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January 21, 2021

Meeting held via video.

  1. Call to Order
  2. BOARD ELECTIONS
  3. Agenda Approval
  4. Announcement of Conflict of Interest
  5. Update (W. Ahmed)
    1. COVID-19 Update
  6. Approval of Minutes
    1. Regular Board Meeting: December 17, 2020
  7. Business Arising
  8. Consent Agenda
    1. INFORMATION REPORTS
      1. Mosquito Surveillance and Control Program 2020 (K. McBeth)
      2. First Responder Curriculum Project – Mental Health Literacy and Resiliency – Building (N. Dupuis)
      3. December Communications Recap
    2. RECOMMENDATION REPORTS
  9. New Business
    1. Budget Timing (T. Marentette/L. Gregg)
    2. CTS Update – Next Steps (T. Marentette)
    3. W-E Vaccine Rollout Plan (T. Marentette)
  10. Other Board of Health Resolutions/Letters – For information
    1. Town of Kingsville – Letter to The Hon. Doug Ford, The Hon. Minister Christine Elliott, Medical Officer of Health, Dr. Wajid Ahmed and the Windsor-Essex County Board of Health – Resolution in Support of Small Businesses to remain open
    2. Town of Essex – Letter to The Hon. Doug Ford, The Hon. Minister Christine Elliott, Chief Medical Officer of Health, Dr. David Williams, Medical Officer of Health, Dr. Wajid Ahmed, and CEO Theresa Marentette, Windsor-Essex County Health Unit – Resolution requesting that immediate action be taken to deem Small Businesses as Essential Services
  11. Committee of the Whole (Closed Session in accordance with Section 239 of the Municipal Act)
  12. Next Meeting: At the Call of the Chair February 18 , 2021 – Via Video
  13. Adjournment

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DATE

January, 2021

SUBJECT

First Responder Curriculum Project – Mental Health Literacy & Resiliency-Building


BACKGROUND - The First Responder Mental Health Coalition (FRMHC)

In recent years, there has been a growing recognition among national policy makers and legislators that first responders’ unique experiences result in mental health needs distinct from many other occupational groups. In 2016, the Ministry of Labour (MOL) amended the Workplace Safety & Insurance Act, Post-Traumatic Stress Disorder (1997) with Bill 163, Supporting Ontario’s First Responders Act, Post-Traumatic Stress Disorder (2016). Under Bill-163, all employers of first responders are required to develop, sustain, and implement post-traumatic stress disorder prevention plans.

In support of these legislative changes, the MOL issued a call for proposals for the 2017-2018 Occupational Health, Safety, and Prevention Innovation Program (OHSPIP). First responder organizations and other supporting agencies in Windsor-Essex County (WEC), including the Windsor-Essex County Health Unit (WECHU), formed a First Responder Mental Health Coalition (FRMHC) to prepare and submit a successful OHSPIP proposal.

In 2020, a five year sustainability plan was developed by the FRMHC for 2020-2025 to maintain the coalition beyond the OHSPIP grant and to build on the initiatives and programs established to date. In 2021, membership on the FRMHC includes all first responder organizations in WEC representing policing/law enforcement, fire and rescue, emergency medical services (EMS), and emergency healthcare, as well as several local partner agencies with a vested interest in promoting and supporting first responder mental health at the local level. These partner agencies include:

  • Canadian Mental Health Association – Windsor-Essex County Branch (CMHA-WECB)
  • Family Services Windsor-Essex (FSWE)
  • Windsor-Essex County Health Unit (WECHU)
  • Occupational Health Clinics for Ontario Workers (OHCOW)
  • St. Clair College

THE FIRST RESPONDER CURRICULUM PROJECT

As part of the 2017-2018 OHSPIP proposal, six project commitments were identified for the partnership to promote and support first responder mental health in WEC. The WECHU has taken a lead role in fulfilling the second project commitment outlined through the OHSPIP proposal:

“Work with representative(s) from St. Clair College to investigate the feasibility of developing a common mental health module to be included in all First Responder programs offered by the college (i.e., Pre-Service Firefighter Education and Training, Police Foundations, Paramedics)”.

The First Responder Curriculum Project was initiated by the WECHU in 2018 as a means to fulfill this project commitment. The purpose of the First Responder Curriculum Project is to develop a mental health literacy and resiliency-based curriculum module that can be embedded into local post-secondary programs for first responder students and allied health professionals, including firefighters, paramedics, police officers, nurses, and physicians.

Prior to the development of curricular content, the WECHU conducted a needs assessment to determine the key training needs and opportunities surrounding mental health literacy and resiliency-building for student and early-career first responders. The WECHU presented the final needs assessment results to the FRMHC on December 10th of 2020. Key informant interviews were conducted with 29 local representatives from the policing/law enforcement, fire and rescue, paramedic, emergency healthcare, and higher educational professions (n=28 interviews). The data was analyzed and key themes were identified that will drive the development and implementation of the curriculum module(s):

  • Curriculum Topics – The main training needs and opportunities for student and early-career first responders as related to personal/professional mental health literacy and resiliency include:
    • Resiliency-Building & Coping
    • Stigma Reduction & Help-Seeking Efficacy
    • Mental/Emotional Readiness for the Realities of the Role
    • Mental Health & Mental Illness – Theoretical, Conceptual, & Clinical Concepts
    • Strategic Uses of Social Supports
    • Early Intervention & Proactivity
    • Work-Life Balance
    • Team Building
  • Delivery Formats – Key themes supported the development of a hybrid online and in-person curriculum module with the embedment of lived experience from first responders in the profession (n=25).
  • Implementation Methods – Key themes supported the early and continual implementation of an adaptable, inter-professional curriculum module into the following post-secondary and new recruit training programs for local students and early-career first responders:
    • Pre-Service Firefighter Education & Training Program (St. Clair College)
    • Paramedic Program (St. Clair College)
    • Police Foundations Program (St. Clair College)
    • Bachelor of Nursing Program (St. Clair College & University of Windsor)
    • New recruit training programs at local first responder organizations in WEC, specifically volunteer recruit training programs at local fire departments

Current Initiatives

The WECHU is currently transitioning into the curriculum development and implementation phases of the project. In 2021, project leads at the WECHU will use the needs assessment findings to inform the development of educational and instructional components for the curriculum. The WECHU continues to consult and collaborate with local representatives on the FRMHC for knowledge, expertise, and support in solidifying key areas for curricular content, structural design, and student engagement in the curriculum module.

In collaboration with several interested members on the FRMHC, project leads at the WECHU plan to coordinate  follow-up meeting(s) with the first responder higher educational group at St. Clair College early in 2021 to update their team on the recent initiatives completed for this project and to solidify partnered strategies for implementation. Future consultations with leadership at St. Clair College, as well as representatives on the FRMHC, will inform the processes and operations undertaken in 2021-2022 to pilot, implement, and evaluate the curriculum module following its initial development and review.


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DATE

January 21, 2021

SUBJECT

Mosquito Surveillance and Control Program 2020


BACKGROUND

The Environmental Health Department conducts annual monitoring and testing of 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 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, Eastern Equine Encephalitis (EEE) Virus, and Zika Virus in our community. 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. The WECHU received a federal grant from the Public Health Agency of Canada’s Infectious Disease and Climate Change Program (August 2019 to March 2022)  to study the effects of climate change and mosquito populations in our local communities. For the 2020 season, an additional 14 traps were placed in Leamington to monitor mosquito populations as part of this grant.

During this year’s season:

  • Total number of mosquitoes trapped: 205,569
  • Total number of pools tested: 2,052
  • Number of positive pools for West Nile virus : 30
  • Number of positive pools for Zika virus: 0
  • Number of positive pools for EEE virus: 0

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. In 2020, over 135,000 treatments of larvicide were applied to roadside catch basins and standing water sites.

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. In 2020, there were two confirmed and one probable case of WNV in WEC. To date, there have been no human cases of Zika Virus identified in WEC.

Education and Awareness Raising Activities

Fight the Bite public awareness campaign was launched in June and included key messages that focused on preventing mosquito bites, removal of standing water and the cause and symptoms of West Nile Virus. These messages were communicated through the WECHU website, radio, billboard and bus shelter ads, social media, and print materials.

CURRENT INITIATIVES

All activities, including monitoring and testing mosquitoes and education regarding personal protection from mosquito bites and removing standing water, will continue in 2021.  Targeted promotion and messaging will be used to reach priority populations and inform the public of hot spots identified through previous monitoring efforts.


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December 17, 2020

Meeting held via video.

  1. Call to Order
  2. Introduction: Felicia Lawal, Acting Director, Health Protection
  3. Agenda Approval
  4. Announcement of Conflict of Interest
  5. Update (W. Ahmed)
    1. COVID-19 Update
  6. Approval of Minutes
    1. Regular Board Meeting: November 19, 2020
  7. Business Arising
  8. Consent Agenda
    1. INFORMATION REPORTS
      1. Healthy Families Department and Healthy Babies, Healthy Children Program Updates (N. Dupuis)
      2. Oral Health Program Update (N. Dupuis)
      3. Influenza Vaccine Update (K. McBeth)
      4. Q2 Financial Report (L. Gregg)
      5. November Communications Recap
    2. RECOMMENDTION REPORTS
      1. Bill 216 – An Act to amend the Education Act – Food Literacy (N. Dupuis)
  9. New Business
    1. Long-term Service Awards (T. Marentette)
    2. Records Management (L. Gregg)
  10. Other Board of Health Resolutions/Letters – For information
    1. WECHU Letter to The Honourable Justin Trudeau – Federal Government Supervision of Self-Isolation Period for Arriving Migrant Workers
    2. Grey-Bruce Public Health Unit – Letter from Board Chair Mitch Twolan – Public Health Regionalization
    3. Timiskaming Health Unit – Letter to The Honourable Stephen Lecce, The Honourable Christine Elliott, The Honourable Ernie Hardeman – Bill 216 Food Literacy for Students Act 2020
  11. Committee of the Whole (Closed Session in accordance with Section 239 of the Municipal Act) 27
  12. Next Meeting: At the Call of the Chair January 21, 2021 – Via Video
  13. Adjournment

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DATE

December 17, 2020

SUBJECT

Influenza Vaccine Update


BACKGROUND

The Windsor-Essex County Health Unit (WECHU) plays a key role in the implementation of the Ministry of Health’s Universal Influenza Immunization Program (UIIP) which offers influenza vaccine free of charge each year to all individuals six months of age and older who live, work, or attend school in Ontario. The WECHU receives influenza vaccine shipments from the Ontario Government Pharmacy (OGP) and is responsible for the distribution to local health care providers and approved facilities in the community.  Allocation to providers is based on total community allocation, number of clients to be served, past usage by the provider, available fridge space, and the proportion of high-risk clients the provider is responsible for. As of December 1, 2020, there were no laboratory-confirmed cases of influenza in Windsor and Essex County.

SUMMARY OF VACCINE ALLOCATION & DISTRIBUTION

The WECHU received initial shipments of the influenza vaccine on September 28 and October 5.  In total, the WECHU received 127, 150 doses of the vaccine from the Ministry. Of these, 31,800 were the High Dose Trivalent Inactivated Vaccine (HD-TIV) for individuals 65 and over.

As of November 27, the WECHU has distributed 89% (113,960 doses) of our total allocation of the influenza vaccine, and 100% (31,800 doses) of the HD-TIV to the community, including 41 long-term care facilities and retirement homes, 4 hospitals, and approximately 200 healthcare providers. The OGP distributed the influenza vaccine directly to 101 pharmacies in WEC that were approved by the Ministry of Health, and at the time this report was written, pharmacies have administered 43,955 doses to WEC residents.

 

QIV

High Dose - TIV

Total

# of doses of flu vaccine the WECHU has received from the Ministry

97,850

31,800

127,650

# of doses of flu vaccine the WECHU has distributed to the Community

82,160

31,800

 

113,960

 

The initial supply of influenza vaccine is prioritized for the immunization of high-risk individuals, such as residents and staff of long-term care homes and retirement homes. Overall, the WECHU has distributed 5,655 influenza vaccine doses to 19 long-term care homes, and 2,240 doses to 22 retirement homes in WEC. A further breakdown is provided below:

 

QIV

High Dose – TIV

Total

# of doses of flu vaccine the WECHU has distributed to Long-Term Care Homes

3,000

2,655

5,655

# of doses of flu vaccine the WECHU has distributed to Retirement Homes

790

1,450

2,240

 

HIGH DOSE -TIV

On November 16th, the Ontario Ministry of Health notified all Health Units that Fluzone High Dose is out of stock, and will not be available for the remainder of the season. However the standard dose of Quadrivalent Influenza Vaccine (QIV) is still available, and there is no preferential recommendation for high dose over QIV.

ADVERSE EVENTS FOLLOWING IMMUNIZATION

Concerns were identified through the Adverse Events Following Immunization reporting system, and the administration of a specific lot of FluLaval Tetra was suspended. Investigation is underway nationally, and the WECHU has contacted all healthcare providers on record who had received the affected vaccine to halt its use until further notice. The WECHU will continue to update healthcare providers as more information is received from the Ministry of Health.

CURRENT INITIATIVES

Although the WECHU is not administering the influenza vaccine to clients this year, we continue to support widespread availability of the influenza vaccine in our community by working collaboratively with many community partners, including those in primary care, to identify service gaps and promote vaccine uptake.

The WECHU continues to raise awareness of the risks of contracting influenza (especially for high-risk groups), and the importance of being vaccinated amongst the COVID-19 pandemic through our social media platforms (i.e., Facebook, Twitter, and Instagram).


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PREPARED BY

Lorie Gregg, Director of Corporate Services

DATE

December 17, 2020

SUBJECT

Q2 Financial Results


BACKGROUND

The Leadership Team of the Windsor-Essex County Health Unit (“the WECHU”) monitors financial results on an on-going basis for related programs funded 100% by the Ministry of Children, Community and Social Services (“MCCSS”).  These programs are:

  • Healthy Babies Healthy Children Program;
  • Prenatal and Postnatal Nurse Practitioner Program.

The budgets for these programs were approved by the Board of Health for the WECHU on May 21, 2020.  On October 30, 2020, the budgets were formally submitted to the MCCSS along with financial information for the period April 1, 2020 to September 30, 2020.  Details of that submission is included in the narrative below.

Of noteworthy mention is the following:

  • The MCCSS required that financial information for the aforementioned programs, both budget and year-to-date actuals, be reported on a combined basis.  For consistency with the WECHU’s presentation of the 2020/2021 budgets on May 21, 2020, the WECHU has continued to report these programs separately.
  • The prior year’s comparative information for the aforementioned programs has not been presented due to the change the MCCSS change in fiscal years (was January to December; now April to March).

On September 30, 2020, the MCCSS launched the Transfer Payment Ontario (TPON) system.  The TPON will enhanced transfer payment business processes and reduce administrative burden on service providers, enhance efficiency and improve outcomes and the overall client experience.  More specifically, transfer payment recipients such as the WECHU will be able to submit financial and non-financial reporting requirements to the MCCSS on-line.

HEALTHY BABIES HEALTHY CHILDREN PROGRAM INITIATIVE

 

 

Annual Budget

Budget at 09 30 2020

Actual 09 30 2020

Variance – Budget from Actual

Salaries and benefits

2,583,600

1,311,695

1,067,842

176,209

Operating expenditures:

 

 

 

 

     Mileage

60,000

30,000

9,233

20,638

     Travel and meetings

3,000

1,500

3,000

1,500

     Professional development

10,400

5,200

10,400

5,200

     Program supplies

83,841

22,026

44,051

17,599

     Purchased services

15,000

7,500

15,000

6,382

Total operating expenditures

172,241

66,226

132,451

51,319

Total budget

2,755,841

1,377,921

2,755,841

227,528

The Heathy Babies Healthy Children Program Initiative supports 26 FTEs comprised of managers (2), nurses (16), family home visitors (4), social worker (1.0) and support staff (3.0).  The objective of the program is to ensure a healthy future for children and their families.  Total funding envelope for this program initiative is $2,755,841. 

PRENATAL AND POSTNAL NURSE PRACTITIONER PROGRAM INITIATIVE

 

Annual Budget

Budget at  09 30 2020

Actual 09 30 2020

Variance – Budget from Actual

Salaries and benefits

139,000

69,500

71,179

1,679

Total budget

139,000

69,500

71,179

1,679

The Nurse Practitioner Program Initiative supports 1.0 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.  Total funding envelope for this program is $139,000.


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DATE

December 17, 2020

SUBJECT

Oral Health Program Update


BACKGROUND

The novel Coronavirus (COVID-19) has affected many public health services, including the WECHU’s oral health program. Those services include the Healthy Smiles Ontario (HSO) and the Ontario Seniors Dental Care Program (OSDCP) dental clinics, as well as in-school dental and vision screening programs.

ORAL HEALTH

Following guidance from the Royal College of Dental Surgeons of Ontario (RCDSO) and the Ministry of Health, the WECHU suspended all non-essential and elective dental services on Monday, March 16, 2020 and redeployed oral health staff to the COVID-19 response.  Dental screenings in schools were suspended and the clinic remained open in Windsor for emergency services only until June 22, providing 79 office visits from March.

Due to the shutdown, 2,377 OSDCP and HSO appointments had to be cancelled. Following the health care sector restart guidance from the Ministry of Health, the Windsor clinic resumed full operations at the end of June, while the reopening of the Leamington clinic was gradual and operational at the end of August. All oral health staff have returned to the department, while continuing to support the COVID-19 call centre as part of their regular duties. As of November 26, 2020, 93% of the 2,377 appointments have been contacted and rescheduled.

All dental screening and vision screening programs have been suspended at this time.

In the 2019/20 school year:

  • 73 schools of the 123 schools required for dental screening were completed
  • 8,300 children screened, approximately 6,673 children were un-screened under the oral health screening program
  • 2,840 (68%) of SK students attending 78 Windsor-Essex elementary schools received vision screening. 35 schools were not completed.

CURRENT INITIATIVES

COVID-19 has affected many public health programs and services, including future program operations. In addition, infection prevention and control measures call for limiting the number of essential visitors in the school. As a result, school dental and vision screening may not resume in 2020-2021.

The WECHU has partnered with the Southwest Ontario Aboriginal Health Access Centre (SOAHAC) to provide free oral health screenings for First Nation, Métis, and Inuit (FNMI) people and their families. A Registered Dental Hygienist (RDH) from the WECHU works at the SOAHAC Windsor location bi-weekly, providing dental screenings and oral hygiene instruction to their clients. This service had been shut down due to COVID-19 but was reinstated on November 23, 2020.

ORAL HEALTH PROGRAMS

Baby Oral Health Program (BOHP)

Parents of babies born at Windsor Regional Hospital usually receive an infant dental education kit. Despite being put on hold due to COVID-19, this service resumed in July. So far this year, 1,802 bags were delivered to the hospital for distribution.

WECHU Healthy Smiles Ontario and Ontario Seniors Dental Care Plan

PROGRAM

# of CLIENTS

# of VISITS

OSDCP (WECHU)

408

1,392

OSDCP (CKPHU)

26

76

HSO – EESS

379

769

HSO – CORE

727

1,062

HSO - PSO

846

1,229

TOTAL

2,386

4,528

We have a high patient volume and due to reduced clinical services for four months, we have experienced a slight backlog in treatment. Approximately 40-45 HSO and OSDCP clients are seen daily across the two clinic locations. We are currently booking into March 2021 for certain dental procedures. From January 2020 to November 2020 the WECHU saw 2,386 HSO and OSDCP clients for 4,528 appointments.

The OSDCP began at the WECHU in January 2020, providing free, routine dental services for low-income seniors 65 years of age or older. Since the program’s provincial implementation in November 2019, 1,002 seniors from the Windsor-Essex area enrolled in the program. Each client requires a new patient exam. To date we have completed 405 new patient exams therefore, we can determine that we have seen 40% of the seniors that have enrolled into the OSDCP program in this region. Our contract denturist has completed 88 denture consultations.

Currently, we have one full-time dentist, four contract dentists and a contract denturist. We plan to bring on a second full-time dentist in 2021.


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DATE

December 17, 2020

SUBJECT

Healthy Families Department and Healthy Babies, Healthy Children Program Update


BACKGROUND

Healthy Babies, Healthy Children Program (HBHC) is a provincial home visiting program designed to help children get a healthy start in life through nursing and peer support. The program supports the most vulnerable and marginalized families in our community with the goal of improving developmental outcomes. HBHC has three entry stages namely; Prenatal; Postpartum; and Early Identification; and requires screening to identify a family at risk (screen score 2 or >). The HBHC screen identifies a family experiencing a need, issue or risk that may compromise healthy child development; and/or parenting ability; and who may benefit from a more thorough evaluation and receipt of HBHC program services or other community services. HBHC staff utilize standardized assessments and evidence-based interventions to work on family centred goals and develop a Family Service Plan that monitors the progress and achievement of those goals. HBHC is a free voluntary home-visiting program compromised in WECHU of 16 nurses, 4 Family Home Visitors (lay providers) and Social Workers (SW) that support families with:

  • healthy pregnancy and prenatal care
  • developing a positive relationship with their child
  • promoting child’s growth and development
  • connecting families to resources and programs within their community
  • working together with families to help give their child the best start in life

PROGRAM UPDATE

As a result of COVID-19, pandemic-related redeployment significant adjustments were made to service delivery.  Beginning in March 2020, in-person home visits with families were discontinued due to the COVID-19 pandemic. Two nurses and one social worker continued to support 138 existing HBHC families. All visits with families moved to virtual and phone support and any new qualifying parents who wished to participate in the program were placed on a waitlist until June (48). These forms of communication have inherent limitations (e.g., inability to provide hands-on demonstration or effectively observe the home environment) and many clients did not have access to the technology needed to facilitate meaningful interactions. To maintain engagement and support client progress, staff needed to customize service delivery to meet client needs. The HBHC Social Worker has since worked to improve client access to the internet via financial aide.

The Healthy Family’s department hotline has remained operational, triaging calls on healthy growth & development, community resources and breastfeeding. The Lactation Consultant (LC) was also available to provide breastfeeding support over the phone or virtually to both HBHC clients and community members. Due to the cancellation of services and limited supports available to new mothers during the pandemic, the Healthy Families department prioritized calls to all mothers the HF within 48-72 hours of birth.

Lack of departmental engagement of physicians and midwives during this time likely contributed to the significant reduction in referrals to the HBHC program. Overall, referrals decreased by 14% over the pandemic compared to the same period in 2019. This may also be in part due to the absence of HBHC Hospital Liaison nurse.  Prenatal referrals have been the most significantly affected. Only 22 prenatal referrals were received during this time, compared to 160 in 2019. This change warrants further investigation since prenatal intervention within the HBHC program can improve pregnancy outcomes and better prepare families to navigate the challenging newborn stage of parenting.

Currently, HBHC has six (6) public health nurses supporting 161 clients on caseload. Staff have reported an increase in mental health concerns among their clients and increased severity for those with pre-existing anxiety and depression. This may be attributed, at least in part, to the financial strain, isolation, and general uncertainty caused by the pandemic as reported by some clients. In response, WECHU has hired an additional Social Worker for the HBHC program to focus on mental health-related issues. This Social Worker will consult with HBHC staff regarding mental health challenges, provide brief counselling directly to clients, and help clients access appropriate supports within the community.

Additionally, staff have reported that clients continue to struggle to afford healthy food for their families and access affordable housing. Pandemic-related income loss, along with the simultaneous increase in the price of food and housing have placed excessive strain on the program’s low-income families. This strain has left some families looking for ways to save on groceries, including prematurely discontinuing the use of infant formula. Transitioning from infant formula to fluid cow’s milk before nine months is linked to nutrient deficiency that can hinder a child’s lifelong growth and development potential. To ensure that clients have access to the funds they need to afford infant formula or support a nutritious diet for the breastfeeding mother, the department’s Registered Dietitian and HBHC Social Worker are developing a procedure to ensure clients are able to access the province’s Special Diet Allowance in a timely manner. The Special Diet Allowance provides additional funds to families on social assistance who are pregnant, breastfeeding, or reliant on infant formula.  The Social Worker is also continuing to investigate actions to improve access to affordable housing.  

During these unprecedented times, HBHC staff have remained committed to providing the best possible service to the most vulnerable families within our community. We have continued to work and develop processes with our community partners to ensure wrap around care for our families. Outreach to local midwives and physicians has begun with regard to increasing our Prenatal and Early-ID referrals. Additionally, Policies and Procedures have been prepared to safely reinitiate in-person home visits, on a case-by-case basis, in an on-going effort to improve client engagement and adequately address their needs.

COMPARISON OF WITH RISK SCREENS, 2019 & 2020

Entry Level into HBHC- April 1st-November 25, 2019/2020

Screens Completed

Screens with Risk >2

2019

2020

2019

2020

Prenatal

160

22

122

22

Postpartum

2564

2344

1203

1017

Early Identification-18 Month Screening Assessment

75

58

70

37

 


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November 19, 2020

Meeting held via video.

  1. Call to Order
  2. Agenda Approval
  3. Announcement of Conflict of Interest
  4. Update (W. Ahmed)
    1. COVID-19 Update
  5. Approval of Minutes
    1. Regular Board Meeting: October 15, 2020
  6. Business Arising
  7. Consent Agenda
    1. INFORMATION REPORTS
      1. Student Immunization Catch-up Plan (Grade 7/8) (K. McBeth)
      2. Potassium Iodide (KI) Tablet Distribution Continues during COVID-19 Pandemic (K. McBeth)
      3. Consumption and Treatment Services Site – Application Status (T. Marentette)
      4. October Communications Recap
    2. RECOMMENDTION REPORTS – None
  8. New Business
    1. CEO Quarterly Reports (T. Marentette)
    2. 2021 Board of Health Meeting Schedule
  9. Other Board of Health Resolutions/Letters – For information
    1. WECHU Letter to The Right Honourable Justin Trudeau and The Right Honourable Chrystia Freeland – Basic Income During and After the COVID-19 Pandemic
    2. Grey-Bruce Public Health Unit – Letter to The Honourable Patty Hajdu, the Honourable Marilee Fullerton and Ontario's Long- Term Care COVID-19 Commission – COVID-19 and Long-Term Care Reform – Supporting Simcoe Muskoka District Health Unit's letter regarding same 19
    3. Grey Bruce Public Health Unit – Letter to the Honourable Patty Hajdu and The Honourable Christine Elliott – Municipal Drug Strategy Coordinators Network Ontario, Safe Supply 23
  10. Committee of the Whole (Closed Session in accordance with Section 239 of the Municipal Act)
  11. Next Meeting: At the Call of the Chair December 17, 2020 – Via Video
  12. Adjournment


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DATE:

November, 2020

SUBJECT:

Consumption and Treatment Services Site – Application Status


BACKGROUND

On April 1, 2019  the Board of Health of the Windsor-Essex County Health Unit (WECHU) passed a resolution in support of public health-led assessment of the feasibility of a Consumption and Treatment Services (CTS) site in the City of Windsor. In September of the same year, following the release of the Supervised Injection Services Community Consultations Report, the Board of Health subsequently resolved in support of the submission of an application for the creation of a site in the City of Windsor. This application to the provincial Ministry of Health would be accompanied by a corresponding submission to the Federal Government for an exemption to the Controlled Drugs and Substances Act, an additional necessary component for the legal operation of a CTS site. In addition, the September resolution supported the completion of a comprehensive community consultation to determine a suitable and accessible location for a CTS site in the City of Windsor

In order to facilitate this process, a CTS Stakeholder Advisory Committee was created including membership from the following agencies representing the multiple sectors with vested interest in the creation of a CTS:

  • The City of Windsor
  • The AIDS Committee of Windsor (Pozitive Pathways Community Services)
  • Windsor-Essex Community Health Centre
  • Hotel-Dieu Grace Healthcare
  • Canadian Mental Health Agency – Windsor-Essex County
  • Windsor Police Services
  • Windsor Downtown Mission

The WECHU also hired a Substance Use Coordinator to lead the site selection process and completion of the application. The coordinator role was initially responsible for facilitating the decision-making process amongst the Stakeholder Advisory Committee ultimately establishing the criteria and requirements for an eligible site. These requirements acomplement the mandatory criteria set out in the federal and provincial application documents and are outlined below:

  • Site must be 200m from a sensitive land use (e.g. parks, daycare centers, and schools) as well as 600m from other CTS sites OR If  located within 200m of a sensitive land use, application must include plans on how to address community concerns
  • Site must be easily accessible by public transit
  • Site must be within walking distance to areas known to be frequented by people who use drugs
  • Space should be greater than 590ft2 (for six consumption booths) or 385ft2 (for three booths)

Using these criteria, and in consultation with WECHU legal representation and procurement procedures, the WECHU issued a Request for Expressions of Interest (RFEOI) through the MERX Online Public Tenders solicitation database. With an expiry period of one week, the initial RFEOI did not result in any responses. A second, more widely promoted RFEOI was issued and received media coverage from all local major media outlets. Per the health unit’s standard procurement process the WECHU hosted an information Session with two interested parties to answer questions and provide further information on the site criteria and selection process. Ultimately, however this tender also expired without any submissions.

CURRENT INITIATIVES

With the RFEOI process not yielding any potential locations, the WECHU is once again consulting with the CTS Stakeholder Committee and working through the Substance Use Coordinator to determine if there is mutual interest in a shared space among partners. In addition, the WECHU will be reviewing eligible properties and hiring a Real Estate representative in order to guide an equitable and transparent strategy for proactively contacting property owners and managers who appear to meet the set criteria.

Prior to community consultations, environmental audits will be completed by Windsor Police Services in order to determine the safety of the area and guide any mitigating interventions which can improve the safety of the areas surrounding the site and discourage criminal activity.

Community consultations may include open Town Hall Meetings to all residents, as well as targetted meetings in the neighbourhoods in which the sites reside, and online surveys for residents who are unable to attend in-person meetings. Following the consultation process, any decisions regarding the site will require both Board of Health approval and the approval of the Municipality prior to the submission of the final CTS application.


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SUBMITTED BY:

Environmental Health Department

DATE:

November 9, 2020

SUBJECT:

Potassium Iodide (KI) Tablet Distribution Continues during COVID-19 pandemic


BACKGROUND

The Windsor and Essex County (WEC) region is located within the primary and secondary zones of two (2) nuclear installations – the Enrico Fermi 2 and the Davis-Besse. Although both installations are not located within Canadian borders, the impact they have on our region is the same in the event a nuclear emergency occurs.

According to the Canadian Nuclear Safety Commission (CNSC), all nuclear installations must ensure that potassium iodide tablets are pre-distributed and that pre-distribution includes a public education plan. Potassium iodide tablets are a stable iodine salt that blocks the thyroid from absorbing radioactive iodine during a nuclear incident. In the improbable event of a nuclear emergency, residents will receive instructions from local and provincial authorities to take their tablets to prevent the long-term development of thyroid cancer.

Since the Enrico Fermi 2 Nuclear Generating Station and the Davis – Besse Nuclear Power Station are not regulated by the CNSC, the responsibility for potassium iodide tablet distribution falls on the Windsor-Essex County Health Unit (WECHU), the Municipalities of Windsor and Essex County, and the Ministry of Health. In 2018, the WECHU acquired over 17,000 potassium iodide (KI) kits and coordinated a multi-phase approach that involved distribution to primary and secondary zone residents. Almost 3600 kits were distributed to residents during the first two phases, with an online registration and distribution method implemented for the 2019 season. A targeted communication campaign was completed in 2019, which focused on families with young children in the primary and secondary zone resulting in the distribution of an additional 6500 potassium iodide (KI) kits within the community.

CURRENT INITIATIVES

The ongoing distribution plan for KI tablets in 2020 was met a number of challenges due to the COVID-19 pandemic including post office delays and lack of volunteers to support community pick up centres. Despite some of these barriers, the WECHU has disseminated kits to over 10,600 households in our region this year. Distribution for the 2020 season ended in October due to temperature changes in the environment and will resume in the spring of 2021. The 2021 season, will see additional engagement with stakeholders such as schools, businesses and municipally owned buildings to discuss supply planning and storage in the event of a nuclear emergency.


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SUBMITTED BY:

Healthy Schools Department (Immunization)

DATE:

November 9, 2020

SUBJECT:

Student Immunization Catch-Up Plan (Grade 7/8)


BACKGROUND

By law, the Immunization of Schools Pupils Act (ISPA) R.S.O.1990 requires children and adolescents attending primary or secondary school to be appropriately immunized against designated diseases, unless they have a valid exemption. Local public health units are mandated to keep and assess immunization records for every student attending school in their region, and provide provincially funded immunization programs through school-based clinics.

Due to COVID-19, a novel highly contagious respiratory virus, the Ontario Government closed all publicly funded schools from March to September 2020.  As a result of these closures, the Windsor-Essex County Health Unit (WECHU) could not implement the spring school-based immunization clinics scheduled for grade 7/8 students. In order to support widespread availability of publicly funded vaccines to protect children from Hepatitis B, HPV, and Meningococcal Disease (Men-C-ACYW135), the WECHU has been working collaboratively with local healthcare providers to ensure students have access to these vaccines in the community. Since May 2020, the WECHU vaccine distribution team has fulfilled school-based vaccine orders from community healthcare providers to administer catch-up vaccines for 1383 students.

CURRENT INITIATIVES

The WECHU will be hosting a series of catch-up clinics beginning on November 2, 2020 to service families with children born in 2006/2007 that were not able to receive their school-based immunizations from the WECHU in spring 2020 or their primary healthcare provider during the on-going COVID-19 pandemic. These clinics are part of a larger Healthy Schools Department strategy aimed at reducing barriers for clients, especially priority populations; and ultimately decreasing the number of students that are behind on their vaccinations. Families will be able to book an appointment during the day, afternoons, evenings, and weekends at the Windsor or Leamington office, or a convenient location in the community. The WECHU will be preparing tailored communications to update families, healthcare providers, school board liaisons, and school administrators regarding options available to students who require immunizations.

The WECHU is also in the process of adapting the delivery method of our immunization education sessions under the Immunization of School Pupils Act (ISPA) to an e-Learning format. Since 2017, a mandatory immunization education session has been a requirement under the ISPA O.Reg 645 for parents seeking a non-medical exemption for their child. These education sessions were historically required to be delivered in-person, but the Ministry of Health has recently eliminated this requirement. Currently, there are about 50 clients on our waiting list. 


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SUBMITTED BY:

Communications Department

DATE:

November 9, 2020

SUBJECT:

October Communications Recap


October Metrics

SOURCE

SEPTEMBER

OCTOBER

DIFFERENCE

News Releases Issued

0

3

+3

Media Advisories Issued

6

1

-5

Media Statements or Notifications

21

35

+14

Media Requests Received 1

46

47

+1

AM 800 Morning Segments 2

12

12

0

YouTube Live Media Briefing Videos3

22

16

-5

Wechu.org/cv/local-updates visits 4

201,598

166,394

-35,204

YouTube Channel Subscribers

620

669

+49

Email Subscribers 5

1,400

1,400

0

Emails Distributed

38

39

+1

SOCIAL MEDIA6

Facebook Fans

15,639

15,753

+114

Facebook Posts

123

115

-8

Twitter Follower

4,613

4,728

+115

Twitter Posts

114

105

-9

Instagram Followers

778

803

+25

Instagram Posts

10

18

+8

LinkedIn Followers

663

682

+19

LinkedIn Posts

76

73

-3

Media Exposure7 844 661 -183

Media Exposure

Graph display media exposure numbers

Trending Themes

Wordcloud displaying trending themes

Top Sources

Chart displaying top traffic sources

Media Participating in Teleconference for YouTube Live

  • AM 800 CKLW, Blackburn News, CBC Windsor, and The Windsor Star join every Monday, Wednesday, and Friday. On occasion, CTV Windsor and windsoriteDOTca will also join the briefing.

Current Notable Projects

  •  Microsoft Power BI was implemented on the COVID-19 Local Data webpage led by the Epidemiology and Evaluation department. Continuous Improvements occur to the webpage.
  • We helped launch the COVID-19 Monitoring Indicators for Windsor-Essex to align with the province’s Framework for Reopening our Province. The 3 colour system is used to help residents know the current local pandemic status.
  • Radon – Know Your Level messages are being promoted on social media throughout the month of November.
  • We are working on a local flu shot campaign to complement the provincial roll out of their upcoming campaign.

Data Notes:

Most requests are related to the local COVID-19 pandemic.

  1. Media requests received is a compiled list of documented requests we captured for interviews, data clarification, or general request for information from the media. Given the volume of requests during COVID-19, many exchanges with the media through text messages or quick phone calls to correct errors may not be captured. In many instances, each request led to multiple interactions with reporters.
  2. Dr. Ahmed joined Mike and Lisa on the AM 800 Morning Drive every morning at 8:06 a.m. starting on Wednesday, March 17. On August 17, we went to a Monday, Wednesday, and Friday schedule with holidays off. He continues to do join Mike and Lisa every other morning to keep the community informed.
  3. We changed the platform we broadcasted live videos from Facebook to YouTube at the end of June. YouTube Live videos started on June 23, 2020. Prior Public Health Update videos on YouTube were exported videos recorded through Facebook Live.
  4. Website analytics are provided by Siteimprove. The metric provided is for page views to COVID-19 Local Updates Page. During the COVID-19 pandemic, changes were made to landing pages. For consistency in reporting, the most popular page was selected.
  5. Email subscribers are those individuals who signed up to receive promotional emails from the Windsor-Essex County Health Unit. The analytics are provided through Mailchimp.
  6. Social media metrics are provided through Hootsuite.
  7. Graphs and media exposure information in this report were generated using Meltwater Media Monitoring Solution. Significant changes in numbers can be partially attributed to configuration changes made to the new service to better monitor and report media activity. News stories may be duplicates or missing as the platform is currently being optimized to better track Windsor-Essex County Health Unit mentions in the media landscape.

View Document page

Board Members Present:

Gary McNamara, Tracey Bailey, Joe Bachetti, Rino Bortolin, Fabio Costante, Dr. Debbie Kane, Gary Kaschak (via phone), Judy Lund, John Scott, Ed Sleiman, Larry Snively

Board Member Regrets:

N/A

Administration

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


QUORUM:  Confirmed

  1. Call to Order
    Board Chair, Gary McNamara, called the meeting to order at 4:01 p.m.
  2. Agenda Approval
    Moved by: Judy Lund
    Seconded by: Rino Bortolin
    That the agenda be approved.
    CARRIED
  3. Announcement of Conflicts of Interest – None
  4. Update (Dr. W. Ahmed)
    1. COVID-19 Update

      Dr. W. Ahmed provided an update on the status of COVID-19 cases in our region and noted that cases are increasing worldwide. Canada is responding well to the pandemic compared to some countries, but there is a lockdown in Europe, and we seem to be heading in that direction. Ontario case counts were close to 650 per day, but has now more than doubled up to approximately 1,500 per day. Data around hospitalizations and admissions to ICU is showing that we are moving in the wrong direction in respect to morbidity and mortality rates.

      Locally, we saw an increase in cases in November, likely due to Halloween parties and social gatherings, and are averaging about 20 cases a day. The virus is spreading in different sectors likely now through community spread, and we are coming closer to numbers that we have seen in the first wave. Hospitalization was more manageable through the first wave, but admissions to hospitals and ICU due to COVID-19 is increasing.

      From an exposure perspective the highest number of cases is through close contact, followed by community transmission and then travel related. Transmission through close contacts is higher than in the first wave and is a concerning trend, likely related to social gatherings. We currently have three Long-Term Care homes in outbreak, two schools and one farm, the trend is showing that the positivity rate is also increasing. As of November 14, 2020, our positivity rate is at 2.9%, which is considered high for our region.

      Our health system capacity is at 92%. Recognizing that most COVID patients admitted are placed in isolation rooms this is increasing pressure on hospitals. The ICU is close to 80%, triggering a shift in the acute care system and ventilator capacity is currently at 40%. Public health is running at 86% capacity in contacting cases within 24 hours, but with the surge in cases, there is now a slight decline sometimes taking up to 48 hours, signaling pressures on our health unit.

      Dr. Ahmed said that if there is a case in the school and a cohort is dismissed home they are advised to self-isolate. Anyone else in the household or cohort is deemed high risk and is advised to self-monitor. Testing is recommended 5-7 days later or if an individual becomes symptomatic. Parents of student cohorts would be considered a contact of a contact and unless they become a case would not be of concern.

      J. Bachetti said when school started in September there was a lot of anxiety and wanted to compliment the public health staff assigned to the school. They did a fabulous job with school staff, parents and children and he wanted to say thank you.

      F. Costante asked when the province determines regional status, how much emphasis is place on the capacity of the health care system.

      Dr. Ahmed said the first thing the province looks at is the case counts and moving averages. Based on that they look at the Person Positivity Rate then the Effective Reproduction Rate, i.e. meaning how many cases occur from one positive case. If that data is pointing to any pressure in any of these areas, they then look at capacity.

      Dr. Ahmed said that the WECHU does get some notice from the province if our region is changing levels. The province will reach out for more information and details if they see a concerning trend and ask for our local perspective. With this framework they know what the thresholds are and we have specific conversations on how it affects us locally. Decisions made are forwarded to Cabinet and then to the Premier to make an announcement.

      We are currently in Yellow status and if we move to Orange, the extra restrictions would commence this coming Monday at 12:01 am. Just looking at the increase in the number of cases in our region, I believe we will be moved up another level to Orange, but that decision is ultimately made by the province. Before any announcement is made, they will connect with us for our perspective.

      Moved by: Ed Sleiman
      Seconded by: Larry Snively
      That the information be received.
      CARRIED

  5. Approval of Minutes
    1. Regular Board Meeting: October 15, 2020
      Moved by: John Scott
      Seconded by: Joe Bachetti
      That the minutes be approved.
      CARRIED
  6. Business Arising – None
  7. Consent Agenda
    1. INFORMATION REPORTS
      1. Student Immunization Catch-up Plan (Grade 7/8) (K. McBeth)
        Brought to the Board for information.
      2. Potassium Iodide (KI) Tablet Distribution Continues during COVID-19 Pandemic (K McBeth)
        Brought to the Board for information.
      3. Consumption and Treatment Services Site – Application Status (T. Marentette)
        Brought to the Board for information. R. Bortolin asked if there were any discussion around working with partners on a possible location. T. Marentette said that WECHU emailed WECOSS partners to determine if there was any interest in a shared space or other location. WECHU will be working with legal to move forward to next steps in securing a real estate agent.
      4. October Communications Recap (L. Gregg)
        Brought to the Board for information.

      Moved by: Rino Bortolin
      Seconded by: John Scott
      That the information reports be received.
      CARRIED

    2. RECOMMENDATION REPORTS – None
  8. New Business
    1. CEO Quarterly Reports (T. Marentette)
      T. Marentette said that the 2020 CEO Quarterly Reports are up to date, highlight issues around the pandemic, and note that most public health programs have been suspended. Most WECHU staff has been redeployed to work on COVID-19 and the CEO Report has identified these circumstances. G. McNamara commended the MOH and CEO and the entire WECHU staff for their efforts.
      Moved by: Rino Bortolin
      Seconded by: Judy Lund
      That the information be received.
      CARRIED
    2. 2021 Board of Health Meeting Schedule (T. Marentette)
      Gary McNamara advised that the WECHU is planning Board of Health meetings for 2021 and is looking to the Board for approval to commence holding monthly Board meetings every 3rd Thursday of the month.
      Moved by: Debbie Kane
      Seconded by: Ed Sleiman
      That the WECHU Board of Health monthly meetings for 2021 be held on the 3rd Thursday of each month.
  9. Other Board of Health Resolutions/Letters – For Information
    1. WECHU Letter to The Right Honourable Justin Trudeau and The Right Honourable Chrystia Freeland – Basic Income During and After the COVID-19 Pandemic

      G. McNamara said that this has been on the Board’s radar prior to the pandemic. R. Bortolin said that this might tie into something not directly related to public health but more political. He asked if we are advocating because other health units are leading the charge and would this happen at a Board level or be lead by Dr. Ahmed. N. Dupuis said that our Board has supported a Resolution on this in the past and has formally endorsed. We have a Resolution standing and have sent letters in the past. Food insecurity has a common link with social determinants of health.

      G. McNamara said that social determinants are nutrition, living capabilities, etc. and all play into building a healthy society. It can difficult for many to properly feed their families. Basic income is to support the basic requirements of society to sustain themselves in better way. The Board of Health has supported this pre-COVID so that people living in poverty can get to a level where they can get proper nutrition and we advocate for that. Social determinants have a reflection on public health and we would support moving people out of poverty the best we can. This is a basic need and is in everyone’s best interest, and should be supported by all health units.

    2. Grey-Bruce Public Health Unit – Letter to The Honourable Patty Hajdu, The Honourable Marilee Fullerton and Ontario’s Long-Term Care COVID-19 Commission – COVID-19 and Long-Term Care Reform – Supporting Simcoe Muskoka District Health Unit’s letter regarding same
    3. Grey-Bruce Public Health Unit – Letter to The Honourable Patty Hajdu and The Honourable Christine Elliott – Municipal Drug Strategy Coordinators Network Ontario, Safe Supply

    Moved by: Rino Bortolin
    Seconded by: Debbie Kane
    That the information be received.
    CARRIED

  10. Committee of the Whole (CLOSED SESSION, in accordance with Section 239 of the Municipal Act)
    Moved by: John Scott
    Seconded by: Judy Lund
    That the board move into Committee of the Whole.
    CARRIED
    The Board moved into Committee of the Whole at 4:41 pm
    The Board moved out of Committee of the Whole at 5:05 pm
  11. Next Meeting: At the Call of the Chair, or December 17, 2020 – Via Video
  12. Adjournment
    Moved by: John Scott
    Seconded by: Judy Lund
    That the meeting be adjourned.
    CARRIED
    The meeting adjourned at 5:06 pm.

RECORDING SECRETARY:

SUBMITTED BY:

APPROVED BY:


View Document page

October 15, 2020

Meeting held via video.

  1. Call to Order
  2. Agenda Approval
  3. Announcement of Conflict of Interest
  4. Update (W. Ahmed)
    1. COVID-19 Update
  5. Approval of Minutes
    1. Regular Board Meeting: September 17, 2020
  6. Business Arising
  7. Consent Agenda
    1. INFORMATION REPORTS
      1. Q3 Quarterly Report (L. Gregg)
      2. Influenza Season 2020/2021 (K. McBeth)
      3. Safe Return to School – COVID-19 Engagement, Resources and Collaboration (N. Dupuis)
      4. September Communications Recap
    2. RECOMMENDTION REPORTS – None
  8. Board Correspondence – None
  9. New Business
  10. Other Board of Health Resolutions/Letters – For information
    1. Letter from the Ministry of the Solicitor General – Enforcement and Amendments under the Reopening Act, 2020 24
    2. Letter from Town of Lakeshore – Resolution passed – that Lakeshore Council request that the WECHU notify businesses prior to releasing names of businesses where persons with COVID-19 have attended 28
  11. Committee of the Whole (Closed Session in accordance with Section 239 of the Municipal Act)
  12. Next Meeting: At the Call of the Chair November 19, 2020 – Via Video
  13. Adjournment

View Document page

Board Members Present:

Gary McNamara, Tracey Bailey, Joe Bachetti, Rino Bortolin, Fabio Costante, Dr.Debbie Kane, Gary Kaschak, Judy Lund, John Scott, Ed Sleiman

Board Member Regrets:

Larry Snively

Administration

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


QUORUM:  Confirmed

  1. Call to Order
    Board Chair, Gary McNamara, relinquished the Chair to Vice-Chair, John Scott, who called the meeting to order at 4:09 p.m. 
  2. Agenda Approval
    Moved by:  Judy Lund
    Seconded by: Fabio Costante
    That the agenda be approved.
    CARRIED
  3. Announcement of Conflicts of Interest – None  
  4. Update (Dr. W. Ahmed)
    1. COVID-19 Update

      Dr. W. Ahmed provided an update on the status of COVID-19 cases in our region.  The province has officially declared that it is in the second wave of the virus, notably in the GTA region.  We are seeing case counts of 700-800 cases per day in the Toronto, Peel, Ottawa, York and Hamilton regions, while we are reporting mostly single digits in Windsor-Essex.

      We have declared an outbreak in a bunkhouse at one farm.  The approximately 20 workers are no longer infectious and are going back to work.  The number of cases from close contacts is increasing, suggesting that people continue to gather, despite recommendations and restrictions.

      The Province has moved to testing based on appointments to help clear the current backlog of tests, and conduct direct testing for those who are symptomatic.   COVID testing is also available through three Shoppers Pharmacies in Windsor for residents with symptoms.

      The WECHU will be moving to a more interactive website, which will allow individuals different options on how to view the data.  We will continue to build on answering questions from the public as well as the media.

      School cases are still relatively low compared to other regions.  We are communicating regularly with the school boards and we currently have no outbreaks.  Moving forward we do anticipate there will be more cases in the community and will continue to work with the Agri-Sector and Long-Term Care/Retirement Homes to provide guidance to prevent cases in their high-risk settings.  Our WECHU team is working with about 65 active cases in our region.

      Moved by:    Fabio Costante
      Seconded by:  Judy Lund
      That the information be received.
      CARRIED

  5. Approval of Minutes
    1. Regular Board Meeting:  September 17, 2020
      Moved by:  Judy Lund
      Seconded by:  Rino Bortolin
      That the minutes be approved.
      CARRIED
  6. Business Arising – None
  7. Consent Agenda

    Moved by:  Ed Sleiman
    Seconded by:  Gary Kaschak
    That the information reports be received.
    CARRIED

    1. INFORMATION REPORTS
      1. Q3 Quarterly Report (L. Gregg)
        Brought to the Board for information.
        R. Bortolin asked if there have been further conversations with the Ministry providing coverage for overages around our deficit. T. Marentette said that the WECHU has submitted its extraordinary expenses related to COVID-19 to the Ministry.  The Ministry has responded back to health units with questions for clarity and we are in the process of completing this.  Further discussion on this will continue in Committee of the Whole.
      2. Influenza Season (2020/2021) (K .McBeth)
        Brought to the Board for information.
      3. Safe Return to School – COVID-19 Engagement, Resources and Collaboration (N. Dupuis)
      4. September Communications Recap (L. Gregg)
    2. RECOMMENDATION REPORTS – None
  8. Board Correspondence – None
  9. New Business – None  
  10. Other Board of Health Resolutions/Letters
    1. Letter from the Ministry of the Solicitor General – Enforcement and Amendments under the Reopening Act, 2020               
    2. Letter from Town of Lakeshore – Resolution passed – that Lakeshore Council request that the WECHU notify businesses prior to releasing names of businesses where persons with COVID-19 have attended.
       J. Lund asked if the WECHU will notify business when they will be included in a public announcement around possible COVID-19 exposure. T. Marentette advised that this is our practice and the Resolution from Lakeshore Council is likely in response to an earlier notification where the business was not aware of a prior announcement.  Our current practice addresses this issue and we will abide by this Resolution. 

       

       

       

      Moved by:  Gary McNamara
      Seconded by:   Joe Bachetti
      That the information be received.
      CARRIED

  11. Committee of the Whole (CLOSED SESSION, in accordance with Section 239 of the Municipal Act)
    The Board moved into Committee of the Whole at 4:22 pm
    The Board moved out of Committee of the Whole at 4:45 pm
  12. Next Meeting: At the Call of the Chair, or November 19, 2020 – Via Video
  13. Adjournment
    Moved by:  Joe Bachetti
    Seconded by:  Gary Kaschak
    That the meeting be adjourned.
    CARRIED

The meeting adjourned at 4:46 pm.

RECORDING SECRETARY:

SUBMITTED BY:

APPROVED BY:


View Document page

September 17, 2020

Meeting held via video.

  1. Call to Order
  2. Agenda Approval
  3. Announcement of Conflict of Interest
  4. Update (W. Ahmed)
    1. COVID-19 Update
  5. Approval of Minutes
    1. Regular Board Meeting: July 16, 2020
  6. Business Arising
    1. School-Focused Nursing Recruitment (D. Sibley)
  7. Consent Agenda
    1. INFORMATION REPORTS
      1. July, August Communications Recap
    2. RECOMMENDTION REPORTS – None
  8. Board Correspondence – None
  9. New Business
    1. WECHU 2020-21 Public Health Funding (T. Marentette/L. Gregg)
    2. Extraordinary Cost Reimbursement Process (L. Gregg)
  10. Other Board of Health Resolutions/Letters
    1. Simcoe-Muskoka District Health Unit – Letter to the Honourable Christine Elliott – urging the immediate provision of the funding allocations to local boards of health regarding the COVID-19 Extraordinary Expenses and for the School-Focused Nurses in order to enable a response by local public health units that is unobstructed by local financial shortfalls
    2. WECHU Response to Town of Kingsville, Town of Essex and Town of Amherstburg – Request for more detailed information and data regarding the spread of COVID-19 in Essex County – For information
  11. Committee of the Whole (Closed Session in accordance with Section 239 of the Municipal Act)
  12. Next Meeting: At the Call of the Chair October 15, 2020 – Via Video
  13. Adjournment

View Document page

Board Members Present:

Gary McNamara, Tracey Bailey, Rino Bortolin, Fabio Costante, Dr. Debbie Kane, Judy Lund, John Scott, Larry Snively, Joe Bachetti (arrived at 5:05 pm)

Board Member Regrets:

Gary Kaschak, Ed Sleiman

Administration Present:

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


This meeting was held via video conference.

QUORUM:  Confirmed

  1. Call to Order
    Board Chair, Gary McNamara, called the meeting to order at 4:10 p.m.
  2. Agenda Approval
    Moved by: Judy Lund
    Seconded by: Rino Bortolin
    That the agenda be approved.
    CARRIED
  3. Announcement of Conflicts of Interest – None
  4. Update (Dr. W. Ahmed)
    1. COVID-19 Update

      Dr. W. Ahmed provided an update on the status of COVID-19 cases in our region, along with a presentation around the numbers and the increase of cases in the province. Graphs in the presentation show the overall rates, spikes in cases according to age and municipality, how the virus is being transmitted, and capacity in the health care system should we see a surge of cases requiring hospitalization. Our case fatality rate is at 3.0%, which is lower than the provincial average. Approximately 5,000 to 6,000 tests are being conducted weekly across our region, and positive case rates remain relatively low while the GTA and Ottawa regions are spiking.

      One student in a local school tested positive and their cohort was also advised to isolate for 14 days. Our data shows a spike in cases in the 0-19 age group over the last two weeks, and we take this information seriously with our messaging to the various school boards.

      The region seems to be moving in a stable direction in the Agri-sector. Positive cases amongst farm workers are low with some occasional travel related cases after arriving in Canada.

      G. McNamara said that the WECHU Epidemiology Department has done excellent work on the graphing and mapping. The recent roadmap created around the cluster of cases that happened recently was interesting to see, and shows how quickly the virus can spread. The province was impressed at how quickly we addressed the cluster by finding its origins and roots. Information like this is critically important to show residents how quickly the virus can easily get out of control by not following public health measures.

      Moved by: Fabio Costante
      Seconded by: John Scott
      That the information be received.
      CARRIED

  5. Approval of Minutes
    1. Regular Board Meeting: July 16, 2020
      J. Lund noted that Beach Testing (water sampling) was discussed at the July 16, 2020 Board meeting and that the WECHU was one of the only health units that still conducts the testing. She asked how other health units do beach testing. Dr. Ahmed said that water testing is done by their municipalities or contracted out to a third party.
      Moved by: Judy Lund
      Seconded by: Fabio Costante
      That the minutes be approved.
      CARRIED
  6. Business Arising
    1. School-focused Nursing Recruitment (D. Sibley)
      D. Sibley said that 18 of the 19 school nursing positions have been filled. Ten internal WECHU staff on lay off filled some of these positions and 8 new staff have been hired over the last couple of weeks. We are recruiting for 1 French speaking position. We have redeployed existing WECHU staff to be ready for the school year and all of these positions should be filled within the next two weeks.
      Moved by: Debbie Kane
      Seconded by: John Scott
      That the information be received.
      CARRIED
    2. Consumption and Treatment Services (CTS) Site Update (Addition to Agenda) R. Bortolin

      T. Marentette said that the health unit continues to work with a dedicated stakeholder group on the application submission for a CTS site in Windsor. The work was delayed for several months due to the pandemic and we recently moved forward around a site location, which is required prior to submitting the application. Criteria for the site was based on requirements in both Health Canada’s and the Ministry of Health’s applications.

      A Request for Expression of Interest (EOI) for interested landlords or property owners for a proposed site went out in August 2020. There was no interest. We reposted the information to the same website, did a media release and extended the timeline to September 4, 2020 and the process still did not generate any interest.

      We have reached out to our legal advisors for guidance on next steps and will reconvene our stakeholder group to determine how to proceed. Steps following the site selection would include a CPTED (Crime Prevention Through Environmental Design) audit on the site, a site inspection and a brief assessment. Consultations with the public would follow with extensive community engagement along with our Board of Health and the municipality of the site location.

      R. Bortolin asked if one submission was received, and the size and technical specifications are reached, would we go that route and what level of consideration is given to those items. T. Marentette said that there is criteria that must be met and we would work with our Environmental Health Department and Windsor Police Services, i.e. acceptable site, meeting mandatory requirements from Health Canada and the Ministry of Health, distancing from sensitive areas, etc., and it would be brought to the Stakeholder Advisory Committee.

      R. Bortolin asked about the public consultation phase and what that would look like when we are at the point of Board of Health approval of the potential site. He has received many questions from residents in his ward about the CTS site being located in the downtown Windsor core. T. Marentette advised that public consultations would occur prior to going to our Board or the municipality for site confirmation and approval. We were hoping to have 2 or 3 sites with extensive community consultation, and feedback, before moving forward. The public would have a say and will have the opportunity to voice their concerns prior to the site being confirmed.

      The process is presenting the sites that meet the criteria as well as meeting the needs of the people who would use the service. With the pandemic, there will be no gatherings in person. We will need to conduct consultations through surveys and virtual discussions, and there was talk of having a virtual Town Hall. All residents in the municipality can participate in the process, not just residents or businesses in that location.

      R. Bortolin said if the process goes through public consultation and is presented to our Board of Health and the municipality, does the municipality have the power to veto, or is it presented to the municipality simply for endorsement.

      T. Marentette noted that under the Health Promotion and Protection Act, (HPPA) the municipality must approve the site. R. Bortolin said that it would likely be through a Motion to the particular municipality’s council.

      R. Bortolin asked if WECHU has considered how many meetings should take place, that they are well publicized and that there are enough people on the calls to hear from residents instead of it being a one-way virtual meeting. T. Marentette said that this was all considered in the planning, we have people dedicated to the process, GANTT charts for timelines and that we recognize the need to make sure it is inclusive of everyone who wants to have a voice.

      R. Bortolin said that since there has been no interest from the EOI has there been any discussion around conversations with municipalities, other agencies or potential partners for space.

      T. Marentette advised that we have consulted with our legal advisors on this to make sure the process is transparent and adheres to any public protocol or disclosure and, based on feedback, we will reconvene the stakeholder group, and expect that the next step is to reach out to potential partners.

  7. Consent Agenda
    1. INFORMATION REPORTS
      1. July and August Communications Recap (L. Gregg)
        Brought to the Board for information.
        Moved by: Rino Bortolin
        Seconded by: Judy Lund
        That the information reports be received.
        CARRIED
    2. RECOMMENDATION REPORTS – None
  8. Board Correspondence – None
  9. New Business
    1. WECHU 2020-21 Public Health Funding (T. Marentette/L. Gregg)

      T. Marentette said that the WECHU received its Public Health Funding and Accountability Agreement for the 2020-2021 funding year on August 21, 2020 which provided our approved base and one-time funding. This includes the changes to the provincial/municipal cost-sharing agreement effective January 1, 2020, one-time mitigation funding and funding for public health programs and services.

      An overview of other one-time funding approvals include:

      • Public Health Inspector Practicum Program (one student) – $10,000
      • Seasonal Farm Contract Tracing under our TB Program – included on-site contact tracing, TB screening, translations services, salaries and mileage – $4,400
      • Vector-Borne Disease Program – this funding initiative is used to support staffing, mileage surveillance activities and an awareness campaign for enhanced surveillance for mosquitos – $40,000
      • Pandemic Pay for eligible nursing staff – this initiative provided additional support for eligible Board of Health employees dependent upon responsibilities for the period April 24, 2020 to August 13, 2020. Total funding received for our health unit was $161,700.

      In addition, an amended agreement was received by the Ministry related to the following:

      • School-focused nurses (19 in total) to support the reopening of schools (August 1, 2020 to March 31, 2021 and April 2021 to March 31, 2022)
      • Funding to support the new public health Case and Contact Management solution (CCM)

      Board of Health member L. Snively left the meeting at 4:59 pm

      L. Gregg advised that on August 21, 2020 the Ministry of Health issued WECHU’s 2020 Budget Approval. Total funding allocation is as follows:

      • $15,981,600 in base funding for the Mandatory programs – funded at a rate of 70% Ministry of Health and 30% Obligated Municipalities
      • $1,674,700 in base funding for the Ontario Seniors Dental Care Program funded 100% by the Ministry of Health

      The Ministry of Health approved mitigation funding of $1,260,800 to be used to offset the increased public health program costs to municipalities as a result of cost-sharing change from what was 75/25 to 70/30. An allotment of mitigation funding was approved for the period January 1, 2020 to December 31, 2020 and a second allotment in the same amount was approved for January 1, 2021 to December 31, 2021.

      Moved by: Judy Lund
      Seconded by: Rino Bortolin
      That the information be received.
      CARRIED

    2. Extraordinary Cost Reimbursement Process (L. Gregg)

      L. Gregg advised that on August 21, 2020 the Ministry of Health initiated a process for public health units to request reimbursements of one-time extraordinary expenses related to COVID-19. The deadline for this submission is September 18, 2020 for the timeframe of January 1, 2020 to December 31, 2020 and includes actual and forecasted costs. As with all submissions to the Ministry, it is subject to review and some expenditures may not be admissible. It is our understanding that additional requests for reimbursement may be available at a later date.

      Total forecasted salaries and benefits related to COVID-19 for calendar 2020 are $10,728,391. This excludes the School Nurse initiative, which will be funded through separate approval. R. Bortolin noted that many WECHU staff are unionized and eligible for overtime. He asked if this amount takes into account a provision for the WECHU Leadership Team who have been unable to take vacation or time off due to the workload with the pandemic. Their working ratio is likely 15%-30% higher than what they are receiving in salaries.

      L. Gregg advised there was a provision for vacations not taken by the WECHU Leadership Team but there was no augment in the number of hours the team has worked, and continues to work, in this analysis. The provision just includes their base salaries. There was a line-by-line analysis for all staff so there was a detailed review.

      R. Bortolin asked if WECHU should increase the ask in the submission to the Ministry to help cover compensation to the WECHU Leadership Team for unused vacations.

      T. Marentette said that there was no provision for compensation for the Leadership Team during the pandemic and if it is deemed not admissible by the Ministry it would likely fall on the municipalities and is included in this ask. R. Bortolin asked if WECHU can balance its budget for 2020 if the submission was approved. T. Marentette said that close to $3M has been submitted and if that is received from the Ministry than WECHU should be able to balance its budget. To our understanding, the province is not saying this is a 70/30 split.

      Moved by: Joe Bachetti
      Seconded by: John Scott
      That the information be received.

    3. Request from Ontario Health Team (W. Ahmed)

      Dr. W. Ahmed said that many Board of Health members are aware that the province, through Ontario Health, is creating Ontario Health Teams (OHT) to provide patient centered care in various regions of the province. OHTs are groups of health care providers and organizations that are clinically and fiscally accountable for delivering a full and coordinated continuum of care to a defined geographic population.

      The expectation is that the OHTs will enable patients, families, community agencies and healthcare providers to work together in a new way. Over time, it is expected that OHTs will develop innovative and locally driven solutions to meet the healthcare needs of their defined geographic population and will be accountable for the health outcomes and healthcare costs of that population.

      OHTs are being introduced to provide a new way of organizing and delivering care that is more connected to patients in their local communities. Under OHTs, health care providers (including hospitals, doctors and home and community care providers) work as one coordinated team. Public Health supported the local collaborative work to create a Windsor-Essex Ontario Health Team. The next stage of the OHTs development is a full application, which is currently being submitted.

      In the application, the OHT has to identify a priority population and the group decided to work with individuals with chronic diseases living in a congregate settings. There are 155 congregate living setting in our region and the team is planning to prioritize them based on the risk to these settings. For example, using EMS data to identify top 10 congregate living facilities in our region that receive the bulk of calls in the past 12 months.

      The OHT is leveraging on the existing relationship and partnership developed for COVID response in the region.

      The Windsor Essex OHT is comprised of over 45 local healthcare program and services providers including the three hospitals, primary care and community support providers, public health, municipalities, mental health and addictions agencies, Long-term care, and others social service providers in Windsor Essex.

      The Windsor Essex OHT is requesting their partner agencies submit a letter of support along with a sign off from their Board. WECHU is in support of the Windsor Essex OHT but we also recognize that the public governance and accountability are very different. We are governed under the HPPA and are accountable to our Board of Health.

      We are recommending that the WECHU submit a letter of support from the Medical Officer of Health and the CEO that we will continue to support and collaborate with the OHT. Due to our mandate and accountability, we do not believe that we require a formal board sign off and are looking to the Board for direction and support.

      Moved by: Tracey Bailey
      Supported: Rino Bortolin
      That the WECHU Medical Officer of Health and CEO submit a Letter of Support to continue to support and collaborate with the OHT and that formal Board of Health sign off is not required.
      CARRIED

  10. Other Board of Health Resolutions/Letters

    Moved by: Rino Bortolin
    Seconded by: John Scott
    That the information be received.
    CARRIED

    1. Simcoe-Muskoka District Health Unit – Letter to Honourable Christine Elliott – urging the immediate provision of the funding allocations to local boards of health regarding the COVID-19 Extraordinary Expenses and for the School-Focused Nurses in order to enable a response by local public health units that is unobstructed by local financial shortfalls – For information
    2. WECHU Response to Town of Kingsville, Town of Essex and Town of Amherstburg – Response to their request for more detailed information and data regarding the spread of COVID-19 in Essex County – For information
  11. Committee of the Whole (CLOSED SESSION, in accordance with Section 239 of the Municipal Act)
    The Board moved into Committee of the Whole at 5:14 pm
    The Board moved out of Committee of the Whole at 5:20 pm
  12. Next Meeting: At the Call of the Chair, or October 15, 2020 – Via Video
  13. Adjournment
    Moved by: Rino Bortolin
    Seconded by: Tracey Bailey
    That the meeting be adjourned.
    CARRIED

The meeting adjourned at 5:21 pm.

RECORDING SECRETARY:

SUBMITTED BY:

APPROVED BY:


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July 16, 2020

Meeting held via video.

  1. Call to Order
  2. Agenda Approval
  3. Announcement of Conflict of Interest
  4. Update (W. Ahmed)
    1. COVID-19 Update
  5. Approval of Minutes
    1. Regular Board Meeting: June 18, 2020
  6. Business Arising
  7. Consent Agenda
    1. INFORMATION REPORTS
      1. Effect of climate change of invasive mosquitoes, Zika Virus, and migrant worker health in Windsor-Essex
        (K. McBeth)
      2. June Communications Recap
    2. RECOMMENDTION REPORTS
      1. 2020 Budget Amendments (T. Marentette/L. Gregg)
  8. Board Correspondence – None
  9. New Business
    1. COVID-19 Task Force (T. Marentette)
  10. Other Board of Health Resolutions/Letters
    1. Resolution from Town of Essex – Spread of COVID-19 in our Farm Worker Population (T. Marentette)
  11. Committee of the Whole (Closed Session in accordance with Section 239 of the Municipal Act)
  12. Next Meeting: At the Call of the Chair August 20, 2020 – Via Video
  13. Adjournment

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SUBMITTED BY:

Epidemiology and Evaluation Department

DATE:

July 16, 2020

SUBJECT:

Effect of climate change on invasive mosquitoes, Zika virus, and migrant worker health in Windsor and Essex County


BACKGROUND

Between 1941 and 2012, the annual average temperature for the City of Windsor increased by almost 1°C (City of Windsor, 2012). Windsor and Essex County (WEC) also experienced a 1-3% increase in rainfall per decade from 1970 to 2000 (City of Windsor, 2012), with level of precipitation and humidity expected to continue to increase in southern Canada in the coming decades (Ng et al., 2019).

One potentially dangerous effect of these climatic changes in Windsor and Essex County (WEC) is the proliferation of invasive mosquitoes. The past four years have seen the introduction of Aedes albopictus and Aedes aegypti, both carriers of the Zika virus, to WEC, and climatic changes are expected to encourage greater numbers of these mosquitoes in the coming decades (Ng et al., 2019). More specifically, rising temperatures combined with stagnant water from flooding are expected to facilitate the survival and proliferation of these species (Kovats et al., 2003). Indeed, the Aedes albopictus population in WEC (identified from trapping) increased from 17 in 2016 to 1,129 adult mosquitoes in 2018, thus demonstrating that these mosquitoes can reproduce rapidly. Furthermore, these mosquitoes spread out from one to seven different trapping locations from 2016-18.

One particular population that may be at risk for exposure to these mosquitoes are migrant farm workers. Leamington has over 8,000 migrant workers during the summer season who are housed in over 600 bunkhouses (Hennebry, McLaughlin & Preibisch, 2016). The majority of these migrant workers are from Mexico and nearby Caribbean countries, which are endemic for mosquito-borne diseases such as Zika. A recent survey in Ontario, however, found that less than a quarter of migrant farm workers saw a doctor for any health symptoms (Hennebry et al., 2016). Therefore, it is imperative that surveillance of Aedes mosquitoes and incidence of the Zika virus be increased in this area, not only to protect the health and well-being of migrants, but also the well-being of WEC as a whole.

CURRENT INITIATIVES

Funding for a three-year exploratory study (2019-2022) of invasive mosquito species in Leamington, Ontario was awarded to the Windsor-Essex County Health Unit by the Public Health Agency of Canada (PHAC) via the Infectious Disease and Climate Change Fund. The primary goal of the study is increased surveillance of invasive mosquito species in Leamington, including coordination with Parks Canada for surveillance and viral testing in Point Pelee National Park. An additional objective is to assess potential risks to the Leamington community, with special attention paid to vulnerable populations, such as migrant farm workers.

Prior to mosquito surveillance (scheduled to begin May 2020), a scoping review of all literature relating to climate change, Aedes mosquitoes, the Zika virus, and migrant workers was completed. From over 65,000 reviewed records, 88 were chosen to address the specific scoping review objectives. About two-thirds (65/88) of these records were empirical studies, and 23% (20/88) were done in Canada.

Results of the review revealed extensive information on Aedes mosquitoes, the Zika virus, and climate change in the United States and other parts of the world affected by these mosquitoes. However, there are gaps in the literature regarding how Aedes mosquitoes, Zika, and climate change may affect vulnerable populations. Empirical work, such as WECHU’s current PHAC grant, that examines how Aedes mosquitoes, Zika, and climate change interact in their effect on migrant workers in Canada is greatly needed.


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