Board of Health Meeting Documents

1. DEFINITIONS
   1. “Wrongdoing” for the purposes of this Policy includes the following:
      
      1. contravention of any law or regulation applicable to the Health Unit;
      2. act or omission that creates a substantial and specific danger to the life, health or safety of individuals other than a danger inherent in the performance of the duties or functions of an employee, external contract worker, student or volunteer, as the case may be;
      3. an act or omission that creates a substantial and specific danger to the environment;
      4. gross mismanagement of public funds or a public asset;
      5. material violation of Health Unit policies;
      6. contravention of any material contractual commitment of the Health Unit; and
      7. counselling an individual to commit any of the above,
         that has already occurred, is in the process of occurring or is about occur.
   2. “Reprisal” includes any adverse action taken against an employee, external contract worker, student or volunteer, as the case may be, who seeks advice on making a report of Wrongdoing, makes a report of Wrongdoing, or co-operates in an investigation of Wrongdoing, or declines to participate in a Wrongdoing.  Examples of Reprisal include:  a dismissal, layoff, suspension, demotion or transfer, discontinuation or elimination of a job, change of job location, reduction in wages, change in hours of work or reprimand, or any other adverse measure (e.g., bullying), and/or threats to do any of the foregoing.
2. PURPOSE
   1. Recognizing that whistle blowing is an important element of transparency and that transparency in turn contributes to accountability, the board of the Health Unit has enacted By-laws requiring the establishment of a transparency framework, including a whistle blowing policy.  The purposes of this Policy are to:
      
      1. Implement the By-law requirements.
      2. Facilitate the reporting of Wrongdoing.
      3. Protect those who report Wrongdoing, investigate Wrongdoing, or take action subsequent to a finding of Wrongdoing, so that such reporting, investigation and action can be undertaken without fear of Reprisal.
      4. Provide for the appropriate management of reports of Wrongdoing.
      5. Promote public confidence in the Health Unit.
3. APPLICATION
   1. Applies To.  This Policy applies to Health Unit board members, employees, external contract workers, students and volunteers.
4. GUIDING PRINCIPLES
   1. Implementation of this Policy will be guided by the following principles and policy statements:
      
      1. The Health Unit complies with all relevant laws and regulations.
      2. All policies support and embody the Health Unit’s core values.
      3. The Health Unit maintains high standards of business and ethical conduct and applies these standards to all matters of business.
      4. All reports of Wrongdoing will be dealt with promptly, be fully reviewed and/or investigated as appropriate in a fair and equitable manner, ensuring a respectful process is followed for all those involved.
      5. There will be no Reprisals against anyone reporting Wrongdoing in good faith under this Policy, investigating Wrongdoing or taking action subsequent to a finding of Wrongdoing.
      6. Confidentiality will be protected to the maximum extent possible.
5. INTERNAL REPORTING
   1. Reporting Responsibility.
      
      1. Individuals becoming aware of Wrongdoing must report the same as soon as possible.
      2. Reports of Wrongdoing should include the following:
         
         1. a description of the Wrongdoing;
         2. the name of the individual or individuals involved in the Wrongdoing;
         3. the date of the Wrongdoing; and
         4. any additional information that may reasonably be required in order to investigate the Wrongdoing.
   2. Acting in Good Faith.
      
      1. In making a report of Wrongdoing, an individual must act in good faith and on reasonable grounds.
      2. An individual who makes a report of Wrongdoing knowing it to be false or makes it with malicious intent, may be subject to discipline, up to and including termination.
   3. Confidentiality.
      
      1. Anyone involved in a report process will keep the matter confidential to the maximum extent possible, consistent with the Health Unit’s legal and ethical responsibilities, including the need to conduct an effective investigation and comply with the Municipal Freedom of Information and Protection of Privacy Act.
      2. Confidentiality may not mean anonymity.
      3. The Health Unit will accept reports under this Policy on an anonymous basis.
      4. The Health Unit will not tolerate any attempts to identify an individual who reports in good faith on a confidential or anonymous basis.
   4. Internal Reporting Targets and Investigation Responsibility
      

      1. “Individual” Being Reported	Reported To	Investigated By
         Chair	Reporter’s manager, Director, Human Resources , AMOH, MOH, CEO or board vice-chair	Committee of 3 appointed by the rest of the board based on skills/expertise, in consultation with qualified external party selected by the committee
         Board member (other than Chair)	Reporter’s manager, Director, HR Director, AMOH, MOH, CEO or board chair	Committee of 3 appointed by the rest of the board based on skills/expertise, in consultation with qualified external party as selected by the committee.
         Board as a whole	Reporter’s manager, Director HR Director, AMOH, MOH or CEO	CEO in consultation with qualified external party as selected by the CEO.
         CEO	Reporter’s manager, HR Director, AMOH, MOH (if different from CEO) or board chair	Committee of 3 appointed by the board based on skills/expertise, in consultation with qualified external party selected by the committee
         MOH	Reporter’s manager, Director, HR Director, AMOH, CEO (if different from MOH) or board chair	Committee of 3 appointed by the board based on skills/expertise, in consultation with qualified external party selected by the committee
         	Subject to professional obligations of the reporter and the nature of the report, report may also be required to The College of Physicians and Surgeons of Ontario.
         AMOH	Reporter’s manager, Director, HR Director, MOH, CEO or board chair	Committee of 3 appointed by the board based on skills/expertise, in consultation with qualified external party selected by the committee
         	Subject to professional obligations of the reporter and the nature of the report, report may also be required to The College of Physicians and Surgeons of Ontario.
         Directors	Reporter’s manager, HR Director (unless reporting HR Director), AMOH, MOH, CEO or board chair	Committee of 3 appointed by the board based on skills/expertise, in consultation with qualified external party selected by the committee
         Managers, other employees or external contract workers who are regulated health professionals and students studying to become regulated health professionals	Reporter’s manager, director, HR Director, AMOH, MOH or CEO	CEO in conjunction and consultation with such persons as the CEO determines appropriate.
         	Subject to professional obligations of the reporter, the status of the individual being reported as a regulated health professional and the nature of the report, report may also be required to the professional college of the individual being reported.
         Other employees, external contract workers, students and volunteers	Reporter’s manager, HR manager, AMOH, MOH or CEO	CEO in conjunction and consultation with such persons as the CEO determines appropriate.

      2. Any individual who receives a report of Wrongdoing shall notify:
         
         1. the chair, if the CEO is the subject of the report;
         2. the vice-chair, if the chair is the subject of the report;
         3. otherwise, the CEO.
   5. INVESTIGATION OF WRONGDOING
      1. Accountability.  Those who have an investigation responsibility as detailed above are accountable for ensuring a report of Wrongdoing is investigated in accordance with this Policy.
      2. Principles.  Investigations of Wrongdoing will be conducted based on the following principles:
         
         1. The investigation will be carried out fairly and without bias.
         2. Those involved in the investigation will be independent of both the person who made the report and any persons under investigation.  This means they should not either be reporting to, or supervising, any such persons.
         3. Appropriate action shall be undertaken to preserve evidence.
         4. Disclosure of information will be limited to those who need to be involved in order to carry out the investigation.
         5. The person who is the subject of the report is entitled to know the substance of the allegation(s) and have an opportunity to respond.  Knowing the identity of the person who made the report is not a part of this and should not be disclosed.
         6. Investigations will be conducted in a timely manner.
         7. Investigations will be conducted in a manner which is as sensitive as possible to any fears of Reprisal.
         8. Individuals are required to cooperate during any investigation.
      3. Report. Those who are responsible to investigate Wrongdoing shall conclude their investigation with a written report, including recommendations.  The report shall be submitted to:
         
         1. the CEO, unless the subject of the report is the CEO; and
         2. the Chair, if the subject of the report is the CEO, MOH, AMOH, Director or any member of the board.
   6. ACTION SUBSEQUENT TO INVESTIGATION
      1. Accountability.  Subsequent to any investigation pursuant to this Policy, the CEO is accountable for ensuring that appropriate action is undertaken in connection with any finding of Wrongdoing by any employee, external contract worker, student or volunteer.  The board is accountable for ensuring that appropriate action is undertaken in connection with any finding of Wrongdoing by any board member.
      2. Types of Action.  The actions that may be taken to address a Wrongdoing will depend on the particular circumstances, and consequences may include, but are not limited to, discipline up to and including termination.
      3. Communication with Reporter.  The individual who made the report of Wrongdoing should be notified that the investigation is complete, and what (if any) recommendations are made based on the findings of the investigation.
   7. PROTECTION FROM REPRISAL
      1. No Reprisal.  Individuals reporting Wrongdoing in good faith under this Policy will not suffer Reprisal, even if after the investigation has been completed the Wrongdoing has not been substantiated.
      2. Report Reprisal.  Individuals who experience any form of Reprisal before or after submitting a report of Wrongdoing should report the same as a further Wrongdoing.
      3. Consequences for Reprisal.  An individual who commits any form of Reprisal against another individual involved in reporting, investigating or taking subsequent action in connection with a Wrongdoing will be subject to discipline, which may include termination.
      4. Statutory Protection.  It is noted that:
         
         1. Criminal Code.  Section 425.1 of the Criminal Code makes it a criminal offence for employers, anyone acting on behalf of an employer, or a person in a position of authority over an employee, to adversely affect or threaten to adversely affect the employee’s employment, or threaten to, in order to force the employee to refrain from providing information to law enforcement officials about the commission of an offence by his or her employer or by an officer, employee or board member of the employer.  However, employees are only protected if they approach a person whose duties include law enforcement.  They are not given protection if they contact a media source or an outside agency or advocacy group.
         2. Other.  It is further noted that there are other statutory protections against Reprisal embedded in certain provincial legislation, including human rights, occupational health and safety and environmental protection legislation.
   8. RECORDS
      1. Separate and Secure.  Records of reports of Wrongdoing and related investigations must be clearly marked and kept separate from other records and stored in a secure location with access limited to those who have a need to know.
      2. Not in Personnel Files.  No records of Wrongdoing will be kept in any personnel files unless there has been a finding of Wrongdoing that results in disciplinary action.  In that case, the outcome of the investigation will be reflected in the personnel file.
   9. SUPPORT FOR INDIVIDUALS
      1. Anyone involved with reporting a Wrongdoing, investigating a Wrongdoing, taking subsequent action to a finding of Wrongdoing or is the subject of a report of Wrongdoing, is encouraged to use the confidential counseling service that is available to all individuals through the Health Unit’s employee assistance program.
   10. REPORTING
       1. The CEO shall report any finding of Wrongdoing to the board that is within the scope of the CEO’s reporting obligations pursuant to the By-laws.
   11. RELATED POLICIES
       1. Code of Conduct.

A by-law respecting the financial and asset management of the Board of Health for the Windsor-Essex County Health Unit (“Health Unit”) passed under the Health Protection and Promotion Act, R. S.O. 1990, c. H.7 (“HPPA”)

ENACTED by the Board this _____ day of  ______________, 2022                             

Chair

Secretary

To be reviewed no later than the _____ day of  ______________, 2024

A by-law respecting the management of real property of the Board of Health for the Windsor-Essex County Health Unit.

1. The Chief Executive Officer or their designate, shall be responsible for the care and maintenance of all properties owned by the Board), including but not limited to, the following:
   
   1. The repair and maintenance of building systems such as heating and cooling systems, roof, structural work, plumbing, electrical systems;
   2. The repair and maintenance of the parking areas and exterior of buildings, where applicable;
   3. The care and upkeep of the grounds of the property, where applicable;
   4. The cleaning, maintaining, decorating, and repairing of the interior of the buildings, where applicable; and
   5. The maintenance of up-to-date fire and liability insurance coverage.
2. Where a property is leased by the Board, the Board shall enter into a lease that addresses all maintenance, care and insurance requirements. The Chief Executive Officer shall be responsible for ensuring that the property is operated in accordance with the terms of any such lease.
3. The Board shall ensure that all such properties comply with all applicable local, provincial and/or federal statutory requirements (I.e.  Building codes and fire codes).
4. The Board shall maintain and adopt policies with respect to the acquisition, sale and other disposition of real property.   The Real Property Management Policy will be reviewed on a three (3) year basis, or more frequently, if appropriate.  The CEO shall report asset disposals to the Board annually as per the Health Unit’s Real Property Management Policy.

ENACTED by the Board this _____ day of  ______________, 2022                             

Chair

Secretary

To be reviewed no later than the _____ day of  ______________, 2024

PREPARED BY

Planning and Strategic Initiatives Department

DATE

May 19, 2022

SUBJECT

2022 Board Self-Assessment Survey

BACKGROUND/PURPOSE

The Ontario Public Health Standards (2021), under the Good Governance and Management Practices Domain, states: “the board of health shall have a self-evaluation process of its governance practices and outcomes that is completed at least every other year. Completion includes an analysis of the results, board of health discussion, and implementation of feasible recommendations for improvement, if any”. 

In order to meet this requirement, the WECHU developed a competency based self-evaluation survey for Board of Health (BOH) members. The survey includes twelve competency areas used to identify the strengths of the BOH, as well as opportunities to provide additional training and support for the BOH.

DISCUSSION

The survey will be sent to current BOH members via email in May 2022. A report will be presented to BOH members in early summer 2022. Upon request, Board members will receive individual reports, which compare their competency scores to the overall group scores, and will identify strengths and areas for potential improvement.

PREPARED BY

Epidemiology and Evaluation Department

DATE

May 4, 2022

SUBJECT

COVID-19 Surveillance and Epidemiology – April, 2022

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 the 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. Due to these changes, data from before December 31, 2021 should not be compared to data after the testing changes.

Trends

In the month of April, the health unit reported 3,131 confirmed high-risk cases of COVID-19. As the weeks progressed in April, the weekly high-risk incidence rate decreased from 187.6 cases per 100,000 population (Week 14) to 112.0 cases per 100,000 population (Week 17).  

In-Patient and ICU Admissions

In April, in-patient COVID-19 hospitalizations remained relatively stable in Windsor-Essex County although there was an increase at the beginning of the month. A total of 266 new COVID-19 related patients were admitted to local hospitals.

Percent Positivity

Locally, Windsor-Essex County continued to experience an incremental increase in percent positivity for the first three weeks in April, followed by a decrease during the last week. This is in contrast to week-to-week increase observed in March. The local percent positivity rate for COVID-19 declined to approximately 13.8% in the last week of the month. It is also important to note that these were for high-risk individuals that were eligible for testing.

Wastewater Surveillance

For the month of April, viral signal for COVID-19 in wastewater saw a significant increase for the first two weeks, followed by a decline during the last two weeks. Current levels are beginning to reach levels observed during the onset of the Omicron wave in December 2021.  

Outbreaks

In the month of April, 40 outbreaks were declared in high-risk settings compared to the 21 outbreaks in March. This includes 21 outbreaks in long-term care and retirement homes, 9 in hospital settings, and 10 in other congregate settings. As of April 30th, there were 29 active outbreaks in the Windsor-Essex County region.

Deaths

For the month of April 2022, 17 deaths were reported that were attributed to COVID-19. This is similar to the number of deaths reported in March.

DISCUSSION

With the changes in testing eligibility, and guidance with case, contact, and outbreak management, the health unit has modified its public reporting to better understand the burden of illness locally. New indicators, such as wastewater data, have been included as a proxy indicator for COVID-19 case counts, which are underestimated. 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.

PREPARED BY

Infectious Disease Prevention – COVID Response

DATE

May 19, 2022

SUBJECT

COVID-19 Case and Contact Management- Q1 2022 Report

BACKGROUND/PURPOSE

Due to the unique characteristics of the Omicron variant, the Case and Contact Management (CCM) guidelines and testing eligibility were revised to ensure that workers and families in highest risk settings are protected implementing changes to Ministry guidance documents. As a result of the changes to the provincial guidance in the context of Omicron, the WECHU is only investigated COVID-19 cases associated with highest risk settings (e.g. hospitals, congregate settings, long-term care homes). During Q1, Non-highest risk cases were contacted to ensure isolation was implemented and education and other resources provided. There was a need for redeployment of WECHU staff from various departments to manage this surge associated with the Omicron variant.

DISCUSSION

The Omicron surge brought with it changes to CCM and isolation guidelines to ensure those living, volunteering, and working in the highest risk settings continue to be protected. The CCM Team updated practice to align with the current Ministry guidance, including the creation of CCM tip sheets for various highest risk settings (e.g., Long-term Care Homes/Retirement Homes and hospitalized patients). To help residents navigate the various changes to COVID-19 testing and isolation requirements, the Team collaborated with the Communications Department to provide up-to-date content and guidance changes for the WECHU website. This included changes to workplace and school screening and instructions for non-highest risk settings (e.g., schools, daycares, workplaces).

In January 2022, the Province of Ontario updated its COVID-19 guidance for seasonal IAWs, in order to manage cases and close contacts and control the ongoing transmission of COVID-19 in farm operator-provided accommodations. This guidance required that third-party health assessments be provided for all IAWs exposed to, or testing positive for, COVID-19 and their close contacts. CCM staff collaborated with staff from the EH department to create the COVID-19 Farm Operator Communication Guidance document that summarized the recent changes and resulting process updates. This information was shared during a live webinar for farm operators and provided WECHU an opportunity to address any questions or outstanding issues.

Investigations Conducted

Despite the shift in case and contact management guidance to investigating only cases associated with highest risk settings, staff completed 14, 295 case investigations between January 1, 2022 to March 31, 2022.

Partnerships

Partnerships, both internally and externally, have been integral to CCM and have occurred throughout the pandemic. The WECHU has numerous community partners, including the City of Windsor, the Canadian Red Cross and the Windsor-Essex Emergency Medical Services (EMS) who together, ensure that individuals who need isolation support and health assessments receive these services (e.g., at the Isolation and Recovery Centre [IRC]).

The WECHU partnered with Community Living Windsor and Essex, to build the capacity of their staff to conduct COVID-19 testing on staff and residents. Windsor-Regional Hospital continues to partner in CCM, providing information required to complete case and contact investigations and infection prevention and control measures in outbreaks. Internally, the CCM staff work with the Outbreak Team/Infectious Disease Prevention Department, and the Environmental Health Department (EH) (i.e., Public Health Inspectors) to manage and identify outbreaks related to the highest risk settings.

SUMMARY

The COVID-19 pandemic has created opportunities for WECHU staff to work together to provide support and educational resources to a variety of sectors. The WECHU is committed to working with community partners and conducting CCM in a timely fashion to prevent the spread of COVID-19. The team will continue to revise plans as Ministry guidelines and direction change.

SUBMITTED BY

Communications Department

DATE

May 19, 2022

SUBJECT

March 15 – April 14, 2022 Communications Update

BACKGROUND/PURPOSE:

Provide regular marketing and communication updates to the Board of Health.

Data Notes can be provided upon request.

Media Exposure Overview Graph

Website Overview Graph

Discussion

Current notable projects that the department is working on.

We are promoting the arrival of the GO-VAXX bus for COVID-19 vaccinations in Leamington on May 2 and 3. This was a collaboration between the WECHU and the Municipality of Leamington through multiple media channels.

Food Handler Certification Examinations news release was issued on Tuesday, April 5.

The Communications department is maintaining marketing and communication efforts regarding COVID-19 vaccinations in the region with our partners. In particular, the COVID-19 pop up clinics in the community and at WECHU offices.

We continue to provide support for the Catch-Up Immunization Clinics for Students in Grades 7 to 12 that will occur until August in multiple locations throughout Windsor and Essex County.

PREPARED BY

Environmental Health Department

DATE

May 19, 2022

SUBJECT

2022 Vector-borne Surveillance Program

BACKGROUND/PURPOSE

The Environmental Health Department delivers a vector-borne surveillance program to monitor West Nile Virus (WNV), Eastern Equine Encephalitis (EEE), Zika Virus and Lyme disease activity in Windsor and Essex County (WEC). The program is required under the Health Protection and Promotion Act and provides the community with an early warning system for disease transmission through ticks and mosquitoes known as vector-borne diseases. This program is made up of the following components: mosquito larval surveillance and larviciding, adult mosquito trapping, human case surveillance for WNV and Lyme disease, public education, and active tick surveillance. The tasks of mosquito larval surveillance and control, along with mosquito identification and viral testing, are performed by contracted agencies on behalf of the WECHU.

DISCUSSION

Active Tick Surveillance

Lyme disease is a vector-borne disease caused by the bacterium Borrelia burgdorferi. It is transmitted to humans through the bite of infected black-legged ticks. The WECHU's role is to measure and evaluate the risk of this tick-borne disease in our area.

Active surveillance is used to assess the local distribution and incidence of black-legged ticks in WEC. It involves the dragging of a white cloth through grassy areas whereby ticks attach themselves to the fabric and can be easily spotted and identified. Any black-legged ticks identified are sent to an accredited laboratory for testing of Lyme disease. Tick dragging is performed twice yearly in the spring and the fall.

This year tick dragging will be conducted at the following four sites during the months of May and September:

• Ojibway Prairie Nature Reserve
• Chrysler Greenway
• Gesstwood Camp and Education Centre
• Ruscome Shores Conservation Area

Mosquito Surveillance

Adult mosquito surveillance is an important component of the vector-borne disease program and involves the deployment of black-light CDC traps and BG-Sentinel 2 (BGS-2) traps at various locations throughout WEC.

The CDC traps are equipped with light and dry ice that attracts and traps the mosquitoes. These traps capture mosquitoes for testing to determine the presence of WNV and EEE in our region. BG-Sentinel 2 (BGS-2) traps are species-specific traps set up to catch invasive species of mosquitoes (Aedes albopictus and Aedes aegypti) that were identified during routine WNV surveillance in WEC in 2016. These traps use a scent lure and dry ice to attract daytime mosquitoes and are set up in high-traffic areas (such as near transport routes and industrial cargo areas) as well as in residential homes. The trapped mosquitoes are sent to an accredited laboratory for identification and testing to determine if any of the mosquitoes carry the WNV, EEE or Zika virus.

The trap deployment will start on May 25, 2022, and run until mid-October. Once a week, 50 mosquito traps (26 CDC light traps and 24 BGS 2 traps) will be set up across WEC to collect mosquitoes for identification and viral testing. The weekly mosquito surveillance data will be made available on the WECHU's Mosquito Surveillance Dashboard.

Human case Surveillance

The human case surveillance program identifies human cases of WNV and Lyme disease in WEC to determine the source of the disease. Physicians and hospitals must report all probable and confirmed cases to the WECHU.

The health unit investigates all suspected, probable and confirmed WNV and Lyme disease cases among WEC residents based on case definitions developed by the Ministry of Health (MOH). Standardized medical information, including demographics, symptoms, risk factors (such as travel history or having received blood products) and test results, are entered into the MOH's Integrated Public Health Information System (iPHIS). Through case interviews and GIS mapping, the health unit identifies clusters and geographic areas that may need targeted intervention.

Fight the Bite! Campaign

Fight the Bite! Public awareness campaign will launch in July 2022. It will focus on the prevention of mosquito breeding sites, information on tick removal, signs and symptoms of WNV and Lyme disease, and personal protection. Messages and promotional materials will be developed to reach priority populations and inform the public of hot spots identified through previous monitoring efforts. This event is done in conjunction with health unit external stakeholders such as municipalities and other health units.

Board Members Present:

Gary McNamara, Joe Bachetti, Tracey Bailey, Rino Bortolin, Fabio Costante, Gary Kaschak, Judy Lund, Robert Maich, Mark Ferrari

Board Member Regrets:

Ed Sleiman, Aldo DiCarlo

A SHORT-TERM VISION FOR LOCAL PUBLIC HEALTH PRIORITIES AND PLANNING IN WINDSOR-ESSEX

The COVID-19 pandemic has dramatically influenced the focus of local public health efforts and resources. COVID-19 has disrupted public health programing, created a backlog of public health services, and impacted established partnerships. As well, the pandemic has furthered existing health inequities and depleted health care capacity, expanding the health disparity gap for those most in need of support. Immediate plans and services will ensure a focus on those disproportionately affected by the pandemic. 

While public health must continue to remain vigilant in response to the pandemic, it is necessary for local public health efforts to shift toward other pressing public health concerns. The WECHU will proceed cautiously, balancing the continued COVID-19 emergency response with incremental and strategic steps forward. This will include ongoing assessment of health needs and public health capacity. Longer-term renewal and transformation efforts will require internal capacity building, ongoing assessment and surveillance to ensure that resources align with the needs of residents. This will include addressing organizational readiness and capacity building to achieve community-based goals. This short-term focused set of priorities will direct our planning and actions in specific areas, providing the most value to the community.

The Windsor-Essex County Health Unit (WECHU) will work towards re-establishing and catching up on mandated program areas where the WECHU is the sole or a primary service provider. These programs include services such as health inspections, dental services (for qualifying children and adults), new parent supports (for qualifying parents), required school-aged immunizations, and infection prevention and control supports for the community. Beyond these core programs and services, the WECHU has identified mental health, substance use, and healthy growth and development as priorities for immediate response. These priorities will set the direction for the Windsor-Essex County Health Unit for the 2022 year.

Goal

Renew public health services to address immediate local public health needs and address service backlogs as the COVID-19 pandemic stabilizes. Development of a foundation for sustained long-term support for public health transformation based on local priorities.

Short-Term Priorities

Health Assessment and Surveillance

• Assessing the impact of COVID-19 on local population health outcomes to inform long-term priorities.
• Assessing partner resources and direction to support local public health priorities while the COVID-19 pandemic stabilizes.
• Providing data and support to the community based on assessments to support long-term planning for program renewal and transformation.

Addressing Backlog of Services

• Restart dental health screenings in schools with increased supports for high and moderate risk schools.
• Increasing support for qualifying dental service groups (i.e., children and seniors).
• Routine support for school-age vaccinations.
• Completing all infectious disease investigations in a timely manner.
• Completing all outstanding inspections across the community in a timely manner.
• Enrolling and engaging all qualifying parents in the Healthy Babies, Healthy Children program.
• Providing community support for infection prevention and control practices.

Mental Health and Substance Use

• Development of long-term plans/supports based on the assessment of local needs, partner service plans, and evidence-based interventions.
• Mental health and substance supports for school-aged children and youth, families, and workplaces.
• Enhanced support for existing mental health programs/services provided by the Windsor-Essex County Health Unit.
• Enhanced support for existing substance use programs/services provided by the Windsor-Essex County Health Unit.

Healthy Growth and Development

• Increased support for positive parenting.
• Support for maternal mental health through new or existing programs and services.
• Breastfeeding support for new mothers.

Capacity Building

• Staff re-orientation, training, and preparation for response to long-term local public health priorities.
• Assessing and providing internal support for burnout and mental health considerations because of the COVID-19 pandemic response.

Recommendation/Resolution Report
2022/23 Budget for Programs Funded by the Ministry of Children, Community and Social Services

MAY 19, 2022

ISSUE/PURPOSE

The Windsor-Essex County Health Unit (WECHU) administers the Healthy Babies Healthy Children Program and the Pre-natal and Post-natal Nurse Practitioner Program (collectively referred to as the Programs).  These Programs are funded entirely by the Ministry of Children, Community and Social Services (MCCSS).  The operating budget for the fiscal year April 1, 2022 to March 31, 2023, requires approval by the Board of Health prior to submission to the MCCSS.

BACKGROUND

For fiscal 2022/23, these Programs support twenty-five and three quarters (25.75) FTEs comprised of one (1.0) manager FTE, one-quarter (0.25) director FTE,  sixteen (16.0) public health nursing FTEs, one (1.0) nurse practitioner FTEs, four (4) family home visitor FTEs, one (1.0) social worker FTE, two and one-half (2.5) support staff FTEs.

The 2022/23 operating budget is detailed below:

Significant changes in the operating budget include the following:

• Increase in Salaries and Benefits $129,008 - The 2021/22 fiscal year contemplated a more fluid staffing complement to support the WECHU’s COVID-19 Pandemic response, including case and contact management and vaccinations.  For example, in Q1 and Q2 of 2021/22, the public health nursing FTE complement was 6 and 4 respectively, grading upward in Q3 and Q4.  Conversely, the social worker FTE complement in Q1 and Q2 of 2021/22, was 2 and 10 respectively, grading downward in Q3 and Q4.  The 2022/23 budget contemplates staffing to return to pre-pandemic levels. 
• Reduction in Mileage of $10,000 – The 2022/23 fiscal year contemplates staff re-orienting to the Programs.  In addition, it is anticipate that client visits will be a hybrid of in-person and virtual.
• Reduction in Professional development of $11,600 – The 2021/22 fiscal year contemplated substantially higher professional development costs due to the fluctuation in the staffing complement throughout the fiscal year.
• Reduction in Program Supplies of $101,608 – The fiscal 2021/22 budget contemplated expenditures being incurred on account of information technology hardware and software to address increased FTEs. 
• Reduction in Purchased Services of $5,800 – The fiscal 2021/22 budget contemplated the costs of the annual financial statement audit.  For 2022/23, it is anticipated that these costs will be borne by the Cost-Share Budget. 

PROPOSED MOTION

Whereas, The Windsor-Essex County Health Unit receives grants from the Ministry of Children, Community and Social Services to fund the Healthy Babies Healthy Children and Pre-natal and Post-natal Nurse Practitioner Programs,

Whereas, the total budgeted expenditures for the Programs for the period April 1, 2022 to March 31, 2023 is $2,894,941, and

Now therefore be it resolved that the Windsor-Essex County Board of Health approve the operating budget as presented by Administration for the period April 1, 2022 to March 31, 2023

Meeting held via video: https://youtu.be/3wmW8cdpJW4

PREPARED BY

Records Coordinator & Privacy Officer

DATE

April 21, 2022

SUBJECT

2021 IPC Annual Statistical Reporting 

BACKGROUND

The WECHU is a “health information custodian (HIC)” in accordance with section 3 of the Personal Health Information Protection Act (PHIPA), and an “institution” in accordance with section 2 of the Municipal Freedom of Information and Protection of Privacy Act (MFIPPA). Under this legislation the WECHU has obligations to ensure the rights of individuals with respect to privacy, access and correction of records of personal information (PI) and personal health information (PHI), and access to general records that pertain to the WECHU operations and governance.

All institutions under MFIPPA, and HICs under PHIPA, are required to provide statistical reports to the Information and Privacy Commissioner of Ontario (IPC) on an annual basis with respect to:

• Confirmed privacy breaches under PHIPA (Appendix A)
• Access and correction requests under PHIPA (Appendix B)
• Access and correction requests under MFIPPA (Appendix C)

The WECHU submitted statistical reports for each category by the required deadline of March 1st for PHIPA reports and March 31st for MFIPPA.

DISCUSSION

Privacy breaches

In 2021, the WECHU had eight confirmed breaches, compared to thirteen in 2020. Privacy breaches in 2021 predominantly included incidents where PI and/or PHI was emailed or faxed to the wrong person and/or organization.

The WECHU is looking at various ways to prevent breaches of this manner through training and investigating additional email security options.

MFIPPA Access and correction to information requests

In 2021, the WECHU received thirty-eight formal MFIPPA access requests, compared to thirty-five in 2020, and zero correction requests during the reporting year. One of the requests was transferred to Statistics Canada. Thirty-one of the requests were completed within the reporting year and six of the requests carried over to the 2022 reporting year.

Of the thirty-eight access requests completed in 2021, the majority of requests came from an “individual by agent” or lawyer (48%). This was followed by “individual/public” (29%), “business” (13%), and “media”, “government” and “other” (3% each).

PHIPA Access and correction to information requests

In 2021, the WECHU received five formal PHIPA access requests and sixty-two formal correction requests during the reporting year. This was a significant increase from 2020 due to the WECHU’s involvement in supporting the proof of COVID-19 vaccination certificate program, as well as in the implementation of a COVax client access and correction process.

CONCLUSION

In summary, 81% of all MFIPPA requests and 100% of all PHIPA requests were completed within the statutory time limits, despite the operational impacts of the pandemic. Priorities for the coming year will include continued dedication of resources for the access to information and privacy program, including additional training, and class customization within the WECHU’s M-Files system. These actions will improve records and information management (RIM) within the program, and allow the WECHU to respond with increased efficiency to information requests.

PREPARED BY

Oral Health Department

DATE

April 21, 2022

SUBJECT

WECHU Oral Health Services and Oral Health Month

BACKGROUND

April is Oral Health Month. Oral health is a critical component of overall health and well-being. Oral Health month highlights the importance of good oral health practices and the role of dental professionals in improving community oral health.

In Ontario, one in every three people do not have access to dental insurance, requiring  them to pay out of pocket for ongoing and urgent oral health needs (StatsCan, 2018). We know in Windsor-Essex, to avoid the high cost of dental bills, many individuals forgo treatment impacting their overall quality of life (WECHU, 2018).  The Healthy Smiles Ontario (HSO) program, offered for qualifying children under the age of 18,  the Ontario Seniors Dental Care Program (OSDCP) for qualifying seniors 65 years and older, offer opportunities for routine, emergency and urgent dental services at no cost. The provincial Ministry of Health’s Oral Health Protocol (2021) provides direction to local public health units for the delivery of these oral health services, as well as oral health screening, and oral health promotion and education.

DISCUSSION

Oral Screening, Assessment and Surveillance

In 2021, COVID-19 impacted many public health programs and services, including the WECHU’s oral health program. While clinical services offered through HSO and OSDCP experienced some setbacks and delays through 2021, the WECHU was unable to complete school dental screening.   As part of the Oral Health Protocol (Ministry of Health, 2021), all public health units implement dental screening for all students in Junior Kindergarten (JK), Senior Kindergarten (SK), and Grade 2. Screenings are completed by registered dental hygienists and certified dental assistants during the school day. Oral health screening requires the collection of the total number of decayed, missing and filled teeth (DMFT). Data on DMFT is used to determine if additional grades are also to be screened. Following the Oral Health Protocol, schools that are identified as medium risk also receive screening for all Grade 7 students and for schools identified as high risk, Grades 4 and 7 are screened in addition to the standard grades for screening.

Despite dental screening not occurring in 2021, the WECHU Oral Health department sent out screening information to parents and families and offered virtual and on-site screening at one of our two oral health clinics. Parents who wanted their children screened were able to book an appointment and choose the option that best suited their needs.

Oral health screening is not only an important part of overall oral health surveillance for Windsor-Essex, it provides an opportunity to identify oral health concerns early and to provide parents with information about the Healthy Smiles Ontario program and options for a dental home. With schools reopening for additional visitors the Oral Health department at the WECHU has developed an ambitious and comprehensive plan to resume oral health screening over last three months of the 2021-2022 school year. The oral health team will focus on schools identified as high risk and medium risk from previous years to ensure that we are able to reach all students most in need of oral health screening, prevention and support. The oral health screening teams have already reached out to these schools and screening will commence in April, running through June of this year.  

WECHU Healthy Smiles Ontario (HSO) Program

Over the course of 2021,there were 1,572 children/youth screened at one of the WECHU’s dental clinics and referred into either the HSO-Emergency and Essential Services Stream (EESS), or the HSO-PSO (preventive services only) program. The EESS program is provided to child/youth identified with an emergency or essential dental condition such as infection, haemorrhage or pathology that requires immediate clinical treatment. The PSO stream is delivered through public health unit clinics only and identified through health unit screening activities. Treatments covered under the PSO stream include topical fluoride, pit and fissure sealants, scaling, and some interim stabilization therapies.

Ontario Seniors Dental Care Program (OSDCP)

In 2021, the WECHU oral health department supported 3,349 clinic visits across all clients enrolled in the OSDCP. This includes 398 new patient exams, for an average of 1.6 new patients added to our client roster every working day. New dentures have been provided to 117 clients at the WECHU, with 1,311 appointments with a dentist or denturist to be fitted for these new dentures. The oral health department supports the OSDCP at both clinic sites (Windsor and Leamington). Clinic hours of operation are Monday to Friday from week day from 8:30 a.m. to 8 p.m in Winsor and 8:30 a.m. to 4:30 p.m. in Leamington.

Oral Health Resources for Educators

The Ontario Public Health Standards outline the requirement for health units to support health related curriculum and health needs in schools. Oral health education programs can help to build skills of young children, in terms of their oral health knowledge and practices and are a key area of need for children and youth in Windsor-Essex. In 2021, oral health resources for educators were updated and posted to the WECHU website. These included lesson plans and resources intended to help teach students from Kindergarten to Grade 8 about oral health and how students can keep their teeth and mouth healthy. Presentations are also available to schools and community programs at request.

Baby Oral Health Program (BOHP)

The Canadian Dental Association and the Canadian Pediatric Society recommend children see a dentist by their first birthday, even before they have all of their teeth. The BOHP provides free screening for all children, aged 0 to 4, in Windsor-Essex County. A screening by a registered dental hygienist includes a check for signs of cavities, education on supporting a healthy mouth and teeth, and a fluoride treatment, if needed. These screenings are important as they offer an opportunity for early intervention. During a BOHP visit families are also encouraged to visit a dentist or make a follow-up appointment at the WECHU if they do not have a home dental office. Children who present with urgent dental needs are enrolled into the HSO program, if eligible, or receive outside referrals for dental treatment. In 2021, 138 infants and toddlers were screened through the BOHP.

SUBMITTED BY

Communications Department

DATE

April 21, 2022

SUBJECT

February 15 – March 14, 2022 Communications Update

BACKGROUND/PURPOSE:

Provide regular marketing and communication updates to the Board of Health.

Data Notes can be provided upon request.

Media Exposure Overview Graph

Website Overview Graph

Discussion

Current notable projects that the department is working on.

We promoted World TB Day on March 24 - Shining a Red Light for World TB Day through multiple media channels.

The First Case of Influenza A Confirmed in Windsor-Essex news release was issued on Tuesday, March 22.

The Communications department is maintaining marketing and communication efforts regarding COVID-19 vaccinations in the region with our partners. In particular, the COVID-19 pop up clinics in the community continue to be promoted and we are working on messages around the Devonshire Mall Vaccination Centre To Cease Operations Saturday, April 2nd.

We are providing support for the Catch-Up Immunization Clinics for Students in Grades 7 to 12 that will occur until August in multiple locations throughout Windsor and Essex County.

SUBMITTED BY

Epidemiology and Evaluation Department

DATE

April 21, 2022

SUBJECT

COVID-19 Surveillance and Epidemiology – March, 2022

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 the 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. Due to these changes, data from before December 31, 2021 should not be compared to data after the testing changes.

Trends

In the month of March, the health unit reported 2,353 confirmed high-risk cases of COVID-19. As the weeks progressed in March, the weekly high-risk incidence rate increased from 124.0 cases per 100,000 population (Week 9) to 145.1 cases per 100,000 population (Week 13).  

In-Patient and ICU Admissions

In March, in-patient COVID-19 hospitalizations began to increase in Windsor-Essex County. A total of 155 new COVID-19 related patients were admitted to local hospitals.

Percent Positivity

Locally, Windsor-Essex County continued to experience a week-over-week increase in percent positivity in March after observing the opposite for February. As the month drew to a close, the local percent positivity rate for COVID-19 rose to approximately 19.3% in the last week of the month. It is also important to note that these were for high-risk individuals that were eligible for testing.

Wastewater Surveillance

For the month of March, viral signal for COVID-19 in wastewater intensified as the month drew to a close. Current levels are beginning to reach levels observed during the onset of the Omicron wave in December 2021.  

Outbreaks

In the month of March, 21 outbreaks were declared in high risk settings compared to the 24 outbreaks in February. This includes seven outbreaks in long-term care and retirement homes, four in hospital settings, and ten in other congregate settings. As of March 31st, there were 16 active outbreaks in the Windsor-Essex County region.

Deaths

For the month of March 2022, 16 deaths were reported that were attributed to COVID-19. This represents a 45% decline in comparison to the deaths reported in February.

DISCUSSION

With the changes in testing eligibility, and guidance with case, contact and outbreak management, the health unit has modified its public reporting to better understand the burden of illness locally. New indicators, such as wastewater data, have been included as a proxy indicator for COVID-19 case counts, which are underestimated. 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.

Board Members Present:

Gary McNamara, Joe Bachetti, Tracey Bailey, Fabio Costante, Aldo DiCarlo, Gary Kaschak, Judy Lund, Robert Maich, Ed Sleiman

Board Member Regrets:

Rino Bortolin

1. Period covered by this report:  January 1, 2022 to March 31, 2022
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 including transition of staff from case and contact management to support the vaccination efforts as directed by the province.
• Increased expenses related to vaccination to support resources required for implementing booster/third doses across the population.

Item (x) the CEO reports the following:

In January 2022, the WECHU had an unplanned termination of a single non-union staff person.

Date: March 31, 2022

Signature: Nicole Dupuis, Chief Executive Officer

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Please contact us if you require this document in an alternate format.