Written by the reviewer from the ASR + docket; [verbatim-ASR] = quoted machine transcript; [paraphrase] = reviewer's wording, not a quote.
0:00 Okay, we're going to call the Health
0:02 and Human Service Committee meeting to order.
0:05 I want to welcome the people who are here from the county,
0:10 Board of Health, who do so much to help us here in Lakewood.
0:13 We appreciate your services so much.
0:16 So, I'd like to approve the minutes
0:19 of the May 5th, 2025 meeting.
0:28 Those minutes are approved.
0:30 And I believe there's communication
0:33 from Law Director Vargo.
0:39 Thank you, Madam Chair.
0:41 Yeah, I drafted the communication to inform council
0:46 that we have a renewal agreement request.
0:49 The renewal is with the County Board of Health
0:53 for the regulatory work they do
0:55 and the registration work they do
0:57 with our retail establishments in various sectors.
1:01 And we invited representatives of the County Board of Health
1:04 here tonight to answer any specific questions
1:07 this committee would have.
1:09 Thank you, Director Vargo.
1:10 And just for a little background in history,
1:13 for those who may not know,
1:16 the city of Lakewood used to have its own Board of Health,
1:19 which was disbanded many years ago.
1:23 And now those duties are assigned to the county,
1:28 so they help us out with many, many different areas
1:32 And they're going to give us some background on that
1:35 and some statistics on what they do.
1:37 That's right, Madam Chair, thank you for that.
1:39 And just for more background,
1:44 when you get the cities of our size and similar size,
1:49 state statutes allow the city to have their own Board
1:52 of Health or to combine with other cities with the county.
1:57 And we have found that that synergy with the county
2:00 is far more efficient for our city.
2:02 And that is the norm across Ohio
2:05 of cities of our size and smaller.
2:09 Thank you, that's very true.
2:10 We spent a lot of money that we didn't need to.
2:15 Well, or that they're doing a better job
2:17 than we could do on our own, so we appreciate the county.
2:20 So I'll turn it over to the county.
2:22 If you want to introduce yourselves.
2:34 Good evening, my name is Suzanne Rush.
2:36 I'm the Director of External Affairs
2:37 for the Cuyahoga County Board of Health.
2:39 Madam Chairperson, other chairpeople and members,
2:44 Mr. Regger, thank you for having us.
2:46 I'm here with our legal counsel, sorry, John Mills,
2:52 and our Director of Environmental Public Health,
2:53 Mr. Matt Johnson, my partners,
2:56 and they work with me at the Board of Health
2:58 as part of our senior leadership team.
3:00 We appreciate your kind words
3:01 and the fact that you recognize that combined,
3:04 we are doing a fantastic job serving the 58 communities
3:08 other than the city of Cleveland.
3:09 They have their own Board of Health that serves them,
3:11 but we handle the other 58.
3:14 We're about 188 people strong at the Board of Health.
3:18 And three people, their full-time job
3:22 would be working in your city.
3:23 And that would be in the Environmental Public Health.
3:25 The rest of us work in the periphery,
3:26 little bits and pieces of our job.
3:28 But a few communities combined for a person
3:32 who works in food, a person who works in district,
3:34 and a person who works in water,
3:35 and I'll explain those briefly.
3:37 The food protection person does anything that sells food,
3:39 whether it's a bowling alley, a grocery store, a school.
3:42 If they sell food to people,
3:43 they would be in there doing that inspection.
3:45 A water person does everything watershed protection
3:49 anything to do with a beach or storm water
3:51 or sewage or septic or a complaint
3:53 about any of those things
3:54 or anything to do with groundwater being contaminated.
3:58 We know you're a very sustainable city
4:00 and you have a lot of programs that coincide
4:02 with what we do on the watershed protection type thing,
4:05 including things around trees
4:07 and things around green space.
4:08 You guys are phenomenal.
4:09 You're kind of our goals.
4:10 You and Cleveland Heights are our gold status.
4:12 We point your two cities out all the time
4:13 and brag on you guys for the great work that you do.
4:16 The other person that works in district
4:18 does pretty much everything else.
4:20 Like just today, we received a complaint about a street,
4:22 a Bayes Avenue residence having sewer rats.
4:25 So our district sanitarian, Mr. Johnson is already on it.
4:29 He's already referred that to a district sanitarian.
4:30 He'll be able to serve.
4:32 So those are just in the environmental public health.
4:34 And before I leave today, I want you to all have
4:37 and we'll leave these with you,
4:38 brochures that talk about all the service areas.
4:40 Environmental is just one of the programs we do.
4:43 We have population health,
4:44 which works more towards chronic disease prevention.
4:47 Things like heart disease and sedentary lifestyle,
4:49 things like healthy farm to school initiatives
4:52 to get kids eating healthfully as young children.
4:54 So they learn it all the way up.
4:56 We used to work closely with Nature's Bend.
4:57 When they were here, we cried a little bit
4:59 when they closed because we did so many programs
5:01 for special needs folks and so many programs
5:03 for kids who really didn't know about eating healthfully.
5:06 And we want to do more of that.
5:07 We are working with your YMCA on some of those programs
5:09 now and trying to get more into schools.
5:11 We're working on that.
5:12 But the idea is population health helps combat
5:16 chronic disease or the folks over in our nursing
5:18 and clinical services help to combat acute disease.
5:21 And they do this by all sorts of health screenings
5:24 and checks, all sorts of STI testing
5:27 for sexually transmitted infections.
5:29 We do have a clinic here in your city
5:31 and we ran some numbers on it.
5:32 In 2024, they saw 79 patients with 122 visits.
5:37 In 2025, 67 patients with 106 visits.
5:41 Anyone can walk into our clinic and get a flu shot.
5:44 Anybody can walk in and get an immunization.
5:46 If we carry them and we know that they're coming.
5:48 If not, our main campus, which is in Parma,
5:50 or our east side location, which is in Warrensville Heights,
5:52 they can come to by making an appointment with us.
5:58 It's in, what street is it on, like what I knew?
6:01 I apologize, I don't remember.
6:02 I want to say it's where the old clinic building
6:05 used to be, so it should be that way on Detroit.
6:07 I believe it's by, it's right by an Einstein Bagels.
6:11 It's like a block, a block away.
6:16 I don't know the answer to that.
6:17 I've never been to the Lakewood location.
6:18 I regularly go, I'm an Eastsider.
6:20 I regularly go to the Eastside location,
6:21 but I've not been to that one, so I apologize.
6:23 But I can get you the street address, thank you.
6:26 But the idea is chronic disease prevention,
6:29 again with population health,
6:30 whereas acute disease prevention
6:32 and also regular immunizations of vaccines
6:35 that happen through our clinics.
6:37 We do not see the traffic to be perfectly transparent
6:40 and one of the reasons that we want an increase,
6:43 a 12% increase for two years,
6:45 we have just launched a mobile medical unit.
6:48 We got that mobile medical unit with dollars from COVID,
6:51 but we are putting it to use going forward
6:53 for all chronic and acute disease prevention.
6:56 Because even though we only focus
6:58 on reproductive health and STIs,
7:01 our other groups and services that focus
7:04 on things like chronic disease prevention
7:05 can still use that as an attractant
7:07 to get people to come in.
7:08 For example, if I'm just standing
7:09 at a little table at a fair,
7:11 I might get 50 or 100 people
7:13 at a big event come by me.
7:15 But if I've got this big new shiny vehicle
7:16 that nobody's ever seen,
7:17 they're gonna come there and listen to that messaging,
7:19 whether it's how to wash the hands properly,
7:22 whether it's anything to do with nursing
7:24 or baby latching on with maternal and child health,
7:27 which we do in population health,
7:28 whether it's cardiovascular wellness
7:30 and stroke prevention.
7:31 We are partnering with lots of hospital systems
7:33 because again, we have this many resources
7:36 and this many people to help,
7:37 so we're partnering with UH,
7:38 we're partnering with Metro,
7:39 we're partnering with Cleveland Clinic
7:41 to get more manpower.
7:42 They have dollars they have to spend,
7:45 So we're trying to do both.
7:46 And every time we talk about health equity,
7:48 people lose sight of what that really means.
7:50 It doesn't mean if I have enough money
7:52 to give everybody $50,
7:53 I give everybody $50, so that's equality.
7:56 We give the people that need it most,
7:57 that truly need it most,
7:59 the most care and services
8:00 because they don't have insurance,
8:01 they are underinsured, undercared for.
8:04 And that's really the focus of what we do.
8:06 But that mobile medical unit is gonna be huge.
8:08 We do a thing called accreditation
8:11 through the Public Health Accreditation Board.
8:12 And that's what is the gold standard for boards of health.
8:15 And we are already accredited.
8:17 We have just filed for reaccreditation.
8:19 And this week, we should hear that we got that approval.
8:22 We're counting on it
8:23 because when they came to do our summary
8:26 they had nothing to tell us that we had a share.
8:28 They were like, we're good.
8:29 You just have to wait for the hearing.
8:30 So I think that's this week,
8:31 if I'm not mistaken.
8:32 Either this week or next week,
8:33 but right before Thanksgiving,
8:34 we're supposed to hear and get another plaque
8:36 and say we're reaccredited.
8:37 That is a huge undertaking.
8:39 It is what compares health departments
8:41 across the nation, apples to apples,
8:43 to make sure that we're qualified for the money to receive
8:45 and we're doing the work we need to do.
8:47 We have to give all sorts of evidence.
8:49 The point of that being,
8:50 we're not just taking money and going,
8:52 yep, we're doing work.
8:53 Yep, we're doing work.
8:54 We have to prove health outcomes by the work that we do.
8:56 Every day, the work we do,
8:58 our health commissioner is charging us with,
9:00 at the end of the day,
9:02 what health outcomes to prove
9:03 because of the work that you've done.
9:05 And I think in the past, way back when,
9:07 even before, when Lakewood was its own,
9:09 when I started and when Matt started,
9:11 Cleveland had their own Board of Health,
9:12 so did Cleveland Heights, East Cleveland,
9:14 Lakewood, Shaker, and then we did the rest.
9:17 Those all have been absorbed except for Cleveland.
9:20 And each time, our health commissioner asked us
9:22 to be more efficient, more effective,
9:24 and do more with less people.
9:26 When I started, there was 260-some people
9:28 with all the nurses that we have.
9:31 We're doing 15 or 20 more programs than we did that.
9:34 We have to be more efficient.
9:36 We have to be more effective.
9:37 So part of accreditation says,
9:40 you must go out and do a community health needs assessment
9:42 and then create from it a community health improvement plan.
9:45 And we did that work.
9:47 We hired outside agencies to help us and we did it,
9:49 and we asked from each community.
9:51 And this is what we heard over and over.
9:53 You're not communicating with us enough.
9:54 You're not engaging us enough.
9:56 We need more communication, better engagement.
9:58 More communication, better engagement.
9:59 We heard it over and over.
10:01 So these are the things we've changed.
10:02 We've created a position that I do,
10:04 which is external affairs,
10:05 and you'll get a stack of my cards before I go.
10:08 Any public event that you have
10:10 where we're tabling or we have an opportunity
10:12 to speak like this or offer a presentation,
10:14 we want to know about it.
10:15 And that's my job to coordinate that.
10:19 If you come to us and you say,
10:21 we want an expert in lung cancer.
10:23 Unfortunately, we don't have an expert in lung cancer,
10:25 but our friends at WellLink do.
10:27 Boom, I will connect you the same day
10:28 with somebody who has it.
10:29 If we don't have what you need,
10:31 we will be the conduit.
10:32 That's the reason our tagline is your trusted source
10:35 for public health information.
10:36 We may not have the service,
10:38 but we'll get you the information.
10:39 We'll get you to who you need to be.
10:41 That's really what we're charged with.
10:42 We cannot possibly,
10:44 for the 1.2 million people or so that we serve,
10:46 we cannot possibly do everything for all those people.
10:49 We'll be a partner with people that do.
10:51 That's what we're charged with.
10:53 So another thing we've done
10:54 is we've created a speakers bureau,
10:55 which will be rolled out this spring.
10:57 And that's gonna be about 61 or 62 different topics
11:00 to start that you will have the option
11:02 for free presentations, free in-services,
11:05 free hands-on demos, depending on what it is.
11:07 And I'll just give you one example.
11:08 Matt's team does food protection.
11:11 They do thousands and thousands of food inspections.
11:14 But for laypeople, you know, the moms and pops,
11:17 the grandmas and grandpas,
11:18 whoever's cooking food for the family,
11:19 they might not know a lot of that stuff.
11:21 So whether it's a senior center
11:23 or it's the parents at a childcare center
11:25 or it's kids that don't have home ec in school
11:27 anymore, home ec's being weeded out we're seeing.
11:30 But kids have to learn that
11:31 because moms and dads are both working.
11:32 Kid comes home and they have to kind of cook
11:34 or prep or snack with their sibling.
11:36 We wanna show them how to do it safely.
11:38 So we partner with area chefs
11:40 and they come in and we do a chef demo
11:41 with a tasting and the kids get to try stuff.
11:44 We almost make it like fear factor.
11:45 What do you mean you don't eat Brussels sprouts?
11:46 We're gonna show you how you're gonna like it.
11:48 What do you mean you don't eat beets?
11:49 We're gonna get them trying food
11:51 that they've never had before.
11:53 And we're partnering in new and different ways.
11:54 We partner with Mark's Grocery Stores.
11:57 They donated this year over four million packets
12:00 So we partner in the spring with folks
12:02 and we get them growing gardens
12:04 and then later in the year we harvest what they grow
12:06 and we teach them how to safely prepare that food
12:08 in a delicious, heart-healthy way.
12:10 And I don't think many health departments
12:12 are doing this type of engagement.
12:13 In fact, I know they're not
12:14 because on the national level
12:16 we're being asked to come speak,
12:18 to jump on teams, to fly to places,
12:20 to do this kind of thing
12:21 because it's unique in its individual.
12:23 We want to bring public health to you
12:25 in a way that you won't ever
12:26 hesitate again in the future.
12:27 That you'll see us so much
12:29 that you'll say, yeah, we don't just see you
12:31 doing inspections and checking out animal venues
12:33 and tattoo parlors and sampling beaches.
12:37 We know who you are.
12:39 This contract is no problem.
12:40 We know about the services that we get.
12:42 And you specifically asked some questions
12:44 that I want to address if it's okay
12:46 about spotted lantern flies, lead, and about bed bugs.
12:50 So I brought some things with me.
12:52 We have worked with the Bed Bug Task Force in the area
12:54 while they were in cahoots, I guess,
12:58 with us for years and years
12:59 and they have since waned
13:01 because that progress has really gone a long way.
13:03 We have less and less,
13:04 less and less need.
13:05 And so these are little gauges, they call them,
13:08 and they go underneath the bed frame,
13:10 the four posts of the bed.
13:12 And it gives you all the directions
13:13 on how to identify and eliminate bed bugs
13:16 using these things.
13:18 So I brought some information for you.
13:20 We have more of these kits available.
13:21 The Bed Bug Task Force gave them to us for free.
13:23 We've got a cute little bag that it goes in.
13:25 We can bring these to you.
13:26 We could talk to residents.
13:27 If you knew that it was a wide scale problem,
13:29 there's a bunch of apartments or a bunch of homes.
13:31 We could have a meeting here at any time.
13:33 We could bring an expert, Tom Barsa.
13:35 He's an absolute expert with our vector control.
13:37 So I'll leave this information for you.
13:39 Matt certainly is an expert
13:40 if you have any specific questions,
13:42 but bed bugs identification is really key.
13:45 People spot other things that aren't bed bugs
13:47 and think they are,
13:48 so we brought you some really simple
13:50 identification cards so they can really see
13:51 what the differences are.
13:53 And we are happy any time to jump on a call.
13:56 I'm not sure if you know this,
13:57 but 24-7-365, we have an emergency phone available.
14:01 Bed bugs aren't something that we would consider
14:03 an emergency, but let me give you an example
14:04 where we want you to call that number.
14:06 You're out in your garage.
14:07 You're in the significant other.
14:08 You're putting away the garden tools
14:10 because you're sweeping up all that.
14:11 You're trying to rake up all the leaves
14:12 and somebody gets grazed by a bat and they drew blood.
14:15 You don't know if it's a claw, a tooth,
14:16 what it got you, but you're bleeding.
14:18 And you saw the bat, but it flew away.
14:20 Absolutely, positively, 216-201-2000.
14:23 You call that number.
14:24 We will order the prophylaxis.
14:26 You have to have it.
14:27 Rabies is not curable.
14:28 If you contract rabies, you die.
14:30 Because rabies regularly are tested positive,
14:33 bats are positively tested for rabies in this state,
14:36 we would want to act on it the same day.
14:37 Same thing, you get mauled by a raccoon.
14:39 You go into your garbage and you're pushing a bag down
14:41 and a raccoon comes out and bites you.
14:43 If you can't get that raccoon and kill it,
14:45 which we don't expect you to be able to do that,
14:47 but if for some reason you could,
14:48 someone in your family is like,
14:50 The police officer shot it.
14:51 We're gonna go ahead and have the head tested.
14:53 Don't shoot it in the head.
14:53 We need to test the head.
14:54 But let's just say you couldn't catch the animal.
14:57 We would absolutely prophylax you.
14:59 We would have to get ahold of you
15:00 and that we do that emergency-like.
15:03 Another example of emergency,
15:05 we had a case of a person presenting
15:07 with clustering botulism at St. John's West Shore.
15:10 And on emergency phone, I took that call
15:13 and we ordered the anti-vax from Atlanta.
15:15 And the same night it came.
15:16 It comes basically on a special plane, just with that.
15:19 It's really a crazy thing.
15:20 The gentleman came to my vehicle.
15:22 He met me on the tarmac at Cleveland-Hawkins
15:24 and he communeers your vehicle.
15:26 He literally handcuffs the stuff to your wrist.
15:27 You hold the little package, drive right to the hospital.
15:30 They give the guy the shot.
15:31 20 minutes later, he wakes up.
15:32 The person would die without it.
15:33 Botulism's not curable unless you have anti-vax.
15:36 It's these kind of things that we do behind the scenes.
15:38 On a simple level, we just did a hand, foot,
15:40 and mouth case, a communicable disease
15:43 that happens in child cares all the time in your city.
15:45 We are constantly acting on epidemiological cases.
15:49 I have a whole list of them for the county for the year.
15:51 They do not break it out by zip code
15:53 because sometimes you can track it
15:54 in a different zip code than where you live.
15:56 So it's hard for diseases.
15:57 We just do the whole county.
15:59 But I'll leave that with you
16:00 to see all the behind the scenes,
16:01 whether it's botulism.
16:03 I mean, we investigated an anthrax case.
16:05 It didn't happen to be anthrax, thankfully,
16:07 but you never know leprosy.
16:08 We invested a leprosy case.
16:10 You never know what kinds of weird biblical proportion
16:12 things that we're doing behind the scenes.
16:14 So that's the last service area I wanted to touch on,
16:16 epidemiology, surveillance, and informatics.
16:18 They're the folks that keep all the data
16:21 regarding different types of illness.
16:23 One such report that people don't even know
16:25 that is world-class that we do.
16:26 Literally, people all over the globe want to see it,
16:29 want to read it, and want to mimic it.
16:30 It's our child fatality review.
16:32 It basically examines all the reasons
16:34 that children would die in our county.
16:37 Although it's exhaustive, reading it, it's very sad.
16:39 It is also very telling, and it helps us educate
16:42 on the things that we can do prevention-wise,
16:44 and we are working toward those things.
16:46 You guys mentioned about the spotted lanternflies.
16:49 I wish I had better news.
16:51 They are an invasive species.
16:52 The only good news is that they're kind of cool-looking,
16:55 and they're not harmful.
16:57 They're not a pest from the standpoint of disease.
17:00 They can kill plants and trees, unfortunately,
17:04 and they can kill other beautiful species
17:05 like butterflies, because their stickiness
17:07 that they leave behind can trap some of those animals,
17:10 those flying insects, on the trees.
17:12 But I brought information about them
17:14 and what they look like in all their different stages,
17:16 and how you can prevent a sort of a checklist
17:18 for residents on what they can do to negate them.
17:21 It's nearly impossible.
17:23 So they do follow the railroad track line,
17:25 because they're hoppers.
17:26 They hop from one thing, almost like a tic does.
17:28 They don't fly very well, but they hop.
17:30 So they came in from Asia, and they came in on railroads.
17:33 So they are all along our B&O railroad line,
17:36 unfortunately, and they're actually watching it
17:38 from the Eastern Seaboard all the way out west now.
17:40 They've already gone across the United States.
17:41 But the only good news is they don't carry
17:43 any kind of disease.
17:44 They won't bite you.
17:45 They're just icky, and they leave
17:47 a sticky mess on your trees.
17:48 So I left information about the things
17:50 that you could do for them.
17:52 I have a question about lead,
17:54 and one of our lead specialists gave me a great handout.
17:58 And I'll leave this for you,
17:59 but just to give you some statistics,
18:01 we test the micrograms per deciliter of blood levels,
18:06 and we do that two ways.
18:08 We either do it with capillary testing,
18:09 which isn't as exact, or venous testing.
18:12 So we tested in 2024 about 120, or 115, rather,
18:18 people, and we're looking for that 3.5
18:21 micrograms per deciliter.
18:21 That's sort of the range that we're checking.
18:23 Anybody over 10 micrograms would be considered
18:26 positive for lead, and we would take action
18:27 to remediate it, chelating their blood,
18:29 giving them medication.
18:31 And as far as lead remediation,
18:33 the numbers are huge in your community.
18:35 In the last five or six years,
18:38 we're upwards of $450,000 toward home remediation.
18:42 We addressed the lead hazards in 25 units
18:45 during the same time period.
18:46 Five of those had lead hazard control orders.
18:49 So as we get money for lead, and we know
18:52 one of the main reasons that we are anticipating
18:55 the shortage that we anticipate in our budget
18:57 the next two years, which is the cause
18:58 for us to do the 12%, 12%, and 2026 and 2027,
19:02 we've been told that both the state and federal level
19:05 anticipate getting less monies trickling down to you.
19:08 There's a number, a large number of our grants
19:10 that are questionable, lead being one of them.
19:14 I'm not sure how familiar you are with NOACA
19:16 or the maps that NOACA produces,
19:17 but they give these what they call heat maps.
19:19 And they show Greater Cuyahoga County.
19:22 And the same places that were redlined years ago
19:24 are underserved populations
19:26 are worse for every single thing, y'all.
19:28 Whether it's smoking cessation problems,
19:30 they can't quit smoking, or drinking problems,
19:33 or lack of income, or lack of education,
19:35 or lack of money in general, lack of health insurance,
19:38 lead in homes, complaints about mosquitoes,
19:41 and every single thing that it coincides,
19:45 every single thing with redlining,
19:47 because these are underserved poor communities
19:48 and they have been for a long time.
19:50 They don't have as healthy of food choices.
19:51 They don't have safe places to exercise.
19:53 They have higher crime rates and drug rates.
19:56 The one silver lining, the one program
19:59 that we can show you up one side and down the other
20:01 that we are remediating is lead.
20:03 And the reason is, unlike things like opioid addiction
20:05 where it's cyclical and it repeats itself,
20:07 once you've gotten rid of the lead, it's done forever.
20:10 It's a success, it's a huge win.
20:11 And our lead program is doing a fantastic job.
20:15 And they've been doing a fantastic job
20:17 since I've been there, which is 1998.
20:19 I can't speak before.
20:19 I think you were ahead of me by a year, Matt.
20:21 So you could maybe speak a year more.
20:24 And one of our recent retirees,
20:25 our deputy director, John Sobolewski,
20:28 He has received millions and millions of dollars
20:30 in grants that he's put directly into homes
20:32 across the county for our least served people.
20:35 And he's turning it around.
20:36 So he retired and we all sniffed a little
20:39 when he left us, because we love him.
20:41 But he did a great job and he left a great team
20:43 including Matt behind him to follow in his steps.
20:45 And I can tell you that has been a huge success.
20:47 But in the meantime,
20:49 while we're waiting for those dollars to come through,
20:50 I brought for you some tips
20:52 about preventing childhood lead exposure.
20:55 Because in the meantime,
20:56 while we're waiting to remediate the actual lead paint
20:58 and the lead surfaces, we could be doing things
21:01 to knock down that lead dust and keep kids safe.
21:03 So these are the kinds of materials
21:05 that for a sanitarian like myself,
21:08 or for our legal expert, a legal counsel,
21:11 Any time day or night that you contact us,
21:14 And if it's something that you're like,
21:15 hey, I need this today because blah, blah, blah,
21:17 we've got somebody coming to Lakewood.
21:19 We'll have them swing by and get it and get it to you.
21:21 We want that kind of reaction time.
21:23 We know dollars are gonna be tight
21:24 for the feds and the state.
21:27 But we know that you expect superior service.
21:29 So between the Speaker's Bureau,
21:30 our approved brand new website,
21:32 our increase in IT infrastructure,
21:34 we have made a huge investment in our IT.
21:37 We can get data to you much quicker.
21:38 If you haven't visited our ccbh.net,
21:43 You will be amazed at all the things you can look at,
21:45 whether it's COVID or flu
21:47 or any kind of communicable disease.
21:48 We've got data up there.
21:50 I mean, our trackers, our informaticians are amazing
21:52 with some of the stuff that they do.
21:54 So I'm gonna leave you a bunch of literature.
21:57 I'm definitely gonna give you some of our new
21:59 and improved lip balm,
22:00 because it is that season
22:01 and we wanna keep you fresh and kissable
22:04 And of course, our agency brochure, which is brand new,
22:07 literally today, it was finished,
22:09 which has just an overview of all the programs
22:12 and services that I mentioned so quickly.
22:13 I'm the youngest of 11, I'm the only girl,
22:15 so you know, I talk kinda quick, sorry about that.
22:18 Is there any questions that we can try to answer
22:20 or any services that you can tell us this evening
22:22 that you need us to respond to immediately?
22:31 And I hope to see you often in Lakewood,
22:34 educating the community about the services
22:37 that you have to offer.
22:38 I think that's gonna become even more important
22:40 as our medical situation, hospital situation is impacted.
22:46 People are losing their insurance and Medicaid
22:49 and the underserved, as you mentioned,
22:51 will really need more education.
22:54 And when you talk about your vaccines that you give,
22:58 how would someone know that they can go
23:00 to the Board of Health to get them?
23:03 Excellent question.
23:03 So you could call us at the 216-201-2041.
23:07 That's the rollover clinic number.
23:09 So no matter which clinic you're talking about,
23:11 that main line, there's two gals, Lara and Dar,
23:15 one of the two would answer the phone
23:17 and they'd ask you what your zip code is
23:19 to try to see what place is closed.
23:20 Because for example, Lakewood will only open
23:22 two days a month, whereas Warrensville Heights
23:25 open two days a week, and then ours in the main
23:28 is open every day of the week.
23:30 But let's say, for example, you needed a vaccine
23:33 and we didn't have it, or we weren't gonna be near you.
23:36 They will pull up, we have a map to find you vaccine
23:39 in your area and give you CVS.
23:40 Our job's to get you to whoever.
23:42 Most vaccines are either insurance covered,
23:46 free, or on a sliding scale.
23:48 The worst case scenario is a sliding scale.
23:49 Now, we have people that are affluent that can pay
23:52 and they do have to pay.
23:53 Again, the poorest people not.
23:54 But things like flu vaccines always free.
23:56 As if your insurance doesn't cover it, it's picked up.
23:59 No one is refused on ability to pay
24:01 for a communicable disease.
24:03 If they didn't have the money for something
24:04 that's person to person.
24:05 Now, unfortunately, rabies is not person to person.
24:09 That's one that you have to pay for.
24:10 So that's, and it's expensive.
24:12 It's $600 and it's five shots.
24:14 So that's not an easy lift,
24:15 but unfortunately that one is not covered.
24:17 But most everything we do,
24:19 and we do tons and tons of screening
24:21 under our HIV AIDS program.
24:23 We do tons of screenings for free,
24:25 testing for free, exams for free.
24:27 You can get a preliminary breast exam
24:29 and then be referred to mammography if you need it.
24:31 What we're trying to do is be a stop gap for folks
24:34 even before all the cuts that are going on now.
24:36 Because there's so, so many people
24:37 that are uninsured or underinsured.
24:40 And I do think you offer a great service,
24:43 but my concern is I don't think people know about you.
24:47 And you might even consider putting some articles
24:51 in the Lakewood Observer,
24:54 which is the local paper that the residents can read
24:58 and understand how you serve the community
25:01 and where you are and how to access you.
25:04 Because you can say, call the phone number,
25:05 but if they don't even know you exist,
25:07 they're not gonna call a number.
25:09 I was remiss in not mentioning Ms. Marks
25:10 that we do provide articles anytime.
25:13 We read about 15 newsletters every time they come out.
25:16 We're happy to add yours to it.
25:18 We have a whole bunch of things on
25:20 whether it's vaccine and clinical,
25:21 whether it's childcare type,
25:24 hand, foot and mouth prevention, hand hygiene,
25:27 everything from how to handle your septic tank
25:29 to how to chlorinate your well to whatever.
25:32 If you have questions and it's something even around
25:36 different holidays, we're about to push out
25:37 a bunch of things about Thanksgiving.
25:38 Our website and our social media are blowing up.
25:40 We have a whole social media team now that's communicating
25:43 and you're welcome to link to us
25:45 and grab any of those articles
25:46 because all the types of things we're using social.
25:48 But so many folks really want us to come
25:51 and talk to seniors or talk to kids or talk,
25:53 we're happy to do that.
25:55 But to your point, we know we're gonna be spending,
25:57 making our biggest media purchase ever.
26:00 We just got a communication officer,
26:02 I'm embarrassed to say, in 2011
26:03 and we've been open since 1990.
26:06 There's a reason that there's an adage about public health
26:08 that says we're the best story never told
26:10 and that's very unfortunate.
26:11 But you're 100% right
26:13 and when we say better community engagement,
26:16 better communication, we are doing that.
26:17 We're going to be doing a major media buy.
26:20 We're not sure with who they'll have to go out to bid
26:22 to get to take our business,
26:23 but there's two or three main players
26:25 and we're gonna be all over the radio and TV
26:26 coming up in the next two years
26:28 because we have to do it, to your point.
26:30 And it can't just be people at tables.
26:31 Although we do that.
26:32 We're happy to table at any event.
26:34 We get lots of hits that way.
26:36 But we know we need to do a better job
26:38 advertising ourself
26:39 and that's part of what this 12% will pay for.
26:41 And I think communication is important in everything
26:44 and there are always people out there saying,
26:46 I didn't know or how do you hear?
26:49 So you just have to cover all bases.
26:51 So I'll open questions to the other members
26:55 Does anyone have a question?
26:58 That's one in Street Big.
27:02 Thank you, Chair Marks.
27:05 Just for a point of clarity,
27:06 cause I'm looking at the agenda for today
27:11 and it says that we're going to be entering an agreement
27:13 with the district advisory council of Cuyahoga County,
27:17 the Ohio general health district.
27:19 But I also hear board of health.
27:21 Is that the nickname?
27:22 That's the old name and this is the new official name
27:25 or tell me about how that goes.
27:27 Sure, that's a good eye.
27:28 We need you to scrutinize some of our literature
27:31 Excellent that you even know, you're the first person
27:33 and there's 58 of these, so good for you.
27:35 The district advisory council is the overseeing board
27:38 that votes on our board of health members.
27:40 They're even above the board of health
27:42 and above the health commissioner.
27:43 They are comprised of members,
27:44 usually the mayor or trustee from townships
27:48 Cities do not sit on a DAC,
27:50 but there are governing board
27:51 and they're who actually accept on our behalf,
27:55 any monies that are considered general revenue.
27:57 They have to approve and they did approve already
27:59 for us to go out to say that we could even do
28:02 this 12% increase between our board and the DAC.
28:04 It was presented to them first.
28:05 Once they approve it, then we come to each community
28:08 and say, here's your contract that coincides.
28:10 So good eye, but that's,
28:11 we're one in the same with them.
28:13 I mean, I'm trying to figure out who to call
28:15 because sometimes you call the city.
28:18 Sometimes you call the board of health
28:19 and I wasn't sure if now we had a third party here
28:21 that we were supposed to get a phone number for, so.
28:23 And before I leave, you'll have my card,
28:25 so you'll have my actual cell.
28:26 You can call or text me whenever.
28:29 You stated that we have three specific people
28:32 that work in Lakewood.
28:33 One does food, one does water,
28:38 Your district person, her name is Stacey Coltis.
28:40 We'll have them each come by and introduce
28:42 and leave business cards with the mayor's office,
28:44 but Stacey Coltis has been with us for 30 years.
28:47 Go ahead, I'm sorry, Matt.
28:50 What the district person is, that's our term.
28:53 They're a generalist.
28:55 That person is typically your senior sanitarian.
28:59 They've probably already spent many years in food
29:01 and doing other things.
29:03 Now they're doing pools and pools
29:06 and handling your nuisance complaints,
29:12 Sometimes we might send somebody else in here
29:14 to do lead that's very specific.
29:17 But those folks are typically the ones
29:19 that have been around for many years,
29:22 usually more than eight, I would say,
29:24 although we're getting very young.
29:27 That's with the district sanitarian.
29:29 They're typically the person that handles everything
29:33 You want to see your water person in Lakewood very often
29:35 because frankly, there isn't a lot of sewage
29:36 and water to deal with.
29:39 They're gonna spend most of their time in other areas.
29:43 But food person would be in City Hall more
29:47 because they're dealing with restaurants every day
29:49 so they're interacting with the building commissioner.
29:51 You know, Chris Sargent, our food sanitarian,
29:54 talks to your building commissioner weekly
29:57 about different issues.
29:58 So those are the three main ones
30:01 and here in Lakewood, you're gonna see food
30:04 and your generalist in your district.
30:08 Thank you for that explanation.
30:08 Okay, I'm sorry, Madam Chair.
30:10 The address, I looked it up for you,
30:13 for the immunization clinic in Lakewood,
30:17 Sam was right, it's right down the road here.
30:21 And we probably don't operate that every day.
30:23 You know, someone would have to call twice a month.
30:26 Two days a month, yeah.
30:28 And as the need increases, as we advertise more,
30:31 we will be here more.
30:34 And then I had a question about,
30:36 and I'm excited for your new medical vehicle too,
30:40 is it just education
30:41 or do you also do treatment out of that as well?
30:44 No actual treatment.
30:44 We have a nurse practitioner.
30:46 Her name is Kelly Stake.
30:47 She is absolutely phenomenal.
30:49 Wait until you meet her.
30:50 We want her to come and speak.
30:51 She does a lot of idea stream for us now
30:53 and radio, we regularly are on the radio
30:55 and on TV and doing all sorts of articles.
30:57 With our increase in external affairs communication,
31:00 we're doing a lot more of that.
31:01 But Kelly is wonderful plus a whole team of nurses.
31:03 So they actually would test anonymously for STIs.
31:08 We can't have a mobile medical unit that just does that.
31:10 Who's walking onto a unit that says outside,
31:12 hey STIs, get tested.
31:14 Nobody's walking, right?
31:15 That would be very bad.
31:16 So they do a lot of education and training.
31:18 They do breast cancer screening
31:20 and then they do the STI testing
31:22 and every kind of immunization that you can think of.
31:24 And we have an excellent unit in our fire department
31:26 that does outreach too.
31:27 And I don't know if you're partnering with them
31:29 and are not on anything.
31:31 That might be another good idea
31:33 to reach out to our chief on that one.
31:36 Well, we used to partner with Gordy Pallando
31:39 a lot when Gordy was here.
31:40 We did tons of preparedness training with him.
31:43 And he was a chemical engineer, basically background.
31:46 He had a PhD, super great with anything.
31:48 I mean, he always wore t-shirts
31:49 that showed you explosives and things.
31:50 I'm like, you're freaking me out, Gordy.
31:52 But he was phenomenal.
31:53 We did a lot with him.
31:54 And I know during COVID, you guys helped us.
31:56 We did COVID clinics here and you guys were phenomenal,
31:58 but I will reach back out to them.
32:01 And then I guess my last comment in question,
32:04 really more of a comment,
32:05 is just thank you for all these things.
32:07 I mean, it's just amazing the extent that you go to
32:12 and maybe a connection
32:14 to the Lakewood Community Service Center
32:16 might be the only other suggestion.
32:18 Might be able to offer.
32:19 So thank you all for being here tonight
32:21 to help us understand this.
32:24 It's our pleasure, truly.
32:25 So many of our cities,
32:26 I can tell you that Lakewood is the one
32:28 you do present a big problem to us
32:30 and it's more Matt's problem than mine.
32:31 So I like it that it's I get to pass it.
32:33 And that is when someone gets moved out of Lakewood,
32:35 whether district, food, water, or anybody,
32:37 they don't like it.
32:38 Even when our nurses get transferred
32:40 and go to a different, everybody loves this city.
32:42 It's one of the cities they fight for.
32:43 And it's funny to me,
32:45 when you have a responsive building and fire department,
32:48 two libraries, you have a lot of really cool things
32:50 in Lakewood, our people don't wanna leave.
32:52 They love the city.
32:53 A lot of us live here.
32:54 Several, John lives here.
32:56 A bunch of us live in Lakewood.
32:58 But a bunch of people do live in Lakewood.
33:00 So you should be very proud of who you are
33:03 And you've always partnered,
33:04 even at your festivals, your big events.
33:06 When you were gonna have all the mobile units down
33:08 and the beer gardens and that whole thing,
33:10 it could have been a nightmare.
33:11 Other cities, it might have been.
33:12 But you guys handle things so professionally.
33:14 You make it easy for us.
33:15 So we appreciate it.
33:16 We're gonna give you a bunch of information.
33:19 We even, you know, English as a second language
33:21 is a huge push for us right now.
33:23 We're really trying.
33:24 Our website is available in Arabic, Spanish, and English.
33:28 Every one of us on our work cell phone
33:30 has a language line now.
33:31 Over 400 languages are transmitted in real time
33:34 with a live human interpreter.
33:35 So whether we're helping someone in a clinic,
33:38 we're talking on a disease investigation,
33:39 or we're doing a food inspection,
33:41 we can get that live human interpreter to help us
33:43 to communicate better.
33:44 You know, we used to spend a lot of time
33:45 yelling at folks because we'd get stressed
33:47 and they'd get stressed,
33:48 and then they're just standing there blinking
33:49 and you're realizing, I'm talking louder.
33:52 They just don't understand me.
33:54 So just to give you a, for instance,
33:55 just in our lead book alone,
33:57 it's available in Nepali, in English,
34:00 in Spanish, and in Bhutanese.
34:02 We're trying to meet people where they are.
34:04 And lead is a huge problem across our county still.
34:07 We're working on it.
34:07 We're making successes.
34:08 But I'll leave these just to give you a feel.
34:10 And you certainly have all these populations
34:13 So we want to meet people really where they're at.
34:15 And this is just one program.
34:17 And our food program has quite a few,
34:19 seven or eight different languages for things,
34:20 but we know we need to do more.
34:22 And we're engaging more.
34:23 And the last thing I want to leave you with too,
34:25 because we didn't touch on it,
34:26 but when we talk about underserved,
34:28 our homeless population is getting to be
34:30 greater and greater, which is unfortunate.
34:32 We are doing more work with Lyft
34:33 and Bridge Street Outreach.
34:34 Those are serving underserved
34:36 or homeless people every weekend.
34:39 And we're stepping it up as an agency.
34:41 A bunch of us are volunteering.
34:42 It's not on the clock,
34:43 but it's something that we care about.
34:44 And I know you care about it.
34:45 I know Nature's been to a lot of that work.
34:47 I care why it does a lot of that work.
34:49 So if you need us for that,
34:50 if there's resources needed,
34:51 we have a group of medical students from CASE
34:53 who are going out with us
34:54 and actually treating folks on the street.
34:56 So we're trying to expand the services
34:58 that we do in new and creative ways,
34:59 even if we have to do it as volunteers on the weekend,
35:02 because we care about people.
35:03 We want to make sure they're healthy.
35:05 Were there any other questions for us this evening?
35:10 Thank you, Chair Marks.
35:12 So you talked about the,
35:16 so the question I have,
35:17 you talked about the health outcomes
35:19 and the plan that you have.
35:20 What are the health outcomes specifically for Lakewood?
35:24 And are you able to share what those are?
35:28 I love that question.
35:29 Unfortunately, we have broken out as an entire county.
35:34 And again, it's because sometimes where we meet
35:35 the person is where they're employed,
35:37 where they go to school,
35:38 not necessarily where they live.
35:39 So it's not by zip code,
35:40 but what we're working on,
35:42 and we're gonna ask for input from the communities
35:44 before we roll it out for next year
35:46 is an actual report card by community.
35:48 That would be amazing.
35:49 Yeah, and the reason that it's really difficult
35:51 is because the data is not stratified that way.
35:53 A lot of the data comes into us bulk,
35:55 and we didn't create it.
35:58 So it's Child Mutality Review is a prime example.
36:00 We will know that a child drowned,
36:02 but a lot of times we don't even,
36:05 and we don't even know where that child is from.
36:07 We don't have data on where they live.
36:09 So it's Cuyahoga County, but it's just generalized.
36:12 And I shouldn't say a lot of times.
36:14 Normally we know, but sometimes we don't.
36:16 So a lot of the data that comes in on illness and injury,
36:19 it isn't collected by our people,
36:21 and unfortunately we don't get every bit that we need.
36:23 But we're working on a plan,
36:25 and I know our friends in Strongsville,
36:26 our friends in Cleveland Heights,
36:28 our friends in Shaker have already asked us,
36:30 when will the report cards be available?
36:32 It probably, to be very honest,
36:34 either late 2026 or early 2027,
36:36 because we still have to merge
36:38 about seven different information systems.
36:41 But we do have some very specific data
36:43 on the entire county which I'm leaving for you.
36:46 And if you ever have want for something specific,
36:49 you're like, hey, someone in my family got campylobacter,
36:51 someone got shigella, someone got staph,
36:54 I wanna know, I can give you data county-wide,
36:56 and I can give you anecdotal information
36:58 about outbreaks we've investigated in your area.
37:01 Because that's interesting to people when they're like,
37:02 I got XYZ, I got clustering for fringes,
37:05 we'll see a spike, knock wood, we will not,
37:07 Every Thanksgiving,
37:08 because people don't thaw their turkey properly,
37:10 and they don't handle their raw stuffing properly,
37:12 and then we have an outbreak.
37:13 That's why we're doing a big campaign,
37:15 radio, TV, social media, website,
37:18 to try to push out information about this.
37:20 But every year, the Monday and Tuesday
37:22 after Thanksgiving, we see a spike.
37:24 So if you wanted to know about clusters of illness
37:26 as we found them, we would happily share that with you.
37:29 Okay, and then the other one,
37:31 you talked about the community health needs assessment
37:32 and an action plan,
37:33 and I'm not sure if you're familiar that we,
37:36 as a city, did a community health needs assessment,
37:39 and we have a community health action team
37:43 and created an action plan.
37:45 So is the county, that's county-wide, correct?
37:49 And is that available on the website?
37:53 It's outside companies putting together,
37:55 and then they're gonna vet through us,
37:56 and we're gonna look it over and type it,
37:57 because there's always some things
37:59 that granularly we wanna drill down our epi's.
38:02 But yes, it will always be available.
38:04 Our strategic plan is on our website already.
38:11 our annual report is already on our website,
38:13 and then as soon as that's finished, it'll be up there.
38:15 And if you would ever like us to sit with you
38:17 and say, hey, John, Suzanne, Matt,
38:20 this is what we're doing.
38:21 Where can you fit in?
38:22 How can you help us?
38:23 We're doing that for two other communities already.
38:25 We're doing that in Highland Heights.
38:27 We're doing that in Maple Heights.
38:28 We would be happy to try.
38:29 Yeah, I'm thinking that we can,
38:32 we should definitely connect you,
38:34 Chair Marks, we should definitely connect her
38:35 with our chat team.
38:38 And I think there would be some overlap there.
38:40 And also as we are in the process
38:43 of finalizing a racial equity plan,
38:46 I think that there would be some great,
38:49 perhaps information that can just be pulled
38:55 your health needs assessment as well,
38:58 as that's getting finalized.
39:00 We would be happy to.
39:01 Our expert, I would say,
39:02 we have two, Nichelle Shaw and her,
39:04 upline her director, Martha Helco,
39:07 are phenomenal with all things,
39:08 Chad and all those different plans.
39:11 And then, I'm not sure if you're aware,
39:12 but we also have a director
39:13 of equity, diversity, and inclusion,
39:17 And he has La Donne, monthly owned his employee,
39:19 who's spent a lot of time in your city.
39:21 They do a ton with LGBTQ community
39:24 and just communities of color in general,
39:26 communities, anybody who's underserved
39:28 English as a second language,
39:29 they're doing a lot about brain health,
39:31 equity relative to dementia patients.
39:33 I mean, tons, we do these brown bag lunches.
39:35 We would love to connect you
39:36 with both of those groups,
39:37 because they are real,
39:38 I'm either her free taking notes,
39:40 but they're the experts.
39:41 Yeah, no, I think that would be great.
39:42 And that work is happening right now.
39:43 We do have a consultant that is going through
39:47 and working through that
39:48 with our anti-residents task force.
39:49 So I think that would be a great connection.
39:51 So I can definitely follow up and connect you.
39:53 And then my last, well, two more points, sorry.
39:57 I see that Ian Andrews walked in.
40:00 So my question was, are you familiar with Lakewood Alive?
40:03 And I'm assuming you work together
40:06 because I know you talked about bedbugs
40:08 and I know Mr. Andrews has dealt with that.
40:11 They get a lot of calls.
40:12 So I'm just wanting to make sure
40:13 that those connections are made.
40:15 I know that your team sends stuff to us a lot.
40:20 We do get a lot of calls and questions
40:23 and we have gotten complaints
40:25 relative to bedbugs and different things.
40:26 I have not worked with you guys yet,
40:28 but I do know of you,
40:29 because when I used to volunteer at Nature's Bend,
40:31 they bragged on you guys all the time
40:33 and I regularly work with the YMC and the library
40:35 and they brag on you all the time.
40:36 So my cards are here.
40:37 I hope you will take one and reach out.
40:40 As this position, I was in food protection
40:42 for years and years
40:42 and just wanting to do this kind of stuff,
40:44 but now I get to do it for my full-time job.
40:45 So I would love to connect more.
40:49 And then the last one is,
40:51 I do have an opportunity for you in the summers
40:54 that would be great for you to come out at least once.
40:57 It's Madison Court Community Coalition.
40:59 It's a group that I was co-founded
41:01 and they do monthly block parties that start in,
41:05 they typically start in May,
41:06 depending on the weather,
41:07 but they may start in June.
41:08 But so June, July, August for sure.
41:11 And it's in our award four,
41:12 which is our, has a lot of high needs in that area.
41:18 So it would be a great connection point.
41:21 And if that mobility van is available,
41:24 I think coming out to one of the block parties,
41:26 parking right there in the parking lot
41:28 and being there to serve the community,
41:30 I think would be great.
41:31 So let's connect after, get your business card
41:34 and I'll follow up with some of those connections.
41:37 The more of an area,
41:38 we've almost tripled this year.
41:40 I'm looking for two more before the end of the year,
41:42 so I can say we've tripled the number of outreach
41:43 from last year to this year
41:45 with the creation of my position.
41:46 And we're being very discerning.
41:47 We're not just going for 10 people.
41:49 You know what I'm saying?
41:50 We're going to the places where people are in mass,
41:52 whether it's in Cleveland or outside of Cleveland,
41:54 because we know people are like,
41:55 you shouldn't be working in Cleveland.
41:56 They have their own health department.
41:58 Many of our folks from the outer 58 go to Cleveland.
42:01 When it's a big event, they're going.
42:03 There's thousands of people.
42:04 So we want to be where you need us.
42:08 I have all the materials here.
42:10 Did I miss anything, gentlemen?
42:12 Well, oh, we're good.
42:14 You can see why she's our communications director.
42:17 You're not clear by now.
42:18 Well, thank you all for coming.
42:22 Thanks for having us.
42:23 I'd like to move to move this forward
42:27 to council for full approval.
42:34 Oh, I moved to, I need a second.
42:35 You need a motion to move this favorably back to council.
42:40 I will second that.
42:46 So if there's no more business,
42:48 we can help the meeting to a close.
42:52 Thank you, everybody.
42:55 Thank you again very much.
42:56 Thank you, Ms. Marks.