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January 20, 2022

Meeting held via video: https://youtu.be/wPLC3gHLecA

  1. Call to Order
  2. Board Elections
  3. Agenda Approval
  4. Announcement of Conflict of Interest
  5. Update (Dr. S. Nesathurai)
    1. COVID-19 Update (Dr. S. Nesathurai)
    2. WECHU Operations Update (N. Dupuis)
  6. Approval of Minutes
    1. Regular Board Meeting: December 16, 2021
  7. Business Arising
    1. Consumption and Treatment Services Update (E. Nadalin)
  8. Consent Agenda
    1. INFORMATION REPORTS
      1. Smoking Cessation Programing and Vaping Supports (E. Nadalin)
      2. Influenza Vaccine Update (K. McBeth)
      3. COVID-19 Surveillance and Epidemiology (N. Dupuis) 
      4. December Communications Recap (E. Nadalin)
    2. RESOLUTIONS/RECOMMENDATION REPORTS – None
  9. New Business
    1. Fluoride Update – ENWIN Report (N. Dupuis)
    2. CEO Quarterly Compliance Report (N. Dupuis)
    3. Project Governance Committee – December 10, 2021 Meeting    Minutes (J. Lund/N. Dupuis)

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

  11. Committee of the Whole (Closed Session in accordance with Section 239 of the Municipal Act)
  12. Next Meeting: At the Call of the Chair February 17, 2022 – Via Video
  13. Adjournment


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SUBMITTED BY:

Epidemiology and Evaluation Department

DATE:

January, 2022

SUBJECT:

COVID-19 Surveillance and Epidemiology


BACKGROUND

Overview

The Epidemiology & Evaluation department conducts on-going population health assessment and surveillance. The data and surveillance for COVID-19 plays an integral role in understanding and managing the pandemic locally. The evidence provides information on how the pandemic has and is evolving, assessing the risk and severity, and assists in the development of timely interventions to limit further spread in the community.

Due to the recent surge in Omicron cases and changes in eligibility for testing, testing capacity is limited and case, contact, and outbreak management has been modified to focus on high-risk settings. As a result, case counts in this report are an underestimate of the true number of individuals with COVID-19 in Windsor-Essex County and may impact data completeness. Please interpret these data accordingly.

Trends

In the month of December (2021), the health unit reported 3,811 confirmed cases of COVID-19. This is a 174.0% increase in case counts compared to the previous month of November (2021). Similarly, the monthly case rate for December was 881.8 cases per 100,000 population, which is higher compared to the monthly rate in November (321.8 cases per 100,000 population). In Ontario, during the month of December, the case rate was 935.7 cases per 100,000 population.

Age and Gender

Approximately 52% (1,971) of the cases were among females and 47% (1,828) among males. A disproportionately (22.0%) higher number of cases, in November 2021,  were reported among those 20 to 29 years of age, followed by 20.9% among those 0 to 19 years of age, and 16.5% in the 30 to 39 year age group. Comparatively, from the onset of the pandemic locally (March 1, 2020 to December 31, 2021), approximately 16% of our cases were in the 0 to 19 age group.

Municipal Distribution

The Town of Tecumseh had the highest case rates (1184.3 cases per 100,000 population), followed by Amherstburg (976.8 cases per 100,000 population), Leamington (972.1 cases per 100,000 population), and Kingsville (925.1 cases per 100,000 population). However, looking at the distribution of cases, 53% of cases were from the City of Windsor, 9% from Lakeshore, 8% from Tecumseh and 8% from Leamington.

Risk Factors

For the month of December 2021, the top three risk factors reported were being an elementary or secondary student (15.6%), being a healthcare worker (2.4%) and being an educational staff (2.2%).

Source of Acquisition

Approximately, 23.0% of cases in December (2021) acquired COVID-19 from an unknown source (no epi-link identified), 19.9% from a household contact and 12.9% from a close contact outside of their household. With the change in testing eligibility in the province in December alongside the high number of cases, approximately 29.7% of cases are still under investigation.

Outcome Status

Of the 3,811 cases reported in December (2021), 47.4% (1,808) had their infection resolved, 1,145 cases (30.0%) were active and being followed by the health unit, and 20.0% (764) of cases were lost to follow-up. Twenty-four deaths were reported in December (2021) due to COVID-19.

Vaccination Status

107,139 doses were administered to Windsor-Essex County residents in the month of December (2021) compared to over 36,141 doses in the month of November. This represents a 196.4% increase for the month of December (2021) due to the eligibility of 5 to 11 year olds and access for third dose boosters. Approximately 86.7% of the doses administered were third doses/boosters, 8.8% were first doses to individuals who were previously unvaccinated, and 4.5% were among those completing their vaccination series (fully vaccinated).

Among the 3,811 cases reported in December (2021), 64.0% were fully vaccinated, 29.6% were unvaccinated, 4.7% were partially protected with one dose, and 1.8% were not yet protected after receiving the first dose. Among the 1,129 unvaccinated cases, approximately 65.6% were among those 0 to 18 years of age, which includes children who were ineligible to receive the vaccine.

CURRENT INITIATIVES

With the changes in testing eligibility, and guidance with case, contact and outbreak management, the health unit is exploring other methods to conduct COVID-19 surveillance and epidemiological analyses. The health unit will continue to monitor and provide epidemiological expertise on COVID-19 to internal leadership, community partners, and residents to support evidence-informed decision-making. This includes daily epidemiological updates, weekly epidemiological presentations to the community and supporting policy decisions through data driven approaches.


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SUBMITTED BY:

Healthy Schools Vaccine Department

DATE:

January 20, 2022

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 7, 2021 there were no laboratory-confirmed cases of influenza in Windsor and Essex County (WEC).

SUMMARY OF VACCINE ALLOCATION & DISTRIBUTION

The WECHU received initial shipments of the influenza vaccine on September 21, 2021.  In total, the WECHU received 110,990 doses of the vaccine from the Ministry. Of these, 27,430 doses were the High-Dose Quadrivalent Inactivated Vaccine (HD-QIV) for individuals 65 and over; and 10,000 doses were the standard dose Adjuvanted Trivalent Vaccine (TIV-adj) for individuals 65 and over.

As of December 9, the WECHU has distributed 83% (92,240 doses) of our total allocation of the influenza vaccine, 85% (62,580 doses) of the QIV, 100% (27,430 doses) of the HD-QIV, and 22% (2,230 doses) of the TIV-adj to the community. This includes 37 long-term care facilities and registered retirement homes, 4 hospitals, and approximately 200 healthcare providers. The OGP distributed the influenza vaccine directly to 124 pharmacies in WEC that were approved by the Ministry of Health and at the time this report was written, pharmacies have administered 35,714 doses to WEC residents.

 

QIV

High Dose - QIV

Adjuvanted TIV

Total

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

73,560

27,430

10,000

110,990

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

62,580

27,430

2,230

92,240

HIGH DOSE-QIV

Although the WECHU is out of stock of the HD-QIV, and will not be available for the remainder of the season, the TIV-adj is still available for individuals 65 and over. There is no preferential recommendation for HD-QIV over TIV-adj or QIV. National Advisory Committee on Immunization (NACI) states that all three vaccines protect against influenza, the most important thing is for seniors to be vaccinated.

LONG-TERM CARE/RETIREMENT HOMES

The initial supply of influenza vaccine was 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 5,140 influenza vaccine doses to 19 long-term care homes, and 2,480 doses to 18 registered retirement homes in WEC. A further breakdown is provided below:

 

QIV

High Dose – QIV

Total

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

2,690

2,450

5,140

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

920

1,560

2,480

CURRENT INITIATIVES

The WECHU continues 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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SUBMITTED BY:

Chronic Disease and Injury Prevention Department (CDIP)

DATE:

January 20, 2022

SUBJECT:

Smoking Cessation Programing and Vaping Supports


BACKGROUND

Tobacco remains the leading cause of preventable disease and death in Canada. Tobacco use and exposure to second-hand smoke are linked to cancer, heart disease, and several other diseases. Locally the burden of premature illness and death caused by smoking remains high in Windsor and Essex County with one in five adults (19.6%) reporting that they currently smoke tobacco.1

In addition to tobacco smoking, the rise of vaping or e-cigarette use, particularly in youth, has been a concern from both health officials and local schools in Windsor-Essex. In Windsor-Essex, 6% of grade 9 to 12 students are current smokers and 26% of students have used an e-cigarette.2 In Ontario, while the rate of past year use of tobacco cigarettes has been declining (from 7% to 5% from 2017-2019), the past year use of e-cigarettes doubled from 11% to 23% in the same period.3  Vaping can expose youth to chemicals that could negatively impact their health in several ways, such as lung damage, nicotine dependence, and negative effects on brain development, including memory and concentration.4 

CURRENT INITIATIVES

Tobacco and Vaping Cessation

The health unit has continued to provide eligible Windsor-Essex County residents with individual cessation programming throughout the pandemic, where clients enter the program by self-referral, or by referral from a community partner.  Through a one-on-one cessation program, clients are provided with behavioural counseling sessions and up to 16 weeks of nicotine replacement therapy (NRT) such as patches or gum. Follow-up counseling sessions are also provided to active clients for additional support and adjustment of their NRT dosing as needed.

In 2021, 107 new clients were added to the program with nearly 600 counselling sessions completed. Currently, there are 53 active clients enrolled in the program who meet with the counsellor on a weekly or bi-weekly basis to ensure goals are being met, challenges are being addressed, and NRT dosage remains appropriate.

Tobacco and Vaping Prevention with Local School Boards                    

To address rising rates of vaping among youth, the WECHU Chronic Disease and Injury Prevention Department and Healthy Schools Department developed a toolkit for educators. This toolkit includes a presentation for high school students, posters, and educational handouts. This toolkit will continue to be promoted to schools and community partners in 2022.

With limitations to in-person school access in 2021, health promotion support related to tobacco and vaping moved to a virtual format. Health unit staff provided virtual trainings for parents and staff as well as smoking and vaping presentation to students led by Tobacco Vaping Enforcement Officers and Healthy Schools Department Public Health Nurses.  Assistance in education and enforcement was also provided by Tobacco and Vaping Enforcement Officers to address concerns of smoking and vaping in and around school property. Ongoing support of these initiatives will continue to be prioritized in the current school year as staffing allows.

References

  1. The Windsor-Essex County Health Unit. (2019). Community needs assessment: June 2019 update. Retrieved from https://www.wechu.org/sites/default/files/edit-resource/em-community-needs-assessments-report-2019/cnareport2019.pdf   
  2. University of Waterloo. (2018). COMPASS Study data (Cannabis use, Obesity, Mental health, Physical activity, Alcohol use, Smoking, Sedentary behavior).
  3. Centre for Addiction and Mental Health. (2020). Ontario Student Drug Use and Health Survey Data Brief. Retrieved from https://camh.ca/-/media/files/pdfs---ebulletin/osduhs_databrief_march2020_drugusehighlights-pdf.pdf
  4. Health Canada. (2020). Risks of vaping. Retrieved from https://www.canada.ca/en/health-canada/services/smoking-tobacco/vaping/risks.html
  5. Centre for Addiction and Mental Health. (2020). Ontario Student Drug Use and Health Survey Data Brief. Retrieved from https://camh.ca/-/media/files/pdfs---ebulletin/osduhs_databrief_march2020_drugusehighlights-pdf.pdf

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SUBMITTED BY

Communications Department

DATE

January 2022

SUBJECT

December 2021 - Communications Update


Metrics

SOURCE NOVEMBER DECEMBER DIFFERENCE

News Releases Issued

5

8

+3

Media Advisories Issued

1

1

0

Media Statements or Notifications

36

28

-8

Media Requests Received1

43

69

+26

AM 800 Morning Segments2

6

2

-4

YouTube Media Briefing Videos3

11

12

+1

Wechu.org page views4

857,259

1,461,105

+603,846

YouTube Channel Subscribers

1,747

1,469

+22

Email Subscribers5

8,324

8,314

-10

Emails Distributed

42

34

-8

Facebook Fans

18,490

18,574

+84

Facebook Posts

124

112

-12

Twitter Follower

7,968

8,242

+274

Twitter Posts

118

104

-14

Instagram Followers

1,331

1,373

+42

Instagram Posts

9

5

-4

LinkedIn Followers

1,024

1,035

+11

LinkedIn Posts

81

59

-22

Media Exposure8

910

1,503

+593

Media Exposure Overview

This is a complex graphical representation of data. Please contact us for detail

Website Overview

This is a complex graphical representation of data. Please contact us for detail

Social Media Growth

This is a complex graphical representation of data. Please contact us for detail

Current Notable Projects

  • Maintaining marketing and communication efforts regarding ongoing vaccine rollout in the region by public health and our partners. In particular, the opening of the especially with the opening of the Hôtel-Dieu Grace Healthcare (HDGH) in West Windsor and Nature Fresh Farms Recreation Centre in Leamington.
  • Responding to media and public inquiries through multiple channels including emails, calls, and web form submissions. Social media direct messages are currently redirected to the wechu.org web form.

Data Notes:

  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 answer questions 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, 2020. On August 17, 2020, we went to a Monday, Wednesday, and Friday schedule with holidays off. On July 19, 2021, Dr. Ahmed continued to join Mike and Lisa Monday and Wednesday mornings to keep the community informed. On September 16, 2021, Nicole Dupuis and Dr. Nesathurai were conducting interviews with Mike and Lisa on Monday and Wednesday mornings. Staring the week of November 15, 2021, interviews were being conducted on Wednesdays only. December 8 was the last Wednesday WECHU appearance on the program as a regular weekly guest.
  3. YouTube Live videos started on June 23, 2020. Prior Public Health Update videos on YouTube were exported videos recorded through Facebook Live. In July 2021, YouTube Live broadcasts were scaled down to Fridays only from a Monday, Wednesday, and Friday rotation. In September 2021, media briefings were increased to Monday, Wednesdays and Fridays and streamed live. On September 20, 2021, media briefings were recorded and then posted to YouTube.
  4. Website analytics are provided by Siteimprove. The metric provided is for page views to wechu.org. Previously, we were reporting on the local-updates webpage only.
  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. Media exposure information in this report were generated using Meltwater Media Monitoring Solution. 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.

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December 16, 2021

Meeting held via video: https://youtu.be/wHQogjtcW28

  1. Call to Order
  2. Agenda Approval
  3. Announcement of Conflict of Interest
  4. Update (Dr. S. Nesathurai)
    1. COVID-19 Update
  5. Approval of Minutes
    1. Regular Board Meeting: November 18, 2021
  6. Business Arising
    1. Consumption and Treatment Services Update (N. Dupuis/E. Nadalin)
  7. Consent Agenda
    1. INFORMATION REPORTS
      1. Ontario Seniors Dental Care Program (E. Nadalin)
      2. Legacy for Children Parenting Program (F. Lawal)
      3. COVID-19 Surveillance and Epidemiology (N. Dupuis)
      4. Q3 Reporting (L. Gregg)
      5. November Communications Recap (E. Nadalin)
    2. RESOLUTIONS/RECOMMENDATION REPORTS – None
  8. New Business
    1. Project Governance Committee – Terms of Reference (N. Dupuis/J. Lund (Co-Chairs)
    2. Board of Health Meeting Schedule – 2022 (L. Damphouse)
  9. Correspondence
    1. Algoma Public Health – Letter to Hon. Christine Elliott – Request for Annualized IPAC Hub Funding and Increase in Provincial Based Funding for Local Public Health (Support) (K. McBeth)
    2. Haliburton, Kawartha, Pine Ridge Health Unit – Letter to Hon. Christine Elliott and Dr. Sheldon Salaba (Ontario Association of Optometrists) – Lack of Vision Services for patients under OHIP
    3. Town of Essex – Letter to Dr. S. Nesathurai, Acting MOH, and Nicole Dupuis, CEO, of the Windsor-Essex County Health Unit – Resolution in Opposition to the Letter of Instruction issued by the Windsor-Essex County Health Unit on December 5, 2021
  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 January 20, 2022 – Via Video
  12. Adjournment


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Board Members Present:

Gary McNamara, Joe Bachetti, Tracey Bailey, Rino Bortolin, Fabio Costante, Gary Kaschak, Judy Lund, Ed Sleiman, Larry Snively

Board Member Regrets:

Robert Maich

Administration Present:

Nicole Dupuis, Dr. Shanker Nesathurai, Lorie Gregg, Felicia Lawal, Kristy McBeth, Eric Nadalin, Dan Sibley, Lee Anne Damphouse


QUORUM:  Confirmed

The Board moved into Committee of the Whole at 4:02 pm
The Board moved out of Committee of the Whole at 4:14 pm

  1. Call to Order
    Board Chair, Gary McNamara, called the meeting to order at 4:14 p.m.
  2. Agenda Approval

    Moved by: Rino Bortolin
    Seconded by: Judy Lund
    That the agenda be approved.
    CARRIED

  3. Announcement of Conflicts of Interest – None
  4. Update (Dr. S. Nesathurai)
    1. COVID-19 Update

      Dr. S. Nesathurai said that it is clear that disease activity of COVID-19 has increased in our community.  There have been 45 deaths from COVID-19 in our region since August of this year, two-thirds among individual who were unvaccinated and one-third of those that were vaccinated living with serious medical conditions.  Hospitalizations due to COVID-19 has immediate consequences on our health care system, and is affecting access to timely medical treatment for other health issues. 

      The strategy to manage the spread of COVID-19 starts with containment of the virus, and the second part of the strategy is vaccination.  The Ministry of Health has asked us to shift our resources from containment to vaccination efforts.  With this request comes a trade off, meaning a decrease in resources in Case and Contact Management, and those who benefit most from containment are the unvaccinated.  With approximately 300,000 individuals eligible for vaccination in Windsor-Essex, the magnitude of this request is staggering.  Hundreds of thousands of individuals in our region will need to be vaccinated in short order.  Our region is equipped with a mass vaccination centre, participating pharmacies, some primary care providers and mobile clinics.  Vaccinating 300,000 people, at 6,000 people per day, would still take 50 days to complete.  The WECHU has exhausted every avenue to increase vaccine availability, and has reached out to family physicians, the Dean of the local Medical School for student resources, and anyone who can help with immunizations to get as many people vaccinated as possible.  

      G. McNamara asked how to address the public in the rationale that organized team sport activities are acceptable, but gatherings or informal sport activities are not.  N. Dupuis advised that we provide FAQ’s and include these interpretations on our website, however this is the health unit’s interpretation. Each region may obtain their own legal interpretation of the ROA and its regulations that differ from other areas. Many of the definitions we work from are already part of the legislation such as what is defined as a social gathering versus what is defined as sport and recreation. Dr. S. Nesathurai acknowledged there are apparent inconsistencies and that Medical Officers of Health have asked the province to provide more uniform measures across health units.  

      E. Nadalin advised that the WECHU meets every 2 weeks with regional enforcement who have their own legal council that interprets the ROA.  There are gray areas and this would be up to the municipalities to interpret.  This group has been meeting for over a year and things have changed at different points during the pandemic.  One members of this group has been collating all legislation, our Letters of Instruction and Section 22 Orders into a document for the group.  Communication is paramount and ongoing, and we have sought provincial support from multi-ministry agencies. 

      L. Snively asked how the Omicron Variant of Concern (VOC) compares to the Delta VOC.   Dr. S. Nesathurai said that the knowledge of the Omicron VOC is still evolving.  Evidence shows that the vast majority of people with COVID-19 recover, and those that are vaccinated are likely to have mild to moderate infections, but there will be deaths from COVID among healthy individuals.  The unvaccinated have a higher probability of severe disease and are more likely to be hospitalized, placed on a ventilator or die from COVID-19. 

      The Omicron VOC is expected to infect more people than the Delta VOC, but we cannot conclude that Omicron will be more or less severe than previous VOCs.  We are seeing case counts rising significantly and our biggest concern is hospital saturation with more people in ICU, more people requiring ventilators and hospitals being unable to admit those that need medical care for other diseases and health issues.  The major risk of hospital staff being infected could cripple our hospitals ability to function and we need to continue to encourage people to get vaccinated.  Under the old paradigm we would have been in complete lockdown, but we now have the vaccine.  The immediate problem is how to get through these next few weeks to provide sufficient containment and not overwhelm the health care system.

      Approximately 800 cohorts have been dismissed from schools, about 16,000 students, and are missing part of their education to prevent transmission to a parent, grandparent or an unvaccinated person.  R. Bortolin said he has been hearing from parents whose children were potentially exposed.  Some were dismissed from school for 10 days, some for 14 days, and is there a reason why we have not looked at rapid testing in school.  Dr. S. Nesathurai said that testing at home versus testing at the lab has its disadvantages, and it is best to be tested by a professional.  With over 800 cohort dismissals and no school closures, that means school boards have put public health measures in place.  If we start to relax public health measures we take the chance of penetration into schools and potential closure.  The current guidance from the ministry is to isolate all high risk contacts for 10 days and obtain a PCR (Polymerase Chain Reaction) Test at the Assessment Centre.

      Moved by:  Judy Lund
      Seconded by:  Larry Snively
      That the information be received.
      CARRIED

  5. Approval of Minutes
    1. Regular Board Meeting:  November 16, 2021
      Moved by: Joe Bachetti
      Seconded by: Gary Kaschak
      That the minutes be approved.
      CARRIED
  6. Business Arising
    1. Consumption and Treatment Services Update (N. Dupuis/E. Nadalin)

      N. Dupuis advised that the WECHU were scheduled to address Windsor City Council at its December 20, 2021 Council Meeting for the approval of the Consumption and Treatment Services Site at 628 Goyeau Street in Windsor, but have subsequently been rescheduled to appear before Council in January 2022.  We were originally scheduled to address City Council in November.  E. Nadalin is working on plans for the application, and we have also finalized various reports and materials to proactively address council and any potential questions they may have. 

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

  7. Consent Agenda

    1. INFORMATION REPORTS
      1. Ontario Seniors Dental Care Program (E. Nadalin)

        E. Nadalin noted that the Ontario Seniors Dental Care Program (OSDCP) is geared to providing standard dental care to low income seniors and has been operational since the fall of 2019.  The OSDCP has been a priority during the pandemic, one challenge being the massive interest and we have initiatives in place to address the wait times.  The Report is attached and received for information by the Board.

      2. Legacy for Children Parenting Program (F. Lawal)
        F. Lawal noted that this new program will target low income mothers, infants and young children and will be launching in February 2022. The Report is attached and received for information by the Board.

      3. COVID-19 Surveillance and Epidemiology (N. Dupuis)
        L. Gregg noted that this report was submitted to the Ministry earlier this week. The Report is attached and received for information by the Board.

      4. November Communications Recap
        The Report is attached and received for information by the Board.

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

    2. RESOLUTIONS/RECOMMENDATION REPORTS - None
  8. New Business
    1. Project Governance Committee – Terms of Reference (N. Dupuis/J. Lund)
      N. Dupuis noted that we have commenced meetings with the Project Governance Committee and resurrected the capital project for a potential new space for the WECHU.  The Terms of Reference have been updated and Judy Lund was voted in as a replacement for former Co-Chair, John Scott, whose term as a provincial member on our board expired in March 2021.

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

    2. Board of Health Meeting Schedule for 2022
      The Board agreed to continue with scheduling Board of Health meetings on the third Thursday of each month for 2022.  Calendar invites to follow.
      Moved by:  Joe Bachetti
      Seconded by:  Judy Lund
      That Board of Health meetings for 2022 be scheduled on the 3rd Thursday of each month. 
      CARRIED

  9. Correspondance
    1. Algoma Public Health – Letter to Hon. Christine Elliott – Request for Annualized IPAC Hub Funding and Increase in Provincial Based Funding for Local Public Health (for support) 

    2. Haliburton, Kawartha, Pine Ridge Health Unit – Letter to Hon. Christine Elliott and Dr. Sheldon Salaba (Ontario Association of Optometrists) – Lack of Vision Services for patients under OHIP

    3. Town of Essex – Letter to Dr. S. Nesathurai, Acting MOH, and Nicole Dupuis, CEO of the Windsor-Essex County Health Unit – Resolution in Opposition to the Letter of Instruction issued by the Windsor-Essex County Health Unit on December 5, 2021

      Moved by:    Judy Lund
      Seconded by:  Ed Sleiman
      That the Board support item 9.1, Algoma Public Health’s request for Annualized IPAC Hub Funding and an increase in Provincial Based Funding for Local Public Health
      CARRIED

      Moved by:  Joe Bachetti
      Seconded by: Ed Sleiman
      That items 9.2, and 9.3 be received.
      CARRIED

  10. Committee of the Whole (CLOSED SESSION, in accordance with Section 239 of the Municipal Act)
    The Board moved into Committee of the Whole at 4:02 pm
    The Board moved out of Committee of the Whole at 4:14 pm

  11. Next Meeting: At the Call of the Chair, or January 20, 2022 – Via Video 

  12. Adjournment

    Moved by: Rino Bortolin
    Seconded by: Judy Lund
    That the meeting be adjourned.
    CARRIED

    The meeting adjourned at 5:25 pm.

RECORDING SECRETARY: L. Damphouse

SUBMITTED BY: N. Dupuis

APPROVED BY: WECHU Board of Health, January 20, 2022


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November 18, 2021

Meeting held via video: https://youtu.be/3amhiiN2J90

  1. Call to Order
  2. Agenda Approval
  3. Announcement of Conflict of Interest
  4. Update (Dr. S. Nesathurai)
    1. Flu Vaccination
  5. Approval of Minutes
    1. Regular Board Meeting: October 21, 2021
  6. Business Arising
    1. Consumption and Treatment Services Update (N. Dupuis/E. Nadalin)
  7. Consent Agenda
    1. INFORMATION REPORTS
      1. COVID-19 Surveillance and Epidemiology (N. Dupuis)
      2. October Communications Recap (E. Nadalin)
    2. RESOLUTIONS/RECOMMENDATION REPORTS
      1. 2022 Budget (L. Gregg)
      2. COVID-19 Vaccine and the Immunization of School Pupils Act (ISPA) (K. McBeth) (Separate document)
  8. New Business – None
  9. Correspondence
    1. Huron Perth Public Health – Letter to Hon. Christine Elliott – Recommendation of Mandatory Staff Vaccination for Staff working in the Home and Community Care Sector (Support)
    2. North Bay Parry Sound Health Unit – Letter to Hon. Christine Elliott – Public Health Funding 2022
    3. Southwestern Public Health – Letter to Hon. Christine Elliott – Ongoing Government Financial Support
    4. Windsor-Essex County Health Unit – Letter to Hon. Christine Elliott and Hon. Doug Ford – Increase in base-funding for specific mandatory programs and one-time funding to support recovery/catch-up efforts over a multi-year period (2022-2024)
  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 16, 2021 – Via Video
  12. Adjournment

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SUBMITTED BY

Epidemiology and Evaluation Department

DATE

November, 2021

SUBJECT

COVID-19 Surveillance and Epidemiology – October, 2021


BACKGROUND

Overview

The Epidemiology & Evaluation department conducts on-going population health assessment and surveillance. The data and surveillance for COVID-19 plays an integral role in understanding and managing the pandemic locally. The evidence provides information on how the pandemic has and is evolving, assessing the risk and severity, and assists in the development of timely interventions to limit further spread in the community.

Trends

In the month of October (2021), the health unit reported 808 confirmed cases of COVID-19. This is a 47.6% decrease in case counts compared to the previous month of September (2021). Similarly, the monthly case rate for October was 186.95 cases per 100,000 population, which is lower compared to the monthly rate in September (356.8 cases per 100,000 population). In Ontario, during the month of October, the case rate was 91.5 cases per 100,000 population. This is approximately 2.0 times lower compared to the rate of Windsor-Essex County.

Age and Gender

Approximately 51% (413) of the cases were among males and 49% among females. A disproportionately (28.6%) higher number of cases, in October 2021,  were reported among those 0 to 18 years of age, followed by 15.6% among those 30 to 39 years of age, and 15.3% in the 19 to 29 year age group. Comparatively, from the onset of the pandemic locally (March 1, 2020 to October 31, 2021), approximately 15% of our cases were in the 0 to 19 age group.

Municipal Distribution

The Town of Leamington had the highest case rates (403.1 cases per 100,000 population), followed by Essex (349.8 cases per 100,000 population), Tecumseh (199.5 cases per 100,000 population), and the city of Windsor (17.1 cases per 100,000 population). However, looking at the distribution of cases, 49% of cases were from the City of Windsor, 15% from Leamington, and 9% from Essex.

Risk Factors

For the month of October 2021, the top five risk factors reported were being an elementary or secondary student (19.1%), being a resident of congregate living setting (5.0%), being a health care worker (2.4%), being a farm worker (2.1%), and being an educational staff member (1.9%).

Variants of Concern (VOCs)

Of the 1,542 cases reported in the month of October, genomic sequencing results were available for 718 cases (89% of cases). Overall, 69% of cases reported were due to the Delta variant (B.1.617.2), 7% of cases reported results without a variant, and 24% were not sequenced to identify a mutation or a VOC.

Source of Acquisition

Approximately, 38% of cases in October 2021 acquired COVID-19 from their household contact, 20% from a close contact outside of their household, 5% due to being related to an outbreak, and 4% from travel-related outside of the province (e.g., to another province and/or outside of Canada).

Outcome Status

Of the 808 cases reported in October 2021, 72% (582) had their infection resolved, 194 cases (24%) were active and being followed by the health unit, and 2.6% (21) of cases were lost to follow-up. Six deaths were reported in October (2021) due to COVID-19.

Vaccination Status

21,889 doses were administered to Windsor-Essex County residents in the month of October compared to over 34,500 doses in the month of September. This represents a 36% decrease for the month of October (2021). Approximately 62% of the doses administered were second doses to complete a vaccination series, 32% were first doses to individuals who were previously unvaccinated, and 6% were among those in the highest risk priority groups (e.g., residents of long-term care and retirement homes).

Among the 808 cases reported in October 2021, 63% were unvaccinated (or not eligible to receive a vaccine), 29% were fully vaccinated, 6% were partially protected with one dose, and 2% were not yet protected after receiving the first dose. Among the 356 unvaccinated cases, approximately 58% were among those 0 to 18 years of age which includes children who were ineligible to receive the vaccine.

CURRENT INITIATIVES

The health unit will continue to monitor and provide epidemiological expertise on COVID-19 to internal leadership, community partners, and residents to support evidence-informed decision-making. This includes daily epidemiological updates, weekly epidemiological presentations to the community and supporting policy decisions through data driven approaches


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SUBMITTED BY

Communications Department

DATE

November, 2021

SUBJECT

October 2021 - Communications Update


October Metrics

SOURCE SEPTEMBER OCTOBER DIFFERENCE

News Releases Issued

7

5

-2

Media Advisories Issued

3

2

-1

Media Statements or Notifications

36

32

-4

Media Requests Received 1

58

28

-30

AM 800 Morning Segments 2

7

7

0

YouTube Media Briefing Videos3

5

11

+6

Wechu.org page views 4

976,425

591,660

-384,765

YouTube Channel Subscribers

1,736

1,738

+2

Email Subscribers 5

8,396

8,358

-38

Emails Distributed

49

41

-8

Facebook Fans

18,437

18,466

+29

Facebook Posts

157

138

-19

Twitter Follower

7,774

7,884

+110

Twitter Posts

152

126

-26

Instagram Followers

1,309

1,317

+8

Instagram Posts

19

19

0

LinkedIn Followers

1,001

1,019

+18

LinkedIn Posts

85

79

-6

Media Exposure8

922

861

-61

Media Monitoring Highlights

This is a complex graphical representation of data. Please contact us for detail
This is a complex graphical representation of data. Please contact us for detail

Facebook Highlights

This is a complex graphical representation of data. Please contact us for detail

Twitter Highlights

This is a complex graphical representation of data. Please contact us for detail
This is a complex graphical representation of data. Please contact us for detail

Media Participating in Media Briefings

  • AM 800 CKLW, Blackburn News, CBC Windsor, CTV Windsor, CFTV and the Windsor Star join regularly.

Current Notable Projects

  • Maintaining marketing and communication efforts regarding ongoing vaccine rollout in the region by public health and our partners.
  • Shift of media responses from media requests to proactive recorded media sessions in order to reduce burden on Communications and Leadership Team staff while maintaining and improving responsiveness to inquiries.
  • Maintaining and updating website as new information changes regarding COVID-19.

Data Notes:

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 answer questions 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, 2020. On August 17, 2020, we went to a Monday, Wednesday, and Friday schedule with holidays off. On July 19, 2021, Dr. Ahmed continued to join Mike and Lisa Monday and Wednesday mornings to keep the community informed. On September 16, 2021, Nicole Dupuis and Dr. Nesathurai were conducting interviews with Mike and Lisa on Monday and Wednesday mornings.

3. YouTube Live videos started on June 23, 2020. Prior Public Health Update videos on YouTube were exported videos recorded through Facebook Live. In July 2021, YouTube Live broadcasts were scaled down to Fridays only from a Monday, Wednesday, and Friday rotation. In September 2021, media briefings were increased to Monday, Wednesdays and Fridays and streamed live. On September 20, 2021, media briefings were recorded and then posted to YouTube.

4. Website analytics are provided by Site improve. The metric provided is for page views to wechu.org. Previously, we were reporting on the local-updates webpage only.

6. 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.

7. Social media metrics are provided through Hootsuite.

8. Graphs and media exposure information in this report were generated using Meltwater Media Monitoring Solution. 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.


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ISSUE

On Thursday October 28, 2021, Chief Medical Officer of Health Dr. Kieran Moore indicated during a news briefing that the Province of Ontario would not be adding COVID-19 to the list of nine diseases that public school students must be immunized against.

Currently, there is no requirement for eligible students to provide proof of vaccination against COVID-19 for school attendance. Schools are a high-risk setting for COVID-19 and other communicable diseases as they bring together large numbers of individuals for long and extended periods of time increasing the likelihood transmission of certain diseases. As of November 15th, there have been more than 450 cohorts of students dismissed through schools and daycares due to COVID-19 exposure. The Immunization of School Pupils Act (Ministry of Health, 2021)requires that children and youth attending school be immunized against designated diseases, unless they have a valid exemption. The addition of COVID-19 as a ”designated disease” within the Immunization of School Pupils Act would support a number of important public health priorities including:

  • Increased uptake of the vaccine, providing protection for those who are too young or medically unable to be vaccinated in school communities and beyond. This will result in a safer learning environment for students, staff, their families and the broader community.
  • A systematic framework for parental vaccine education. 

BACKGROUND

Vaccines are the safest and most efficient way to guard against communicable diseases and prevent outbreaks. The Immunization of School Pupils Act (ISPA) R.S.O. 1990 (Ministry of Health, 2021) requires that specified vaccines to be given for a child to attend school in Ontario making sure that all school aged children are protected from vaccine preventable diseases. Currently under the ISPA, students must be immunized against measles, mumps, rubella, diphtheria, tetanus, meningococcal, varicella and polio, or have a valid Medical, or Conscience or Religious Belief exemption on file at the Health Unit. There is no cost for vaccines covered by the publicly funded immunization program in Ontario.

MOTION

Whereas available COVID-19 vaccines have been approved by Health Canada to be safe and effective for students born in 2009 or earlier; and

Whereas additional approval by Health Canada to vaccinate individuals born after 2009 with COVID-19 vaccine is anticipated by the end of 2021; and

Whereas the COVID-19 pandemic is a global pandemic;

Whereas the Windsor-Essex region has been disproportionately affected by the COVID-19 pandemic; and

Whereas the Windsor-Essex region has lower rates of vaccination against COVID-19 particularly among eligible children and youth; and

Whereas the purpose of the Immunization of School Pupils Act is to increase the protection of the health of children against the diseases that are designated diseases; and

Whereas the IPSA requires that students be immunized for “designated diseases”: diphtheria, measles, mumps, poliomyelitis, rubella, and tetanus, unless a specific exemption is sought through the act.

Now therefore be it resolved that the Windsor-Essex County Board of Health recommends that the Province of Ontario amend the Immunization of School Pupils Act to include COVID-19 as a “designated disease”.

References:

Ministry of Health. (2021, April 19). Immunization of School Pupils Act, R.S.O. 1990, c. | .1. Retrieved from Government of Ontario Laws: ontario.ca/laws/statute/90i01


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ISSUE

The Windsor-Essex County Health Unit (WECHU) requires the Board of Health to approve the annual operating budget, as this budget forms the basis of the Annual Service Plan and Budget Submission to the Ministry of Health (MOH).

BACKGROUND

The WECHU is a publicly funded organization; as such, the WECHU has a responsibility to spend funds prudently with the objective of providing public health programs and services as required by the Health Protection and Promotion Act (HPPA) and the Ontario Public Health Standards:  Requirements for Programs, Services, and Accountability (OPHS).

The WECHU receives funding in the following manner:

  • The Province of Ontario, more specifically the Ministry of Health, annually grants the WECHU funding to a maximum of 70% of admissible expenditures for its Mandatory Program.  In addition, the WECHU receives required contributions for the Corporation of the City of Windsor, The Corporation of the County of Essex, and the Corporation of the Township of Pelee (hereinafter collectively referred to as the Obligated Municipalities) at a minimum of 30% of admissible expenditures.
  • The Ministry of Health annually provide grants for certain related health protection and promotion programs at a rate of 100% of admissible expenditures.  More specifically this includes the Ontario Seniors Dental Care Program and the AMOH/MOH Compensation Initiative.
  • The Ministry of Children, Community and Social Services (MCCSS) provides annual grants to fund the Healthy Babies Healthy Children Program Initiative and the Nurse Practitioner Program Initiative at a rate of 100% of admissible expenditures.

On an annual basis, the WECHU prepares its operating budgets for review and approval by the Board of Health.  This budget approval than becomes the foundation of the Annual Service Plan and Budget Submissions to the Ministry of Health.  The due date for the 2022 Annual Service Plan and Budget Submission to the Ministry of Health is tentatively set for March of 2022. 

The operating budgets for programs funded by MCCSS will be reported to the Board of Health in a separate report in March of 2022.

Mandatory Program

  2022 2021 Change

Salaries and employee benefits

16,106,151

16,982,867

(876,716)

Other operating expenditures

 

 

 

  Association and membership fees

53,250

53,250

-

  Mileage

272,925

272,925

-

  Professional development

82,605

82,605

-

  Travel meetings

65,451

65,451

-

  Advertising

3,000

4,000

(1,000)

  Bank charges

5,000

5,000

-

  Board expenses

14,571

9,978

4,593

  Office equipment rental

85,000

104,000

(19,000)

  Office supplies

32,000

39,000

(7,000)

  Postage and freight

33,000

30,500

2,500

  Professional fees

 

 

 

    Program – dentistry

150,000

150,000

-

    Program – legal

20,500

15,000

5,500

    Corporate – legal

132,000

172,000

(40,000)

    Corporate – audit

19,900

19,500

400

    Corporate - consulting

6,900

6,900

-

  Program supplies

 

 

 

     Programs

989,671

994,671

(5,000)

     Corporate

440,732

410,370

30,362

  Purchased services

 

 

 

     Programs

110,054

110,054

-

     Corporate

176,446

15,088

161,358

  Building maintenance

150,600

149,300

1,300

  Insurance

205,000

205,000

-

  Parking

37,500

37,500

-

  Property taxes

210,000

220,000

(10,000)

  Rent

697,000

770,000

(73,000)

  Security

14,900

14,914

(14)

  Telephone

145,000

150,500

(5,500)

  Utilities

148,000

159,000

(11,000)

  Vehicle

2,300

2,300

-

Total other operating expenditures

4,303,305

4,268,806

34,499

Total budgeted expenditure

20,409,456

21,251,673

(842,217)

Less:  Offset revenue

(147,724)

(153,359)

5,635

Total net expenditures

20,261,732

21,098,314

(836,582)

The Mandatory Program budget supports 151.98 FTEs, more specifically:

  • Leadership Team 6.75 FTEs
  • Management Team 9.60 FTEs
  • Coordinators 5.75 FTEs
  • Administrative support staff (all departments) 25 FTEs
  • Communications staff 4.0 FTEs
  • Oral health staff 13.50 FTEs
  • Nursing staff (all) 32.50 FTEs
  • Enforcement staff (Public health inspectors and Tobacco and Vaping Enforcement officers) 22 FTEs
  • Corporate services staff including Human Resources 13 FTEs
  • Health promotion and mental health specialists 14.88 FTEs
  • Other program staff 5.00 FTEs

The following represents a summary of changes in the 2022 Mandatory Program budget compared to 2021:

  • Salaries and employee benefits decreased $876,716.  In 2022, the Mandatory Program budget supported 152.23 FTEs as compared to 164.50 FTEs in 2021.  In 2022, additional human resource capacity was shifted from Mandatory Programs to support the COVID-19 activities and recovery activities.
  • Increase in other operating costs of $34,499.  The most notable changes are as follows:
    • A decrease in office equipment rental of $19,000 due to the decline in rental fees in the latter part of the agreement. 
    • A net decrease in professional fees of $34,100, namely legal fees.
    • An increase in purchased services of $161,358. The WECHU will employ third party consultants/services to support the Corporate Services division, namely in the areas of Finance and Facilities.  From a Facilities perspective, these services will be focused on the Windsor Facility Project. 
    • A decrease in building occupancy costs of $99,514.  In 2022, the WECHU will only lease two (2) office facilities (Windsor and Leamington), as compared to three (3) in 2021 (Windsor, Essex and Leamington).

Vector-Borne Diseases Programs

  West Nile Virus Program Enhanced Mosquito Surveillance Program Tick-Borne Diseases Program

Salaries and employee benefits

94,018

62,678

-

Other operating expenditures

 

 

 

  Communication and awareness

10,000

10,000

20,000

  Mileage

6,500

6,000

-

  Program supplies

15,000

16,000

-

  Purchased services

150,000

29,500

-

Total Operating expenditures

181,500

61,500

20,000

Total 2022 budgeted expenditures

275,518

124,178

20,000

Total 2021 budgeted expenditures

276,257

122,129

20,000

Included within the Mandatory Program budget are costs associated with the Vector-Borne Diseases Program (VBD).

The VBD Program is further divided into three sub-programs, the West Nile Virus Program, the Enhanced Mosquito Surveillance Program and the Tick-Borne Disease Program.

In totality, these programs support the salaries and benefits of five (5.0) public health inspection student FTEs and one-half (0.5) of a public health inspector FTE.

COVID-19 Program

  2022 2021(Combined)

Salaries and employee benefits

5,697,435

7,668,839

Other operating expenditures

 

 

  Mileage

29,205

154,653

  Program supplies

 

 

    Communication and awareness

15,773

117,838

    Information technology

-

79,478

    Medical

-

57,321

    Personal protective equipment

-

160,780

    Other

25,440

50,880

    Telephone

27,417

44,003

  Purchased services

 

 

    Case and contact management support

-

549,504

    Legal

-

30,528

    Other

295,969

231,929

    Sharps disposal

-

50,000

    Translation and interpretation

65,635

103,287

    Transportation

132,910

232,681

  Travel and meetings

-

4,000

Total operating expenditures

592,349

1,866,882

Total budgeted expenditures

6,289,784

9,535,721

The COVID-19 Program budget includes activities to support the response to COVID-19 pandemic in Windsor and Essex County including vaccination efforts. This budget supports 62.04 FTEs, more specifically:

  • Leadership Team 1.00 FTE
  • Management Team 7.00 FTEs
  • Coordinators, including Performance Improvement and Accountability Specialists 1.25 FTEs
  • Administrative support staff (all departments) 4.50 FTEs
  • Communications staff 1.00 FTEs
  • Nursing staff (all) 34.50 FTEs
  • Enforcement staff (Public health inspectors and Tobacco and Vaping Enforcement officers) 7.00 FTEs
  • Corporate services staff 1.25 FTEs
  • Other program staff 4.54 FTEs

The COVID-19 Program budget has decreased $3,245,937 over 2021 primarily due to the following:

  • Decrease in salaries and employee benefits of $1,971,404.
  • Decrease in operating expenditures of $1,274,533.  This is attributed to:
    • Decrease in Mileage of $125,448.  The 2021 COVID-19 Program budget contemplated additional mileage costs associated with multiple mass vaccination sites operating throughout Windsor and Essex County.  In 2022, only one mass vaccination site will be in operation supplemented by mobile vaccination events.
    • Decrease in Program supplies of $441,670.  The 2021 COVID-19 Program budget contemplated expenditures on such items as personal protective equipment (PPE), information equipment and medical supplies.  In 2021, vaccine administration supplies including PPE were provided by the MOH with vaccine deliveries.  Additionally, iPads, and other information technology accessories, were provided to public health units to support mass vaccination centres and other related efforts.  Nominal expenditures associated with Program supplies are anticipated for 2022.
    • Decrease in Purchased services of $703,415. In 2021, the WECHU employed a third party provider to support case and contact management ($549,504).  This support is not anticipated to continue in 2022. 

The WECHU will include the COVID-19 Program budget as a one-time request for funding from the MOH.

Recovery

  2022

Salaries and employee benefits

2,164,934

Other operating expenditures

 

Program supplies

 

    Communication and awareness

17,299

    Other

25,440

 Purchased services

 

    Other

90,126

    Translation and interpretation

32,054

Total Operating expenditures

164,919

Total budgeted expenditures

2,329,853

The Recovery Program budget includes activities related to recovery from the COVID-19 pandemic in the community of Windsor and Essex County as well as catch-up efforts.  This budget supports 22.73 FTEs, more specifically:

  • Management Team 1.40 FTEs
  • Coordinators, including Performance Improvement and Accountability Specialists 2.50 FTEs
  • Administrative support staff (all departments) 0.50 FTEs
  • Communications staff 1.00 FTEs
  • Nursing staff (all) 9.50 FTEs
  • Corporate services staff 1.00 FTEs
  • Epidemiology and evaluation staff 5.00 FTEs
  • Other program staff 1.83 FTEs

The WECHU will include the Recovery Program budget as a one-time request for funding from the MOH.

Ontario Seniors Dental Care Program

  2022 2021

Salaries and employee benefits

1,633,878

1,086,828

Other operating expenditures

 

 

  Association and membership fees

2,000

2,000

  Mileage

15,000

15,000

  Professional development

10,000

3,000

  Program supplies and other

 

 

      Bank charges

1,000

1,000

      Clinic supplies and other

400,000

397,372

      Office supplies

4,000

4,000

  Purchased services

 

 

      Professional services

300,000

150,000

      Security

11,500

11,500

  Travel and meetings

4,000

4,000

Total Operating expenditures

747,500

587,872

Total budgeted expenditures

2,381,378

1,674,700

The Ontario Seniors Dental Care Program (OSDCP) supports eleven and one-half (16.5) FTEs comprised of one and one-half (1.5) manager FTEs; one and one-half (1.5) dentist FTEs, one (1.0) denturist FTE, five (5) dental assistant FTEs, four (4) dental hygienist FTEs, one (1.0) health promotion specialist FTE, and two and one-half (2.5) support staff FTEs.  The ODSCP expenditure budget is funded in its entirety by the MOH.

The OSDCP budget has increased $706,678 over 2021 primarily due to the following:

  • Increase in salaries and employee benefits of $547,050. This is attributed to the following:
    • one (1) denturist FTE ($121,845)
    • two (1) dental assistant FTEs ($174,760)
    • one (1) dental hygienist FTE ($97,138)
    • one-half (0.5) health promotion specialist FTE ($53,903)
    • one-half (0.5) support staff FTE ($36,487)
    • other salaries and benefits increases ($62,917)
  • Increase in operating expenditures of $159,628.  This is primarily attributed to an increase in professional services of $150,000.

FUNDING

Administration has arrived at three funding scenarios for consideration by the Board of Health. The purpose of these scenarios is to define the financial risk to the WECHU and the Obligated Municipalities for the 2022 Budget, if additional funding is not available for COVID-19 related expenditures or to support recovery efforts.

SCENARIO 1

Under scenario 1, the Mandatory funding approval from the MOH for 2022 would be $16,301,232.  It anticipates a two (2) percent increase in the 2021 funding approval of $15,981,600.  Additionally, this scenario contemplates the opportunity for one-time funding for costs in excess of the Mandatory funding approval, funded at a rate of one hundred (100) percent.  Total contributions from the Obligated Municipalities for 2022 would be $6,986,242 (Table 1).  These contributions do not contemplate the Mitigation funding approval for 2022 in the amount of $1,260,800.  Such Mitigation funding will be apportioned to the Obligated Municipalities during the 2022 settlement process, if eligibility requirements have been met.

Funding Scenario 1 - Table 1
  2022 2021 Change

The Corporation of the City of Windsor

3,803,275

3,728,701

74,574

The Corporation of the County of Essex

3,178,852

3,116,522

62,330

The Corporation of the Township of Pelee

4,115

4,034

81

 

6,986,242

6,849,257

136,985

Table 2 below summarizes total funding compared to total budgeted expenditures for all programs except OSDCP, as this program is funded entirely by the MOH.

Funding Scenario 1 - Table 2
  2022

Total Mandatory funding approval - MOH

16,301,232

Total Contributions – Obligated Municipalities

6,986,242

Total Mandatory funding - 2022

23,287,474

Total Mandatory Program budget

20,261,732

Total COVID-19 Program budget

6,289,784

Total Recovery budget

2,329,853

Total 2022 expenditures

28,881,369

Excess of total 2022 expenditures over total mandatory funding – 2022

5,593,895

One-time funding

5,593,895

SCENARIO 2

Under scenario 2, total contributions from the Obligated Municipalities for 2022 would be $8,664,410 or 30% of total 2022 expenditures as noted in table 2 above of $28,881,369.  Similar to Scenario 1, contributions do not contemplate the Mitigation funding approval for 2022 in the amount of $1,260,800.  Such Mitigation funding will be apportioned to the Obligated Municipalities during the 2022 settlement process, if eligibility requirements have been met.

Funding Scenario 2
  2022 2021 Change

The Corporation of the City of Windsor

4,716,861

3,728,701

988,160

The Corporation of the County of Essex

3,942,445

3,116,522

825,923

The Corporation of the Township of Pelee

5,104

4,034

1,070

 

8,664,410

6,849,257

1,815,153

SCENARIO 3

Under scenario 3, total contributions from the Obligated Municipalities for 2022 would be $12,580,137. This represents the Obligated Municipalities 30% share of the Mandatory program funding plus 100% of costs in excess of the Mandatory program budget.  Similar to Scenarios 1 and 2, contributions do not contemplate the Mitigation funding approval for 2022 in the amount of $1,260,800.  Such Mitigation funding will be apportioned to the Obligated Municipalities during the 2022 settlement process, if eligibility requirements have been met.

Funding Scenario 3
  2022 2021 Change

The Corporation of the City of Windsor

6,848,563

3,728,701

3,119,862

The Corporation of the County of Essex

5,724,164

3,116,522

2,607,642

The Corporation of the Township of Pelee

7,410

4,034

3,376

 

12,580,137

6,849,257

5,730,880

RISK ASSESSMENT

The inherent risk associated with the budget process is other than low, due to the number of factors:

  • Mandatory Funding approval from the MOH.  A risk exists that the Mandatory funding approval for 2022 will be greater than or less than 2021 approval of $15,981,600.  If less, the Obligated Municipalities will be required to increase their contributions to fund programs and services in excess of the required 30%.  If greater, Obligated Municipalities will be required to increase their contributions to bring their funded portion of the WECHU’s budget to 30%.  Should Obligated Municipalities not increase their contributions in response to changes in funding by the MOH, the WECHU would be required to curtail programs and services.
  • One-time Funding approval from the MOH.  A risk exists that the MOH will not provide on-going financial support to public health units for expenditures incurred on account of COVID-19 response, including vaccination.  In addition, there is a risk that the MOH will not provide financial support to public health units for program restart and program development as we enter Recovery.
  • The future state of the COVID-19 pandemic continues to be the most substantial risk impacting public health.  The question of whether the COVID-19 pandemic will transition from a pandemic to an endemic disease state in 2022, remains unknown.
  • Costs associated with capital projects.  Except for project management costs, no other costs associated with the capital project have been contemplated in the 2022 budget.  Administration will investigate capital funding opportunities through the Health Capital Investment Branch of the MOH to mitigate the WECHU’s exposure to this financial risk.
  • Other operating costs.  In arriving at budgeted operating costs, Administration attempted to factor in the impact of external pressures, such as inflation and market pressures.  Administration will mitigate these risks by ensuring appropriate procurement processes and procedures have been followed.  Additionally, the WECHU will actively monitor budget to actual financial results and implement mitigation strategies when required.

MOTION

Whereas, the Windsor-Essex County Health Unit receives grants annually from the Ministry of Health to a maximum of 70% of admissible expenditures associated with the Mandatory Program.  In addition, the WECHU receives required contributions from the Obligated Municipalities at a minimum of 30% of admissible expenditures, and

Whereas the Ministry of Health annually provides grants for certain related health protection and promotion programs at a rate of 100% of admissible expenditures,

Now therefore be it resolved that the Windsor-Essex County Board of Health approve the 2022 Mandatory Program budget, requiring $16,301,232 in base funding from the Ministry of Health and $6,986,242 in contributions from the Obligated Municipalities, the Corporation of the City of Windsor, the Corporation of the County of Essex and the Corporation of the Township of Pelee, be approved.

FURTHER THAT the Windsor-Essex County Board of Health approve the 2022 Mandatory Program budget with total expenditures of $20,261,732 and offset revenue of $147,724, and

FURTHER THAT the Windsor-Essex County Board of Health approve the 2022 COVID-19 Program budget with total expenditures of $6,289,784, and

FURTHER THAT the Windsor-Essex County Board of Health approve the 2022 Recovery Program budget with total expenditures of $2,329,853, and

FURTHER THAT the Windsor-Essex County Board of Health apply for one-time funding for costs in excess of the Mandatory funding approval, funded at a rate of one hundred (100) percent in the amount of $5,593,895 associated with the 2022 COVID-19 Program budget and the 2022 Recovery Program budget.


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October 21, 2021

Meeting held via video: https://youtu.be/ihy4DY9cdU8

  1. Call to Order
  2. Agenda Approval
  3. Announcement of Conflict of Interest
  4. Board Elections
    1. Audit Committee Member
  5. Update (Dr. S. Nesathurai)
    1. COVID-19 Update
  6. Approval of Minutes
    1. Regular Board Meeting: September 16, 2021
  7. Business Arising
    1. Q2 Report to the Ministry (L. Gregg)
  8. Consent Agenda
    1. INFORMATION REPORTS
      1. Infection Prevention and Control Hub (K. McBeth)
      2. COVID-19 Surveillance and Epidemiology (N. Dupuis)
      3. Communications Recap (E. Nadalin)
    2. RESOLUTIONS/RECOMMENDATION REPORTS – None
  9. New Business
    1. CEO Quarterly Compliance (N. Dupuis)
    2. Fall Immunization Plan (K. McBeth)
    3. Project Governance Committee – Review of Membership (N. Dupuis)
    4. alPHa Fall Symposium, November 2021 (N. Dupuis)
  10. Correspondence
    1. City of Hamilton, Mayor's Office – Letter to Hon. Christine Elliott – Regional Modernization and Support for Local Public Health
    2. Haliburton, Kawartha, Pine Ridge District Health Unit – Letter to Hon. Christine Elliott – Ongoing government financial support for local public health
    3. Grey Bruce Public Health Unit – Letter to Hon. Christine Elliott – In support of Haliburton, Kawartha, Pine Ridge District Health Unit's letter to Christine Elliott – Ongoing government financial support for local public health
    4. Corporation of the City of Windsor – Council Services – Council Decision CR377/2021 to adopt a Regional Active School Travel Charter
  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 18, 2021 – Via Video
  13. Adjournment

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SUBMITTED BY:

Ramsey D’Souza, Manager of Epidemiology and Evaluation

DATE:

October 2021

SUBJECT:

COVID-19 Surveillance and Epidemiology


BACKGROUND

Overview

The Epidemiology & Evaluation department conducts on-going population health assessment and surveillance. The data and surveillance for COVID-19 plays an integral role in understanding and managing the pandemic locally. The evidence provides information on how the pandemic has and is evolving, assessing the risk and severity, and develop timely interventions to limit further spread in the community.

Trends

In the month of September 2021, the health unit reported 1,542 confirmed cases of COVID-19. This is a 14% decrease in case counts compared to the previous month of August 2021. Similarly, the monthly case rate for September was 356.8 cases per 100,000 population, which is lower compared to the monthly rate in August (312.1 cases per 100,000 population). In Ontario, during the month of September, the case rate was 139.6 cases per 100,000 population. This is approximately 2.6 times lower compared to the rate of Windsor-Essex County.

Age and Gender

Approximately 51% (793) of the cases were among females and 48% among males. A disproportionately (26%) higher number of cases, in September 2021,  were reported among those 0 to 18 years of age, followed by 19% among those 19 to 29 years of age, and 17% in the 30 to 39 year age group. Comparatively, from the onset of the pandemic locally (March 1, 2020 to September 30, 2021), 14% of our cases were in the 0 to 19 age group.

Municipal Distribution

The Town of Leamington had the highest case rates (447.1 cases per 100,000 population), followed by the Town of Kingsville (443.0 cases per 100,000 population) and the City of Windsor (376.0 cases per 100,000 population). However, looking at the distribution of cases, 58% of cases were from the City of Windsor, 9% from Leamington and 8% from Lakeshore.

Risk Factors

For the month of September 2021, the top five risk factors reported were an elementary or secondary student (11.2%), farm worker (3.2%), healthcare worker (2.4%), resident of a congregate living setting (1.8%) and a student in a childcare setting (1.4%).

Variants of Concern (VOCs)

Of the 1,542 cases reported in the month of September, genomic sequencing results were available for 1,391 cases (90% of cases). Overall, 78% of cases reported were due to the Delta variant (B.1.617.2), 12% of cases reported results without a variant, and 10% were not sequenced to identify a mutation or a VOC.

Source of Acquisition

Approximately, 32% of cases in September 2021 acquired COVID-19 from their household contact, 17% from a close contact outside of their household, 7% due to being related to an outbreak, and 3% from travel-related outside of the province (e.g., to another province and/or outside of Canada).

Outcome Status

Of the 1,542 cases reported in September 2021, 76% (1,175) had their infection resolved, 268 cases (18%) were active and being followed by the health unit, and 5.4% (83) of cases were lost to follow-up. Seventeen deaths were reported in September 2021 due to COVID-19.

Vaccination Status

Over 34,500 doses were administered to Windsor-Essex County residents in the month of September compared to 31,700 doses in the month of August. This represents a 9% increase for the month of September 2021. Approximately 51% of the doses administered were second doses to complete a vaccination, 39% were first doses to individuals who were previously unvaccinated, and 10% among those in the highest risk priority groups (e.g., residents of long-term care and retirement homes).

Among the 1,542 cases reported in September 2021, 66% were unvaccinated (or not eligible to receive a vaccine), 23% were fully vaccinated, 6% were partially protected with one dose, and 4% were not yet protected after receiving the first dose. Among the 775 unvaccinated cases, approximately 48% were among those 0 to 18 years of age which includes children who were ineligible to receive the vaccine.

CURRENT INITIATIVES

The health unit will continue to monitor and provide epidemiological expertise on COVID-19 to internal leadership, community partners, and residents to support evidence-informed decision-making. This includes daily epidemiological updates, weekly epidemiological presentations to the community and supporting policy decisions through data driven approaches.

CONSULTATION:

The following individuals were contributed to this report: Bridget Irwin, Scott Miller, Karanveer Banipal, Anum Khan, Noor Al-Azary


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SUBMITTED BY:

Kristy McBeth, Director, Health Protection

DATE:

October 2021

SUBJECT:

Infection Prevention and Control (IPAC) Hub


BACKGROUND

Ontario Health has identified organizations including hospitals, public health units and others from across the province to lead local Infection Prevention and Control (IPAC) Hubs (Ministry of Health, 2020). These organizations work with partners from across the local health system who have IPAC expertise to ensure that this specialized guidance and support is available to local congregate living settings though a one-window model.

IPAC Hubs:

  • Identify and monitor IPAC training and practice needs within their catchment area - including in congregate living settings funded and overseen by the Ministry of Health (MOH), Ministry of Long-Term Care (MLTC), Ministry of Seniors and Accessibility (MSAA), Ministry of Municipal Affairs and Housing (MMAH) and the Ministry of Children, Community & Social Services (MCCSS).
  • Strengthen current partnerships and broker new ones; supporting a network of IPAC service providers and experts; working to align local resources to meet IPAC needs within congregate living settings for both prevention and response. Services will be allocated according to a risk-based framework.
  • Bring forward and escalate issues of concern that are outside of the scope of IPAC through established mechanisms with ministry partners.

Local public health and Public Health Ontario (PHO) are key partners in each local IPAC Hub. Working in coordination with the IPAC Hub, public health partners support the provision of IPAC knowledge, training and expertise, and build on existing local partnerships. In addition to contributing to IPAC Hubs as experts, the local public health unit retains the responsibility to oversee the management of outbreaks. Local public health units also have a key linkage to Ministry of Labour, Training, and Skills Development (MLTSD), but does not replace the duties employers of congregate living organizations have to notify the MLTSD as required under the Occupational Health and Safety Act, 1990 and other relevant requirements.

CURRENT INITIATIVES

In collaboration with our local IPAC Hub members, and the current Hub lead Windsor Regional Hospital (WRH), it has been determined that in order to most effectively utilize existing and future human and financial resources, that the WECHU would transition to the role of IPAC Hub for lead for Windsor-Essex effective October 2021. Funding for this initiative, received through Ontario Health, will be allocated to the WECHU to support program deliverables starting in October 2021. This work will be performed through augments to staffing in the Environmental Health Department and will also include FTE allocations from existing staff including Public Health Inspectors. The WECHU’s IPAC Hub program will be an inter-disciplinary team of Public Health Inspectors and Public Health Nurses under the management of a certified Infection Control Practitioner. The current funding for this Hub program is in place until March 31, 2022.

Some of the main WECHU Responsibilities as the local IPAC Hub lead for Windsor and Essex County include:

  • The creation of implementation targets and monitoring of progress;
  • The establishment of local IPAC Hub priorities for service delivery;
  • Leading communication with Hub Partners (Public Health Ontario, hospitals and other providers) and congregate living settings in our defined catchment area
  • Maintaining detailed financial records of expenses and supporting weekly reporting requirements.

The WECHU will continue to work collaboratively with partners in the Hub framework with the new model in place in order to facilitate enhanced local supports for infection prevention and control strategies within congregate settings of our community.

DOCUMENTS:

Ministry of Health. (2020, September). Infection Prevention and Control Hubs. Retrieved from IPAC Hub Program Description:
https://www.health.gov.on.ca/en/pro/programs/publichealth/coronavirus/do...

 


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Board Members Present:

Gary McNamara, Joe Bachetti, Tracey Bailey, Rino Bortolin, Fabio Costante, Gary Kaschak (4:07 pm), Judy Lund, Robert Maich (4:12 pm), Ed Sleiman, Larry Snively

Administration Present:

Nicole Dupuis, Dr. Shanker Nesathurai, Felicia Lawal, Kristy McBeth, Eric Nadalin, Dan Sibley, Lee Anne Damphouse

Administration Regrets:

Lorie Gregg


QUORUM:  Confirmed

  1. Call to Order
    Board Chair, Gary McNamara, called the meeting to order at 4:03 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. Board Elections

    1. Audit Committee Member
      Nominations for Audit Committee Member
      The Chair opened the floor for nominations for a Member of the Audit Committee, noting that Administration had received two (2) written nominations; one (1) for Tracey Bailey, and one (1) for Robert Maich.  The Chair asked for nominations from the floor (three times).  Given that there were no further nominations, nominations for an Audit Committee Member were closed.  The Chair asked Tracey Bailey if she accepted the nomination – Tracey Bailey accepted.  The Chair asked Robert Maich if he accepted the nomination – Robert Maich accepted.  Tracey Bailey and Robert Maich were appointed as a Members of the Audit Committee by acclamation.

      G. McNamara asked if Tracey Bailey, as Board Treasurer, would automatically be appointed to the Audit Committee.  N. Dupuis noted that this is not reflected as a requirement under the Audit Committee Terms of Reference or the Board By-Laws.  

      N. Dupuis also recommended that the WECHU recruit one external member to fulfill committee composition requirements, and to bring an outside perspective. 

      Moved by: Rino Bortolin
      Seconded by:  Gary Kaschak
      That the WECHU recruit an external Audit Committee Member.
      CARRIED

  5. Update (Dr. S Nesathurai)
    1. COVID-19 Update

      Dr. S. Nesathurai said that the Windsor-Essex region currently has a lower number of positive COVID-19 cases than what was being reported at the last Board of Health meeting, but the burden is still significant in our communities with outbreaks at businesses, schools and the hospitals.  Cohorts of over 300 young people have been dismissed from schools due to exposure to COVID 19, and our key goal is to keep schools open for instruction. Two thirds of eligible students are vaccinated and one third are not.  We are over a year and a half into the pandemic and health care workers are fatigued. 

      Although COVID-19 is the number one public health concern, Dr. S. Nesathurai wants to bring to light the current opioid crisis which requires more public attention.  In Ontario in 2020 about 2,400 people died from opioid related deaths compared to about 550 who perished in automobile accidents.  Opioid deaths are four time higher than car accidents.  In 2020 in Windsor-Essex we reported 420 cases and approximately 80 deaths.  We need to consider focusing our attention here.  About one-fifth, or twenty percent of individuals who die by overdose die with someone else in attendance. That is where Naloxone comes in to play and can help save a life.  We would ask those who are using not to use alone and to get a Naloxone kit.  COVID is a priority but we also need to focus on other public health priorities.  Naloxone kits are free of charge and our Windsor-Essex Community Opioid and Substance Strategy (WECOSS) website https://wecoss.ca/ has all of this information on where people can get one including the list of participating pharmacies.  E. Nadalin noted that there is a direct link on our website where to obtain these kits from various community partners and we act as a community hub.  The bulk of the kits are distributed to pharmacies, making them easily accessible when filling prescriptions.  

      Moved by: Judy Lund
      Seconded by: Ed Sleiman
      That the information be received.
      CARRIED

  6. Approval of Minutes
    1. Regular Board Meeting:  September 16, 2021

      Moved by: Judy Lund
      Seconded by: Joe Bachetti
      That the minutes be approved.
      CARRIED

  7. Business Arising
    1. Q2 Report to the Ministry (L Gregg)
      N. Dupuis noted that the WECHU submitted its Q2 Report to the Ministry.  We will defer this portion of the meeting to next month when L. Gregg is available to present

  8. Consent Agenda
    1. INFORMATION REPORTS
      1. Infection Prevention and Control Hub (K McBeth)
        The funding for this initiative flows through Ontario Health to our hospitals.  We are working in collaboration with Windsor Regional Hospital (WRH), and have an agreement to take over this work which aligns with the work of public health.

      2. COVID-19 Surveillance and Epidemiology (N. Dupuis)
        To be brought to the Board for information.

      3. Communications Recap
        To be brought to the Board for information.

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

    2. RECOMMENDATION REPORTS - None
  9. New Business
    1. CEO Quarterly Compliance – July 31, 2021 to September 30, 2021 (N. Dupuis)
      N. Dupuis brought the report to the board for information, noting there is nothing out of the ordinary to report. 

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

    2. Fall Immunization Plan
      N. Dupuis advised that the Ministry has requested a significant vaccination plan from the WECHU for the fall of 2021 and into the new year.  This plan includes all immunizations, i.e. Influenza, ISPA (Immunization of School Pupils Act) and COVID-19.  We are currently in a good position due to the hard work by our staff under the leadership of Kristy McBeth and community partners.  K. McBeth noted that the immunization plan is in three sections.

      1.    Influenza Vaccine 
      We are well underway with influenza vaccines.  The hospitals and LTCHs/RHs have received them in September.  The vaccine has also been distributed to 214 primary care providers and pharmacies, including the high dose vaccine for the 65 plus population.  To date, 115,200 influenza vaccines have been administered in our communities, an increase from 97,000 last year. We’ve seen an increase in demand and in our supply. The province is encouraging people to get the flu vaccine, and we have received guidance from the ministry on co-administering the flu and COVID-19 vaccines. NASI has indicated that it is safe to co-administer the COVID vaccine with other vaccines. We are working with our partners and mobile clinics, particularly in high-risk neighbourhoods, around messaging, and the vaccine is free to all residents of Ontario. Dr. S. Nesathurai said he believes there has been a drop globally around influenza cases due to masking and public health measures, but will circle back at the next board meeting with more information.

      2.    COVID-19 Vaccine
      COVID-19 vaccines commenced January 1, 2021 and will be ongoing to January 1, 2022.  We have completed 3rd doses locally for all of our LTCHs/RHs, and there will be some follow up for those who have not yet reached the 5 month timeline between vaccines. All of this work is being done in the background by our front line WECHU staff. Individuals who are considered high risk, immuno-compromised or vulnerable, are eligible for a 3rd dose of the vaccine. J. Bachetti asked about those that are homebound and if they are eligible for the 3rd dose.  K. McBeth advised that the LHIN had worked with homebound individuals on the first and second doses, but many are currently not eligible, depending on what their medical condition may be.  We can still support once they become eligible. 

      First and second doses are still considered priority and we continue to support the mass vaccination site at Sears.  Support from CRST, EMS and ESHC will continue with clinics in community centres, buses, parks, and other mobile locations.  We continue to work with school boards for the 12-17 age group.

      Immunization planning for the 5-11 year age group will be a big component for fall.  Providing options and more opportunity for vaccination is key. We are engaging with primary care providers and are hoping for an increased uptake for this group by accessing their family doctors.  Pharmacies and mobile sites will be an option as well to support this age group.  The strategy will be different for this group and we will need to revise various segments of the mass clinic, the size of syringes, chairs, mats on floor, to make them more comfortable and alleviate any feelings of anxiety. 

      E. Sleiman asked if vaccine has to occasionally be thrown out due to open vials or expiry.  K. McBeth said as part of vaccine management we never want to throw out supply.  There are limitations if vials are open and at the end of the day there are some doses that we cannot use as they are multi-use vials and have to be allocated.  Zero wastage is our goal.

      3.    School-age Immunization
      Due to school closures during the pandemic we had to change our school immunization strategy.  Our staff will be in the schools in November administering the first round of vaccines, and again in the spring for the second round.  We also have support from primary care providers. We will offer catch up clinics in December and January and are also offering in-house clinics in Windsor and Leamington. L. Snively asked if we had numbers of our youth vaccinated.  K. McBeth advised that our WECHU Epidemiology team has this information on the Dashboard on our website, broken down by age and postal code.  Numbers are going up, but not substantially.  We have seen a steady decline over the last month or so at our mobile clinics. Daily number were at 200-300 attendees, and now can be down to as low as single digits.  We have benefited greatly from the mass site at Sears, and pharmacies have picked up a good amount of traffic.

      Moved by: Larry Snively
      Seconded by: Gary Kaschak
      That the information be received.
      CARRIED

    3.  

      Project Governance Committee – Review of Membership 
      The Project Governance Committee’s (PGC) composition is made up of 6 Board of Health members; 2 City representatives (Rino Bortolin and Fabio Costante); 2 County representatives (Gary McNamara and Joe Bachetti); 2 provincial appointees (Judy Lund and Robert Maich) along with the CEO, Nicole Dupuis, and Director of Corporate Services, Lorie Gregg.  The Terms of Reference were included in this month’s board package for information.

    4. alPHa Fall Symposium
      Information on the alPHa Fall Symposium was brought forward for information.  The conference will be held virtually and is a one day session.  The cost for registration is $149 per person, plus HST.  In the past we have limited the number of attendees.  Given what is happening in public health and that the conference is being held virtually, we are encouraging any board or leadership team members who wish to attend to do so, and to reach out to Lee Anne Damphouse for registration.  An email went out to today with further conference details. G. McNamara said he would be interested in attending.

      Moved by: Judy Lund
      Seconded by: Ed Sleiman
      That the information be received.
      CARRIED

  10. Correspondence
    1. City of Hamilton, Mayor’s Office – Letter to Hon. Christine Elliott – Regional Modernization and Support for Local Public Health

    2. Haliburton, Kawartha, Pine Ridge District Health Unit – Letter to Hon. Christine Elliott – Ongoing government financial support for local public health

    3. Grey Bruce Public Health Unit – Letter to Hon. Christine Elliott – In support of Haliburton, Kawartha, Pine Ridge District Health Unit’s Letter to Christine Elliott – Ongoing government financial support for local public health

    4. Corporation of the City of Windsor – Council Services – Council Decision CR377/2021 to adopt a Regional Active School Travel Charter

      Moved by:  Rino Bortolin
      Seconded by: Ed Sleiman
      That items 10.1, 10.3, 10.4 be received for information, and that the WECHU prepare a letter of support for item 10.2.
      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 4:55 pm
    The Board moved out of Committee of the Whole at 5:14 pm

  12. Next Meeting: At the Call of the Chair, or November 18, 2021 – Via Video

  13. Adjournment

    Moved by: Fabio Costante
    Seconded by: Judy Lund
    That the meeting be adjourned.
    CARRIED

    The meeting adjourned at 5:15 pm.

RECORDING SECRETARY: L. Damphouse

SUBMITTED BY: N. Dupuis

APPROVED BY:


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  1. Period covered by this report:  April 1, 2021 to June 30, 2021
  2. For the period covered by this CEO Quarterly Compliance Report:
    1. The undersigned has personal knowledge of the matters herein reported or has made due inquiry with respect to the same.
    2. Except as reported in any previous CEO Quarterly Compliance Report, the undersigned reports as follows:
      1. that the Health Unit has been in material compliance with all laws, regulations, orders, judgments or decrees applicable to it.  Without limiting the generality of the foregoing the Health Unit is current in respect of all tax and related withholding and remittances required by law;
      2. the Health Unit has been in material compliance with its By-laws;
      3. the Health Unit has been in material compliance with all other Board resolutions;
      4. the Health Unit has been in material compliance with all contracts and commitments to which the Health Unit is a party including without limitation all funding and accountability agreements;
      5. the Health Unit is current with respect to the payment of all remuneration (including salary and benefits) to its employees;
      6. there are no material variances between what is contemplated by the Operational Plan and what in fact transpired or appears likely to transpire
      7. more specifically, no material changes are required in respect of financial resource allocation plans to address shifts in need and capacity
      8. no material adverse change has occurred in the operations of the Health Unit or its assets and liabilities taken as a whole
      9. there have been no material breaches of the Ethics Code of Conduct by anyone who is subject to it;
      10. there have been no unplanned terminations of any Health Unit employees;
      11. there have been no claims made pursuant to any insurance policies maintained by the Health unit; and,
      12. nothing has come to the attention of the undersigned which would materially adversely change any previous CEO Quarterly Compliance Report, except as detailed below:
        Items (vi), (vii), and (viii) have been revised due to the COVID -19 pandemic as follows:

On March 17, 2020, the Province of Ontario enacted the Emergency Management and Civil Protection Act, R.S.O. 1990, c. E.9. (“the Act”), to support efforts to contain the spread of COVID-19, in our communities.  The Act supports public health units to, regardless of their collective bargaining agreements, suspend services, redeploy staff as deemed appropriate, modify hours of work, cancel and or defer vacations, utilize part-time/contract staff to perform the duties and responsibilities of bargaining unit staff and suspend the grievance process.

The WECHU, in its response to COVID-19 within the communities of Windsor and Essex County has:

  • Redeployed staff as considered appropriate to facilitate our response to the pandemic;

Date:   June 30, 2021                    

Signature(s):   

Nicole Dupuis, Chief Executive Officer
Lorie Gregg, Director, Corporate Services
Dan Sibley, Director, Human Resources


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  1. Period covered by this report:  July 31, 2021 to September 30, 2021
  2. For the period covered by this CEO Quarterly Compliance Report:
    1. The undersigned has personal knowledge of the matters herein reported or has made due inquiry with respect to the same.
    2. Except as reported in any previous CEO Quarterly Compliance Report, the undersigned reports as follows:
      1. that the Health Unit has been in material compliance with all laws, regulations, orders, judgments or decrees applicable to it.  Without limiting the generality of the foregoing the Health Unit is current in respect of all tax and related withholding and remittances required by law;
      2. the Health Unit has been in material compliance with its By-laws;
      3. the Health Unit has been in material compliance with all other Board resolutions;
      4. the Health Unit has been in material compliance with all contracts and commitments to which the Health Unit is a party including without limitation all funding and accountability agreements;
      5. the Health Unit is current with respect to the payment of all remuneration (including salary and benefits) to its employees;
      6. there are no material variances between what is contemplated by the Operational Plan and what in fact transpired or appears likely to transpire
      7. more specifically, no material changes are required in respect of financial resource allocation plans to address shifts in need and capacity
      8. no material adverse change has occurred in the operations of the Health Unit or its assets and liabilities taken as a whole
      9. there have been no material breaches of the Ethics Code of Conduct by anyone who is subject to it;
      10. there have been no unplanned terminations of any Health Unit employees;
      11. there have been no claims made pursuant to any insurance policies maintained by the Health unit; and,
      12. nothing has come to the attention of the undersigned which would materially adversely change any previous CEO Quarterly Compliance Report,

      except as detailed below:
      Items (vi), (vii), and (viii) have been revised due to the COVID -19 pandemic as follows:

On March 17, 2020, the Province of Ontario enacted the Emergency Management and Civil Protection Act, R.S.O. 1990, c. E.9. (“the Act”), to support efforts to contain the spread of COVID-19, in our communities.  The Act supports public health units to, regardless of their collective bargaining agreements, suspend services, redeploy staff as deemed appropriate, modify hours of work, cancel and or defer vacations, utilize part-time/contract staff to perform the duties and responsibilities of bargaining unit staff and suspend the grievance process. 

The WECHU, in its response to COVID-19 within the communities of Windsor and Essex County has:

  • Redeployed staff as considered appropriate to facilitate our response to the pandemic;

Date: September 30, 2021

Signature(s):

Nicole Dupuis, Chief Executive Officer


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September 16, 2021

Meeting held via video.

  1. Call to Order
  2. Agenda Approval
  3. Welcome and Introduction:  Dr. Shanker Nesathurai
  4. Announcement of Conflict of Interest
  5. Committee of the Whole (Closed Session in accordance with Section 239 of the Municipal Act)       
  6. Update (S. Nesathurai)
    1. COVID-19 Update  
  7. Approval of Minutes
    1. Regular Board Meeting:  July 22, 2021  
  8. Business Arising
  9. Consent Agenda
    1. INFORMATION REPORTS                                                                   
      1. Vaccine Distribution Update – COVID 19 Vaccine and UIIP (K. McBeth)  
      2. Q2 Financial Report (L. Gregg)
      3. Recruitment of a Medical Officer of Health (N. Dupuis)
      4. Appointment of an Acting Medical Officer of Health (N. Dupuis)
    2. RECOMMENDATION REPORTS
      1. Consumption and Treatment Services (E. Nadalin)
      2. Signing Authority – Dr. W. Ahmed (N. Dupuis)
  10. New Business
    1. Membership on Audit Committee and Project Governance Committee (N. Dupuis/L. Gregg)
    2. GEM Extension (N. Dupuis)
  11. Correspondence
    1. Windsor-Essex County Health Unit – Letter to Hon. Christine Elliott and Hon. Doug Ford – Appeal to the Province of Ontario – Public Health Funding
    2. Ministry of Health – Letter to WECHU Board Chair, Gary McNamara – Ontario government extending the one-time mitigation funding through 2022
    3. Northwest Public Health – Letter to Hon. Christine Elliott – Support to Establish the Infection Prevention and Control (IPAC) Hub Model as an ongoing program
    4. Peterborough Public Health – Letter to Hon. Christine Elliott – Funding increase to cost-shared base budget to accommodate additional FTE's to update the Environmental Health Database for the implementation of the Menu Labelling, Child Vision Health and Vision Screening, and Consumption and Treatment Services Compliance and Enforcement
  12. Next Meeting: At the Call of the Chair or October 21, 2021 – Via Video
  13. Adjournment


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PREPARED BY:

Lorie Gregg, Director of Corporate Services

DATE:

September, 2021

SUBJECT:

Q2 Financial Results


BACKGROUND

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

  • Mandatory and related programs funded to a maximum of 70% (“Cost-Shared”) by the Ministry of Health (“MOH”) and 30% 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 funded 100% by the MOH.  More specifically, this includes the Ontario Seniors Dental Care program and the AMOH/MOH Compensation Initiative.
  • Related programs funded 100% by the Ministry of Children, Community and Social Services (“MCCSS”). 
  • One-time business cases funded 100% by the MOH.

The second quarter financial report to the Board includes a budget to actual comparison and narrative for material variances for all programs listed above, except related programs funded 100% by the Ministry of Children Community and Social Services (MCCSS).  Forecasted financial results will be provided with the Q3 and Q4 financial report.

Related programs funded 100% by the MCCSS will be reported on in November of 2021.

COST-SHARED PROGRAM FINANCIAL RESULTS

The following is the financial information for the Mandatory and related programs funded on a cost-shared basis for the period January 1, 2021 to June 30, 2021.
  BUDGET 2021 YTD BUDGET
06 30 2021
YTD ACTUAL
06 30 2021
VARIANCE TO BUDGET
Salaries 13,438,229 6,719,115 6,304,061 415,053
Employee benefits 3,544,638 1,772,319 1,667,785 104,534

Other operating expenditures:

       
  Association and membership fees 53,250 26,625 36,519 (9,894)
  Mileage 272,925 136,463 107,060 29,403
  Professional development 82,605 41,303 5,791 35,511
  Travel meetings 65,451 32,726 - 32,726
  Advertising 4,000 2,000 - 2,000
  Bank charges 5,000 2,500 2,044 456
  Board expenses 9,978 4,989 - 4,989
  Office equipment rental 104,000 52,000 46,583 5,417
  Office supplies 39,000 19,500 9,840 9,660
  Postage and freight 30,500 15,250 3,877 11,373
  Professional fees:        
    Program -dentistry 150,000 75,000 12,219 62,781
    Program - legal 15,000 7,500 8,535 (1,035)
    Corporate - legal 172,000 86,000 73,219 12,781
    Corporate - audit 19,500 9,750 4,723 5,027
    Corporate - consulting 6,900 3,450 - 3,450
  Program supplies:        
    Programs 994,671 497,336 311,139 186,196
    Corporate 410,370 205,185 298,296 (93,111)
  Purchased services:        
    Programs 110,054 55,027 55,023 4
    Corporate 15,088 7,544 - 7,544
    Building maintenance 149,300 74,650 81,253 (6,603)
    Insurance 205,000 102,500 155,265 (52,765)
    Parking 37,500 18,750 18,204 546
    Property taxes 220,000 110,000 97,743 12,257
    Rent 770,000 385,000 383,898 1,102
    Security 14,914 7,457 4,317 3,140
    Telephone 150,500 75,250 55,863 19,387
    Utilities 159,000 79,500 50,038 29,462
    Vehicle 2,300 1,150 1,235 (85)
Total Other operating expenditures 4,268,806 2,134,403 1,822,684 311,719
Total Expenditures 21,251,673 10,625,837 9,794,530 831,306
Less: Offset revenue (153,359) (76,680) (55,514) (21,165)
Total Net expenditures 21,098,314 10,549,157 9,739,016 810,141

At June 30, 2021, the variance from budget to actual total expenses amounts to $810,141. Specific variances are as follows:

  • Salaries and Benefits:  Expenditures in these financial captions relate to salaries and benefits paid to the WECHU staff in service of the Mandatory Cost-Shared Program. Cumulatively, these financial captions are $519,587.  Substantial human resources were deployed to support COVID-19 Response and COVID-19 Vaccination Programs.  Salaries and benefits allocated to the Mandatory Program are not entirely an accurate depiction of the human resources working on Mandatory Programs at June 30, 2021.  A secondary analysis is being compiled for the purposes of Q2 reporting to the MOH delineating resources in a more granular fashion.  This report will be brought to the Board in October of 2021.
  • Mileage, Professional development, and Travel and meetings:  Expenditures in these financial captions support WECHU staff in the completion of their public health responsibilities.  Cumulatively, these financial captions are $97,640 underspent at June 30, 2021. Mandatory program activities continue to be impacted by COVID-19 Pandemic.  A substantial portion of the WECHU staff continue to work-from-home and employ virtual means to interact with clients, partners, etc.  Professional development is completed on an “as needed basis” taking into consideration staff capacity.
  • 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 early in the fiscal year.  While overspent at June 30, 2021, the WECHU anticipates that this financial statement caption will remain within its overall budget for fiscal 2021.
  • 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 corporate service departments such as Information Technology and Communications.  Cumulatively the Program supplies financial caption is underspent $93,385.  Program related expenditures continue to be underspent due to the on-going focus on the COVID-19 Pandemic (underspent $186,196).  Corporately, the budget is overspent $93,111, which is primarily to the prepayment of Information Technology software licensing for calendar years 2021 and 2022. 
  • Professional fees:  Expenditures in this financial caption include legal, audit, consulting fees and dentistry services.  At June 30, 2021, this caption is underspent $83,004.  This variance is primarily associated with the variance in dentistry fees paid on account of the Healthy Smiles Ontario Program (HSO).  In February of 2021, the WECHU successfully recruited a second dentist FTE, whose time would be allocated evenly between the ODSCP and the HSO Program, reducing the requirement subcontracted dentistry services.
  • 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:  i) Costs incurred to install electrical for 12 desks in the Leamington office in the amount of $5,662;  ii)  Prepayment of certain maintenance costs for calendar years 2021 and 2022. 
  • 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 anticipates that the budget for this financial statement caption will remain underspent for 2021. 
  • Utilities:  Expenditures in this financial caption include utility costs for the Windsor and Leamington offices.  Utilities are underspent $29,462 due to lower than anticipated utilization (i.e. staff working from home; environmental factors).
  • Vehicle:  Expenditures in this financial caption include vehicle maintenance, repair and fuel.  The WECHU incurred augmented fuel costs on account of: 1. Vaccine delivery to retirement homes, long-term care homes, pharmacies and physicians; 2. Supplies delivery to mass vaccination sites. It is anticipated that this financial caption will remain within budget for 2021.
  • 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 June 30, 2021, offset revenue is under budget by $21,165.  More specifically:  i) nil interest was earned (under budget $2,500).  ii) Nil was earned on account of food handler courses (under budget $5,000).  iii) Nil was earned on account of vaccine recoveries (under budget $18,844).  iv)  $618 was earned on account of the sale of contraceptives (under budget $6,382). v)  $14,186 was earned on account of parking revenues (over budget $686).  vi)  $34,708 was earned on account of seasonal housing inspections (over budget $7,622).  vii)  Sale of tangible capital assets of $4,759 (over budget $4,259). viii)  $1,280 in user fees (under budget $970).

COVID-19 RESPONSE PROGRAM

  BUDGET 2021 YTD BUDGET
06 30 2021
YTD ACTUAL
06 30 2021
VARIANCE TO BUDGET
Salaries and employees benefits 2,889,843

1,444,922

1,062,040

382,882

Other operating expenditures:

       
  Mileage 25,000 12,500 2,899 9601
  Program supplies:        
    Communication and awareness 46,199 23,100 - 23,100
    Other 25,440 12,720 18,449 (5,729)
    Telephone 10,832 5,416 2,281 3,135
  Purchased services:        
    Case and contact management support 549,504 274,752 407,636 (132,884)
    Legal 30,528 15,264 - 15,264
    Translation and interpretation 82,426 41,213 6,613 34,600
  Travel and meetings 2,000 1,000 - 1,000
Total operation expenditures 3,661,772 1,830,886 1,499,917 330,969

The COVID-19 Response Program was established to respond to the on-going impact of the COVID-19 Pandemic in Windsor and Essex County.  The budget for this program included 30 FTEs, more specifically: one (1) director FTE, five (5) Manager FTEs, nine (9) Registered Practical Nurse FTEs, seven (7) Public Health Nurse FTEs, four (4) Public Health Inspector FTEs, one (1) Epidemiologist FTE and three (3) Support Staff FTEs.

Variances from budget at June 30, 2021 are as follows:

  • Salaries and benefits are underspent $382,882:  The staffing complement of this program has evolved from January to June of 2021, in response to the changes in local case counts.  Additionally, the Province of Ontario provided human resource support for case and contact management at no cost.  This provided the WECHU the opportunity to deploy nursing resources to support COVID-19 Vaccinations in March of 2021.

Programs supplies

  • Communication and awareness is underspent $23,100: At June 30, 2021, $ nil was spent on communication and awareness campaigns associated with the COVID-19 Pandemic (excluding vaccine).  The WECHU has determined that there is a greater need for human resource capacity to support the Communications Department and, by extension, the messaging and media associated with public health measures as well as COVID-19 vaccination efforts.  As such, these financial resources will be expended on staffing to support this area.  Recruitment will occur in Q3 of 2021.

Purchased services

  • Case and contact management support is overspent $132,884:  At June 30, 2021, 6,645 hours were acquired from Global Excel Management to support case and contact management.   The budget for case and contact management support of $549,504 was intended for a 6-month period. While on a pro-rata basis, the budget for case in contact management is overspent, the amount expended at June 30, 2021, is within the budgeted amount for the initial term of the contract.
  • Translation and interpretation is underspent $34,600:  Translation and interpretation costs were lower than anticipated in the area of case and contact management.  Higher than anticipated translation and interpretation costs were experienced as for the COVID-19 Vaccination Program.

COVID-19 VACCINE PROGRAM

  BUDGET 2021 YTD BUDGET
06 30 2021
YTD ACTUAL
06 30 2021
VARIANCE TO BUDGET

Salaries and employees benefits

4,778,996

2,389,498

2,861,282

(471,784)

Other operating expenditures:

       
  Mileage 129,653 64,827 89,123 (24,297)
  Association and membership fees - - 100 (100)
  Program supplies:        
    Communication and awareness 71,639 35,820 1,883 33,937
    Information Technology 79,478 39,739 115,512 (75,773)
    Medical 57,321 28,661 60,736 (32,076)
    Personal protective equipment 160,780 80,390 48,515 31,875
    Other 25,440 12,720 82,612 (69,892)
    Telephone 33,171 16,586 5,094 11,492
  Purchased services:        
    Other 231,929 115,965 340,214 (224,250)
    Sharps disposal 50,000 25,000 23,535 1,465
    Transportation 232,681 116,341 1,154 115,187
    Translation and interpretation 20,861 10,431 49,129 (38,699)
  Travel and meetings 2,000 1,000 5 995
Total expenditures 5,873,949 2,936,975 3,678,894 (741,920)
         
Less: Offset Revenue - - - -
Total net expenditures 5,873,949 2,936,975 3,678,894 (741,920)

As per the approved budget (March of 2021), the COVID-19 Vaccine Program supports 63 FTEs comprised of two (2) manager FTEs, one (1) health promotion specialist FTE, ten (10) public health nurse FTEs, forty (40) registered practical nurses FTEs and ten (10) support staff FTEs.  Similar to the COVID-19 Response Program, the composition of the COVID-19 Vaccination Program evolved with vaccination requirements, as well as the availability of vaccine within Windsor and Essex County. 

Variance from budget at June 30, 2021 are as follows:

  • Salaries and benefits are overspent $471,784: Additional human resource capacity was added at all levels to support three mass immunization clinics, mobile vaccination events as well as vaccine distribution to physicians and pharmacies in Windsor and Essex County. 
  • Mileage is overspent $24,297:  The budget for this financial caption did not contemplate the additional human resource capacity (in excess of 63 FTEs) as well as the length of time mass vaccination sites would remain in operation.

Program supplies

  • Communications and awareness is underspent $33,937:  At June 30, 2021, a nominal amount was expended on account of communication and awareness campaigns associated with COVID-19 Vaccinations.  The WECHU leveraged its YouTube broadcasts, media releases, website and social media (relatively in expensive), for communicating messaging.  Similar to the discussion noted under the COVID-19 Response Program, the WECHU has determined that there is a greater need for human resource capacity to support the Communications Department and, by extension, the messaging and media associated with public health measures as well as COVID-19 vaccination efforts. As such, these financial resources will be expended on staffing to support this area.  Recruitment will occur in Q3 of 2021.
  • Information technology is overspent $75,773: Additional hardware was acquired to support COVID-19 Vaccination staff.  Computer hardware such as laptops, monitors, keyboards, mice, printers and cables were acquired ($97,721).  Tablets were acquired to support the check-in and queuing process at each of the mass clinics ($10,137).  Upgraded temperature control and monitoring equipment was acquired for the WECHU vaccine fridges and freezers ($4,975).
  • Medical equipment is overspent $32,076:  This financial caption includes the cost of acquiring medical equipment and supplies to support COVID-19 vaccinations in various settings (i.e. long-term care and retirement homes; mobile events; mass clinics; physician offices).    Supplies included: Epi pens, needles, syringes, drape sheets, bandages, alcohol swabs, etc.  In the latter part of Q1, the Province of Ontario included vaccine administration supplies with its shipment of vaccine.  The WECHU continued to acquire and use its own needles and syringes for the administration of Moderna up to June 30, 2021, as our vaccination supplies more consistently drew additional doses per vial of Moderna.  This was critical at this time due to the limited supply of vaccine in Windsor and Essex County.
  • Personal protective equipment is underspent $ 31,875:  This financial caption includes costs associated with rental and or purchase of isolation gowns, the purchase of N95 masks, and the purchase of nitrile gloves, hand sanitizer and similar supplies to support COVID-19 Vaccinations in various settings.  In the latter part of March 2021, certain personal protective equipment were distributed with vaccine shipments, eliminating the need for the WECHU to continue to acquire these supplies.
  • Other is overspent $69,892:  This financial caption included:  Tents, generator and security for pop-up events ($6,080); Office supplies ($19,570); Licensing for scheduling application ($35,839); Copier/printer charges for printing resources ($9,388); Calibration and electrical for vaccines freezers ($5,418); other general supplies ($6,317).

Purchased services

  • Other is overspent $224,250:  This financial caption includes amounts paid to independent contractors and paid volunteers (immunizers) augmenting the WECHU capacity to administer COVID-19 Vaccinations in various settings.  More specifically:
    • Total hours incurred on account of direct client service at a mass vaccination clinic were 7,109 hours or $199,937. 
    • Total hours incurred on account of call centre activities, support booking vaccination appointments were 1,637 hours or $100,681. 
    • Total hours incurred on account of other activities associated with planning were 216 hours or $6,520.
      In addition, costs were incurred on account of legal, namely the writing and review of legal agreements with the COVID-19 Vaccination Program totaling $33,075.
  • Transportation is underspent $115,187:  The budget for this financial caption was developed based on the WECHU’s COVID-19 Vaccination plan submitted to the Ministry of Health in January of 2021.  The WECHU plan focused on the distribution and administration of vaccines through physicians and pharmacies thus resulting in the WECHU incurring additional costs associated with transportation (couriers).  The provincial vaccination plan varied from the WECHU plan, with a focus on vaccine administration at mass vaccination clinics.  Physicians and pharmacists were on-boarded later on in the process.
  • Translation and interpretation was overspent $38,699:  This financial caption includes translation and interpretation costs to support mass vaccination clinics and mobile clinics.  The budget did not appropriately contemplate the volume of vaccinations to be delivered in a mass vaccination setting.

ONTARIO SENIORS DENTAL CARE PROGRAM

  BUDGET
2021
YTD BUDGET
06 30 2021
YTD ACTUAL
06 30 2021
VARIANCE
TO BUDGET
YTD ACTUAL
06 30 2020

Salaries and employees benefits

1,086,828

543,414

473,601

69,813

435,570

Other operating expenditures:

         
  Association and membership fees 2,000 1,000 1,253 (253) 1,294
  Mileage 15,000 7,500 4,683 2,817 3,142
  Professional Development 3,000 1,500 - 1,500 2,035
  Program supplies and other:          
    Bank Charges 1,000 500 263 237 183
    Clinic supplies and other 397,372 198,686 140,939 57,747 100,705
    Office supplies 4,000 2,000 - 2,000 833
  Purchased services:          
    Professional services 150,000 75,000 82,746 (7,746) 9,508
    Security 11,500 5,750 3,753 1,997 1,742
  Travel and meetings 4,000 2,000 - 2,000 4
Total expenditures 1,674,700 837,350 707,238 130,112 555,016
           
Less: Offset Revenue - - 1,907 1,907 -
Total net expenditures 1,674,700 837,350 705,331 132,019 555,016

The Ontario Seniors Dental Care Program (OSDCP) supports eleven and one-half (11.5) FTEs comprised of one and one-half (1.5) manager FTEs, one and one-half (1.5) dentist FTEs, three (3.0) dental hygienist FTEs, three (3.0) dental assistant FTEs, one (1) health promotion specialist FTE and two (2) support staff FTEs.

Variances from budget at June 30, 2021 are as follows:

  • Salaries and benefits are underspent $69,813 - This variance predominantly relates to: i) Deployment of one (1) manager FTE for the period January 1, 2021 to April 30, 2021, to support COVID-19 Response, representing a decrease in salaries and benefits of $43,571; ii) Delay in the recruitment of a second dentist supporting the OSDCP, and Healthy Smiles Ontario Program, representing a decrease in salaries and benefits of $8,600.
  • Mileage, Travel and meetings, Professional Development are underspent $6,317 - These financial captions continue to be underutilized due to the on-going impact of the COVID-19 Pandemic.   Virtual or telephone conferencing continues to be leveraged to engage with clients and/or partners.  Professional development is completed on an “as needed basis”.
  • Clinical supplies and other are underspent $57,747 - This financial caption is directly impacted by client volumes/visits.  For the period January to June 2020, the WECHU dental clinic had 272 visits from 148 OSDCP clients.  For the period January to June 2021, the WECHU dental clinic had 1,590 visits from 582 OSDCP clients.  Year-over-year increase in expenses is reasonable.  In terms of the variance from budget, the WECHU is relatively early in its experience administering the OSDCP.  The WECHU will continue to collect data on the experience/utilization of supplies to support a more accurate estimate of expenditures in future budget processes.
  • Professional services are overspent by $7,746 - This financial caption includes translation and interpretation costs, fees paid on account of a denturist and dentist, lab fees and fees paid on account of oral surgery referrals.  In terms of the variance from budget, and similar to clinical supplies and other, the WECHU is still relatively early in its experience administering the OSDCP.  The WECHU will continue to collect data and experience to support more accurate estimates of professional services expenditures in subsequent budgeting processes.  Details of Professional services as at June 30, 2021 are as follows:
Service Amount
Translation and interpretation $9,760
Denturist and lab fees 58,286
Dentistry including oral surgery 13,782
Other 918
Total 82,746

FINANCIAL INFORMATION FOR RELATED PROGRAMS FUNDED 100% BY THE MOHLTC

  2021/2022
BUDGET
YTD ACTUAL
06 30 2021
VARIANCE
TO BUDGET
Mandatory programs: Public Health Inspector
Practicum Program
20,000 - 20,000
School-Focused Nurses Initiative 1,900,000 339,892 1,560,108
  1,920,000 339,892 1,580,108

Note:  All funding approvals are for the period April 1, 2021 to March 31, 2022.

Public Health Inspector Practicum Program:  This one-time funding supports the hiring of two Public Health Inspector Practicum positions.  Eligible costs include student salaries, wages and benefits, transportation expenses associated with practicum positions.  At June 30, 2021, a recruitment for public health inspector practicum students had not yet been completed.

School-Focused Nurses Initiative:  This funding supports the hiring of 19 nurses to creating additional capacity to provide rapid-response support to school boards and schools, facilitating public health and preventative measures related to the COVID-19 Pandemic.  At June 30, 2021, $339,892 were incurred on account of salaries and benefits. The WECHU anticipates being on-budget for this program initiative at March 31, 2022.

Approved by: Nicole Dupuis


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