a variance to Board of variance to City of Salem Board of Health Regulation #27, requirement that an applicant provide proof of a Health Regulation #27 Body Art high school diploma or its equivalent. Mr. Blanchard states he owns and Regulation 4.0, ¶ 4(A), Proof of a High School Diploma or its operates Tomb Gallery and is requesting a variance to the requirement for a equivalent. high school diploma or its equivalent. J. Schiller asked how long this requirement has been in the regulations. D. Greenbaum informed the Board that this has been in the regulations since they went into effect in the 1990’s. D. Greenbaum provided some history regarding the body art regulations. At one time cities and towns banned body art establishments outright, practitioners sued, and the courts ordered that body art establishments be allowed to operate. At which time the Commonwealth of MA provided model body art regulations for municipalities to amend and adopt for establishments and practitioners and this requirement is in those regulations. D. Greenbaum further explained that the cities and towns involved in the Public Health Excellence Grant are in the process of updating these regulations regionally and during a recent meeting to discuss the regulations the group felt strongly that this requirement should be kept in the regulations. The need for a high school diploma or GED is important to be able to read and write, advise clients for consent to receive the procedure and to provide after care instructions to the client. S. Moore asked if there is any precedent for a variance when it comes to having practiced for a long period of time. D. Greenbaum explained that is being discussed but that the communities 1|Page working on this feel strongly that a minimum education requirement should be part of the regulation. M. Blanchard inquired if this requirement was only implemented in this area. D. Greenbaum explained that it was his understanding that this was not only implemented on the North Shore but was written into the model body art regulations by the state and that most communities had adopted them very similarly to the way they were written. D. Greenbaum further explained that Salem has been the most progressive with their body art regulation allowing guest artists, apprenticeships, and micropigmentation. M. Blanchard states he has been fully licensed since 2006 and has another shop in Cambridge, he complies with all the rules and regulations. D. Greenbaum can’t speak about why Cambridge does not have this requirement but that all the communities involved in the effort to mend our current regulations feel strongly that a minimum educational requirement should be in the regulations. G. Yuhas asked about the skin anatomy course? Mr. Blanchard explained it is a course required by the state and that he has taken it twice and that he has contacted Cambridge to get a copy of his certificate. He is only looking for a variance for the requirement to have a high school diploma or GED. J. Schiller asked if Mr. Blanchard was applying for a license in Salem. Mr. Blanchard explained that he has been licensed in Salem since 2021 and is in the process of renewing his license for 2022. J. Schiller asked if this was an issue in 2021? M. Blanchard explained that it was not addressed. D. Greenbaum explained that Mr. Blanchard submitted letters stating he was unable to get a copy of his high school diploma, these letters were not approved by myself or the Public Health Nurse, but the application was approved. This was an oversight and should not have been approved last year. S. Moore states it surprises her that if you are able to do the things necessary to get licensed that should take precedence over a high school diploma. Mr. Blanchard explained that he has taken First Aid and CPR several times, the skin course twice and that he has a reputation not only in MA but in other states and internationally, conducting seminars and tattooing. G. Yuhas asked if Mr. Blanchard has had any issues with clients being unhappy with his work. Mr. Blanchard explained that he has not had dissatisfied customers, he keeps the standards very high and runs a very private practice. G. Yuhas inquired as to the possibility of granting a temporary variance or grand-father Mr. Blanchard seeing he had already been licensed. S. Darmody stated she asked this exact question with the regional working group and that the working group did feel strongly that this basic educational requirement remained in the updated regulations. Additionally, this requirement has been in regulation for a long time and every other practitioner working in Salem has met this requirement. J. Schiller stated he wonders if it might be possible for the Board to gather more information to determine what the rationale is for the educational requirement. Could the Board issue a variance seeing he has all this experience. D. Greenbaum explained that the discussion around variances took place 2|Page  with the working group, and some felt strongly that granting variances would set a precedent that applicants could simply get a variance to not have to comply with the regulations. He further reiterated the working group felt strongly that the minimum educational requirement be maintained and that there should be no allowance for work experience and that this would be his recommendation. G. Yuhas asked if the Board could issue a temporary variance for a year while more information is gathered about the educational requirement. D. Greenbaum recommended that if the Board feels they need more information, then they table this discussion to January or February. The department would work with Mr. Blanchard to complete the renewal process. He also informed the Board that part of the reason to update the regulations regionally was to cut down on some of the variations in regulations from one community to another, standardizing what is taking place in all communities. Also, the regulations could become a template for other regions in the state. J. Schiller stated this should be tabled until the next meeting to gather additional information. S. Moore requested that as part of this information it be clearly spelled out what a high school diploma gets an applicant vs. what licensure gets an applicant. Item tabled to the January or February Board of Health meeting. 4. Discussion and Deliberation of Assistant City Solicitor, Victoria Caldwell, was in attendance to present proposed Board of Health Regulation Concerning Deceptive this proposed regulation. V. Caldwell stated that the regulation has not Advertising Practices of Limited changed since it was first discussed a few months ago and it is designed to Services Pregnancy Centers prevent deceptive advertising of limited services pregnancy centers. She further explained that there is not one of these facilities in Salem currently, there are approximately 30 centers of this type in MA and only five of those are licensed by the MA DPH, these are largely unlicensed operations. What is proposed in these regulations is to put forth community values towards access for all to all types of care for people in the city. There are a couple of other communities that have done this by ordinance and the Attorney General’s Office has issued a guidance document that this proposed regulation is consistent with. There is also information on the state website, and she believes on MA Health warning what an individual might expect should they seek help at a limited services pregnancy center. Any time something like this is done there is a risk that the city could be sued. The belief is small that that will happen in Salem as there are no facilities like this in the city currently. We are only talking about fines as a penalty and the risk of a lawsuit is not a big issue for us. G. Yuhas asked where the closest center to Salem is. V. Caldwell explained there is one in Revere, she is not sure but there may be some in Lynn and there used to be one in Beverly, but she is unsure if that facility is still there. J. Schiller, likes the idea of this but wanted V. Caldwell to guide the Board so that they would not be at risk of passing this regulation. S. Moore, particularly in the area of online advertising and how the Board would regulate online advertising if the information doesn’t originate from Salem. 3|Page  V. Caldwell explained this was part of a package that came from the Mayor’s office after the Dobbs decision. The City Council also passed a companion piece regarding gender affirming health care and insuring access to all services, as well as directing City employees as to what they can and can’t do should enforcement activities come from outside the state with respect to people who received services here. S. Moore, if there is a center in Lynn advertising on the internet and that information is consumed by a resident of Salem does that center face any consequences because of the internet the information is still being consumed by a Salem resident? The regulation is geared to a center that would site itself physically in Salem. J. Schiller inquired what other municipalities have or are considering adopting this. V. Caldwell, Somerville and Cambridge have adopted, the City of Pittsburgh and there has been a lot of interest in local efforts around this. S. Moore – I am fully in support of this but wonder if we could specify under Section 3.0, Deceptive Practices, that this applies to centers physically sited in Salem? V. Caldwell, are you proposing an amendment that reads, No limited services pregnancy centers, located within the City of Salem, with the intent…? The Board agreed that would be the one edit they would like to see in the regulation. P. Kirby asked how does enforcement work after the third violation? V. Caldwell explained that it is unclear what would happen after a third violation, however if a center was located in Salem and not complying with the regulation the Board could always seek injunctive relief in the courts. Additionally, we are always looking to gain compliance and would only fine after the center failed to come into compliance with the regulation. P. Kirby motioned to adopt the proposed regulation with the proposed amendment in Section 3.0, effective January 1, 2023. , Second S. Moore. Roll call vote: J. Schiller - yes P. Kirby – yes G. Yuhas - yes S. Moore – yes D. Elias – yes Motion passed by a vote of 5-0 5. Chairperson Communications J. Schiller updated the board on the status of a regional working group of Board of Health chairs. It has taken two years, but the group finally met a few weeks ago. This is something he has been trying to put together, in particular during the pandemic. This is the beginning of a novel way of all the boards communicating. D. Greenbaum added that local public health collaborates all the time and especially during the pandemic if we did not have our regional partners to lean on it would have been a whole lot worse. J. Schiller informed the Board the regional group of board chairs would be meeting quarterly and as necessary. 4|Page 6. Public Health Announcements /Reports/Updates a. Public Health S. Darmody updated the Board on permit renewals and that she is watching Nurse Report flu trends, there is a lot of flu in the community this year. The good news is that DPH has indicated that the flu vaccine is a good match for the strains of flu circulating this year. The regional public health nurses have held some flu and COVID booster clinics. The council on aging is holding a Christmas party and staff from the Board of Health will be on hand to distribute some giveaways. J. Schiller asked if the department is distributing COVID test kits. D. Greenbaum explained that the department still has a significant amount of b. Health Agent Report test kits available and reminded the public that if they need test kits they can come to the Board of Health office, we are giving five kits per person in the household. D. Greenbaum informed the Board that the state has notified us that the City is eligible for another allotment of test kits, and we will be receiving an additional 122 cases of kits. As this will be the sole source of surveillance in the community it was felt we should continue to accept test kits from the state and distribute them in the community. J. Schiller asked if the opioid settlement funding from the state has been designated for expenditure yet. D. Greenbaum explained that is does not believe the funding has been designated for spending yet. Dr. Schiller asked if the Board of Health will have a role in how the money is spent and D. Greenbaum stated he hoped the Board would have a role in this and one of the things he thinks would be important to do would be hire a substance use coordinator to organize all the substance use activities that are currently going on in the City. D. Greenbaum updated the Board on the new state contract for Elliot Behavioral Health to provide community based behavioral health services. He is working with the schools to make sure they have access to the services provided by Elliot. G. Yuhas asked about the homeless population, in particular those that are sleeping outdoors. D. Greenbaum explained that the Community Impact Unit from the Police Department has had the primary role in this issue. They have explained that the PD is limited in what they can do. They cannot move from the area because it is a public way and if they take action people begin videotaping and file lawsuits against the police. G. Yuhas asked if the police offer services and was informed that they do offer them services. The PD has been very proactive offering services like treatment but they have refused assistance. D. Greenbaum updated the Board on the transition that will take place as the Mayor leaves at the beginning of January to become Lt. Governor. Discussion took place of what could happen during the transition and the timeline for special elections. S. Moore updated the Board on the formal formation of the Food Policy Council. She is working with Kerry Murphy on an MDAR grant for FPCs to hire a consultant to do strategic planning. Lainey Gaiero, a student at SSU asked if she could have some questions 5|Page  answered for a class she is taking. She was advised to call the office and D. Greenbaum could answer her questions. Copy available at BOH office. c. Administrative Report d. Council Liaison Updates M. Riccardi was not in attendance. No updates NONE 7. New Business/Scheduling of Future Agenda Items  Items that could not be anticipated prior to the posting of the agenda MEETING ADJOURNED: G. Yuhas moved to adjourn. P. Kirby 2 nd. Roll call vote: J. Schiller – yes P. Kirby – yes S. Moore – yes D. Elias – yes G. Yuhas - yes Motion passed by a vote of 5 to 0. 7:57 PM Respectfully submitted, David Greenbaum Health Agent Next regularly scheduled meeting is Tuesday, January 10, 2023 at 7:00pm At City Hall Annex, 98 Washington Street, 1st Floor, Salem, MA 6|Page