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May 16, 2019

  1. Call to Order
  2. Agenda Approval
  3. Announcement of Conflict of Interest
  4. Presentation: Topical Issues: Measles/Vaccines (Dr. W. Ahmed)
  5. Approval of Minutes
    1. Regular Board Meeting: April 18, 2019
  6. Consent Agenda
    1. INFORMATION REPORTS
      1. Q1 Financial Report
      2. Oral Health
      3. Vector Borne
      4. Measles Report
      5. Q1 Planning Update
      6. Q1 Strategic Plan
      7. Media Recap (Hand-out)
    2. RECOMMENDATION REPORT
      1. Smoke-Free Multi-Unit Dwelling
  7. Business Arising
  8. Board Correspondence – Circulated
  9. New Business
  10. Other Board of Health Resolutions/Letters – For Support
    1. Windsor-Essex County Health Unit – For Information
      2019 Ontario Budget – Letter to Christine Elliott
    2. MOHLTC – Public Health Modernization – For Information
      Letter from Chief MOH, Dr. David Williams
    3. Simcoe Muskoka District Health Unit – For Support
      Alcohol consumption – Letter to Christine Elliott
  11. Appendices
    1. Appendix A – 2019 Q1 Strategic Plan Progress Report
  12. Committee of the Whole (Closed Session in accordance with Section 239 of the Municipal Act)
  13. Next Meeting: At the Call of the Chair or June 20, 2019 - Essex
  14. Adjournment

View Document page

Prepared By:

Kim Casier, Oral Health Manager, Oral Health Department

Date:

May 16, 2019

Subject:

Oral Health Screening, Assessment and Surveillance, Healthy Smiles Ontario (HSO) Program 2018

Background:

Dental decay (cavities) in children is an important public health issue. The current Oral Health Protocol (2018) provides direction on the delivery of oral health services, which includes oral screening, assessment and surveillance, and services offered through the Healthy Smiles Ontario Program (HSO) Program.

As per the protocol, all children in JK, SK and Grade 2 are screened by registered public health dental hygienists during the school year. The screening protocol requires the collection of the total number of primary and permanent teeth with decay (d+D).

Dental benefits for children and youth fall under provincial/territorial jurisdiction. Children in low-income families (whether on social assistance or not) are typically granted some level of support for accessing dental services. On January 1, 2016, Ontario’s six publicly funded dental programs for children were combined into the new Healthy Smiles Ontario (HSO) program. HSO is a government-funded dental program that provides free preventive, routine, and emergency dental services for children and youth 17 years old and under from low-income households. The services covered by this program may include exams and routine checkups, preventive services, extractions, fillings, and x-rays. This program does not cover cosmetic dentistry and braces.

Current Initiatives

Oral Screening, Assessment and Surveillance

During the 2017/2018 school year, 15,117 elementary children received a dental screening across 115 Windsor-Essex elementary schools (publically and privately funded). Screening is conducted by five teams, each team consisting of a registered dental hygienist and a certified dental assistant. Based on the screening results of the Grade 2 students at each school, the school is categorized into three levels of intensity: Low, Medium or High. Higher intensity levels require additional grades to be screened. The need for and the urgency of care is recorded and parents are advised of the required follow-up. As well indicators of previous dental caries (missing and filled) are recorded.  Of the 115 schools that participated, 27 (23.48%) were classified as high intensity schools, 17 (14.78%) were classified as medium intensity schools and 71 (61.74%) were classified as low intensity schools.

Approximately 91% of eligible students were screened in the 2017/18 school year. Reasons a student is not screened include: absence, exclusion by parent, or refusal to be seen on their own.

 

Total

Screened

Absent

Refused

Excluded

Abs+Ref+Exl

 

#

%

#

%

#

%

#

%

Grand Total

16601

15117

1030

6.20%

102

0.16%

352

2.12%

1484

8.93%

Other significant 2017/18 dental screening statistics include:

  • 1,984 (13.1%) children/youth had an urgent dental care issue/need; eligible for Healthy Smiles Ontario Program’s Emergency and Essential Services Stream (HSO-EESS).
  • 6,157 children/youth were clinically eligible for Healthy Smiles Ontario Program’s Preventive Services Only Stream (HSO-PSO).
  • 74% of JK students surveyed were found to be visually caries free.
  • 62% of SK students surveyed were found to be visually caries free.
  • 45% of Grade 2 students surveyed were found to be visually caries free.

WECHU Healthy Smiles Ontario Dental Clinics

Windsor Essex County Health Unit dental clinics are very busy. Our team of dental hygienists and dental assistants provide dental screenings, topical fluoride treatments, dental sealants, scaling (cleaning) and oral hygiene instruction. In 2018:

  • 2,308 children/youth received a dental screening at one of our HSO dental clinics (Windsor and Leamington). 
  • 1,212 children/youth had an urgent dental care issue/need; or were eligible for HSO-EESS.
  • 798 children/youth were enrolled in the HSO-PSO (preventive services only) program.
  • 1,730 children/youth received PSO (preventive services only) clinical services in our WECHU dental clinics.
  • 734 children/youth received 1634 dental procedures completed by our clinic dentists

There are currently four dentists contracted to work in our HSO dental clinics. Dr. Azza Al-Ryahi works Mondays in our Leamington clinic and Tuesdays in our Windsor clinic. Dr. Robert Trajkovski works in the Windsor clinic on Friday and Dr. Thomas Oper, pediatric dentist, recently joined our clinics in October 2018. Dr. Oper works with us on Wednesday and Thursday mornings.  We currently have an Arabic speaking dental hygienist and dentist working in our HSO clinics.

Baby Oral Health Program (BOHP)

The Canadian Dental Association recommends a dental assessment for infants within six months of their first tooth appearing and no later than one year of age. Our Windsor-Essex County Health Unit also supports the establishment of a dental home by one year of age. The rationale of this program focuses on early professional intervention to provide a dental screening, risk assessment and anticipatory guidance for parents, so that early childhood cavities can be prevented.  In 2018, 265 children received a BOHP screening at one our HSO dental clinics.

Consultation:

The following individuals were contributed to this report:
Mathew Roy, Epidemiologist

Approved by:

Theresa Marentette


View Document page

Prepared By:

Stacy Manzerolle, Manager Healthy Schools 
Lora Piccinin, Manager Infectious Disease Prevention

Date:

May 2019

Subject:

Measles Update

Background:

Measles is a serious and highly contagious virus that spreads easily when an infected person coughs or sneezes, spreading droplets that contain the virus into the air. The virus can live on surfaces (e.g., door knobs, shopping carts, utensils, etc.) and can remain active in the air for up to 2 hours even after the person has left the air space. If people breathe in contaminated air or touch infected surfaces, they can become infected. Symptoms can include a rash, fever and cough. Measles can spread to others 4 days before or after the appearance of the rash. In some instances, measles can cause long-term complications in the lungs, ears and/or the brain and can lead to death in vulnerable individuals.

In Canada, measles is relatively rare due to high immunization rates across the country. Children in Ontario are scheduled to receive two doses of measles containing vaccine before the age of seven. Endemic measles has been eliminated in Canada; however, travel related cases continue to occur. Immunization is the best way to protect against becoming infected with measles. Those who have received two doses of measles-containing vaccine as a child, or who have been previously infected with measles, are generally protected from the virus. The measles vaccine is free for anyone who lives, works, or attends school in Ontario.

Current Initiatives

There have been no confirmed cases of measles since 1998 in Windsor and Essex County. In 2017, 8 cases of measles were reported in Ontario. In recent months some areas of Canada and the U.S. have reported an increase in the number of confirmed measles cases.

  • As of March 30th, 2019, 33 cases of measles have been reported in Canada (Quebec, British Columbia, Northwest Territories, Ontario and Alberta)
  • In Ontario, cases have been reported in Toronto, Ottawa and Kingston
  • In the US, outbreaks have been declared in the state of Michigan, New York and Washington

Due to the growing number of measles cases within North America and growing awareness and concern, the WECHU has investigated a number of suspect measles reports within the community. Historically 1-2 cases are investigated per year; however, since January 2019, the Health Unit has investigated seven possible cases of measles, all determined to be negative.

To assist health care providers and community partners, the WECHU has developed and disseminated clinical information updates and supporting documents to guide diagnostic testing, reporting, and management of suspected measles cases. Further information is available on our website.

The WECHU continues to work closely with local health care providers to monitor the situation and address the potential spread of measles and other reportable infectious diseases. The Health Unit will continue to keep the community informed about measles related activity within the region to ensure the ongoing protection of the health and wellbeing of our residents.

Approved by:

Theresa Marentette


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Prepared By:

Communications Department

Date:

May 8, 2019

Subject:

April Media Relations Recap Report

April Media Coverage

Total Media Coverage

71

Interview Requests

25

Mentions (In the news without direct interviews)

40
Requests for Information 6

April 2019 Media Relations Recap - Media Coverage

April 2019 Media Relations Recap - Story Source

Media Coverage

Outlet

Number of Stories

AM 800

17

Blackburn

8

CBC

12

CBC Radio-Canada

2

CTV

10

London Free Press

1

St. Clair College (Student)

1

Toronto Star

1

TV Cogeco

1

Vice Magazine

1

Windsor Star

13

windsorite.ca

3

Yahoo News

1

TOTAL

71

News Release and Media Advisories

Date Type Headline Response

April 3, 2019

Media Statement

Result of the Tentative Agreement Vote

12 Stories Reported

April 10, 2019

Media Advisory

WECOSS 2018 Annual Report and Website Launch

6 Stories Reported (combined with the news release for this event)

April 10, 2019

Media Statement

Public Health Nurses Reject Final Offer

7 Stories Reported

April 12, 2019

News Release

WECOSS 2018 Annual Report and Website Launch

6 Stories Reported (combined with the media advisory for this event)

April 16, 2019

News Release

Health Unit Launches Cannabis Safety Campaign for Young Adults

7 Stories Reported

April 17, 2019

Media Advisory

Windsor-Essex County Health Unit Board of Health Meeting at Ciociaro Club

6 Stories Reported

Stories Reported by the Media

AM 800

Note: Digital stories were not available for two of AM 800’s requests.

Publish Date

Title

April 2, 2019

Update: Nurses Vote Down Tentative Deal

April 4, 2019

Health Unit Disappointed Striking Nurses Rejected Offer

April 9, 2019

Tecumseh Joins Windsor In Fluoridation

April 10, 2019

Free Dental Care For Low Income Seniors Expected In Budget

April 11, 2019

Nurses Reject Latest Health Unit Contract Offer

April 12, 2019

Video: Nurses Union Presents Petition To County Warden

April 13, 2019

Health Unit Chair Stands Firm On Latest Offer To Striking Nurses

April 13, 2019

New Website Launched For Opioid And Substance Strategy

April 28, 2019

Sunday Moring Live - 9:30 AM - Risks Of Using Marijuana

April 18, 2019

Lynn Martin Show

April 18, 2019

Cannabis Campaign Launched By Local Health Unit

April 18, 2019

Striking Health Unit Nurses Attend County Council

April 18, 2019

Health Unit Chair Says $1.5-Million In Funding Axed By Province

April 22, 2019

Local Health Unit To Take Lead On Applying For A Safe Injection Site

April 23, 2019

Striking Public Health Nurses Receive Noise Warning

Blackburn News

Publish Date

Title

April 2, 2019

Tentative Deal Reached In Public Health Nurses Strike

April 2, 2019

Public Nurses In Windsor-Essex Reject New Deal

April 11, 2019

It's A 'No' From Public Health Nurses In Windsor

April 12, 2019

We Want To Save Every Life.

April 12, 2019

Update: Nurse Union Petitions County Warden To End Strike

April 19, 2019

4-20 Prompts Cannabis Education Campaign From Health Unit

April 25, 2019

Health Unit May Not Be Operator Of Possible Safe Injection Site

April 24, 2019

Low-Income Seniors To Get Better Dental Care Access

CBC News

(also includes CBC Radio and Radio-Canada)

Note: Digital stories were not available for one of CBC’s requests.

Publish Date

Title

April 2, 2019

Windsor-Essex Public Health Nurses Vote Against Tentative Agreement

April 3, 2019

Windsor 'Months Away' From Potentially Applying For Supervised Injection Site

April 9, 2019

Fluoride Coming Back Into Windsor's Water, After Tecumseh's Yes Vote

April 10, 2019

Windsor-Essex Public Health Nurses Reject Final Offer

April 12, 2019

First Annual Opioid Strategy Report Released

April 12, 2019

First Annual Opioid Strategy Report Released

April 12, 2019

Support At Rainy Rally 'Overwhelming' For Nurses Association

April 15, 2019

Les Infirmières En Santé Publique De Windsor-Essex Rejettent L'Offre Finale De Leur Employeur

April 16, 2019

Class Project Turns Into Opioid Panel Discussion

April 18, 2019

A Huge Hit': Wechu Loses $1.5m In Provincial Funding To 2019 Budget

April 21, 2019

Windsor Health Unit Wants To 'Take The Lead' On Bringing Supervised Injection Site To City

April 24, 2019

Santé Publique : Toronto Demande À La Province D'annuler Les Compressions De 1 Milliard

April 25, 2019

Ontario Medical Association Urges Vaccination In Light Of Spiking Measles Cases

CTV News

Publish Date

Title

April 2, 2019

Strike Continues As Public Health Nurses Vote Against Tentative Deal

April 3, 2019

Surprised And Disappointed: Health Unit Reacts To Nurses Rejecting Deal

April 9, 2019

Fluoride Returning To Windsor's Water Supply

April 10, 2019

Adding Fluoride To Windsor Water Supply May Take 18 Months

April 10, 2019

Health Unit 'Disappointed' As Nurses Reject Final Offer.

April 12, 2019

First Annual Report Release On By Windsor-Essex Opioid Committee

April 12, 2019

Striking Public Health Nurses Rallying For New Employer Mandate

April 12, 2019

What's In The Ontario Budget For Windsor-Essex, Chatham-Kent

April 17, 2019

Windsor-Essex Health Unit Amping Up Cannabis Education Campaign

April 22, 2019

Health Unit Chair Concerned About $1.5m Loss In Funding

London Free Press

Publish Date Title

April 4, 2019

Opioid Overdose Spike 'Worst It's Ever Been,' Health Official Warns

Toronto Star

Publish Date Title

April 11, 2019

Windsor Public-Health Nurses Return To Picket Line After Rejecting 'Final' Offer

Vice Magazine

Publish Date Title

April 11, 2019

Relapse: Opioid Crisis in Canada

Windsor Star

Publish Date Title

April 1, 2019

Nurses, Health Unit Resume Talks As Strike Continues

April 2, 2019

Striking Nurses Reject Tentative Agreement With Windsor-Essex County Health Unit

April 4, 2019

Photos: Nurses' Challenge Aims To Help Needy

April 10, 2019

Fluoride To Return To Windsor-Area Tap Water After Tecumseh Vote

April 10, 2019

Photos: Annual Health Access Day Draws Hundreds

April 11, 2019

Nurses Reject Offer From Windsor-Essex Health Unit, Return To Picket Lines

April 12, 2019

New Website Unveiled With First Annual Report Of Opioid And Substance Strategy

April 12, 2019

Nurses Blame Windsor-Essex Health Unit As Strike Continues

April 15, 2019

Overdose Crisis Rally Slated For Windsor, 20 Other Cities Nationwide

April 17, 2019

Windsor-Essex County Health Unit Administrators Hope Any Changes Retain Local Focus

April 16, 2019

Health Unit Launches Cannabis Awareness Campaign

April 29, 2019

Reader Letter: A Wage Increase For Public Health Nurses Is Fair

April 20, 2019

Jarvis: Where Is The Sense Of Urgency In Ending Strike By Public Health Nurses?

Windsorite.ca

Publish Date Title

April 3, 2019

Health Unit Releases Statement After Contract Voted Down

April 10, 2019

Health Unit's Final Offer To Nurses Rejected

April 16, 2019

Health Unit Launches Cannabis Safety Campaign For Young Adults

Yahoo News

Publish Date Title

April 12, 2019

Support At Rainy Rally 'Overwhelming' For Nurses Association

Note: The digital story was not available for St. Clair College. The interview with TV Cogeco does not take place until May.

The following individuals contributed to this report: Jennifer Jershy, Marc Tortola, and Michael Janisse


View Document page

Prepared By:

Darcie Renaud, Performance Improvement & Accountability Coordinator (PIAC), Planning & Strategic Initiatives Department

Date:

May 2019

Subject:

Q1 Planning Update 

Background

In 2018, the Ministry of Health and Long Term Care (MOHLTC) introduced a new Annual Service Plan (ASP) that Health Units are required to submit each year. In order to ensure a single, integrated approach to planning, the Planning and Strategic Initiatives (PSI) department worked with the Information Technology (IT) department to align our planning system with the MOHLTC requirements. With the support of PSI, staff members develop and enter their work plans which are then reviewed and approved by the leadership team and integrated in the WECHU’s Annual Service Plan for the Ministry.

Following the planning cycle each year, PSI undertakes an assessment of the process in order to understand the challenges and successes, and to look for ways to further improve for the next cycle. The PSI team then compiles and summarizes the feedback, and incorporates suggested changes and improvements into the next planning cycle.

Current Initiatives

Annual Service Plan (ASP) Submission

WECHU’s 2019 Annual Service Plan was submitted to the MOHLTC on April 1, 2019. The plan provides details about planned expenditures and program plans for 2019 including more than 198 interventions under 54 different programs to be delivered.

Reporting Structure

The MOHLTC provided reporting structures for Q4 of the 2018 ASP in early February.  The Financial reports were submitted on February 20 and program activity reports will be submitted on April 26.

Planning for 2020

The PSI and IT departments have begun to incorporate changes from the 2019 ASP template and reporting requirements, as well as the feedback received from managers and staff, into the planning approach for 2020.  It is anticipated that the next planning cycle will be launched in early summer.

Consultation

The following individuals contributed to this report:

  • Kristy McBeth, Director, Knowledge Management
  • Marc Frey, Manager, Planning & Strategic Initiatives

Approved by:

 Theresa Marentette

 


View Document page

Prepared By:

Darcie Renaud, Performance Improvement & Accountability Coordinator (PIAC), Planning & Strategic Initiatives Department

Date:

May 2019

Subject:

Q1 Strategic Plan Report

Background

The 2017-2021 WECHU Strategic Plan sets out our plan to enhance our delivery of quality public health programs and services to all residents in Windsor and Essex County. The current strategic plan details our organization’s vision, mission, values, and our four strategic priorities.

Each quarter the Board of Health (BoH) will receive a report on the status of progress made towards the Strategic Priorities in that quarter.

Current Initiatives

The 2019 Q1 Strategic Plan Progress Report provides the objectives under each strategic priority with corresponding Q1 updates to measure our advancement towards achieving the goal. Progress has continued on most of the strategic objectives, and the WECHU remains on-track to achieve all objectives by 2021.

In Q1, the PSI and Communication departments also began work to re-launch communication efforts internally about the strategic plan, to ensure those in the organization continue to understand and integrate the strategic plan into their work.

Consultation

The following individuals contributed to this report:

  • Kristy McBeth, Director, Health Protection
  • Marc Frey, Manager, Planning & Strategic Initiatives
  • Michael Janisse, Manager, Communications
  • Ramsay D’Souza, Manager, Evaluation & Epidemiology
  • Jessica Kipping-Labute, Policy Advisor, Planning & Strategic Initiatives

Approved by:

 Theresa Marentette

 


View Document page

Prepared By:

Lorie Gregg, Director of Corporate Services

Date:

May 1, 2019

Subject:

Q1 Financial Results

Background

The Leadership Team of the Windsor-Essex County Health Unit (“the WECHU”) monitors financial results on an on-going basis for the following programs:

  • Mandatory programs funded to a maximum of 70% (prior to April 1, 2019, 75%) (“Cost-Shared”) by the Ministry of Health and Long-Term Care (“MOHLTC”) and 30% (prior to April 1, 2019, 25%) by  the Corporation of the City of Windsor, the Corporation of the County of Essex and the Corporation of the Township of Pelee (hereinafter referred to as the “Obligated Municipalities”);
  • Related programs such as Vector-Borne Diseases and Small Drinking Water Systems, funded on a cost-shared basis to a maximum of 70% (prior to April 1, 2019, 75%) by the MOHLTC and 30% (prior to April 1, 2019, 25%) certain surrounding municipalities within the geographic boundaries of Windsor and Essex County;
  • Related programs funded 75% (prior to April 1, 2019, 100%) by the MOHLTC and 30% (prior to April 1, 2019, nil%) by the Obligated Municipalities;
  • Related programs funded 100% by the Ministry of Children, Community and Social Services (“MCSS”).  As at the date of this report, there have been no changes to the funding model.
  • One-time business cases.  As at the date of this report, the MOHLTC has not communicated what changes, if any, will occur with the funding of these initiatives.

The first quarter financial report to the Board includes a budget to actual comparison and narrative for material variances for all programs listed above.

Cost-Shared Program Financial Results

The following is the financial information for the Cost-shared programs including Vector-Borne Diseases and Small Drinking Water Systems for the first quarter of 2019.

  2019 Budget YTD Budget YTD Actual 2019 YTD Actual 2018 Variance to Budget % Spent
Salaries 13,255,133 3,313,783 2,753,572 2,919,340 560,211 21%
Employee benefits 3,575,890 893,973 876,964 794,344 17,009 25%
Travel and meetings 48,752 12,188 859 1,338 11,329 2%
Mileage 216,425 54,106 23,160 16,215 30,946 11%
Professional development 109,100 27,275 10,510 19,617 16,765 10%
Association and membership fees 45,000 11,250 12,709 16,130 (1,459) 28%
Office supplies 40,000 10,000 6,520 4,061 3,480 16%
Program supplies 714,626 178,657 179,363 179,833 (706) 25%
Office equipment rental 142,000 35,500 24,861 30,160 10,639 18%
Advertising and promotion 8,500 2,125 709 897 1,416 8%
Purchased services 105,310 26,328 21,722 12,249 4,606 21%
Board expenses 22,450 5,613 1,866 2,369 3,747 8%
Professional fees 143,300 35,825 45,419 16,529 (9,594) 32%
Bank charges 20,000 5,000 5,471 3,712 (471) 27%
Rent 770,000 192,500 183,059 158,622 9,441 24%
Building maintenance 161,300 40,325 42,020 30,649 (1,695) 26%
Utilities 155,000 38,750 21,614 31,800 17,136 14%
Taxes 221,000 55,250 94,775 67,941 (39,525) 43%
Insurance 83,500 20,875 79,749 79,351 (58,874) 96%
Telephone 121,200 30,300 27,728 27,205 2,572 23%
Security 17,500 4,375 1,564 4,186 2,811 9%
Vehicle expenses 2,100 525 113 199 412 5%
Postage and freight 33,500 8,375 5,660 4,129 2,715 17%
Parking 91,000 22,750 22,734 20,921 16 25%
  20,102,586 5,025,647 4,442,721 4,441,797 582,926 22%
Offset revenues (200,000) (50,000) (34,879) (35,817) (15,121) 17%
  19,902,586 4,975,647 4,407,842 4,405,980 567,805 22%
West Nile Virus 350,000 87,500 - 1,049 87,500 0%
  20,252,586 5,063,147 4,407,842 4,407,029 655,305 22%

For the period January 1, 2019 to March 31, 2019, cash flows relating to the 2019 program year are as follows:

MOHLTC
$3,489,132
Corporation of the City of Windsor
$746,184
Corporation of the County of Essex
$654,486
$4,889,802

Material variances by financial caption compared to budget include the following:

  • Association and Membership Fees:  Expenditures in this financial caption relate to memberships in an association or other group by virtue of professional requirements or to support initiatives associated with Public Health.  The majority of Association and Membership Fees are paid in the first half of the fiscal year.  The WECHU anticipates that this financial statement caption will remain within its overall budget for fiscal 2019.
  • Program Supplies:   Expenditures in this financial caption support the functions of departments, those that directly support Public Health Programs as well as those that support departments such as Information Technology and Communications.  The variance in the Program Supplies caption relates to the timing of purchases and is nominal.  The WECHU anticipates that this financial caption will remain within its overall budget for fiscal 2019.
  • Professional fees:  Expenditures in this financial caption include legal, audit and consulting fees paid to third parties.  The budget variance in Professional fees relates to an increase in legal costs to support the current collective bargaining with the employees represented by the Ontario Nurses Association (“ONA”).
  • Bank charges:  Expenditures in this financial caption include processing fees associated with payroll.  The variance in this financial caption is due to additional costs incurred for processing of year-end payroll reporting (i.e. T4 slips).
  • Building Maintenance:  Expenditures in this financial caption include costs to maintain Windsor, Essex and Leamington locations.  More specifically, these costs relate to building and equipment maintenance, grounds keeping and housekeeping supplies.  The variance here relates primarily to grounds keeping costs.  These costs are incurred in five (5) of twelve (12) months of the fiscal year (January to March, November and December). Greater than one-half of the year’s grounds budget was expended in Q1 of 2019 ($7,440 of the total $12,300).
  • Taxes:  Expenditures in this financial caption include property taxes for the Windsor and Leamington offices.  Windsor property taxes are paid on an installment basis, six (6) times per year while Leamington taxes are paid monthly.  The year-to-date variance/overspend results from three (3) of the six installments for the Windsor office having been paid in Q1 and three (3) of the twelve installments having been paid for the Leamington office.
  • Insurance:  Expenditures in this financial caption include costs associated with general liability insurance, property insurance, director and office insurance coverage as well as cyber coverage.   Insurance premiums are paid at the beginning of the year.  The WECHU that the budget for this financial statement caption will remain slightly underspent for fiscal 2019.
  • Security:  Expenditures in this financial caption include security costs contracted on an as needed basis for after-hours events at our Windsor office location.  The WECHU incurred additional security costs for the period March 8, 2019 to March 31, 2019, due to the labour disruption.  These additional security costs will be reflected in the Q2 financial results.
  • Offset revenue:  Revenues included in the financial caption relate to interest, proceeds on sale of tangible capital assets, parking revenue, vaccine recoveries, sales of contraceptives as well as course fees relating to the food handler course and examination.  At March 31, 2019, offset revenue is under budget by $15,121, in part due to the timing (i.e. vaccine recoveries are higher in the latter part of the year) as well as a loss in parking revenue of $4,000 due to the labour disruption.

Healthy Babies Healthy Children Program Financial Results

  2019 Budget YTD Budget YTD Actual 2019 YTD Actual 2018 Variance to Budget % Spent
Salaries and benefits 2,629,189 657,297 517,802 553,991 139,495 20%
Mileage 60,000 15,000 9,322 8,083 5,678 16%
Travel and Meetings 3,000 750 -      
Professional Development 10,400 2,600 653 6,695 1,947 6%
Program Supplies 38,252 9,563 7,238 5,118 2,325 19%
Purchased Services 15,000 3,750 1,180 2,138 2,570 8%
Professional Fees - - - 1,450 - 0%
  2,755,841 688,960 536,195 577,475 152,015 19%
Funding - MCSS (2,755,841) (688,960) (688,956) (688,956) (4) 25%
  - - (152,761) (111,481) 152,011  

The Healthy Babies/Healthy Children Program is funded through the Ministry of Children, Community and Social Services.  This program supports 27.0 FTEs comprised of managers (2), nurses (17), family home visitors (4), social worker (1), and support staff (3).  The objective of the program is to ensure a healthy future for children and their families. 

For the first quarter of 2019, the HBHC program is $152,761 underspent.  Factors contributing to the total amount underspent at March 31, 2019 include:  1.  Labour disruption involving employees represented by the ONA which commenced March 8th, 2019;  2.  Lower than anticipated purchased services costs (i.e. translation) because of our use of an Arabic speaking nurse to address the needs of our community.

Nurse Practitioner Programs

  2019 Budget YTD Budget YTD Actual 2019 YTD Actual 2018 Variance to Budget % Spent
Salaries and benefits 146,617 36,654 27,267 35,001 9,387 19%
  146,617 36,654 27,267 35,001 9,387 19%
Funding - MCSS (139,000) (34,750) (34,746) (34,746) (4) 25%
  7,617 1,904 (7,479) 255 9,383  

The Nurse Practitioner Program is funded through the Ministry of Children, Community and Social Services.  This program supports 1 FTE (nurse practitioner).  The objectives of the program are to promote healthy pregnancy, birth and infancy for children, improve parenting and family supports, strengthen early childhood development, learning and care.

The budget variance of $9,387 due to the labour disruption involving employees represented by the ONA, which commenced March 8th, 2019.

Financial Information for Related Programs Funded 100% by the MOHLTC

  2019 Budget YTD Budget YTD Actual 2019 YTD Actual 2018 Variance to Budget % Spent
Salaries and Benefits 1,207,326 301,832 292,147 280,728 9,684 24%
Admin and accommodation 31,445 7,861 7,861 8,287 - 25%
Travel and meetings 8,000 2,000 167 68 1,833 2%
Mileage 10,000 2,500 2,443 1,779 57 24%
Professional development 5,500 1,375 100 1,270 1,275 2%
Association and membership fees 300 75 184 288 (109) 61%
Office supplies 4,500 1,125 44 54 1,081 1%
Program supplies 100,229 25,057 35,325 31,194 (10,268) 35%
Purchased services 162,400 40,600 22,850 8,830 17,750 14%
Total expenditures 1,529,700 382,425 361,122 332,498 21,303 24%
Offset revenue - - - (6,300) - 0%
Funding - MOHLTC (1,529,700) (382,425) (382,425) (352,200) - 25%
  - - (21,303) (26,002) 21,303  

The Healthy Smiles Ontario Program is funded through the Ministry of Health and Long-Term Care.  This program supports 14.25 FTEs comprised of a manager (0.75), dental assistants (5.5), dental hygienists (5.5), a health promotion specialist (0.5), and support staff (2).  This program provides preventative, routine, and emergency and essential dental treatment for children and youth, from low-income families, who are 17 years of age or under

At March 31, 2019, the HSO budget is underspent $21,303.  Primarily, this variance relates to Purchased Services, which includes professional services provided by dentists as well as translation.  In Q1 of 2019, there were fewer available dentists hours in the months of February and March.  Subsequent to March 31, 2019, additional dentists hours are available and it is anticipated that the Purchased Services budget will trend to be on budget for the remainder of the fiscal year.

  2019 Budget YTD Budget YTD Actual 2019 YTD Actual 2018 Variance to Budget % Spent
Salaries and benefits 546,350 136,588 145,749 127,364 (9,162) 27%
Mileage 30,000 7,500 6,756 5,364 744 23%
Travel and meetings 3,045 761 262 1,235 499 9%
Professional development 3,380 845 - 4,564 845 0%
Program supplies 28,725 7,181 1,496 3,362 5,685 5%
Purchased services 25,200 6,300 4,204 3,723 2,096 17%
Total expenditures 636,700 159,175 158,467 145,612 708 25%
Funding - MOHLTC (636,700) (159,175) (148,431) (159,175) (10,744) 23%
  - - 10,036 (13,563) (10,036)  

Enclosed above is the financial information associated with the WECHU’s requirements to:

  • Comply and adhere to the Electronic Cigarettes Act:  Public Health Unit Guidelines and Directives: Enforcement of the Electronic Cigarettes Act;
  • Comply and adhere to the Smoke-Free Ontario Strategy:  Public Health Unit Tobacco Control Program Guidelines and the Directives:  Enforcement of the Smoke-Free Ontario Act. 

At March 31, 2019, total expenditures are under budget $708.  Salaries and benefits remain overspent for Q1 due to the addition of one contract Tobacco Enforcement Office to December of 2019, to assist with the increasing demand for enforcement activities due to the legalization of cannabis. 

  2019 Budget YTD Budget YTD Actual 2019 YTD Actual 2018 Variance to Budget % Spent
Chief Nursing Officer Initiative 121,500 30,375 28,812 25,673 1,563 24%
Enhanced Food Safety - Haines Initiative 53,800 13,450 3,967 3,677 9,483 7%
Enhanced Safe Water 32,900 8,225 7,741 869 484 24%
Harm Reduction Program Enhancement 250,000 62,500 54,459 62,930 8,041 22%
Infection Prevention and Control Nurses Initiative 105,251 26,313 6,388 24,255 19,925 6%
Infectious Diseases Control Initiative 466,517 116,629 112,659 110,197 3,970 24%
Needle Exchange Program Initiative 63,000 15,750 15,750 15,750 - 25%
Social Determinants of Health Nurses Initiative 210,502 52,626 37,131 46,414 15,495 18%
Total expenditures 1,303,470 325,868 266,907 289,765 58,960 20%
Funding - MOHLTC (1,253,500) (313,375) (313,375) (308,875) - 25%
  49,970 12,493 (46,468) (19,110) 58,960  

A description of other related programs is included below:

Chief Nursing Officer Initiative:  Under the Organizational Requirements of the Ontario Public Health Standards, the Chief Nursing Officer role serves to enhance health outcomes of the community at individual, group and population levels:  i) Through contributions to organizational strategic planning and decision making; ii) By facilitating recruitment and retention of qualified, competent public health nursing staff; iii) By enabling quality public health nursing practice.  This funding envelope supports 1 FTE meeting certain qualifications as required by the Ontario Public Health Standards.  At March 31, 2019, there are no negative variances to report on.

Enhanced Food Safety – Haines Initiative:  This initiative was established to enhance the Board of Health’s capacity to deliver the Food Safety Program as a result of the Provincial Government’s response to Justice Haines’ recommendations in his report “Farm to Fork:  A Strategy for Meat Safety in Ontario”.  At March 31, 2019, there are no negative variances to report on. 

Enhanced Safe Water:  This initiative was established to enhanced the Board of Health’s capacity to meet the requirements of the Safe Water Program Standard under the Ontario Public Health Standards.  At March 31, 2019, there are no negative variances to report on.

Harm Reduction Program Enhancement:  Base funding for this initiative supports the Board of Health’s in the activities associated with its Local Opioid Strategy.  More specifically it supports 2.5 FTEs dedicated to working on activities associated with:  i) Our local opioid response; ii) Naloxone Distribution and Training;  iii)  Opioid Overdose Early Warning and Surveillance.   At March 31, 2019, the budget for this program initiative is underspent by $8,041 due to the labour disruption involving employees represented by the ONA, which commenced March 8th, 2019 as well as other staff vacancies.

Infection Prevention Control Nurses Initiative:  This initiative was established to support one additional infection prevention and control nursing FTE having certain qualifications.  At March 31, 2019, the budget for this program initiative is underspent by $19,925 due to an unpaid absence as well as the labour disruption involving employees represented by the ONA, which commenced March 8th, 2019.

Infectious Disease Control Initiative:  This initiative was established to support the hiring of infectious diseases control positions (4.5 FTEs) and supporting these staff to monitor and control infectious diseases.  They serve to enhance the Board of Health’s ability to handle and coordinate increased activities related to outbreak management.  At March 31, 2019, the budget for this program initiative is underspent by $3,970 due to the labour disruption involving employees represented by the ONA, which commenced March 8th, 2019.

Needle Exchange Program Initiative:  This initiative was established to support the purchase of needles and syringes, and their associated disposal costs, for the Board of Health’s Needle Exchange Program.  At March 31, 2019, there are no negative variances to report on.

Social Determinants of Health Nurses Initiative:  This initiative was established to support 2 public health nursing FTEs with specific knowledge and expertise in social determinants of health and health inequities issues, and to provide enhanced supports internally and externally to the Board of Health to address the needs of priority populations impacted most negatively by the social determinants of health.  At March 31, 2019, the budget for this program initiative is underspent by $15,495 due to the labour disruption involving employees represented by the ONA, which commenced March 8th, 2019.

Financial Information for Related Programs Funded 100% by the MOHLTC

  2018/2019 Budget YTD Actual March 31, 2019 Variance to Budget % Spent
Mandatory Programs: Potassium Iodide Distribution Program 167,000 134,901 32,099 81%
Mandatory Programs: Public Disclosure System 20,000 10,380 9,620 52%
Capital: Windsor Office Project 275,000 80,057 194,943 29%
Needle Exchange Program Initiative 10,100 10,100 - 100%
Public Health Inspector Practicum 20,000 20,000 - 100%
Vector-Borne Diseases Program: Enhanced Mosquito Surveillance 46,700 46,700 - 100%
Funding - MOHLTC 538,800 302,138 236,662 56%

Mandatory Programs - Potassium Iodide Distribution Program:  One-time funding to improve nuclear emergency preparedness and increase knowledge amongst residents living within the primary and secondary zone of the Fermi 2 nuclear generating station.  Eligible costs include potassium iodide pill packs, staff salaries, project materials, printing and postage associated with the distribution of KI packs and on-going communication campaigns.  At March 31, 2019, $134,901 of the total approval of $167,000 was expended. While the WECHU had anticipated that this funding would be expended at March 31, 2019, staff time associated with this project was reallocated to other priorities.

Mandatory Programs - Public Disclosure System:  One-time funding must be used to update software and inspection forms to meet the new disclosure requirements under the Ontario Public Health Standards.   Eligible costs include software update, disclosure and migration.  At March 31, 2019, $10,300 of the funding approval was expended.  Activities related to the implementation of this disclosure system were concluded in February of 2019 and no additional costs are anticipated. 

Capital:  This one-time funding must be used to assist with costs to complete the capital planning requirements for a Stage 2 – Business Case Submission. Utilization of these funds is dependent upon the status of the work being completed internally and by third party consultants based upon the direction from the WECHU’s Board.  At March 31, 2019, $80,057 of the funding approval was expended.  On October 31, 2018, the WECHU submitted a request to extend the deadline to expend funding either to, December 31, 2019, or March 31, 2020.  As at the date of this report, the WECH has not received approval for the funding extension.  Activities related to this initiative are presently on-hold awaiting further direction from the Board and the MOHLTC.

Needle Exchange Program Initiative:  This one-time funding supports extraordinary costs associated with delivering the Needle Exchange Program.  Eligible costs include purchase of needles/syringes and associated disposal costs.  At March 31, 2019, this funding was fully expended.

Public Health Inspector Practicum Program:  This one-time funding supports the hiring of approved Public Health Inspector Practicum positions.  Eligible costs include student salaries, wages and benefits, transportation expenses associated with practicum positions, equipment and educational expenses.  This funding relates to practicum placements for the four-month period, which commenced May of 2018 and concluded in August of 2018.  At March 31, 2019, this funding was fully expended.

Vector-Borne Diseases Program - Enhanced Mosquito Surveillance:  This one-time funding supports an enhanced surveillance program.  Eligible costs include salaries for students, supplies and additional equipment, identification and testing expenses, promotional costs and mileage.  At March 31, 2019, this funding was fully expended.

Approved by:

 Theresa Marentette

 


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Prepared By:

Amandeep Hans, Health Promotion Specialist, Environmental Health Department

Date:

May 2019

Subject:

Vector-Borne Diseases

Background

The Environmental Health Department conducts annual monitoring and testing of tick and mosquito populations in Windsor and Essex County (WEC) as part of the WECHU’s Zoonotic and Vector-borne Diseases Program.

Mosquito Surveillance and Testing

Adult mosquito surveillance is an important component of the Zoonotic and Vector-borne Diseases Program. Surveillance runs from May to early October every year and may extend depending on the weather and temperatures. Species-specific traps are deployed in various locations throughout WEC to capture mosquitoes for testing and identification to determine the presence of West Nile and Zika Virus in our communities. In 2018, the Environmental Health Department collected samples from almost 1000 mosquito traps, identifying and testing over 80,000 mosquitoes by the end of the season. Invasive mosquito species Aedes aegypti (Yellow Fever Mosquito) and Aedes albopictus (Asian Tiger Mosquito) are also monitored each year through our Enhanced Mosquito Surveillance Program. These species are known carriers of diseases such as Zika, Malaria, Dengue, and Chikungunya. There were over 1000 invasive mosquitoes identified and tested in 2018, which is a 200% increase from the previous year. Due to the increased numbers of Asian Tiger Mosquitoes noted during trapping, the Public Health Agency of Canada (PHAC) has determined the City of Windsor and Essex County to be endemic for these mosquitoes.

Mosquito Control

The mosquito control program involves applying larvicide to catch basins and standing water sites such as ditches and lagoons that hold water. All municipalities in WEC have standing water by-laws in place. Last year over 133,000 treatments of larvicide were applied to roadside catch basins and standing water sites. Targeted treatment was also conducted for identified “hot spots” during the summer season. A “hot spot” would be a location where,

  • Invasive mosquito species have been identified,
  • Positive samples for West Nile Virus found or,
  • Clusters of human cases of West Nile Virus have been confirmed.

Human Cases

The WECHU follows up on all human cases of West Nile Virus. Cases are investigated to assess if additional mosquito control activities are required. If a cluster of cases is identified, the Environmental Health Department will increase mosquito control and surveillance activities. To date there have been no human cases of Zika Virus identified in WEC.

Ticks and Lyme Disease

The WECHU’s role is to measure and evaluate the risk of tick-borne disease in our area through both passive and active tick surveillance activities. Our surveillance data in the last 3 years indicates an increase in black-legged ticks (Ixodes scapularis) in WEC. The black-legged tick is the main vector for Borrelia burgdorferi, the bacteria that causes Lyme disease.

Passive surveillance involves residents submitting ticks to the health unit for identification and subsequent testing if the ticks are identified as blacklegged. Last year, 339 ticks were submitted to the WECHU, 31 were identified as blacklegged ticks and two of these ticks tested positive for Borrelia burgdorferi.

Active surveillance involves active field surveillance from Environmental Health staff. Active surveillance is usually conducted in the spring and fall seasons in parks and on trails that are frequented by the community.  Black- legged ticks that are identified in both the spring and fall would indicate that the area is potentially endemic. There were 12 blacklegged ticks identified when active surveillance was conducted at the Ojibway Prairie Nature Reserve and Chrysler Greenway in 2018

Tick Control

There is no formalized tick control program for our local parks and trails. Ticks are transported around by birds, deer and other wildlife and are not very mobile. Education is provided to the general public on tick removal and signs and symptoms for Lyme Disease.

Human Cases

In 2018, there were nine cases of Lyme disease in WEC.  All laboratory confirmed cases are interviewed to determine where they may have encountered black-legged ticks. Any local parks or trails that are noted during the investigation would prompt active surveillance.

Current Initiatives

In addition to continued surveillance and monitoring efforts, the WECHU will be launching a Fight the Bite public awareness campaign in June 2019. The awareness campaign will focus on prevention of mosquito breeding sites as well as personal protection. Targeted promotion and messaging will be used to reach priority populations and inform the public of hot spots identified through previous monitoring efforts.

Consultation

The following individuals were contributed to this report:

  • Kristy McBeth, Director, Health Protection
  • Phil Wong, Manager, Environmental Health Department
  • Saamir Pasha, Epidemiologist, Epidemiology and Evaluation Department
  • Approved by:

 Theresa Marentette

 


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Issue

In January 2014, the Board of the Windsor-Essex County Health Unit resolved to endorse the following actions and policies to reduce the exposure of second-hand smoke in multi-unit housing: 

  1. Encourage all landlords and property owners of multi-unit housing to voluntarily adopt no-smoking policies in their rental units or properties;
  2. All future private sector rental properties and buildings developed in Ontario should be smoke-free from the onset;
  3. Encourage public/social housing providers to voluntarily adopt no-smoking policies in their units and/or properties;
  4. All future public/social housing developments in Ontario should be smoke-free from the onset.
  5. Encourage the Ontario Ministry of Housing to develop government policy and programs to facilitate the provision of smoke-free housing.

Background

In January 2014, the Board of the Windsor-Essex County Health Unit resolved to endorse several actions and policies to reduce the exposure of second-hand tobacco smoke in multi-unit housing. This included action from existing and future private landlords, existing and future public/social housing providers to adopt smoke-free policies in their rental units or properties, as well as encouraging the Ontario Ministry of Housing to develop government policy and programs to facilitate the provision of smoke-free housing. Since that time, emerging tobacco and non-tobacco products have evolved and/or become available legally such as e-cigarettes and cannabis. It is important that smoke-free policies adapt to include such products for the health and safety of all residents of multi-unit housing, and also to protect the investment of landlords and property owners.

In December 2015, the Government of Canada announced its commitment to legalize, regulate, and restrict access to non-medical cannabis in Canada, with the intent to keep cannabis out of the hands of children and the profits out of the hands of criminals. In response, the Windsor-Essex County Health Unit Board of Health passed a resolution on January 14, 2016 supporting a public health approach to cannabis legalization, including strong health-centered and age-restricted regulations to reduce the health and social harms associated with cannabis use. In addition, the resolution mandated the Windsor-Essex County Health Unit support the development of healthy public policies and enforcement of future regulations to ensure minimal negative effects on public health and safety. The federal government introduced Bill C-45, the Cannabis Act, in April of 2017. This legislation would legalize access to non-medical (i.e., recreational) cannabis in Canada and provide a foundation of regulations on which provincial/territorial governments could develop more specific controls for how cannabis is grown, distributed, and sold in their provinces and territories. This Act came into effect on October 17, 2018.

Prior to its legalization, cannabis was the most commonly used illegal substance in Canada (CCSA, 2017). Approximately 15% of Ontario residents report cannabis use within 12 months (CCSA, 2016). In Windsor-Essex County, approximately 28, 900 residents used cannabis in the last year and among those who consume cannabis, rates are highest among youth and young adults (WECHU, 2016). Cannabis smoke contains similar toxins to those found in tobacco smoke associated with cancer, heart and respiratory disease (SHAF, 2016). Due to the added psychoactive properties of cannabinoids such as THC (tetrahydrocannabinol), cannabis also increases the risk of injury or harms associated with impaired driving, falls, and other preventable incidents. Cannabis can also cause short or long term damage to cognitive functioning (i.e., memory, focus, ability to think and learn), depression, anxiety, psychosis, and addiction. These harms increase when cannabis use begins prior to the age of 25, and with frequent or heavy use (CCSA, 2016; Parachute Vision Zero Network, 2018). Lastly, maternal cannabis use is linked to low birth weight, pregnancy complications, and may affect children’s cognitive functioning, behaviour, mental health and future substance use (Best Start, 2017).

Exposure to cannabis smoke should be limited, especially for children and those with respiratory or cardiovascular illness. Smoking or vaping of cannabis should be restricted to outdoors (Health Canada, 2018). Research on the effects of second-hand cannabis smoke exposure is limited; however, studies have shown that exposure to second-hand cannabis smoke leads to cannabinoid metabolites in bodily fluids, and can cause exposed individuals to experience psychoactive effects (Holitzki, Dowsett, Spackman, Noseworthy & Clement, 2017). 

Electronic cigarettes may or may not resemble traditional tobacco cigarettes. They consist of a battery, a heating element, and a cartridge that holds “e-liquid” or “e-juice,” a solution usually made of propylene glycol, glycerin, flavouring agents, and in many cases, nicotine. When a user “puffs” on the device, the solution is heated and the resulting vapour is inhaled into the lungs and exhaled in the same manner as a tobacco cigarette. E-cigarette devices can also be used to ingest cannabis-infused oils (PHO, 2018).

Bill S-5, which received Royal Assent in May 2018, established a new legislative framework for regulating vaping products in Canada. Under this framework, e-cigarettes and other vaping products are classified into two main categories: recreational or therapeutic. ‘Recreational’ e-cigarettes (with and without nicotine) do not make any health claims and are regulated under the federal Tobacco and Vaping Products Act for the manufacture, sale, labeling and promotion of vaping products. ‘Therapeutic’ e-cigarettes may be used to treat nicotine dependence, are allowed to make health claims, and are regulated under the more stringent Food and Drugs Act. On September 27th, 2018 the Government of Ontario introduced Bill 36 that makes amendments to the e-cigarette provisions under the Smoke-Free Ontario Act, 2017 and came in to force on October 17th, 2018, replacing  the Smoke-Free Ontario Act, 2006 and the Electronic Cigarettes Act, 201 (PHO, 2018).

The safety of e-cigarette use and second-hand vapour in the short and long term is still unknown as the health effects have not been thoroughly studied. While Health Canada has approved propylene glycol and glycerin as food additives, it is possible that they may be dangerous when vaporized and inhaled. The particles in e-cigarette vapour, including flavouring compounds, are particularly hazardous because they reach deep into lung tissue when used as intended. Some studies have shown e-cigarette vapour can also include heavy metals and other cancer-causing compounds such as formaldehyde (Czoli, Reid, Rynard & Hammond, 2015). Exposure to e-liquids, including accidental ingestion, eye contact, or skin exposure can also lead to adverse health effects. As of May 2018, nicotine can be legally present in vaping products in Canada. The addictive properties of nicotine could result in dependence on e-cigarettes.  Children and youth are especially susceptible to the negative effects of nicotine including addiction, and negative effects on brain development, memory and concentration (PHO, 2018).

In 2015, 3.2% of Canadians aged 15 or older used e-cigarettes in the past month.  In all age groups, the prevalence of past month e-cigarette use increased from 2013 to 2015. Prevalence in Canada is highest among youth (15-19 years) and young adults (20-24 years), where 6.3% reported the use of e-cigarettes in the past month. In Ontario, youth and young adults report the highest past year use of e-cigarettes of all age groups. The CAMH Monitor estimates that in 2016, 20% of Ontario young adults (18-24 years) used e-cigarettes in the past year. The Ontario Student Drug Use and Health Survey (OSDUHS) estimates that in 2017, 18% of Ontario youth (grades 7-12) used e-cigarettes in the past year (PHO, 2018).

Under the Smoke-Free Ontario Act, 2017, smoking or vaping is prohibited in indoor common areas of condominiums, apartment buildings and college and university residences. Examples of common areas include elevators, stairwells, hallways, parking garages, laundry facilities, lobbies, exercise areas and party or entertainment rooms. This means that unless you have signed an agreement or lease or are in a condominium with bylaws that say otherwise, you are allowed to smoke or vape in your private home. In the Act “Smoking” means smoking (inhaling and exhaling) or holding lighted tobacco or cannabis (medical or recreational), and “vaping” means inhaling or exhaling vapour from an electronic cigarette (e-cigarette) or holding an activated e-cigarette, whether or not the vapour contains nicotine (Government of Ontario, 2018).

The legalization of cannabis and vape products in Canada may increase access, normalization, rates of smoking and/or vaping, exposure to second-hand smoke, and exposure to smoking behaviour. While more research is needed to understand the health effects of long-term exposure to second and third-hand smoke, it is recommended to align tobacco and marijuana smoking policies to be most effective (Holitzki, Dowsett, Spackman, Noseworthy & Clement, 2017). Given the potential harms of cannabis and e-cigarette use behaviour and smoke or vape exposure, it is vital that the Board of Health expand on its resolution for smoke-free multi-unit dwellings to encourage housing providers to adopt smoke-free housing policies which explicitly include these products.

Proposed Motion

Whereas, the federal government has passed the Cannabis Act, 2017 to legalize non-medical cannabis, coming into effect on October 17th, 2018, and

Whereas, cannabis smoke contains many of the same carcinogens, toxins, and irritants found in tobacco smoke with the added psychoactive properties of cannabinoids like THC, and

Whereas, Ontarians spend most of their time at home, and it is in this environment where exposure continues to be reported, and

Whereas, indoor air studies show that, depending on the age and construction of a building, up to 65% of the air in a private residence can come from elsewhere in the building  and no one should be unwillingly exposed or forced to move due to unwanted second-hand smoke exposure,

Now therefore be it resolved that the Windsor-Essex County Board of Health endorse the following actions and policies to reduce the exposure of second-hand smoke in multi-unit housing:

  1. Encourage all landlords and property owners of multi-unit housing to voluntarily adopt no-smoking policies in their rental units or properties and explicitly include cannabis smoke and vaping of any substance in the definition of smoking;
  2. All future private sector rental properties and buildings developed in Ontario should be vape and smoke-free from the onset;
  3. Encourage public/social housing providers to voluntarily adopt no-smoking and/or vaping policies in their units and/or properties;
  4. All future public/social housing developments in Ontario should be smoke and vape-free from the onset.
  5. Encourage the Ontario Ministry of Housing to develop government policy and programs to facilitate the provision of smoke-free housing.

AND FURTHER that this resolution be shared with the Honorable Prime Minister of Canada, local Members of Parliament, the Premier of Ontario, local Members of Provincial Parliament, Minister of Health and Long-term Care, Federal Minister of Health, the Attorney General, Chief Medical Officer of Health, Association of Local Public Health Agencies, Ontario Boards of Health, Ontario Public Health Association, the Centre for Addiction and Mental Health, and local community partners.

References

 


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April 18, 2019

  1. Call to Order
  2. Agenda Approval
  3. Announcement of Conflict of Interest
  4. BOARD ELECTIONS
    1. Terms of Reference/Board Committee Representatives:
      Chair, Vice-Chair, Treasurer
      1. Joint Board Extension Committee
      2. Audit Committee
        1 Vacancy
      3. Project Governance Committee
        4 Vacancies – City (2), County (1), Prov (1)
  5. Approval of Minutes
    1. Regular Board Meeting: February 28, 2019
  6. Consent Agenda
    1. INFORMATION REPORTS
      1. KI Distribution
      2. 2018 Strategic Plan Year End Report
      3. The new Canada’s Food Guide
      4. Media Recap (Feb/March 2019)
    2. RESOLUTION/RECOMMENDATION REPORTS
      1. Consumption and Treatment Services Application
  7. Business Arising
  8. Board Correspondence – Circulated
  9. New Business
    1. CEO Quarterly Report (January – March 2019) (T. Marentette)
    2. 2019 alPHa Fitness Challenge (T. Marentette)
    3. 2019 alPHa AGM (June 9-11, 2019) (T. Marentette)
  10. Other Board of Health Resolutions/Letters
    1. Peterborough Public Health – For Support (Vaping Products)
      Smoke-Free Ontario Act, 2017 – Letter to Hon. Christine Elliott
    2. Southwestern Public Health – For Support (Vision Screening)
      Child Visual Health and Vision Screening Protocol – Letter to Hon. Christine Elliott
  11. APPENDICES:
    1. Appendix A – 2018 Strategic Plan Year End Report
  12. Committee of the Whole
    (Closed Session in accordance with Section 239 of the Municipal Act)
  13. Next Meeting: At the Call of the Chair or May 16, 2019 – Windsor
  14. Adjournment

View Document page

Prepared By:

Darcie Renaud, Performance Improvement & Accountability Coordinator (PIAC), Planning & Strategic Initiatives Department

Date:

April 1, 2019

Subject:

2018 Strategic Plan Year-end Report

Background:

The 2017-2021 WECHU Strategic Plan identifies key roles, priorities, and directions for the organization. It sets out what we plan to do, how we plan to do it, and how we will measure our progress. The Strategic Plan outlines opportunities to enhance our delivery of quality public health programs and services to all residents in Windsor and Essex County. The current strategic plan is based on four strategic priorities: Communication and Awareness; Partnerships; Organizational Development; and Evidence-Based Public Health Practice.

As outlined in the 2017-2021 Strategic Plan under “Implementation and Monitoring”, the plan is to be reviewed and its progress measured and reported to the BoH annually. The annual review process consists of a meeting with the Strategic Planning Committee (SPC), during which the plan elements are discussed, reviewed and altered where necessary. After the SPC review, a strategic plan report is prepared and presented to the BoH for consideration. This year-end report is in addition to quarterly tracking and reporting implemented by the Planning and Strategic Initiative department in early 2018.

Current Initiatives

The 2018 Strategic Plan Year-End Report provides the objectives under each strategic priority and summarizes the progress our organization made during the second year (2018) of implementation and provides evidence of our commitment to quality, excellence, and accountability. It includes previous years’ measures (where established), 2018 measures/results, and next steps. The report also identifies changes made under Objectives 1.3, 3.4 and 4.4 as a result of discussions at the annual SPC review meeting.

The colour-coded state for all of the objectives either remained consistent or moved forward. In some cases, the goal for the measure of an objective was reached (e.g., under Objective 1.2) yet the work necessary to fully achieve the objective was not complete. In these cases, the colour-coded state of the objective remained yellow (progress being made but objective not met). Overall, progress has continued on all of the strategic objectives.

In Q1 of 2019, the PSI department will work with the Communication department to re-launch communication efforts internally about the strategic plan to ensure ongoing understanding of WECHU’s strategic objectives and allow departments to better understand their role in meeting them. These efforts will include a web update, the development of a new strategic plan e-learning module for staff and the BoH, and plans for mid-point activities to highlight WECHU’s progress on the 5-year plan.

Consultation:

The following individuals contributed to this report:

  • Kristy McBeth, Director, Health Protection
  • Marc Frey, Manager, Planning & Strategic Initiatives
  • Michael Janisse, Manager, Communications
  • Ramsay D’Souza, Manager, Evaluation & Epidemiology
  • Jennifer Johnston, Health Promotion Specialist, Planning & Strategic Initiatives
  • Jessica Kipping-Labute, Policy Advisor, Planning & Strategic Initiatives
  • Dave Jansen, Performance Improvement and Accountability Coordinator, Planning & Strategic Initiatives

Approved by:

 Theresa Marentette


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Prepared By:

Communications Department

Date:

March 6, 2019

Subject:

February Media Relations Recap Report

February Media Coverage

Total Media Coverage

26

Interview Requests

9

Mentions (In the news without direct interviews)

11
Requests for Information 6

February 2019 Media Relations Recap - Media Coverage

Story Source

February 2019 Media Relations Recap - Story Source

Media Coverage

Outlet

Number of Stories

AM 800

4

Blackburn

2

CBC

7

Chatham Daily News

1

CTV

4

National Post

1

The MediaPlex (St. Clair College)

1

Windsor Star

3

windsorite.ca

3

TOTAL

26

News Release and Media Advisories

Date Type Headline Response

February 6, 2019

Media Advisory

New Inspection Disclosure Website To Be Launched

7 Stories Reported

February 7, 2019

News Release

New Inspection Disclosure Website To Be Launched

1 Story Reported

February 25, 2019

News Release

Follow The “New” Canada’s Food Guide – Take The Challenge Today!

3 Stories Reported

February 27, 2019

Media Advisory

Windsor-Essex County Health Unit Board Of Health Meeting At Essex Office – February 2019

0 Stories Reported

(Note: The stories that came from the BOH meeting will be part of the March media recap report as they appeared in the news in March.)

Stories Reported by the Media

AM 800

Publish Date

Title

February 7, 2019

Inspection Reports More Easily Available: Health Unit

February 12, 2019

Tecumseh Puts Fluoride Decision On Hold

February 21, 2019

Conciliation Talks Set For Nurses At Local Health Unit

February 25, 2019

Health Unit Nurses Hoping To Raise Awareness Over Conciliation

Blackburn News

Publish Date

Title

February 7, 2019

Health Unit Rolls Out New Inspection Report System

February 25, 2019

Local Public Health Nurses Could Hit The Picket Lines In Two Weeks

CBC News

Note: Digital stories were not available for five of CBC’s requests.

Publish Date

Title

February 6, 2019

It Needs To Be Exceptional': Why Schools Stay Open When The Buses Are Cancelled

February 7, 2019

New Disclosure Website For Health Unit, Changes To Five-Star Ratings

Chatham Daily News

Publish Date

Title

February 21, 2019

Climate Change Will Have More Severe Effect On Health Of C-K Residents

In Future

CTV News

Note: Digital stories were not available for two of CTV’s requests.

Publish Date

Title

February 8, 2019

New Website Offers Safety Information Across Windsor-Essex

February 19, 2019

Nurses Strike Looms At Windsor-Essex County Health Unit

Windsor Star

Publish Date Title

February 8, 2019

Health Unit Inspection Reports Now Easy To Find Online

February 9, 2019

Jarvis: Another Potential Game Changer In The Fluoride Debate

February 25, 2019

Health Unit Launches Healthy Eating Online Challenge

Windsorite.ca

Publish Date Title

Publish Date

Title

February 7, 2019

Health Unit Launches New Online Inspection Results Website

February 19, 2019

Health Unit Nurses Could Strike If Conciliation Fails

February 28, 2019

Take The New Food Guide Challenge

Note: Digital stories were not available for National Post and The MediaPlex (St. Clair College).

The following individuals contributed to this report:

Jennifer Jershy, Marc Tortola, and Michael Janisse


View Document page

Prepared By:

Communications Department

Date:

April 3, 2019

Subject:

March Media Relations Recap Report

February Media Coverage

Total Media Coverage

81

Interview Requests

30

Mentions (In the news without direct interviews)

50
Requests for Information 1

March 2019 Media Relations Recap - Media Coverage

Story Source

March 2019 Media Relations Recap - Story Source

Media Coverage

Outlet

Number of Stories

AM 800

16

Blackburn

15

CBC

14

CTV

16

Newswire

3

The MediaPlex (St. Clair College)

1

Toronto Star

1

TVO

1

Windsor Star

8

windsorite.ca

6

TOTAL

81

News Release and Media Advisories

Date Type Headline Response

March 1, 2019

News Release

2019 Living Wage Calculations Released

3 Stories Reported

March 1, 2019

Media Statement

Statement from Theresa Marentette, Chief Executive Officer, Chief Nursing Officer

4 Stories Reported

March 4, 2019

News Release

High School Suspension Date of March 29th Cancelled

2 Stories Reported

March 8, 2019

Media Advisory

ONA Strike and Impacted Client Services

7 Stories Reported

March 13, 2019

Media Statement

Statement Regarding Infectious Disease Management During Labour Disruption

5 Stories Reported

March 25, 2019

News Release

Let’s Keep Our Immunization Records Up-To-Date

0 Stories Reported

March 26, 2019

Media Statement

Statement Regarding Bargaining with ONA

11 Stories Reported

Stories Reported by the Media

AM 800

Publish Date

Title

March 1, 2019

Flu Numbers Down In Windsor-Essex

March 2, 2019

Health Unit Blames Union For Failed Talks

March 8, 2019

Video: 'On Strike At The Windsor-Essex County Health Unit

March 8, 2019

Video: Services Impacted By Health Unit Nurses Strike

March 12, 2019

Labour Council Pledges Support for Striking Nurses

March 13, 2019

Striking Health Unit Nurses To Hold Diaper Drive

March 14, 2019

Health Unit Nurse Hit By Vehicle While On The Picket Line

March 14, 2019

Health Unit Is Prepared To Address Measles Concerns

March 15, 2019

Video: Unions Rally Behind Striking Health Unit Nurses

March 15, 2019

Rally Planned To Support Striking Nurses

March 19, 2019

Video: Questions Over Funding As Nurses Strike Continues

March 26, 2019

Local Health Unit And ONA Heading Back To The Bargaining Table

March 27, 2019

Video: Negotiations Abruptly End Due To Picket Sign: Health Unit

March 28, 2019

Talks Resume In Health Unit Nursing Strike

March 28, 2019

Local Unions Support Striking Health Unit Nurses

March 29, 2019

Talks Between ONA And Local Health Unit To Resume Monday

Blackburn News

Publish Date

Title

March 4, 2019

Health Unit Cancels March Suspension Date For Immunizations

March 6, 2019

Message From The Health Unit Regarding Contract Talks

March 6, 2019

Time Ticking On A Nurses' Strike At The Health Unit

March 8, 2019

Update: Public Health Nurses Hit The Picket Line (Gallery)

March 13, 2019

WE Health Unit Remains Ready To Deal With Infectious Diseases

March 15, 2019

Nurses, Politicians Rally In Windsor

March 15, 2019

Striking Nurses Collecting Diapers For Downtown Mission

March 19, 2019

Health Unit Answers Public Health Nurses About Money Left On The Table

March 27, 2019

Public Salaries Soar Across Ontario

March 27, 2019

Health Unit Monitoring Measles Outbreak In Michigan

March 28, 2019

Nurses, Health Unit To Take Another Shot At Bargaining

March 28, 2019

Postal Workers Support Striking Nurses On The Picket Line

March 26, 2019

Hatfield Calls On Province To Intervene In Health Unit Strike

March 26, 2019

Update: Talks Broken Between Nurses And Health Unit

March 31, 2019

Local Public Health Nurses Back At Bargaining Table On Monday

CBC News

(also includes CBC Radio and Radio-Canada)

Note: Digital stories were not available for one of CBC’s requests.

Publish Date

Title

March 1, 2019

Living Wage In Windsor-Essex Pegged At More Than $15 An Hour: Health Unit

March 1, 2019

Strike deadline looming for public health nurses in Windsor Essex

March 5, 2019

Suspensions for incomplete immunization records cancelled due to potential strike

March 6, 2019

Road Widening, Flood Prevention: A Look At Windsor's 3.3 Per Cent Proposed Tax Increase

March 7, 2019

Windsor-Essex Public Health Nurses 'Overwhelmingly' Vote To strike At Midnight

March 8, 2019

Public Health Nurses Strike Cancels Services In Windsor, Leamington, and Essex

March 8, 2019

Les infirmières en santé publique de Windsor-Essex en grève

March 14, 2019

Striking Nurse Hit By Car In Leamington

March 14, 2019

Une infirmière happée par un véhicule pendant qu'elle manifestait à Leamington

March 15, 2019

Les infirmières de santé publique de Windsor-Essex aident les mères dans le besoin, même pendant la grève

March 25, 2019

Probable Measles Case In Chatham: Exposure At Taco Bell, Walmart, Hospital

March 26, 2019

It Will Take Care Of Itself': Mixed Reactions About Potential Measles In Chatham-Kent

CTV News

Note: Digital stories were not available for two of CTV’s requests.

Publish Date

Title

March 1, 2019

New Living Wage Calculations Released For Windsor-Essex

March 4, 2019

Health Unit Programs Cancelled Amid Looking Nurse Strike

March 6, 2019

Low Levels Of Radon Found Across Windsor-Essex

March 8, 2019

Windsor-Essex Public Health Nurses Strike, Several Programs Cancelled

March 13, 2019

Health Unit Managing Infectious Disease Despite Strike

March 15, 2019

Nurses Rally In Windsor To Back Wage Demands

March 19, 2019

Nurses Union Believes Health Unit Was Intentionally Underspending On Salaries

March 26, 2019

Possible Measles Exposure In Chatham-Kent, Health Unit Warns

March 26, 2019

Talks Between Health Unit And Striking Nurses To Resume Wednesday

March 27, 2019

Sunshine List Reveals Top Earners For Public Employees

March 27, 2019

Sign Derails Talks Between Nurses' Union And Health Unit

March 27, 2019

Talks end

March 27, 2019

Lab Test Confirms No Measles In Chatham-Kent

March 28, 2019

Talks To Resume Between Nurses And Windsor-Essex County Health Unit

Newswire

Publish Date Title

March 8, 2019

Public Health Nurses Spend International Women’s Day on the Picket Lines

March 13, 2019

Media Advisory - Striking Windsor-Essex County Public Health Nurses to Hold Diaper Drive

March 27, 2019

ONA Deeply Disappointed as HU Employer Walks Away from New Talks, Leaving the Community at Risk of a Measles Outbreak

TVO

Publish Date Title

March 22, 2019

Why This Ontario Town Is Divided Over Fluoridation

Windsor Star

Publish Date Title

March 1, 2019

Jarvis: The Fluoride Debate: 'I Know What I Saw'

March 1, 2019

Health Unit Says Living Wage In Windsor-Essex In 2019 Is $15.15 Per Hour

March 1, 2019

Nurses, Windsor-Essex County Health Unit end negotiations

March 8, 2019

Windsor-Essex County Health Unit Nurses Head To The Picket Line Amid Strike

March 16, 2019

Striking Health Unit Nurses Push For Return To Bargaining Table

March 20, 2019

Loved Ones Of First Responders Are Encouraged To Share Input In New Survey

March 28, 2019

National Nurses Union Pushes For Health Unit To Return To Bargaining

March 28, 2019

Measles sign derails health unit talks with striking nurses

Windsorite.ca

Publish Date Title

March 1, 2019

Health Unit Issues Statement About Contract Talks

March 4, 2019

Health Unit Cancels High School Suspension Date Set For End Of March

March 8, 2019

Health Unit Nurses on Strike

March 26, 2019

Talks To Resume In Health Unit Strike

March 27, 2019

Windsor-Essex County Health Unit's Sunshine List For 2018 Released

March 28, 2019

Talks To Resume Again in Health Unit Strike

Note: Digital stories were not available for the Toronto Star and The MediaPlex (St. Clair College).

The following individuals contributed to this report:

Jennifer Jershy, Marc Tortola, and Michael Janisse


View Document page

2018 WECHU Strategic Plan Progress - At a Glance

Communication and Awareness

Objective

2017

2018

1.1. 60% of survey respondents are aware of the programs and services offered by the WECHU by 2021.

Progressing Progressing

1.2 60% of survey respondents have seen or heard about the WECHU by 2021.

Progressing Progressing

1.3 60% of survey respondents are satisfied with internal communication efforts in the WECHU by 2021.

Work Needed Progressing

Partnerships

Objective

2017

2018

2.1. 100% of program/service driven departments implement a formal feedback process with at least one external partnership by 2021.

Progressing Progressing

2.2. At least 20% of activities in the operational plan identify formal internal partnerships by 2021.

Work Needed Progressing

Organizational Development

Objective

2017

2018

3.1. A minimum of 2 organization-wide quality improvement activities will occur annually through to 2021.

Objective Met Objective Met

3.2. 100% of the WECHU staff are trained in change management strategies by 2021.

Progressing Progressing

3.3. 100% of corporate risks identified as high have mitigation strategies developed and implemented by 2021

Progressing Progressing

3.4. 80% of the WECHU staff have a positive view of organizational culture by 2021.

Work Needed Progressing

Evidence-based Public Health Practice

Objective

2017

2018

4.1. 100% of departments collect corporate level client satisfaction data by 2021.

Progressing Progressing

4.2. 100% of the Ontario Public Health Standards (OPHS) 2018 program areas have at least one activity focused on healthy public policy development by 2021.

Progressing Progressing

4.3. 100% of the OPHS population health assessment requirements (7), the research, knowledge exchange, and communication requirements (3) and the related protocols are being addressed by 2021.

Progressing Objective Met

4.4. 100% of our programs and service departments have adopted a health equity approach to an activity by 2021.

Progressing Progressing

Introduction

Our strategic plan allows our organization to identify key roles, priorities, and directions across 2017 to 2021. It sets out what we plan to accomplish as an organization, how we plan to do it, and how we will measure our progress toward our goals. The current strategic plan is based on four strategic priorities: Communication and Awareness; Partnerships; Organizational Development; and Evidence-Based Public Health Practice.

As outlined in the 2017-2021 Strategic Plan under “Implementation and Monitoring”:

In order to support a framework of continuous improvement, the strategic plan will be reviewed and its progress will be measured and reported to the BoH annually. The annual review process will consist of a meeting with the SPC, with an attempt to have all previous committee members involved, during which the plan elements, including goals and indicators will be discussed and reviewed. At that time, based on consensus discussion and decision making, elements of the plan, specifically objectives, goals and indicators, may be altered to account for changes in the internal and external environment. The mission, vision, values statements, and priorities will remain consistent throughout the duration of the plan to ensure a consistent focus is maintained. After the SPC review, a strategic plan report will be prepared and presented to the BoH for consideration.

This report provides the objectives under each strategic priority, summarizes the progress our organization made during the second year of implementation (2018) and provides evidence of our commitment to quality, excellence, and accountability. The report also identifies changes made as a result of discussions at the annual SPC review meeting and includes previous years’ measures (where established), 2018 measures/results, and next steps.

Communication and Awareness

OBJECTIVE 1.1

Strengthen the community’s awareness of our programs and services by developing and implementing a corporate communications strategy.

Goal

60% of survey respondents are aware of the programs and services offered by the WECHU by 2021.

Measure

% level of awareness of WECHU programs and services.

Previous Year(s) Results

  • RRFSS Data (May 2015 to April 2017): 71.5% (N=1,167) of individuals surveyed reported that they were to some extent, familiar with the health unit programs and services.
  • 2016 CNA Data: 76% of respondents were somewhat or very familiar with WECHU programs and services
  • 2017 Corporate External Client Experience Survey: 66.7 % of respondents (n=48) reported being somewhat or very familiar with Health Unit programs and services.

2018 Results

  • 2018 Corporate External Client Experience Survey: 63.77% of respondents (n=69) reported being somewhat or very familiar with Health Unit programs and services.

Next Steps

In addition to continuing to ask this question in the Corporate External Client Experience website survey, this question will be included in the upcoming community needs assessment refresh survey. Community awareness of WECHU programs and services will also be explored through a set of focus groups being conducted by Ipsos on behalf of the WECHU. The information gathered from these focus groups sessions will be used to inform next steps in improving community awareness of our programs and services.

The Communications department will continue to develop the Marketing and Communications plan. In 2018, five policies and procedures which address elements of organizational branding across media channels were developed and rolled out to the organization, and work has begun to define the WECHU’s programs and services.

OBJECTIVE 1.2

Increase the WECHU’s visibility by developing and implementing a community engagement approach.

Goal

60% of survey respondents have seen or heard about the WECHU by 2021.

Measure

% of survey respondents that have seen or heard about the WECHU in the past 3 months.

Previous Year(s) Results

  • AM 800 Trailer: 81.1% (N=281) had seen or heard about the WECHU in the last 3 months.
  • Corporate External Client Experience Survey: 52.7% of respondents (N=74) had seen or heard about the WECHU in the last 3 months.

2018 Results

  • 2018 Corporate External Client Experience Survey: 64.03% of respondents (N=139) had seen or heard about the WECHU in the last 3 months.

Next Steps

The PSI and Communications departments have identified a need to revisit this objective in 2019, including the associated goals and measures, to better define what is meant by engagement and develop a formal engagement strategy. As a first step, Ipsos will be conducting a community survey followed by a number of focus groups on behalf of the WECHU in Q1 of 2019. Once the strategy is complete, recommendations will be provided to the SPC late in 2019 or early 2020 to review and modify the objective, goal, and measures in order to accurately reflect achievements in this area.

OBJECTIVE 1.3

Improve communication within the WECHU by developing and implementing an internal communication strategy.

Goal

A Net Promoter Score (Internal Communications) greater than 30

Measure

Average Net Promoter Score (Internal Communications) of seven internal communications items found on the employee engagement survey.

Previous Year(s) Results

From the pre- and post-accreditation survey item:

  • Summer 2016/ Pre-accreditation: 54.0% were in agreement
  • Summer 2017/ Post-accreditation: 85.4% were in agreement

2018 Results

Net Promoter Score (Internal Communications): 10.86

Next Steps

Work to improve internal communications as part of the overall employee engagement strategy will continue into 2019 including the redevelopment of the intranet, regular Chats with Theresa, team meeting discussion questions, and web-based all staff meetings.

*Note: the SPC decided to change the measure of this objective by using the average Net Promoter Score (NPS) of seven internal communications questions asked in a monthly employee engagement survey with a goal of a score greater than 30.

The NPS is calculated in the following way: Respondents are asked about their satisfaction with seven aspects of internal communication on a scale of 0 and 10 and are then grouped into promoters (9-10 rating, extremely satisfied), passively satisfied (7-8 rating), and detractors (0-6 rating, extremely unsatisfied). The percentage of detractors is subtracted from the percentage of promoters to get an overall score. A final net promoter score above 0 is considered positive. For example, if there were 40% promoters and 25% detractors, the NPS score would be +15.

 

Partnerships

OBJECTIVE 2.1

Increase the effectiveness of partnerships through formal feedback mechanisms.

Goal

100% of program/service driven departments implement a formal feedback process with at least one external partnership by 2021.

Measure

% of program/service driven departments who have completed a partnership feedback process.

Previous Year(s) Results

The partnership tool was in development.

2018 Results

The partnership tool has been developed and finalized. Training for management and staff took place in Q4 of 2018. On track to meet the goal by 2021.

Next Steps

E&E and PSI to develop tracking system to be included in the 2020 planning cycle in order to measure whether partnership evaluations have been completed. A second goal related to developing and acting on a plan to deal with ineffective partnerships may be considered in 2020 and beyond, as a way to enhance this objective.

OBJECTIVE 2.2

Increase the number of internal partnerships.

Goal

At least 20% of activities in the operational plan identify formal internal partnerships by 2021.

Measure

% of operational activities that identify formal internal partnerships.

Previous Year(s) Results

7.9% (8 out of 101) of operational activities identified an internal partnership in 2017.

2018 Results

19% of work plans included in the 2018 Operational Plan referenced this objective.

Next Steps

The updated planning tool now includes more detail about internal partnerships for the 2019 planning cycle. By creating program summaries with owners and co-owners we have identified strategic internal partnerships that set the stage for implementing the standards in a coordinated way.

In the future, E&E may consider adapting the external partnership evaluation framework to internal partnerships to ensure their effectiveness in meeting objectives (e.g., improving internal communication, reducing silos, reducing duplication, and creating efficiencies) in 2020.

Organizational Development

OBJECTIVE 3.1

Improve performance by striving towards operational excellence and a focus on continuous quality improvement.

Goal

A minimum of two organization-wide quality improvement activities will occur annually through to 2021.

Measure

# of corporate level quality improvement activities.

Previous Year(s) Results

A total of three corporate level quality improvement activities occurred in 2017:

  • A Corporate Risk registry was developed.
  • Achievement of Bronze Level Accreditation.
  • An electronic operational planning process was developed and identified opportunities were addressed (based on feedback from the prior planning cycle).

2018 Results

Four corporate level quality improvement activities began in 2018:

  • The Risk Registry was updated with mitigation plans incorporated into the 2019 planning approach.
  • The planning system was updated to incorporate ministry requirements with training provided to all teams.
  • Background work on our quality improvement plan (QIP) approach began.
  • Proposals for potential approaches to maintain AODA adherence were developed.

Next Steps

In addition to continuing the work begun on quality improvement activities in 2018 (AODA Adherence, Corporate QIP, and the Risk Registry), the following activities are planned for 2019:

  • Gap analysis in order to identify steps needed to achieve Silver Level Accreditation.
  • Work to further improve the operational planning process and implementing the required changes for 2020 operational planning.

OBJECTIVE 3.2

Increase our readiness to adapt to internal and external factors through effective change management practices.

Goal

100% of the WECHU staff are trained in change management strategies by 2021.

Measure

% of staff trained in change management strategies.

Previous Year(s) Results

Change management training was offered to staff and managers in the fall of 2017.

A total of 80 employees attended the training (33.1% of WECHU employees).

  • 15 (65.2%, n= 23) members of the leadership and management teams received the training.
  • 65 (29.7%, n=219) staff members received the training.

2018 Results

Not reportable. Down from previous year given that no further training in change management took place in 2018.

Next Steps

The PSI department will explore standardized change management training and approaches to increase the use of the WECHU’s change management plan template/process. A strategy to train remaining WECHU employees and ensure that all new hires receive change management training will be developed.

*Note the SPC discussed whether the measure being used for this objective accurately reflects the work being accomplished towards this goal, and may wish to revisit this measure in the future.

OBJECTIVE 3.3

Enhance our understanding and monitoring efforts of identified corporate risks to embrace opportunities, create flexibility, and preserve organizational assets.

Goal

100% of corporate risks identified as high have mitigation strategies developed and implemented by 2021.

Measure

% of corporate risks deemed to be ‘high risk’ that have mitigation strategies developed and implemented.

Previous Year(s) Results

In 2017, the Leadership Team developed and finalized the corporate risk registry. There were a total of 32 risks identified:

  • 2 were identified as high risk
  • 23 as moderate risk
  • 7 as low risk

2018 Results

The risk registry has been significantly updated. There are now five corporate risks identified as having high residual risk, but far fewer moderate risks than there were before. Four out of the five (80%) corporate risks identified as having “high residual risk” now have mitigation plans in place.

Next Steps

All high risks, and many moderate risks, have identified “actions required” to be implemented moving forward. The risk registry will soon include Key Risk Indicators (KRI’s), each with a reporting schedule.

A draft risk management template has been released from the MOHLTC regarding risk identification and mitigation strategies. Their template has the same columns as the WECHU’s internal template. Risk identification practices will continue as planned.

OBJECTIVE 3.4

Improve organizational culture through people development and employee engagement strategies.

Goal

A Net Promotor Score (Engagement) greater than 30

Measure

Net Promoter Score (Engagement)

Previous Year(s) Results

A strategy to report corporately and yearly on employee engagement aspects was in development.

2018 Results

Net Promoter Score (Engagement): 19.79

Recommendations and Next Steps

Implementation of the Employee engagement strategies will continue, including activities such as all staff meetings, monthly team meeting questions, and other strategies that involve obtaining staff input and dialogue.

*Note the SPC decided to change the measure of this objective by using the Net Promoter Score (NPS) of the question, “How likely is it that you would recommend this organization as a good place to work?”, with a new goal of a score greater than 30. Responses to this question are highly correlated with other measures of engagement found in the monthly engagement survey sent to 30 randomly selected staff (which began in Q2 of 2018). Please see Objective 1.3 for an explanation of the NPS calculation.

Evidence-Based Public Health Practice

OBJECTIVE 4.1

Establish organizational supports for client-centered service strategies.

Goal

100% of departments collect corporate level client satisfaction data by 2021.

Measure

% of departments that collect corporate level client satisfaction data.

Previous Year(s) Results

The Corporate Client Experience Survey was launched in the second quarter of 2017.

Also in 2017, the Family Health department launched a Healthy Babies Healthy Children Client Survey. They were the first department to launch a departmental client experience survey.

2018 Results

The Healthy Families department continues to be the only external facing department to collect client satisfaction data. In addition, a survey on the health unit website continues to collect client satisfaction data at the corporate level.

Next Steps

In 2019, the PSI department will develop an overarching framework for client experience measurement, analysis, reporting, and related action. This process will begin by establishing standardized measurement approaches, followed by a pilot implementation with up to two external-facing departments.

OBJECTIVE 4.2

Develop and implement a framework to support healthy public policy.

Goal

100% of the Ontario Public Health Standards (OPHS) program areas have at least one activity focused on healthy public policy development by 2021.

Measure

% of OPHS program areas with an activity focused on healthy public policy development.

Previous Year(s) Results

2017: 4 of 9 (40.4%) OPH program standard areas had at least one activity focused on healthy public policy development in 2017.

2018 Results

6 of 9 (66%) OPH program standard areas had at least one activity focused on healthy public policy development in 2018.

Next Steps

The PSI department will continue to support the implementation of the Healthy Public Policy Toolkit and Guidance document. This includes identifying and proactively addressing healthy public policy development activities; supporting organizational capacity building efforts related to healthy public policy; providing support and guidance to those developing healthy public policies; and evaluating the effectiveness of the Healthy Public Policy Toolkit and the related processes. Based on information gathered throughout the year, additional support for targeted organizational knowledge and skill development may be implemented.

The PSI Department will revisit the goal in 2019 to ensure that healthy public policy development is being appropriately measured.

OBJECTIVE 4.3

Enhance local data collection efforts and analysis to support knowledge exchange both internally and externally.

Goal

100% of the OPHS population health assessment requirements (7), the research, knowledge exchange, and communication requirements (3) and the related protocols are being addressed by 2021.

Measure

% of OPHS population health assessment requirements (7), the research, knowledge exchange, and communication requirements (3) and related protocols being addressed.

Previous Year(s) Results

Not established. Deferred due to the introduction of the modernized OPHS.

2018 Results

100% of OPHS population health assessment requirements (7), the research, knowledge exchange, and communication requirements (3) and related protocols being addressed.

Next Steps

This objective will be measured in M-Files as work plans are reviewed. E&E will input the appropriate requirements under the two standards for each Intervention Work Plan that requires E&E support.

OBJECTIVE 4.4

Develop and implement protocols that ensure all programs and services are using a health equity approach.

Goal

100% of our programs have adopted a health equity approach by 2021.

Measure

% of programs that have adopted a health equity approach.

Previous Year(s) Results

Two key initiatives were completed in 2018 to support programs adopting health equity focused approaches:

1) Implementing a corporate Health Equity Strategy.

  • This plan outlines health equity focused goals, expectations, and specific areas for action.
  • It demonstrates the organization’s commitment to effectively responding to community needs and supports meeting Ontario Public Health Standard requirements.

2) Evaluating and improving corporate Health Equity Impact Assessment (HEIA) planning tools and processes.

  • Results enhance the organization’s ability to identify priority population and plan programs based on local evidence.
  • Results increase opportunities to integrate health equity-focused approaches into annual service planning and reporting.

2018 Results

68% of programs have adopted a health equity approach in 2018.

Next Steps

The following initiatives are planned for 2019 to advance this strategic objective:

  • Develop a brief reference guide to enhance understanding of objective 4.4
  • Implement a Health Equity Strategy Internal Communication Plan
  • Implement a Health Equity Strategy Measurement and Reporting Plan
  • Develop an action plan to enhance opportunity to engage with priority populations

*Note: the SPC decided to delete the words, “and service departments” and “to an activity” from the goal and measure to enhance alignment with annual service plans. Based on ministry requirements, the updated 2019 planning system details WECHU interventions by program area and intervention, not department and activity.


View Document page

Prepared By:

Alicia Chan, Public Health Nutritionist, Chronic Disease and Injury Prevention
Mariel Munoz, Public Health Nutritionist, Healthy Schools
Jennifer Jacob, Public Health Nutritionist, Healthy Families

Date:

April 1, 2019

Subject:

The new Canada’s Food Guide

Background:

Canada’s Food Guide (CFG) is a recognized education tool that helps Canadians support their health. Over the years, CFG has undergone a series of revisions, each seeking to ensure alignment with the most current evidence on nutrition and health, and making the recommendations applicable to the lives of everyday Canadians (https://www.canada.ca/en/health-canada/services/canada-food-guide/about/...). A new edition of Canada’s Food Guide was unveiled by Health Canada on January 22, 2019, a culmination of years of scientific review and public consultation (https://food-guide.canada.ca/en/).

The updated food guide has undergone significant changes. The new guide acknowledges that healthy eating is “more than the foods we eat” and encourages Canadians to consider how the context in which they eat may influence food choices. The updated food guide is also moving away from the one-document approach to a suite of online resources to better support Canadians. The suite includes recipes and other practical resources.

In terms of healthy eating recommendations, Health Canada has opted for providing a visual representation of a healthy balanced plate (i.e., half a plate of vegetables and fruit, a quarter plate of whole grains, and a quarter plate of protein foods). Part of a healthy pattern is to choose a variety of healthy foods each day. The following healthy eating advice is also offered:

  • Eat plant-based proteins more often;
  • Plan for meals and shop only what you need;
  • Cook more often;
  • Pay attention to internal hunger and fullness cues;
  • Make water the beverage of choice, and limit sugar-sweetened beverages;
  • Eat and enjoy food together with family and friends;
  • Limit foods high in sugar, saturated fat, and salt;
  • Limit processed food.

Additionally, the new food guide provides information about food labels, food marketing, food environments, and environmental sustainability.

A complementary professional guidance document, titled Canada’s Dietary Guidelines (https://food-guide.canada.ca/en/guidelines/) is available for health professionals as well as policy makers. These documents present new opportunities for public health nutrition practice and support many current and future advocacy initiatives, including the reintegration of food skills into the Ontario school curriculum, healthy food procurement policies, and actions to limit marketing to children.

More resources are slated for release later this year to help support the implementation and clarification of the new Food Guide. These include:

  • Canada’s Healthy Eating Pattern for Health Professionals and Policy Makers, which will build on Canada’s Dietary Guidelines and provide specific guidance on amounts and types of food for people across all life stages, such as recommendations for young children and older adults.
  • More online resources, to be expanded on an ongoing basis.
  • Considerations for Indigenous Peoples, which include healthy eating tools tailored to Indigenous Peoples that align with the new Food Guide.

Current Initiatives

Education and Communication for Key Stakeholders

Public health nutritionists and registered dietitians in Healthy Families, Healthy Schools, and Chronic Disease and Injury Prevention have reached out to key stakeholders to disseminate updates and changes, as well as to advocate for policy opportunities. It is also important to note that some nutrition programs are based on guidelines from the 2007 edition of Canada’s Food Guide, such as PPM150 (i.e., The School Food and Beverage Policy Nutrition Guidelines), the Student Nutrition Program Guidelines, as well as Nutrition Guidelines for Childcare Settings (i.e., The Child Care and Early Years Act, 2014).

Education for Staff and the General Public

National Nutrition Month, which happens in March each year, was celebrated by the WECHU with the release of an online challenge titled Building Healthy Habits with Canada’s Food Guide. The online challenge helped to build goal setting skills while also disseminating healthy eating information from Canada’s Food Guide, sharing additional resources and recipes with the general public.  Over 300 individuals registered for the challenge. In addition, WECHU registered dietitians presented various topics from the new Canada’s Food Guide during a total of four Healthy Active Living Segments on AM800 in February and March.

Finally, the CDIP registered dietitian has scheduled meetings with each internal department to disseminate the new Food Guide recommendations.

Nutrition Resources Update

The WECHU resources and webpages are currently undergoing review and updates to ensure that healthy eating messages are not outdated and reflect the new Canada’s Food Guide (e.g., do not mention the previous four food groups).

Advocacy Opportunities

Many opportunities exist in terms of advocacy. For example, a key section of Canada’s Dietary Guidelines promotes healthy food environments that align with Canada’s healthy eating recommendations, especially in publically funded settings such as schools and recreation facilities. Workplaces and other private organizations were also recommended to improve their food environments to make the healthy choice the easy choice. Examples of some aspects of food environment that influence individual choice include: food marketing and advertising, the availability, cost, and strategic placement of food choices, and different ways in which we may interact with food on a daily basis, such as fundraisers at school or meetings at work. Therefore, Canada’s Food Guide has also become an advocacy tool for WECHU to use when promoting healthy food environments in the community.

Canada’s Food Guide also places a major focus on the importance of promoting food skills as a component of food literacy to support lifelong eating habits. Food skills can be taught, learned, and shared in a variety of settings, such as at home and in schools (e.g., integrating cooking skills into the curriculum). This presents another avenue for advocacy for WECHU.

Consultation:

The following individuals contributed to this report:

Heather Nadon, Registered Dietitian, Chronic Disease and Injury Prevention (CDIP)

Approved by:

 Theresa Marentette

 


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Prepared By:

Cathy Bennett, Public Heath Emergency Preparedness Coordinator

Date:

April 1, 2019

Subject:

Distribution of Potassium Iodide (KI) Pills 

Background:

The Windsor-Essex County Health Unit (WECHU), in collaboration with the Community Emergency Management Coordinators, has been working to ensure that all residents within the primary and secondary zone of the Enrico Fermi 2 Nuclear Generating Station are prepared in case of a nuclear emergency.  According to the Canadian Nuclear Safety Commission (CNSC), all nuclear installations must ensure that KI pills are pre-distributed and that pre-distribution includes a public education plan. Since the Enrico Fermi 2 Nuclear Generating Station is not regulated by the CNSC, the responsibility for KI distribution falls on the WECHU, the Municipalities of Windsor and Essex County, and the Ministry of Health and Long Term Care.

The Potassium Iodide (KI) Distribution Plan includes three phases.

Phase one of the plan focused on increasing the basic knowledge of nuclear emergency preparedness in the primary zone residents of Windsor and Essex County (WEC), as well as the distribution of KI Pills to all residential households in the primary zone and on Boblo Island.  Phase one was launched on April 26, 2018 with a media release event, news release, social media campaign, and advertising in the Amherstburg River Town Times. All residential property owners identified as living in the primary zone of Amherstburg and on Boblo Island (approximately 388) received a letter, inviting them to attend information and pick-up session at the Libro Centre in Amherstburg either on May 7th and 8th, 2018. These events were co-hosted by staff from WECHU, and staff from the Amherstburg Fire Department. One hundred and forty-seven KI Pill Kits were distributed at these two sessions. Following consultation with the Amherstburg Fire Department, two additional KI pick-up sessions were scheduled on Saturday, July 21st at Amherst Point, and on Saturday, August 11th at the Boblo Island Ferry Terminal. The Public Health Emergency Preparedness Coordinator and staff from the Amherstburg Fire Department distributed 27 KI Pill Kits at each of these sessions.  Approximately 52% of the identified primary zone residents received their KI Pill Kits at the end of phase one of the KI Distribution Plan.

Phase two of the KI Distribution Plan focuses on the distribution of KI Pills to residents of the secondary zone of WEC who wish to have them in their households. Based on experiences from other jurisdictions, it was anticipated that approximately 10% of the secondary zone households would request KI Pills. The communication campaign began with a media advisory on October 11th, 2018 and a press conference on October 15th, 2018. The campaign included 4 weeks of radio advertising and billboards in the Windsor area, print advertisements in the Windsor Star and Amherstburg River Town Times, Windsor Star on-line, and web information and registration on the WECHU website. The KI Distribution Plan for the secondary zone promoted the completion of an on-line KI Pill request form and the selection of a pick-up date and location by WEC residents.  In consultation with the Community Emergency Management Coordinators (CEMC) of Windsor and Essex County, 23 individual KI Pill Kit pick-up events were scheduled from November 3rd to December 5th at multiple locations across Windsor and Essex County. Venues included recreation centres, fire stations, arenas, municipal offices, civic centers, and the WECHU Windsor office site.  The Public Health Emergency Preparedness Coordinator attended all sessions with the assistance of WECHU clerical staff, the CEMCs and Fire Department staff from multiple municipalities. At the completion of the pick-up sessions, 2748 KI Pill Kits were distributed through this strategy.  Approximately 62% of those who registered for pick-up sessions actually attended their scheduled session; however approximately 500 KI Pill Kits were distributed to “walk-in” residents who had not pre-registered.  Since October, secondary zone residents have also had the option of registering for future KI Pill Kit mail-out if they were unable to attend a KI pick-up session.  Additionally, secondary zone residents have been able to receive registration assistance by submitting emails and/or by calling the KI Hotline to speak with the Emergency Preparedness Coordinator or clerical staff.  

Total # of KI Pill Kits available to WEC residents Phase 1:
# of KI Pill Kits distributed
Phase 2:
# of KI Pill Kits distributed in 23 pick-up sessions
Nov/Dec 2018
Phase 3:
# of KI Pill Kits on Mail Out List January 2019
Total # of residents who have requested KI Pill Kits to date
Total # of residents who have requested KI Pill Kits to date
17,000.00* 201 2748 3600 6549
* minus the KI Pills provided to Chatham-Kent residents       Approximately 39 % of Total KI Pill Kits available

Additionally, three KI pill kit pick-up sessions were held for the WECHU staff at the Windsor, Essex and Leamington Office locations in February.

Phase two also aims to stock KI Pills (stock bottles) in the schools within the Town of Amherstburg and work with the schoolboards (Public, Catholic, and French) to create policies around KI administration to students in the event of an emergency.

Phase three of the KI Pill Distribution Plan will be focused on the sustainability of the KI Program, including the replacement of pills prior to the expiration date, and the promotion of basic knowledge of nuclear emergency preparedness for WEC residents.

Current Initiatives

Current plans include the preparation for mail out of the KI Pill Kit packages to approximately 3600 WEC residents who have submitted their on-line requests. This group includes those who were unable to attend the pick-up sessions in November and December and/or submitted their request for a future mail out option. Since the KI Pills are sensitive to temperature and must be stored between 15 to 30 degrees Celsius, this mail out is scheduled for the spring of 2019.

A second round of communication campaign began in February/March 2019 that focussed on the target population of younger families with children. Communication strategies included social media, digital, and targeted print advertisements promoting the submission of on-line requests for the KI Pill Kits for mail out.

The list of the current numbers of first responders for emergency services in Windsor and Essex County has been updated to determine the volume of KI Pill Stock bottles required in the event of a nuclear incident. This list includes: fire department staff in 8 municipalities, police services, Ontario Provincial Police in Essex County, Emergency Medical Services for Windsor and Essex County, and the Canadian Coast Guard. Estimates of the required amount of KI Pills to stockpile for evacuation centers has also been determined based on an estimate of 10% of the population of Amherstburg.

There is continued consultation and communication with the CEMC group as the KI Pill Distribution Plan continues in 2019. There is opportunity for further collaboration with municipalities in the distribution of KI Pills at municipal centers.

Windsor and Essex County school board representatives will be contacted by the Public Health Emergency Preparedness Coordinator to request individual meetings to discuss the process of providing stockpiles of Potassium Iodide Pills for four Amherstburg schools:  Amherstburg Public, Stella Marais, Ste. Jean Baptiste, and General Amherst High School. An initial presentation regarding the proposed plan for the distribution of Potassium Iodide (KI) Pills in the Amherstburg school setting was completed at the August 23, 2018 WECHU/School Board Liaison Meeting.

WECHU has committed to provide the Chatham-Kent Public Health Unit with sufficient KI Pills to support distribution to 10% of the Chatham-Kent households identified as being within the secondary zone.

Consultation:

The following individuals contributed to this report:

Dr. Wajid Ahmed, Medical Officer of Health

Approved by:

 Theresa Marentette


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Board Members Present:

Joe Bachetti, Tracey Bailey, Dr. Ken Blanchette, Judy Lund, Gary McNamara, John Scott, Ed Sleiman, Larry Snively, Michelle Watters, Rino Bortolin, Fabio Costante

Board Member Regrets:

Dr. Deborah Kane, Dr. Carlin Miller

Administration Present:

Dr. Wajid Ahmed, Nicole Dupuis, Lorie Gregg, Theresa Marentette, Kristy McBeth, Dan Sibley, Lee Anne Damphouse

Invited Guest Present:

Mr. J.P. Karam, Willis Law, WECHU Legal Representative

QUORUM:  Confirmed


  1. Call to Order
    Board Chair, Gary McNamara, called the meeting to order at 4:04 p.m.  Gary McNamara introduced invited guest, Mr. J. P. Karam, WECHU legal representative from Willis Law.
  2. Agenda Approval
    It was moved
    That the agenda be approved. - CARRIED
  3. Announcement of Conflicts of Interest – None.
  4. Board Elections
    1. Joint Board Extension Committee
      Nominations for Chair
      G. McNamara relinquished the Chair to T. Marentette, Board Secretary, to begin the election process. T. Marentette opened the floor for nominations for the position of Chair noting that Administration had received one (1) written nomination for Gary McNamara.  Board member Ed Sleiman nominated Gary McNamara for the position of Board Chair. T. Marentette 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
      T. Marentette relinquished the Chair to Chair Elect, G. McNamara.  The Chair opened the floor for nominations for the position of Vice-Chair noting that Administration had received one (1) written nomination for Dr. Ken Blanchette.  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.  Dr. K. Blanchette, 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 one (1) written nomination for John Scott.  The Chair asked for further nominations from the floor (three times). Given that there were no further nominations, nominations for the position of Treasurer were closed. J. Scott, having accepted the nomination, was appointed Treasurer by acclamation.
      4:09 pm – Councillors Rino Bortolin and Fabio Costante arrived during the nomination process

    2. Audit Committee
      The chair opened the floor for nominations for the position of Audit Committee Member.  Board member Larry Snively nominated Tracey Bailey.  The nomination was seconded by Dr. K. Blanchette.  The Chair asked for further nominations from the floor (three times).  Given that there were no further nominations, nominations for the position of Audit Committee Member were closed.  T. Bailey, having accepted the nomination, was appointed to the Audit Committee.
    3. Project Governance Committee
      The Project Governance Committee (PGC) is comprised of 2 representatives from each the City, the County and the Province. There are currently 2 openings for city representation, 1 opening for county representation and 1 opening for provincial representation.  The Chair opened the floor for positions on the PGC.
      City of Windsor Representation
      Board member Ed Sleiman nominated Fabio Costante to represent the City of Windsor. The nomination was seconded by J. Scott.  Board member Joe Bachetti nominated Rino Bortolin to represent the City of Windsor.  The nomination was seconded by Dr. K. Blanchette.  The Chair asked for further nominations from the floor (three times). Given that there were no further nominations, nominations for City representation on the PGC were closed.  Fabio Costante, having accepted the nomination, was appointed as a representative for the City of Windsor to the Project Governance Committee.  Rino Bortolin, having accepted the nomination, was appointed as a representative for the City of Windsor to the Project Governance Committee.

      County of Essex Representation
      Board member Tracey Bailey nominated Joe Bachetti to represent the County of Essex.  The nomination was seconded by Dr. K. Blanchette.  The Chair asked for further nominations from the floor (three times). Given that there were no further nominations, nominations for County representation on the PGC were closed.  Joe Bachetti, having accepted the nomination, was appointed as a representative for the County of Essex to the Project Governance Committee.

      Provincial Representation
      Board member Dr. K. Blanchette nominated Judy Lund to represent the Province.  The nomination was seconded by J. Scott.  The Chair asked for further nominations from the floor (three times). Given that there were no further nominations, nominations for Provincial representation on the PGC were closed.  Judy Lund, having accepted the nomination, was appointed as a representative for the Province to the Project Governance Committee.

  5. Approval of Minutes
    1. Regular Board Meeting: February 28, 2019
      It was moved
      That the minutes be approved. - CARRIED
  6. Consent Agenda
    1. INFORMATION REPORTS
      The following information reports were presented to the Board.
      1. KI Distribution
      2. 2018 Strategic Plan Year End Report
      3. The New Canada’s Food Guide
      4. Media Recap – February/March 2019
        It was moved
        That the information reports be received. - CARRIED
    2. RECOMMENDATION/RESOLUTION REPORTS
      1. Consumption and Treatment Services Application
        The following Recommendation/Resolution Report was brought forward to the Board for support and approval:
        It was moved
        That the Recommendation/Resolution report be supported and approved and that the WECHU take the lead role, with key community partners, in facilitating the completion of the Application for CTS in Windsor-Essex - CARRIED
  7. Business Arising – None
  8. Board Correspondence – Circulated
  9. New Business
    1. CEO Quarterly Report (January – March 2019)
      T. Marentette made note to the reference of the labour disruption in the report.
      It was moved
      That the report be received - CARRIED
    2. 2019 alPHa Fitness Challenge
      T. Marentette referenced the 2019 alPHa fitness challenge for Boards of Health.  WECHU participated last year with a 30 minute walk prior to the board meeting, and we would be happy to coordinate another walk prior to the May board meeting if everyone agrees. One member suggested riding your bike was another option.
    3. alPHa AGM (June 9-11, 2019)
      T. Marentette provided information to Board of Health members regarding the alPHa Conference and AGM in June.  If any board members wish to attend please see L. Damphouse for registration and list of eligibility.
  10. Other Board of Health Resolutions/Letters – For Support
    1. Peterborough Public Health – For Support (Vaping Products)
      Smoke-Free Ontario Act – Letter to Hon. Christine Elliott
    2. Southwestern Public Health Unit – For Support (Vision Screening)
      Child Visual Health and Vision Screening Protocol – Letter to Hon. Christine Elliott
      It was moved
      That the above correspondence be supported. - CARRIED
  11. Appendices
    1. Appendix A – 2018 Strategic Plan Year End Report
      The above report was reviewed in conjunction with information report 6.1.2.
  12. Committee of the Whole (CLOSED SESSION, in accordance with Section 239 of the Municipal Act)
    It was moved
    That the Board move into Committee of the Whole at 4:13 p.m. - CARRIED
    It was moved
    That the Board move out of Committee of the Whole at 5:19 p.m. - CARRIED
  13. Next Meeting: At the Call of the Chair, or May 16, 2019 in Windsor, Ontario
  14. Adjournment
    The meeting adjourned at 5:58 pm.

RECORDING SECRETARY:

SUBMITTED BY:

APPROVED BY:


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April 1, 2019

Issue

Increasing rates of opioid overdose across Canada have prompted action at all levels of government.  In addition to the broad increases in opioid-related emergency department (ED) visits, hospitalizations, and deaths noted at the provincial level (Ontario Agency for Health Protection and Promotion (Public Health Ontario), 2017), a recent report identified Windsor-Essex having an increased burden of opioid-related harms (Windsor-Essex County Health Unit, 2017) relative to other regions in Ontario. 

In October 2018, after a provincial review of existing Supervised Consumption Services (SCS) and Overdose Prevention Sites (OPS), the Government of Ontario announced its commitment to fund a re-purposed version of the Consumption and Treatment Services (CTS) program. The CTS program supports local organizations to address physical and mental health as well as social needs of people addicted to opioids and other drugs. In December 2018, organizations and communities considering a CTS who did not currently have one were encouraged to submit an application well in advance of April 2019.  In order to apply, organizations need to ensure the provision of treatment and rehabilitation services, and offer connections to health and social services, including primary care, mental health supports, housing, and employment. Before and after each site is selected, community consultations are needed to ensure the voices of residents are heard. Applying organizations must also have a plan in place to ensure community concerns are addressed on an ongoing basis.

An opportunity exists to address opioid overdoses in Windsor-Essex with strategies driven by community need and a community focused approach to overdose prevention and harm reduction. The process of assessing local need for CTS, collaboratively developing an application, and supporting the implementation, operation, and evaluation of CTS requires an organization with a broad understanding of and connection to local need, to take a lead role in the successful completion and submission of an application for CTS.

Background

The rate of opioid use in Windsor-Essex is the 7th highest in the province. Opioid-related emergency department visits have increased by 3.6 times since 2003. Opioid related deaths in the City of Windsor are significantly greater than the rest of the county, with 19 out of 24 deaths county-wide occurring in the City in 2015.  Based on the morbidity and mortality data in this region, the burden of illness for opioid misuse is disproportionately greater among the working-age (20-64 years-old) population (primarily males) in the City of Windsor (Windsor-Essex County Health Unit, 2017).

There are also significant public health concerns related to needle sharing and public injection and discarding of needles. The number of hepatitis C cases, a blood-borne infection, increased from 143 reported cases in 2016 to 181 reported cases in 20176. In 2017, 62% (101 cases) of the 164 confirmed hepatitis C cases that reported at least one risk factor other than unknown, reported injection drug use7. There have been 167 documented needle-related calls from January 1, 2014 to February 5, 2018 to local municipal services (3-1-1), predominantly in downtown Windsor8. The number of needle-related calls have significantly increased, from 43 in 2016 to 121 in 20178.

In December of 2016, the Windsor-Essex Community Opioid Strategy Leadership Committee (WECOSS-LC) was formed, bringing together leadership and key stakeholders across many sectors to collectively address rising rates of opioid use in Windsor and Essex County. The WECOSS-LC is committed to the ongoing development and implementation of the Windsor-Essex Community Opioid Strategy. As part of this strategy, community organizations are having conversations about consumption and treatment services including a safe injection site (SIS). As a result, in October 2018, the Windsor-Essex County Health Unit (WECHU) launched a community consultation regarding SIS. The goal of the consultation is to assess the need and acceptability of SIS in WEC.

Proposed Motion

Whereas, the Government of Ontario announced its funding commitment and endorsement of Consumption and Treatment Services in October 2018, and

Whereas, Windsor and Essex County is experiencing significant public health concerns related to the use of opioids and other substance use, including illnesses, deaths, blood borne infections, and public discarding of used needles, and

Whereas, Consumption and Treatment Services have the potential to address such public health issues, in addition to reducing health care costs.

Whereas, the Windsor-Essex County Health Unit’s (WECHU) lead role in the Windsor-Essex Community Opioid Strategy and understanding of harm-reduction services in the community, creates an opportunity for the WECHU to lead the successful completion of a comprehensive and collaborative application for Consumption and Treatment Services in our community.

Now therefore be it resolved that the Windsor-Essex County Board of Health supports ongoing public health led assessment of the need for and feasibility of Consumption and Treatment Services, and.

FURTHER THAT, should Consumption and Treatment Services be identified as a local need, as a result of such assessments, that, the Windsor-Essex County Health Unit,  take a lead role to facilitate the completion of an application, in collaboration with key community partners and stakeholders, to the provincial government for Consumption and Treatment Services in Windsor-Essex.


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February 28, 2019

Flu Vaccines will be available for Board of Health members from 3:30 pm – 4:00 pm

  1. Call to Order
  2. Agenda Approval
  3. Announcement of Conflict of Interest
  4. Presentation: Radon (P. Wong and K. Lukic)
  5. Approval of Minutes
    1. Regular Board Meeting: January 17, 2019
  6. Consent Agenda
    1. INFORMATION REPORTS
      1. Disclosure Requirements Update
      2. Living Wage
      3. Nutritious Food Basket
      4. Influenza Update
      5. Media Recap
    2. RESOLUTION/RECOMMENDATION REPORTS
      1. Radon
      2. Children Count Task Force
  7. Business Arising
  8. Board Correspondence – Circulated
  9. New Business
  10. Other Board of Health Resolutions/Letters – For Support
    1. Peterborough Public Health – Opioid Crisis – Letter to Hon. Premier Doug Ford – For Support
    2. Provincial Oral Health Program for Low-Income Adults and Seniors – For Support:
  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 or March 21, 2019 (Board of Health Retreat) - Windsor
  13. Adjournment

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Prepared By:

Phil Wong, Manager, Environmental Health Department

Date:

January 23, 2019

Subject:

Disclosure Requirement UPDATE

Background

Since 2009, the Safe Food Counts disclosure program has provided the public access to online inspection reports for all food premises in the City of Windsor and Essex County. In addition to online reports, signage called Star Signs were distributed and displayed on site to direct the public to www.safefoodcounts.ca for further details on reports. Although all food premises inspected received Star Signs during each compliance inspection, not every municipality had by-laws in place to require posting.

In 2018, amendments were made to regulations under the Health Protection and Promotion Act, which made disclosure signage mandatory for a number of inspected facilities such as food premises, personal service settings and recreational water facilities. Public Health Inspectors enforce the new requirements across the province of Ontario. Furthermore, amendments made in 2018 to the Ontario Public Health Standards: Requirements for Programs, Services, and Accountability 2018 (OPHS) made it mandatory for local boards of health to have online disclosure of inspection reports and enforcement activity for the following provincial protocols:

  • Food Safety Protocol, 2018;
  • Health Hazard Response Protocol, 2018;
  • Infection Prevention and Control Complaint Protocol, 2018;
  • Infection Prevention and Control Disclosure Protocol, 2018;
  • Infection Prevention and Control Protocol, 2018;
  • Recreational Water Protocol, 2018;
  • Safe Drinking Water and Fluoride Monitoring Protocol, 2018;
  • Tanning Beds Protocol, 2018;
  • Tobacco Protocol, 2018;
  • Electronic Cigarettes Protocol, 2018.

Current Initiatives

In February 2019, the Windsor Essex County Health Unit (WECHU) will be launching the new disclosure website www.wechu.org/inspections. The new website will replace the Safe Food Counts website and contain inspection reports and enforcement activity for a variety of inspected facilities. Some of these include but are not limited to,

  • Food Premises (restaurants, take-out, fast food, cafeterias, bakeries etc.)
  • Personal Service Settings (ex. tanning, hair, tattoo and nail salons etc.)
  • Licensed Child Care Centres
  • Public Pools, Spas and Splash Pads
  • Campgrounds
  • Small Drinking Water Systems
  • Legal Activity (ex. orders, closures, tickets and advisories)

The Environmental Health Department will continue to disclose the following on the WECHU website:

  • Infection Prevention and Control (IPAC) Lapses in clinics, non-regulated and personal service settings;
  • Outbreaks in Long-term Care Homes and Nursing Homes;
  • Interactive Public Beach Map and Water Results;
  • Food and Product Recalls;
  • Extreme Weather Alerts.

The online disclosure program promotes transparency of inspection reports and allows the public to make informed decisions when visiting inspected facilities in the City of Windsor and Essex County.

Approved by:

 Theresa Marentette, CEO

 


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