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October 18, 2018

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. Approval of Minutes
    1. Regular Board Meeting:  September 20, 2018
  5. Consent Agenda
    1. INFORMATION REPORTS:
      1. Budget – Recommendation Report  (L. Gregg)
        • Resolution Recommendation
      1. Cannabis – Recommendation Report (N. Dupuis)
        • Resolution Recommendation
      1. Vote for Health Survey Results (T. Marentette)
      2. Community Partners List 2018 (T. Marentette)
      3. September Media Relations Recap (K. McBeth)
  6. Business Arising
    1. PGC Capital Project Update (T. Marentette)
  7. Board Correspondence – Circulated
  8. New Business
    1. Staff Appreciation (D. Sibley)
  9. Other Board of Health Resolutions/Letters – For Support/Information
    1. Smoke-Free Ontario Act – For Support
      1. alPHa – Letter to Laura Pisko, MOHLTC
      2. Peterborough Public Health – Letter to Hon. Christine Elliott
    2. Ontario’s Basic Income Pilot – For Support/Information
      1. Windsor-Essex County Health Unit – For Information – Letter to Hon. Lisa McLeod
      2. Southwestern Public Health – For Support – Letter to Hon. Lisa McLeod
    3. Why Ontario Needs a Chronic Disease Prevention Strategy – For Support
      1. Kingston, Frontenac and Lennox & Addington Public Health – Letter to Hon. Christine Elliott
    4. Drug Policy – For Support
      1. Kingston, Frontenac and Lennox & Addington Public Health – Letter to Right Hon. Justin Trudeau
    5. Repeal of Section 43 of the Criminal Code of Canada – For Support
      1. Southwestern Public Health – Letter to Hon. Jody Wilson-Raybould
    6. Dedicated Funding for Local Public Health Agencies – Cannabis Sales – For Support
      1. Middlesex-London Health Unit – Letter to Premier Doug Ford
    7. Displays and Promotion of Vaping Products in Convenience Stores and Gas Bars – For Information
      1. Ontario Campaign for Action on Tobacco (OCAT) – Media Release
  10. Committee of the Whole (Closed Session in accordance with Section 239 of the Municipal Act) 77
  11. Next Meeting: At the Call of the Chair, or November 15, 2018 –  Windsor
  12. Adjournment

View Document page

Prepared By:

Communications Department

Date:

October 1, 2018

Subject:

September Media Relations Recap Report

August Media Coverage

Total Media Coverage

45

Interview Requests

21

Mentions (In the news without direct interviews)

24

September 2018 Media Relations Recap - Media Coverage

Story Source

September 2018 Media Relations Recap - Story Source

Media Coverage

Outlet

Number of Stories

AM 800

8

Blackburn

11

CBC

7

CBC – Radio Canada

1

CTV

7

St. Clair College

1

Windsor Star

5

windsorite.ca

5

TOTAL

45

News Release and Media Advisories

Date Type Headline Response

September 4, 2018

Heat Warning

Windsor-Essex County Health Unit Issues Extended Heat Warning

2 Stories Reported

September 5, 2018

News Release

Vote for Health: Municipal Candidates Asked to Share Their Views on Local Health Issues

1 Story Reported

September 14, 2018

News Release

Death Related to West Nile Virus Confirmed

5 Stories Reported

September 18, 2018

Media Advisory

Windsor-Essex County Health Unit Board of Health Meeting

3 Stories Reported

September 19, 2018

News Release

Students in Senior Kindergarten to Grade 5 with Incomplete Immunization Records Suspended from School Today

9 Stories Reported

September 20, 2018

News Release

Register for the Screen-Free Meal Time Challenge today!

0 Stories Reported

September 21, 2018

News Release

Windsor-Essex County Health Unit Board of Health Confirms Selection of New Medical Officer of Health and Chief Executive Officer

3 Stories Reported

September 24, 2018

News Release

Windsor-Essex Joins World Rabies Day Activities By Offering Low-Cost Rabies Vaccine Clinics

3 Stories Reported

Stories Reported by the Media

AM 800

Publish Date

Title

September 10, 2018

Health Unit Looks For Feedback From Municipal Candidates

September 14, 2018

Windsor-Essex Resident Dies Of The West Nile Virus

September 18, 2018

Lynn Martin - 10AM – Immunization Deadline In Windsor

September 19, 2018

Parents Pack Health Unit To Update Immunization

September 24, 2018

A New Medical Officer Of Health For Windsor-Essex

September 25, 2018

Questions Remain Ahead of Pot Legalization

Note: Two requests from AM 800 do not have a reported story. The station chose not to broadcast the stories.

Blackburn News

Publish Date

Title

September 2, 2018

No swimming recommended at three local beaches this week

September 4, 2018

Stifling heat prompts extended heat warning

September 10, 2018

Suicide Awareness Raised In Windsor-Essex

September 12, 2018

No Swimming At Four Recommended At Four Local Beaches This Week

September 14, 2018

West Nile virus claims local victim

September 14, 2018

Hep A Scare In Michigan Prompts Vaccination Clinic In Windsor

September 14, 2018

Walk Promotes Suicide Prevention One Step At A Time

September 19, 2018

School Suspensions Start Today For Kids Who Are Not Vaccinated

September 20, 2018

Health Unit Seeks To Clear The Air On Weed Guidelines

September 23, 2018

Health Unit Make Top Executive Positions Permanent

September 25, 2018

Veterinarians Offer Low Cost Rabies Vaccine Clinics

CBC News

Publish Date

Title

September 4, 2018

Windsor's heat warning extended to Wednesday

September 10, 2018

Mosquito Trap Tests Positive For West Nile Virus In Chatham-Kent

September 17, 2018

Meet The People Running For Council In Windsor

September 21, 2018

Swimmers Beware, More Warnings For West Belle River Beach Than Others

September 19, 2018

578 Students In Windsor-Essex Suspended Due To Incomplete Immunization Records

September 21, 2018

8 Opioid-Related Deaths In Windsor-Essex January To March This Year

Note: We were unable to conduct an interview for one of the requests from CBC.

CBC - Radio Canada (French)

Publish Date

Title

September 19, 2018

Vaccination : près de 600 élèves suspendus dans Windsor-Essex

CTV News

Publish Date

Title

September 13, 2018

Time running out for parents to update immunization records

September 14, 2018

Windsor-Essex County Health Unit Confirms Death Related To West Nile Virus

September 14, 2018

Mosquitoes From Chatham-Kent Trap Test Positive For West Nile Virus

September 19, 2018

Over 500 Windsor-Essex Students Suspended Due To Incomplete Immunization Records

September 21, 2018

More Questions Than Answers About Legalized Marijuana

September 24, 2018

Used Needle Found By Students At Windsor School

September 28, 2018

Some Windsor-Essex Vets Offering Low-Cost Rabies Vaccine Clinics

Windsor Star

Publish Date Title

September 16, 2018

First Local West Nile Death Of The Year Confirmed

September 19, 2018

Hundreds Of Students Suspended For Incomplete Immunization Records

September 20, 2018

Students Discover Discarded Syringe In Schoolyard

September 24, 2018

$30 Rabies Shots Available For Dogs, Cats On World Rabies Day

Note: We were unable to comment on one interview request since it was outside the scope of public health.

Windsorite.ca

Publish Date Title

September 13, 2018

Final Weekend Beach Report: Swimming Not Recommended Four Local Beaches

September 14, 2018

One Person Dies From West Nile Virus

September 14, 2018

Health Unit Holding Hepatitis A Vaccination Clinic For Those Who Attended The Michigan Renaissance Festival

September 19, 2018

Over 500 Students Suspended For Incomplete Immunization Records

September 21, 2018

News Medical Officer Of Health And Chief Executive Officer Chosen To Lead Health Unit

Note: The request from St. Clair College will not appear in their student media channels until October.

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


View Document page

On an annual basis, the WECHU prepares its operating budgets for review and approval by its Board.  The budget approval then becomes the foundation for the Annual Service Plan and Budget Submissions to the MOHLTC and MCYS. The due date for the 2019 Annual Service Plan and Budget Submission to the MOHLTC is March 1, 2019. The due date for the Budget Submission to MCYS is April 30, 2019.

Should you require this report in an alternative format, please contact the Health Unit.

2019 Budget Report - PDF (PDF)
View Document page

Background

On September 5th, the Windsor Essex County Health Unit (WECHU) distributed a voluntary survey to all local council and mayoral candidates running in the 2018 municipal election. The survey asked candidates how they would prioritize their efforts based on seven local public health priority areas. These areas included: dental health, substance misuse, food insecurity, mental illness, built environment, and climate change. These priority areas were identified based on local data, results from the WECHU’s 2016 Community Needs Assessment, and the Association of Local Public Health Agencies’ (alPHa) Municipal Election Policy Priorities document. This approach was adapted with permission from the Simcoe Muskoka District Health Unit, and was modified to address locally relevant issues. The results of the survey were posted on the WECHU’s website on October 5th.

Demographics

The survey was sent to all 174 mayoral and councillor candidates from Amherstburg, Essex, Kingsville, Lakeshore, Lasalle, Leamington, Tecumseh, and Windsor. In total, 50% (87) of the candidates completed the survey. There were more respondents from Essex County than the City of Windsor.

Table 1: Respondents by position

Position

# of candidates

# of respondents

Mayor

19

8 (42%)

Deputy Mayor

16

11 (69%)

Councillor

139

68 (49%)

Total

174

87 (50%)

Table 2: Respondents by municipality

Municipality

# of candidates

# of respondents

Amherstburg

20

11 (55%)

Essex

19

8 (42%)

Kingsville

17

12 (71%)

Lakeshore

25

14 (56%)

Lasalle

12

5 (42%)

Leamington

19

10 (53%)

Tecumseh

12

9 (75%)

Windsor

50

18 (36%)

Total

174

87

Resource Allocation

Candidates were asked how they would spend $100 on the identified local public health issues. They were told that their answers should reflect the amount of time and resources they would give to each topic in their community.

All candidates that completed the survey said that they would allocate resources towards mental illness. On average, candidates provided 25% of their resources to mental health in the community (in relation to the other six public health issue areas). The second highest allocation was towards substance misuse in the community; on average candidates provided 16% of their resources to the issue.

Table 3: Average dollar amount per health issue

Health Topic

$

Mental illness

25.49

Substance misuse

16.21

Built environment

13.76

Food insecurity

13.28

Health inequity

13.14

Dental health

9.55

Climate change

8.57

Vote for Health - Total dollar amount per health issue

Candidate Actions

When candidates gave resources to one of the local public health issues, they were then able to select actions they might take. These actions are evidence-supported ways to address the local public health issues.

  • Mental illness had the two highest actions selected; where 89% of candidates said they would advocate for funding for low-or no-cost mental health care to increase local access to treatment, and 87% would support training for first responders and front-line service providers to help people living with mental illness.
  • Food insecurity had the third highest selected action; where 84% of candidates said that they would support local programs, such as farmer’s markets, community gardens, and community kitchens. However, overall food insecurity had the fourth lowest average dollar amount ($13.28) allocated.
  • Putting fluoride into community water was the least selected by respondents.
  • Substance misuse had the second and third lowest selected action; about 28% of respondents supported local efforts to investigate the feasibility of safe injection sites, and 38% supported increasing the availability of naloxone and needle disposal bins in the community.

Actions selected by health topic

Table 4.1 Dental Health

Action

Yes

No

Put fluoride into the water in your community.

8.05%

91.95%

Increase support for dental health education and awareness.

59.77%

40.23%

Advocate for increased funding for dental health services and expansion of public dental programs.

63.22%

36.78%

Advocate for a provincially-funded dental health program for low income adults and seniors.

67.82%

32.18%

Table 4.2. Substance Misuse

Action

Yes

No

Advocate for sustained resources to address the rising rates of substance misuse.

73.56%

26.44%

Support local efforts to investigate the feasibility of safe injection sites.

27.59%

72.41%

Increase availability of naloxone and needle disposal bins in your community.

37.93%

62.07%

Advocate for increased timely access to treatment services and supportive housing for people struggling with addiction.

77.01%

22.99%

Table 4.3. Food Insecurity

Action

Yes

No

Implement, promote, and support the Living Wage program.

43.68%

56.32%

Support local programs, such as farmer’s markets, community gardens, and community kitchens.

83.91%

16.09%

Participate in the Windsor-Essex Food Policy Council to help shape a sustainable and healthy food system.

65.52%

34.38%

Implement a local food procurement policy for all municipally run facilities (e.g., recreation centres, day cares, etc.)

50.57%

49.43%

Table 4.4. Climate Change

Action

Yes

No

Advocate for ways to improve local air quality (e.g., anti-idling policies).

59.77%

40.23%

Provide support and resources to develop response plans for extreme weather events.

58.62%

41.38%

Prevent diseases such as Zika Virus, Lyme Disease, and West Nile Virus by allocating more funding and support for surveillance and education.

50.57%

49.43%

Advocate for increased education and support to protect our public beaches, preventing beach closures, as well as blue green algae.

65.52%

34.48%

Table 4.5. Mental Illness

Action

Yes

No

Advocate for funding for low- or no-cost mental health care, to increase local access to treatment.

88.51%

11.49%

Support training for first responders and front-line service providers to effectively help people living with mental illness.

87.36%

12.64%

Support local mental health awareness campaigns.

81.61%

18.39%

Table 4.6: Built Environment

Action

Yes

No

Advocate for investments in active transportation infrastructure (e.g., bike trails, walking paths, sidewalks) and public transit.

79.31%

20.69%

Support by-laws, policies, and planning that encourages healthy design characteristics (e.g., safe bike lanes, lighting, green space, parks, walkability).

71.26%

28.74%

Enhance neighborhood walkability by supporting higher residential density and mixed land use.

50.57%

49.43%

Advocate for increased natural and built shade structures.

58.62%

41.38%

Table 4.7: Health Inequity

Action

Yes

No

Ensure there is a wide range of safe and affordable housing options, including rental accommodations.

68.97%

31.03%

Expand opportunities for residents to gain safe and secure jobs with fair pay.

63.22%

36.78%

Increase access to affordable community and recreation programming.

64.37%

35.63%

Support the development and expansion of municipal social investment plans and poverty reduction strategies.

65.52%

34.48%

Table 5: Actions selected by percentage

Action

Selected

Advocate for funding of low- or no-cost mental health care, to increase local access to treatment.

88.51%

Support training for first responders and front-line service providers to effectively help people living with mental illness.

87.36%

Support local programs, such as farmer’s markets, community gardens, and community kitchens.

83.91%

Support local mental health awareness campaigns.

81.61%

Advocate for investments in active transportation infrastructure (e.g., bike trails, walking paths, sidewalks) and public transit.

79.31%

Advocate for increased timely access to treatment services and supportive housing for people struggling with addiction.

77.01%

Advocate for sustained resources to address the rising rates of substance misuse.

73.56%

Support by-laws, policies, and planning that encourages healthy design characteristics (e.g., safe bike lanes, lighting, green space, parks, walkability).

71.26%

Ensure there is a wide range of safe and affordable housing options, including rental accommodations.

68.97%

Advocate for a provincially-funded dental health program for low income adults and seniors.

67.82%

Participate in the Windsor-Essex Food Policy Council to help shape a sustainable and healthy food system.

65.52%

Advocate for increased education and support to protect our public beaches, preventing beach closures, as well as blue green algae.

65.52%

Support the development and expansion of municipal social investment plans and poverty reduction strategies.

65.52%

Increase access to affordable community and recreation programming.

64.37%

Advocate for increased funding for dental health services and expansion of public dental programs.

63.22%

Expand opportunities for residents to gain safe and secure jobs with fair pay.

63.22%

Increase support for dental health education and awareness.

59.77%

Advocate for ways to improve local air quality (e.g., anti-idling policies).

59.77%

Provide support and resources to develop response plans for extreme weather events.

58.62%

Advocate for increased natural and built shade structures.

58.62%

Implement a local food procurement policy for all municipally run facilities (e.g., recreation centres, day cares, etc.)

50.57%

Prevent diseases such as Zika Virus, Lyme Disease, and West Nile Virus by allocating more funding and support for surveillance and education.

50.57%

Enhance neighborhood walkability by supporting higher residential density and mixed land use.

50.57%

Implement, promote, and support the Living Wage program.

43.68%

Increase availability of naloxone and needle disposal bins in your community.

37.93%

Support local efforts to investigate the feasibility of safe injection sites.

27.59%

Put fluoride into the water in your community.

8.05%


View Document page

Prepared By:

Melissa Valentik, Health Promotion Specialist

Eric Nadalin, Manager, Chronic Disease and Injury Prevention

Date:

October 5, 2018

Subject:

Non-Medical Cannabis Legalization

Background

Cannabis is currently the most commonly used illegal substance in Canada (CCSA, 2017). Approximately 15.7% of Ontario residents self-reported cannabis use within 12 months (CAMH, 2016).  In Windsor and Essex County, approximately 28, 900 residents used cannabis in the last year. Among those who consume cannabis, rates are highest among youth and young adults (WECHU, 2016). With legalization of cannabis, effective October 17, it is anticipated that the number of residents that report using cannabis will rise given the social acceptability of cannabis use.

Although cannabis smoke contains similar toxins to those found in tobacco smoke including those that are associated with cancer, as well as heart and respiratory disease, the harms of cannabis consumption extend beyond those directly associated with long-term chronic disease. Increased rates of injury or harms associated with impaired driving, falls or general impairment, damage to cognitive functioning (i.e., memory, focus, ability to think and learn), depression, anxiety, psychosis, and addiction are all associated with cannabis use. These harms increase when cannabis use begins prior to the age of 25, as well as 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).

The process leading toward legalization began In December 2015, when 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. The federal Cannabis Act contains the following baseline regulations:

  • restricts youth access to cannabis by prohibiting sale or supply to anyone under the age of 18;
  • applies a personal possession limit of no more than 30g;
  • limits personal cultivation to a maximum of four plants per household;
  • prohibits packaging or labelling which makes cannabis products appealing to youth;
  • requires standardized serving sizes and potency, and
  • allows for only certain cannabis products to be offered for sale (i.e., dried cannabis, oils, and seeds), with others to be permitted at a later date (i.e., edibles).

In anticipation of further provincial regulation, the Windsor-Essex Board of Health passed a second resolution which aimed to better position municipalities to prepare in the context of federal and provincial regulation. This resolution, passed in October 2017, provided Windsor-Essex County Health Unit (WECHU) the mandate to prepare and protect our community from potential harms of cannabis legalization by:

  1. Encouraging Windsor-Essex municipalities to develop strict licensing, planning, and zoning regulations,
  2. Working with enforcement agencies and municipalities to support smoking prohibitions, and
  3. Promoting Canada’s Lower-Risk Cannabis Use Guidelines to reduce harms of cannabis use.

Building on the foundation of regulations provided by the federal government, the Province of Ontario passed the provincial Cannabis Act on December 12, 2017 to further refine the legal sale and use of cannabis in Ontario by applying the following broad set of controls:

  • restricts sale, purchase, possession, and sharing of cannabis to age 19 or older (consistent with the minimum age for obtaining alcohol); and
  • allows for the purchase and possession of up to 30 grams (about one ounce) of dried cannabis at one time;
  • permits the smoking and vaping of cannabis anywhere the smoking of tobacco is permitted; and
  • allows for the growth of up to four plants per household for personal use.

Recently, the provincial government released its plan for retail sale of cannabis in Ontario. The provincially controlled Ontario Cannabis Retail Corporation (OCRC) will be the exclusive online retailer of cannabis in Ontario as well as the exclusive wholesaler of cannabis products to private retailers across the province. Online sale will be the only legal means through which consumers will be able to access cannabis in Ontario as of October 17th, with retail storefronts to be permitted beginning in April 2019. The licensing and enforcement of regulations for private retail businesses will be the responsibility of the Alcohol and Gaming Commission of Ontario (AGCO) and currently, there is no plan to set a cap on the number of licenses that will be issued in a particular area or municipality. Municipalities have the opportunity to “OPT OUT” of permitting cannabis retail outlets in their communities with a deadline of January 22nd, 2019 to submit this decision. Store authorizations will be permitted in areas that do not opt out, but each application will be subject to a 15-day consultation period for public to input to be considered by the AGCO in granting an authorization for a given location. In addition, the proposed legislation currently leaves no room for municipal control in the form of licensing or zoning for retail storefronts which would allow municipalities to determine appropriate areas for locations based on the unique needs of their municipalities.

Under the proposed provincial retail model, private retailers would be licensed to operate by the Alcohol and Gaming Commission of Ontario (AGCO), which will issue a Retail Operator License, a Retail Store Authorization, and Cannabis Retail Manager Licence to authorized individuals. The AGCO will conduct compliance and audit processes, including store inspection prior to opening. The proposed provincial legislation would also establish due diligence requirements and specific eligibility criteria for the issuance of licenses and involve a public consultation process for each retail establishment. Store operating parameters are set to be established by regulations prior to the AGCO receiving applications for licenses beginning at the end of 2018. The proposed legislation also proposes distance buffers between retail storefronts and schools, which would also be set through regulation.

There are clear areas for intervention from a public health perspective, which would decrease harms associated with this new framework for cannabis sale in Ontario communities. With respect to Windsor and Essex County, the OPT OUT approach would certainly provide the greatest level of protections to residents by prohibiting the operation of retail outlets across the region. Such a model would prevent municipalities from competing with one another for revenue, while ensuring that vulnerable populations would not be exposed to cannabis retail in Windsor-Essex. Should opting out on a permanent basis not be the appetite of incoming municipal councils, the possibility of opting out on a temporary basis should be strongly encouraged. Such an opportunity would provide municipalities the opportunity to learn from others across the province who did not choose to opt out, learn more about their options upon the passing of the final provincial regulations, and consider (to the extent which is permitted by the provincial legislation) the possibility of establishing regulations at the local level to establish appropriate areas for retail storefronts in their communities. Additional advocacy activities should be implemented at the municipal level to provide for the opportunity for such regulations at the local level, rather than the black and white Opt in or Opt out model proposed at the provincial level. See the attached Board of Health Resolution for additional recommendations for provincial and municipal oversight.

In-kind resources have been allocated from the Windsor-Essex County Health Unit’s cost-shared budget to begin educating the public about the health implications of cannabis use, safer consumption practices, how to speak with children, impaired driving, and other key message areas ahead of legalization. Additionally, the Smoke-free Ontario Act 2017 is set to come into effect as well on October 17th. Recent amendments to this Act permit the consumption of medical and non-medical cannabis anywhere where the smoking of tobacco is permitted. This will add to the enforcement role and broaden the scope of responsibility for Windsor-Essex County Health Unit Tobacco Enforcement Officers. These two activities alone will burden the WECHU with additional costs tied to legalization, in addition to those which may be required to be added in the form of human resources to respond to cannabis legalization and address the potential harms to health and safety.

WECHU Activities to Date

Internal Health Promotion Collaboration – WECHU Cannabis Legalization Working Group

The Windsor-Essex County Health Unit’s Cannabis Legalization Working Group (CLWG) is a collaborative of staff from various departments that aims to mitigate the potential harms of cannabis legalization across broad target populations. The group convened in 2017 and is Chaired by the Chronic Disease and Injury Prevention department, with representation from Policy and Strategic Initiatives, Epidemiology and Evaluation, Communications, Healthy Schools, and Healthy Families departments. Guided by the findings of a situational assessment, the CLWG has established key messages and target populations for cannabis health promotion efforts.

Internal Staff Training and Knowledge Assessment

A survey was distributed to staff of the Windsor-Essex County Health Unit to assess their knowledge and confidence in speaking to clients or community partners related to key cannabis health messages. Findings were used to identify areas of training that would best prepare staff for engaging with their clients. Following this, training for all direct-client service departments provided an overview of the resources available, and WECHU’s key messages. Based on the unique populations served by staff in each department, additional information was provided (e.g., information regarding risks to pregnant and breastfeeding women for Healthy Families, youth-focused information for Healthy Schools).

Community Environmental Scan

In August, 2018, an environmental scan was disseminated to health and social service providers, school boards, law enforcement and emergency services to assess the work currently being done in Windsor-Essex County to address cannabis use disorders or prevention efforts, and gaps in efforts to reduce cannabis harms in Windsor and Essex County.

Cannabis Mass Media Campaign

A mass media campaign has been created to begin educating the public utilizing a variety of media to target priority populations. This campaign will largely make use of content housed on the WECHU website. The goal of WECHU’s Cannabis- Your Questions, Answered campaign is to direct residents to credible, evidence-informed information in a format that encourages sharing through online and social networks. The website contains information related to key messages, a directory of treatment options for cannabis use and other addictions, and resources for workplaces, healthcare providers, and educators. In addition, radio ads have been created to disseminate our key messages and expand the campaign reach, and billboards have been developed to promote safe driving.

Community Outreach and Presentations

As a supplement to the mass media campaign, WECHU staff have already begun delivering community presentations and distributing resources. For example, in June of 2018, two presentations were provided at the Erie St. Clair Regional Cancer Program Frontline Connect events. In addition, a presentation was given to attendees of the Working Toward Wellness Luncheon in June 2018, along with the hosting of an information and resource booth.

Current and Future Initiatives

Windsor-Essex Cannabis Community of Practice

The Windsor-Essex Cannabis Community of Practice will be led by WECHU and meet biannually, starting in 2019, for the purposes of information sharing, collaboration, and capacity building. Group members have been identified through the Environmental Scan with representatives from health, social and community services, and education and municipal services. Meetings of the Community of Practice will include provincial/federal updates related to cannabis legalization, information sharing among members on current community activities, identifying gaps in community services related to legalization, combining resources and identifying opportunities to collaborate, and building capacity to address cannabis use.

Municipal Engagement

Through connecting with representatives from the administration of each municipality, WECHU has provided recommendations on how they can address cannabis in their communities. Primarily, it is the goal of these engagements to encourage municipalities to opt out of retail establishments; however, in the event that this is not of interest, WECHU is committed to supporting municipalities through the development of local regulations which will place restrictions on the areas in which cannabis-related businesses are permitted to operate. Such regulations may involve licensing or zoning parameters, which restrict cannabis-related businesses to operate in areas near schools, addictions facilities, parks, playgrounds, and other areas that serve or are frequented by vulnerable populations.

Teachers, Schools, and School Boards

Ongoing discussion and meetings between WECHU and school board liaisons have led to the population of an online drop box with presentations, toolkits, curriculum supports, posters, resources, and background information on the dangers of cannabis consumption for young people. A letter of support was provided for School Board advocacy of zoning for the location of cannabis retailers and production facilities to have municipalities set minimum distance between such establishments and school property. Support has also been offered onsite at school events and during teacher professional development opportunities, with additional school-aged presentations planned for the 2018-2019 school year that focus on cannabis-impaired driving. Cannabis activities in the school setting have also been integrated with the Windsor-Essex Community Opioid and Substance Strategy through the development of a Youth Engagement Strategy as part of their work in general substance use prevention and education.

Employers and Workplaces

The WECHU has supported workplaces in preparing for legalization by attending community events and developing template resources for employers to utilize in setting up health-promoting education and environments for their employees. By communicating with employers through existing communication channels and continuing to attend community events, WECHU will provide resources for employers to utilize in making decisions related to cannabis and impairment in the workplace.

Social Service and Healthcare Providers

To support reproductive healthcare providers and reach clients through WECHU and community programs, WECHU has utilized resources developed by the Public Health Agency of Canada to their clients through various programs offered through WECHU’s Healthy Families Department (i.e., hospital liaison program, Physician Outreach Program, Healthy Babies Healthy Children, lactation support, Well Baby Clinics and Building Blocks for Better Babies). Additional resources developed by WECHU and gathered from external partners will be provided through other WECHU networks such as the Windsor-Essex Cannabis Community of Practice, and the Windsor-Essex Tobacco Cessation Community of Practice.

Ongoing Surveillance and Monitoring

Currently, WECHU staff contribute to the Ontario Public Health Collaboration on Cannabis Indicators Working Group which seeks to identify existing indicators for cannabis use and related health outcomes and support development of cannabis surveillance at regional and provincial levels. Locally, ongoing work is being done to assess existing local data for cannabis-related health outcomes that can be used to monitor cannabis health outcomes pre and post-legalization, and identify gaps and opportunities for new data collection methods.

Provincial Collaboration

The Windsor-Essex County Health Unit is a co-applicant for the Public Health Ontario Substance Use Locally Driven Collaborative Project. The focus of this project is to identify regional strategies employed by public health agencies and applicable partners in addressing cannabis use among 18-25 year olds. This age often represents the highest rate of cannabis use, is not protected by age restrictions under the federal Cannabis Act, and is still at risk for cognitive damage tied to consumption due to continued brain development at this age. In addition, WECHU attends bi-monthly meetings as part of the Ontario Public Health Collaboration on Cannabis and through this network of public health professionals working in cannabis health promotion, is able to share and gather information on existing strategies and key message areas with public health units across the province.

Approved By:

Theresa Marentette, CEO

References

 

 


View Document page

Prepared By:

Jessica Kipping-Labute

Date:

October 18, 2018

Subject:

“Vote for Health” Municipal Election Survey Results

Background

Municipal governments and elected representatives can shape the health of communities through the design and delivery of local policies, programs, and services. The Ontario Public Health Standards (OPHS) and the Windsor Essex County Health Unit’s (WECHU) Strategic Plan both include a focus on developing, supporting, and participating in local healthy public policy. The Ontario Public Health Standards (OPHS) specify that Public Health Units (PHUs) are to share healthy public policy recommendations, and participate with stakeholders in the development of public policy that reduces barriers to positive health outcomes. The OPHS also specifies that PHUs are to use data to influence and inform the development of local healthy public policies.

On September 5th, the WECHU launched a voluntary survey distributed to all local council and mayoral candidates running in the upcoming 2018 municipal election. The survey asked candidates how they would prioritize their efforts based on seven local public health priority areas. The priority areas were identified based on local data, results from the WECHU’s 2016 Community Needs Assessment, and the Association of Local Public Health Agencies’ (alPHa) Municipal Election Policy Priorities document. The results of the survey were posted on the WECHU’s website on October 5th.

Results Summary

Candidates were asked how they would spend $100 on the local public health issues. In total, 50% (87) of the candidates completed the survey. They were told that their answers should reflect the amount of time and resources they would give to each public health issue. All candidates that completed the survey said that they would allocate resources towards mental illness. On average, candidates provided 25% ($25.49) of their resources to mental health in the community. The second highest allocation (16%; $16.21) was towards substance misuse in the community.

When candidates gave resources to one of the local public health issues, they were then able to select actions they might take. The actions provided were evidence-supported ways to address the local public health issues.

  • Mental illness had the most frequently selected actions – 89% of candidates said they would advocate for funding for low-or no-cost mental health care to increase local access to treatment; and 87% would support training for first responders and front-line service providers to help people living with mental illness.
  • Food insecurity had the third most frequently selected action – 84% of candidates said that they would support local programs, such as farmer’s markets, community gardens, and community kitchens.
  • Putting fluoride into community water was the least selected action by respondents, with 8% of supporting this action.
  • Substance misuse had the second and third least frequently selected actions – 28% of respondents supported local efforts to investigate the feasibility of safe injection sites; and 38% supported increasing the availability of naloxone and needle disposal bins in the community.

Next Steps

The results from this survey were posted on the WECHU’s website to provide information to the public about municipal candidate stances on healthy public policy issues. The results from the survey will also be used to inform future planning and program development within the WECHU. In 2019 the WECHU will provide an opportunity to all elected municipal officials to meet with the organizations CEO to discuss local healthy public policy issues.

Consultation:

The following individuals contributed to this report:

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

Approved By:

Theresa Marentette, CEO


View Document page
  DIVISIONS
PARTNERS Health
Protection
Health
Promotion
Knowledge
Management
Corporate
Services
AIDS Committee of Windsor X X    
Association of Public Health Epidemiologists in Ontario     X  
Bulimia Anorexia Nervosa Association   X    
Canadian Food Inspection Agency X      
Canadian Mental Health Association (CMHA) Windsor-Essex  X X    
Cancer Care Ontario X   X  
Central West Communicators Network Group     X  
Child Care Operators (Licenced) X X    
Children First   X    
Children's Safety Village Windsor   X    
Council on Aging Windsor-Essex County   X    
Detroit Health Department X      
Downtown Mission   X    
Environment and Climate Change Canada X      
Erie St. Clair Local Health Integration Network (LHIN) X X X X
Essex County Dental Society   X    
Essex County Federation of Agriculture (ECFA)   X    
Essex Region Conservation Authority (ERCA) X X    
Essex-Windsor EMS X X X  
F.A.R.M.S. X      
Family Health Teams (Windsor-Essex County) X X    
Family Services Windsor-Essex   X    
Fire Departments and Designated Officers (Local) X X    
First Nations - local (e.g. Caldwell First Nation) X X    
Great Lakes Water Institute X      
Health Canada X X    
Health Quality Ontario X      
Healthy Kids Community Challenge    X    
Hiatus House   X    
Homeless Coalition of Windsor-Essex County   X    
Hospitals (Windsor-Essex) X X   X
IDEAS  (Improving & Driving Excellence Across Sectors) Foundations of Q.I. Program      X  
John McGivney Centre   X    
Long-Term Care Facilities/Rest Homes (Windsor-Essex County) X      
Maryvale   X    
Medical Professionals (e.g. Dietitians, Dentists, Midwives, Obstetricians, Nurse Practitioners, Pediatrians, Pharmacists, Physicians,  Veternarians) X X    
Ministry of Education   X    
Ministry of Environment, Conservation and Parks X   X  
Ministry of Finance   X    
Ministry of Health and Long-Term Care     X X
Ministry of Transportation   X    
Municipalities - Bylaw Enforcement X X    
Municipalities - Community Control Group (Emergency Management) X      
Municipalities (Windsor-Essex,  County of Essex)  X X X X
Newcomer Settlement Agencies - Interpreters and Settlement Workers (e.g. Canadian Multicultural Council, Multicultural Council of Windsor and Essex County, New Canadians' Centre of Excellence, South Essex Community Council) X X X  
Nurse Practitioner-Led Clinics   X    
Office of the Chief Medical Officer of Health       X
Ontario Association of Communicators in Public Health     X  
Ontario Indigenous Cultural Safety Program Leaders     X  
Ontario Living Wage Network/Committee   X X  
Ontario Ministry of Agriculture Food and Rural Affairs (OMAFRA) X      
Ontario Student Nutrition Program   X    
Police Services (including RCMP and OPP) X X    
Preschool and Family Literacy Centres (5 locations)   X    
Public Health Agency of Canada X   X X
Public Health Ontario X   X X
Raising the Bar: W-E County Committee   X    
Regional Communications Network - Local     X  
Sandwich Community Health Centre X      
School Boards - Local (Agency, Faith-Based, Public, Private) X X    
School Boards - Ontario (e.g. Lambton-Kent District School Board, Rainy River)   X    
Schools - Post Secondary (e,g. St. Clair College, University of Windsor, University of Guelph,
University of Waterloo, Queens University, Brock)
X X    
Seniors Active Living Centres/Clubs (e.g. Life After Fifty)   X    
Service Canada X      
Smoker's Helpline   X    
Southwest Active Recreation Guild (SWARG)   X    
St. Leonard's House    X    
Statistics Canada     X  
Talk 2 Me   X    
Teen Health X      
Treatment Centres - Local (e.g. House of Sophrosyne, Brentwood)   X    
United Way/Centraide Windsor-Essex County   X X  
VON Erie St. Clair Immigrant Health Clinic X X    
Walkerton Clean Water Centre (WCWC) X      
Water Treatment Plants  X      
Welcome Centre Shelter for Women and Families X      
Windsor-Essex Children and Youth Planning Committee   X    
Windsor-Essex Children's Aid Society   X    
Windsor-Essex Communities In Motion (WE-CIM)   X    
Windsor-Essex Local Immigration Partnership (LIP)   X    
Windsor-Essex Regional Chamber of Commerce   X X  
Windsor-Esssex County Children's Aid Society     X  
Working Toward Wellness Committee   X    

View Document page

September 20, 2018

  1. Call to Order
  2. Agenda Approval
  3. Announcement of Conflict of Interest
  4. Approval of Minutes
    1. Regular Board Meeting: June 21, 2018
  5. Committee of the Whole (Closed Session in accordance with Section 239 of the Municipal Act)
  6. Consent Agenda
    1. INFORMATION REPORTS:
      1. Q2 Reporting (L. Gregg)
      2. Q2 Financial Results (L. Gregg)
      3. Q2 Strategic Plan Report (K. McBeth)
      4. Q2 Planning Report (K. McBeth)
      5. Supervised Injection Services (T. Marentette)
      6. Vote for Health Municipal Election Survey (T. Marentette)
      7. Media Recap (June – August 2018)
      8. CEO Quarterly Compliance (April – June 2018)
  7. Business Arising
  8. Board Correspondence – Circulated
  9. New Business
    1. 2017 Annual Report (K. McBeth)
    2. 2018 BOH Competency Based Self-Evaluation (K. McBeth)
  10. Board Correspondence/Other Health Unit Letters/Resolutions
    1. Mandatory Food Literacy Curricula in Schools – For Support
      1. Kingston, Frontenac and Lennox & Addington Health Unit – Letter to Minister Responsible for Early Years and Child Care, Hon. Indira Naidoo-Harris
      2. Peterborough Public Health – Letter to Deputy Premier, Hon. Christine Elliott
    2. The Toronto Board of Health – Student Nutrition Program –     For Support – Memo to Board of Health in Ontario
    3. The Toronto Board of Health – Toronto Overdose Action Plan – For Support – Reinforce with provincial and federal governments the urgency of the opioid poisoning emergency, and the critical need to scale up actions in response
    4. Association of Local Public Health Agencies – Supervised Consumption Facilities – For Support
    5. Ontario Physical and Health Education Association (OPHEA) – Ministry of Education – Sexual Health Education Component curriculum reverting back to the 1998 version – For Support – Requesting that WECHU align our position with school boards in the Windsor-Essex region leading into the 2018/2019 school year
    6. Smoke-Free Ontario Act, 2017 – Delay in Implementation – For information Only
      1. Sudbury & District Public Health – Letter to Premier Ford
      2. Timiskaming Health Unit – Letter to Hon. Christine Elliott, Minister of Health and Long Term Care
      3. Kingston, Frontenac and Lennox & Addington Health Unit – Letter to Hon. Christine Elliott, Minister of Health and Long Term Care
      4. Windsor-Essex County Health Unit – Letter to Premier Ford
      5. Municipality of Chatham-Kent Public Health Unit – Letter to Premier Ford
      6. Grey Bruce Health Unit – Letter to Premier Doug Ford
  11. Next Meeting: At the Call of the Chair, or October 18, 2018 – Essex
  12. Adjournment

View Document page

Prepared By:

Lorie Gregg, Director of Corporate Services

Date:

August 29, 2018

Subject:

Q2 Reporting

Background

The Windsor-Essex County Health Unit (“the WECHU”) administers programs that are funded in whole or in part by the Ministry of Health and Long-Term Care and Ministry of Children and Youth Services (hereinafter referred to collectively as “Ministries”).  Quarterly, the WECHU is required to report to the Ministries the year-to-date budget to actual financial results for those programs as well provide forecasted annual financial results.

Q2 Reporting

The Q2 reporting to the Ministries include the following:

  • Q2 2018 Standards Activity Reports as of June 30, 2018 submission to the Ministry of Health and Long-Term Care;
  • Healthy Babies Healthy Children Quarterly Financial Report – 2018 2nd quarter submission to the Ministry of Children and Youth Services;
  • Prenatal and Postnatal Nurse Practitioner Program Financial Report – 2018 2nd quarter submission to the Ministry of Children and Youth Services

Approved by:

Theresa Marentette


View Document page

Prepared By:

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

Date:

August 14, 2018

Subject:

Quarter #2 Planning Report

Background

Following the completion of the 2018 planning cycle and the submission of the new Annual Service Plan (ASP) required by the Ministry of Health and Long Term Care (MOHLTC), the Planning and Strategic Initiatives (PSI) department undertook an assessment of its planning processes in order to look for ways to better align our planning approach with the MOHLTC requirements in the development of new planning and reporting structure for 2019 and beyond.

Current Initiatives

Planning for 2019

The PSI department worked with the Information Technology (IT) department to align our planning system with the MOHLTC requirements to ensure a single, integrated approach to planning for 2019. Changes to the process include the incorporation of Ministry terminology, the inclusion of intervention performance indicators, and increased planning support for staff and managers. The PSI department has provided several planning training sessions with staff and management from all divisions. Work with managers and departments has continued over the summer months to align the 2019 organizational planning outcomes with the MOHLTC requirements, in order to maximize efficiency and ensure consistency across the organization.

Reporting Structure

The MOHLTC has yet to provide standard reporting structures for the ASP. Upon receiving the updated reporting templates and guidelines the PSI department will work with the IT department to integrate these requirements into the planning system.

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

2018 Q2 WECHU Strategic Plan Progress - At a Glance

Communication and Awareness

Objective

2018 Q1

2018 Q2

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.

Progressing Progressing

Organizational Development

Objective

2018 Q1

2018 Q2

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.

Progressing Progressing

Partnerships

Objective

2018 Q1

2018 Q2

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

Work Needed Progressing

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

Progressing Progressing

Evidence-based Public Health Practice

Objective

2018 Q1

2018 Q2

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.

Objective Met Objective Met

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

Progressing Progressing

Communication and Awareness

OBJECTIVE

GOAL

Q2 UPDATE

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

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

Marketing and Communications plan still to be developed. 5 policies and procedures are developed and under review. They address elements of organizational branding across media channels.

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

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

Community engagement plan still to be developed. Enhanced focus on organizational branding has been implemented.

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

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

The employee engagement strategy is currently being implemented. Baseline measurements associated with internal communication will be generated in Q4.

Partnerships

OBJECTIVE

GOAL

Q2 UPDATE

2.1 Increase the effectiveness of partnerships through formal feedback mechanisms.

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

Partnership tool is developed and is currently under review. Piloting will be the next step.

2.2 Increase the number of internal partnerships.

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

The updated planning tool now includes more detail about internal partnerships for the 2019 planning cycle.

Organizational Development

OBJECTIVE

GOAL

Q2 UPDATE

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

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

The Risk Registry was updated with mitigation plans incorporated into the 2019 planning approach.

The planning system has been updated to incorporate ministry requirements, and training has been provided to all teams. Background work on our quality improvement plan approach is in progress.

Proposals for potential approaches to maintain AODA adherence have been developed.

 

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

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

Exploring options related to ongoing change management training.

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

 

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

The leadership team has continued to review the risk registry.

Key risk indicators, each with a reporting schedule, will be developed this year.

3.4 Improve organizational culture through people development and employee engagement strategies.

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

The employee engagement strategy is currently being implemented. Baseline measures for employee engagement are currently being collected. Baseline measurements will be generated in Q4.

Evidence-Based Public Health Practice

OBJECTIVE

GOAL

Q2 UPDATE

4.1 Establish organizational supports for client-centered service strategies.

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

Through Q2, existing client satisfaction efforts to collect and act on client satisfaction data continued to operate. This has involved one external-facing department and all internal facing departments. Client experience in other departments is yet to be planned out.

4.2 Develop and implement a framework to support healthy public policy.

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

Management and staff received training on the WECHU’s Public Policy Toolkit and Guidance Document.

There were 6 activities focused on healthy public policy completed in Q2 under the Substance Use and Injury Prevention Standard, Chronic Diseases Prevention and Well-being Standard, and the Healthy Environments Standard. There are activities focused on healthy public policy in progress under the Chronic Diseases Prevention and Well-being Standard, Substance Use and Injury Prevention Standard, the Healthy Environments Standard, and the Infectious and Communicable Diseases Prevention and Control Standard.

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

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.

In the 2018 planning process, 100% of the population health assessment requirements (7), the research, knowledge, exchange, and communication requirements (3) were being addressed by at least one work plan. Moving forward, the way in which this objective is measured and reported is under review and the SPC may consider incorporating the achievement of ASP objectives and indicators related to these requirements into the goal for this objective.

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

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

The WECHU’s health equity strategy was approved by the Leadership Team, and presented to the Board of Health (BoH) as an information report. Strategy launch presentation and engagement sessions were completed with the Management Team and 86% of the departments to date.

A health equity-focused planning tools evaluation and summary report was completed. Recommended improvements to the tools and procedures are in the process of being implemented.

A health equity focused education session was provided to the BoH in Q3.


View Document page

Prepared By:

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

Date:

July 12, 2018

Subject:

Strategic Plan Q2 Report

Background

The 2017-2021 WECHU Strategic Plan allows our organization to identify key roles, priorities and directions and sets out what we plan to accomplish, how we plan to do it, and how our progress will be measured. The plan is based on four strategic priorities: Communication and Awareness, Partnerships, Organizational Development, and Evidence-Based Public Health Practice.

In early 2018, the Planning and Strategic Initiatives department implemented a corporate tracking system to monitor Strategic Plan performance and to provide quarterly and annual updates to the BoH. In the first quarter of 2018, progress was made on a number of objectives, while more work was needed to move others forward. 

Current Initiatives

In the second quarter of 2018, progress continued on most of the strategic objectives.  The 2018 Q2 Strategic Plan Progress Report provides updates on each objective with corresponding next steps (see appendix A). 

Consultation

The following individuals contributed to this report:

  • Kristy McBeth, Director, Knowledge Management
  • Marc Frey, Manager, Planning & Strategic Initiatives
  • Ramsey D’Souza, Manager, Epidemiology & Evaluation
  • Michael Janisse, Manager, Communications
  • 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


View Document page

Prepared By:

Jenny Diep, Health Promotion Specialist

Date:

August 30, 2018

Subject:

Supervised Injection Services (SIS) Community Consultation Project

Background

Locally in Windsor-Essex County (WEC), we are facing increased morbidity and mortality related to the use of opioids and other drugs.  There were 382 opioid-related emergency department visits in WEC in 2015, which is 3.6-times greater than in 20031.  The rate of opioid-related emergency department visits in Windsor was 2.8-times greater than the rate in Essex County.  There were 24 opioid-related deaths in WEC in 2015; 19 deaths were in the city of Windsor1. Furthermore, the number of hepatitis C cases, a blood-borne infection, increased from 143 reported cases in 2016 to 181 reported cases in 20172.  In 2017, out of the 164 confirmed cases that reported at least one risk factor other than unknown, injection drug use was reported by 62% of cases (101 cases)3.  There have been 211 documented needle-related calls from January 1, 2014 to February 5, 2018 to local municipal service (3-1-1), predominantly in downtown Windsor4.  Number of needle-related calls have significantly increased, from 43 in 2016 to 121 in 2017 (City of Windsor, 3-1-1 calls)4.

Overdose Prevention Sites (OPS) and Supervised Consumption Services (SCS)

In December 2017, in response to overdose-related deaths, Health Canada announced that it would provide temporary class exemptions to provinces and territories demonstrating evidence of an urgent public health need. This allowed for possession and use of controlled substances on exempted sites, known as OPS. This provided a space for people to consume drugs in a safe environment, where staff or volunteers can provide overdose response measures as required. This interim measure allowed communities to plan for a long-term solution, such as a SCS.

 

A SCS is a legally sanctioned site that provides a location where people can bring their own illicit substances to consume under safer conditions and supervised by trained workers who can respond to an overdose as needed5. A SCS includes SIS, and offers treatment, health, and social services for people who are ready to stop or reduce their drug use. An OPS may not have these services in place as a temporary site, while a SCS aims to connect people who use drugs to health and social services. A SCS reflects harm reduction principles, which recognizes that individuals with substance use issues may not wish or be able to abstain from substance use, and thus, seeks to minimize the harms associated with drug use6. It is a part of Health Canada’s Canadian drugs and substances strategy. Benefits of SISs, as acknowledged by the Government of Canada7, include:

  • Reduced overdose-related morbidity and mortality8,9;
  • Reduced injecting and discarding of needles in public space9;
  • No evidence of increased drug-related crime or loitering or rates of drug use9;
  • Increased access to withdrawal management and treatment services and other health and social services5,9;
  • Reduced transmission of blood-borne infections, such as hepatitis C and HIV, through decreased needle sharing8,9; and
  • Reduced health care costs, ambulance calls, use of emergency departments, and hospital admissions8,9.

Prior to the establishment of a supervised consumption site (SCS) and also a requirement of Health Canada’s application for exemption under Section 56.1 of the Controlled Drugs and Substances Act, community engagement is essential to informing the need and feasibility for a SIS and predicting its success5.  Similar projects have been conducted in London, Toronto, Hamilton, and Waterloo in Ontario.  These projects similarly reflect such projects in British Columbia.

Locally, organizations have expressed interest in applying for a SCS in Windsor.

Current Initiatives

As part of the Windsor-Essex Community Opioid & Substance Strategy (WECOSS) under the Harm Reduction Pillar, the Windsor-Essex County Health Unit (WECHU) is leading the Supervised Injection Services Community Consultation Project (SIS-CC) to assess the need and acceptability of SIS in WEC.  The study will:

  • Explore the need for SIS in WEC;
  • Explore the design, potential locations, and conditions under which an SIS would be preferred by potential clients and stakeholders in Windsor; and
  • Assess community perceptions of SIS and identify any concerns and strategies to mitigate such concerns.

This project will involve a mixed methods approach (i.e., quantitative and qualitative):

  1. Analysis of local surveillance data. Existing surveillance data regarding morbidity and mortality related to opioid and substance use, including hepatitis C rates, public discarding of needles, health care service use related to opioid use, and harm reduction service use.
  2. In-person surveys with people who inject drugs (PWIDs). The 45-minute survey explores drug use and injection practices, perceptions of SIS and its implementation (e.g., policies, hours, location), experiences of overdose, health and drug treatment. Peer researchers will be trained to recruit and administer the survey. Peer researchers are hired staff who have had lived experience with injection drug use, and may more likely be able to build a rapport with potential participants to complete the survey.
  3. Public Online survey with the Windsor-Essex County community. The 5-minute online survey involves questions related to perceptions of drug use and SISs and its implementation. This survey may identify additional needs outside of Windsor, and thus, inform future community consultation projects.
  4. Interviews with key informants. A 30-minute interview will be conducted with identified key informants and community leaders including harm reduction service providers, local politicians, key leaders from community service agencies/organizations, advocacy groups and emergency services from Windsor.
  5. Focus groups with key stakeholder groups. A 1.5-hour focus group will be conducted with individuals from key stakeholder groups that have an interest in drug-using populations and can be affected by or affect policy and implementation (or non-implementation) of SIS.  These include first responders (police, fire, and emergency medical services), representatives from municipal government departments, community services agencies/organizations, and community, neighbourhood and business groups from Windsor.

The project will be promoted through social media and the Health Unit and WECOSS websites, which is currently being developed.  More information about SIS, SCS, OPS, and the project will be provided on the WECOSS website.

An application to the University of Windsor Research Ethics Board (REB) has been submitted and pending final approval we expect to launch the survey in late September with data collection continuing to the end of 2018.

References

  1. Windsor-Essex County Health Unit. (2017, June). Opioid misuse in Windsor-Essex. Retrieved from https://www.wechu.org/about-us/reports-and-statistics/opioid-misuse-windsor-essex-county.
  2. Windsor-Essex County Health Unit. (2018). Monthly infectious disease report – February 2018. Windsor, ON: Windsor-Essex County Health Unit.
  3. Data Source: Integrated Public Health Information System (iPHIS), Ministry of Health and Long-Term Care [extracted 2018 Jun 8]
  4. Data Source: City of Windsor, 3-1-1 calls [extracted 2018 Feb 05]
  5. Government of Canada. (2017, July 6). Supervised consumption site: Guidance for application form. Retrieved from https://www.canada.ca/en/health-canada/services/substance-abuse/supervised-consumption-sites/guidance-document.html.
  6. Canadian Mental Health Association. (2018). Harm reduction. Retrieved from https://ontario.cmha.ca/harm-reduction/.
  7. Government of Canada. (2017, May 26). Statement from the Minister of Health – Health Canada authorizes four new supervised consumption sites. Retrieved from https://www.canada.ca/en/health-canada/news/2017/05/statement_from_themi....
  8. Ng, J., Sutherland, C., & Kolber, M.R. (2017). Does evidence support supervised injection sites. Canadian Family Physician, 63(11), 866.
  9. Kennedy, M.C., Karamouzian, M., & Kerr, T. (2017). Public health and public order outcomes associated with supervised drug consumption facilities: A systematic review. Current HIV/AIDS Reports, 14(5), 161-183. https://doi.org/10.1007/s11904-017-0363-y

Approved by:

Theresa Marentette


View Document page

Prepared By:

Jessica Kipping-Labute

Date:

September 10, 2018

Subject:

“Vote for Health” Municipal Election Survey

Background

Municipal governments and elected representatives can shape the health of communities through the design and delivery of local policies, programs, and services.  Working with partners and decision makers to achieve these outcomes is part of the Ontario Public Health Standards (OPHS), and is one objective of the Windsor-Essex County Health Unit’s (WECHU) 2017-2021 Strategic Plan. 

Under the Foundational Standard of the OPHS, Public Health Units (PHUs) are to share reports, advisories, and healthy public policy recommendations.  As well, PHUs are to contribute to policy work aimed at reducing barriers to positive health outcomes. Specifically, leading, supporting, and participating with stakeholders on policy development to decrease health inequities. In the Program Standards PHUs are to use data to influence and inform the development of local healthy public policies.

Current Initiatives

On September 5th, the WECHU launched ‘Vote for Health’, a voluntary survey distributed to all local council and mayoral candidates running in the upcoming 2018 municipal election. The survey asks about how municipal candidates would prioritize their efforts based on seven identified local health priority areas. These areas include dental health, substance misuse, food insecurity, mental illness, built environment, and climate change. These priority areas were identified based on local data, results from the WECHU’s 2016 Community Needs Assessment, and the Association of Local Public Health Agencies’ (alPHa) Municipal Election Policy Priorities document. This approach was adapted with permission from the Simcoe Muskoka District Health Unit and modified to specifically address locally relevant aspects. The results of the survey will be posted on WECHU’s website in late September. The information collected from municipal candidates does not necessarily reflect the views of the WECHU, but instead provides an opportunity for candidates to share their views on local public health issues with the community.

The purpose of the survey is to:

  • Raise awareness of local public health issues.
  • Provide an opportunity for municipal candidates to share their views on these public health issues.
  • Provide residents with municipal candidate’s views on these public health issues to support informed decision-making when voting in the October municipal election.

Support the development of healthy public policy during and after the election period.

Consultation

The following individuals contributed to this report:

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

Approved by:

Theresa Marentette


View Document page

Prepared By:

Communications Department

Date:

July 4, 2018

Subject:

June Media Relations Recap Report

June Media Coverage

Total Media Coverage

46

Interview Requests

17

Mentions (In the news without direct interviews)

29

June 2018 Media Relations Recap - Media Coverage

Story Source

June 2018 Media Relations Recap - Story Source

Media Coverage

Outlet

Number of Stories

AM 800

8
Blackburn 6
Canada.com 1
CBC 4
Chatham This Week 1
CTV 5
Essex Free Press 1
Wallaceburg Courier Press 1
Watertoday.ca 1
Windsor Star 13
Windsorite.ca 3
TOTAL 44

News Release and Media Advisories

Date Type Headline Response

June 5, 2018

News Release

Mosquito Trap Reveals 2 Aedes albopictus Species in the Area

5 Stories Reported

June 12, 2018

News Release

Beach Water Test Results Available June 13

15 Stories Reported

June 15, 2018

Heat Warning

Windsor-Essex County Health Unit Issued Extended Heat Warning

1 Story Reported

June 18, 2018

Media Advisory

Health Unit First In Windsor-Essex To Receive Baby-Friendly Initiative Designation

3 Stories Reported

June 20, 2018

Media Advisory

Windsor-Essex County Health Unit Board of Health Meeting at Essex Office

1 Story Reported

June 26, 2018

News Release

Windsor-Essex County Health Unit Strives to Help Women Achieve Breastfeeding Goals

1 Story Reported

Stories Reported by the Media

AM 800

Publish Date

Title

June 5, 2018

Mosquitoes In Windsor-Essex Test Negative For Zika Virus

June 7, 2018

Oral Health Presentation Bring Fluoride Debate To Essex County Council

June 13, 2018

No Swimming At One Local Beach

June 20, 2018

Local Health Unit Recognized For Its Support For Breastfeeding

June 21, 2018

Health Unit Prepares For Changes To The Smoke-Free Ontario Act

June 21, 2018

Swimming Not Recommended At Four Area Beaches

June 26, 2018

Lynne Martin Show – Breastfeeding Reports Are Dismal

June 28, 2018

One Local Beach Not Recommended For Swimming

Blackburn News

Publish Date

Title

June 5, 2018

Mosquitoes Found In Windsor-Essex Not Carrying Zika Or West Nile

June 6, 2018

Several Sides Sink Their Teeth Into Vigorous Debate Over Fluoride

June 8, 2018

Mental Health Problems Too Prevalent In Windsor-Essex

June 13, 2018

Most Windsor-Essex Beaches Clear For Swimming

June 20, 2018

Four Local Beaches Have High Levels Of Bacteria

June 28, 2018

All Windsor-Essex Beaches Are Open For Swimming

Canada.com

Publish Date

Title

June 20, 2018

Health Unit Strives To Improve Dismal Local Breastfeeding Rate

CBC News

Publish Date

Title

June 5, 2018

Mosquito Trap In Windsor-Essex Captures Known Carriers Of Zika And West Nile Viruses

June 13, 2018

Eight Out Of Nine Beaches Tested In Windsor-Essex Cleared For Swimming

June 13, 2018

Health Unit Warns Businesses To Prepare For Legalized Pot Implications In The Workplace

July 2, 2018

New Rules Outlaw Cannabis Lounges, Windsor Owner Refuses To Shut Down

Chatham This Week

Publish Date

Title

June 20, 2018

Water Sampling Now Bare Minimum (Chatham This Week)

CTV News

Publish Date

Title

June 5, 2018

Two Mosquitos Known To Transmit Zika Found In Windsor-Essex Trap

June 13, 2018

Only One Windsor-Essex Beach Not Recommended For Swimming

June 15, 2018

Extended Heat Warning Issued For Windsor-Essex

June 15, 2018

https://windsor.ctvnews.ca/video?clipId=1420685

June 27, 2018

Most Windsor-Essex Beaches Deemed Safe For Swimming This Weekend

Essex Free Press

Publish Date Title

June 14, 2018

WECHU Oral Health Report Recommends Fluoridation Of Drinking Water (Pgs 8-9)

Wallaceburg Courier Press

Publish Date Title

June 20, 2018

Water Sampling Now Bare Minimum (Wallaceburg Courier Press)

Windsor Star

Publish Date Title

June 6, 2018

Daytime Biting Mosquitoes That Could Carry Zika Found In Windsor For Third Year

June 6, 2018

Looming Vaping Regulations Will Drive People To Smoke Cigarettes, Vaping Advocates

June 7, 2018

Health Unit Calls On Windsor, Essex County Municipalities To Add Fluoride To Water

June 13, 2018

Beach Monitoring Season Starts With Single Warning For High Bacteria

June 13, 2018

Reader Letter: Fluoridation Of Drinking Water Obsolete And Detrimental

June 14, 2018

Beware Of Ticks — Local Number Of Lyme Disease Cases Continues To Grow

June 14, 2018

Employers Seek Guidance For Workplace Rules For Marijuana

June 15, 2018

Lasalle Pharmacist Named Ontario's 2018 Pharmacist Of The Year

June 20, 2018

Health Unit Strives To Improve Dismal Local Breastfeeding Rate

June 22, 2018

Keep Taking Precautions Against Deer Ticks, Says Health Unit

June 28, 2018

Swimming Not Recommended At Belle River Beach

June 29, 2018

Heat Warnings Issued For Blistering Long Weekend

Windsorite.ca

Publish Date Title

June 13, 2018

Weekly Beach Report: Swimming Not Recommended At One Beach

June 20, 2018

Weekly Beach Report: Swimming Not Recommended At Four Beaches

June 27, 2018

Weekly Beach Report: Swimming Not Recommended At One Local Beach

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


View Document page

Prepared By:

Communications Department

Date:

August 1, 2018

Subject:

July Media Relations Recap Report

July Media Coverage

Total Media Coverage

45

Interview Requests

8

Mentions (In the news without direct interviews)

37

July 2018 Media Relations Recap - Media Coverage

Story Source

July 2018 Media Relations Recap - Story Source

Media Coverage

Outlet

Number of Stories

AM 800

8

Blackburn

5

CBC

10

CTV

8

The Square

1

Windsor Star

7

Windsorite.ca

5

Yahoo News

1

TOTAL

45

News Release and Media Advisories

Date Type Headline Response

July 6, 2018

Heat Warning

Windsor-Essex County Health Unit Ends Extended Heat Warning

3 Stories Reported

July 11, 2018

News Release

First West Nile Virus Positive Mosquito Pool Found

7 Stories Reported

July 12, 2018

Heat Warning

Windsor-Essex County Health Unit Issues Extended Heat Warning

0 Stories Reported

Stories Reported by the Media

AM 800

Publish Date

Title

July 4, 2018

Essex Council Say No To Fluoride

July 4, 2018

Three Lake Erie Beaches Not Recommended For Swimming

July 6, 2018

Relief! Heat Warning Lifted For Windsor-Essex

July 11, 2018

Three Local Beaches Not Recommended For Swimming

July 11, 2018

Signs Of West Nile In Windsor-Essex

July 18, 2018

Sandpoint Beach Closed Because Of High Bacteria Counts

July 25, 2018

Two Area Beaches Closed

July 31, 2018

One Local Beach Not Recommended For Swimming

Blackburn News

Publish Date

Title

July 4, 2018

Three Local Beaches Not Recommended For Swimming

July 11, 2018

Three Local Beach Warnings This Week

July 11, 2018

West Nile Virus Found In Windsor-Essex

July 18, 2018

Two Thirds Of Local Beaches Are Not Safe For Swimming This Week

July 25, 2018

Two Beaches Closed This Week

CBC News

Publish Date

Title

July 3, 2018

Windsor-Essex Remains Under Heat Warning Until Thursday

July 4, 2018

Essex Town Council Says 'No' To Fluoride In Drinking Water

July 10, 2018

'There's No Relief,' Street Help Says Heat Makes Life Even Harder For Homeless

July 11, 2018

3 Essex County Beaches Unsage For Swimming, Health Unit Warns

July 11, 2018

Mosquito Pool Test Positive For West Nile Virus In Windsor-Essex

July 19, 2018

First Beach Closure This Year In Windsor At Sandpoint Beach Due To E. Coli

July 25, 2018

Windsor Closes Second Beach In As Many Weeks After High E. Coli Levels In Colchester

July 30, 2018

Beach Closures Mean Unsafe Sand Too, Says Water Quality Specialist

CTV News

Publish Date

Title

July 4, 2018

Essex Council Says Resounding ‘No’ To Fluoridated Water

July 5, 2018

Three Of Nine Local Beaches Post High Bacteria Counts

July 6, 2018

Extended Heat Warning Ends In Windsor-Essex, Chatham-Kent

July 11, 2018

High Bacteria Counts At Three Windsor-Essex Beaches Prompt Warning From Health Unit

July 11, 2018

First Sign Of West Nile Virus This Season Found In Windsor

July 18, 2018

Sandpoint Beach Closed Due To High Bacteria Counts

July 25, 2018

Two Windsor-Essex Beaches Closed To Swimmers

The Square

Publish Date Title

July 12, 2018

West Nile Mosquito Pool Found

Windsor Star

Publish Date Title

July 2, 2018

Highway 3 Reopened After Extreme Heat Buckled Road

July 3, 2018

Province Pauses New Rules Outlawing Cannabis Lounges For Medical Users

July 5, 2018

Essex Councillors Vote Against Fluoridating Drinking Water

July 12, 2018

First Positive West Nile Mosquito Pool Found

July 12, 2018

Health Unit Warns Three Local Beaches Unsafe For Swimming

July 18, 2018

'Danger!' — Pollution Spike Leads To Sand Point Beach Shutdown

July 19, 2018

Nursing Student's App Aimed At Saving Opioid Overdose Victims

Windsorite.ca

Publish Date Title

July 4, 2018

Weekly Beach Report: Swimming Not Recommended At Three Local Beaches

July 11, 2018

Weekly Beach Report: Swimming Not Recommended At Three Local Beaches

July 11, 2018

First West Nile Virus Positive Mosquito Pool Found

July 18, 2018

Weekly Beach Report: One Beach Closed, Swimming Not Recommended At Five Others

July 25, 2018

Weekly Beach Report: Two Beaches Closed, Swimming Not Recommended At One Other

Yahoo News

Publish Date Title

July 30, 2018

Beach Closures Mean Unsafe Sand Too, Says Water Quality Specialist (shared article from CBC)

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


View Document page

Prepared By:

Communications Department

Date:

September 7, 2018

Subject:

August Media Relations Recap Report

August Media Coverage

Total Media Coverage

49

Interview Requests

7

Mentions (In the news without direct interviews)

42

August 2018 Media Relations Recap - Media Coverage

Story Source

August 2018 Media Relations Recap - Story Source

Media Coverage

Outlet

Number of Stories

AM 800

7

Blackburn

9

CBC

10

CTV

10

Windsor Star

5

Windsorite.ca

8

TOTAL

49

News Release and Media Advisories

Date Type Headline Response

August 20, 2018

News Release

Six West Nile Virus Positive Mosquito Pools Found

7 Stories Reported

August 23, 2018

News Release

Student Suspensions Will Begin September 19th For Students Born Between 2008 to 2013 With Incomplete Immunization Records

5 Stories Reported

August 24, 2018

News Release

First Human Case of West Nile Virus Confirmed

6 Stories Reported

Stories Reported by the Media

AM 800

Publish Date

Title

August 9, 2018

Weekend Beach Testing Results

August 15, 2018

Colchester Beach Not Recommended For Swimming

August 20, 2018

Local Health Unit Needs Up To Date Immunization Records

August 20, 2018

Six Mosquito Pools Test Positive For West Nile Virus

August 22, 2018

Swimming Not Recommended At West Belle River Beach

August 23, 2018

Local CMHA Expands Suicide Prevention Awareness Week

August 24, 2018

First Human Case Of West Nile Virus In Windsor-Essex

   

Blackburn News

Publish Date

Title

August 1, 2018

All Beaches Open For Swimming

August 9, 2018

High Bacteria Levels Close Two Local Beaches

August 15, 2018

Swimming Not Recommended At One Local Beach

August 20, 2018

West Nile-Positive Mosquito Pools Found In Windsor-Essex

August 21, 2018

Swimming OK In All But One Local Beach

August 23, 2018

Are Your Child's Immunization Records Up To Date

August 24, 2018

Health Officials Identify First Human Case Of West Nile This Season

August 28, 2018

Two Local Beaches Not Fit For Swimming

August 31, 2018

Information Fair On Overdose Prevention

CBC News

Publish Date

Title

August 1, 2018

Windsor-Essex Beaches Open With A Warning Issued At One

August 1, 2018

Amid EpiPen shortage, a Canadian-based company has approval for an alternative

August 9, 2018

E. Coli Forces Closure Of Two Beaches In Windsor-Essex This Week

August 15, 2018

No Windsor-Essex Beach Closures But Colchester Beach Unsage

August 15, 2018

Hotel-Dieu CEO Says Overdose Prevention Sites Are 'Necessary' For Windsor-Essex

August 17, 2018

Algal Blooms No Longer Visible At Point Pelee

August 20, 2018

West Nile Virus Found In Chatham-Kent And Windsor-Essex Mosquitoes Again

August 22, 2018

Warning Issued For West Belle River Beach, No Closures

August 24, 2018

Windsor-Essex Health Unit Confirms First Human Case Of West Nile Virus For 2018

CTV News

Publish Date

Title

August 1, 2018

West Belle River Beach Deemed Unsafe For Swimming

August 9, 2018

Two Beaches Unsafe For Swimming In Windsor-Essex: Health Unit

August 8, 2018

Health Minister Discusses Opioid Problem In Windsor

August 15, 2018

Colchester Beach Not Recommended For Swimming

August 20, 2018

Six Windsor-Essex Mosquito Pools Test Positive For West Nile Virus

August 20, 2018

Two More Mosquito Traps In Chatham-Kent Test Positive For West Nile

August 22, 2018

Warning Issued For West Belle River Beach

August 22, 2018

Local Agencies Expand Suicide Prevention Awareness Campaign

August 23, 2018

Students Born Between 2008 and 2013 Face Suspension If Not Immunized

August 24, 2018

Health unit confirms this year’s first human case of West Nile Virus

Windsor Star

Publish Date Title

August 15, 2018

Ontario Freezes Pay Of Public Sector Execs Making $100 K Or More

August 17, 2018

Suicide Prevention: Keep Writing Your Story, Says Woman Who Lost Friend To Suicide

August 20, 2018

Six West Nile Pools Tested Positive This Past Week

August 23, 2018

Windsor-Essex County Health Unit Reminds Students To Get Immunizations

August 24, 2018

Summer's first local human case of West Nile virus confirmed

Windsorite.ca

Publish Date Title

August 1, 2018

Weekly Beach Report: Swimming Not Recommended One Local Beach

August 8, 2018

Updated: Weekly Beach Report: Wimming Not Recommended At Three Local Beaches

August 15, 2018

Weekly Beach Report: Swimming Not Recommended One Local Beach

August 20, 2018

Six West Nile Virus Positive Mosquito Pools Found

August 22, 2018

Weekly Beach Report: Swimming Not Recommended One Local Beach

August 23, 2018

Student Suspensions Will Begin September 19th For Students With Incomplete Immunization Records

August 24, 2018

First Human Case Of West Nile Virus Confirmed

August 29, 2018

Labour Day Weekend Beach Report: Swimming Not Recommended Two Local Beaches

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


View Document page

Prepared By:

Lorie Gregg, Director of Corporate Services

Date:

September 6, 2018

Subject:

Q2 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 75% (“Cost-Shared”) by the Ministry of Health and Long-Term Care (“MOHLTC”) and 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 75% by the MOHLTC and certain surrounding municipalities within the geographic boundaries of Windsor and Essex County;
  • Related programs funded 100% by the MOHLTC;
  • Related programs funded 100% by the Ministry of Children and Youth Services (“MCYS”);
  • One-time business cases.

The second quarter financial report to the Board includes a budget to actual comparison and narrative for material variances for all programs listed. Forecasted financial results will be presented as a part of the Q3 and Q4 reporting.

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 second quarter of 2018.

 

 

2018 Budget

YTD Budget

YTD Actual 2018

YTD Actual 2017

Variance to Budget

% Spent

Salaries

12,946,856

6,473,428

5,906,244

5,987,092

567,184

46%

Employee Benefits

3,331,935

1,665,968

1,684,183

1,569,870

-18,215

51%

Travel and Meetings

39,650

19,825

9,064

11,082

10,761

23%

Mileage

198,531

99,266

94,109

99,005

5,157

47%

Professional Development

108,700

54,350

27,295

43,500

27,055

25%

Association and Membership Fees

45,000

22,500

34,525

40,140

-12,025

77%

Office Supplies

35,000

17,500

14,239

18,463

3,261

41%

Program Supplies

655,847

327,924

276,185

351,212

51,739

42%

Office Equipment Rental

144,000

72,000

70,113

61,537

1,887

49%

Publications

500

250

897

-

-647

179%

Purchased Services

105,000

52,500

24,498

55,746

28,002

23%

Promotional

8,829

4,415

400

7,250

4,015

5%

Board Expenses

22,294

11,147

8,714

1,131

2,433

39%

Professional Fees

128,600

64,300

32,748

30,643

31,552

25%

Bank Charges

17,900

8,950

8,046

9,386

904

45%

Rent

770,000

385,000

349,109

355,927

35,891

45%

Building Maintenance

145,200

72,600

81,854

69,107

-9,254

56%

Utilities

147,000

73,500

62,589

65,954

10,911

43%

Taxes

227,500

113,750

103,754

113,885

9,996

46%

Insurance

80,000

40,000

79,351

77,334

- 39,351

99%

Telephone

121,200

60,600

54,648

66,531

5,952

45%

Security

28,000

14,000

10,442

9,992

3,558

37%

Vehicle Expenses

2,100

1,050

279

766

771

13%

Postage and Freight

17,450

8,725

8,473

8,398

252

49%

Parking

88,000

44,000

41,746

33,866

2,254

47%

 

19,415,092

9,707,548

8,983,505

9,087,817

724,043

46%

Offset revenues

- 179,175

-89,588

-71,547

-48,429

-18,041

40%

 

19,235,917

9,617,960

8,911,958

9,039,388

706,002

46%

West Nile Virus

128,800

64,400

24,018

64,400

40,382

19%

 

19,364,717

9,682,360

8,935,976

9,103,788

746,384

46%

For the period January 1, 2018 to June 30, 2018, cash flows on account of the 2018 program year for this program are as follows:

MOHLTC $6,660,548
Corporation of the City of Windsor $1,491,516
Corporation of the County of Essex 1,246,642
$9,398,706

For material variances where the financial captions percentage spent exceeds 50%, an explanation has been provided:

  • Benefits: Expenditures in this financial caption relate to amounts paid/payable by the WECHU on account of medical, dental and extended health benefits as well as amounts paid on account of certain other payroll remittances (i.e. OMERS contributions, CPP, EI, EHT, WSIB). The dollar negative variance is not material and will be monitored over the remainder of the fiscal year with any remaining negative variances funded by the Salaries financial statement caption.
  • 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 earlier in the fiscal year.  For the remainder of the year, fees will be lower and thus tracking will be in line with budget as the year progresses.
  • Publications:  Expenditures in this financial caption include costs of subscriptions.  The dollar value of this negative variance is not material and will be monitored and offset by other underutilized financial captions as the fiscal year progresses.
  • Building Maintenance:   Expenditures in this financial caption relate to amounts paid on account of building maintenance, grounds keeping and house keeping supplies.  At June 30, 2018, the negative variance of $9,254 resulted from:  i) annual elevator maintenance fees for the period May 1, 2018 to April 30, 2019 of $8,546 were paid; ii) grounds keeping costs for snow removal are typically higher in the first half of the fiscal year compared to the latter half (3 months of service from January to March of 2018 compared to 2 months of service from November to December of 2018); iii) additional costs incurred on account of unplanned HVAC repairs.  
  • 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.  There will be no further insurance premiums in 2018 and this financial caption should remain underspent at year-end.

Risks:  Of noteworthy mention when considering the financial information above are the following:

  • Status of collective bargaining agreements – Collective bargaining agreements with CUPE (contract expired December 31, 2017) and ONA (contract expired March 31, 2018) remain outstanding.  As such, the WECHU may be required, dependent upon the results of negotiations, to make retroactive payment for contractual increases not yet reflected in the year-to-date financial results disclosed above.
  • Status of other labour related matters – Other labour related matters (i.e. pay equity; impacts associated with grievances) which remain unsettled, have not be reflected in the year-to-date financial results above given the uncertainty associated with the settlement of those matters.

Healthy Babies Healthy Children Program Financial Results

 

2018 Budget

YTD Budget

YTD Actual 2018

YTD Actual 2017

Variance to Budget

% Spent

Salaries and benefits

2,623,390

1,311,695

1,231,909

1,228,035

79,786

47%

Mileage and travel

60,000

30,000

25,162

25,018

4,838

42%

Professional Development

13,400

6,700

7,299

4,676

(599)

54%

Program Supplies

38,251

19,126

14,710

16,758

4,416

38%

Purchased Services

15,000

7,500

3,664

10,008

3,836

24%

Professional Fees

5,800

2,900

2,900

-

-

50%

 

2,755,841

1,377,921

1,285,644

1,284,495

92,277

47%

Funding - MCYS

(2,755,841)

(1,377,921)

(1,399,929)

(1,377,929)

22,008

51%

 

-

-

(114,285)

(93,434)

114,285

 

The Healthy Babies/Healthy Children Program is funded through the Ministry of Children and Youth 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 second quarter of 2018, the HBHC program is $92,277 underspent due in part to staffing vacancies associated with leaves of absence (i.e. maternity leaves, unpaid absences, etc.).  
Refer to the Risks discussion noted in the Cost-Shared Program Financial Results section of this report, as this would be relevant to this program.

Nurse Practitioner Program Financial Results

 

2018 Budget

YTD Budget

YTD Actual 2018

YTD Actual 2017

Variance to Budget

% Spent

Salaries and benefits

139,000

69,500

73,284

71,307

- 3,784

53%

 

139,000

69,500

73,284

71,307

- 3,784

53%

Funding - MCYS

- 139,000

- 69,500

- 69,508

- 63,717

8

50%

 

-

-

3,776

7,590

- 3,776

 

The Nurse Practitioner Program is funded through the Ministry of Children and Youth 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 2018 budget submission to the MCYS includes a one-time grant request for $5,210 representing the forecasted overage in Salaries and Benefits for the year-ending December 31, 2018.  As at the date of this report, our one-time funding request has not been approved.  The WECHU will continue to monitor this unfavourable variance and anticipate that it will ultimately be funded by the Cost-Shared Budget.

Financial Information for Related Programs Funded 100% by the MOHLTC

Healthy Smiles Ontario

2018 Budget

YTD Budget

YTD Actual 2018

YTD Actual 2017

Variance to Budget

% Spent

Salaries and Benefits

1,206,022

603,011

557,685

534,555

45,326

46%

Admin and Accommodation

33,149

16,575

16,575

25,000

(0)

50%

Travel and Meetings

8,000

4,000

647

1,134

3,353

8%

Mileage

10,000

5,000

8,031

6,270

(3,031)

80%

Professional Development

5,100

2,550

2,976

2,571

(426)

58%

Association and Membership Fees

300

150

546

443

(396)

182%

Office Supplies

4,500

2,250

342

341

1,908

8%

Program Supplies

100,229

50,115

66,269

31,437

(16,154)

66%

Purchased Services

162,400

81,200

31,805

30,625

49,395

20%

Total expenditures

1,529,700

764,851

684,876

632,376

79,974

45%

Offset revenue

-

-

(6,300)

-

6,300

0%

Funding - MOHLTC

(1,529,700)

(764,850)

(704,400)

(554,400)

(60,450)

46%

 

-

-

(25,824)

77,976

25,824

 

The 2018 Annual Service Plan and Budget Submission included a budget of $1,529,700 for Healthy Smiles Ontario (“HSO”), inclusive of the $120,900 augment approved by the MOHLTC on May 7th, 2018.

At June 30, 2018, the net underspent budget amounted to $79,974.  Material variances are detailed below:

  • The base funding approval of $120,900 included an addition of 1 FTE (dental assistant) of $71,471 Salaries and benefits that the WECHU would not operationalize until such time as an approval was received.  The budget impact of this deferral resulted in an approximate underspend of $35,735. 
  • In Q2 of 2018 additional Program Supplies costs of $16,425 were incurred on account equipment replacements.
  • Purchased services were underspent at June 30, 2018, due to the following:  i) The May 7th, 2018 augment to base funding included additional funding for purchased services of $36,400 for contract dentistry.  The WECHU is currently in the process of completing the requisite policy work to procure the services of a contract pediatric dentist.  It is anticipated that this dentist will be in place by Q4 of 2018.  ii) The WECHU had only 2 contract dentists for Q1.  A third contact dentist was added in March of 2018 servicing our Leamington dental clinic; iii) Fees paid to contract dentists are typically one month behind.
  • Offset revenue of $6,300 was earned in Q1 of 2018 on account of the sale of three autoclaves using a third party auction site as required by the WECHU policies and procedures for disposing of tangible capital assets.

Refer to the Risks discussion noted in the Cost-Shared Program Financial Results section of this report, as this would be relevant to this program.

Smoke-Free Ontario and Electronic Cigarettes Acts

2018 Budget

YTD Budget

YTD Actual 2018

YTD Actual 2017

Variance to Budget

% Spent

Salaries and benefits

519,217

259,608.50

258,241

255,699

1,368

50%

Mileage

35,800

17,900

16,815

15,740

1,085

47%

Travel and Meetings

6,245

3,122.50

1,794

1,675

1,329

29%

Professional Development

5,500

2,750

4,291

839

(1,541)

78%

Association and Membership Fees

156

78

-

-

78

0%

Program Supplies

44,582

22,291

12,421

14,288

9,870

28%

Purchased Services

25,200

12,600

7,653

7,295

4,947

30%

Total expenditures

636,700

318,350

301,215

295,536

17,135

47%

Funding - MOHLTC

(636,700)

(318,350)

(318,349)

(318,349)

(1)

50%

 

-

-

(17,134)

(22,813)

17,134

 

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 June 30, 2018, the total unspent budget amounted to $17,135.  The most notable variance relates to the Professional Development financial caption.  In Q1 of 2018, an individual was sent to a non-violence conflict resolution train-the-trainer course amounting to $4,180.  The unfavourable budget variance in the Professional Development financial caption continues to be monitored with any remaining budget overage to be offset against the favourable variance Program Supplies financial caption.

Refer to the Risks discussion noted in the Cost-Shared Program Financial Results section of this report, as this would be relevant to this program.

Other MOHLTC Related Programs

2018 Budget

YTD Budget

YTD Actual 2018

YTD Actual 2017

Variance to Budget

% Spent

Chief Nursing Officer Initiative

121,500

60,750

55,838

57,495

4,912

46%

Enhanced Food Safety - Haines Initiative

53,800

26,900

19,122

505

7,778

36%

Enhanced Safe Water

32,900

16,450

914

7,449

15,536

3%

Harm Reduction Program Enhancement

250,000

125,000

116,232

-

8,768

46%

Infection Prevention and Control Nurses Initiative

90,100

45,050

49,323

6,667

(4,273)

55%

Infectious Diseases Control Initiative

461,700

230,850

216,307

223,702

14,543

47%

Needle Exchange Program Initiative

63,000

31,500

31,500

-

-

50%

Social Determinants of Health Nurses Initiative

180,500

90,250

97,348

93,075

(7,098)

54%

Total expenditures

1,253,500

626,750

586,584

388,893

40,166

47%

Funding - MOHLTC

(1,253,500)

(626,750)

(308,875)

(246,375)

11

25%

 

-

-

277,709

142,518

40,177

 

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 June 30, 2018, there are no negative variances to report on.

Enhanced Food Safety – Haines Initiative:  Base funding for this initiative supports the enhancement of 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 June 30, 2018, there are no negative variances to report on.  It is anticipated that these funds will be fully expended by Q4 of 2018.

Enhanced Safe Water:  Base funding for this initiative supports the enhancement of the Board of Health’s capacity to meet the requirements of the Safe Water Program Standard under the Ontario Public Health Standards.  At June 30, 2018, there are no negative variances to report on. It is anticipated that these funds will be fully expended by Q4 of 2018.

Harm Reduction Program Enhancement:  Base funding for this initiative supports the Board of Health 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 June 30, 2018, there are no negative variances to report on.

Infection Prevention Control Nurses Initiative:  Base funding for this initiative supports one additional infection prevention and control nursing FTE having certain qualifications.  At June 30, 2018, negative variances of $4,273 have resulted as salaries and benefits for this position have exceeded the approved funding.  Negative variances will be absorbed by the Cost-Shared Budget.

Infectious Disease Control Initiative:  Base funding for this initiative supports 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 June 30, 2018, there are no negative variances to report on.
Needle Exchange Program Initiative:  Base funding for this initiative supports the purchase of needles and syringes, and their associated disposal costs, for the Board of Health’s Needle Exchange Program.  At June 30, 2018, 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 June 30, 2018, negative variances of $7,098 have resulted as salaries and benefits for these positions have exceeded the approved funding.  Negative variances will be absorbed by the Cost-Shared Budget.

Refer to the Risks discussion noted in the Cost-Shared Program Financial Results section of this report, as this would be relevant to these programs.

Financial Information for Related Programs Funded 100% by the MOHLTC

 

2018 Budget

YTD Actual 2018

Variance to Budget

% Spent

Mandatory Programs: Potassium Iodide Distribution Program

167,000

19,492

147,508

12%

Mandatory Programs: Public Disclosure System

20,000

8,548

11,452

43%

Capital: Windsor Office Project

275,000

36,861

238,139

13%

Needle Exchange Program Initiative

10,100

-

10,100

0%

Public Health Inspector Practicum Program

20,000

10,789

9,211

54%

Vector-Borne Diseases Program: Enhanced Mosquito Surveillance

46,700

16,480

30,220

35%

Total expenditures

538,800

92,170

446,630

 

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, and staff salaries, project materials, printing and postage associated with the distribution of KI packs and ongoing communication campaigns.  It is anticipated that funds will be utilized by March 31, 2019.

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.  Implementation of the disclosure system is planned for November of 2018 and will require 3rd party resources as well as internal resources for support (i.e. Information Technology; Healthy Environments).  It is anticipated that funds will be utilized by March 31, 2019.

Needle Exchange Program Initiative:  One-time funding for extraordinary costs associated with delivering the Needle Exchange Program.  Eligible costs include purchase of needles/syringes and associated disposal costs.  One-time funds were expended in Q3 of 2018.

Public Health Inspector Practicum Program:  One-time funding must be used to hire the approved Public Health Inspector Practicum positions.  Eligible costs include student salaries, wages and benefits, transportation expenses associated with practicum positions, equipment and educational expenses.  The practicum placements commence in May and conclude in August annually.  It is anticipated that these funds will be utilized in Q3 of 2018.

Vector-Borne Diseases Program:  Enhanced Mosquito Surveillance:  One-time funding must be used for an enhanced surveillance program.  Eligible costs include salaries for students, supplies and additional equipment, identification and testing expenses, promotional costs and mileage.  It is anticipated that these funds will be utilized by Q4 of 2018 with the conclusion of this year’s surveillance program.

Capital:  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. 

Approved by:

Theresa Marentette


View Document page

June 21, 2018

  1. Call to Order
  2. Agenda Approval
  3. Announcement of Conflict of Interest
  4. Approval of Minutes
    1. Regular Board Meeting:  May 17, 2018
  5. Presentations
    1. Smoke-Free Ontario Act, Changes/Highlights (E. Nadalin)
  6. Consent Agenda
    1. Information Reports:
      1. Q1 Reports Submitted to Ministry
      2. Changes in Public Health Disclosure Requirements
      3. Ticks and Lyme Disease Surveillance
      4. Baby Friendly Initiative – Journey to Designation
      5. Smoke-Free Ontario Act, 2017 – New Regulations
      6. Health Equity Strategy
      7. May Media Relations Recap
    2. Recommendation Reports:
      1. 2017 Annual Financial Statements
  7. Business Arising
    1. Board of Health Retreat – February 21, 2019 (T. Marentette)
    2. WECHU Letter in Support of Fluoride (W. Ahmed) (Handout)
    3. Oral Health Report to Essex County Council (W. Ahmed)
  8. Board Correspondence – Circulated
  9. New Business
    1. Board of Health Education Sessions (T. Marentette)
  10. Other Board of Health Resolutions/Letters – For Support/Information
    1. Dedicated funding for Local Public Health Agencies from Cannabis Sales Taxation Revenue – Hastings Prince Edward Public Health – For Support
    2. Mandatory Food Literacy Curricula in Ontario Schools – Kingston, Frontenac and Lennox & Addington Public Health – For Support
    3. Canada's Tobacco Strategy – alPHa – For Information (Handout)
  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 Sept. 20, 2018 – Windsor
  13. Adjournment

View Document page

Prepared By:

Communications Department

Date:

June 4, 2018

Subject:

May Media Relations Recap Report

May Media Coverage

Total Media Coverage

35

Interview Requests

14

Mentions (In the news without direct interviews)

21

May 2018 Media Relations Recap - Media Coverage

Story Source

May 2018 Media Relations Recap - Story Source

Media Coverage

Outlet

Number of Stories

AM 800

5

Amherstburg River Town Times

1
Blackburn 4
Canada.com 2
CBC 5
CTV 4
University of Windsor News

1

Windsor Star 6
Windsorite.ca 2
Yahoo News 1
TOTAL 31

News Release and Media Advisories

Date Type Headline Response
May 15, 2018 Media Advisory

Windsor-Essex County Health Unit Board Of Health Meeting - May 2018

1 Story Reported
May 16, 2018 Media Advisory

Windsor-Essex County Health Unit Starting Active Tick Surveillance

5 Stories Reported
May 18, 2018 News Release

Launch Of The 2018 West Nile Virus Campaign

9 Stories Reported
May 28, 2018 News Release

Windsor-Essex County Health Unit Issues Special Weather Statement

3 Stories Reported
May 28, 2018 News Release

WTW Luncheon Series: Marijuana In The Workplace – Managing The Impact Of Legalization

2 Stories Reported
May 31, 2018 News Release

World No Tobacco Day is May 31, 2018

0 Stories Reported

Stories Reported by the Media

AM 800

Publish Date

Title

May 7, 2018

Essex County Dental Society Wants Fluoride Back In Windsor Water

May 8, 2018

Listen In: Mosquito Season Not Far Away

May 17, 2018

Local Health Unit Kicks Off Tick Surveillance Program

May 17, 2018

Access To Care Key For Health Unit Heading Into Election

May 28, 2018

Health Unit Issues Heat Statement

Amherstburg River Town Times

Publish Date

Title

May 19, 2018

Distribution Of KI Pills "Steady," Town May Look To Other Methods To Distribute

The Rest

Blackburn News

Publish Date

Title

May 5, 2018

Flu Season Finished At Windsor Regional Hospital

May 7, 2018

Dentists Call For Fluoride’s Return

May 15, 2018 Orkin Takes On Fight Against Mosquitos In Windsor
May 22, 2018 Drastic Jump In West Nile Virus Across Windsor-Essex

Canada.com

Publish Date

Title

May 18, 2018

Tick surveillance underway at local natural areas

May 22, 2018

West Nile Virus Numbers In Windsor-Essex Increase As Health Unit Begins Annual Prevention Program

CBC News

Publish Date

Title

May 3, 2018

cbc.ca/player/play/1225239619867 @ 5 mins 35 seconds - Resource no longer available

May 7, 2018

Fluoride Debate Pushed Back As Windsor Council Asks Staff To Submit A Report

May 17, 2018

Tick Season Is here and the health unit in Windsor-Essex is on the lookout

May 21, 2018 Health Unit begins battle against West Nile Virus
May 22, 2018

How A Tick Bite Sent This Essex Woman's Life Into A 'Vicious Circle'

CTV News

Publish Date

Title

May 8, 2018

Fluoride Debate Put On Hold In Windsor

May 17, 2018

Tick Surveillance Program Begins In Windsor-Essex

May 18, 2018

Health Unit To Launch 2018 West Nile Virus Campaign

May 28, 2018

Spring Heatwave: Windsor-Essex Officials Warn Of Heat-Related Illnesses

University of Windsor News

Publish Date Title

May 15, 2018

GLIER Researchers To Provide Updates From Citizen Scientist Water Collection

Windsor Star

Publish Date Title

May 3, 2018

University Finds Legionella Bacteria In Water Pipes Of Six Buildings

May 8, 2018

Decision On Fluoridation Delayed

May 18, 2018

Tick Surveillance Underway At Local Natural Areas

May 22, 2018

West Nile Virus Numbers In Windsor-Essex Increase As Health Unit Begins Annual Prevention Program

May 28, 2018

Expect A Fast, Hot Start To Summer In Windsor-Essex, Says Weather Network

May 28, 2018

Luncheon Health Lecture To Focus On Pot In The Workplace

Windsorite.ca

Publish Date Title

May 21, 2018

Larviciding Program Set To Get Underway

May 28, 2018

Health Unit To Hold Luncheon Series To Discuss Marijuana In The Workplace

Yahoo News

Publish Date Title

May 21, 2018

Health Unit Begins Battle Against West Nile Virus

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


View Document page

Prepared By:

Debbie Silvester, Manager Healthy Families

Date:

June, 2018

Subject:

Baby Friendly Initiative – Journey to Designation

Background

The WECHU’s official road to Baby Friendly Designation started in 2012. However, the promotion and support of breastfeeding has been an integral part of the programs and services provided to pregnant and breastfeeding women and their families for decades.

In 2012, the Ministry of Health and Long-term Care added the Baby Friendly Initiative (BFI) as an accountability indicator for the Family Health standard. The ministry provided guidelines for the process based on the Breastfeeding Council of Canada’s (BCC) Baby Friendly Designation process.

The purpose of the Baby Friendly Initiative is to protect, promote and support breastfeeding. It ensures pregnant families and families with infants have the information they need to make an informed decision on how to feed their infants. It supports not only families who choose to breastfeed but also those who cannot or choose not to breastfeed.  It encourages community partners to work together to promote breastfeeding and ensure families have consistent evidence based breastfeeding information as well as local program and services to help families when they need additional breastfeeding supports.

Current Initiatives

Journey Milestones:

  • May 2012 – Implementation of an external BFI multidisciplinary committee
    • Windsor Essex Baby Friendly Initiative and Healthy Families Committee was formed, comprised of community partners who provide services to pregnant and breastfeeding families (e.g., WECHU Healthy Families Department, local birthing hospitals, LaLeche League, Building Blocks for Better Babies, local Doulas, Early On Centres etc.).
  • August 2012 -  BFI Self-Appraisal Assessment completed
    • The Self-Appraisal was used to identify gaps and develop an overarching plan for the WECHU to achieve BFI designation.
  • Throughout 2013 – Development of BFI policy and Review of all Healthy Families Resources
    • An eLearning module was created to supplement the BFI Policy.
    • All healthy families teaching tools and client resources were reviewed for BFI compliance.
  • May 2014 – Annual corporate BFI Policy and eLearning modules launched
    • All health unit staff and board members completed the eLearning module and signed off on the BFI Policy. In addition, BFI leads were identified within each department.
  • April 2015 –Document Review forwarded to BCC Lead Assessor
    • It included a copy of all current Healthy Families teaching and client resources.
  • September 2015 - Process to gather local breastfeeding rates initiated
    • Began obtaining consents from postpartum moms prior to hospital discharge to contact them in 6 months to complete an infant feeding survey.
  • March 2016 -  Documentation Review finalized and Pre-Assessment Visit booked for Nov. 22, 2016
    • September through November 2016 – All Health Unit staff and board members were provided with education and resources in preparation for the Pre-Assessment Visit.
  • October 2016 – Initial analysis of infant feeding surveys completed
    • Local breastfeeding rate were required for the Pre-Assessment Visit.
  • November 22, 2016 – Pre-Assessment Visit
    • During the visit the Lead BCC BFI Assessor interviewed staff from every department along with several of our direct care staff from the Healthy Families department. The Lead Assessor also visited one of our community programs and contacted several of our clients.
    • In December the BCC Lead Assessor provided a report with requirements and recommendation that needed to be addressed before the WECHU was ready for the External Assessment Visit.
  •  March 2017 – External Assessment Visit booked for November 21, 22, and 23, 2017
    • BCC Lead Assessor approved the Health Unit’s plan to address the recommendations as outlined during the Pre-Assessment Visit and booked the External Assessment Visit.
  • June 14 2017 – A community event held for community partners
    • Information was provided on BFI and how community partners could support BFI messages with their prenatal families and families with young children.
  • September 2017 -  Second analysis of infant feeding surveys completed
    • Update of local Breastfeeding rates were required for the External Assessment Visit.
  • September through November 2017 – All staff and board members prepared for External Assessment Visit
    • All staff, senior management and board members were provided with education and resources in the event they were interviewed by a BCC Assessor.
  • November 21, 22, and 23, 2017 – External Assessment Visit
    • Lead BCC assessors and two additional BCC assessors visited all three health unit sites and conducted staff interviews, reviewed resources, attended community programs and contacted clients. The BCC assessors where impressed with how knowledgeable and prepared the health unit staff were during the interviews.
    • In December, as with the Pre-Assessment Visit the health unit was provided with a report that outlined additional requirements that needed to be addressed prior to receiving the BFI designation. Additional requirements included improving communication with our community partners about BFI and ensuring that spaces in the community WECHU utilizes for maternal and newborn programming are supportive of BFI and the WHO code.
    • March 2018 -  Health unit submitted plan to address concerns outlined in the External Assessment report.
  • April 13, 2018 – Received BFI Designation
    • The Lead Assessor reviewed the plan, requested clarification on resources to be distributed and education materials. Officially awarded the BFI designation after the Health Unit’s response.

While the Healthy Families Department lead the journey, it took all health unit board members, senior management, managers and staff working together to achieve Baby Friendly Designation. Community partners also played a significant role.  Without their willingness to incorporate key BFI messages into their programming; distribute BFI compliant resources; or work directly with us to improve access to community breastfeeding resources we would never have been able to meet all the requirements for Baby Friendly Designation.

Next Steps:

Receiving Baby-Friendly designation ends one leg of our journey and begins another. Re-designation is required every 5 years. We will continue to:

  • Support families to make an informed decision about feeding their babies.
  • Support breastfeeding anytime, anywhere.
  • Promote breastfeeding as the normal way of feeding a baby.
  • Promote exclusive breastfeeding for the first six months of a baby’s life, and continued breastfeeding for up to two years and beyond.
  • Provide breastfeeding education and supports to pregnant and breastfeeding families.
  • Provide individual education and supports to families who cannot or choose not to breastfeed their babies.
  • Provide annual education to health unit staff, senior management and board member on key baby-friendly messages. 
  • Monitor local breastfeeding rates and collaborate with community partners to develop strategies to improve breastfeeding outcomes.

Consultation:

The following individuals contributed to this report:

  • Debbie Silvester, Healthy Families Manager
  • Cathy Bennett, Healthy Families Manager
  • Amanda Ellard-Ryall, Healthy Families Manager

Reviewed by:

Nicole Dupuis, Director Health Promotion

Approved by:

Theresa Marentette, Acting CEO


View Document page

Prepared By:

Jennifer Johnston, Social Determinants of Health – Health Promotion Specialist, Planning and Strategic Initiatives Department

Date:

June, 2018

Subject:

Corporate Health Equity Strategy

Background

The Ontario Public Health Standards (OPHS) outline the minimum expectations for public health programs and services and direct what Boards of Health are required to do. The new modernized OPHS specify that Boards of Health must demonstrate that they are focusing efforts to increase opportunities for health disadvantaged groups to achieve higher levels of health and well-being. Achieving greater health equity in our community has the potential to increase the effectiveness of public health programs and services.

To advance this work, the WECHU’s Planning and Strategic Initiatives Department has developed a corporate health equity strategy. The strategy will help the organization more strategically document efforts, identify areas of opportunity, measure progress, and share successes. 

Based on results from the most recent Board of Health self-evaluation survey, health equity was also identified as an area requiring more information, training, and support. Reviewing the Health Equity Strategy will help increase Board of Health members’ understanding of this topic. An education session on health equity is being planned for the Board of Health in July of this year. 

Current Initiatives

The OPHS provide detailed expectations concerning what Boards of Health are required to do, but they do not include how these should be met. The WECHU’s Health Equity Strategy describes how the organization plans to address these requirements. It is a plan that supports all staff and the Board of Health to build health equity consideration into planning and service delivery.

The WECHU’s Health Equity Strategy is informed by an extensive literature review, consultations with experts in the field of public health equity action, and shaped by staff feedback. It is intended to direct organizational priorities around health equity and outline a shared understanding of equity focused approaches. To increase the effectiveness of the Health Equity Strategy, a detailed action plan is included. This action plan is based on a yearly quality improvement process, enabling the WECHU to continually revise specific approaches to better meet the needs of our staff and the community. This plan is being widely communicated to staff within the organization and will be included as a part of the health equity education session planned for the Board of Health this year.

Consultation:

The following individuals contributed to this report:

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

Approved by:

Theresa Marentette, Acting CEO


View Document page

Prepared By:

Phil Wong, Manager, Environmental Health Department

Date:

June 11, 2018

Subject:

Changes in Public Disclosure Requirements

Background

Health Protection and Promotion Act – Regulatory Changes

The Health Protection and Promotion Act (HPPA) specifies the organization and delivery of public health services in the province of Ontario. The HPPA requires local boards of health such as the Windsor- Essex County Health Unit (WECHU) to oversee or ensure the provision of public health programs and services within their local municipalities.

On October 25th, 2017, proposed amendments to a number of regulations under the HPPA were posted on the Ontario Regulatory Registry. The changes were to modernize and update regulatory requirements to better reflect current evidence and practices for public health programs and services. The changes have addressed inconsistencies, removed redundancies and provide clarity for delivery of the public health services. Some of the changes came into effect on January 1st, 2018 with the remaining changes to come into effect on July 1st, 2018. There were over 110 amendments to the safe food and safe water regulations alone, with over 70% of the changes in the HPPA having direct impact on environmental health program delivery. Any changes to regulations during the modernization process subsequently effects corresponding environmental health protocols, guidance documents and other acts such as the Provincial Offences Act.

Below is a list of new or amended regulations that are enforced by Public Health Inspectors (PHIs) at the WECHU.

  • Personal Service Settings - Ontario Regulation 136/18
  • Food Premises - Ontario Regulation 493/17
  • Public Pools - Ontario Regulation 494/17
  • Public Spas Revocation - Ontario Regulation. 495/17
  • Transitional Small Drinking Water (repeal) - Ontario Regulation 499/17
  • Camps in Unorganized Territory - Ontario Regulation 502/17
  • Recreational Camps - Ontario Regulation 503/17
  • Communicable Disease General - Ontario Regulation 557/90
  • Rabies Immunization – Ontario Regulation 567/90
  • Control of West Nile Virus – Ontario Regulation 199/03

Ontario Public Health Standards - Standard Changes

On January 1st, 2018, the new Ontario Public Health Standards: Requirements for Programs, Services, and Accountability 2018 (OPHS) came into effect.  The OPHS outlines mandatory health programs and services which WECHU must comply with. Local boards of health such as the WECHU are accountable for implementing the standards including any protocols, guidelines and reference documents associated with it. Collectively, there has been a release of over 100 amendments to these documents with many still projected to be released on or after July 1st, 2018. 

Quality and Transparency

The standards require local boards of health to promote a culture of quality and transparency, as well as accountability to community members, clients and other stakeholders. In order to demonstrate transparency, the WEHCU is required to publicly disclose results of all inspections or information in accordance with the following protocols:

  • Food Safety Protocol, 2018 (or as current);
  • Health Hazard Response Protocol, 2018 (or as current);
  • Infection Prevention and Control Complaint Protocol, 2018 (or as current);
  • Infection Prevention and Control Disclosure Protocol, 2018 (or as current);
  • Infection Prevention and Control Protocol, 2018 (or as current);
  • Recreational Water Protocol, 2018 (or as current);
  • Safe Drinking Water and Fluoride Monitoring Protocol, 2018 (or as current);
  • Tanning Beds Protocol, 2018 (or as current);
  • Tobacco Protocol, 2018 (or as current)/ Electronic Cigarettes Protocol, 2018 (or as current);

Summary of Changes

  • Online disclosure is mandatory for all inspections, complaints, convictions and closures
  • On site physical disclosure according to PHI request for all of the following:
    • Personal Service Settings i.e., barber shops, nail salons and tattoo parlors
    • Food premises i.e., restaurants, take out and fast food
    • Recreational water facilities i.e., pools, spas and splash pads
    • Recreational camps

Current Initiatives

In response to these requirements, an upgrade is being made to the Environmental Health Department’s inspection software to facilitate the availability of inspection results on our website.  The Environmental Health Department utilizes inspection software for all inspections, time tracking and investigations. WECHU was one of the first health units in Ontario to use inspection software, migrating from pen and paper to electronic documentation in the early 2000s. This disclosure will go live by the end of 2018.

Owners and operators of premises affected by these changes have been informed in writing in advance of the regulation coming into effect. Letters were mailed out to all municipalities for food premises, personal service settings owners/operators, and owners/operators of public pools and contained a summary of changes and action required in order to comply with the regulation. The Environmental Health Department and the Communications Department at the WECHU are working on a communication plan to launch the new on site physical disclosure requirement, projected to be launched by the end of 2018.

Additionally, the Environmental Health Department will be updating all web content, inspection forms, fact sheets and offering online and onsite operator/owner training courses that reflect the changes to the regulations. All of these updates will be completed by July 1st, 2018.

Data Sources:

 

Consultation:

The following individuals contributed to this report:

  • Karen Lukic, Health Promotion Specialist, Environmental Health Department

  • Mike Tudor, Manager, Environmental Health Department

  • Theresa Marentette, Acting CEO and Director, Health Protection Division

Approved by:

Theresa Marentette, Acting CEO


View Document page

Prepared By:

Amandeep Hans, Health Promotion Specialist, Environmental Health Department

Date:

June 11, 2018

Subject:

Ticks and Lyme Disease Surveillance

Background

Ticks are a relative to the spider and are a crawling, non-flying insect. They vary in size and colour. Ticks are very small (1 to 5 mm) when unfed and female ticks get larger and change colour when fed. Ticks are usually found in wooded areas or areas with long grass, where they attach themselves to humans and animals passing by.

Ticks can spread many diseases including Lyme Disease, Rocky Mountain Spotted Fever, Powassan Virus Disease, and Tularemia. Blacklegged ticks (Ixodes scapularis, formerly called deer ticks) spread the bacteria that cause Lyme disease. The bacteria (Borrelia burgdorferi) are most likely to be transmitted after the tick has been attached to you for more than 24 hours.

The most common symptom of Lyme disease is an expanding bulls-eye skin rash. The rash can begin at the site of the tick bite between three and 30 days after exposure and usually grows in size for several days. Many people never get or see a rash. If the disease is left untreated, other symptoms may develop in the weeks following exposure, including rash, fever, chills, headache, fatigue, muscle and joint aches, problems with your heartbeat, breathing, balance and short-term memory. In rare cases Lyme disease may result in death.

Southwestern Ontario is an established area for Lyme disease. Closer to home, Point Pelee National Park has been identified as an endemic area for blacklegged deer ticks as well as the north shore of Lake Erie, particularly in areas around Long Point, Turkey Point, Rondeau Park and the St. Lawrence Islands National Park. Ticks can be active anytime the temperature is above freezing but the greatest risk of exposure to a tick is during the spring, summer and early fall months.

During the spring and early summer months, ticks can be very small (called nymphs) and once attached can often go unnoticed. This results in a higher chance of being infected with Lyme disease.

Anyone can get Lyme disease, but people who spend more time outdoors are at higher risk. These include: hikers, campers, hunters, people who live or work in an area near woods or overgrown bush, or people who have outdoor jobs. For Lyme disease, there are no vaccines to prevent the illness. Early detection is important to help reduce the risk of developing long-term health effects. Residents can reduce the risk of Lyme disease by using personal protection measures.

To prevent tick bites: 

  • Avoid walking in tall grass and stay on the centre of paths.
  • Cover up. Wear long- sleeved shirts and pants. Tuck your pants into your socks and wear closed toed shoes.
  • Use insect repellant containing DEET or Icaridin on exposed skin and clothing (read and follow directions for use on children). 
  • Do a full body check on yourself and your children after being outdoors. 
  • Shower within 2 hours of being outdoors.
  • Carefully remove any ticks with a tick key or a pair of tweezers.

Current Initiatives

The Windsor Essex County Health Unit’s (WECHU) role is to measure and evaluate the risk of tick-borne disease in our area.  To measure the local distribution and incidence of ticks and Lyme disease cases in Windsor and Essex County (WEC), WECHU uses three surveillance techniques:

Active surveillance involves dragging a white cloth through grassy areas. The ticks attach themselves to the cloth and can be easily spotted. Ticks collected on the cloth are sent to the lab for testing. Tick dragging is performed twice yearly to identify areas in WEC that have populations of blacklegged ticks. Areas for dragging are selected based on known tick habitats as well as areas deemed suitable for potential tick habitats.

Passive surveillance involves residents of Windsor and Essex County submitting ticks to the health unit for identification and subsequent testing if the tick is identified as a blacklegged tick. Passive surveillance is mainly for collection of data and should not be used for diagnostic purposes.

  • In 2017, 386 ticks were submitted through passive surveillance
    • Dermacentor variabills (329 ticks, 84.5%),
    • Ixodes scapularis (32 ticks, 8.2%),
    • Two tested positive for B. burgdorferi. (Lyme Disease)
    • Amblyomma americanum (7 ticks, 1.8%).

Human case surveillance is another important method to determine the level of risk in the community. Lyme disease is a disease of public health significance in Ontario. WECHU investigates reported cases of Lyme disease in the region, although the number of cases fluctuates from year to year.  In 2017, there were 7 cases of Lyme disease in WEC residents.

Table: Ticks and Lyme Disease Surveillance Summary, 2012 to 2017, Windsor-Essex County
Year Blacklegged ticks submitted (%) Other tick species submitted (%) Total ticks submitted that were identified Blacklegged ticks testing positive for B. burgdorferi(%) No. of Lyme Disease cases
2012 1 (2.3%) 43 (97.7%) 44 None 0
2013 4 (4.3%) 90 (95.7%) 94 2 ticks (50%) 3
2014 4 (9.5%) 38 (90.5%) 42 None 5
2015 11 (9.1%) 110 (90.9%) 121 4 ticks (36.3%) 6
2016 7 (4.2%) 160 (95.8%) 167 1 tick (14.3%) 2
2017 32 (8.3%) 354 (91.7%) 386 2 tick (6.25%) 7

Public education awareness campaign in 2017 included key messages that focused on different types of ticks, preventing tick bites, tick removal, tick submission and the cause and symptoms of Lyme disease. These messages were communicated through the WECHU website, social media, presentations and print materials (fact sheets). All surveillance related activities will continue in 2018. Tick dragging was done on May 17, 2018 at 2 sites: Ojibway Nature Centre and Chrysler Greenway. Twelve dog ticks and four black-legged ticks (males) were collected during the tick–dragging session. The black-legged ticks have been sent to the lab for further testing.

References

Consultation:

The following individuals contributed to this report:

  • Theresa Marentette, Acting CEO and Director, Health Protection Division

  • Phil Wong, Manager, Environmental Health Department

  • Mike Tudor, Manager, Environmental Health Department

  • Saamir Pasha, Epidemiologist, Epidemiology and Evaluation Department

Approved by:

Theresa Marentette, Acting CEO


View Document page

Prepared By:

Ashley Kirby, Health Promotion Specialist, Eric Nadalin, Manager, Chronic Disease and Injury Prevention 

Date:

May 25, 2018

Subject:

Smoke-Free Ontario Act 2017 – New Regulations

Background

The Smoke-Free Ontario Act (SFOA) came into effect in May of 2006 imposing regulatory changes which led to significant reductions in smoking and tobacco use across Ontario. These changes led to over 180,000 less smokers across the province, including nearly 13,000 fewer in Windsor-Essex County alone (Canadian Community Health Survey, 2014). In the Spring of 2017, the Minister of Health and Long-Term Care and the government of Ontario committed to the modernization of the Smoke-Free Ontario Act updating the smoking and vaping laws in Ontario to address emerging smoking products which continue to come to market and to continue to make progress toward achieving the lowest smoking rates in the province. Effective July 1, 2018 the Smoke-Free Ontario Act 2017 (SFOA 2017) regulations will repeal the existing SFOA and Electronic Cigarettes Act, 2015 (ECA). The SFOA 2017 will regulate the sale, supply, use, display, and promotion of tobacco and vapour products (e-cigarettes), and the smoking and vaping of medical cannabis. 

Places of Use

The SFOA, 2017 will prohibit the smoking of tobacco, the vaping of any substance, and the smoking of medical cannabis in all enclosed public spaces and workplaces, as well as additional prohibited places, such as children’s playgrounds and sporting fields, which were prohibited under the former SFOA. The SFOA 2017, will further protect Ontarians from second hand smoke and vapour by prohibiting the smoking of tobacco, the use of e-cigarettes, and the smoking and vaping of medical cannabis in additional places that were not previously prohibited under the SFOA. A summary of these prohibitions and a comparison to the previous version and municipal bylaws can be found in Table 1 below.

Table 1: Summary of Regulation Changes Related to Places of Use
Topic/Regulation Current:
Smoke-Free Ontario Act/
Electronic Cigarettes Act
As of July 1st:
Smoke-Free Ontario Act 2017
Impact on Municipal Bylaws
Prohibited Products
  • Smoke or hold lighted tobacco.
  • Smoke or hold lighted tobacco.
  • Smoking or vaping of medical cannabis.
  • Use of an electronic cigarette.

Inclusion of smoking or vaping of medical cannabis and use of an electronic cigarette

Smoke-free Bylaws Impacted:

Municipality of Leamington
Bylaw: 311-13

Smoking/Vaping Prohibition on School Grounds
  • A school as defined in The Education Act.
  • A school as defined in The Education Act.
  • Public areas within 20m of any point on the perimeter of a school.
  • Inclusion of Smoking or vaping of medical cannabis and use of an electronic cigarette.

School property not referenced in any local municipal Bylaws.

Smoke-free Bylaws Impacted:

None.

Smoking/Vaping Prohibition on Children’s Playgrounds and Play Areas
  • Children’s playgrounds
  • Public areas within 20m of any point of the perimeter of a children’s playground.
  • No change for prohibited spaces.
  • Inclusion of Smoking or vaping of medical cannabis and use of an electronic cigarette.

These regulations will continue to supersede outdoor smoking Bylaws in municipalities which provide exemptions for parking lots or designated smoking areas within 20m from the perimeter of playgrounds and play areas.

Smoke-Free Bylaws Impacted:

Town of Amherstburg
Bylaw: 2016-113

Town of Essex
Bylaw: 1228

Town of Tecumseh
Bylaw: 2014-60

City of Windsor
Bylaw: 113-2006

Town of LaSalle
Bylaw: 7775

Smoking/Vaping Prohibition for Sporting Areas
  • Sporting areas
  • Spectator areas
  • Public areas within 20m of any point on the perimeter of a sporting area or spectator area.
  • No change for prohibited spaces.
  • Inclusion of smoking or vaping of medical cannabis and use of an electronic cigarette.

These regulations will continue to supersede outdoor smoking Bylaws in municipalities which provide exemptions for parking lots or designated smoking areas within 20m from the perimeter of sporting areas or spectator areas.

Smoke-Free Bylaws Impacted:

Town of Amherstburg
Bylaw: 2016-113

Town of Essex
Bylaw: 1228

Town of Tecumseh
Bylaw: 2014-60

City of Windsor
Bylaw: 113-2006

Town of LaSalle
Bylaw: 7775

Smoking/Vaping Prohibition on Recreation Centre Property
  • No provincial regulations, but most municipal recreation centers are covered in Smoke-Free Bylaws.
  • The outdoor grounds of a community recreation facility and public areas within 20m of any point on the perimeter of the grounds.
  • Inclusion of smoking or vaping of medical cannabis and use of an electronic cigarette.

These regulations will supersede outdoor smoking Bylaws in municipalities which provide exemptions for parking lots or designated smoking areas on recreation centre property or within 20m of any point on the perimeter of the property.

Smoke-Free Bylaws Impacted:

Town of Amherstburg
Bylaw: 2016-113

Town of Essex
Bylaw: 1228

Town of Tecumseh
Bylaw: 2014-60

City of Windsor
Bylaw: 113-2006

Town of LaSalle
Bylaw: 7775

Smoking/Vaping Prohibitions of Restaurant and Bar Patios
  • Restaurant and bar patios
  • Restaurant and bar patios
  • Public areas within 9m of any point on the perimeter of a restaurant or bar patio.
  • Inclusion of smoking or vaping of medical cannabis and use of an electronic cigarette.

These regulations will supersede outdoor smoking Bylaws in municipalities which provide exemptions for designated smoking areas within 9m of any point on the perimeter of a bar or restaurant patio, such as those which are in operation as part of a fair or festival.

Smoke-free Bylaws Impacted:

Town of Amherstburg
Bylaw: 2016-113

Town of Essex
Bylaw: 1228

Town of Tecumseh
Bylaw: 2014-60

City of Windsor
Bylaw: 113-2006

Town of LaSalle
Bylaw: 7775

Display and Promotion

The SFOA, 2017 will also prohibit the display and promotion of tobacco products, branded tobacco product accessories, and vapour products and any other prescribed product or substance at places where they are sold or offered for sale. While these regulations were in place for tobacco products under the previous legislation, the regulations related to electronic cigarettes and other prescribed products and substances are new and specific to SFOA 2017.

The regulation will include exemptions for Tobacconists and Specialty Vape Shops to display these products if specific conditions are met. These exemptions require business owners to register annually with the Board of Health and abide by the conditions outlined below: 

  • Tobacconists: permitted to display and promote vapour products, if a minimum of 85% of the store's revenues or inventory is dedicated to speciality tobacco products. These requirements have expanded from 50% under the previous Act.
    • The other 15% of store's revenue/inventory can be dedicated to items associated or branded with the name of the tobacconist or a brand of tobacco.
  • Speciality vape stores: permitted to display and promote vapour products, if a minimum of 85% of the store's revenues or inventory is dedicated to vapour products.
    • Are not permitted to sell tobacco products, the other 15% of store's revenue/ inventory can be dedicated to items associated or branded with the name of the vape store or a brand of vape product.

Current Initiatives

Prior to the implementation of the SFOA 2017, our Health Unit will be reaching out to effected stakeholders in the following ways:

  • Meeting with municipalities to educate them on the impact that the Act will have on recreation facilities, sporting areas, parks and playgrounds. As well as how these new regulations will interact with existing smoke-free outdoor space bylaws.
  • Written and in person support to vendors who currently sell e-cigarettes, tobacconists, and speciality vape shops to aid them in complying with SFOA 2017.
  • Written and in person contact with restaurant and bar owners as well as fair and festival organizers to notify them of the restrictions around smoking within 9 metres of patios.
  • Written notification, along with in person meetings with our school board liaison committee and principals to provide education and enforcement expertise regarding the smoke-free space within 20 metres of their school property.
  • Contact owners of medical cannabis vape lounges to inform them that as of July 1st, their current operations will not be compliant with SFOA 2017.
  • Shared work plan being developed among southwest regional health units to create public education materials and a consistent enforcement approach across eight health unit regions.

Consultation:

The following individuals contributed to this report:

  • Southwest Tobacco Control Area Network Steering Committee
  • Southwest Tobacco Control Area Network Enforcement Subcommittee
  • Middlesex-London Health Unit

References:

  • Canadian Community Health Survey. (2014). Tobacco Informatics Monitoring System. Retrieved May 29, 2018

Approved by:

Theresa Marentette, Acting CEO


View Document page

May 17, 2018

Introduction of New Managers:
Kelly Farrugia, Manager, Healthy Schools
Amy Wolters, Manager, Accounting & Financial Reporting

  1. Call to Order
  2. Agenda Approval
  3. Announcement of Conflict of Interest
  4. Approval of Minutes
    1. Regular Board Meeting:  April 19, 2018
  5. Presentation
    1. 1st Quarter Financial Results (L. Gregg)
  6. Consent Agenda
    1. Information Reports
      1. 1st Quarter Financial Results (L. Gregg)
      2. 1st Quarter Update – Strategic Plan (K. McBeth)
    2. Recommendation Report
      1. Provincial Election Priorities (N. Dupuis)
    3. Media Coverage Summary Report (Handout)
  7. Business Arising
    1. Oral Health Presentation (Dr. Ahmed)
    2. KI Distribution Update (Dr. Ahmed)
  8. Board Correspondence - Circulated
  9. New Business
    1. Budget Update - (T. Marentette/L. Gregg) (Handout)
    2. alPHa AGM/Conference-June 10-12, 2018 (T. Marentette)
  10. Other Board of Health Resolutions/Letters - Circulated
  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 June 21, 2018, Essex
  13. Adjournment

View Document page

2018 Q1 WECHU Strategic Plan Progress - At a Glance

Communication and Awareness

Objective

2017

2018
Q1

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

Organizational Development

Objective

2017

2018
Q1

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

Partnerships

Objective

2017

2018
Q1

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

Progressing Work Needed

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

Work Needed Progressing

Evidence-based Public Health Practice

Objective

2017

2018
Q1

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

Communication and Awareness

OBJECTIVE

GOAL

Q1 UPDATE

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

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

Corporate marketing and communications plan still to be developed. Policies and procedures are being updated and developed to address organizational branding across media channels.

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

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

Community engagement plan still to be developed. Enhanced focus on organizational branding has been implemented.

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

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

Employee engagement strategy implementation begins at the start of Q2. Measurements associated with internal communication will be generated as a result of these activities. Activities include: team meeting discussion question on intranet, new web-based all staff meeting, engagement survey with section on internal communication measures.

Partnerships

OBJECTIVE

GOAL

Q1 UPDATE

2.1 Increase the effectiveness of partnerships through formal feedback mechanisms.

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

Development of the partnership tool is still in progress. The tool is in the final stages of development and is currently being revised.

2.2 Increase the number of internal partnerships.

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

19% of work plans included in the 2018 Operational Plan referenced objective 2.2. The PSI department is working to refine the way in which internal partnerships are identified for the 2019 planning cycle.

Organizational Development

OBJECTIVE

GOAL

Q1 UPDATE

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

 

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

2021.

Four corporate level quality improvement activities have been identified for 2018 and are underway, including: maintaining the risk registry and mitigation plans, continuing to improve our planning approach for 2019, developing corporate quality improvement plans, and creating standard procedure for the meeting AODA requirements.

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

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

Exploring options related to ongoing change management training.

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

 

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

Working with leads from LT, the risk registry has been significantly updated through the PSI department. 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. An information report was provided to the Board of Health in April 2018 to apprise them of these updates.

3.4 Improve organizational culture through people development and employee engagement strategies.

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

Employee engagement strategy implementation begins in Q2.

Evidence-Based Public Health Practice

OBJECTIVE

GOAL

Q1 UPDATE

4.1 Establish organizational supports for client-centered service strategies.

 

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

Data collection and analysis of internal client experience survey has continued, with quarterly reporting now for the IT and Facilities Departments. The research protocol for the external facing department client experience survey has been renewed until 2021 through the University of Windsor’s Research Ethics Board. Client experience in other departments is yet to be planned out.

4.2 Develop and implement a framework to support healthy public policy.

 

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

The Public Policy Toolkit and Guidance Document is complete. It will be launched in Q2 with training provided for staff and management. There were two activities focused on healthy public policy completed in Q1 under the Chronic Disease Prevention and Healthy Environments Standard. There are activities focused on healthy public policy in progress under the Chronic Diseases Prevention and Well-being Standard, Substance Use and Injury Prevention Standard, and Healthy Environments Standard.

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

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.

100% of the population health assessment requirements (7), the research, knowledge, exchange, and communication requirements (3) are being addressed by at least one work plan identified in the 2018 planning process. Moving forward, the SPC may consider incorporating the achievement of ASP objectives and indicators related to these requirements into the goal for this objective.

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

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

A corporate health equity strategy was developed and presented to LT. Once implemented, progress towards achieving the goal of the health equity strategy will demonstrate evidence of programs and services using health equity approaches. In addition, the 3 health equity-focused planning tools will be evaluated and a summary report prepared by the end of Q2.


View Document page

Prepared By:

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

Date:

April 10, 2018

Subject:

Strategic Plan Quarterly Report

Background

The 2017-2021 WECHU Strategic Plan allows our organization to identify key roles, priorities and directions and sets out what we plan to accomplish, how we plan to do it, and how our progress will be measured. The plan is based on four strategic priorities: Communication and Awareness, Partnerships, Organizational Development, and Evidence-Based Public Health Practice.

The plan was reviewed by the Strategic Planning Committee (SPC) at the beginning of 2018and a report provided to the WECHU Board of Health (BoH) which summarized the progress our organization made during the first year of implementation.

Current Initiatives

The Planning and Strategic Initiatives department has begun the implementation of a corporate tracking system to monitor Strategic Plan performance and to provide quarterly and annual updates to the BoH. In the first quarter of 2017, progress was made on a number of objectives. The 2018 Q1 Strategic Plan Progress Report provides updates on each objective with corresponding next steps (see appendix A).

Consultation:

The following individuals contributed to this report:

  • Kristy McBeth, Director, Knowledge Management
  • Marc Frey, Manager, Planning & Strategic Initiatives
  • Ramsey D’Souza, Manager, Epidemiology & Evaluation
  • Michael Janisse, Manager, Communications
  • 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


View Document page

Prepared By:

Communications Department

Date:

May 16, 2018

Subject:

April Media Relations Recap Report

April Media Coverage

Total Media Coverage

25

Interview Requests

19

Mentions (In the news without direct interviews)

6

April 2018 Media Relations Recap - Media Coverage

Story Source

April 2018 Media Relations Recap - Story Source

Media Coverage

Outlet

Number of Stories

AM 800

5
CBC 5

CTV

5

Windsor Star

4

Blackburn

2
St. Clair College Media Plex News

1

Watertoday.ca

1

Windsorite.ca

1

Yahoo News

1

News Release and Media Advisories

Date Type Headline Response
March 13, 2018 News Release Windsor Express, Windsor Lancers, and 2 Stories Reported St. Clair Saints Battle It Out at Sliced

2018!
2 Stories Reported
March 14, 2018 Media Advisory Windsor-Essex County Health Unit Board of Health Meeting 3 Stories Reported
March 16, 2018 News Release Windsor-Essex County Health Unit Re-Launches Living Wage Program 5 Stories Reported
March 20, 2018 News Release Grade 11 & 12 Students with Incomplete Immunization Records Suspended Today 7 Stories Reported

Links to Stories

AM 800

Publish Date

Title

April 4, 2018

Lyme Carrying Deer Ticks Found At Ojibway Prairie Complex

April 6, 2018

Health Unit Asking Parents To Brush Up On The Facts

April 20, 2018

Health Unit Want To Reintroduce Fluoride Into The Drinking Water

April 29, 2018

Radon Study Results Worrying Health Unit

April 29, 2018

Health Unit Launches Campaign For Rabies Month

Blackburn News

Publish Date

Title

April 23, 2018

Health Unit Urging Reintroducing Fluoride

April 26, 2018

Amherstburg To Begin Ki Pill Distribution

CBC News

Publish Date

Title

April 20, 2018

Windsor Health Unit Wants Fluoride Put Back Into The Water

April 25, 2018

To Drink Or Not To Drink? Fluoride Debate Set To Hit Council, Again

April 26, 2018

Potassium Iodide Pills To Be Distributed To Amherstburg Residents In Fermi Nuclear Plant's 'Primary Zone'

CTV News

Publish Date

Title

April 8, 2018

'Deliverbae' Delivers

April 25, 2018

Amherstburg Residents Near Nuclear Plant To Get Anti-Radiation Pills

April 29, 2018

Health Unit Launches Campaign For Rabies Month

May 4, 2018

Essex County Dentists Want Fluoride Back In Drinking Water

Watertoday.ca

Publish Date

Title

April 25, 2018

How Health Units Across the Province Are Coping

Windsor Star

Publish Date

Title

April 4, 2018

Deer Ticks That Can Carry Lyme Disease Found At Ojibway

April 4, 2018

Use Of Vapes On The Rise By High School Students

April 19, 2018

Province Narrows Down Potential Sites For Cannabis Retail Store In Windsor

April 20, 2018

Health Unit's Oral Healthcare Plan Calls For Return Of Fluoridation

Windsorite.ca

Publish Date

Title

April 26, 2018

Potassium Iodide (Ki) Pill Distribution To Start In Amherstburg

Yahoo News

Publish Date

Title

April 20, 2018

Windsor Health Unit Wants Fluoride Put Back Into The Water

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


View Document page

Issue

The upcoming provincial election presents the opportunity to promote the endorsement of healthy public policies to key stakeholders vying for seats in Ontario’s Legislative Assembly. The Association of Local Public Health Agencies (alPHa) has released a set of provincial election priorities, spanning across numerous public health topic areas, to call on candidates in the 2018 provincial election to commit their support for a healthier Ontario through a strong local public health system.  These priorities were previously shared with provincial party leaders in December of 2017. The promotion of these priorities is an important step in continuing to advance the profile of public health issues.  Topical public health issues which would benefit from increased regulation, funding, or renewed attention include, tobacco, oral health, opioids, cannabis, and mental health.

In addition, The Centre for Addiction and Mental Health (CAMH) has called upon the three main political parties to “Erase the Difference” in funding between physical health and mental health/addictions. This proposal, in recognition that mental health and addiction agencies currently receive only 6.5% of Ontario’s health budget, is supported by the disproportionately high rates of mental health issues or mental illness as well as the relative burden of these conditions.

Background

The Association of Local Public Health Agencies have outlined five key areas of election policy priorities that focus on improving Ontarians’ health:

  • Tobacco Endgame in Ontario
  • Oral Health for Adults in Ontario
  • Universal Pharmacare Program
  • Public Health Approach to Cannabis in Ontario
  • Opioid Strategy Action Plan for Ontario

Tobacco

Tobacco remains the leading cause of preventable death and illness in Ontario with approximately 36 deaths per day as a result of tobacco use or related conditions. As one of the primary causes of lung disease, heart disease, lung cancer and many other illnesses there is growing support in Canada and globally for a tobacco endgame, with the adoption of endgame targets in Ireland, Scotland, Finland, and New Zealand. A Steering Committee for Canada’s Tobacco Endgame was convened in 2015 and identified an endgame goal of less than 5% tobacco use by 2035.

Oral Health

According to the World Health Organization (WHO), oral health is essential to general health and quality of life. In spite of this, many low income, and middle income Canadians suffer from pain, discomfort, disability, and loss of opportunity because of poor oral health. With under one-third of Ontario workers without employer dental benefits, and 13.9% of the Ontario population living on a low income, there exist significant and impactful financial barriers which prevent many marginalized and low-income adults from accessing preventive and acute dental care. Many acute dental complications which result in emergency department visits are avoidable with timely preventive care such as cleanings and fluoride treatments as well as fillings and extractions. In order to address the underlying causes of the disproportionate number of low-income adults and seniors without access to preventative dental treatments, we recommend that the Ontario government commit to a provincially funded oral health program for low-income adults and seniors in Ontario before 2025.

Opioids

Ontario has one of the highest prescription rates in Canada for opioids, a class of drugs that includes pain relievers such as fentanyl, morphine and OxyContin.  While these drugs can be an effective part of pain management for some medically supervised patients, opioids can be harmful and result in addiction and overdoses. Over the past 13 years, the province of Ontario has experience increasing opioid overdose fatalities and opioids have risen to become the third leading cause of accidental death in the province. In June 2016, Ontario made naloxone, a medicine designed to quickly reverse the effects of opioid overdose, available without a prescription at pharmacies across the province. In October of the same year, Ontario announced its Opioid Strategy to prevent opioid addiction and overdose. Recognizing that lives can be saved through a coordinated prevention, treatment, harm reduction, and enforcement response, many health regions, including Windsor-Essex County, have adopted this four pillar approach in their communities.

Cannabis

Cannabis use carries health risks, including problems with brain functioning (e.g., drug-impaired driving), respiratory problems, and dependence. Canadian youth are among the top users of cannabis in the developed world. In April 2017, the federal government introduced Bill C-45, An Act respecting cannabis and to amend the Controlled Substances Act, the Criminal Act and other Acts. The Act seeks to legalize and regulate recreational cannabis in order to keep cannabis out of the hands of Canadian youth and to prevent organized crime from profiting from the illegal cannabis market.  As provinces and territories will be responsible for licensing and overseeing the distribution and sale of cannabis, there exists the opportunity to develop stringent regulations on promotions, advertising, and marketing, particularly to children and youth These policies have proven effective in tobacco control and should be applied to cannabis legalization. In addition, the government should develop a comprehensive framework to address and prevent cannabis-impaired driving. Indeed, the government should fund a public health approach to cannabis legalization including public education on: risk factors; safer consumption; and a strategy to address impaired driving; would help to mitigate concerns associated with the anticipated increased use as a result of legalization.

Mental Health (Erase the Difference)

Similar to physical health, mental health and illness can take many forms including anxiety disorders, depression/bipolar disorder, eating disorder, obsessive compulsive disorder, phobias/panic disorders, post-traumatic stress disorder, schizophrenia, and suicide. Mental health issues and mental illness affect one in five Ontarians every year however only 6.5% of Ontario’s health budget is allocated to the treatment of these conditions. Inadequate service systems and social alienation are a reality for those affected with poor mental health. A recognition of the importance and prevalence of mental illness and mental health issues warrants a reallocation of resources to help address the treatment “bottle neck”, which acts as a barrier to so many looking for help.

PROPOSED MOTION                       

Whereas, tobacco use remains the number one preventable cause of death in Ontario; and

Whereas, oral diseases, including dental caries and periodontal disease, are among the most prevalent and preventable chronic diseases; and

Whereas, Ontario’s universal health care system does not include dental care for adults and nearly 1 in 3 Windsor-Essex County residents report having no form of dental insurance coverage; and

Whereas, rates of opioid use and opioid-related harms continue to increase in Windsor-Essex County and across the province; and

Whereas, cannabis legalization presents a number of public health concerns and a comprehensive education, harm reduction, and regulatory framework would help to reduce risks associated with youth; and

Whereas, 1 in 5 Canadians struggle with mental health issues and illness every year and the difference in funding between mental and physical health has led to a dearth of services available to those struggling with mental health issues and illness; and

Now therefore be it resolved that the Windsor-Essex County Board of Health supports the Association of Local Public Health Agency’s five areas of provincial election priorities; and

FURTHER THAT, the Windsor-Essex County Board of Health supports a provincial focus on the Tobacco Endgame, tobacco usage rate of less than 5% in Ontario by 2035, and a shift from tobacco “control” to a future that is free from commercial tobacco; and

FURTHER THAT, the Windsor-Essex County Board of Health encourages the Ontario government to fund a, comprehensive, multifaceted action plan for the Ontario Opioid Strategy, including education, harm reduction and treatment.  The action plan should include targets, deliverables, timelines and an evaluation component and be supported by Public Health Units and key community stakeholders; and

FURTHER THAT, the Windsor-Essex County Board of Health encourages the provincial government to adopt and fund a comprehensive public health approach to cannabis legalization, regulation, restriction of access, education and harm reduction in Ontario. This approach should align the regulatory restrictions on cannabis with those on tobacco, as provided in the Smoke-Free Ontario Act; and

FURTHER THAT, the Windsor-Essex County Board of Health supports CAMH’s request for the provincial government to address ongoing financial support inequities and “Erase the Difference” between physical and mental health funding in the Ontario.

Approved by:

Theresa Marentette


View Document page

April 19, 2018

  1. Call to Order
  2. Agenda Approval
  3. Announcement of Conflict of Interest
  4. Approval of Minutes
    1. Regular Board Meeting:  March 15, 2018
  5. Presentation –  Radon Study (P. Wong)
    Oral Health (Dr. Ahmed)
  6. Consent Agenda
    1. Information Reports
      1. Radon (T. Marentette)
      2. Risk Management (L. Gregg/K. McBeth)
      3. Quarterly Planning Update (K. McBeth)
      4. Seasonal Housing (T. Marentette)
    2. Recommendation Reports
      1. Reserves (T. Marentette/L. Gregg)
      2. Oral Health (N. Dupuis)
    3. Media Coverage Summary Report
  7. Business Arising
  8. Board Correspondence - Circulated
  9. New Business
    1. Board of Health alPHa Fitness Challenge (K. McBeth)
  10. Other Board of Health Resolutions/Letters - Circulated
  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 May 17, 2018, Windsor
  13. Adjournment

View Document page

Prepared By:

Phil Wong, Manager, Environmental Health Department

Mike Tudor, Manager, Environmental Health Department

Date:

April 19, 2018

Subject:

Seasonal Housing and Tenant Complaint Processes

Background

The Environmental Health Department’s (EHD) role can be divided into two distinct activities when discussing housing in the City of Windsor and Essex County. These activities include the inspection and assessment of boarding and lodging homes, which include the seasonal housing accommodation, and the investigation of tenant complaints. Both activities require high levels of collaboration with local municipalities, as well as provincial and federal agencies. All activities conducted by the EHD in relation to housing is mandated by Part III of the Health Protection and Promotion Act (HPPA) and the Ontario Public Health Standards: Requirements for Programs, Services and Accountability 2018 (OPHS) and its related protocols and guidelines.

Windsor and Essex County (WEC) leads the province of Ontario when it comes to agricultural activities, with a large number of greenhouses producing crops such as tomatoes and cucumbers. The greenhouse farm operations allow for high yields year round which is unique to this region.  Many of the seasonal agricultural workforce are offshore workers from Mexico and Caribbean countries. This large number of offshore workers adds to the vibrant multicultural communities in towns such as Leamington and Kingsville. It is essential from a public health perspective that seasonal workers are provided with a good standard of living and access to public health programs.

Currently, there are approximately 650 seasonal accommodations throughout WEC that are inspected annually. In 2017 Public Health Inspectors (PHIs) conducted close to 900 inspections, including re-inspections for the approval of these accommodations used to house foreign workers, as well as the investigation of health hazard complaints in these premises. Due to the steady growth of the agricultural sector in the last three years the number of staff hours dedicated to  seasonal housing accommodation inspections has almost doubled. The EHD works with Services Canada and the Foreign Agricultural Resource Management Services (FARMS) to approve all seasonal accommodations for occupancy. PHIs also work with local fire, building, and by-law enforcement to address issues that are associated with seasonal worker accommodations. The inspection and complaint process requires a great deal of coordination as multiple government agencies are involved with the entire process including the Mexican and Jamaican Consulates.

All complaints of potential health hazards are followed up by the EHD. All complaint investigations are required to be initiated within 24 hours and are addressed according to the Health Hazard Protocol 2018 and Health Protection and Promotion Act. The PHI investigating the complaint will collaborate with the local municipal departments that would have the primary role to deal with the identified hazard. This may include joint inspections with local building, fire, by-law enforcement, or public works departments. In 2017 PHIs followed up on over 1000 complaints in WEC of which 170 were related to residential settings. These complaints include but were not limited to mould, sewage, heating, pest, indoor air quality, hoarding, lack of potable water, etc.

Current Initiatives

The Health Hazard Response Protocol 2018 provides direction on the investigation, assessment, and management of mitigation strategies to prevent or reduce the burden of illness from potential, suspected, and/or identified health hazards. The protocol identifies facilities as a place with “public access and/or that serve priority or vulnerable populations in situations where they may present an elevated risk of exposure to health hazards to the public or priority populations. These facilities may include, but are not limited to ice arenas, seasonal farm workers’ housing, schools, childcare centres and other childcare facilities, shelters, and other facilities that may serve priority populations.

The EHD currently provides education, conducts inspections, surveillance, and monitoring, and has a 24/7 on call system in place to respond to all notifications of potential health hazards in the community. A response to all calls received will be initiated within 24 hours of the notification. It is a requirement under the OPHS that the EHD continues to work and collaborate with local municipalities and other community partners to develop effective strategies to reduce the exposures to health hazards.

Approved by:

Theresa Marentette                       


View Document page

Prepared By:

Karen Lukic, Health Promotion Specialist, Environmental Health Department

Date:

April 19, 2018

Subject:

Radon: Know Your Level Project

Background

Radon is a gas that is produced when naturally occurring uranium, found in soil and rock, decays. It can’t be seen, smelled or tasted and is in nearly every home across Canada. When radon gets into buildings and homes, it can accumulate to levels high enough to cause an increase in lung cancer risk. According to Health Canada (2014), long- term exposure to radon is the second leading cause of lung cancer after smoking and the primary cause for non-smokers. Health Canada has set the Canadian guideline for radon levels in the home at 200 Bq/m3. It is recommended that if homes test at 200 Bq/m3 or higher, they should be remediated to reduce levels to as low as physically possible.

Unfortunately, many homeowners are not aware of radon or the level of radon exposure within their homes. A local telephone based survey conducted by the Windsor- Essex County Health Unit (WECHU) found the majority of respondents (62.3%) had no plans to have their dwelling tested with 17.0% of them believing radon testing is not important and there is no risk. In addition, 7.5% did not know how to test their home (RRFSS, 2017). In a cross- Canada study released by Health Canada in 2012, 13.8% of homes tested in Windsor- Essex County (WEC) had radon levels at or above 200 Bq/m3 (Health Canada, 2012). These numbers were comparable to the internal 2015/2016 and 2016/2017 radon studies completed by the WECHU which found 12.2% and 14.6% of homes respectively had levels above 200 Bq/m3 (WECHU, 2016 and 2017). In comparison, based on the Health Canada study in 2012, the proportion of homes in Lambton and Chatham-Kent counties with levels above 200 Bq/m3 were 8.5% and 18.4% respectively.

Public awareness initiatives such as the Radon: Know Your Level Project are put in place to address potential environmental exposures of health hazards to the general public such as radon gas. The WECHU’s Environmental Health Department (EHD) coordinates the monitoring, and surveillance of environmental exposures of public health significance and provides the public with education and mitigation options. These activities are required in the Health Hazard Response Protocol, 2018 and Healthy Environments and Climate Change Guideline, 2018.

The "Radon: Know Your Level" Project

The Radon: Know Your Level Project is a 3-year research study led by the EHD which began in 2015. The goals of the project are to increase awareness of radon and its association with lung cancer; provide the public with radon reduction resources on how to test and reduce the amount of radon in their homes and; determine areas in WEC with higher average indoor radon concentrations and home characteristics associated with higher risk.

During each year of this study, approximately 1000 local homeowners received a free radon testing kit for their homes. Promotion and test kit distribution was strategically implemented during the month of November which is Lung Cancer Awareness month and Radon promotion month in Canada. The kits were distributed equally across the WEC communities and to date, almost 3000 homes in Windsor-Essex have been tested for radon. This project was divided into two phases for each of the study years.

Phase 1

Promotion and Education

Begins in October with a press release announcing the launch of the study and application process, social media posts (Facebook and Twitter) that provide information about radon and promotion of the study, development of WECHU website articles, and posters are distributed throughout the community to notify the public. The WECHU utilizes different avenues to educate homeowners, targeting members of the community through online, in-person and telephone. 

Kit Distribution

The general public was invited to apply to be part of the study by completing a survey that determines eligibility and collects information about the applicant and their home. Phase 1 ends with the distribution of the radon kits to eligible applicants and the beginning of the approximate 3-month testing phase.

Phase 2

Kit Retrieval

This phase begins in March and involves the collection of test kits from study participants. Collected kits are shipped to an accredited laboratory for testing. Results are received within 6-8 weeks of the lab receiving the kits and relayed to the homeowner.

Data Analysis

All data is collected, processed and analyzed by the WECHU team to look for trends to report to the public. All data collected is used to inform future program planning. The data supports the development of strategies that further raises public awareness and reduces environmental health risks in our community.

Highlights of the 2016/2017 Study Report

  • 14.6% of homes in WEC had radon levels above 200 Bq/m³ (compared to 12.2% in the 2015/2016 study).
  • Essex County had a significantly greater proportion of homes with levels above the Canadian guideline (22%)  compared to the City of Windsor (8%).
  • The average indoor radon level for WEC from the 2016/2017 study results was 106 Bq/m³.
  • Amherstburg, Kingsville, Leamington, and LaSalle had average concentrations 20 to 33 Bq/m3 higher than the WEC average.
  • Newer builds (2011 or after) had the highest average indoor radon concentrations.
  • Homes with two levels (i.e., basement and main floor) had 21% higher average radon levels compared to one-level houses with a crawl space partially or completely under the house.

Current Initiatives

The final year of the Radon: Know Your Level project (2017/2018 Study) is nearing completion. Phase 2 was recently completed in March of 2018.  A total of 832 kits were received from the 947 that were distributed for a response rate of 88%.  A report with results from the 2017/2018 study and a final report summarizing all 3 years of the study will be completed in 4th quarter 2018.

Consultation:

The following individuals contributed to this report:

  • Theresa Marentette, Acting CEO and Director, Health Protection Division
  • Phil Wong, Manager, Environmental Health Department
  • Mike Tudor, Manager, Environmental Health Department
  • Saamir Pasha, Epidemiologist, Epidemiology and Evaluation Department

Data Sources:

Approved by:

Theresa Marentette


View Document page

Prepared By:

Dave Jansen, Performance Improvement & Accountability Coordinator (PIAC), Planning & Strategic Initiatives Department

Date:

March 19, 2018

Subject:

Risk Management

Background

In September 2017, a Risk Management Framework was presented to the Windsor-Essex County Board of Health along with a draft risk registry. In this framework, the Planning and Strategic Initiatives (PSI) Department was tasked to maintain the corporate risk registry and construct a plan for corporate risk reporting.

Current Initiatives

To begin the transition of risk management to PSI, the WECHU’s risk management framework was compared to the Association of Local Public Health Agencies’ (alPHa) three-phase implementation approach. This comparison highlighted the progress made to date and the actions necessary to develop risk preparedness. The alPHa documentation suggests that their approach should take approximately three years, with one year assigned to each phase. To summarize this comparison, the WECHU has completed most of the first phase actions, with some updates currently underway. The WECHU is now pursuing a number of items in the second phase, including the creation of a risk management review cycle, complete with key risk indicators, reporting mechanisms, and reporting timelines.       

The second phase of the implementation approach includes a structured and comprehensive risk registry. As such, the draft risk registry approved in September 2017 has been updated to allow for a more robust assessment of risk. Based on resources provided through alPHa, and using the Ontario Public Service Risk Framework, the risk registry was updated as follows:

Risk Identification

Many risks and their consequences were reshaped to better express the uncertainties each risk category brings. With these updates, the corporate risk registry was reduced to 29 risks.


Inherent Risk Assessment

This section still assesses the gross risk, or risk before controls. Each risk’s likelihood and impact are assessed on a scale of one to three, and the inherent risk score is a product of the two.


Controls

This section indicates the efforts we currently have in place to prevent, detect, or correct the risk.


Residual Risk Assessment

This new section measures exposure, that being the level of risk after evaluating the effectiveness of controls. If the control was preventative, the likelihood was reduced. If the controls are detective or corrective, the impact was reduced. The residual risk score is then the product of the two.

If that new score exceeds our risk tolerance or risk appetite, further mitigation actions were identified.


Risk Ownership

Each risk now identifies three separate ownership roles. First is the accountable person, who may approve or veto decisions regarding each risk. Second is the risk owner, who is responsible for the management of that risk. Third is the control owner, who ensures that the control strategies are appropriate and effective.


Risk Monitoring

This section will help monitor the status of risks and action plans, and measure the effectiveness of controls. Key Risk Indicators (KRI’s) will be developed in the near future along with specific timelines for each. Updates to the registry will be made using this data.


The following table provides two separate examples pulled from the updated risk registry.

Section

Subsection

Example A

Example B

Risk Identification

Risk ID

SDO1

F1

Risk

Program Planning. WECHU may be at risk of programs and services not being planned to address the needs of our community or public health requirements.

Funding. WECHU may be at risk that funding uncertainties will hamper the financial planning, monitoring, and decision making processes.

Consequences

  • Inability to meet the requirements of the Ontario Public Health Standards (2018).
  • Staff time and resources gathered through data collection and knowledge exchange wasted or not being used effectively.
  • Increased health disparity/inequity in Windsor-Essex.
  • Inability to satisfy the WECHU's objectives (Strategic and Operational).
  • Inability to meet the requirements of the OPHS.
  • Cost reduction measures (i.e. headcount reductions; prioritization of expenditures) and resulting impact on staff morale.
  • If late approval or approval in excess of budget, lost opportunities if the WECHU is unable to act on plans.
  • Organization’s reputation is at risk.

Inherent Risk Assessment

Likelihood (L)

2

3

Impact (I)

3

3

Score (L x I)

6

9

Controls

Control Type

Preventative & Corrective

Detective

Control Strategy

  • Annual Service Plan submitted to MOHLTC
  • WECHU Operational and Departmental Plans. 
  • Departmental and corporate planning support from Planning and Strategic Initiatives Department (PSI).
  • Monthly variance analysis comparing budget to actual financial results reviewed by Leadership Team (LT) and Board of Health (BoH).
  • Responsible budget process that balances finite resources with program/departmental priorities.
  • Identification of priorities (i.e. contract positions, operating expenditures) to be strategic with budget/planning reallocation when positive budget variances are realized.
  • Forecasting of expenditures on a quarterly basis (internal).

Residual Risk Assessment

Likelihood (L)

1

3

Impact (I)

2

2

Score (L x I)

2

6

Action Required

  • Continually review and update planning processes and procedures to meet changing public health requirements and organizational needs.
  • Expanded variance analysis to provide budget to actual, budget to forecast, and year-over-year variance analysis.
  • Evaluation of budget (process and quality).

 

Ownership

Accountable

CEO

CEO

 

Risk Owner

Director,

Knowledge Management

 

Director,

Corporate Services

Control Owner

Director,

Knowledge Management

Manager,

Accounting & Financial Reporting

Risk Monitoring

KRI’s

TBD

TBD

Reporting Period

TBD

TBD

The WECHU expects to begin the third phase of the risk management implementation approach by the end of the 2018, which will involve rolling out risk management to all operational levels.

Consultation:

The following individuals contributed to this report:

  • Lorie Gregg, Director, Corporate Services
  • Kristy McBeth, Director, Knowledge Management
  • Marc Frey, Manager, Planning & Strategic Initiatives

Approved by:

Theresa Marentette


View Document page

Prepared By:

Communications Department

Date:

April 4, 2018

Subject:

March Media Relations Recap Report

March Media Coverage

Total Media Coverage

40

Interview Requests

31

Mentions (In the news without direct interviews)

9

March Media Relations Recap - Media Coverage

Breakdown of Top Stories

Topic

Requests for Interviews

Mentions in the News (no interviews)

CHC Smoke-Free Housing Policy

2

1

Dental Health Coverage/NDP

1

0

Dental Health Survey

1

0

ER Trips For Kids With Severe Allergies

1

0

Flu Update

2

1

Health Needs/Town Of Amherstburg

1

0

Living Wage

3

2

Measles

2

0

Online Nutrition Challenge

1

0

Opioids

3

1

Sliced

1

1

Student Immunizations and Suspensions

11

2

Ticks

1

1

Vaping and Student Health

1

0

March Media Relations Recap - Story Source

Media Coverage

Outlet

Number of Stories

CBC

10

AM 800

7

CTV

7

Windsor Star

6

Blackburn

4

Windsorite.ca

3

Advocator.ca

1

Windsor Business Magazine

1

Yahoo News

1

News Release and Media Advisories

Date Type Headline Response
March 13, 2018 News Release Windsor Express, Windsor Lancers, and 2 Stories Reported St. Clair Saints Battle It Out at Sliced

2018!
2 Stories Reported
March 14, 2018 Media Advisory Windsor-Essex County Health Unit Board of Health Meeting 3 Stories Reported
March 16, 2018 News Release Windsor-Essex County Health Unit Re-Launches Living Wage Program 5 Stories Reported
March 20, 2018 News Release Grade 11 & 12 Students with Incomplete Immunization Records Suspended Today 7 Stories Reported

Links to Stories

AM 800

Publish Date

Story Link

March 7, 2018

Sad But Not Surprised: Local Reaction To Latest Stats On Opioid-Related Deaths

March 16, 2018

Living Wage In Windsor-Essex Is $14.81/Hour According To Local Health Unit

March 19, 2018

Health Unit Put Focus On Nutrition With Sliced Competition

March 20, 2018

388 High School Students Suspended In Windsor-Essex

March 27, 2018

Suspensions Down Due To Incomplete Immunization Records

Advocator.ca

Publish Date

Story Link

March 31, 2018

Deer Ticks Found at Ojibway Prairie Complex. Do They Carry Lyme Disease?

Blackburn News

Publish Date

Story Link

March 13, 2018

Over 800 Students Face Suspension Next Week

March 20, 2018

Nearly 400 Students Suspended

March 23, 2018

Flu Season Not Over Yet in Windsor-Essex

CBC News

Publish Date

Story Link

March 12, 2018

Flu has already caused 18 deaths and 31 outbreaks, and the season is not over yet

March 15, 2018

Windsor Essex Community Housing Corporation implements smoke-free policy

March 16, 2018

Health officials say $14.81/hr is what it costs to live comfortably in Windsor-Essex

March 16, 2018

Immunization deadline for grade 11 and students is Monday

March 16, 2018

Detroit measles exposure prompts health unit to remind people to be vaccinated

March 20, 2018

Almost 400 students suspended over incomplete immunization records

March 29, 2018

Ticks that can transmit Lyme disease found at Ojibway Prairie Complex

CTV News

Publish Date

Story Link

March 8, 2018

Opioid-related deaths up across province in 2017, including Windsor-Essex

March 13, 2018

Health Unit reminds residents of online immunization reporting tool

March 16, 2018

Health unit says living wage in Windsor-Essex is $14.81/hour

March 19, 2018

Suspensions expected as immunization deadline looms for high school students

Windsor Star

Publish Date

Story Link

March 2, 2018

Social housing starts forbidding smoking in units, with little protest

March 6, 2018

Guidelines released to combat opioid epidemic call on doctors, hospitals to join fight

March 15, 2018

Travellers at Detroit airport might have been exposed to the measles

March 15, 2018

Health unit calculates 2018 local living wage at $14.81 an hour

Windsorite.ca

Publish Date

Story Link

March 16, 2018

Health Unit Re-Launches Living Wage Program

March 17, 2018

Photos: Annual Sliced Competition Cooks Up A Storm At Devonshire Mall

March 20, 2018

Students With Incomplete Immunization Records Suspended Today

Yahoo News

Publish Date

Story Link

March 15, 2018

Windsor Essex Community Housing Corporation implements smoke-free policy

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


View Document page

Prepared By:

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

Date:

March 27, 2018

Subject:

Quarterly Planning Report

Background

In 2017, the WECHU introduced a new electronic planning system using project management principles to help us more closely align our planning strategies with operational activities. This system was developed with key public health program and service requirements in mind, and focused on embedding evidence-based approaches, health equity, privacy, ethics, and our strategic priorities into departmental work plans. Shortly after development, training, and implementation of the WECHU’s new planning system, the Ministry of Health and Long Term Care (MOHLTC) officially released the modernized Ontario Public Health Standards (OPHS) 2018.

With the introduction of the modernized standards, the MOHLTC included the requirement to complete an Annual Service Plan (ASP) in conjunction with the 2018 budget submission.  The ASP describes the programs and services that the WECHU plans to deliver based on provincial public health requirements, local needs, and budgets at the program level, and includes self-generated objectives and measures for monitoring program performance.

Following the completion of the 2018 planning cycle and the submission of the first ASP, the Planning and Strategic Initiatives (PSI) Department undertook an assessment of both processes and templates in order understand the challenges and successes of each process and to look for ways to better align our planning approach with the MOHLTC requirements.  Planning staff and managers took part in a multi-step feedback process, and the ASP was reviewed by the PSI department to compare its content to 2018 work plans previously completed by departments. This information will be used to inform the development of a new reporting structure for 2018 and beyond.

Current Initiatives

2018 Reporting Structure

The primary goals of the WECHU’s reporting structure (including both operational and strategic reporting) is to ensure ongoing quality improvement through monitoring and to provide organizational insight to the Leadership Team and the WECHU BoH to facilitate evidence driven decision making. A coordinated and consistent planning and reporting structure also provides timely identification of emerging issues and program/service gaps, and supports the values, priorities, and objectives of the WECHU’s strategic plan.

Over the next quarter, an updated reporting structure, reflective of new public health requirements, will be developed to monitor the objectives and indicators identified in the WECHU’s ASP, and to support the implementation of operational work plans as required.

Operational Planning/ASP Alignment

Based on the ASP and work plan comparison as well as feedback from the 2017 cycle, PSI staff will work with managers and departments to align the 2018 organizational planning outcomes with the MOHLTC requirements in order to maximize efficiency and ensure consistency across the organization.

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

Issue

Constrained financial resources coupled with late funding approvals from the Ministry of Health and Long-Term Care limits the ability of the Windsor-Essex County Health Unit to address public health needs within the Community of Windsor and Essex County.

Background

The Windsor-Essex County Health Unit (“WECHU”) is a publicly funded organization.  As such the WECHU has a responsibility to spend funds prudently and with the objective of providing public health programs and services as required under the Health Protection and Promotion Act, R.S.O. 1990 (“HPPA”) and the Ontario Public Health Standards:  Requirements for Programs, Services, and Accountability (“OPHS”). 

The WECHU is funded through grants from the Province of Ontario, more specifically the Ministries of Health and Long-Term Care (“MOHLTC”) and the Children and Youth Services (“MCYS”) (collectively referred to as “Ministries”).  As well it is funded through required contributions from the Corporation of the City of Windsor (“City”), the Corporation of the County of Essex (“County”) and the Corporation of the Township of Pelee (“Pelee”) (collectively referred to as “the Obligated Municipalities”). 

Programs funded by the Ministries through grants can be categorized as follows:

  • Public Health and Health Promotion Mandatory Programs funded to a maximum of 75% by the MOHLTC;
  • Public Health Mandatory Programs funded at a rate of 100% by the MOHLTC;
  • Health Promotion Programs funded at a rate of 100% by the Ministries
  • Public Health and Health Promotion one-time funding business cases funded by the MOHLTC;
  • Health Capital one-time funding business cases (historically funded at a rate of 100% but depends on the nature of the request) funded by the MOHLTC.

The budget for the Public Health and Health Promotion Mandatory Programs funded to a maximum of 75%, commonly referred to as the Cost Shared Program, is presented to the Board of Health for the Windsor-Essex County Health Unit in the November to January timeframe annually.  That budget forms the basis of the Annual Service Plan and Budget Submission to the MOHLTC. Approval of the Annual Service Plan and Budget Submission by the MOHLTC has historically been in the 4th quarter of the WECHU’s fiscal year (January 1 to December 31).  For example, the Cost Shared Program budget for the 2017 fiscal year was approved in December of 2016.  MOHLTC funding approvals were received mid-November 2017.

The delay in the approval process creates a number of challenges for the WECHU:

  1. Overspending – The delay in the approval process puts the WECHU at risk of overspending.  This circumstance can arise if the budget submission assumes an increase in MOHLTC funding that is subject to approval historically at a later date.  In this circumstance, the Obligated Municipalities would be required to fund a deficit that may arise from operationalizing the approved Cost Shared Budget.  This obligation is set out in the HPPA, in the following provision:
    Payment by obligated municipalities
    72 (6) Where additional expenses incurred
    If, after a notice is given by a board of health under subsection (5) in a respect of a year, additional expenses referred to in subsection (1) that were not anticipated at the time the notice was given are incurred during the year, the board of health may give another written notice to each obligated municipality in the health unit, specifying the additional amount for which the obligated municipality is responsible under this section and the time at which the addition amount must be paid.
  2. Underspending – This is the inability of WECHU to spend funding received from the Ministries and Obligated Municipalities. The following scenarios help articulate this challenge:
    1. Mandatory Programs – Human Resource Information System (“HRIS”):  The 2017 budget submission included a one-time business case to support WECHU acquiring and implementing a HRIS.  As approval of this business case was not received until mid-November of 2017, WECHU Administration was not able to embark upon the necessary activities to acquire and successfully implement the HRIS by March 31, 2018.  This funding will be returned to the MOHLTC.  A one-time business case for an HRIS was submitted to the MOHLTC with the 2018 Annual Service Plan and budget submission.
    2. Assumed increase in funding from the MOHLTC:   In recent history, the WECHU has integrated an assumed percentage increase in base funding from the MOHLTC.  Recognizing that the Obligated Municipalities bear financial risk in the event that the budgeted augment in funding is not approved, the WECHU proceeds cautiously during the fiscal year monitoring budget variances and identifying other operating efficiencies to ensure the budget is not overspent.  Administration recognizes and does its best to balance what is required of the WECHU under the HPPA with the fact that we operate using finite financial resources funded by the Community of Windsor-Essex County that we serve. 
  3. Re-prioritization of resources to address emerging public health needs – In 2017 in response to increasing opioid-related deaths in Windsor and Essex County as well as the Province of Ontario, WECHU reassigned already constrained resources to help support the development of a local opioid strategy.  In early 2017, the WECHU made certain decisions to defer activities associated with other public health needs to address this emergent issue.   The MOHLTC announced additional funding to support this initiative in June of 2017.

The above represent a few examples of the challenges faced by the WECHU associated with late funding approvals from the MOHLTC.  Like the other 36 public health units within Ontario we have expressed our concerns to the MOHLTC regarding late funding approvals.  We have made appeals to the MOHLTC for certain one-time 100% funded business cases to be extended to allow us the opportunity to establish these initiatives and expend funding.  In two instances in recent years we have been successful.  But this success likely represents a lost opportunity in future periods to redirect those funding asks and efforts to other public health needs.

Reserves and reserve funds

Reserve and reserve funds have historically been used by public sector entities to ensure that adequate financial resources exist to fund specific initiatives and/or circumstances that arise that were unforeseen in the current year’s budget.   Contributions to and utilization of reserves and reserve funds typically follow a prescribed methodology in accordance with an Organization’s Corporate By-Laws or approved policy. The Province of Ontario does not permit Public Health Units to contribute unspent grant funding into a reserve fund.  The following section within the 2014 Accountability Agreement dated January 1st, 2014, address this matter:

15.5 Carry Over of Grant Not Permitted.  The Board of Health is not permitted to carry over the Grant from one calendar year to the next, unless pre-authorized in writing by the Province.

Therefore, reserves or reserve funds held by a public health unit would need to be established through contributions from Obligated Municipalities or other funding sources.

The WECHU currently has the following reserve funds.  These reserve funds were not established using contributions from the Obligated Municipalities.  They have specified purposes for which funding can be utilized.

Employee future benefits fund:  This reserve fund was established as a result of the demutualization of Mutual Life to help defray the future employee benefit costs incurred by the WECHU.  At December 31, 2016, the balance of this reserve fund was $180,929.

Septic fund:  The Septic reserve fund was established from the Ministry of Environment for septic inspection services and have been retained in a reserve fund to help defray costs associated with septic inspection services.  At December 31, 2016, the balance of this reserve fund was $43,365.

The WECHU did an informal survey of 36 other public health units in Ontario to understand whether they do/do not have reserve funds and if so, are those reserve funds supported by policy.

The enclosed table summarizes the results from the respondents

Public Health Unit

Does your PHU have reserves?

Do you have Policy?

Types of Reserves?

Algoma Public Health

Yes

Yes

Working Capital Reserve, Land Control Reserve, Human Resources Management Reserve, Public Health Initiatives and Response Reserve, Corporate Contingencies Reserve, Facility and Equipment Repair and Maintenance Reserve

Chatham-Kent Public Health Unit

Administered by Municipality

-

-

Elgin-St. Thomas Public Health

Yes

Yes

Reserve funds are to be used for items such as employee pay equity adjustments, vacation and sick leave entitlements, capital repairs and replacements, unforeseen program and or corporate expenses, or any other items as deemed necessary by the Board of Health.

Grey Bruce Health Unit

Yes

No details provided.

No details provided.

Haliburton, Kwartha, Pine Ridge District Health Unit

Yes

Yes

Use at the discretion of the Board of Health and to be maintained at no less than 75% of one month’s operating expenses.

Halton Region Public Health

Administered by Municipality

-

-

Hastings Prince Edward Public Health

Yes

Yes

Operating Fund Reserve, Capital Fund Reserve

KFL&A Public Health

Yes

Yes

Board of Health Reserve Fund; Capital Fund Reserve; Excess recoveries for private sewage system programs

Lambton Public Health

Administered by Municipality

-

 

-

Middlesex-London Health Unit

Yes

Yes

Funding Stabilization Reserve, Dental Treatment Reserve Fund, Sick Leave Reserve Fund, Environmental Reserve - Septic Tank Inspections,  Technology & Infrastructure Reserve Fund, Employment Costs Reserve Fund

Niagara Region Public Health

Administered by Municipality

-

-

North Bay Parry Sound District Health Unit

Administered by Municipality

-

Examples of how reserves can be used:  i)  to address one-time short-term expenditures, planned or unplanned; ii) to match provincial dollars (25/75) or be used 100% toward the cost of the expenditure.

Ottawa Public Health

Yes

Yes

Technology Reserve

Perth District Health Unit

 

Yes

No details provided.

No details provided.

Peterborough Public Health

Yes

Practices in place but no specific policy.

Capital, Program, Contingency, Septic Program, Other

Public Health Sudbury & Districts

Yes

Yes

Working Capital, HR Management, Public Health Initiatives& Response, Corporate Contingencies, and Facility Equipment Repairs and Maintenance

Simcoe Muskoka District Health Unit

Yes

Yes

Sick Leave Reserve Fund, Contingency Reserve Fund, Capital Reserve Fund

Thunder Bay District Health Unit

Yes

Yes

Sick Leave Plan Allowance Reserve, Capital Expenditures Reserve, Land Development Reserve, Program Contingency Reserve, Benefit Cost Stabilization Reserve, SFH Training Reserve

Toronto Public Health

Administered by Municipality

-

-

Wellington-Dufferin Guelph Public Health Unit

Yes

Yes

Facilities Reserve, Contingency Reserve, Technology Reserve, Orangeville Facilities Reserve, Guelph Facilities Reserve, Fluoride Varnish Program Reserve, Poverty Elimination Task Force Reserve

Public Health Units that responded indicated that they either held reserves directly or that reserves were administered by their respective municipalities.  Furthermore, respondents indicated that reserves were supported by policy and or guidelines as established by corporate bylaws.  Certain of these Organizations have shared those policies with the WECHU and will serve as good resources to support our own policy development if directed by the Board to do so.

With a proper policy and reporting structure, the reserve fund mechanism funded through contributions from the Obligated Municipalities could provide the necessary resources to address the challenges identified above.  More specifically:

  • Reserve funds could assist in mitigating financial risk in future periods to the Obligated Municipalities in instances where the WECHU has overspent.
  • Reserve funds could serve to provide cash flow for implementation of 100% funded business cases in advance of MOHLTC approvals thus ensuring that funding approvals will be spent irrespective of the timing of those approvals.  Cash flows would then be returned to the reserve fund for future uses.
  • Reserve funds could serve to provide cash flow for emergent public health needs rather than re-prioritizing or deferring other public health activities.

Proposed Motion

Whereas the Windsor-Essex County Health Unit is funded through grants from the Province of Ontario and required contributions from the Obligated Municipalities, and

Whereas the Province of Ontario does not permit for unspent grants to be carried forward to the next fiscal year irrespective of the timing of approvals, and

Whereas the Windsor-Essex County Health Unit presently does not have reserves and reserve funds that could be drawn upon to address the challenges associated with late funding approvals from the Province of Ontario as well as emergent public health needs, and

Now therefore be it resolved that the Windsor-Essex County Board of Health direct Administration to send an appeal to the Province of Ontario requesting that they consider revisiting the timelines for approval of grants to public health units as approvals in recent years have hindered public health units to implement public health initiatives with approved funds.  In addition, the appeal should request for the Province of Ontario to revisit its position on contribution of unspent grant funding into a reserve, recognizing that the Province of Ontario would need to provide appropriate policy and reporting structure over such reserve funds.

FURTHER THAT the Board direct Administration to write a report, including a proposed policy and reporting framework, and present their request for the establishment of Reserves and Reserve Funds to the Administrations of the Obligated Municipalities for feedback and support, and

FURTHER THAT the Board direct Administration to present a report to the Councils of the Obligated Municipalities for the establishment of Reserves and Reserve Funds for their consideration and approval.


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Issue

Oral health is a key part of overall well-being and can directly impact a person’s quality of life. The Canadian Dental Association outlines oral health as a state that is linked to a person’s physical and emotional well-being (Canadian Dental Association, 2010). Good oral health means being free of mouth and facial pain, cavities, periodontal disease, and any other negative issues that impact our mouths (World Health Organization). Two of the most common oral health diseases are tooth decay (cavities) and periodontal disease (gum disease). In Canada, 57% of children, 59% of adolescents and 96% of adults have been affected by tooth decay.

Oral health has a direct as well as an indirect impact on a person’s overall health and quality of life. At a community level, complications from poor dental health may also have serious consequences for our healthcare system including unnecessary oral health related trips to our hospital emergency departments further adding to the existing long waits in the emergency rooms. In Ontario, over 60,000 emergency department visits were related to tooth pain. The Ontario medical system spends at least 38 million dollars per year treating oral health problems in emergency departments and physician’s offices. Prevention is critical to good health. Tooth decay and gum diseases are almost always preventable, with preventive oral health services/strategies that should be available to all individuals in our community. In Ontario, the majority of oral health care services are not publicly funded, which means that Ontarians are responsible for the costs of their own dental care. Ontario provides public dental coverage to children of low income families, but there are very few options for adults with low income, including seniors (Wellesley Institute, 2015).

Windsor-Essex County’s Oral Health 2016 report highlighted the oral health profile of our community and also made recommendations to improve the oral health status and access to oral health care in our community. Despite all these efforts, the oral health status of our community continues to remain a public health concern.

Background

Oral health and general health should not be thought of separately; oral health is one important component of overall health (Seto et al.2014). In recent years an increasing amount of research has shown an important link between oral health and overall health. Oral health issues have been linked to respiratory infections, cardiovascular disease, diabetes, as well as a potential link between maternal periodontal disease and babies with low birth weights.

Many of the same social and economic determinants of health (e.g., income, employment, education, access to health services, social support networks) also impact the oral health of people and communities. The World Health Organization states that oral health is an important determinant of the quality of life.

Oral Health Services in Windsor and Essex County:

There a many programs that operate in Windsor-Essex County with the aim of improving oral health, primarily among children. These include programs and services offered in collaboration between public health, school boards, primary care and others. The Windsor-Essex County Health Unit (WECHU) provides clinics in both Leamington and Windsor serving children and youth from 0-17 under the Healthy Smiles Ontario program (HSO). 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. Over the past several years WECHU has seen an increase in the number of individuals requiring treatment as well as an increase in the wait times associated with services. As a result, the WECHU has increased their staffing and clinics with additional funding from the Ministry of Health and Long Term Care in order to address some of the increasing need. The WECHU has also worked closely over the past few years with the dental community and its community partners to increase oral health education including the introduction and implementation of the baby oral health program and fluoride varnish pilot.

Unlike those for children, there are very few publically funded programs available to adults, including seniors, in Ontario. Ontario Works and the Ontario Disability Support Program offer services to some adults, but are limited to very basic dental services (which are at the discretion of the municipality that funds these programs). In Windsor-Essex County there are two options available for adults and seniors who do not have insurance or the resources to pay for dental services (cleanings only). St. Clair College offers full mouth scaling by dental hygiene students. A second program offering dental services (cleanings only) is Street Health, a program of the Windsor Essex Community Health Centre.  Operation Smile is an event that is hosted by the Essex County Dental Society, in partnership with the St. Clair College dental clinic. The yearly one-day event is designed to promote oral health in the community and offers basic restorative and surgical services to people that might not otherwise have access to such services.

Oral Health Assessment and Surveillance Reporting in Windsor-Essex:   

The Windsor-Essex County Health Unit (WECHU) provides programs and services under the guidance and direction of the Health Promotion and Protection Act (HPPA) and the Ontario Public Health Standards (OPHS). The OPHS include a requirement for the assessment, surveillance and reporting of oral health data including information collected through school based screening conducted in accordance with the Oral Health Protocol. The information collected through school screening includes the number of decayed, missing and filled teeth (DMFT) for each child in JK, SK and grade 2 and is recorded in the Oral Health Information Support System (OHISS). The WECHU began reporting DMFT in OHISS in the school year 2011/2012 and has continued to screen and report since that time.

In keeping with population assessment and surveillance requirements identified in the OPHS and associated protocols, in 2015 the WECHU devised a plan to report oral health data to community stakeholders, the general public, and target populations for the purpose of knowledge exchange, informing healthy public policy and health service planning. This plan included the development of the first Oral Health Report released in 2016 with the intent to update every five years. The 2016 Oral Health Report provided a comprehensive view of the oral health status of residents in Windsor-Essex using the most current data available and accessible by the health unit for the past five years. In the beginning of 2016, Ontario made changes to all provincially funded oral health programs combining them into a newly launched Healthy Smiles Ontario (HSO). Due to the changes in how eligibility is assessed and services are provided under HSO it was determined that reporting data up to 2016 was a natural starting point for the Oral Health survey ensuring the five-year cycle from 2016 to 2021 would represent five years under the new HSO system.

Requests for Oral Health Assessment and Surveillance Data and Response:

In 2013 the City of Windsor council made a decision to discontinue the fluoridation of the water supply. This decision affected the communities of LaSalle, Tecumseh and the City of   Windsor. Specifically, the council decision was as follows:

That City Council PASS a by-law DIRECTING the Windsor Utilities Commission to CEASE the fluoridation of the City of Windsor water supply while ensuring continued regulatory compliance, and that the savings from this action BE DIRECTED to oral and health nutrition education in Windsor and Essex County, for a period of 5 years, to be spent at the discretion of the Community Development and Health Commissioner.

At that time the WECHU had agreed to look at its oral health data and that of the community for a period of five years beginning in 2013 and bring back a report on the oral health of the community in 2018. Since this time, the WECHU has continued to collect and analyze its oral health data and has consulted with experts in oral health research to best determine what is able to be reported given the data available and the time frame of collection. The Oral Health Report (2018, update) provides 6 years of school screening data and allows the WECHU to look at overall oral status of the community, compare with Ontario averages and determine the trends for oral health outcomes across Windsor-Essex.

Based on the findings detailed in the Oral Health report (2018 update) the WECHU recommends:

  • Windsor-Essex municipalities continue to or introduce community water fluoridation as a key prevention strategy for dental caries
  • Continued support for oral health education and awareness in the community
  • Improve access to oral health services within Windsor-Essex
  • Advocate for improved funding and expansion for public dental programs such as Healthy Smiles Ontario

Amended Motion

Whereas Oral health is an essential part of overall health, and

Whereas the Ontario Public Health Standards require the assessment, surveillance and reporting of Oral Health data to community partners including municipalities, and

Whereas municipalities are in the position to create healthy public policies and bylaws that impact resident’s health and overall wellbeing, and

Whereas the Oral health of residents in Windsor-Essex is much worse than Ontario and comparable communities and continues to worsen, and

Now therefore be it resolved that the Windsor-Essex County Board of Health receive the Oral Health Report (2018) and supports the accompanying recommendations for:

  • The City of Windsor to reintroduce fluoridation in the water system.
  • The County municipalities to reintroduce fluoridation in the water system.
  • Ongoing support for oral health education and awareness in the community.
  • Improved access to oral health services within Windsor-Essex.
  • Advocacy efforts for improved funding and expansion for public dental programs such as Healthy Smiles Ontario.

FURTHER THAT the Windsor-Essex County Board of Health share the Oral Health Report (2018) and this resolution with municipal and community partners, stakeholders, the general public and identified target groups, and

FURTHER THAT the Windsor-Essex County Board of Health request through delegation to present the Oral Health report, its findings and recommendations at the whole of City of Windsor Council and the County of Essex Council in May/June of 2018, and

FURTHER THAT the Oral Health Report (2018) and this resolution be shared with all other health units in the province of Ontario, the Minister of Health and Long Term Care, the Ontario Dental Association and local members of parliament.


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March 15, 2018

Introduction:  Board of Health Member, Judy Lund

  1. Call to Order
  2. Agenda Approval
  3. Announcement of Conflict of Interest
  4. Approval of Minutes
    1. Regular Board Meeting:  February 15, 2018
  5. Presentation - None
  6. Consent Agenda
    1. Information Report - Shared Calendar Project (N. Dupuis)
    2. Information Report –Windsor-Essex Community Housing Corporation Smoke-Free Policy (N. Dupuis)
    3. Information Report – Immunization of Schools Pupils Act Implementation Update (T. Marentette)
    4. Information Report – Windsor-Essex County Living Wage Program (N. Dupuis/K. McBeth)
    5. Media Coverage Summary Report
  7. Business Arising
    1. Reserves (G. McNamara)
  8. Board Correspondence - Circulated
  9. New Business
    1. Annual Service Plan - Handout (T. Marentette)
    2. Annual Service Plan – Resolution and Recommendation Report - Handout (T. Marentette/L. Gregg)
  10. Other Board of Health Resolutions/Letters - Circulated
  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 April 19, 2018, Essex
  13. Adjournment
Board Meeting Agenda - March 2018 (PDF)
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Board Members Present:

Joe Bachetti, Paul Borrelli, Mark Carrick, Dr. Deborah Kane, Judy Lund, Bill Marra, Gary McNamara, Richard Meloche, Carlin Miller, Gord Queen, Ed Sleiman, Michelle Watters

Board Member Regrets:

Dr. Ken Blanchette, Hilary Payne, John Scott

Administration Present:

Dr. Wajid Ahmed, Nicole Dupuis, Lorie Gregg, Theresa Marentette, Kristy McBeth, Dan Sibley, Rosanne St. Denis (Recorder)

Administration Regrets: 

None.

  1. Call to Order
    The meeting was called to order at 4:01 p.m. Judy Lund was welcomed as the latest addition to the board. Dr. Carlin Miller was welcomed having been reappointed by the province.
  2. Agenda Approval – Addition - 13.0 Other
    It was moved
    That the agenda be approved
    CARRIED
  3. Announcement of Conflicts of Interest– None
  4. Approval of Minutes
    1. Regular Board Meeting: February 15, 2018.
      It was moved
      That the minutes be approved.
      CARRIED
  5. Presentations – None
  6. Consent Agenda:
    There was no business arising from the consent agenda below.

     

    1. Information Report – Shared Calendar Project
    2. Information Report – Windsor-Essex Community Housing Corporation Smoke-Free Policy
    3. Information Report – Immunization of Schools Pupils Act Implementation Update
    4. Information Report –Windsor-Essex County Living Wage Program
    5. Media Coverage Summary Report
      It was moved
      That the consent agenda be received.
      CARRIED
  7. Business Arising
    1. Reserves

      At the last Board meeting, the topic of Reserves was briefly discussed and materials were subsequently distributed, at the request of the Chair, to the Board.

      Other public health units within the Province have reserves funded through contributions from their respective obligated municipalities as the Province of Ontario does not permit grant monies to be contributed to a reserve.   The Board Chair provided background on Health Unit funding, indicating that the WECHU receives a grant from the Ministry of Health and Long-Term Care (“the Ministry”) to a maximum of 75% for the Cost-Shared Program and that the Municipalities are obligated to fund public health.  Furthermore, the timing of budget approvals by the Ministry presents a challenge for public health units to spend their budget in a given year.

      Establishing municipal reserves would allow for the use of unspent municipal dollars already allocated to the Health Unit through the annual budget process.

      It was decided that the Board’s position be stated in the form of a resolution. Administration will bring forward a resolution recommendation to the April board meeting.  It was further requested that Administration’s report include information regarding the need for a reserve fund by the WECHU as well as a brief chronology of what has happened in the past for the benefit of new members and a refresh for past members.

      The Board discussed taking a more assertive approach to increasing Windsor-Essex’s base budget.

      In 2015, there was lobbying to increase this health unit’s base budget. As a result, approximately 1.2 million dollars was received. This additional funding translated to an 8% base budget increase. The Province did agree that Windsor-Essex received 80% of what it should be receiving in comparison to other health units. Of the 36 health units, this health unit still remains one of the lowest funded health units.

      It is the full responsibility of municipalities to pay for public health. The Ministry provides a grant of up to 75% of individual health unit budget requests while the municipalities are responsible for the remaining percentage. The Board has agreed that the funding model for health units is flawed. Furthermore, the Board needs to look at what is needed for to address public health needs in this community rather than getting fixated on the 75/25 funding formula. This Health Unit has different needs than some others because of its geographic location being a border community.

      With the recent introduction of the 2018 Standards, some of the mandates will require more resources and dollars.

      The Board Chair would like to see continued dialogue with the Province. It was further proposed by the Board that the WECHU needs to develop a three to four-year plan for increasing the base budget in advance so that the municipalities are aware of the plan and the strategies for moving forward.

  8. Board Correspondence – Circulated
  9. New Business
    1. Annual Service Plan
      Further to the WECHU’s 2018 budget submissions, the Ministry requested completion of an annual service plan. Public health units were asked to link relevant funding with program activities and staffing. The Annual Service Plan and Budget Submission was submitted to the Ministry by the March 1, 2018 deadline. Seventy-three program plans were submitted.

      The CEO reviewed the WECHU Annual Service Plan and Budget Submission 2018 document as distributed highlighting the ten base funding requests and ten one-time funding requests submitted.

    2. Annual Service Plan – Resolution and Recommendation Report
      Public Health Units are required to have a board resolution to support the submission of Annual Service Plan and Budget Submission.

       

      As presented by the WECHU in January of 2018, the 2018 Cost-Shared budget contemplated a base funding request of 3.23% or $429,974.  Of that, $355,528 related funding to address operational pressures allowing the WECHU to maintain current service levels in Windsor and Essex County.  The remaining $74,446 represented a staff augment relating to mental health requirements within the modernized OPHS.  The $74,446 request is included as part of the Mental Health Specialist full-time equivalent base funding request.  The $355,528 increase is included as part of the General Base Funding request of $1,026,092.  The remainder of the General Base Funding request or $670,574, represents an ask to help reduce the funding disparity that was highlighted in the global funding formula review of 2015.  The funding review indicated that the WECHU was not receiving its model share of public health funding.  Base funding requests put forward in the 2018 Annual Service Plan and Budget submission outside of the $429,974 contemplated in the January 2018 budget presentation, will not be operationalized until such time as approval is received from the Ministry of Health and Long-Term Care (“the Ministry”).

      L. Gregg provided a summary of the base funding and one-time funding requests. One-time funding request are typically funded at a rate of 100% by the Ministry.  Base funding requests can be funded to a maximum of 75% by the Ministry or at a rate of 100% depending upon their nature. In the budget presented in January of 2018, the Ministry’s funded share of the 2018 budget was 71.51%.  If the General Base Funding, Mental Health Specialist, School Screening, and Public Health Inspector full time equivalents base funding requests are approved, the Ministry’s funded shared of the 2018 budget would increase to 72.81%.

      A question was raised by the Board regarding the expected timing of Ministry approvals.  L. Gregg responded that approvals could be expected in late summer or early fall but reminded the Board that 2017 approvals were received as late as November of 2017.

      A motion to support the following 2018 budget requests (the first three were approved as part of the 2018 budget) is needed for submission to the Ministry.
      It was moved
      That the Windsor-Essex County Board of Health approve the following:

      i) Budget for Mandatory Cost-Shared Program of $19,222,184.
      ii) Budget for Vector-Borne Disease Cost-Shared Program of $128,000.
      iii) Budget for Small Drinking Water Systems Program of $13,733.
      iv) Budget for Mandatory 100% Funded Programs of $3,357,033.
      v) Additional Base Funding Requests of $1,678, 924.
      vi) One-Time Funding Requests of $724,888.

      CARRIED

  10. Other Board of Health Resolutions/Letters – Circulated
  11. 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 5:15 p.m.
    CARRIED
    It was moved

     

     

    That the Board move out of Committee of the Whole at 5:40 p.m.
    CARRIED

  12. Next Meeting: At the Call of the Chair, or April 19, 2018, Windsor, Ontario
  13. Other
    Prior to adjournment board member G. Queen commented that he would be bringing forward a question regarding Seasonal Housing at the April board meeting.
  14. Adjournment
    The meeting adjourned at 5:44 p.m.

RECORDING SECRETARY:

SUBMITTED BY:

APPROVED BY:


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February 15, 2018

  1. Call to Order
  2. Agenda Approval
  3. Announcement of Conflict of Interest
  4. Approval of Minutes
    1. Regular Board Meeting:  January 18, 2018
  5. Presentation
    1. Opioid Overview (Dr. W. Ahmed)
  6. Consent Agenda
    1. Information Report – Opioid Strategy
    2. Information Report – Naloxone Distribution
    3. Media Coverage Summary Report
  7. Business Arising
  8. Board Correspondence Circulated
  9. New Business
    1. Reserves (G. McNamara)
    2. 2017 Strategic Plan Progress Update – Report  (K. McBeth)
    3. 2017 WECHU Operational Plan Annual Summary (K. McBeth)
  10. Other Board of Health Resolutions/Letters
  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 15 2018 in Windsor
  13. Adjournment
Board Meeting Agenda - February 2018 (PDF)
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January 18, 2018

  1. Call to Order
  2. Agenda Approval
  3. Announcement of Conflicts of Interest
  4. Board Elections – 2018
  5. Approval of Minutes
    1. Regular Board Meeting:  December 21, 2017
  6. Presentations
    1. 2018 Budget (L. Gregg)
    2. Influenza Update (Dr. W. Ahmed)
  7. Consent Agenda:
    1. Report Number 2018-R001-HPROT/HPROMO – 0118-TM/ND from Theresa Marentette, Acting CEO, Director, Health Protection and Chief Nursing Officer and Nicole Dupuis, Director, Health Promotion dated January 18, 2018; Health Protection and Promotion Divisions Report to the Board of Health
    2.  
    3. Report Number 2018-R002-KNMGMT– 0118-KM from Kristy McBeth, Director, Knowledge Management dated January 18, 2018; Knowledge Management Division Report to the Board of Health

    Moved by
    Seconded by
    That the reports listed on the Consent Agenda as items 7a) to 7b) be received for
    information.

  8. Reports and Questions
  9. Business Arising – None
  10. Media Coverage – Circulated
  11. Board Correspondence – Circulated
  12. New Business
    1. Financial Controls Checklist (L Gregg) 26
    2. 2017 Q4 Operational Plan Report (K. McBeth) Handout
    3. Board of Health Reports – New templates for 2018 (T. Marentette)
  13. Board of Health Resolutions/Letters – None
  14. Committee of the Whole (CLOSED SESSION, in accordance with Section 239 of the Municipal Act)  37  
  15. Next Meeting:  At the Call of the Chair, or February 15, 2017 – 4:00 pm – Location:  Essex
  16. Adjournment
Board Meeting Agenda - January 2018 (PDF)
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Board Members Present:

  • Mr. Gary McNamara, Chair
  • Mr. Mark Carrick, Treasurer
  • Mr. Paul Borrelli
  • Mr. Richard Meloche
  • Mr. John Scott
  • Ms. Michelle Watters
  • Mr. Ken Blanchette, Vice-Chair
  • Mr. Joe Bachetti
  • Mr. Bill Marra
  • Dr. Carlin Miller
  • Mr. Ed Sleiman

Board Member Regrets:

  • Dr. Deborah Kane
  • Mr. Hilary Payne
  • Mr. Gord Queen

Administration Present:

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

  1. Call to Order
    With quorum officially met Chair, G. McNamara, called the meeting to order at 3:34 pm.
  2. Announcements of Conflict of Interest
    None declared.
  3. Agenda Approval
    The agenda was approved.
    It was moved
    That the agenda be approved.
    CARRIED
  4. Board Elections
    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 three (3) written nominations nominating Gary McNamara.  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 three (3) written nominations 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. Ken 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 three (3) written nominations for Mark Carrick.  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.  Mark Carrick, having accepted the nomination, was appointed Treasurer by acclamation.
  5. Approval of Minutes
    1. Regular Board Meeting: December 21, 2017
      It was moved
      That the meeting minutes presented be approved.
      CARRIED
  6. Presentations
    1. 2018 Budget (L. Gregg)

      L. Gregg provided an overview of the 2018 Budget for the Board.  The WECHU had received a zero increase from the Ministry and is asking for 4% from each of the municipalities and 3.23% from the province.  If funding approval is less than 3.23%, more funding from the municipalities would be required.  Items briefly discussed were professional development, program supplies, professional fees, building occupancy, and an increase in cost to staff parking. Regarding the Capital Project, WECHU has applied for a planning grant and are awaiting approval (likely April 2018 timeline).  The Ministry will determine the sum of the grant approval.
      It was moved
      That the Board move into Committee of the Whole at 4:04 pm
      CARRIED
      It was moved
      That the Board move out of Committee of the Whole at 4:13 pm
      CARRIED
      Board of Health members briefly discussed the Ministry’s funding process.  WECHU is recommending a request of 3.23% funding from the Ministry and 4% from the municipalities
      It was moved
      That the recommendation be approved and the 2018 Budget be accepted as presented.
      CARRIED
      Bill Marra arrived at 4:15 pm

    2. Influenza Update (Dr. W. Ahmed)
      Dr. W. Ahmed provided the Board with a brief overview of this year’s influenza season noting symptoms, how influenza is spread and the number of current outbreaks.  The province is seeing more Influenza A outbreaks, but our community is seeing more Influenza B.  Each year the vaccine is based on the circulating strain of the virus.
      It was moved
      That the presentation be received for information.
      CARRIED
  7. Consent Agenda
    It was moved
    That the reports listed on the Consent Agenda as Items 7a) to 7b) be received for information.
    CARRIED
    G. McNamara leaves the meeting at 4:46 pm – Relinquishes the Chair to Vice-Chair K. Blanchette
  8. Reports and Questions – None
  9. Business Arising – None
  10. Media Coverage – Circulated
  11. Board Correspondence – Circulated
  12. New Business
    1. Financial Controls Checklist (L. Gregg)
      L. Gregg provided a brief overview of the Financial Controls Checklist, the most common deficiency being the lack of segregation of duties.  The Organization does its best to segregate the initiation of purchasing from ordering and receipt. There are instances as a result of vacations, illnesses and other unplanned absence, that impact the Organization’s ability to segregate. To mitigate risk, the Organization segregates the approval function (both for purchase and for payment) from the purchasing and receipt function. The action plan for 2018 and going forward, the Organization will continue to look for different strategies to mitigate risks associated with the segregation of incompatible duties.
      The tracking of aging of accounts receivable is a manual function. As a result, risk exists that invoices may not be followed up on a timely manner.  The action plan for 2018, commencing in the 2nd quarter and moving forward, it is anticipated that the volume of invoicing prepared by the Organization will be reduced.  Manual tracking of aged invoices will remain until such time as a better systems solution can be identified.
      It was moved
      That the Financial Controls Checklist be received for information.
      CARRIED
    2. 2017 Q4 Operational Plan Report (K. McBeth)
      K. McBeth advised that the Board will receive the 2017 Annual Report at the February Board meeting as well as the Operational Plan.
      It was moved
      That the information be received.
      CARRIED
    3. Board of Health Reports – New Templates for 2018 (T. Marentette)
      T. Marentette noted that commencing in February that Board Reports will be AODA compliant and more useful to the Board.  The biggest change will be in the Consent Agenda section with the Leadership Team noting relevant topics which may or may not be aligned with presentations.
      It was moved
      That the information be received.
      CARRIED
  13. Board of Health Resolutions/Letters – None
  14. 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 5:02 pm
    CARRIED
    It was moved
    That the Board move out of Committee of the Whole at 5:03 pm
    CARRIED
  15. Next Meeting:  At the Call of the Chair or February 15, 2018 @ 4:00 pm in Essex
  16. Adjournment
    The meeting adjourned at 5:05 pm

RECORDING SECRETARY:

SUBMITTED BY:

Acting CEO, Director of Health Protection and Chief Nursing Officer, Board Secretary

APPROVED BY:

Chairperson

Board Meeting Minutes - January 2018 (PDF)
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December 21, 2017

November 16, 2017

October 19, 2017

September 21, 2017

April 20, 2017

March 23, 2017

February 16, 2017

January 19, 2017

December 15, 2016

Issue

The practice of marketing unhealthy food and beverages to children remains pervasive, despite years of voluntary industry self-regulation1. Federal legislation that bans all forms of commercial food and beverage marketing to both children and youth is required to adequately protect this vulnerable population.

Background

Young children, under the age of six, are unable to distinguish between truth and marketing claims2. As a result, marketing to this age group is deceptive and unethical. Even as children and youth begin to understand the persuasive intent of marketing, they remain vulnerable to commercial influence because of their underdeveloped ability to control impulses and resist the emotional appeal of advertising2. Accordingly, federal legislation that protects children and youth from commercial marketing of foods and beverages that can harm their health is just and essential to public health.

The majority of marketed food and beverages are calorie-dense and low in nutritional value. Frequent consumption of these foods and beverages, including sugar sweetened beverages, has consistently been linked to excessive weight gain and suboptimal nutrient intake among children and youth. A complete ban on child-focused food and beverage marketing will help decrease demand, and ultimately consumption, of these unhealthy food products3. This type of legislation has been credited for Quebec’s lower rates of childhood obesity and reduced fast food intake4. Quebec imposed legislation in 1980 that restricts marketing to children5. Recognizing the importance of restricting marketing to children, the World Health Organization released a report in 2010 urging governments worldwide to take action to reduce childhood exposure to unhealthy food and beverage advertising6. In Canada, several non-government organizations have developed policy recommendations to address this practice.

The most recognized of these policy recommendations is The Ottawa Principles7 developed by the Stop Marketing to Kids Coalition in collaboration with many of Canada’s leading health and research experts. The Ottawa Principles, have been endorsed by the Association of Local Public Health Agencies, the Canadian Pediatric Society, Dietitians of Canada, and the Ontario Society of Nutrition Professionals in Public Health, in addition to many other respected organizations.

This past October, Canada’s Health Minister, Jane Philpott, announced Health Canada’s intention to introduce new restrictions on commercial marketing of unhealthy foods and beverages to children8. It was also announced at this time that Health Canada is reviewing Private Member’s Bill S-2289, which was tabled in September by Senator Nancy Greene Raine. This bill, if passed by both houses, would prohibit food and beverage marketing to children under the age of thirteen.

Proposed Motion

Whereas The Honourable Federal Health Minister, Dr. Jane Philpott, has recently announced plans to introduce restrictions on marketing unhealthy food and beverages to children, and

Whereas there is an existing set of policy recommendations called The Ottawa Principles to guide regulations on marketing food and beverages to children. These recommendations, developed by the Stop Marketing to Kids Coalition, are endorsed by a number of organizations including the Association of Local Public Health Agencies, the Canadian Pediatric Society, Dietitians of Canada, and the Ontario Society of Nutrition Professionals in Public Health, and

Whereas children remain vulnerable to the effects of marketing well into their teenage years and, therefore, require unique protection from commercial influence throughout adolescence, and

Whereas Ontario’s 2013 Healthy Kids Panel report, No Time to Wait: The Healthy Kids Strategy10, recognized the introduction of food and beverage marketing restrictions as a key strategy to address childhood obesity in the province, and

Now therefore be it resolved that the Windsor-Essex County Board of Health supports federal legislation prohibiting all forms of commercial food and beverage marketing to children age sixteen years and younger to provide the most protection for children’s rights, health, and well-being, and

FURTHER THAT the Windsor-Essex County Board of Health fully endorses the policy recommendation and associated Ottawa Principles developed by the Stop Marketing to Kids Coalition, and

FURTHER THAT that the Windsor-Essex County Board of Health supports the recently announced plans to introduce new restrictions on marketing food and beverages to children as part of the federal Healthy Eating Strategy and urges Health Minister, Dr. Jane Philpott, to ensure these restrictions are in-line with the Ottawa Principles and are implemented as soon as possible, and

FURTHER THAT the Windsor-Essex County Board of Health supports Private Member’s Bill S- 228, tabled in September by Senator Nancy Greene Raine, with the amendment to apply the proposed marketing restrictions to children age sixteen years and younger (opposed to less than 13 years old), and

FURTHER THAT this resolution be shared with the Federal Health Minister, local Members of Parliament, the Minister of Health and Long-Term Care, local Members of Provincial Parliament, the Chief Medical Officer of Health, Association of Local Public Health Agencies, Ontario Boards of Health, Ontario Public Health Association, Senator Nancy Greene Raine, Stop Marketing to Kids Coalition, Dietitians of Canada, Ontario Society of Nutrition Professionals in Public Health, and local community partners.


  1. Stop Marketing to Kids Coalition - Why self-regulation doesn’t work, accessed December 2016
  2. Yale Rudd Centre for Food Policy & Obesity - Older but still vulnerable: All children need protection from unhealthy food marketing, 2014
  3. Sadeghirad, B., Duhaney, T., Motaghipisheh, S., Campbell, N. R. C., and Johnston, B. C. (2016) Influence of unhealthy food and beverage marketing on children's dietary intake and preference: a systematic review and meta-analysis of randomized trials. Obesity Reviews, 17: 945–959. doi: 10.1111/obr.12445.
  4. Dhar, T. and K. Baylis (2011) Fast-Food Consumption and the Ban on advertising Targeting Children: The Quebec Experience, Journal of Marketing Research, 48: 799-813. doi: 10.1509/jmkr.48.5.799
  5. Government of Quebec - Advertising Directed at Children under 13 Years of Age, 2012
  6. World Health Organization - Set of recommendations on the marketing of foods and non-alcoholic beverages to children, 2010
  7. Stop Marketing to Kids Coalition - The Ottawa Principles, 2016
  8. Health Canada - Healthy Eating Strategy, 2016
  9. Senate of Canada - Bill S-228 Child Health Protection Act, 2016
  10. Healthy Kids Panel- No Time to Wait: The Healthy Kids Strategy, 2013

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