Dear Honorable Mayor Yaede,

Last week I contacted your office and requested you consider doing a town hall meeting as it pertained to the issues surrounding Mr Plunkett. I did not receive any response. As a resident I am very concerned about the disclosure by the DOH as it pertains to the lack of inspections performed by Mr. Plunkett of our restaurants and his overall and derelict of his duties. This poses a significant risk on public health in Hamilton. A town hall meeting, chaired by yourself, could ease the concern of residents and the business owners of Hamilton.

In 2018, the Greater Mercer County Public Health Partnership (GMPHP) undertook development of its third Community Health Assessment (CHA). The CHA was designed to ensure that Mercer County public, private, and community-based organizations continue to effectively and efficiently serve the needs of their communities. The CHA was developed in accordance with all federal rules and statutes, specifically PL 111-148 (The Affordable Care Act) which added Section 501(c) to the internal revenue code and, in accordance with New Jersey regulations N.J.A.C. 8:52 10.1-10.3 governing local boards of health.

The Community Health Assessment is a process that determines and evaluates the state of health and health needs of a local population. It enables the identification of major risk factors and causes of ill health; and - Identifies action needed to address these factors. The report they published provides valuable information regarding why and how to improve the community’s health status.

Mercer County was split into 5 pie pieces to ensure that each part of the county is well represented. Out of 5 focus groups held between March 5 – 14, 55 people from diverse backgrounds shared their experiences and opinions. Results were broken down by “Definite Improvement” and “Some Improvement”. The improvement categories are broken down by municipality in the report. I have placed below what was recommended for Hamilton in the report below.

Area Definite Improvement Some Improvement for Hamilton
• Clinics for uninsured
• Support for disabled
• Veterans programs
• Childhood obesity
• Senior services availability
• Opioid addiction

There were additional focuses that were also recommended. Those are listed below from the report.
1) Community/Network Connectedness/Communication
2) Access to care
3) Mental health –the single greatest concern area that was broadly defined - Opioid addiction, Stress/Anxiety management, Suicide prevention
4) Transportation
5) Language barriers/Immigrant population
6) Senior/Adult Needs -Also Veterans Services in some areas
7) Education -Health, Parenting, Social Media, tutoring programs, bullying
8) Medical Conditions - Alzheimer’s/Dementia, Asthma, Cancer, Cardiovascular, Diabetes, Hypertension, Childhood Obesity, Chronic Pain Management Although occasional improvements were noted, respondents characterized access as ‘not good’ or ‘in need’ of improvement’: this was true across all groups.

The Census repors and the MCHA report demonstrate that in Mercer County/Hamilton the Asian population grew by 29% between 2010 and 2018, and Hispanic and Latino populations grew 20% during the same timeframe. Poverty rates in Mercer County for families, people, and children, were higher than the State. In Hamilton, the poverty rate is 38%. Poverty has long been recognized as a contributor to death and disease, but several recent trends have generated an increased focus on the link between income and health. Lower levels of education attainment can indicate issues of health literacy and the ability to follow medical advice. 50% of residents in Hamilton only have a HS or Associates degree level education. (Source: US Census). This also has an effect on healthcare disparities.

The inpatient use rate in Mercer County (171.7 per 100,000) was higher than that of the State, and the zip codes of Trenton/Ewing zip code 08618, Trenton zip code 08628 and Trenton/Hamilton (08609) all have hospital use rates well above the statewide rate. We have a lot of residents that required hospitalization due to their disease states. In Hamilton we have the highest rate of diabetes, renal disease, COPD, and hypertension in the state. The oncology statistics are also rising in the Hispanic and Black communities, all of which are communities rising in population in Hamilton. These patients are all immunocompromised. Thyroid, Renal, uterine, etc are all cancers on a significant rise in MC/HTWP. The overall age adjusted rate for cancer occurrence in Hamilton Mercer County is on the rise and is representative of one of the highest in the entire state of NJ, as compared to other counties in NJ. These are all patients who are immunocompromised. 

Any patient who is immunocompromised does not have the ability to respond to infection due to an impaired or weakened immune system. Young children are readily susceptible to disease and the consequences can be serious or life-threatening. Adult or pediatric patients who are immunocompromised (i.e oncology patients, diabetics, HIV, malnutrition, or on different drugs etc) can die from the simplest event of exposure.

These immunocompromised patients will go out to eat to break the monotony of their disease to get out of the house. The lack of inspections of our eating establishments puts these patients at the highest risk of adverse event. The entire population is at risk, but these residents who are immunocompromised are at the greatest risk.

In Oct 2014, Hamilton lost a small boy, Eli Waller to EVD68. You did a town Hall for that issue. That helped residents. During those Town Halls, Mr Plunkett shared that he was rewriting the SOP’s for the schools. However, when I OPRA’d this information in Oct 2018, I asked for the SOP’s that existed prior to Oct 2014 I was informed that no SOP’s existed. I can forward the OPRA request and the response from the clerk’s office. How is it that Mr Plunkett said he was revising them during those press conferences, yet, an OPRA showed they never existed. That is concerning. Eli was immunocompromised. There was a nationwide epidemic going on in the US for EVD68. NJ was the 30th state to be hit with hit. Yet, Mr Plunkett stated at the press conferences, as did you, that you had never heard of EVD68. As our Director of Public Safety, it is imperative that when nationwide epidemics are occuring, we are ahead of the curve. Educating the community and safeguarding the children in our schools. It was not until the death of Eli that the town reacted to the Nationwide epidemic.

We have a large population of immunosuppressed residents in Hamilton. It is the responsibility of the Mayor, the Public Safety Director and the Department of Health director to ensure the safety of our community. With the indictments that occurred for Mr Plunkett and the recent DOH decision to revoke his license, the residents want and deserve answers. The community must be safe. There must be accountability for the lack of supervision that occurred on Mr Plunkett. To continue to ignore the requests of residents to have a town hall on these important issues is not acceptable.

I just OPRA'd very specific information on inspection reports in Hamilton for food establishments. The clerk's office is not sharing the data. This is not representative of a transparent government. This adds to the level of concern for residents.

I would also like to understand why in the Annual reports prepared by Mr Plunkett he makes no reference to the findings to the Mercer County Community Assessment report. The recommendations made in the report from Hamilton should also be a topic of discussion for the town hall.

We look forward to a response and a town hall for residents in the immediate future.

Kind Regards

Dr Tammy Duffy