Board of Health — Skokie, IL
Date: 2016-03-10

Skokie Board of Health
 March 10, 2016
 Village Hall Conf. Rooms D/E
 7:30 p.m.

 AGENDA
 U




 I. Call to Order


 II. Approval of Minutes


 III. Shelley Wax, RN, BSN
 Susan Reisberg, RNC, MSN, FNP
 Skokie Public Health Nurses
 Skokie School Vaccination Rates


 IV. Update regarding 2016 Community Health Survey



 V. Chair’s Report



 VI. Director’s Monthly Report



 VII. Old/New Items of Business



 VIII. Adjournment/Next Meeting:

 Thursday, April 14, 2016

 Jeff Estrella, MD, MPH (c)
 Northwestern University MPH Student Intern
 Skokie Filipino Community Health Needs Assessment

 7:30 p.m.
 Village Hall
 2nd Floor Conference Rooms D/E
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Skokie Board of Health
 March 10th, 2016

Present Absent Excused
Mr. Abbasi Dr. Topouzian Dr. Vernon Mr. Nidetz
Dr. Dave Ms. Urbanus Dr. Prince
Dr. Drachler Dr. Usman Ms. Jones Thorne
Dr. Gaynes Dr. Varma
Mr. Pandya Dr. Werner
Dr. Sood Dr. Williams
Ms. Nickisch Duggan

Guest,
Nurse Shelley Wax, Staff
Nurse Sue Reisberg, Staff
Dr. Edward McCarron, Family Services Commission

Dr. Catherine Counard, Director of Health
Mr. David Clough, Staff

Call to Order - The meeting was called to order at 7:35 p.m. by Dr. Drachler, Chairman.

Approval of Minutes – Minutes from the February meeting were reviewed. One correction was made:
Dr. Edward McCarron is on the Family Services Commission rather than the Human Relations
Commission. The minutes were approved with this correction.

Vaccination rate in Skokie Schools (a copy of the presentation is attached)
Nurse Shelley Wax spoke about vaccination rates in Skokie schools. Ms. Wax worked as a school nurse
at Solomon Schechter school prior to her employment at the Skokie Health Department. All children in
kindergarten, 6th and 9th grade, as well as any students new to Illinois schools, must provide proof of
having received the required vaccinations by October 15. Vaccinations are reported on the State of
Illinois Certificate of Child Health Examination. If this form is not completed by October 15, children are
excluded from school. This leads to a large rush in the Health Department and in school nurse offices at
the beginning of October each year.

Students must be protected from Diphtheria, Tetanus, Pertussis, Polio, Influenza B, Measles, Mumps,
Rubella, Haemophilus, Pneumococcal Disease, Hepatitis B, Varicella, and Meningitis. Human Papilloma
Virus, Influenza, and Hepatitis A vaccinations are strongly recommended but not required. In a small
number of cases some vaccines can be held if there is a medical reason that the student should not receive
the vaccine. This is only done in the case of extreme allergies or rare medical conditions. This is very
rare and occurs in less than 1% of all Skokie children.

Religious objections are allowed in Illinois but it is now required by law that a form stating which
vaccines the parent/guardian objects to and the reason for the objection. It is also required that the
parent/guardian receive counseling from a healthcare provider on the benefits of immunization and risks
of disease to the child and community at large. For a medical exemption, if there is an outbreak of
disease that the child has not been vaccinated against, the school must pay for home tutoring for the
unvaccinated children, who will be excluded from school until the outbreak is over. However, for
children who have not been vaccinated due to religious objections, the school is not required to pay for
tutoring. Three states, Mississippi, West Virginia, and California, will not accept religious objection as a
basis for refusing vaccinations.

Ms. Wax shared a list of top reasons parents object to vaccines, compiled at Boston Children’s Hospital.
Reasons included:

 • These illnesses are rare
 • These illnesses are not all that bad
 • Vaccines cause autism
 • The preservatives in vaccines are dangerous
 • Vaccines have side effects
 • It’s a conspiracy between the pharmaceutical companies and the government
 • I trust my family, friends, and community more than my doctor.

Dr. Counard pointed out that the connection between vaccines and autism had been debunked and people
have had objections to vaccines since the introduction of the smallpox vaccine in the 1700’s.

Dr. McCarron pointed out that none of the most common reasons for refusal are religious. Dr. Counard
stated that no religions explicitly forbid immunization.

Skokie vaccination data for the 2015 -2016 school year includes data from 16 public schools and 6 private
schools for a total of 13,290 students. Less than 1% of Skokie students remain unvaccinated for either
medical or religious reasons. Varicella and MMR are the vaccines most commonly objected to.

Ms. Reisberg reported that, as of January 1st, the State requires daycare employees to prove they are
immunized with Tdap (whooping cough) and MMR (measles, mumps, rubella).

The Illinois Department of Public Health has recommended a 90% protection level to prevent epidemics.
Both Illinois and Skokie have well over 90% compliance. Both Private and Public schools in Skokie
have better vaccination rates than the rest of Illinois.

Ms. Wax then presented pre- and post- vaccination morbidity rates from vaccine preventable diseases.
All rates dropped dramatically after the introduction of vaccines, most by over 95% and two by 100%

Dr. Drachler pointed out that vaccinations do wear off and many adults think they are up to date but aren’t
because the effect of their vaccinations has expired. He recommends adults get the Tdap vaccine to
protect infants from whooping cough. Ms. Reisberg reported that many prospective grandparents come to
the Health Department for the Tdap vaccination.

Dr. Williams suggested having a shot clinic at the Boards and Commissions recognition night.

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Dr. Werner pointed out the website for the Immunization Action Coalition which consistently updates
vaccine information. Vaccination information is continually changing and new updates are required
regularly.

Sue Reisberg pointed out that while Tdap is recommended just once for adults, immunity likely wanes
within 10 years. She suspects the recommendation will likely be changed to having a booster dose every
10 years.

The group discussed vaccination rates and changes in vaccine recommendations and availability.
Dr. Drachler reported that HPV vaccinations have decreased abnormal pap smears by 20%. They also
discussed adult vaccination rates and how to improve them.

Preliminary Survey Results
Mr. Clough reported that 1620 surveys had been returned at this point. He gave a small breakdown of
which languages had been utilized and the top ethnic groups reported in the online version of the survey.
With a week left to collect surveys the total number has exceeded the amount collected during the last
IPLAN process.

Mr. Clough reported on the progress of the Rethink Your Drink program and offered the 30 day water
bottle challenge to interested board members. Twelve Board members took the Sugar Sweetened
Beverage survey and signed up for the 30 day water bottle challenge.

Chair’s Report
Dr. Luka has resigned from the Board of Health because she is moving to Chicago. Dr. Drachler thanked
her for her years of service. There are now two openings on the Board of Health.

Dr. Drachler encouraged Board members to attend the Boards and Commissions Dinner on Monday
March 14. The Solid Waste Agency of Northern Cook County will present on the topic of recycling.

Dr. Drachler and Dr. Counard attended an open house on March 3 at the Erie Evanston/Skokie Health
Center. The open house included a presentation on the importance of talking to and reading to children.
Dr. Counard and Dr. Drachler were welcomed and acknowledged at the event.

Dr. Drachler requested that Dr. Counard give a summary of the status of the Erie Evanston/Skokie clinic
Dr. Counard reported that Village Manager John Lockerby, Nurse Susan Reisberg and she met with
Dr. Lee Francis, CEO of Erie Family Health Center, to discuss the issue of Skokie residents not being
able to get appointments at the Erie Evanston/Skokie clinic. Residents have been calling the health
department and elected officials stating that they have been turned away by Erie because they did not
have health care insurance. Nurse Reisberg called Erie to verify this information and learned that in fact
people without healthcare insurance were being turned away. The clinic is now closed to new patients.

The Erie Evanston/Skokie clinic was established with extensive support, both time and funding, from the
Village leadership, Health Department, Board of Health and Skokie Hospital, so it is disappointing that
only 16% of the patients are from Skokie. Dr. Counard shared a letter that she and Mr. Lockerby sent to


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Dr. Francis, asking that Erie accommodate another 1,000 Skokie residents as patients within the next
year. A follow-up meeting will be scheduled in 90 days with Dr. Francis to determine progress towards
this goal. A copy of the letter is attached.

Dr. Drachler reported that he has approached the psychologist in charge of the NorthShore weight
management program. She was very receptive and will hopefully come and present to the Board of
Health about the psychology of weight management.

Dr. McCarron has asked the Family Services Commission to support Board of Health efforts to increase
the age to sell or purchase tobacco products in Skokie to 21. Dr. McCarron has been designated to write a
proposal that will be approved by the commission and then passed on to Mayor Van Dusen. Tobacco 21
has also been introduced at the state level with Senate Bill 3011 sponsored by Senator Mulroe. Dr.
Williams has been asked to present supporting a ban of smokeless tobacco in stadiums in Chicago.

Directors Report (attached)

Collecting 2016 Skokie Community Health Survey Dominated February
The Health Department, Board of Health and IPLAN Committee worked to offer the community health
survey to as many people who live, work or attend school in Skokie as possible. The survey was delivered
widely electronically and via paper copies. The survey will close on Sunday, March 13.

Meeting with Asian Human Services
Nurse Susan Reisberg and Dr. Counard met with the leadership of Asian Human Services Family Health
Center to hear how things are going at the new Skokie location. AHS is providing care for more than
1,100 Skokie residents. AHS is upgrading their dental services, installing a new elevator, and adding a
few exam rooms on the second floor. Thanks to Dr. Williams and Midwestern University Dental
students, AHS has increased the number of dental clients served by 40%!

Communicable Disease Concerns
A number of Skokie residents have met the criteria for testing for Zika virus but none have tested
positive. Dr. Drachler reported that climate change and warming environments are leading to increased
Zika rates due to the mosquito that carries it being able to live longer in different areas. The mosquito
abatement district is on high alert to monitor for Zika as well as West Nile Virus this summer.

Turning Point Behavioral Health Center Town Hall Meeting
Dr. Counard and Mr. David Clough attended the Turning Point Town Hall meeting, to hear how the
Illinois budget crisis is affecting access to mental health services. The State owes Turning Point over
$500,000 which is severely limiting their ability to provide services.


Dr. Counard also mentioned that the Director of the Illinois Department of Public Health (IDPH) has
introduced a bill in the Senate (SB2416) to Abolish the State Board of Health. The State Board is the
primary advisory board for IDPH, and functions similar to the Skokie Board of Health. Dr. Counard and
other members of the Northern Illinois Public Health Consortium (NIPHC) traveled to Springfield to
speak out against abolishing the State Board. Dr. Counard will continue to update the Board on SB2416.


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Dr. Drachler asked if the money owed to the Health Department and other entities that has not been paid
due to the budget impasse will be lost permanently if it is not paid by the next budget year. Dr. Counard
reported that it was unclear as to when or if there would be a state budget anytime in the near future.

Dr. Gaynes asked what kind of pressure people were receiving from the Governor’s Office. Dr. Counard
reported that she has heard of relentless calling campaigns to state and local politicians who have objected
to or highlighted the negative impact of the lack of state funding.

Dr. Williams reports that many FQHC’s are being negatively affected by the lack of healthcare payments
by the Illinois government for state employees. Dentists in Illinois are proposing a bill that will allow
providers to cancel state employee enrollment with no penalty if the state has not made payment within
six months.

Mr. Abbasi mentioned an article on lead testing in Chicago and asked how we are doing in Skokie.
Dr. Counard responded that the health department regularly submits drinking water for lead level testing,
and the water has always been well within EPA standards.

Ms. Urbanus proposed adding a health consumer rather than a health professional to the Board.
Dr. Williams proposed getting someone who works at Asian Human Services to join the Board.
Dr. Counard invited all Board members to encourage any community member they would recommend to
apply.

The meeting was adjourned at 9:09PM.




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