Main Page Content

July 18, 2019

  1. Welcome – Theresa Marentette, CEO
  2. Financial Overview – L. Gregg
    1. Budget Education
    2. Recommendation/Resolution Report – 2018 Annual Financial Statements
  3. Program Overview
    1. Health Promotion – N. Dupuis
    2. Health Protection – K. McBeth
  4. SIS Community Update – T. Marentette
  5. Community Needs Assessment – W. Ahmed
  6. Next Meeting – Thursday, August 15 @ 3:00 pm – Windsor
    TOPIC:   Colliers Presentation – Status of Capital Project

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June 20, 2019

  1. Call to Order
  2. Agenda Approval
  3. Announcement of Conflict of Interest
  4. Board Elections – Vice Chair
  5. Presentation: Smoke-Free – Vaping (E. Nadalin)
  6. Approval of Minutes
    1. Regular Board Meeting: May 16, 2019
  7. Consent Agenda
    1. INFORMATION REPORTS
      1. Smoke-Free Ontario – Addressing Youth Vaping in WE County
      2. Vision Screening
      3. Immunization Coverage Report: 2017/2018 School Year (with Summary Brief)
      4. Media Recap
    2. RECOMMENDATION REPORT
      1. Smoke-Free – Smoke/Vape Free Outdoor Spaces
  8. Business Arising
  9. Board Correspondence – Circulated
  10. New Business
    1. Status Report – follow up work impacted from the ONA Strike (T. Marentette)
    2. Status of Capital Project (T. Marentette)
    3. Fluoride Update and Letter to Windsor Utilities Commission (W. Ahmed)
    4. alPHa AGM – Overview (W. Ahmed, L. Gregg, J. Scott, J. Lund)
    5. July Board Education Session – Program Overview, Budget Presentation, Financial Statement Resolution, Community Needs Assessment Update (T. Marentette)
  11. Other Board of Health Resolutions/Letters - For Support
    1. Kingston, Frontenac and Lennox & Addington Board of Health
      Health Promotion – Letter to Hon. Christine Elliott
    2. The Regional Municipality of York
      Immunization Registry – Letter to G. McNamara
  12. Committee of the Whole (Closed Session in accordance with Section 239 of the Municipal Act)
  13. Next Meeting: At the Call of the Chair or July 18, 2019 – Board Education Session – Windsor
  14. Adjournment

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Prepared By:

Eric Nadalin, Manager, Chronic Disease and Injury Prevention Department
Theresa Sarkis, Youth Engagement Specialist

Date:

June 2019

Subject:

Addressing Youth Vaping in Windsor and Essex County

Background:

E-cigarettes are battery-operated devices that mimic the tobacco smoking experience. These products work by vapourizing a fluid which is then inhaled into the user’s lungs in the same manner as a traditional tobacco cigarette. While the substances consumed within an e-cigarette can vary, they generally consist of a combination of propylene glycol, vegetable glycerine, flavouring agents, and in many cases nicotine, the highly addictive chemical found in tobacco. Recent increases in the popularity of these products among youth and young adults have led the United States Food and Drug Administration to declare e-cigarette use an epidemic among young people (U.S. National Academies of Sciences, Engineering and Medicine, 2018), and in Canada student use of vaping products increased by 30% each year between 2015 and 2017 (University of Waterloo, 2017).

There are two pieces of legislation which regulate the promotion and sale of vaping products in Ontario. The federal Tobacco and Vaping Products Act (TVPA) aims to address the rising popularity of vaping products among young people by placing restrictions on how they can be advertised. At the provincial level, the Smoke-free Ontario Act 2017 (SFOA) further regulates these products by restricting their sale to minors, regulating how they can be displayed in storefronts, and restricting their use in certain public spaces. The SFOA is enforced locally by the Tobacco Enforcement Officers (TEOs) at the Windsor-Essex County Health Unit (WECHU) who inspect spaces proactively, ensure the region’s 223 e-cigarette vendors are operating in compliance, and conduct youth access test shopping inspections to discourage the sale of these products to minors. In spite of these protective measures there remains a lack of adequate safe-guards against the promotion of e-cigarette products in places where they may be observed by young people and other vulnerable populations. Promotions are commonly seen at point-of-sale in many convenience and grocery stores, as well as in locations like gas pumps or parking lots associated with the places in which these products are sold. In addition, efforts to prevent the use of these products are being countered by innovative technologies which include more discrete product designs and increased efficiency of nicotine delivery systems. These newer generation vaping products produced by companies such as JUUL©, VYPE©, STLTH©, or SMOK© deliver higher concentrations of nicotine per puff than older versions of e-cigarettes and, in many cases, even tobacco cigarettes (American Cancer Society, 2019).

Although there is little research on the long-term health impacts of e-cigarette use and second-hand exposure, preliminary research has shown an association between use of these products and increased risk for the uptake and intensity of tobacco smoking (Ontario Agency for Health Protection and Promotion (Public Health Ontario), 2018).

Current Initiatives

Prevention and Education

School Vaping Prevention Toolkit: In order to assist teachers and school administrators in providing students with credible and reliable information about the use of e-cigarettes and the associated health impacts, a toolkit has been created which will be provided to the WECHU Public Health Nurses on the Healthy Schools team. The toolkit includes:

  • A guide for parents and teachers on “How to Talk to Teenagers about E-cigarettes”
  • Fact sheets  (for parents, teachers, and teenagers)
  • Vaping prevention posters and postcards  
  • Training presentation for teachers about e-cigarettes and the health effects of vaping and vapour products

Elements of this toolkit have already been utilized in schools, but the full packages will be distributed to all secondary schools, and any other requesting schools, beginning September 2019.

Provincial Vaping Working Group: A representative from WECHU has joined a number of provincial partners to lead a project which will result in consistent messaging across the province for public heath units to utilize in their communication materials. This communication campaign will focus on the potential harms of vaping and is also set to be implemented beginning September 2019.

Cessation

Internal WECHU Education Program: Staff will be educated through an e-module on the types of products available in the marketplace and how to speak with their clients about their use.

School-based Diversion Program: Based on school interest, WECHU’s Youth Engagement Specialist will offer an after-school youth diversion program to students caught vaping on school properties.  This option may be utilized in lieu of ticketing students, with a goal of educating them on the health, legal, and financial implications vaping can have.

Protection & Enforcement

Secondary School Proactive Enforcement Inspections with Police Services: Starting in March of this year, WECHU TEOs conducted joint enforcement inspections at each local high school with officers from the Ontario Provincial Police, LaSalle Police Service, and Windsor Police Service. This “blitz” of secondary schools across the region has yielded 15 charges with fines ranging from $100.00 to $250.00 for the first offense. For many of these students, a Part 3 charge was issued requiring them to meet the WECHU’s lead Prosecutor and appear in court before a Justice of the Peace, in order to determine the amount of their fine.

School and School Board Presentations: Presentations to students about the e-cigarettes and the effects of vaping and vapour products are available to requesting schools for classroom or assembly presentations. Any school which has registered a complaint with WECHU have been offered the opportunity for such a presentation.  In addition, WECHU TEOs, Health Promotion Specialists, and other staff members have provided presentations to school board representatives of the dangers of these products and WECHU’s role in enforcing the regulations which surround them.

Under 25 Electronic Cigarette Vendor Education Program: In addition to the mandated Youth Access Test Shopping inspections conduced by hired youth who are under the age of 19, the Under 25 Vendor Education Program has been implemented by WECHU since 2015. This program expands on the existing inspections which aim to reduce the sale of tobacco and e-cigarettes to minors by educating vendors on their additional legal requirement to request identification from any one who appears to be under the age of 25. For the first time, this program grew in its scope to implement this program with e-cigarette vendors in addition to tobacco vendors.

Smoke/Vape-free Spaces Mass Media Campaign: Given the passing of the SFOA in October of 2018, and the spring and summer seasons bringing additional opportunities to enjoy several outdoor public places which are for the first time vape-free in addition to being smoke-free, a communication campaign including social media, live radio segments, radio ads, public transit ads and other forms of media will be implemented to educate the public about the new regulations. 

Approved by:

Theresa Marentette

References


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Prepared By:

Kim Casier, Oral Health Manager, Oral Health Department

Date:

June 2019

Subject:

Vision Screening

Background:

Each year, in Ontario approximately 3% to 5% of children (4000 to 7000) experience vision loss and left untreated can lead to poor performance in school. Effective September 2018, new requirements for the provision of vision screening for children in senior kindergarten (SK) were introduced in the Ontario Public Health Standards (OPHS).  Vision screening under the Child Visual Health and Vision Screening Protocol, 2018 includes a short sequence of three tests that can detect risk factors for certain vision disorders. The screening does not diagnose vision disorders nor is it a replacement for a comprehensive eye examination conducted by an optometrist.

The vision screening tools that are currently utilized are the HOTV visual acuity chart with crowding bars; the Randot Preschool Stereotest; and an autorefractor.

  1. The HOTV visual acuity chart with crowding bars is a chart that tests visual acuity, otherwise known as the sharpness of one’s eyesight/clarity of vision. Visual acuity is expressed as a fraction, such as 20/20. In addition to visual acuity, this screening test is also designed to identify children at risk for the following vision disorders: amblyopia and refractive errors (e.g., myopia, anisometropia and astigmatism).
  2. The Randot Preschool Stereotest (Randot) is a vision test designed to detect reduced stereopsis/stereoacuity at near distances. Stereoacuity is the ability to visually recognize depth based on differences in the images presented to the two eyes.
  3. An autorefractor is a lightweight, portable, handheld screening device. It automatically screens for, and can identify the presence and size of some refractive errors, including near and farsightedness (myopia/hyperopia), astigmatism (asymmetrical focus), and anisometropia (unequal power between eyes).

Current Initiatives

In the fall of 2018, oral health staff received Ministry-specified training and completed their first school in November. In January 2019, dental staff began coordinating with all Windsor-Essex elementary schools to provide pre-screening notification for vision screening to occur simultaneously with dental screening.

Parents/guardians of children who are screened and identified in need of visual health services and/or treatment are provided with a post-screening notification and referral to an optometrist for further follow up. All other children receive a notification encouraging parents/guardians to book an appointment with an optometrist. Parent notification forms have been translated into Arabic and are also available in French and English.

To date 1400 senior kindergarten students attending 49 Windsor-Essex elementary schools have received vision screening. Of those screened, 34.29% (480) were referred to an optometrist for further follow up.

The vision screening has been conducted in conjunction with St. Clair College and second year nursing students from the Registered Practical Nurse (RPN) program. Nursing faculty viewed this opportunity as a “beneficial learning experience that would help to fulfil our mandate and provide the student with a rewarding community placement with children.” The RPN students received vision training/orientation at the College prior to the school assignment. A total of 136 RPN students (17 groups of 8 students) helped to complete 17 schools from January – April 2019.  In addition, three BScN nursing students from the University of Windsor assisted with the vision screening.

Vision screening information has also been sent to Windsor–Essex community optometrists to increase awareness of the new vision-screening program. As well, a vision-screening pamphlet has been created for the community as well as program information has been posted on the WECHU website.

Next Steps

The 2018/2019 school year provided the WECHU oral health staff the opportunity to implement vision screening in a variety of school settings both with and without the assistance of nursing students. Currently an evaluation is being conducted to assess the best structure for full implementation of vision screening in all elementary schools starting fall of 2019. As well the WECHU has partnered with Sick Kids and McMaster to measure parental awareness and perceptions of vision screening.

Approved by:

Theresa Marentette

 


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Prepared By:

Stacy Manzerolle, Manager, Healthy Schools

Date:

June 2019

Subject:

Immunization Coverage Report: 2017/2018 School Year

Background:

On May 7, 2019 Public Health Ontario (PHO) released the Immunization Coverage Report for School Pupils in Ontario.  This report outlines the latest estimates for immunization coverage and Immunization of School Pupils Act (ISPA) exemptions at the Health Unit level.  The report includes comparisons to provincial and national goals.

Immunization coverage refers to the proportion of a population that is appropriately immunized against a vaccine-preventable disease (VPD) at a point in time. Immunization coverage varies by vaccine, age, and health unit.  Establishing a high immunization coverage rate in the community is essential for the effective prevention and control of VPDs.  Measuring immunization coverage rates allows public health organizations to monitor trends in vaccine uptake over time and identify areas in the province at risk of VPD outbreaks.

In PHO’s report, immunization records for approximately 500,000 students were assessed for a number of vaccines at ages 7, 12 and 17 years. For most vaccines, provincial-level coverage estimates do not meet Canada’s national coverage goals. However, some health units have local coverage estimates that surpass the national goal.

The attached report is a brief summary of the key findings relevant to Windsor and Essex County (WEC) with provincial and national comparisons for the 2017/2018 school year.

Current Initiatives

Key Findings for Windsor-Essex County: Provincial Comparison
ISPA Designated Diseases:
Immunization coverage rates in 7 year olds in WEC for ISPA-designated diseases including measles, mumps, pertussis, polio, rubella, tetanus, diphtheria, meningococcal diseases, and varicella were similar to or higher than Ontario.

Non-ISPA Designated Diseases:
Coverage rates in 7 year olds in WEC for all except one non-ISPA designated disease were similar to or higher than Ontario. Non-ISPA designated diseases that were assessed include: pneumococcal disease, haemophilus influenza type b, human papilloma virus, and hepatitis B.  Coverage for Haemophilus influenza type b was 2.4% lower in WEC than Ontario (80.0% in WEC and 82.4% in Ontario).

Key Findings for Windsor-Essex County: National Comparison
Coverage estimates in 7-year olds met the national goal of 95% for two diseases (meningococcal disease and rubella). For the 12-year-old cohort, the coverage estimates for diseases covered by the school-based immunization program did not meet the national goal of 90%. Coverage estimates in 17-year olds met the national goal of 95% for measles and mumps, as well as the national goal of 90% for rubella and tetanus.

Exemptions for at least one ISPA antigen
The proportion of students with medical and non-medical exemptions was relatively low.  Only 0.3% of 7-year olds and 0.2% of 17-year olds had a medical exemption for at least one ISPA antigen.  These proportions were similar to that of Ontario.

The proportion of students with a non-medical exemption was slightly higher. 3.4% of 7-year olds and 2.6% of 17-year olds had a non-medical exemption for at least one ISPA antigen. The proportion of 7-year olds with a non-medical exemption was slightly higher than Ontario (0.6% higher).

CONSULTATION:

The following individuals contributed to this report:

Stacy Manzerolle, Manager, Healthy Schools Department

Mathew Roy, Epidemiologist, Epidemiology & Evaluation Department

APPROVED BY:

Theresa Marentette


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Introduction

Public Health Ontario has released the latest estimates for immunization coverage and ISPA-antigen exemptions at the Health Unit level. The following is a brief summary of the key findings relevant to Windsor and Essex County (WEC).

Key Findings for WEC (2017/18 School Year)

Comparison to the province (see Figures 1 and 2)

  1. Immunization coverage rates for children in WEC for ISPA-designated diseases were similar to or higher than Ontario
    1. ISPA designated diseases: measles; mumps; pertussis; polio; rubella; tetanus; diphtheria; meningococcal diseases; and varicella
  2. Coverage rates for all except one non-ISPA designated disease were similar to or higher than Ontario
    1. Non-ISPA designated diseases that were assessed include: pneumococcal disease, haemophilus influenza type b; human papilloma virus; hepatitis B
    2. Coverage for Haemophilus influenza type b was 2.4% lower in WEC than Ontario (80.0% in WEC and 82.4% in Ontario).

Comparison to the national goal

  1. Coverage estimates in 7-year olds only met the national goal of 95% for two diseases (meningococcal disease and rubella). There is no national goal for varicella.
  2. Coverage estimates in 12-year olds for diseases covered by the school-based immunization program did not meet the national goal of 90%.
  3. Coverage estimates in 17-year olds met the national goal for measles, mumps, rubella and tetanus. The national goal for measles, mumps, rubella and polio is 95%. The national goal for diphtheria, tetanus and pertussis is 90%

Change from the 2013/14 school year

7-year olds (see Figure 3)

  1. Coverage in 7-year olds for ISPA-designated diseases has improved from 2013/14. The percentage point difference varies by disease and ranges from:
    1. less than a 1.0% increase in coverage for measles, mumps and rubella;
    2. 10.1% to 13.2% increase for pertussis polio, tetanus, diphtheria, and meningococcal disease; and
    3. 53.6% increase for varicella
  2. Coverage in 7-year olds for non-ISPA designated diseases has declined:
    1. 4.9% decrease in coverage for pneumococcal disease. Coverage has decreased year-to-year for three of the last four school years.
    2. 5.0% decrease in coverage for haemophilus influenza type b

12-year olds (see Figure 4)

  1. Coverage in 12-year olds for meningococcal disease has increased by 3.1%
  2. Coverage in 12-year olds for non-ISPA designated diseases have varied:
    1. 2.1% decrease for hepatitis B
    2. 1.0% decrease for HPV
    3. The lower coverage estimates for these diseases may be due to their non-ISPA designation. The health unit does not actively collect immunization records for these diseases.

17-year olds (see Figure 4)

  1. Coverage in 17-year olds for ISPA-designated diseases has varied:
    1. 1.3% and 2.1% increase for measles and mumps, respectively
    2. 0.3% and 0.5% decrease for polio and rubella, respectively
    3. 36.2% to 37.3% increase for diphtheria, pertussis, and tetanus

Exemptions for at least one ISPA antigen (see Figure 5)

  1. The proportion of students with medical and non-medical exemptions was relatively low.  Only 0.3% of 7-year olds and 0.2% of 17-year olds had a medical exemption for at least one ISPA antigen.  These proportions were similar to that of Ontario.
  2. The proportion of students with a non-medical exemption was slightly higher. 3.4% of 7-year olds and 2.6% of 17-year olds had a non-medical exemption for at least one ISPA antigen. The proportion of 7-year olds with a non-medical exemption was slightly higher than Ontario (0.6% higher).

Figure 1. Immunization coverage estimates for 7-year olds: WEC and Ontario (2017/18 school year)

Figure 1. Immunization coverage estimates for 7-year olds: WEC and Ontario (2017/18 school year)

Figure 2. Immunization coverage estimates for 12 and 17-year olds: WEC and Ontario (2017/18 school year)

Figure 2. Immunization coverage estimates for 12 and 17-year olds: WEC and Ontario (2017/18 school year)

Figure 3. Immunization coverage estimates for 7-year olds: WEC (2013/14 to 2017/18 school years)

Figure 3. Immunization coverage estimates for 7-year olds: WEC (2013/14 to 2017/18 school years)

Figure 4. Immunization coverage estimates for 12 and 17-year olds: WEC (2013/14 to 2017/18 school years)

Figure 4. Immunization coverage estimates for 12 and 17-year olds: WEC (2013/14 to 2017/18 school years)

Figure 5. Exemption for at least one ISPA antigen: WEC and Ontario (2017/18 school year))

Figure 5. Exemption for at least one ISPA antigen: WEC and Ontario (2017/18 school year))

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May 16, 2019

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

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Prepared By:

Kim Casier, Oral Health Manager, Oral Health Department

Date:

May 16, 2019

Subject:

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

Background:

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

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

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

Current Initiatives

Oral Screening, Assessment and Surveillance

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

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

 

Total

Screened

Absent

Refused

Excluded

Abs+Ref+Exl

 

#

%

#

%

#

%

#

%

Grand Total

16601

15117

1030

6.20%

102

0.16%

352

2.12%

1484

8.93%

Other significant 2017/18 dental screening statistics include:

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

WECHU Healthy Smiles Ontario Dental Clinics

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

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

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

Baby Oral Health Program (BOHP)

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

Consultation:

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

Approved by:

Theresa Marentette


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Prepared By:

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

Date:

May 2019

Subject:

Measles Update

Background:

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

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

Current Initiatives

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

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

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

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

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

Approved by:

Theresa Marentette


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Prepared By:

Communications Department

Date:

May 8, 2019

Subject:

April Media Relations Recap Report

April Media Coverage

Total Media Coverage

71

Interview Requests

25

Mentions (In the news without direct interviews)

40
Requests for Information 6

April 2019 Media Relations Recap - Media Coverage

April 2019 Media Relations Recap - Story Source

Media Coverage

Outlet

Number of Stories

AM 800

17

Blackburn

8

CBC

12

CBC Radio-Canada

2

CTV

10

London Free Press

1

St. Clair College (Student)

1

Toronto Star

1

TV Cogeco

1

Vice Magazine

1

Windsor Star

13

windsorite.ca

3

Yahoo News

1

TOTAL

71

News Release and Media Advisories

Date Type Headline Response

April 3, 2019

Media Statement

Result of the Tentative Agreement Vote

12 Stories Reported

April 10, 2019

Media Advisory

WECOSS 2018 Annual Report and Website Launch

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

April 10, 2019

Media Statement

Public Health Nurses Reject Final Offer

7 Stories Reported

April 12, 2019

News Release

WECOSS 2018 Annual Report and Website Launch

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

April 16, 2019

News Release

Health Unit Launches Cannabis Safety Campaign for Young Adults

7 Stories Reported

April 17, 2019

Media Advisory

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

6 Stories Reported

Stories Reported by the Media

AM 800

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

Publish Date

Title

April 2, 2019

Update: Nurses Vote Down Tentative Deal

April 4, 2019

Health Unit Disappointed Striking Nurses Rejected Offer

April 9, 2019

Tecumseh Joins Windsor In Fluoridation

April 10, 2019

Free Dental Care For Low Income Seniors Expected In Budget

April 11, 2019

Nurses Reject Latest Health Unit Contract Offer

April 12, 2019

Video: Nurses Union Presents Petition To County Warden

April 13, 2019

Health Unit Chair Stands Firm On Latest Offer To Striking Nurses

April 13, 2019

New Website Launched For Opioid And Substance Strategy

April 28, 2019

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

April 18, 2019

Lynn Martin Show

April 18, 2019

Cannabis Campaign Launched By Local Health Unit

April 18, 2019

Striking Health Unit Nurses Attend County Council

April 18, 2019

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

April 22, 2019

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

April 23, 2019

Striking Public Health Nurses Receive Noise Warning

Blackburn News

Publish Date

Title

April 2, 2019

Tentative Deal Reached In Public Health Nurses Strike

April 2, 2019

Public Nurses In Windsor-Essex Reject New Deal

April 11, 2019

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

April 12, 2019

We Want To Save Every Life.

April 12, 2019

Update: Nurse Union Petitions County Warden To End Strike

April 19, 2019

4-20 Prompts Cannabis Education Campaign From Health Unit

April 25, 2019

Health Unit May Not Be Operator Of Possible Safe Injection Site

April 24, 2019

Low-Income Seniors To Get Better Dental Care Access

CBC News

(also includes CBC Radio and Radio-Canada)

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

Publish Date

Title

April 2, 2019

Windsor-Essex Public Health Nurses Vote Against Tentative Agreement

April 3, 2019

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

April 9, 2019

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

April 10, 2019

Windsor-Essex Public Health Nurses Reject Final Offer

April 12, 2019

First Annual Opioid Strategy Report Released

April 12, 2019

First Annual Opioid Strategy Report Released

April 12, 2019

Support At Rainy Rally 'Overwhelming' For Nurses Association

April 15, 2019

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

April 16, 2019

Class Project Turns Into Opioid Panel Discussion

April 18, 2019

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

April 21, 2019

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

April 24, 2019

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

April 25, 2019

Ontario Medical Association Urges Vaccination In Light Of Spiking Measles Cases

CTV News

Publish Date

Title

April 2, 2019

Strike Continues As Public Health Nurses Vote Against Tentative Deal

April 3, 2019

Surprised And Disappointed: Health Unit Reacts To Nurses Rejecting Deal

April 9, 2019

Fluoride Returning To Windsor's Water Supply

April 10, 2019

Adding Fluoride To Windsor Water Supply May Take 18 Months

April 10, 2019

Health Unit 'Disappointed' As Nurses Reject Final Offer.

April 12, 2019

First Annual Report Release On By Windsor-Essex Opioid Committee

April 12, 2019

Striking Public Health Nurses Rallying For New Employer Mandate

April 12, 2019

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

April 17, 2019

Windsor-Essex Health Unit Amping Up Cannabis Education Campaign

April 22, 2019

Health Unit Chair Concerned About $1.5m Loss In Funding

London Free Press

Publish Date Title

April 4, 2019

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

Toronto Star

Publish Date Title

April 11, 2019

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

Vice Magazine

Publish Date Title

April 11, 2019

Relapse: Opioid Crisis in Canada

Windsor Star

Publish Date Title

April 1, 2019

Nurses, Health Unit Resume Talks As Strike Continues

April 2, 2019

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

April 4, 2019

Photos: Nurses' Challenge Aims To Help Needy

April 10, 2019

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

April 10, 2019

Photos: Annual Health Access Day Draws Hundreds

April 11, 2019

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

April 12, 2019

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

April 12, 2019

Nurses Blame Windsor-Essex Health Unit As Strike Continues

April 15, 2019

Overdose Crisis Rally Slated For Windsor, 20 Other Cities Nationwide

April 17, 2019

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

April 16, 2019

Health Unit Launches Cannabis Awareness Campaign

April 29, 2019

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

April 20, 2019

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

Windsorite.ca

Publish Date Title

April 3, 2019

Health Unit Releases Statement After Contract Voted Down

April 10, 2019

Health Unit's Final Offer To Nurses Rejected

April 16, 2019

Health Unit Launches Cannabis Safety Campaign For Young Adults

Yahoo News

Publish Date Title

April 12, 2019

Support At Rainy Rally 'Overwhelming' For Nurses Association

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

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


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Prepared By:

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

Date:

May 2019

Subject:

Q1 Planning Update 

Background

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

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

Current Initiatives

Annual Service Plan (ASP) Submission

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

Reporting Structure

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

Planning for 2020

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

Consultation

The following individuals contributed to this report:

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

Approved by:

 Theresa Marentette

 


View Document page

Prepared By:

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

Date:

May 2019

Subject:

Q1 Strategic Plan Report

Background

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

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

Current Initiatives

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

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

Consultation

The following individuals contributed to this report:

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

Approved by:

 Theresa Marentette

 


View Document page

Prepared By:

Lorie Gregg, Director of Corporate Services

Date:

May 1, 2019

Subject:

Q1 Financial Results

Background

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

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

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

Cost-Shared Program Financial Results

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

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

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

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

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

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

Healthy Babies Healthy Children Program Financial Results

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

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

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

Nurse Practitioner Programs

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

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

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

Financial Information for Related Programs Funded 100% by the MOHLTC

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

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

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

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

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

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

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

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

A description of other related programs is included below:

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

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

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

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

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

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

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

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

Financial Information for Related Programs Funded 100% by the MOHLTC

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

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

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

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

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

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

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

Approved by:

 Theresa Marentette

 


View Document page

Prepared By:

Amandeep Hans, Health Promotion Specialist, Environmental Health Department

Date:

May 2019

Subject:

Vector-Borne Diseases

Background

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

Mosquito Surveillance and Testing

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

Mosquito Control

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

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

Human Cases

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

Ticks and Lyme Disease

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

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

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

Tick Control

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

Human Cases

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

Current Initiatives

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

Consultation

The following individuals were contributed to this report:

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

 Theresa Marentette

 


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Board Members Present:

Tracey Bailey, Rino Bortolin, Fabio Costante, Dr. Deborah Kane, Judy Lund, Gary McNamara, Ed Sleiman, Larry Snively

Board Member Regrets:

Gary Kaschak, John Scott, Joe Bachetti

Administration Present:

Dr. Wajid Ahmed, Nicole Dupuis (4:25 pm), Lorie Gregg, Theresa Marentette, Kristy McBeth, Dan Sibley, Lee Anne Damphouse

WECHU Manager Present:

Eric Nadalin

QUORUM:  Confirmed


  1. Call to Order
    Board Chair, Gary McNamara, called the meeting to order at 4:04 p.m.
  2. Agenda Approval
    It was moved
    That the agenda be approved.
    CARRIED
  3. Announcement of Conflicts of Interest – None.
  4. Presentation: Topical Issues – Measles/Vaccines (Dr. W. Ahmed)
    Dr. W. Ahmed provided the Board with a presentation on vaccine preventable diseases.  Vaccines are made of small or dead weakened germs, helping the immune system protect itself against particular diseases.  Vaccines are the best way to keep children and adults protected from these diseases.

    Publically funded immunization programs cover residents of all ages for certain diseases, i.e. diphtheria, tetanus, pertussis, polio, hib, pneumococcal, rota virus, meningococcal (both children and seniors), MMR, chickenpox, hepatitis B, HPV, seasonal influenza and shingles.  Primary care providers are able to administer these vaccines to eligible Ontario residents.

    The WECHU Immunization Program covers the following:
    • Provides vaccine distribution to area healthcare providers to administer publically funded vaccines
    • WECHU clinics for publically funded vaccines
    • Immunization record assessments for all childhood vaccines
    • School based clinics for HPV, Hepatitis B and Meningococcal disease
    • Influenza clinics

    There has been a growing number of people opposed to vaccinations, causing a resurgence of measles cases in 2019 across the world.  Confirmed cases of measles from January to March 2019:

    • Canada – 45 cases
    • USA – 839 cases
    • Europe – 3,789 cases

    Out of these 3,789 cases in Europe there were 72 deaths, a major concern for those who are not vaccinated.
    Reasons for resurgence are a distrust of government, fear of adverse events, religious or cultural priorities, personal beliefs, misinformation i.e. Wakefield study (this research paper has since been retracted) and non-medical exemptions, which is at a rate of 3.4% in our area.

  5. Approval of Minutes
    1. Regular Board Meeting: April 18, 2019
      R. Bortolin noted that he and Councilor F. Costante were late in attending the April 18, 2019 Board of Health meeting and asked that the minutes be amended to reflect this change.
      Moved by: Rino Bortolin
      Seconded by: Judy Lund
      That the minutes be approved accepted as amended.
      CARRIED
  6. Consent Agenda
    1. INFORMATION REPORTS
      The following information reports were presented to the Board.
      1. Q1 Financial Report
        With the upcoming changes in funding from the province, L. Gregg provided various scenarios of what the WECHU budget will look like over the next couple of years.  Our 75/25 split is now 70/30.  This 70/30 split applies to all of the funding pots which were 100% funded.  Going forward, everything will be cost-shared. With the regionalization of health units, there is concern once our funding split reaches 60/40, resulting in an increase in funding from municipalities.

        Changes seem to be occurring much quicker than is appropriate, jeopardizing the delivery of services with a reduced amount of dollars.  There will likely be consultation tables over the summer to provide feedback to the Ministry on the changes.

      2. Oral Health
        Brought to the Board for information.
      3. Vector Borne
        Brought to the Board for information.
      4. Measles Report
        Brought to the Board for information.
      5. Q1 Planning Update
        Brought to the Board for information.
      6. Q1 Strategic Plan
        Brought to the Board for information.
      7. Media Recap (Hand-out)
        Brought to the Board for information.

      Moved by: Judy Lund
      Seconded by: Dr. Debbie Kane
      That the Information Reports be received.
      CARRIED

    2. RECOMMENDATION/RESOLUTION REPORTS
      1. Smoke-Free Multi-Unit Dwelling
        T. Marentette introduced Eric Nadalin, WECHU Manager of Chronic Disease and Injury Prevention. E. Nadalin noted that this Resolution had been passed in 2014 to restrict smoking of tobacco in all spaces of multi-unit dwellings, and was recently updated to include the legalization of cannabis, vaping products and electronic cigarettes. The restriction can only be enforced in common areas, i.e. public spaces, stairways, common rooms, hallways and elevators.  This restriction includes the medical use of marijuana.  Other cannabis products will be legal this fall which could minimize how cannabis users ingest the product.
        The following Recommendation/Resolution Report was brought forward to the Board for support and approval

        Moved by: Rino Bortolin
        Seconded by: Dr. Debbie Kane
        That the Recommendation/Resolution Report be supported and approved.
        CARRIED

  7. Business Arising – None  
  8. Board Correspondence – Circulated
  9. New Business – None
  10. Other Board of Health Resolutions/Letters – For Support/Information
    1. Windsor-Essex County Health Unit – For Information
      2019 Ontario Budget – Letter to Hon. Christine Elliott
    2. Ministry of Health & Long-Term Care – For Information
      Public Health Modernization – Letter from Chief MOH, Dr. David Williams
    3. Simcoe Muskoka District Health Unit – For Support
      Alcohol Consumption – Letter to Hon. Christine Elliott

    Moved by: Ed Sleiman
    Seconded by: Rino Bortolin
    That the above correspondence be supported and/or received for information as noted.
    CARRIED

  11. Appendices
    1. Appendix A – 2019 Q1 Strategic Plan Progress Report
      The above report was reviewed in conjunction with Information Report 6.1.6.
  12. Committee of the Whole (CLOSED SESSION, in accordance with Section 239 of the Municipal Act)
    It was moved
    That the Board move into Committee of the Whole at 4:36 p.m.
    CARRIED
    It was moved
    That the Board move out of Committee of the Whole at 4:45 p.m.
    CARRIED
    It was moved
    That the Board move into Committee of the Whole at 4:55 p.m.
    CARRIED
    It was moved
    That the Board move out of Committee of the Whole at 5:01 p.m.
    CARRIED
  13. Next Meeting: At the Call of the Chair, or June 20, 2019 in Essex, Ontario
  14. Adjournment
    The meeting adjourned at 5:20 pm.

RECORDING SECRETARY:

SUBMITTED BY:

APPROVED BY:


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Issue

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

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

Background

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

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

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

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

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

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

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

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

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

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

Proposed Motion

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

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

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

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

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

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

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

References

 


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April 18, 2019

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

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Prepared By:

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

Date:

April 1, 2019

Subject:

The new Canada’s Food Guide

Background:

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

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

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

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

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

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

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

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

Current Initiatives

Education and Communication for Key Stakeholders

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

Education for Staff and the General Public

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

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

Nutrition Resources Update

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

Advocacy Opportunities

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

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

Consultation:

The following individuals contributed to this report:

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

Approved by:

 Theresa Marentette

 


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Prepared By:

Cathy Bennett, Public Heath Emergency Preparedness Coordinator

Date:

April 1, 2019

Subject:

Distribution of Potassium Iodide (KI) Pills 

Background:

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

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

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

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

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

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

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

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

Current Initiatives

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

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

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

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

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

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

Consultation:

The following individuals contributed to this report:

Dr. Wajid Ahmed, Medical Officer of Health

Approved by:

 Theresa Marentette


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Prepared By:

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

Date:

April 1, 2019

Subject:

2018 Strategic Plan Year-end Report

Background:

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

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

Current Initiatives

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

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

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

Consultation:

The following individuals contributed to this report:

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

Approved by:

 Theresa Marentette


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