Chicago Board of Health met July 19.
Chicago Board of Health met July 19.
Here is the minutes provided by the Board:
Board Members Present
Carolyn C. Lopez, M.D., President, Caswell A. Evans, Jr., D.D.S., M.P.H., Victor M. Gonzalez, Steven K. Rothschild, M.D., Horace E. Smith, M.D., Joseph B. Starshak, Melanie Dreher, RN, PhD.
Board Members Absent
Adele Joy Cobbs, M.D. For the Department
First Deputy Commissioner, Fikirte Wagaw
Call to Order: The meeting was called to order at 9:07am by Dr. Lopez, Board President.
Approval of Minutes: The June 2017 minutes were approved unanimously.
Commissioner’s Update: In the absence of Dr. Morita, First Deputy Commissioner Fikirte Wagaw reported the following:
LGBTQ Celebrations In June, Commissioner Morita was proud to march not only once but twice in the 48th annual Chicago Gay Pride Parade with members of the HIV Prevention, Immunization and TB team in partnership with the Chicago Public Library, TPAN (Test Positive Aware Network) and also with Mayor Emanuel as CDPH celebrated Chicago's LGBTQ community.
Infection Control Conference In June, CDPH hosted our annual Infection Control Conference bringing together more than 150 public health leaders, we discussed the growing impact of healthcare-associated infections and how to reduce incidence. Partners were provided an update on Zika, the emerging opioid epidemic and emphasized the need for welcoming policies for immigrants and refugees as necessary to identify and respond to health concerns in all communities.
Healthy Kids Townhall Meetings Thank you for your feedback at the June Board of Health meeting. This month, we look forward to launching the Healthy Kids community townhall meetings and calling on our residents and partners to discuss policy proposals around five key issues:
1. Improving Home Safety 2. Reducing Obesity 3. Empowering Parents 4. Increasing Vaccine Uptake 5. Mitigating Trauma
The Healthy Kids Town Hall locations and dates are as follows, please let us know if would like to attend. Tuesday, July 25, 2017 from 5:30pm to 7:30pm at the West Pullman Library located at 830 W. 119th St., Monday, July 31, 2017 from 9:30am to 11:30am at James Shields Middle School located at 2611 W. 48th St., available in both English and Spanish. Tuesday, August 8, 2017 from 6:00pm to 8:00pm at the Rowan Park Fieldhouse located at 11546 S. Ave. L. Wednesday, August 16, 2017 from 5:30pm to 7:30pm at the Legler Branch Library located 115 S. Pulaski Road.
Teen Birth The U.S. Department of Health and Human Services notified CDPH it will cut the last two years of a 5- year, $5million grant for us to evaluate our current teen pregnancy prevention initiative, the CHAT Program. The evaluation is to demonstrate CHAT’s impact on youth knowledge and health behaviors, and identify it as an evidence-based program that other school districts could replicate. Though CDPH will continue to provide the same services, this move severely undermines our ability to ensure our programs are the most effective they can be. There has been media attention since the release and today, Commissioner Morita and NYC Commissioner Dr. Bassett will be doing a joint interview with Politico’s Dan Diamond, to bring attention and urgency to cuts.
Tobacco Prevention The CDC reported the number of middle and high school students who use tobacco dropped from 4.7 million in 2015 to 3.9 million in 2016. The decline is due primarily to a drop in e-cigarette use, following recent national efforts, and continuing our efforts to focus on communities with the highest rates of teen and adult smoking. We will continue to help drive down tobacco use rates.
West Nile Virus In June, 2017, 80 mosquito traps were placed to monitor for the presence of West Nile virus. Through the end of September, crews will collect mosquitoes twice weekly and test them in the CDPH laboratory, mosquitoes will first be identified, sorted, pooled, and then tested for West Nile virus. As of late June, the first pool of mosquitoes was identified with the West Nile virus near O’Hare area; this is typical of the season and areas near suburbs and downstate jurisdictions. CDPH continues to monitor, provide weekly results via surveillance report, which will help determine the need for targeted spraying, if needed.
In addition, CDPH dropped over 85,000 larvicide tablets in catch basins across the city to decrease the hatching of mosquitoes and therefore minimize the transmission of the virus.
Food Safety CDPH Food Protection Team was onsite at the Taste of Chicago every day. We conducted more than 100 inspections every day and responded to potential issues immediately. The team’s hard work ensured that 1.6 million visitors could enjoy the food free from fear of foodborne illnesses.
Play Streets Kick-off The 2017 play street schedule is available, providing 150 events for children and their families to be active in 23 communities identified with increased rates of child obesity. The design of PlayStreets allows for our two-dozen community based partners to host similar events throughout the year.
Comments by the Board President: Dr. Lopez welcomed all the students and members of the public. Dr. Lopez provided an overview of the board’s history and explained the board’s advisory role in matters of infectious disease and health issues. She requested to continue to be updated on federal budget cuts via Policy Director Lava and Commissioner Morita.
Policy Update: Jesse Lava provided the following federal, state, and local updates.
ACA repeal. The U.S. Senate’s plan to repeal and replace the ACA, also known as the Better Care Reconciliation Act, appears to have died, at least for now, as four senators said they would oppose it. There also appears to be not enough support to pass repeal without replacement, so that idea—Plan C—also seems moot. However, only one of the four opposing senators explicitly used the justification that coverage was removed for too many people. The other three mostly said it didn’t go far enough. So with nearly 300,000 Chicagoans covered under the ACA, we must remain vigilant.
Trump budget. Trump administration’s released its proposed budget in late May. The budget would eliminate the Community Development Block Grant, which means our funding for mental health, lead, and other things. Trump also proposes a 31% cut to the EPA—and most salient for us, 45% to the EPA’s state grants for enforcement, since we get a lot of our funding from that. And the enforcement office would be cut by 40%, so regulations in general will be neglected. However, this is one step in the process. It will be negotiated in congress before passage. Our representatives and senators are against these cuts and we must be vigilant. State Springfield budget. A budget got passed. That is a relief, and good for city residents in terms of the social and behavioral services that are critical to the health infrastructure. However we still don’t know if schools will open. The budget said the funding had to be through an evidence-based model, and we don’t yet have one that Governor Rauner will sign. Again, we must remain vigilant. Chicago Pharma rep license. We enacted new rules on the pharmaceutical representative license. They went into effect July 1st. Reps will have to adhere to a series of ethical provisions, like not attending patient examinations without written permission from the patient, and will stop making calls if the health care professional requests. There are several others. A health care professional will be allowed to ask any drug rep to see their license, and can call the City to file any complaints, which CDPH will review. The ordinance will not apply to wholesalers or Medical Science Liaisons. Some reps would need to disclose their interactions with health care provider. For now, its schedule II only, others can be added another time. Bloomberg. The City of Chicago has joined an initiative led by Bloomberg Philanthropies to work on a policy involving non-communicable disease over the next year and a half. We chose to pursue work involving air pollution given its connection to respiratory conditions. We will give you more details as the plan comes into shape and we begin implementing it.
Presentation: “School-Based Health in Chicago - Strengthening School and Adolescent Health,” Hilary Goldman, CDC PHAP Associate
Comments by the Board: The “School-Based Health” presentations received many positive comments and follow up questions regarding the role that Chicago Public Schools plays in conjunction with the CDPH. Dr. Dreher commended the work that CDPH is doing within the school based programs and prompted the invite for the Dr. Kenneth L. Fox, Chief Health Officer, Office of Student Health and Wellness at Chicago Public Schools to present at the next board of health meeting. Dr. Smith emphasized the need for Chicago Public Schools to continue to focus on structural needs, agrees with the concept and understands the funding is not there and needs to be. Dr. Evans echoed the commandment of Dr. Dreher highlighting the dental program and asked about the children that are experiencing pain. Program Director School-Based Oral Health Program, Mary Pat explained the 1-4 grading system, need for referrals, and partnership with Federally Qualified Health Centers (FQHC). Concerning the pharma rep license, Victor Jimenez noted a RFP mandate that required bidders to contract health centers and how this would help with expanding revenue, Steve Rothschild emphasized the need to not stigmatized certain drugs, if they are added. Dr. Lopez commented on the possibility of the difficulty in implementation. Joseph Starshak asked if charter schools are included in school based health centers, MICAH Program Director, Sarah Parchem confirmed charters are included as they are part of the Chicago Public Schools and there is one charter school that houses a SBHC.
New Business: None.
Old Business: None.
Public Comment: Jameika Sampson from Mercy Hospital and Medical Center mentioned Oakland, San Francisco and Philadelphia’s cities who have followed Chicago’s leadership on flavored tobacco. She asked if there are any new updates regarding flavored tobacco ordinance and Director of Policy, Jesse Lava informed her that Chairman Burke and Alderman Thompson introduced ordinance and there is nothing new now. A resident from Englewood asked for the status of the asthma program. First Deputy Commissioner, Fikirte Wagaw informed him about the New Office of Chronic Disease Prevention and Control. Deputy Commissioner, Brian Richardson added that the tobacco ordinance efforts will also help reduce emergency room visits for asthma. Dr. Lopez mentioned CDPH’s work around environmental efforts is also improving air quality. Student from UIC School of Public health asked about obesity in school age children. Deputy Commissioner, Richardson spoke about the partnership with the Chicago Park Districts, Playstreets initiative, Healthy Chicago 2.0, and the Healthy Kids townhalls which includes a policy proposal to reduce obesity. Maternal, Infant, Child, and Adolescent Health (MICAH) Deputy Commissioner, Kai Tao added that 75% of school age children qualify for Medicaid and there are efforts to ensure they are receiving preventive care. CDC PHAP Associate, Hilary Goldman added that the 13 WIC clinics provide health education and increase access to healthy foods in the community. Dr. Lopez concluded with mention of school gardens and how it should be something institutionalized across the district. Student for UIC School of Public health commented about mental health services in schools and her support for trauma informed and the recast program, and the need to continue to give the tools and resources to teachers. Student for UIC School of Public health asked how the school based health centers work with schools considering there is a shortage on school nurses. CDC PHAP Associate, Goldman spoke about how the centers supplement limited existing services. Student for UIC School of Public health inquired about how sexual education is taught in schools. MICAH Program Director, Sarah Parchem described the alignment with partners like Planned Parenthood, a mandated curriculum to include physical education, Chicago Healthy Adolescents & Teens (CHAT) program and condom availability noting the need for more consistency due to principal discretion and charter schools not being required to participate.
Adjourn: The meeting adjourned at 10:30 a.m.
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