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Salem Board of Health
Special Meeting
Minutes of Meeting
January 22, 2009
Date & Time: Thursday January 22, 2009 7:00pm
Meeting Location: 3rd floor conference room, City Hall Annex, 120 Washington Street
Members Present: Chairperson Paulette Puleo, Martin Fair, Marc Salinas, Larissa Lucas,
Carol Rainville, Noreen Casey, Councillor Steven Pinto, Janet Mancini, Acting Health Agent. Members Absent: Barbara Poremba
Paulette Puleo called meeting to order @ 6:30 pm.
Presentation by Mayor Driscoll regarding a “Pilot Program” involving the merger of Salem’s Board of Health staff with Peabody’s Health Department.
Mayor Driscoll explained that they had an opportunity to meet with five communities, Salem, Peabody, Marblehead, Beverly and Danvers regarding a regionalization. They left the meeting with plans to look at staff, budget and agreed to continue dialog on this opportunity. Since this meeting, financial situations have nose-dived and there is a pressure on municipalities. Cuts they have for this year puts more pressure on next year. Therefore, she is looking to partner with a city maybe sooner than later. She has done some outreach to Peabody and they have some interest in a pilot program. Mayor Driscoll knows the Board is interviewing candidates for the health Agent position and is concerned that instead of hiring someone, it might make sense to discuss a Pilot Program prior to putting someone in. She feels there are a
lot of issues in the public health field and that this is an opportunity to explore a pilot program, however it’s the Board of Health’s decision. Mayor Driscoll feels it’s worthwhile to explore it and hopes Board members look at this as an opportunity.
Some questioned whether there are any other communities similar to Salem that have adopted this type of regionalization/merger. Mayor Driscoll said in western part of state there are and added that we could design how the program looks and feels. Paulette Puleo added that the Tri-Town Health Department includes Lee, Lenox and Stockbridge with a total population of 14,000, 1/3 of the size of Salem alone and their total operating budget is the same as Salem’s.
Marc Salinas asked if there were concerns from the Mayor’s office regarding having one health agent. Mayor Driscoll feels there are larger communities with one health agent, adding that they will have staff with it and each city would still have their own Board of Health. Paulette Puleo gave examples of health department staffing in various communities such as Arlington-population 41,000, 7 staff, Quincy-population 90,000, 12 staff + Beaches Commission & Board on Homelessness, Taunton 56,00, 9 staff and Salem 41,000, 6 staff. Mayor Driscoll explained that details haven’t been worked out and would be saving the salary of health agent of $65,000, which would help since they’re expecting a 10% cut next year in Salem. Peabody may have strengths that we don’t have and vice versa.
Paulette Puleo explained that there are 3 very qualified candidates coming in next Tuesday and expectations for them are higher than prior. One of those expectations is grantsmanship; this will be considered an integral part of the health agent’s professional responsibilities. Larissa Lucas asked if there are any other places where they’d gain efficiency. Mayor Driscoll feels there is but didn’t have definite examples adding that someone may be specialized in certain areas. She is looking at this as a way of having cost efficiency.
Carol Rainville clarified that Mayor Driscoll is asking them to put on hold hiring a health agent. She agrees with Paulette that without details of this pilot program, it’s uncomfortable. If there were an outbreak of something we’d be in trouble. She’d like to see where cost saving is. Mayor Driscoll explained that there is no road map, can’ say here’s where the savings are, etc., and that this is not meant to be rushed into. Suggesting rather than hiring someone to fill a position, work on putting together a pilot program. She thinks it’s worth the energy and time to be creative. How do we manage massive budget cuts and maintain services. Carol Rainville feels they’re asking to do this in a short span of time.
Paulette Puleo stated that she respects and commends the Mayor on her Leadership in finding alternative ways to cut spending. Paulette continued by saying she was not opposed to change, not opposed to regionalization, what she is opposed to is making an impulsive decision in which the consequences of this decision may negatively affect the health and safety of our 41,000 Salem residents.
Mayor Driscoll sees the vacancy as an opportunity to look into a pilot program.
Larissa Lucas said she could imagine that if there were a crisis, it would be nice to ask our neighbor to help than an understaffed department.
(Noreen Casey arrived)
Janet Mancini and Paulette Puleo gave an example of how Salem collaborates with surrounding communities when a crisis arises. Our past health agent, Joanne Scott received a call from Sharon Cameron on May 29th asking Salem to set up a shelter for approximately 900 people and several pets from the Peabody Complex fire. Joanne notified the list of appropriate people and with the utilization the memorandum of understanding obtained from several vendors, Salem’s BOH staff set up a shelter at Salem State College’s gymnasium within hours.
Larissa feels that the mayor is asking BOH permission to look into pilot program. Carol said the hard thing is that they’ve been in a process for hiring and now they’re being asked to stop the process in the eleventh hour. Mayor Driscoll added that it’s about suspending the process. Martin Fair understands there have been meetings with communities and Mayors. How long would it take to meet with other BOH and come up with a framework? Would it take it a few months? Paulette said it has not been voted on with Peabody’s Board of Health nor discussed with the citizens of Peabody to see if they’re interested. Carol Rainville added they can’t go forward unless Peabody BOH is on board. Have to come up with some form of collaboration. Noreen Casey asked why is it Salem and
Peabody? Why not Salem and Marblehead or Swampscott, they’re closer in size to Salem and Mayor Driscoll said those aren’t out of the question. Noreen is concerned that Peabody is stretched to their limit and Mayor Driscoll gave the example Lynn that is much larger with one health agent.
Marc Salinas has a number of concerns but wondered what harm it would be if the process were suspended. Paulette Puleo agrees but thinks it would take more than a month to set up a pilot program. Marc suggested suspending the process for 30 days to have discussion to see if it’s worth it. Paulette doesn’t object to regionalization, she objects to suspension of interview process. Mayor Driscoll believes Peabody is interested but is hesitant like this board, she feels it can be explored and drawbacks be looked at. There are a host of issues to be dealt with and since Salem has an acting health agent she doesn’t thinks it’s detrimental to suspend the process and, it doesn’t mean public health issues take a back seat. Putting resources together could be the best thing or the worst
thing. She’s very concerned about bringing someone on board and having a lot of cutbacks. She doesn’t think it’s terrible to have an acting health agent as Janet is doing a great job. Dialogue for this is driven by economics. Janet Mancini added that the BOH in Salem is strong and that she’s a strong leader. She knows that Peabody contracts out for a lot of their work, Salem doesn’t; Salem is more thorough in inspections than Peabody. We’re highly functioning. Janet wondered why Salem should to go Peabody, why not Peabody come to Salem.
Paulette said one candidate wrote and obtained significant sums of money in the past, which would be helpful for Salem. Mayor Driscoll said there are grant writers in the planning department but Paulette feels you need to have an expertise in public health to find and write public health grants. Councilor Pinto said it’s the Board’s authority to bring health agent in, he feels if they bring in pilot program, they’d lose their authority. Marc Salinas wondered if it makes sense to suspend process and look at program, its strengths and weaknesses, maybe to make our services better. Noreen Casey is nervous about regionalization, wants more details on the pilot program, but is open to discussion.
Carol Rainville said it’s not a bad idea but questioned where they would get details, who gets them, how involved would it be as they are a volunteer board. They would have to have a joint meeting with other BOH. Marc Salinas said if the Board goes in that direction, he thinks suspending for 60-90 days would make the most sense. Mayor Driscoll said she’d be happy to be involved in joint collaboration and find ways to determine advantages and disadvantages. Mayor Driscoll feels the health agent in Peabody would look into what’s involved to bring together. Janet Mancini asked that if the Board is considering it, she feels she should have input with Sharon. Carol Rainville agreed that Janet should meet with Sharon and get the two towns together. Paulette reminded the Board that the Board of
Health’s Mission is first and foremost to protect the health and safety of all the citizens of Salem and that when Sharon Cameron and Janet meet to gather information they will need to prove that a pilot program has the potential to prove two basic goals, to improve Public Health services in both communities and to show the amount of cost savings from the merger.
Paulette Puleo expressed ethical concerns regarding the “pilot program”. Would the Board be acting as an IRB? Should informed consent be obtained through a public hearing?
Meeting Opened to the Public
Len Malazusky felt the Mayor’s plan was not believable and didn’t make sense. He feels the administration hasn’t shown it cares about health. He feels it’s up to the Mayor to find funding, perhaps go to the city council. He asked why she didn’t invite someone from the BOH to that meeting with Mayor Bonfanti and Sharon Cameron. He feels the BOH shouldn’t give up their freedom, as this won’t benefit Salem. It would be a better idea to combine with smaller city. Martin Fair feels to regionalize, it needs to benefit both cities and everyone has fiscal concerns.
Michael, a practicing chiropractor from 8 Almeda St., asked if they were to combine, where would headquarters be? He suggested instead of $65,000 salary for the health agent, lower the salary since we’re in an economic crisis. His other concerns - if we have one health agent, we’ll need agent assistant how much will that be? When agents go back and forth to cities, how much will that cost? He feels that since Salem is congested, things could go bad faster.
Ed Moriarty, 29 Winter Island Road, Attorney couldn’t agree more with the two previous speakers. He feels the BOH’s power is unique and is the single most powerful board whose duty is to preserve and protect the public; they can pass some regulations and can act to enforce them. He has highest belief that they have power. He said there’s no valid reason for merger unless it’s for the betterment of public health. Said BOH should not buy into it, not to let the Mayor do this.
Shirley Walker, 51 Lafayette Street, who previously worked in Executive Office of Human Services, wondered about the funding for the position and who could hire or fire that person. Martin Fair said the money has been appropriated and that the City can cut the budget but not the position. Shirley then added that if the BOH hired for this position, if there was a cut, they would have to make the decision to cut a position. Therefore, they could determine if someone else could get cut instead.
Teasie Riley Goggin feels that in this administration, every time something is put on the table, it’s always made out to be detrimental. She also feels that Salem has its own health problems with beaches etc. Peabody is different. If money is there for the position, then hire and spend it and get someone in. Shirley Walker wondered if they have someone on staff that would be retiring soon or moving on that could counterbalance what you would be spending on the new health agent. Paulette said they’re down 1 iv>
Reason would say that this merger could not improve public health for the residents of either community. Therefore, with the Board’s major objective, according to State Law, protection and promotion of health, why would the Board even consider this merger?”
Sincerely,
George Levesque
There being no further comments, Marc Salinas made a motion to go forward on the interview process and to delay any decision on hiring for 30 days to give the Board of Health the opportunity to explore the pilot program, passed. (3 in favor, 2 against). Motion passed.
Carol Rainville feels the first step is for Janet to talk to Sharon to see if two cities are on the same page. She added that even if they don’t go forward with this pilot program, there might be other opportunities like grant writing. Her concern is whom does this person serve, the health agents? Paulette Puleo said each Board would hold their own authority and the only commonality would be sharing a health agent and staff members. Noreen was concerned that the Mayor came to ask the Board to explore a pilot program but had no details. Marc feels there should be something put on an agenda. He feels any idea is worthwhile looking at. Carol Rainville isn’t ready to jump, Larissa Lucas said we don’t know if will help health. Janet stressed that Salem has a highly functioning Board of Health
and not to give it up.
There being no further business to come before the Board, Paulette Puleo made a motion adjourn, seconded by Noreen Casey and approved (5-0).
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