Board of Health

Skokie Board of Health Committee Meeting Minutes March 14, 2019 Present Excused Absent Mr. Abbasi Dr. Sood Ms. Nickisch Duggan Dr. Dave Ms. Urbanus Dr. Gaynes Dr. Drachler Mr. Usman Dr. Topouzian Ms. Haido Ms. Varma Dr. Williams Ms. Jones Dr. Vernon Mr. Pandya Dr. Werner Dr. Prince Ms. Moy-Wooten Dr. Shim Bruce A. Jones, Staff Husna Khaleeluddin, MPH (c) A. Call to Order: The meeting was called to order at 7:04 p.m. by Dr. Drachler, Chairman. B. Approval of Board of Health Meeting Minutes, Materials Distributed: Dr. Drachler thanked Dr. Werner for chairing the February meeting that unfortunately did not have quorum. The minutes of the January 12th meeting were approved as presented. C. Bruce A. Jones, LEHP, MS, Environmental Health Supervisor, and Husna Khaleeluddin, MPH(c) Skokie Rat Control Program Overview A copy of the presentation is attached Mr. Jones and Ms. Khaleeluddin gave an informative and thought-provoking presentation on the Skokie Rat Control Program. Background Responding to a nearly six-fold increase in rat calls received by the Health Department between 2002 and 2010, a multi-disciplinary Village team came together to develop an aggressive rat control program. The program goals are to: 1) rapidly identify and eradicate rat infestations, and 2) eliminate any contributing factors, so the rats do not return. Rat Biology Mr. Jones gave an overview of rat biology, including how quickly rats reproduce, how rats require very little food or water to survive, and how rats are nocturnal, so if you see rats during the daytime that indicates a significant infestation. A short video taken by staff showed how extensive a rat burrow system could be. Current Program Mr. Jones described the current program, which is handled by a full-time Environmental Health Officer (EHO), with support from a private pest control company during the peak season between April and October. The program is solidly based on systematic data, and the identification and elimination of contributing factors. Public information is very important, along with requiring training for landlords. Anyone who sees rats or contributing factors is encouraged to complete an online report at www.nomorerats.org The EHO will investigate and take action.  Peak Activity and Impact of Weather Rats are most active between April and October, and the number of infestations appears to be affected a great deal by the severity of the preceding winter. The graph shows infestations by month from January 2012 through December 2018. As you can see, severe winters with a polar vortex, indicated by a green star, had fewer infestations the following year. The two mild winters, indicated by a red circle with a slash, had significantly greater numbers of infestations the next season. Main Contributing Factors for Rat Infestations The top contributing factors to rat infestations are listed below. Although there tend to be more rats in high density areas, rats can be attracted to any neighborhood if these factors exist: • Yard waste • Deteriorated properties • Garbage • Overgrown properties • Damaged garbage carts/dumpsters • Catch Basins • Fruit/vegetable gardens • Compost • Bird feeding • Standing water • Rear Enclosures • Dog Feces Focus on High Density Blocks – A CDC recommendation Interestingly, there is no “gold standard” for urban rat control, so much of the approach in Skokie we are determining as we go along (more on that later). The best information that we have is from a long-term study by the Centers for Disease Control and Prevention (CDC) that indicated that focusing on blocks where 2% or more of properties have rat infestations will give the best control results. The blocks highlighted in yellow met this criterion for intensive action in 2018. Key Initiatives Over Time Mr. Jones then described the key initiatives over time, including an annual spring sweep of high density blocks, surveys of blocks looking for contributing factors, and modifications to Village Ordinances to ensure we can enforce compliance from property owners. Two highlighted changes that have made a big difference: 1) requiring property owners to restructure rear enclosures after infestations have been eliminated, and 2) enforcing proper maintenance of catch basins. None of the 73 rear enclosures that have been restructured have been re-infested. This is a collaborative effort across multiple departments! Challenges • Recurrent Rat Infestations – any rat infestation that recurs within 18 months. This is a criterion developed by the Rat Control Team, based on our data. We follow re-infestations closely, because those can indicate an ongoing problem at the property (for example, someone began bird feeding again after the rats were eliminated). We are not, however, stating that rats will never return, just that if it has been more than 18 months it is less concerning. • Chronic Sites – any site where it requires more than 8 weeks to eliminate the rats. These sites serve as a source of infestation for neighboring properties, and necessitate further investigation to better understand what factors are preventing timely eradication of the infestation. Again, this criterion was developed by the Rat Control Team, based upon our own data • Fruit Bearing Trees & Bushes/Vegetable Gardens – fruit trees and vegetable gardens provide an excellent food source for rats, especially if the fruit is allowed to remain rotting on the ground. #550189, Skokie Board of Health Meeting Minutes March 14, 2019  Rats are less likely to consume poison at sites with fruits & vegetables, making it harder to eliminate the rat infestations. These are commonly identified contributing factors at chronic sites Vancouver Rat Project We reached out to the Vancouver Rat Project a few years ago, as one of the only other systematic rat surveillance and response programs we could identify in North America. They were so impressed with the Skokie program, that they came to have a look for themselves and spend time in the field with us. We are participating in a study led by Vancouver, to develop best practices for rat control in urban settings. Other participating municipalities include New York City, Chicago, Boston, Seattle and Washington D.C. Block Level Profiles Ms. Khaleeluddin then described her project over the past year. Our latest hypothesis, based on knowledge from Vancouver, is that rats live in family units on blocks, so we are targeting infestations at the block-level rather than the property-level. Some blocks have had numerous re-infestations, typically involving just a few properties. We believe that targeting high re-infestation addresses will reduce re-infestations at the block level. Ms. Khaleeluddin worked with Mr. Clough to develop high activity block level profiles, which provides action items allowing an interdepartmental, preventative approach to identified addresses. Plans for 2019 • Sweep of high density blocks in April • Continue all other aspects of program • Continue testing block level hypothesis • Focus on eliminating contributing factors, especially food sources Discussion Dr. Drachler asked what predators there are for rats. Mr. Jones replied that they have some predators – owls, hawks, skunks and older more dominate rats will prey on their own. Dr. Werner asked about the sighting of one rat and can you extrapolate the population. Mr. Jones explained that there is no specific scientific way to extrapolate from one sighting. Dr. Drachler asked where the high density blocks are located. Mr. Jones responded that the majority of our infestations are in residential areas that are high density in human population and in some instances can border commercial properties. Mr. Abbasi commented that he had an issue last year and our EHO came out and did a great job to eliminate the problem. He had a neighbor that was bird feeding and contributing to the issue. Dr. Drachler asked if we get much push back from resident about rats. Mr. Jones said that with our public education, flyers and handouts we have overcome this hurdle. We can help in many situations and need cooperation to control the rats. Dr. Vernon asked if people confuse mice for rats. Mr. Jones said some people can mistake mice, chipmunks and opossums for rats but we always investigate any calls Dr. Vernon asked if rats serve any useful purpose. Mr. Jones said none that he is aware of, and that rats were not indigenous to North America until the mid-1800s, having unintentionally been brought over with settlers from Europe. They are now are found on every continent except Antarctica. #550189, Skokie Board of Health Meeting Minutes March 14, 2019  Dr. Werner asked about the use of feral cats to control rats. Dr. Counard and Mr. Jones stated that there is no validity to the claim that feral cats can be used to control rats. Mr. Jones explained that feral cats are fed by their caretaker and are not to leave their property, so there is no likelihood of any control through this source, when considering an entire block. Dr. Drachler asked if we interact with Chicago about rats. Dr. Counard and Mr. Jones replied that we have been in contact with Chicago, but primarily work with communities of similar size that have a state-certified health department. Specifically: Evanston, Oak Park and Stickney Township. Dr. Dave asked if we see someone feeding birds or other violations do we ticket them. Mr. Jones said our first step is to speak to people and provide education, and request that they eliminate the contributing factor. But if there is no compliance we can issue citations. Dr. Prince mentioned he has witnessed issues with rats in Chicago along the sanitary canal. Mr. Jones agreed that there have been rat infestations along the canal in Skokie, and he has walked the entire canal area to ensure elimination when those occur. D. Chair’s Report Dr. Drachler mentioned the April 8th Boards and Commissions dinner. Several members will be receiving awards for years of service: • Dr. Prince – 20 years • Mr. Pandya – 10 years • Dr. Sood – 20 years • Ms. Jones – 5 years Dr. Drachler mentioned the April 1st Board of Trustees meeting, during which we will present the 9th Annual "Public Health Partners in Excellence Awards" in conjunction with National Public Health Week. The meeting begins at 8:00 PM, in the Skokie Village Hall Council Chambers. This year's award recipients are: Chicago Exotics Animal Hospital For supporting the Skokie Animal Control program by accepting unclaimed stray pets that are not dogs or cats, and finding these animals homes. Beyond pets, Chicago Exotics veterinarians accept all of our sick, orphaned, and injured wildlife that have a chance at rehabilitation and recovery. Skokie Chamber of Commerce For many years of supporting public health efforts to reduce the use of tobacco products in Skokie. From the 2003 ban on smoking in workplaces and enclosed public spaces, to the 2018 increase in the age to sell or purchase tobacco products to 21, the Chamber has spoken out in favor. Dr. Drachler mentioned that the General Assembly has passed Tobacco 21 and is awaiting Governor Pritzker’s signature for final approval. On April 29th Dr. Drachler and Dr. Counard will meet with the Mayor and Board of Trustees to discuss the upcoming budgets for FY20/FY21. Dr. Drachler mentioned that he and Dr. Counard will not be available for the May 9th Board meeting. Would it be possible to change the date to May 23rd? Dr. Counard will send out an e-mail to find out if the 23rd will work for a quorum of the Board. #550189, Skokie Board of Health Meeting Minutes March 14, 2019 E. Health Director’s Monthly Report: Dr. Counard presented the February Monthly Report – a copy is attached. Report highlights: Drinking Water Service Line Material Map & Survey A map showing the locations of lead drinking water service lines will be posted online. To help ensure the accuracy of the map, in May an online survey will ask property owners to verify the water service line material where it enters the house or other structure as “copper”, “lead” or “unsure”. FY2019 Budget Shortfall for Influenza Vaccines – Changes for Fall 2019 Program Due to a substantial increase in cost, the number of influenza vaccines purchased for fall 2019 will be reduced, and the clinics decreased to one evening and one daytime. Flu vaccine is widely available and this change is not anticipated to negatively impact the ability of residents to receive vaccine. Tobacco Enforcement Program – Each year the Health and Police Departments partner on the Illinois Tobacco Enforcement Program (TEP). In February, eight establishments were caught selling nicotine products to minors in a sting operation by the Skokie Police Department. Additionally, Peer Services was contracted to provide vaping education at Niles North. Discussion Mr. Pandya asked if anyone can come to our flu clinics. Dr. Counard and Mr. Jones replied that only Skokie residents are served, but during the H1N1 outbreak we offered vaccine to anyone in the priority groups because that was a federal program. There was some discussion about the Board of Health raising funds to support the flu shot clinics through grants or other options. Dr. Counard mentioned that a 2015 Health Department survey revealed that less than 1% of flu shot clinic participants did not have insurance or another source for flu shots. We also now have three locations where people without insurance can receive health care. She would need to think about whether this would be a good use of grant funds. F. Old/New Items of Business April 4th ribbon cutting for Erie Evanston/Skokie Health Center expansion. All are welcome. Ms. Urbanus spoke about a new abortion clinic in Skokie. Dr. Counard explained that we do not have any control over the clinic. Dr. Counard mentioned a concerning new trend for “On Demand IV Drips” with one now open in Skokie and numerous locations nearby in Chicago. These sites pose a high risk for serious health consequences, and are making fraudulent claims. Dr. Vernon asked if there have been any measles cases in Skokie associated with the current outbreak. Dr. Counard said there have been none. Dr. Dave spoke about the SAHELI project. There are now 170 participants in the study and there is a new partnership with School District 69 that is proving effective. The SAHELI study still needs participants, and Dr. Dave asked Board members to continue spreading the word. Adjournment: The meeting adjourned at 8:17 p.m. Next Board of Health Meeting: April 11, 2019 7:00 p.m. Village Hall – 2nd floor Conference Rooms D & E #550189, Skokie Board of Health Meeting Minutes March 14, 2019