January 2022 Board of Health Meeting

1. Call to Order
2. Board Elections
3. Agenda Approval
4. Announcement of Conflict of Interest
5. Update (Dr. S. Nesathurai)
   1. COVID-19 Update (Dr. S. Nesathurai)
   2. WECHU Operations Update (N. Dupuis)
6. Approval of Minutes
   1. Regular Board Meeting: December 16, 2021
7. Business Arising
   1. Consumption and Treatment Services Update (E. Nadalin)
8. Consent Agenda
   1. INFORMATION REPORTS
      1. Smoking Cessation Programing and Vaping Supports (E. Nadalin)
      2. Influenza Vaccine Update (K. McBeth)
      3. COVID-19 Surveillance and Epidemiology (N. Dupuis) 
      4. December Communications Recap (E. Nadalin)
   2. RESOLUTIONS/RECOMMENDATION REPORTS – None
9. New Business
   1. Fluoride Update – ENWIN Report (N. Dupuis)
   2. CEO Quarterly Compliance Report (N. Dupuis)

   3. Project Governance Committee – December 10, 2021 Meeting    Minutes (J. Lund/N. Dupuis)

10. Correspondence
    1. Town of Kingsville – Letter to Windsor-Essex County Health Unit CEO, Nicole Dupuis, and Acting MOH, Dr. Shanker Nesathurai  – Resolution for WECHU to withdraw its Letter of Instruction for capacity limits for restaurants and bars; that WECHU fully enforce current requirements of their section under the ROA to ensure those who are not in compliance with regulations are addressed; and that WECHU increase opportunities for youth vaccination in the county
    2. Grey Bruce Public Health – Letter of Support for the Windsor-Essex County Health Unit – for the province to provide one-time funding to support recovery and catch up efforts over a multi-year period (2022-2024) for communities negatively impacted by the COVID-19 pandemic
    3. City of Windsor – Resolution in Support of the Windsor-Essex County Health Unit – In support of the Windsor-Essex County Health Unit's Resolution dated November 23, 2021 recommending that the Province of Ontario amend the Immunization of Student Pupils Act (ISPA) where students are required to be immunized against designated diseases, and to include COVID-19 as a designated disease

    4. City of Windsor – Resolution in Support of correspondence from Windsor-Essex EMS, Erie Shores Health Care and Chatham-Kent MP Dave Epp – that City of Windsor Administration write to the Federal Government regarding Temporary Foreign Agriculture Workers requesting changes be made as soon as possible around mandatory immunization immediately upon entry into Canada, as well as extending funding for the Isolation and Recovery Centre (IRC) for migrant workers beyond March 31, 2022 

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 February 17, 2022 – Via Video

13. Adjournment

1. Call to Order
   Board Chair, Gary McNamara, called the Regular meeting to order at 4:01 pm. G. McNamara acknowledged Amherstburg Mayor, Aldo DiCarlo, who was just recently appointed to our Board as a county representative, and welcomed him to the WECHU Board of Health.

2. Board Elections

   Nominations for Chair
   G. McNamara relinquished the Chair to N. Dupuis, Board Secretary, to begin the election process. N. Dupuis opened the floor for nominations for the position of Chair noting that Administration had received two (2) written nominations for Gary McNamara. N. Dupuis asked for further nominations from the floor (three times). Given that there were no further nominations, nominations for the position of Chair were closed. G. McNamara, having accepted the nomination, was appointed Chair by acclamation.

   Nominations for Vice-Chair
   The Chair opened the floor for nominations for the position of Vice-Chair noting that Administration had received one (1) written nomination for Rino Bortolin. The Chair asked for further nominations from the floor (three times). Given that there were no further nominations, nominations for the position of Vice-Chair were closed. Rino Bortolin, having accepted the nomination, was elected Vice-Chair by acclamation.

   Nominations for Treasurer
   The Chair opened the floor for nominations for the position of Treasurer noting that Administration had received two (2) written nominations, one for Tracey Bailey and one for Fabio Costante. The Chair asked for nominations from the floor (three times). Given that there were no further nominations, nominations for the position of Treasurer were closed.

   The Chair asked if Tracey Bailey would stand as nominee, of which she declined.

   Fabio Costante, not being present at the meeting, was unable to state whether he would stand as nominee, and therefore the position of Treasurer is still outstanding.

   On behalf of the Board, G. McNamara thanked Tracey Bailey for her role as Treasurer and for her leadership on the Joint Board Extension Committee over the past 3 years.

   Motion: That the nominations for the positions of Chair and Vice-Chair stand, and that the position of Treasurer remains outstanding.
   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

      Dr. S. Nesathurai said that much of the province is experiencing what our region is experiencing with premature and untimely deaths from COVID-19, mostly among the unvaccinated. Our region has lost over 500 individuals to COVID-19. There are approximately 600 beds in our hospitals locally, and with 125 admitted due to COVID that is a ratio of 1 in 6 that have the disease and needed to be hospitalized. The more individuals hospitalized with COVID results in the risk that other essential services or treatments cannot be provided, and ultimately some surgeries have been cancelled. We currently have over 80 local outbreaks, and as more public health measures are relaxed, we will likely see an increase of positive cases of COVID-19.

      Dr. S. Nesathurai noted that there is more to public health services than COVID-19 and that the Windsor-Essex region should be congratulated for instituting a program to allow for fluoridation in its water systems. The American Dental Association states that fluoride is the single most effective public health measure to prevent tooth decay, and for 70 years the experience has overwhelming shown that fluoridation of community water is safe. The Canadian Dental Association states the same facts, and maintaining good oral health can lead to a better quality of life.

      He also commended Nicole Dupuis, the WECHU team and the Board of Health for obtaining the endorsement for a Consumption and Treatment Services Site in downtown Windsor. Approximately 2,500 people die in a 12 month period from opioid and substance abuse and about half parish in car accidents, showing the significant burden of the disease of addiction. Dr. Nesathurai noted that there are no stereotypes for addiction and people come from many walks of life. Residents need to consider that the site is one important measure to help alleviate substance abuse, along with providing access to mental health services. G. McNamara thanked those on Windsor City Council who supported the Consumption and Treatment Services Site, a foundational piece in dealing with the opioid crisis.

      G. McNamara thanked Dr. Nesathurai for his steadfast leadership, strength and wisdom and the issuance of his Letter of Instruction around the insufficient isolation capacity for Temporary Foreign Workers on January 11, 2022. The board extends their thanks on bringing this issue to the forefront to colleagues in Ottawa and to the province, and to N. Dupuis and her team in not only keeping our community safe, but our guest that come here as well.

      Motion: That the information be received.
                     CARRIED
       

   2. WECHU Operations Update (N. Dupuis)
      N. Dupuis said that since passing our 2022 budget in November, there were significant announcements around the Omicron surge, resulting in the WECHU’s need to shift our resources and priorities to deal with the increase in positive COVID cases and focus on vaccination.

      On December 15, 2021, the province shifted vaccination priority to focus on third doses for everyone who would have been eligible. Our directive changed and we pivoted resources into vaccination and made significant changes which impacted what we put forward as a budget as it relates vaccination efforts and Case and Contact Management.

      As a result of that announcement, we redeployed all of our nursing staff, with the exception of a few, to vaccination efforts, including those from Healthy Families, Case and Contact, School Health. Administrative staff has also been redeployed to vaccination and mass clinics, along with various managers, and staff are focused on outbreaks in Long-Term Care/Retirement Homes, group homes, congregate settings and the Agri-sector. We have bolstered our mobile vaccination teams and management support, and have established another mass vaccination site in Leamington at the Nature Fresh Recreation Centre.

      L. Gregg walked through various changes from the budget approved in November and the reality from the impact of vaccination activities as follows:

      - The 2022 Budget approved by the Board in November 2021 did not include deployment of staff, which came from direction by the Ministry of Health. Costs in the first quarter of 2022 will be $2,049,254 to account for salaries and benefits for more than 80 staff, rental fees and purchases.
      - We needed to revaluate the budget for mandatory programs and COVID-19 expenses, and which expenditures were not contemplated. Some of these costs incurred in excess of the 2022 approved budget are salaries, benefits, rentals, mileage and third-party costs which amounts to $527,466.
      - These changes require that we revisit our Annual Service Plan (ASP) which is due to the Ministry of Health on February 18, 2022, the day after our next Board meeting. We are looking to the Board for approval that any changes identified over the next week to 10 days be brought to JBEC for approval in advance of submitting the ASP.
      - We are expecting our request for one-time funding for COVID-19 extraordinary costs be 100% funded, and we are not anticipating that they will have an impact on contributions from the obligated municipalities.
      - A Recommendation Report was brought forward to request that JBEC be allowed to review any identified changes at it’s February 7, 2022 meeting, and that any amendments be brought to the Board at it’s February 17, 2022 Board of Health meeting prior to submission of the ASP to the Ministry on February 18, 2022.

      N. Dupuis stated that the WECHU did not expect to have to open up another mass vaccination site and this as well as the large shift in resources to vaccination created significant changes. We anticipated that the mass vaccination sites would conclude by the end of March 2022.  We are not expecting a significant shift after the first quarter of 2022, especially in relation to mass vaccination sites.

      Motion: That the Windsor-Essex County Board of Health direct the Joint Board Extension Committee (Board Executive), comprised of the Chair, Vice-Chair and Treasurer, to approve the amendments to the 2022 Budget, and that the amendments to the 2022 Budget be brought to the Board of Health for information at the February 17, 2022 Board meeting

      CARRIED

6. Approval of Minutes

   1. Regular Board Meeting: December 16, 2021

      Motion: That the minutes be approved.
      CARRIED

7. Business Arising

   1. Consumption and Treatment Services Update (N. Dupuis/E. Nadalin)
      E. Nadalin noted that Windsor City Council voted 6-5 in favour to endorse the Consumption and Treatment Services Site at 628 Goyeau Street in Windsor. Work on this strategy commenced in 2017 to offset the opioids and substance abuse crisis. R. Bortolin said that a mountain of work has been prepared through projects that were brought to city council. A significant amount of time and effort was put in to meet with residents, stakeholders and business owners. Residents in Ward 3 were educated and willing to get past the stigma and rhetoric, and perceptions had changed. Education and actual engagement is what let to these results. He thanked N. Dupuis, E. Nadalin and their teams for the years of hard work and commitment, and is looking forward to getting the applications completed and the process started.

      G. McNamara congratulated the team for putting together a great plan, and that this crisis is affecting everyone in the community. It will be proven that this was the right thing to do and shows compassion to help the most vulnerable in finding a way out of troubled times.

      Motion: That the information be received.
      CARRIED

8. Consent Agenda
   1. INFORMATION REPORTS
      1. Smoking Cessation Programming and Vaping Supports (E. Nadalin)
         The Report is attached and received for information by the Board.
      2. Influenza Vaccine Update (K. McBeth)
         The Report is attached and received for information by the Board.
      3. COVID-19 Surveillance and Epidemiology (N. Dupuis)
         The Report is attached and received for information by the Board.
      4. December Communications Recap
         The Report is attached and received for information by the Board.
          

          

         Motion: That the information be received.  

         CARRIED

   2. RESOLUTIONS/RECOMMENDATION REPORTS

      1. 2022 Budget Amendment – Noted in 5.2 above
9. New Business
   1. Fluoride Update – ENWIN Report (N. Dupuis)

      N. Dupuis stated that this item has been brought to the Board as an update, with the accompanying presentation from ENWIN. E. Sleiman said he is still receiving emails from residents who are opposed to fluoride and asked if the WECHU are also receiving the same messaging. N. Dupuis advised that there is an organized group of individuals opposed to fluoridation locally and across the province. We have received emails from this group. Specifically on this issue by the community, and we are working closely with municipalities and ENWIN to ensure that the right education is available to the public.

   2. CEO Quarterly Compliance Report (N. Dupuis)
      N. Dupuis advised that there were changes noted on the CEO Quarterly Compliance Report for the period October 1, 2021 to December 21, 2021. This specific change and impact was due to the implementation of the WECHU Immunization policy and changes in expenses related to vaccination.

      Motion: That the information be received.

      CARRIED

   3. Project Governance Committee – December 10, 2021 Meeting Minutes (J. Lund/N. Dupuis)
      J. Lund advised that the Project Governance Committee held a follow up meeting last Friday, January 14, 2022. The process is moving forward on all items noted in the minutes from December 10, 2021. Timelines are tight, but we are confident once the Project Manager is on board, that we will meet our timelines and goals.

      Motion: That the minutes be accepted and adopted.

      CARRIED

10. Correspondence
    1. Town of Kingsville – Letter to Windsor-Essex County Health Unit CEO, Nicole Dupuis, and Acting MOH, Dr. Shanker Nesathurai – Resolution for WECHU to withdraw its Letter of Instruction for capacity limits for restaurants and bars; that WECHU fully enforce current requirements of their section under the ROA to ensure those who are not in compliance with regulations are addressed; and that WECHU increase opportunities for youth vaccination in the county
    2. Grey Bruce Public Health – Letter of Support for the Windsor-Essex County Health Unit – for the province to provide one-time funding to support recovery and catch up efforts over a multi-year period (2022-2024) for communities negatively impacted by the COVID-19 pandemic
    3. City of Windsor – Resolution in Support of the Windsor-Essex County Health Unit – In support of the Windsor-Essex County Health Unit's Resolution dated November 23, 2021 recommending that the Province of Ontario amend the Immunization of Student Pupils Act (ISPA) where students are required to be immunized against designated diseases, and to include COVID-19 as a designated disease
    4. City of Windsor – Resolution in Support of correspondence from Windsor-Essex EMS, Erie Shores Health Care and Chatham-Kent MP Dave Epp – that City of Windsor Administration write to the Federal Government regarding Temporary Foreign Agriculture Workers requesting changes be made as soon as possible around mandatory immunization immediately upon entry into Canada, as well as extending funding for the Isolation and Recovery Centre (IRC) for migrant workers beyond March 31, 2022

    J. Bachetti noted item 9.3 regarding the Resolution recommending that the Province of Ontario include COVID-19 as a designated disease under the ISPA. He asked if both the city and the county endorsed this resolution, and if other regions are doing the same. He commended the health unit’s leadership for putting this forward.

    Dr. S. Nesathurai said he was not aware of any other Boards of Health putting forward a Resolution of this nature, but there are many other Medical Officers of Health who believe that COVID-19 should be included as a designated disease under the ISPA. The statute itself does not require vaccination, but to report vaccination, and believes that we should revisit this again. N. Dupuis advised that all of our resolutions are sent to the Association for Local Public Health Agencies (alPHa) for dissemination to all other Boards of Health across the province, and this particular resolution was also sent to local boards of education and both city and county councils.

    R. Maich said should there be a declaration of this disease becoming an endemic, we should revisit this resolution in the future. G. McNamara that this will have an impact on the younger generation going forward and the conversation should continue.

    Motion: That the information be received.

    CARRIED

11. Committee of the Whole (CLOSED SESSION, in accordance with Section 239 of the Municipal Act)
    The Board moved into Committee of the Whole at 5:06 pm
    The Board moved out of Committee of the Whole at 5:13 pm
12. Next Meeting: At the Call of the Chair, or February 17, 2022 – Via Video
13. Adjournment
    Motion: That the meeting be adjourned.
    CARRIED
    The meeting adjourned at 5:15 pm.

RECORDING SECRETARY: L. Damphouse