MONMOUTH COUNTY REGIONAL HEALTH COMMISSION NO. 1 REGULAR MEETING Tuesday, November 27, 2018 OPEN SESSION: 1hr. 28 min. 52 sec.

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CALL TO ORDER: MONMOUTH COUNTY REGIONAL HEALTH COMMISSION NO. 1 REGULAR MEETING Tuesday, November 27, 2018 OPEN SESSION: 1hr. 28 min. 52 sec. President Roman called the meeting to order at 6:02 p.m. He then led the Regional Board of Health in the salute to the flag. President Roman next read the Open Public Meeting Act Statement. ROLL CALL: Fair Haven Allyson Cinquegrana, Little Silver Dr. Tim Sullivan, Monmouth Beach Joe Nardone, Ocean Twp. Vinnie Buttiglieri, Red Bank Mike Natelli, Shrewsbury Borough Paul Roman, Spring Lake Heights Dr. Len Giles, Tinton Falls John Mack Upon completion of the roll call, the Secretary reported that a quorum was present. ABSENT: Boro of Brielle, Boro of Highlands, Boro of Rumson, Boro of Sea Bright, Boro of Sea Girt, Boro of Spring Lake, Boro of W. Long Branch OTHERS PRESENT: David A. Henry, Health Officer, Bruce Padula, Esq. H. Frketich, Ofc. Coordinator/Commission Secretary MINUTES OF LAST MEETING: OPEN SESSION: October 23, 2018 John Mack motioned to approve the minutes of October 23, 2018, seconded by Vice-President Giles. VOTE: Unanimous of those who were present. CLOSED SESSION: May 22, 2018 pending Fair Haven Commissioner Theresa Casagrande s signature. Vinnie Buttiglieri motioned to approve the minutes of October 23, 2018, seconded by Mike Natelli. Page 1 of 12

CLOSED SESSION (continued) Fair Haven Abstain (Cinquegrana) Spring Lake Absent for Vote Little Silver Y Spring Lake Heights Y Monmouth Beach Y Tinton Falls Y Red Bank Y Wall Twp. (former member MCRHC) Shrewsbury Boro Y 6 Ayes 0 Nays 1 Abstain Motion carries. COMMUNICATIONS: None HANDOUTS: (excerpt from) Fourth National Climate Assessment Summary Findings* see HO Report #5 Public Health Question of the Month: How do I handle a repair of my septic system? HEALTH OFFICER S REPORT: The November 2018 Health Officer s Report (reflecting October 2018 activity), the October 2018 Conferences & Meetings, the October 2018 CDRSS Report, the PHN Monthly Activity Report, the October financials and the 3 rd Quarter Vital Statistics were previously mailed/emailed. 1) State DOH New Dashboard Resource Tool to learn about and track opioid drug data statewide. The link will be forwarded to Commissioners and all towns. 2) HICMIC free training session on December 5 th regarding Navigating STD s in Monmouth County geared toward school nurses and speakers from the NJDOH and CDC 3) Heather Frketich has successfully completed Introduction to the Duties of the Municipal Clerk at Rutgers Division of Local Government Services. She will work with Health Officer to layer in improvements to future Board documentation and procedures. 4) On November 9 th, the Health Officer attended a luncheon of the Root Beer & Checkers Club in Little Silver. He appreciates the invitation and the chance to respond to many public health questions. 5) *Very prominent in the news: 4 th Annual Climate Change Assessment with focus on interesting health components and health related issues in the Northeast and specific to coastal communities. 6) MCRHC s flu clinics and vaccine services are constantly being evaluated. Over recent years the response has been to reduce and consolidate due to low attendance. Page 2 of 12

Page 3 of 12 HEALTH OFFICER S REPORT (continued) 7) Looking forward: MCRHC plans to keep several of its high traffic clinics while researching the possibility of partnering with Walgreens as they are interested in partnering with LHDs. They will be able to provide vouchers for free shots to benefit homeless and vulnerable populations. MCRHC would provide administrative oversight. 8) MCRHC photo and mention in NJ Health Matters of the Hot Shots for Tots campaign success. The program will enter its second year with the 2018-2019 season in participating preschools and kindergartens. 9) Health Officer remains on high alert for any possible measles outbreak as has been evident in Ocean County (Lakewood) which borders Monmouth County. Here have been weekly phone conferences with Monmouth County Health Department to keep abreast of updates. There are currently 15 confirmed cases and 12 under investigation. 10) It is the Health Officer s vision to expand MCRHC s communicable disease investigation shared services. The idea has GPHP approval and a poll to try to determine interest level is in progress via NJACCHO. Varied custom levels of service would be provided in the form of 2 year contracts, resulting in an increase in Consortium membership. 11) Annual 2016 Lead Report indicates just 3 cases of childhood blood lead levels in the MCRHC jurisdiction which was less than projected. However, in 2018 MCHD has experienced much higher case numbers approx... 80 and we currently have 9 cases. 12) MCRHC staff continues their involvement with NJDOH s ICAR team for the purpose of the prevention and reduction of outbreaks in facilities when they occur. 13) Shiga Toxin E-coli has been responsible for 16 cases of individuals ill with kidney problems, 9 cases related to multi-state consumption of Romaine lettuce. 14) MCRHC REHS staff and the Health Officer will shortly be able to obtain CEU s for webinars and in-house programs. This has been a long requested item. 15) Following the Health Officer s submission/nomination, Sr. REHS Diane Beears is being recognized for her work by being named co-recipient of the NJLBHA REHS of the year award. Alice Cadotte of MCHD shares this honor. The award will be presented at a dinner in South Brunswick on Thursday, December 6, 2018. MCRHC will pay for dinner for all who can attend. Congratulations to Diane, who will be retiring next year, on this well-deserved honor. 16) ACCREDITATION: The dates of PHAB s site visit to MCRHC is scheduled for May 1 st and 2 nd of 2019. President Roman reminded the group that as members of the governing body several of them will be involved with this review and asked to share information on their part in MCRHC s operation. A great deal of research is being done. 17) The date of the state audit announced in October remains pending. 18) West Nile Virus: Surprisingly, 58 human cases were confirmed this year, very likely due to the warmer and wetter weather. Looking forward, the State Epis plan even more

HEALTH OFFICER S REPORT (continued) 19) emphasis on combatting this disease and there will be continued stringent focus and efforts by the Monmouth County Mosquito Control Division. A great deal of research is being done. John Mack motioned to approve the Health Officer s Report, seconded by Dr. Sullivan. VOTE: Unanimous NEW AGENDA ITEM displayed: Consent Agenda (as necessary) Resolution 2018-50 MCRHC CLOSED SESSION NO CLOSED SESSION IS REQUIRED AT THIS MEETING. AUDIT COMMITTEE: The 2017 Audit has been completed by Suplee, Clooney and Company. Steve will work with the firm and the attorney toward presentation of the findings to the Commission. CFO REPORT: 2019 HEALTH SERVICES BUDGET PREVIEW Vice-President and Budget & Finance Committee Chair, Dr. Len Giles opened a continuing discussion of the proposed 2019 budget meeting touching on the nursing charges assessment restating the current situation of a total amount of $45,000 paid to VNA annually for 7 towns through the MCRHC. Several other towns carry direct contracts with VNA, Monmouth Beach, Shrewsbury Borough and most recently Fair Haven use the services of the MCRHC nurse.. He also briefly reviewed proposed methods of figuring each town s assessment that have been under consideration by the Budget & Finance Committee. He then turned the meeting over to CFO Gallagher and they co-facilitated the following discussion. Mr. Gallagher directed the Commissioners to page 44 for the VNA discussion highlighting cost distribution adding that in-house nursing is being allocated by population. *Excludes Red Bank (at the moment). A meeting with the Red Bank Administrator is necessary to discuss any options available moving forward. Assessment Options discussed 1) Population Page 4 of 12

CFO REPORT /PROPOSED BUDGET (continued) 2) Minimum charge for member towns (ex. $1,000) with remaining cost allocated by usage 3) Pay for your service/visits In 2019, with option #2 if the town s actual VNA services are less than $1,000, they would be assessed $1,000 In 2019, with option #2 if the town s actual VNA services are greater than $1,000, they would be assessed a minimum fee of $1,000 PLUS the fee for actual services of$90.00 per hour for each occurrence/visit. Joe Nardone spoke out against this method of assessment on behalf of the towns that show zero VNA usage. He would prefer to have actual usage as a starting point. He sees from the worksheets that 13 out of 20 towns currently indicate under $500 of usage. Does not feel an arbitrary minimum fee is reasonable. Town reaction to their assessment should not factor in. Other Commissioner comments: - $45,000 needs to be met in the 2019 budget - There needs to be a starting point, a way to phase in these town assessments - The VNA contract is again likened to an insurance policy for possible future occurrences - All other services are calculated by means of workload or population An argument was made for a lower minimum amount (ex. $500 vs. 1,000) charged in 2019 which would level out over the next year/few years leading to a direct assessment or reflection of actual service usage. President Roman continued by saying that each municipality will receive an individual letter of explanation of the nursing contract options they have. In addition, the VNA has agreed to be paid a minimum charge for the first year of (as a retainer) as we work toward determination of actual service usage annually. There is no way to know where VNA service will be needed in 2019. Dr. Sullivan still does not feel completely comfortable that valid amounts and detail of documentation are being received. President Roman responded by saying that factual data has been received on behalf of the towns and passed on to the Commission. CFO noted the last 2 years apportioned from Surplus to help keep percentages down 2017 $50,000 2018 $91,200 The CFO recommends keeping a minimum charge annually for all towns as a sensible joint feature of being part of a Commission. Dr. Giles made a suggestion and a motion at this point. He would agree to set the minimum uniform charge at $500 for this initial year added to service costs based off of recent VNA data gathered over last full year. Page 5 of 12

CFO/PROPOSED BUDGET (continued) Vice-President Giles motioned to introduce the Proposed 2019 Health Services Budget following the amendment of VNA charges accordingly to use a minimum fee of $500 vs $1000. The motion was seconded by Mike Natelli. Fair Haven Yes Red Bank Yes Little Silver Yes Shrewsbury Boro Yes Monmouth Beach No Spring Lake Heights Yes Ocean Twp. Yes Tinton Falls Yes VOTE: 7 Ayes, 1 Nay, 0 Abstain Motion Carries. The introduced budget will be forwarded to all Commissioners/towns by the CFO and will be posted on the website. TREASURER S REPORT: Presented by Steve Gallagher, CFO in the absence of Liz Finnerty, Treasurer. He briefly reviewed the Statement of Accounts for period ending October 31, 2018. The Treasurer s Report was accepted as presented. BUDGET & FINANCE COMMITTEE: PAYMENT OF BILLS: Vice-President Giles motioned to approve payment of the November 2018 bills in the amount of $ 130,078.92, inclusive of $86,423.09 monthly payroll. The motion was seconded by John Mack. Fair Haven Yes Red Bank Yes Little Silver Yes ShrewsburyBoro Yes Monmouth Beach Yes Spring Lake Heights Yes Ocean Twp. Yes Tinton Falls Yes VOTE: 8 Ayes, 0 Nay, 0 Abstain Motion Carries. HUMAN RESOURCES COMMITTEE: No Report from Chairperson Buttiglieri. President Roman had previously announced that there was a signed MCRHC/Local 97 Union Contract. He was since updated of glitches and unfinished discussions that were remaining and that it has not been finalized with the Union. Attorney Padula further explained that the issue involved a grievance relating to overtime language. George Burr, Union Page 6 of 12

HUMAN RESOURCES COMMITTEE (continued) Representative has been contacted. Attorney Padula ending his brief comments by stating that he expects this matter to be resolved by the end of the week. GOVERNANCE COMMITTEE: No Report OPERATIONS COMMITTEE: No Report OLD BUSINESS: REMINDER: The December MCRHC Meeting will be Tuesday 12/18/18 *It is of great importance that we obtain a quorum for planned vote action on the 2019 Budget. Without this schedule adherence, we will not be able to operate as of January 1, 2019. Website Enhancement Per Resolution 2018-49 adopted at the October 23 rd meeting, City Connections, LLC was awarded this project. The associated contract was e-mailed to Commissioners. Language referencing prepayment does not apply and was removed. A project startup meeting is scheduled for Thursday, November 29 th with City Connections. VNA: Previously part of tonight s budget discussion. NEW BUSINESS MONMOUTH COUNTY PUBLIC HEALTH CONSORTIUM (No current resolutions prepared for vote) A Shared Service Agreement between MCRHC and MPHC (Manalapan, Colts Neck, Long Branch and Freehold) for the Provision of a Communicable Disease Control Program/ Health Education and other Specialized Public Health Services has been drawn up and sent to our attorney for review. Attorney Padula advises the template is fine. The next step is for each individual member of the Consortium to have their specific version to review and then sign off on following authorization of the MCRHC. The Health Officer stated that MCRHC has been experiencing troubles with the US Postal Service and mail deliveries/pickups. Sometimes mail does not reach our location until after closing, but even more of an issue is that mail is plainly not delivered several times a week and there have been indications that items are lost. Mr. Henry has visited the Post Office in the hopes of speaking to the Postmaster in person, but was not able to. He advised all present that he has also contacted the offices of both Congressman Smith and Congressman Pallone. That did result in a response back from the Asbury Park Postmaster who provided him with several ways to contact her should problem continue. The Commission asked if there would be a possibility of placing a locked mail drop box outside the Health Commission s outer door. This will be researched with the landlord. Page 7 of 12

NEW BUSINESS (continued) The Commissioners in attendance had been advised by e-mail of a possible Resolution 2018-52 that would need their consent to be placed on tonight s agenda. The resolution would provide for a temporary or deputy Treasurer as the Health Officer had very recent advisement from a family member that Commissioner Finnerty has been taken ill. She is currently in a rehabilitation facility following her hospital stay and it cannot be determined at this point when she might be able to return to her duties. Vinnie Buttiglieri asked if the issue was going to be addressed as was indicated in the e-mail sent yesterday. Resolution wording was prepared by the Attorney in conjunction with the Health Officer. President Roman stated it would not be addressed. It is his feeling that we are covered for a few months. MCRHC VEHICLE: A memo from the Ms. Ippolito, Bookkeeper in regard to the state of one of the MCRHC fleet vehicles is in tonight s folders. She requests approval to offer the 2004 Jeep Liberty to our municipalities for parts only. After service visits to the Tinton Falls DPW and Seaview Jeep in Ocean Township it has been deemed unsafe to drive. There is an emissions part that cannot be replaced which is allowing for fumes to permeate the vehicle s interior. Edmunds.com does not offer pricing of autos in this condition. As per the MCRHC Capital Property procedures, a formal vote is needed. Allyson Cinquegrana motioned to approve this sale, seconded by Dr. Sullivan. Fair Haven Yes Red Bank Yes Little Silver Yes ShrewsburyBoro Yes Monmouth Beach Yes Spring Lake Heights Yes Ocean Twp. Yes Tinton Falls Yes VOTE: 8 Ayes, 0 Nay, 0 Abstain Motion Carries. SECOND READINGS AND PUBLIC HEARINGS (Three (3) Ordinance Versions to be addressed) Meeting Opened to the Public for a second reading/public hearing on: ORDINANCE 18-01 (currently MCRHC Ordinance 15-01) An Ordinance Amending an Ordinance Establishing a Code Regulating Retail Food Establishments and Fixing Fees for Licensing and Plan Review Thereof, and Penalties for Violations Thereof Page 8 of 12

SECOND READINGS AND PUBLIC HEARINGS (continued) This Ordinance involves the request for digital copies of plan reviews to work toward eliminating the need for the MCRHC to house paper copies of the documents which must be retained indefinitely. NO PUBLIC PRESENT Public Hearing Closed. Vice-President Giles motioned to adopt Ordinance 18-01, seconded by Mike Natelli. Fair Haven Yes Red Bank Yes Little Silver Yes Shrewsbury Boro Yes Monmouth Beach Yes Spring Lake Heights Yes Ocean Twp. Yes Tinton Falls Yes VOTE: 8 Ayes, 0 Nay, 0 Abstain Motion Carries. The adopted ordinance will be forwarded for newspaper publication, posted on our website, distributed to our municipalities and the NJDOH. Copies are available to the general public upon request. Meeting Opened to the Public in regard to Second Reading/Public Hearing on: ORDINANCE 18-06 (currently MCRHC Ordinance 17-06) An Ordinance Amending an Ordinance entitled An Ordinance Establishing and Fixing Fees for Non-Food Inspection Services This Ordinance involves the request for digital copies of plan reviews to work toward the need for the MCRHC to house paper copies of the documents. NO PUBLIC PRESENT Public Hearing Closed. Page 9 of 12

SECOND READINGS AND PUBLIC HEARINGS (continued) Dr. Sullivan motioned to adopt Ordinance 18-06, seconded by Vice-President Giles. Fair Haven Yes Red Bank Yes Little Silver Yes Shrewsbury Boro Yes Monmouth Beach Yes Spring Lake Heights Yes Ocean Twp. Yes Tinton Falls Yes VOTE: 8 Ayes, 0 Nay, 0 Abstain Motion Carries. The adopted ordinance will be forwarded for newspaper publication, posted on our website, distributed to our municipalities and the NJDOH. Copies are available to the general public upon request. Meeting Opened to the Public in regard to Second Reading/Public Hearing on: ORDINANCE 18-08 (currently MCRHC Ordinance 15-08) An Ordinance Establishing and Fixing Minimum and Maximum Salary Ranges and Salaries for Various Employees The Ordinance sets 2018-2020 Minimum and Maximum Salary Ranges and Salaries for Various Employees. Union position salaries are in alignment with the latest 3 year Local 97 Union Contract which was effective January 1, 2018, remaining in effect until December 31, 2020. NO PUBLIC PRESENT Public Hearing Closed. Vinnie Buttiglieri motioned to adopt Ordinance 18-08, seconded by Allyson Cinquegrana. Fair Haven Yes Red Bank Yes Little Silver Yes Shrewsbury Boro Yes Monmouth Beach Yes Spring Lake Heights Yes Ocean Twp. Yes Tinton Falls Yes VOTE: 8 Ayes, 0 Nay, 0 Abstain Motion Carries. Page 10 of 12

SECOND READINGS AND PUBLIC HEARINGS (continued) The adopted ordinance will be forwarded for newspaper publication, posted on our website, distributed to our municipalities and the NJDOH. Copies are available to the general public upon request. PUBLIC COMMENT PERIOD: None PRESIDENT S REPORT: President Roman attended the November 5, 2018 MCRHC Staff Meeting. Some of the topics covered were future structure and codification of our ordinances, the need to resolve an issue with duplicate mobile unit inspections, a more expansive MCRHC vehicle safety policy to possibly include group roadside service membership and issues the staff has experienced, the Health Officer s plan for new shared services/additional Consortium based revenue services, the upcoming need for a new lead meter (trade-in option to be researched) for possible purchase in 2020 and anticipated reimbursement from the lead grant to still be in force. The cost of a lead meter is over $20,000. President Roman remarked that the staff thanks the Commission for their continuing supports the work they do. The Governor s office has put 7 million dollars toward the funding of increased e-cigarette public health awareness. This very serious problem for our youth who most times do not know the dangers it carries. Student education and cessation counseling programs to be part of future campaigns, Proposed legalization of recreational marijuana in the state addressed yesterday in a legislature joint committee hearing of Budget and Appropriations.Legislative Committee hearing. The Health Officer advised that it was heavily attended, comprised of pro/con testimonies. It is understood that the proposed legislation is next being passed on to the Joint Assembly, bypassing the formal process of Senate Health and Assembly Health votes. Senators Cardinali and Rice were armed with stacks of paper as evidence of the adverse public health effects of passage. The NJ Pubic Health Community continues to speak out and rally against the legislation. The Health Officer reiterates his great concern over the policing (assuming it will fall on LHDs) of edibles which has not been addressed in the bill s language. GENERAL COMMENTS: There being no further business, the meeting adjourned at 7:31 pm on a motion by Vinnie Buttiglieri seconded by John Mack. VOTE: Unanimous Page 11 of 12

Next Regular Meeting of the MCRHC #1 Commission will be held on Tuesday, December 18, 2018 at 6:00 P.M. at the Regional s headquarters located at American Red Cross building 1540 West Park Avenue Suite # 1, Tinton Falls, New Jersey. Respectfully submitted, Heather L. Frketich Heather L. Frketich Commission Secretary Reviewed by, David A. Henry David A. Henry Health Officer Page 12 of 12