February 2022 Board of Health Meeting

1. Call to Order
2. Board Elections
3. Agenda Approval
4. Announcement of Conflict of Interest
5. Update
   1. COVID-19 Update (Dr. S. Nesathurai)
6. Approval of Minutes
   1. Regular Board Meeting:  January 20, 2022
7. Business Arising
8. Consent Agenda
   1. Project Governance Committee Meeting Minutes–Jan 14/22
   2. INFORMATION REPORTS
      1. Ontario Naloxone Program: Distribution and Utilization of Naloxone Kits in the Community (E. Nadalin)
      2. COVID-19 Vaccination Update (N. Dupuis)
      3. COVID-19 Surveillance and Epidemiology (N. Dupuis)
      4. January Communications Recap (E. Nadalin)
   3. RESOLUTIONS/RECOMMENDATION REPORTS
      1. Consumption and Treatment Services Site Premises (N. Dupuis)

      2. Amendment to 2022 Budget Submission (L. Gregg)

9. New Business
   1. Project Governance Committee Update (J. Lund/N. Dupuis)
   2. City of Windsor – Auditor General Request (N. Dupuis)
   3. Vaccine Planning Update (K. McBeth)
   4. alPHa Winter Symposium, February 25, 2022
10. Correspondence
    1. Greater Essex Catholic District School Board – Letter to Hon. Minister Stephen Lecce – Resumption of a supported plan for tracking and public reporting of COVID-19 in schools
    2. Halliburton, Kawartha, Pine Ridge Public Health – Letter to Hon. Christine Elliott – Support for Local Public Health
    3. Peterborough Public Health – Letter to Hon. Christine Elliott – Support for Local Public Health
    4. Peterborough Public Health – Letter to Hon. Christine Elliott – Support for Local Public Health - Support for the Windsor-Essex County Health Unit’s Resolution to the Province of Ontario to amend the Immunization of School Pupil’s Act (ISPA) to include COVID-19 as a designated disease
    5. Conseil Scolaire Catholique Providence – Letter to the Hon. Stephen Lecce – Support for the Windsor-Essex County Health Unit's Resolution to the Province of Ontario to amend the Immunization of School Pupil's Act (ISPA) to include COVID-19 as a designated disease 
    6. City of Windsor – City Council Decision CR22/2022 – January 17, 2022 – that the City of Windsor Council Support the WECHU in establishing a Consumption and Treatment Services Site in the City of Windsor post-approval from the provincial and federal governments
    7. Ministry of Health – Letter from Hon. Christine Elliott – to Windsor-Essex County Health Unit advising of one-time funding up to $369,900 for the 2021-22 funding year and one-time funding up to $945,600 for 2022-23 funding year to support the provision of public health programs and services in our community, an extension to one-time mitigation funding to ensure municipalities do not experience any increase as a result of cost-sharing change for 2022, and funding to support the Ontario Seniors Dental Care Program for eligible low-income seniors
    8. Ministry of Health – Letter from Chief Medical Officer of Health, Dr. Kieran Moore – to Windsor-Essex County Health Unit as a follow up to the Letter from the Hon. Christine Elliott noting that WECHU’s maximum total funding under the Accountability Agreement with the Ministry of Health for 2021-22 to be $29,363,300 ($17,684,500 in base funding and $11,678,800 in one-time funding)
11. Committee of the Whole (Closed Session in accordance with Section 239 of the Municipal Act)
12. Next Meeting: At the Call of the Chair March 24, 2022 – Via Video

13. Adjournment

1. Call to Order

   Board Chair, Gary McNamara, called the Regular meeting to order at 4:03 pm.

      The Board moved into Committee of the Whole at 4:03 pm
      The Board moved out of Committee of the Whole at 4:15 pm

2. Board Nomination:  Treasurer

   The Chair noted that at the last meeting of the Board, annual elections took place and the role of Treasurer was left vacant.  The Chair asked former Treasurer, Tracey Bailey, if she would continue to stand as Treasurer for the remainder of the year.  Tracey Bailey having accepted was elected Treasurer by acclamation.

   Motion: That the nomination for Tracey Bailey as Treasurer stands
                  CARRIED

3. Agenda Approval
   Motion: That the agenda be approved.
                   CARRIED
4. Announcement of Conflict of interest – None
5. Update (Dr. S. Nesathurai)
   1. COVID-19 Update

      As we move forward, we will have to monitor the effects of relaxation, as COVID is not likely to be eradicated in the near future.  We need to consider hospital capacity, masking, continuing with social distancing and to start thinking of vaccination as a semi or annual event, along with medications as they become available.  As time progresses, around 6 months or so, the vaccine becomes less effective and the core message is for those who are vaccinated to get their 3rd dose, and for those who are not vaccinated to consider doing so.  The level of immunity provided by vaccines reduces over time and additional vaccination provides enhanced immunity.  COVID-19 is a new disease and we will learn more as time goes on.  His sense is that the mRNA vaccine will be tailored around Variants of Concern, the same as the influenza vaccine which is targeted to different strains. We are also hoping for new classes of medications in the future to fight COVID-19.

      G. Kaschak noted the recent news of an Ontario Health Team for Windsor-Essex and what does that mean for the health unit going forward.  N. Dupuis said that this was an exciting announcement for Windsor-Essex to have our own Ontario Health Team for the region.  N. Dupuis is on their Steering Committee and they are at the point of redefining different partnerships for various sectors.  We will bring updates on the OHT to the board in the future. The focus and intent of Ontario Health Teams is on coordination of health services.

      Motion: That the information be received.
                      CARRIED

6. Approval of Minutes

   1. Regular Board Meeting: January 20, 2021

      Motion: That the minutes be approved.
                      CARRIED

7. Business Arising - None
8. Consent Agenda
   1. Project Governance Committee Meeting Minutes – January 14, 2022 
      The minutes of the Project Governance Committee of January 14, 2022 were brought to the Board for information.
      Motion: That the information be received. 
                      CARRIED

   2. INFORMATION REPORTS

      1. Ontario Naloxone Program: Distribution and Utilization of Naloxone Kits in the Community (E. Nadalin) 
         The Report is attached and presented to the Board for information.

      2. COVID-19 Vaccine Update (N. Dupuis)
         The Report is attached and presented to the Board for information.

      3. COVID-19 Surveillance and Epidemiology (N. Dupuis)
         The Report is attached and presented to the Board for information. 

      4.  January Communications Recap
         The Report is attached and presented to the Board for information. 

         Motion:  That the information be received.   
                          CARRIED

   3. RESOLUTIONS/RECOMMENDATION REPORTS
      1. Consumption and Treatment Services Site Premises (N. Dupuis)
         The WECHU is in the final stages of completing the application to both Health Canada and the Ministry of Health for a Consumption and Treatment Services site in the City of Windsor.  On January 17, 2022, the WECHU obtained approval from Windsor City Council to move forward with a property located at 628 Goyeau Street in Windsor.  A Lease Agreement was drafted by WECHU’s legal council and is presently under review by the landlord.

         This Resolution is begin brought forward to the Board of Health to approve the Lease Agreement between the WECHU and the landlord, and that the Chief Executive Officer be able to enter into an agreement with the landlord on behalf of the organization.
         Motion:  That the Board approve the above noted Lease Agreement and that the CEO enter into an agreement with the landlord at 628 Goyeau Street, Windsor, on behalf of the organization
         CARRIED

      2. Amendment to 2022 Budget Submission (L. Gregg)
         As discussed at the January Board of Health meeting, L. Gregg noted the financial impacts of circumstances that arose in the latter part of 2021, all of which would have a continuing impact on 2022, specifically:
              - Redeployment nursing staff and certain administrative staff to support vaccination
              - Establishment of a Mass Vaccination site in Leamington
              - Redeployment of non-nursing staff to support case and contact management, and outbreaks
         In preparation for the 2022 Annual Service Plan and Budget Submission to the Ministry of Health, the WECHU has prepared a 2022 Budget Amendment to quantify those impacts.  Additionally, provisions are included for COVID-19 vaccination activities beyond March 2022, assuming that the WECHU will be involved with the immunization of the 0 to 4 age group as well as other COVID-19 vaccination priorities.

         The 2022 Budget Amendment specific to the COVID-19 program will result in an increase in expenditures of $1,907,007.  Salaries and benefits, mileage, program expenditures such as rent and supplies, and purchased service account for these expenditures.  This amendment will go in the ASP and one time funding with no obligation to municipalities.  The Annual Service Plan and Budget Submission is due to the Ministry of Health on March 1, 2022.  This Resolution is being brought to the Board to approve the 2022 Budget Amendment requiring an increase of $1,907,007 to the one-time business case to be funded by the Ministry of Health at a rate of 100% for those dollars in excess of the 2022 Mandatory Program Budget.
         Motion: That the Board approve the 2022 Budget Amendment as presented.
                         CARRIED

9. New Business

   1. Project Governance Committee Update (J. Lund/N. Dupuis)
      Board member, J. Lund and Co-chair on the Project Governance Committee, provided the Board with a brief update.

      The goal of the committee is to secure another space for the Windsor-Essex County Health Unit’s Windsor office. This process commenced in 2016.  The lease for the current Windsor office expires at the end of 2023.  The committee had taken a hiatus from the process due to the pandemic and has recently reconvened.  The project is currently planned in 4 phases:
           Phase 1 – Space Needs and Selecting Consulting Partners (December 2021 to March 2022)
           Phase 2 – Site Selection Process (March 2022 to August 2022)
           Phase 3 – New Location Design and Fit out (September 2022 to October 2023)
           Phase 4 – Move in (October 2023 to December 2023)
      In Phase 1 an RFQ was published for a Space Needs Assessment which has been awarded to Architecttura.
      Motion: That the information be received.  
                     CARRIED

   2. City of Windsor – Audit (N. Dupuis)

      N. Dupuis brought forward a letter from the City of Windsor Auditor General inviting the WECHU to participate in their annual audit.  For context, F. Costante added that this was passed as a resolution at city council that this invite be sent to all Board and Committees, and not exclusively to the health unit.  It was recommended that we respectfully decline the offer as we have our own auditor as well as our provincial audit by the Ministry of Health.

      Motion:  That the Board support the recommendation to decline.
                       CARRIED

   3. Vaccine Planning Update (K. McBeth)

      K. McBeth provided an update and a presentation on Vaccination Planning for COVID-19 and other immunizations. The priority for COVID-19 vaccination for February is the 5-11 year age group.  The provincial target for this age group is 70% and Windsor-Essex is at 43.5%.  Targeted vaccination clinics will be available in schools and throughout communities, immunizations are available at 39 pharmacies who have adjusted hours to accommodate families, and more than 20 after school clinics are currently planned through February and March in both elementary and secondary schools to encourage vaccine uptake.

      Mass vaccination sites are not considered long-term and mobile clinics are the most crucial. Our partners at CRST (ESHC/EMS) will continue to provide these mobile vaccination services.  The Sears site will remain open for COVID-19 vaccination on a smaller scale and WECHU will offer ISPA vaccinations for students who are overdue. There are approximately 8,000 students who are overdue and require catch-up immunizations. The WECHU will also offer community immunization clinics for students from April 2022 to August 2022 and we are willing to support Primary Care Providers to administer vaccines to their patients free of charge.

      Starting tomorrow, February 18, the 12-17 year age group will be eligible for 3rd doses if they are 6 months post their second shot.  Vaccine approvals for the 0-4 year age group will likely come at the end of the second quarter of this year.

      J. Lund questioned the consent process for children between 12-17 years and the fact that they can be vaccinated without parental permission.  Dr. S. Nesathurai noted that in medicine consent is not defined by age but by the individual’s ability to understand the risk versus the benefit around treatment, but his preference would be for young people to have this dialogue with their parents or guardians. N. Dupuis said that there is no age of consent under the Health Care Consent Act, and it is up to the health practitioner to determine if an individual, of any age, has an understanding of the treatment provided.  All health units provide the same messaging, as does the Ministry of Health as it relates to the rollout of vaccine, to encourage young individuals to have this dialogue with their parent or guardian.  This is not specific to COVID and we would not refuse health care services to a young person who is capable and has consented for themselves. We appreciate this is a challenging topic.  All of our school-based clinics are after hours making it more flexible for families to attend together.

      Motion: That the information be received.  
      CARRIED

   4. alPHa Winter Symposium, February 25, 2022

      The alPHa Winter Symposium is taking place virtually on Friday, February 25 and Board members are encouraged to attend if they wish to do so.  The deadline to register is tomorrow, February 18, 2022.

      Motion: That the information be received.  
      CARRIED

10. Correspondence
    1. Greater Essex Catholic District School Board – Letter to Hon. Minister Stephen Lecce – Resumption of a supported plan for tracking and public reporting of COVID-19 in schools
    2. Halliburton, Kawartha, Pine Ridge Public Health – Letter to Hon. Christine Elliott – Support for Local Public Health
    3. Peterborough Public Health – Letter to Hon. Christine Elliott – Support for Local Public Health
    4. Peterborough Public Health – Letter to Hon. Christine Elliott – Support for the Windsor-Essex County Health Unit’s Resolution to the Province of Ontario to amend the Immunization of School Pupil’s Act (ISPA) to include COVID-19 as a designated disease 
    5. Conseil Scolaire Catholique Providence – Letter to the Hon. Stephen Lecce – Support for the Windsor-Essex County Health Unit's Resolution to the Province of Ontario to amend the Immunization of School Pupil's Act (ISPA) to include COVID-19 as a designated disease
    6. City of Windsor – City Council Decision CR22/2022 – January 17, 2022 – that the City of Windsor Council Support the WECHU in establishing a Consumption and Treatment Services Site in the City of Windsor post-approval from the provincial and federal governments
    7. Ministry of Health – Letter from Hon. Christine Elliott – to Windsor-Essex County Health Unit advising of one-time funding up to $369,900 for the 2021-22 funding year and one-time funding up to $945,600 for 2022-23 funding year to support the provision of public health programs and         services in our community, an extension to one-time mitigation funding to ensure municipalities do not experience any increase as a result of cost-sharing change for 2022, and funding to support the Ontario Seniors Dental Care Program for eligible low-income seniors
    8. Ministry of Health – Letter from Chief Medical Officer of Health, Dr. Kieran Moore – to Windsor- Essex County Health Unit as a follow up to the Letter from the Hon. Christine Elliott noting that WECHU’s maximum total funding under the Accountability Agreement with the Ministry of Health         for 2021-22 to be $29,363,300 ($17,684,500 in base funding and $11,678,800 in one-time funding)
    9. Peterborough Public Health – Letter to Hon. Christine Elliott – Enhancing Uptake of 3rd COVID-19 Vaccine Doses and Proof of Vaccine Record – For Support
    10. City of Windsor – Council Report C 27/2022 – Updates regarding the Operation of the IRC serving Temporary Foreign Workers, city-wide

11. Committee of the Whole (CLOSED SESSION, in accordance with Section 239 of the Municipal Act)
    The Board commenced with the Committee of the Whole session at the opening of the board meeting. 

12. Next Meeting: At the Call of the Chair, or March 24, 2022 – Via Video

13. Adjournment
    Motion: That the meeting be adjourned.
                    CARRIED
    The meeting adjourned at 5:10 pm.

RECORDING SECRETARY: L. Damphouse