Board of Health

Skokie Board of Health March 10th, 2016 Present Absent Excused Mr. Abbasi Dr. Topouzian Dr. Vernon Mr. Nidetz Dr. Dave Ms. Urbanus Dr. Prince Dr. Drachler Dr. Usman Ms. Jones Thorne Dr. Gaynes Dr. Varma Mr. Pandya Dr. Werner Dr. Sood Dr. Williams Ms. Nickisch Duggan Guest, Nurse Shelley Wax, Staff Nurse Sue Reisberg, Staff Dr. Edward McCarron, Family Services Commission Dr. Catherine Counard, Director of Health Mr. David Clough, Staff Call to Order - The meeting was called to order at 7:35 p.m. by Dr. Drachler, Chairman. Approval of Minutes – Minutes from the February meeting were reviewed. One correction was made: Dr. Edward McCarron is on the Family Services Commission rather than the Human Relations Commission. The minutes were approved with this correction. Vaccination rate in Skokie Schools (a copy of the presentation is attached) Nurse Shelley Wax spoke about vaccination rates in Skokie schools. Ms. Wax worked as a school nurse at Solomon Schechter school prior to her employment at the Skokie Health Department. All children in kindergarten, 6th and 9th grade, as well as any students new to Illinois schools, must provide proof of having received the required vaccinations by October 15. Vaccinations are reported on the State of Illinois Certificate of Child Health Examination. If this form is not completed by October 15, children are excluded from school. This leads to a large rush in the Health Department and in school nurse offices at the beginning of October each year. Students must be protected from Diphtheria, Tetanus, Pertussis, Polio, Influenza B, Measles, Mumps, Rubella, Haemophilus, Pneumococcal Disease, Hepatitis B, Varicella, and Meningitis. Human Papilloma Virus, Influenza, and Hepatitis A vaccinations are strongly recommended but not required. In a small number of cases some vaccines can be held if there is a medical reason that the student should not receive the vaccine. This is only done in the case of extreme allergies or rare medical conditions. This is very rare and occurs in less than 1% of all Skokie children. Religious objections are allowed in Illinois but it is now required by law that a form stating which vaccines the parent/guardian objects to and the reason for the objection. It is also required that the parent/guardian receive counseling from a healthcare provider on the benefits of immunization and risks of disease to the child and community at large. For a medical exemption, if there is an outbreak of disease that the child has not been vaccinated against, the school must pay for home tutoring for the unvaccinated children, who will be excluded from school until the outbreak is over. However, for children who have not been vaccinated due to religious objections, the school is not required to pay for tutoring. Three states, Mississippi, West Virginia, and California, will not accept religious objection as a basis for refusing vaccinations. Ms. Wax shared a list of top reasons parents object to vaccines, compiled at Boston Children’s Hospital. Reasons included: • These illnesses are rare • These illnesses are not all that bad • Vaccines cause autism • The preservatives in vaccines are dangerous • Vaccines have side effects • It’s a conspiracy between the pharmaceutical companies and the government • I trust my family, friends, and community more than my doctor. Dr. Counard pointed out that the connection between vaccines and autism had been debunked and people have had objections to vaccines since the introduction of the smallpox vaccine in the 1700’s. Dr. McCarron pointed out that none of the most common reasons for refusal are religious. Dr. Counard stated that no religions explicitly forbid immunization. Skokie vaccination data for the 2015 -2016 school year includes data from 16 public schools and 6 private schools for a total of 13,290 students. Less than 1% of Skokie students remain unvaccinated for either medical or religious reasons. Varicella and MMR are the vaccines most commonly objected to. Ms. Reisberg reported that, as of January 1st, the State requires daycare employees to prove they are immunized with Tdap (whooping cough) and MMR (measles, mumps, rubella). The Illinois Department of Public Health has recommended a 90% protection level to prevent epidemics. Both Illinois and Skokie have well over 90% compliance. Both Private and Public schools in Skokie have better vaccination rates than the rest of Illinois. Ms. Wax then presented pre- and post- vaccination morbidity rates from vaccine preventable diseases. All rates dropped dramatically after the introduction of vaccines, most by over 95% and two by 100% Dr. Drachler pointed out that vaccinations do wear off and many adults think they are up to date but aren’t because the effect of their vaccinations has expired. He recommends adults get the Tdap vaccine to protect infants from whooping cough. Ms. Reisberg reported that many prospective grandparents come to the Health Department for the Tdap vaccination. Dr. Williams suggested having a shot clinic at the Boards and Commissions recognition night. #493763 Dr. Werner pointed out the website for the Immunization Action Coalition which consistently updates vaccine information. Vaccination information is continually changing and new updates are required regularly. Sue Reisberg pointed out that while Tdap is recommended just once for adults, immunity likely wanes within 10 years. She suspects the recommendation will likely be changed to having a booster dose every 10 years. The group discussed vaccination rates and changes in vaccine recommendations and availability. Dr. Drachler reported that HPV vaccinations have decreased abnormal pap smears by 20%. They also discussed adult vaccination rates and how to improve them. Preliminary Survey Results Mr. Clough reported that 1620 surveys had been returned at this point. He gave a small breakdown of which languages had been utilized and the top ethnic groups reported in the online version of the survey. With a week left to collect surveys the total number has exceeded the amount collected during the last IPLAN process. Mr. Clough reported on the progress of the Rethink Your Drink program and offered the 30 day water bottle challenge to interested board members. Twelve Board members took the Sugar Sweetened Beverage survey and signed up for the 30 day water bottle challenge. Chair’s Report Dr. Luka has resigned from the Board of Health because she is moving to Chicago. Dr. Drachler thanked her for her years of service. There are now two openings on the Board of Health. Dr. Drachler encouraged Board members to attend the Boards and Commissions Dinner on Monday March 14. The Solid Waste Agency of Northern Cook County will present on the topic of recycling. Dr. Drachler and Dr. Counard attended an open house on March 3 at the Erie Evanston/Skokie Health Center. The open house included a presentation on the importance of talking to and reading to children. Dr. Counard and Dr. Drachler were welcomed and acknowledged at the event. Dr. Drachler requested that Dr. Counard give a summary of the status of the Erie Evanston/Skokie clinic Dr. Counard reported that Village Manager John Lockerby, Nurse Susan Reisberg and she met with Dr. Lee Francis, CEO of Erie Family Health Center, to discuss the issue of Skokie residents not being able to get appointments at the Erie Evanston/Skokie clinic. Residents have been calling the health department and elected officials stating that they have been turned away by Erie because they did not have health care insurance. Nurse Reisberg called Erie to verify this information and learned that in fact people without healthcare insurance were being turned away. The clinic is now closed to new patients. The Erie Evanston/Skokie clinic was established with extensive support, both time and funding, from the Village leadership, Health Department, Board of Health and Skokie Hospital, so it is disappointing that only 16% of the patients are from Skokie. Dr. Counard shared a letter that she and Mr. Lockerby sent to #493763 Dr. Francis, asking that Erie accommodate another 1,000 Skokie residents as patients within the next year. A follow-up meeting will be scheduled in 90 days with Dr. Francis to determine progress towards this goal. A copy of the letter is attached. Dr. Drachler reported that he has approached the psychologist in charge of the NorthShore weight management program. She was very receptive and will hopefully come and present to the Board of Health about the psychology of weight management. Dr. McCarron has asked the Family Services Commission to support Board of Health efforts to increase the age to sell or purchase tobacco products in Skokie to 21. Dr. McCarron has been designated to write a proposal that will be approved by the commission and then passed on to Mayor Van Dusen. Tobacco 21 has also been introduced at the state level with Senate Bill 3011 sponsored by Senator Mulroe. Dr. Williams has been asked to present supporting a ban of smokeless tobacco in stadiums in Chicago. Directors Report (attached) Collecting 2016 Skokie Community Health Survey Dominated February The Health Department, Board of Health and IPLAN Committee worked to offer the community health survey to as many people who live, work or attend school in Skokie as possible. The survey was delivered widely electronically and via paper copies. The survey will close on Sunday, March 13. Meeting with Asian Human Services Nurse Susan Reisberg and Dr. Counard met with the leadership of Asian Human Services Family Health Center to hear how things are going at the new Skokie location. AHS is providing care for more than 1,100 Skokie residents. AHS is upgrading their dental services, installing a new elevator, and adding a few exam rooms on the second floor. Thanks to Dr. Williams and Midwestern University Dental students, AHS has increased the number of dental clients served by 40%! Communicable Disease Concerns A number of Skokie residents have met the criteria for testing for Zika virus but none have tested positive. Dr. Drachler reported that climate change and warming environments are leading to increased Zika rates due to the mosquito that carries it being able to live longer in different areas. The mosquito abatement district is on high alert to monitor for Zika as well as West Nile Virus this summer. Turning Point Behavioral Health Center Town Hall Meeting Dr. Counard and Mr. David Clough attended the Turning Point Town Hall meeting, to hear how the Illinois budget crisis is affecting access to mental health services. The State owes Turning Point over $500,000 which is severely limiting their ability to provide services. Dr. Counard also mentioned that the Director of the Illinois Department of Public Health (IDPH) has introduced a bill in the Senate (SB2416) to Abolish the State Board of Health. The State Board is the primary advisory board for IDPH, and functions similar to the Skokie Board of Health. Dr. Counard and other members of the Northern Illinois Public Health Consortium (NIPHC) traveled to Springfield to speak out against abolishing the State Board. Dr. Counard will continue to update the Board on SB2416. #493763 Dr. Drachler asked if the money owed to the Health Department and other entities that has not been paid due to the budget impasse will be lost permanently if it is not paid by the next budget year. Dr. Counard reported that it was unclear as to when or if there would be a state budget anytime in the near future. Dr. Gaynes asked what kind of pressure people were receiving from the Governor’s Office. Dr. Counard reported that she has heard of relentless calling campaigns to state and local politicians who have objected to or highlighted the negative impact of the lack of state funding. Dr. Williams reports that many FQHC’s are being negatively affected by the lack of healthcare payments by the Illinois government for state employees. Dentists in Illinois are proposing a bill that will allow providers to cancel state employee enrollment with no penalty if the state has not made payment within six months. Mr. Abbasi mentioned an article on lead testing in Chicago and asked how we are doing in Skokie. Dr. Counard responded that the health department regularly submits drinking water for lead level testing, and the water has always been well within EPA standards. Ms. Urbanus proposed adding a health consumer rather than a health professional to the Board. Dr. Williams proposed getting someone who works at Asian Human Services to join the Board. Dr. Counard invited all Board members to encourage any community member they would recommend to apply. The meeting was adjourned at 9:09PM. #493763