Board of Health Meeting Documents

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

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/d…

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

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

RECORDING SECRETARY: L. Damphouse

SUBMITTED BY: N. Dupuis

APPROVED BY:

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

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

Meeting held via video.

PREPARED BY:

Lorie Gregg, Director of Corporate Services

DATE:

September, 2021

• 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

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

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

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

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:

FINANCIAL INFORMATION FOR RELATED PROGRAMS FUNDED 100% BY THE MOHLTC

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

Board Members Present:

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

Border Member Regrets:

Gary Kaschak

Administration Present:

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

QUORUM:  Confirmed

RECORDING SECRETARY:

SUBMITTED BY:

APPROVED BY:

ISSUE

The Windsor-Essex County Health Unit (WECHU), in response to the resignation of the Medical Officer of Health (MOH), is required to recruit an Acting MOH.  This individual shall perform the duties of, and have the authority to exercise the powers of the MOH in accordance with the requirements of Section 69(2) of the Health Protection and Promotion Act, R.S.O. 1990

BACKGROUND

Part II, Section 4 of the Board of Health for the Windsor-Essex County Health Unit Consolidated By-laws (By-laws) speaks to the appointment of an Acting MOH by the Board.  The By-law requires that any appointments of greater than six (6) months be subject to approval in writing from the Ministry of Health and the Chief Medical Officer of Health. 

In addition, the Policy Framework on Medical Officer of Health Appointments, Reporting and Compensation established by the Ministry of Health indicates, “A board of health shall appoint forthwith a physician as acting medical officer of health”.  The Minister’s approval is not required for these appointments, as they are meant to be short-term in nature to permit boards of health to recruit the MOH position with a qualified physician on a full-time basis.

PROPOSED MOTION                                               

Whereas, the Medical Officer of Health has resigned effective September 12, 2021, and

Whereas, the WECHU has commenced a recruitment process in accordance with the By-laws, and

Whereas, an Acting Medical Officer of Health will be required to fulfill the duties of the Medical Officer of Health during the recruitment process

Now therefore be it resolved that the Windsor-Essex County Board of Health authorize and approve the Director of Human Resources and the Chief Executive Officer to communicate with the Ministry about a potential secondment and/or recruit a local physician for the role of Acting Medical Officer of Health.

ISSUE

The WECHU, in partnership with representatives on the advisory committee and the Windsor-Essex Community Opioid & Substance Strategy, launched a site-specific community consultation on June 17th of 2021 to gather community feedback about two candidate locations for a local Consumption and Treatment Services (CTS) facility. The purpose of the site-specific community consultation was to understand community perceptions about the feasibility and acceptability of a potential CTS facility at either of the candidate locations. The comprehensive community consultation plan encompassed several components for engaging the community: 

• A widely promoted public survey with a total of 448 survey responses
• 13 key informant interviews with businesses and agency stakeholders within a defined radius from the sites
• 7 focus groups with area stakeholder groups
• 3 Virtual Town Hall meetings that allowed community members to ask questions and voice concerns to a panel of eight expert speakers. Fifty-three (53) community members registered to participate.

BACKGROUND

After an extensive search and consultation with local property owners, the WECHU with support of the CTS advisory committee, identified two candidate locations for a potential CTS facility in Windsor’s downtown core - 101 Wyandotte Street East and 628 Goyeau Street. Both of the candidate locations satisfied each of the mandatory and complementary requirements for an eligible site, and both are situated in the preferred neighbourhood (N9A) identified through the initial Safe Injection Services Community Consultations Report. Prior to facilitating the community consultation process, crime prevention through environmental design audits (CPTED) were completed by Windsor Police Services in order to determine the safety of the candidate locations, and to guide any mitigating interventions for improving the surrounding safety of the sites and discouraging criminal activity. Through the CPTED audits, it was determined that the placement and orientation of both site locations would lend themselves sufficiently to establishing a manageable “Safe Consumption Zone” whereby public safety can be maintained with any risks identified to be mitigated. The WECHU proposed the two candidate locations to the Board of Health on June 17th of 2021, and a resolution was passed in support of the completion of the site-specific community consultation as focused to the assessment of these two potential sites.

The results from the community consultation yielded local support for a potential CTS facility at both of the candidate locations. A majority of survey respondents indicated that they would provide at least some degree of support for a CTS facility at 101 Wyandotte Street East (67%) and/or 628 Goyeau Street (68%). Relatedly, respondents most frequently indicated that they would provide equal support for a CTS facility at both of the candidate locations (39%), while 19% preferred 628 Goyeau Street and 13% preferred 101 Wyandotte Street East. Nineteen percent (19%) of all survey respondents did not support or prefer either location. Survey respondents who identified as living, working, owning a business, or going to school in the N9A postal code area (N=126) responded with similar perceptions to the full sample, with 33% providing equal support for both locations, 22% preferring 628 Goyeau Street, and 13% preferring 101 Wyandotte Street East. Nineteen percent (19%) of respondents in the N9A postal code area did not support or prefer either location.

Majority of the key informant interview and focus group participants demonstrated openness or support to a CTS facility at one or both of the proposed locations, with few expressing strong opposition to either location. Although many of the participants noted minimal differences between the two locations, the primary differentiators in terms of perceived benefits and concerns were tied to the traffic flow surrounding the locations and the visibility of the sites. Many of the participants cited that 628 Goyeau Street is a less visible and lower traffic area compared to 101 Wyandotte Street East, with the perceived advantages of being a safer site option with less risks of pedestrian and vehicular-related injuries or traffic disruptions. Many participants also referenced that 628 Goyeau Street would provide improved privacy for potential service users, many of whom are socially stigmatized and may be deterred by a highly visible and higher traffic location, such as 101 Wyandotte Street East. In contrast, some of the participants highlighted that the visibility of 101 Wyandotte Street East would be particularly advantageous for enhancing observation capabilities and ensuring the safety and security of the surrounding areas.  Overall, five of the seven focus groups reached a consensus of 628 Goyeau Street being the preferred or superior location, while 31% of key informants equally supported both locations, 31% preferred 628 Goyeau Street, and 23% preferred 101 Wyandotte Street East. Fifteen percent (15%) of key informants did not prefer either location.

The results collected through the consultation will be interpreted extensively by the WECHU and the CTS Stakeholder Advisory Committee to inform mitigating strategies to address the cited concerns.

PROPOSED MOTION

Whereas, Opioid overdose and opioid related mortality has been declared a public health crisis, and

Whereas, Opioid overdose and opioid related mortality is at an all time high in Windsor-Essex, and

Whereas, Consumption and Treatment Services have the potential to address opioid overdose and opioid related mortality, and

Whereas, the WECHU is required to submit an application for a CTS that includes a site location and an accompanying community consultation, and

Whereas, the CTS advisory committee has identified a preferred site based on the results of a comprehensive community engagement process led by the WECHU,

Whereas, a formal request to City Council is required in order to present the results of the evaluation and is necessary for an extended presentation time,

Now therefore be it resolved that the Windsor-Essex County Board of Health support the recommendation from the CTS Advisory Committee that the WECHU move forward with their application for the site located at 628 Goyeau Street, and

FURTHER THAT, the Board of Health support administration to continue with the next steps of the application process which includes seeking City of Windsor council approval for the proposed site, and

FURTHER THAT, administration enter into an agreement with the proposed landlord to secure the site for submission of an application.

Meeting held via video.

SUBMITTED BY

Communications Department

DATE

July 2021

SUBJECT

June 2021 - Communications Recap

June Metrics

Media Monitoring Highlights

Trending Themes

Top Sources

Media Participating in Teleconference for YouTube Live

• AM 800 CKLW, Blackburn News, CBC Windsor, CTV Windsor, CFTV and the Windsor Star join every day. Radio Canada joined us in June on a few occasions.

Current Notable Projects

• Maintaining marketing and communication efforts regarding ongoing vaccine rollout in the region.
• Developing promotional campaign and engagement strategy encouraging more youth 12 to 17 years of age to get vaccinated.
• Developing marketing and communication plans to launch public health programs that were on hold during the pandemic.

Data Notes:

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

1. Media requests received is a compiled list of documented requests we captured for interviews, data clarification, or general request for information from the media. Given the volume of requests during COVID-19, many exchanges with the media through text messages or quick phone calls to 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. He continues to do join Mike and Lisa every other morning to keep the community informed.

3. YouTube Live videos started on June 23, 2020. Prior Public Health Update videos on YouTube were exported videos recorded through Facebook Live.

4. Website analytics are provided by Siteimprove. The metric provided is for page views to wechu.org. Previously, we were report 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. Significant changes in numbers can be partially attributed to configuration changes made to the new service to better monitor and report media activity. News stories may be duplicates or missing as the platform is currently being optimized to better track Windsor-Essex County Health Unit mentions in the media landscape.

The accompanying financial statements of the Windsor-Essex County Health Unit (“Health Unit”) are the responsibility of the Health Unit’s management and have been prepared in compliance with legislation, and in accordance with Canadian public sector accounting standards for local governments established by the Public Sector Accounting Board of the Chartered Professional Accountants of Canada. A summary of the significant accounting policies are described in Note 1 to the financial statements. The preparation of financial statements necessarily involves the use of estimates based on management’s judgment, particularly when transactions affecting the current accounting period cannot be finalized with certainty until future periods.

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

Background

Active school transportation (AST) plays an important role in increasing students’ activity levels and associated improvements in mental and physical health. Common modes of active school transportation include walking, cycling, skateboarding, or scootering to and from school. Using active transportation for school travel can add two bouts of physical activity to a student’s day, helping them accumulate the recommended 60 minutes of activity daily from the Canadian 24-hour Movement Guidelines. Additionally, when more families use active transportation, there are fewer vehicles accessing the school zone leading to improvements in safety and air quality in the school community.

In February 2021, an information report was presented to the Board of Health detailing a the reciept of funds from successful grant from Green Communities Canada (GCC); a leading organization promoting active school travel through their administration and oversight of the Ontario Active School Travel Fund (OAST).  The OAST fund was created in 2018 to support active travel initiatives in selected communities across the province. These projects are expected to have a significant and lasting impact in their communities by establishing a foundation for continuing growth in the area of active school travel. Through the successful application led by Windsor-Essex County Health Unit (WECHU), in collaboration with vested commumunity partners in November 2020 the WECHU recieved funding in the amount of $60,000 from the OAST fund. This funding is to be used toward active transportation initiatives for schools throughout Windsor-Essex County during 2021 into early 2022. 

Current Initatives:

Since the information report was presented to the Board of Health in February 2021, the following key intiatives and activities have been completed, as part of the grant application:

• Formed an Active School Travel (AST) Regional Committee which includes the following community partners:
  • The Greater Essex County School Board
  • The Windsor Essex Catholic District School Board
  • Conseil Scolaire Catholique Providence
  • Windsor Essex Student Transportation Services
  • The City of Windsor
  • Windsor Police Services
  • Bike Windsor Essex
  • County of Essex
• Hired and trained an Active Travel Planner to assist schools and boards in implementing plans and coordinate community education and outreach.
• Terms of Reference Created for the AST Regional Committee.
• Active School Travel Charter created to be signed by municipalities and school boards.
• Established pilot school sites (6 schools); Confirmed and onboarded a main point of contact for future school working groups to lead school-focused interventions.
• Conducted baseline surveys with students and family members at six pilot schools to determine typical travel modes to and from school.

Issue

As indicated above, one of the key initiatives completed by the Windsor-Essex County AST Regional Committee was the creation of an Active School Travel Charter (Attached). Active School Travel Charters help in strengthening regional coordination, collaboration, and leveraging our collective resources and knowledge that will help in supporting long-term program sustainability. Endorsing and adopting an Active School Travel Charter would demonstrate support and highlight the importance of active transportation-supporting programs, policies and infrastructure within Windsor-Essex County.

The Charter will help serve as a statement of principles to guide schools, school boards, municipalities, student transportation services, and other community partners to consider how activities and decisions can encourage more active transportation in our local communities. The Charter principles align with the Windsor-Essex County Health Unit’s mandates to support a comprehensive approach to physical and mental health promotion, increase levels of physical activity, reduce sedentary behaviours among children and youth, and make active living accessible and safe in our communities.  In order to gather support from key stakeholders within the community, WECHU would like to present this Active School Travel Charter to local municipalities and school boards to endorse and adopt as part of a regional initiative for Windsor-Essex County.

PROPOSED MOTION

Whereas According the to the 2020 Participaction Report Card on physical activity for children and youth, less than 1 in 5 children (5-11 year-olds) and youth (12-17 year-olds) in Canada are meeting national movement behaviour guidelines for physical activity, sedentary behaviours and sleep.

Whereas Active school transportation (AST) plays an important role in helping to increase students’ activity levels and associated improvements in mental and physical health. In addition, AST helps children/youth accumulate the recommended 60 minutes of activity daily from the Canadian 24-hour Movement Guidelines.

Whereas The Windsor-Essex County Health Unit was awarded funds for the Ontario Active School Travel Grant from Green Communities Canada (GCC) in the amount of $60, 000 which will be used to create initiatives, polices, and environmental supports around active school travel in Windsor-Essex County.

Whereas The Ontario Active School Travel Grant will help provide long-term sustainability and community partnerships to create and improve upon active school travel that is accessible and safe for children and youth in Windsor-Essex County.

Whereas The endorsement from the Windsor-Essex County Board of Health of an active school transportation charter that will help in strengthening regional coordination, collaboration, and leveraging our collective community resources and knowledge and add weight to the importance of active transportation-supporting programs, policies and infrastructure within Windsor-Essex County

Now therefore be it resolved that the Windsor-Essex County Board of Health supports the Windsor-Essex County Health Unit in presenting the AST initiatives and Active School Travel Charter to local municipalities and school boards in order for these key stakeholders to endorse the initiatives and adopt a regional Active School Travel Charter for Windsor-Essex County.

AND FURTHER that this resolution be shared with all local municipal councils, all local school boards, the Association of Local Public Health Agencies, Ontario Boards of Health, Ontario Public Health Association, and Green Communities Canada.

ISSUE

Approval of the annual audited financial statements including:

• Windsor-Essex County Health Unit for the year-ended December 31, 2020 (Appendix A)
• Windsor-Essex County Health Unit Ministry of Children, Community and Social Service Program Initiatives for the year-ended March 31, 2021 (Appendix B)

 (Hereinafter referred to collectively as “the annual financial statements”).

BACKGROUND

Paragraph 59(2) of the Health Protection and Promotion Act R.S.O. 1990 states that “A board of health shall cause to be prepared statements of its financial affairs in each year including but not limited to, (a) an annual statement of income and expenses; (b) an annual statement of assets and liabilities; (c) an annual estimate of expenses for the year.”

The annual financial statements audited by KPMG LLP, independent external auditors appointed by the Corporation of the City of Windsor.  On July 15, 2021, the Audit Committee of the Windsor-Essex County Health Unit convened to review the annual financial statements and audit findings report with Administration and KPMG LLP.  The Audit Committee has recommended the financial statements for approval to the Board. KPMG LLP is prepared to issue, pending approval by the Board, an unmodified audit opinion on the annual financial statements. 

Windsor-Essex County Health Unit

The enclosed is a summary analytical review addressing material changes in financial statement captions year-over-year.

Statement of Financial Position:

• Cash and short-term investments increased $2,898,405.  Refer to the Statement of Cash Flows for details.
• Accounts receivable increased $128,765 due to the following:  a) Increase in grants receivable from the Province of Ontario of $59,531 over 2019.  This balance varies annually based upon the extent and timing of funding approvals for one-time business cases typically funded at a rate of 100%.  b)  Increase in other receivables of $90,273.  For 2020, a grant of $81,725 was outstanding because of the Infections Disease and Climate Change Program for the period January 1, 2020 to December 31, 2020.  For additional details, refer to note 3 to the annual financial statements.
• Due to Province of Ontario increased $627,963.  This net increase is attributed to: a) the claw back of amounts owing for the 2019 settlement year in the amount of $85,701.  The claw back occurred in the January to March 2020 timeframe;  b)  The 2020 settlement amount of $713,446 comprised of $557,562 on account of the Ontario Seniors Dental Care Program (OSDCP), $4,070 on account of capital improvements to support the OSDCP, and $152,032 on account of the Temporary Pandemic Pay grant.  In the period of January through to March of 2021, $709,664 was clawed back.  For additional details, refer to note 4 to the annual financial statements. 
• Due to Municipalities increased $1,593,773.  This increase is attributed to:  a) 2020 settlement resulting in $332,973 of contributions owing back to the Obligated Municipalities. b) Allocation of 2020 Mitigation funding to the Obligated Municipalities of $1,260,800.  The allocation of this funding is based upon the Obligated Municipalities’ pro-rata share of the population of Windsor and Essex County (2016 Census).  For additional details, refer to note 5 to the annual financial statements.
• Due to Community Programs increased $331,213.  This financial statement caption includes amounts owing to other WECHU administered programs not included in these financial statements.  More specifically, this includes balances relating the Windsor-Essex County Health Unit Healthy Babies Healthy Children Program and the Windsor-Essex County Health Unit Nurse Practitioner Program.  These programs do not have separate bank accounts.  Funds received from the Ministry of Children, Community and Social Services are included in the primary WECHU bank account and are reconciled annually.
• Accounts payable decreased $199,635.  Fluctuation in this caption is a function of the extent and timing of procurements in the 30-days prior to year-end. 
• Accrued payable and deductions increased $552,587.  The increase is due to the timing of payroll compared at year-end, as well as accruals for certain other payroll related matters. For the year-ended December 31, 2020, five days remained outstanding as compared to two days for the year-ended December 31, 2019.
• Deferred revenue increased $78,379.  The increase in deferred revenue over 2019, is attributed to the amount and timing of one-time business case approvals for the period April 1, 2020 to March 31, 2021 as compared to one-time business case approvals for the period April 1, 2019 to March 31, 2020.  Of the $805,630 of funding advanced associated with these approvals, $67,068 remained unspent at December 31, 2020.  In addition, the WECHU received a grant from the Greater Essex County District School Board of $20,000 to support the Windsor-Essex Community Opioid and Substance Strategy.
• Tangible capital assets decreased $12,803.  The net decrease is attributed to:  i) Tangible capital asset additions of $279,141; ii) Amortization expense of $291,944.  Of the tangible capital assets acquired in the year, $217,420 were funded by the Ministry of Health using Mandatory Program funding (70%), and $61,721 were funded using Ontario Seniors Dental Care Program funding (100%). Refer to note 9 for additional details.

Statement of Operations and Accumulated Deficit:

• Increase in Revenue from the Province of Ontario of $2,111,005. The net increase is attributed to the following:
  • Decrease in Mandatory funding of $1,260,800 due to the changes in the funding model from 2019 to 2020.
  • Increase in OSDCP funding of $830,674.  In the latter part of 2019, the Province of Ontario launched the OSDCP Initiative.  Therefore, the 2020 revenues are more representative of 12-months of program administration.
  • Increase in Other.  This is attributed to:  i)  Mitigation funding – In recognition of the changes in the funding model from 2019 to 2020, the WECHU was approved for Mitigation funding in the amount of $1,260,800; ii)  COVID-19 Extraordinary Cost funding for 2020 in the amount of $241,920; iii)  School-Focused Nurses Initiative funding for 2020 in the amount of $728,572.

The Ministry of Health funds the WECHU to a maximum of 70% of admissible expenditures.  Admissible expenditures for the purposes of the Ministry of Health Settlement Process is defined below:

For additional details regarding funding from the Province of Ontario, refer to Schedule 2 of the annual financial statements.

• Increase in Expenses of $3,482,835, primarily attributed to Salaries and benefits.  Specific details are as follows:
  • In 2019, the WECHU experienced a labour disruption involving employees represented by the Ontario Nurses Association for the period March 8th, 2019 to May 8th, 2019, resulting in salaries and benefits savings of approximately $635,000.
  • In 2019, in response to anticipated changes in the funding model, the WECHU made a decision to not fill certain positions (predominantly non-union), resulting in salaries and benefits savings of $663,000.
  • March 2020, COVID-19 pandemic.  The WECHU’s response to the pandemic resulted in substantial overtime paid in 2020 ($975,012) and the hiring of additional staff to support the response to COVID-19 in Windsor and Essex County.
  • Increase in salaries in benefits of $654,147 relating to the WECHU’s administration of the Ontario Seniors Dental Care Program.
  • Annual increases (cost of living and grid increases) for all employee groups (1%).

Windsor-Essex County Health Unit Ministry of Children, Community and Social Service Program Initiatives

The annual audited financial statements for the Windsor-Essex County Health Unit Ministry of Children, Community and Social Services Program Initiatives include financial information for the Nurse Practitioner Program and the Healthy Babies Healthy Children Program for the period April 1, 2020 to March 31, 2021. 

The enclosed is a summary analytical review addressing material changes in financial statement captions year-over-year.

Statement of Financial Position:

• Due from the Windsor-Essex County Health Unit:  Refer to the statement of cash flow for details on the increase of $633,533 from March 31, 2021.
• Due to Ministry of Children, Community and Social Services:  The amount outstanding of $581,637 represents the settlement for the period April 1, 2020 to March 31, 2021.

Statement of Operations and Accumulated Deficit:

Year-over-year variations in the financial results are due to the following:

• The variances noted between the March 31, 2021 figures and those of March 31, 2020 related primarily to the reporting timeframes.  The March 31, 2021, is a 12-month fiscal period while the March 31, 2020, is a 15-month fiscal period. 
• Impact of the COVID-19 pandemic on service delivery for the period April 1, 2020 to March 31, 2021.

A summary of the settlement with the Ministry of Children, Community and Social Services is as follows:

PROPOSED MOTION                         

Whereas, at its July 15, 2021, meeting, the Audit Committee reviewed the annual financial statements and recommended them to the Board for approval,

Now therefore be it resolved that the Windsor-Essex County Board of Health approve:

The annual audited financial statements for the Windsor-Essex County Health Unit for the year-ended December 31, 2020; and

The annual audited financial statements for the Windsor-Essex County Health Unit Ministry of Children, Community and Social Service Program Initiatives for the year-ended March 31, 2021.

Meeting held via video.

SUBMITTED BY

Communications Department

DATE

June 2021

SUBJECT

May 2021 - Communications Recap

May Metrics

Media Monitoring Highlights

Trending Themes

Top Sources

Media Participating in Teleconference for YouTube Live

• AM 800 CKLW, Blackburn News, CBC Windsor, CTV Windsor and the Windsor Star join every day. CFTV and Radio Canada joined us in May on a few occasions.

Current Notable Projects

• Supporting ongoing vaccine rollout in the region.
• Working on engagement strategy for parents and students regarding vaccine questions and answers.
• Regular communication with the Ministry of Health about provincial initiatives and their planned launch dates.

Data Notes:

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

1. Media requests received is a compiled list of documented requests we captured for interviews, data clarification, or general request for information from the media. Given the volume of requests during COVID-19, many exchanges with the media through text messages or quick phone calls to correct errors may not be captured. In many instances, each request led to multiple interactions with reporters.

2. Dr. Ahmed joined Mike and Lisa on the AM 800 Morning Drive every morning at 8:06 a.m. starting on Wednesday, March 17, 2020. On August 17, 2020, we went to a Monday, Wednesday, and Friday schedule with holidays off. He continues to do join Mike and Lisa every other morning to keep the community informed.

3. We changed the platform we broadcasted live videos from Facebook to YouTube at the end of June. YouTube Live videos started on June 23, 2020. Prior Public Health Update videos on YouTube were exported videos recorded through Facebook Live.

4. Website analytics are provided by Siteimprove. The metric provided is for page views to wechu.org. Previously, we were report 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 over the last 30 days. 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. Significant changes in numbers can be partially attributed to configuration changes made to the new service to better monitor and report media activity. News stories may be duplicates or missing as the platform is currently being optimized to better track Windsor-Essex County Health Unit mentions in the media landscape.

DATE:

June 2021

SUBJECT:

Temporary Foreign Workers COVID-19 Vaccination Strategy

BACKGROUND

The agri-food sector in Windsor and Essex County has been impacted greatly by the COVID-19 pandemic. The congregate living arrangements that exist for many Temporary Foreign Workers (TFWs), similar to other congregate settings, create challenges for adhering to public health recommendations such as physical distancing and increase the risk for spread of COVID-19.  There are estimated to be between 8,000 -10,000 TFWs working and living in Windsor-Essex, majority in the Leamington and Kingsville area. There are approximately 255 farms operating in Windsor and Essex County with well over 1500 accommodations that are inspected annually by the health unit.  In 2020, there were nearly 50 COVID-19 outbreaks in agriculture settings.

In April 2021, the Ministry of Health released their Phase 2 guidance document for the prioritization of COVID-19 vaccination. Within the phase 2 guidance document, high risk congregate living settings were identified as a priority for vaccination including employer-provided living accommodations for temporary foreign agricultural workers.  

Current Initiatives

Between April 18 and May 6th, 2021, vaccine appointments were reserved for TFWs at the Nature Fresh Recreation Centre vaccination clinic in Leamington. During the 13 days of targeted clinics, 4,768 workers were scheduled for their first dose vaccination across 132 area farms.  As well the WECHU hosted two pop-up clinics the evening of May 20th and 21st in downtown Leamington providing additional opportunities to both documented and undocumented workers to be vaccinated. To date over 5200 temporary foreign workers in the region have received their first dose of COVID-19 vaccine. To achieve this the WECHU worked closely with partners at the Municipality of Leamington and partners of the Workplace Wellness for Agri-Food Workers Task Force to develop a comprehensive outreach and communication plan.  

Health Promotion Resources and outreach:

In order to promote COVID-19 vaccination, educate workplaces and workers and register temporary foreign workers for vaccination multiple health promotion strategies were used. The WECHU sent out an information memo to all farms via MailChimp that included vaccination information for employees and a link to a dedicated vaccine information page for temporary foreign workers (https://www.wechu.org/cv/covid-19-vaccine-information-temporary-foreign-workers). The website includes resources for workers developed by partnering organizations, Health Canada, the Ministry of Health and the WECHU and covers common vaccine concerns, myths and facts, accessibility, after care and frequently asked questions. Resources are available in multiple languages for viewing both in print and video. Resources were shared through the HUB Connect App, WhatsApp Groups, and social media. Health education videos in multiple languages were also shared and displayed at the vaccination site through TV monitors on site.

For mobile clinics the WECHU worked with key partners from the Workplace Wellness for Agri-Food Workers Task Force to identify outreach strategies, locations and timing of mobile clinics. Mobile clinics were supported on site with WECHU staff, staff from Essex-Windsor EMS and Erie Shores Health Care and staff and volunteers from the Migrant Worker Community Program.

Registration and Clinic logistics:

The WECHU created a dedicated pre-registration pathway for all farms with temporary foreign workers as well as a dedicated email for questions and inquiries. Farm operators were asked to identify the number of workers that were interested in receiving their vaccination, as well as provide information on mode of transportation to the site, cohorts and languages spoken by workers. The WECHU booked farms in blocks of time to ensure workers remained in their appropriate cohort.

Before vaccination day for each farm, the WECHU met with each farm operator to go over logistics for the day, including ensuring all workers had appropriate ID, completed consent (in their preferred language), FAQ documents and transportation arrangements.

On-site the WECHU utilized WE Speak centralized interpretation services to support on demand video interpretation at registration tables and within the vaccination clinic. Additionally the WECHU had support from local partners for in-person interpretation to ensure that individuals received care that was accessible and culturally appropriate. 

Farm Experience Evaluation

In order to better understand the effectiveness of this strategy, a feedback evaluation survey was sent to all farms at the end of the 3-week blitz.  There were 57 completed surveys, and the findings are as follows:

• Vaccination Registration Process:
  • 80% received the initial registration email in a timely manner
  • 70% Agreed that the WECHU provided them with the resources they needed to help the worker make an informed choice
  • 71% felt supported during the registration process
• Communication:
  • The following communication methods were rated as being very helpful and helpful:
    • Email – 93%
      WECHU Vaccine Webpage for TFWs* - 75% *Google Analytics report showed 1164 visits to the dedicated webpage, from 836 unique users during the 3-week time period (April 18 - May 6)
    • Phone call/Video meeting – 63%
    • Vaccine day logistics checklist – 73%
• Vaccination Day Logistics:
  • 80% of respondents felt their workers were well supported at the vaccination clinic
  • 75% said the vaccination clinic was well organized and our workers were able to flow through the process without issue (arrival, registration, vaccination, waiting and exiting).
• Feedback
  • Positive
    • Well organized
    • Process was quick at the vaccination centre
    • Very thankful
  • Suggestions for Improvement
    • Reduction in the number of spread sheets required
    • Increased flexibility with scheduling appointments
    • More information sharing directly with the workers
• Successes and Challenges
  • Successes
    • High uptake by farms
    • Well established clinic location
    • Safely and efficiently immunized several thousand TFWs
    • Excellent partnerships from community agencies
    • COVax information uploaded ahead of time helped make day-of registration fast
    • “What to Expect on Vaccination Day” information and consent forms provided ahead of time and in multiple languages helped to reduce day-of questions
  • Challenges
    • Complicated registration system – multiple forms and emails
    • Farms having to coordinate group transportation that kept work cohorts separated
    • Tight timelines for all tasks
    • Resource intensive for everyone involved (WECHU, Farms, Partners)
    • Translations required in multiple languages for every resource
    • Addressing vaccine hesitancy amongst workers and farm owners

Overall, the targeted clinics for Windsor-Essex TFWs were well received and highly successful.  The partnership between the municipality of Leamington, the farm owner/operators, several community organizations and the WECHU was a critical component of the process.

Future Plans

Moving forward, there will be ongoing promotion of the community vaccine clinics to late adopters and newly arriving workers who did not accept airport vaccination. Targeted “pop-up” clinics have been held on off hours in evenings to address access and hesitancy issues. There will also be continued engagement with our community partners to ensure that every worker who would like a vaccine is able to receive one.

Agencies who provided direct support to this vaccine project include:

• Municipality of Leamington
• C.A.R.E for International Workers (made up of 9 different organizations)
• Migrant Worker Community Program
• Consulate of Mexico in Leamington
• Occupational Health Clinics for Ontario Workers Inc. (OHCOW)
• Ontario Greenhouse Vegetable Growers (OGVG)
• Ontario Fruit and Vegetable Growers Association (OFVGA)
• Windsor-Essex Local Immigration Partnership (WE-LIP)
• Erie St. Clair LHIN
• The Neighbourhood Organization (TNO)
• Ontario Provincial Police
• Workplace Wellness for Agri-Food Workers Task Force

Reference:

1. National Collaborating Centre for Methods and Tools. (2020). Rapid Review: What factors increase the risk of COVID-19 outbreaks in congregate living settings? How do outcomes compare to outbreaks in community settings? https://www.nccmt.ca/knowledgerepositories/covid-19-rapid-evidence-service