Board of Health Meeting Documents

Board Members Present:

Joe Bachetti, Dr. Ken Blanchette, Dr. Deborah Kane, Judy Lund, Bill Marra, Gary McNamara, Gord Queen, John Scott, Ed Sleiman

Board Member Regrets:

Paul Borrelli, Mark Carrick, Richard Meloche, Dr. Carlin Miller, Hilary Payne, Michelle Watters

Administration Present:

Theresa Marentette, Dr. Wajid Ahmed, Lorie Gregg, Dan Sibley, Lee Anne Damphouse

Administration Regrets: 

Nicole Dupuis, Kristy McBeth

Introduction:  T. Marentette introduced and welcomed the newest WECHU Manager, Felicia Lawal, Manager of Health Families Department.

T. Marentette also advised Board of Health members that there are KI Pills (Potassium Iodide) available at the meeting and if anyone wishes to obtain to please register accordingly.

RECORDING SECRETARY:

SUBMITTED BY:

APPROVED BY:

Flu Vaccines will be available for Board of Health members from 3:30 pm – 4:00 pm

Prepared By:

Melissa Valentik, Health Promotion Specialist

Eric Nadalin, Manager, Chronic Disease and Injury Prevention

Date:

October 5, 2018

Subject:

Non-Medical Cannabis Legalization

Background

Cannabis is currently the most commonly used illegal substance in Canada (CCSA, 2017). Approximately 15.7% of Ontario residents self-reported cannabis use within 12 months (CAMH, 2016).  In Windsor and Essex County, approximately 28, 900 residents used cannabis in the last year. Among those who consume cannabis, rates are highest among youth and young adults (WECHU, 2016). With legalization of cannabis, effective October 17, it is anticipated that the number of residents that report using cannabis will rise given the social acceptability of cannabis use.

Although cannabis smoke contains similar toxins to those found in tobacco smoke including those that are associated with cancer, as well as heart and respiratory disease, the harms of cannabis consumption extend beyond those directly associated with long-term chronic disease. Increased rates of injury or harms associated with impaired driving, falls or general impairment, damage to cognitive functioning (i.e., memory, focus, ability to think and learn), depression, anxiety, psychosis, and addiction are all associated with cannabis use. These harms increase when cannabis use begins prior to the age of 25, as well as with frequent or heavy use (CCSA, 2016, Parachute Vision Zero Network, 2018). Lastly, maternal cannabis use is linked to low birth weight, pregnancy complications, and may affect children’s cognitive functioning, behaviour, mental health and future substance use (Best Start, 2017).

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

• restricts youth access to cannabis by prohibiting sale or supply to anyone under the age of 18;
• applies a personal possession limit of no more than 30g;
• limits personal cultivation to a maximum of four plants per household;
• prohibits packaging or labelling which makes cannabis products appealing to youth;
• requires standardized serving sizes and potency, and
• allows for only certain cannabis products to be offered for sale (i.e., dried cannabis, oils, and seeds), with others to be permitted at a later date (i.e., edibles).

In anticipation of further provincial regulation, the Windsor-Essex Board of Health passed a second resolution which aimed to better position municipalities to prepare in the context of federal and provincial regulation. This resolution, passed in October 2017, provided Windsor-Essex County Health Unit (WECHU) the mandate to prepare and protect our community from potential harms of cannabis legalization by:

1. Encouraging Windsor-Essex municipalities to develop strict licensing, planning, and zoning regulations,
2. Working with enforcement agencies and municipalities to support smoking prohibitions, and
3. Promoting Canada’s Lower-Risk Cannabis Use Guidelines to reduce harms of cannabis use.

Building on the foundation of regulations provided by the federal government, the Province of Ontario passed the provincial Cannabis Act on December 12, 2017 to further refine the legal sale and use of cannabis in Ontario by applying the following broad set of controls:

• restricts sale, purchase, possession, and sharing of cannabis to age 19 or older (consistent with the minimum age for obtaining alcohol); and
• allows for the purchase and possession of up to 30 grams (about one ounce) of dried cannabis at one time;
• permits the smoking and vaping of cannabis anywhere the smoking of tobacco is permitted; and
• allows for the growth of up to four plants per household for personal use.

Recently, the provincial government released its plan for retail sale of cannabis in Ontario. The provincially controlled Ontario Cannabis Retail Corporation (OCRC) will be the exclusive online retailer of cannabis in Ontario as well as the exclusive wholesaler of cannabis products to private retailers across the province. Online sale will be the only legal means through which consumers will be able to access cannabis in Ontario as of October 17th, with retail storefronts to be permitted beginning in April 2019. The licensing and enforcement of regulations for private retail businesses will be the responsibility of the Alcohol and Gaming Commission of Ontario (AGCO) and currently, there is no plan to set a cap on the number of licenses that will be issued in a particular area or municipality. Municipalities have the opportunity to “OPT OUT” of permitting cannabis retail outlets in their communities with a deadline of January 22nd, 2019 to submit this decision. Store authorizations will be permitted in areas that do not opt out, but each application will be subject to a 15-day consultation period for public to input to be considered by the AGCO in granting an authorization for a given location. In addition, the proposed legislation currently leaves no room for municipal control in the form of licensing or zoning for retail storefronts which would allow municipalities to determine appropriate areas for locations based on the unique needs of their municipalities.

Under the proposed provincial retail model, private retailers would be licensed to operate by the Alcohol and Gaming Commission of Ontario (AGCO), which will issue a Retail Operator License, a Retail Store Authorization, and Cannabis Retail Manager Licence to authorized individuals. The AGCO will conduct compliance and audit processes, including store inspection prior to opening. The proposed provincial legislation would also establish due diligence requirements and specific eligibility criteria for the issuance of licenses and involve a public consultation process for each retail establishment. Store operating parameters are set to be established by regulations prior to the AGCO receiving applications for licenses beginning at the end of 2018. The proposed legislation also proposes distance buffers between retail storefronts and schools, which would also be set through regulation.

There are clear areas for intervention from a public health perspective, which would decrease harms associated with this new framework for cannabis sale in Ontario communities. With respect to Windsor and Essex County, the OPT OUT approach would certainly provide the greatest level of protections to residents by prohibiting the operation of retail outlets across the region. Such a model would prevent municipalities from competing with one another for revenue, while ensuring that vulnerable populations would not be exposed to cannabis retail in Windsor-Essex. Should opting out on a permanent basis not be the appetite of incoming municipal councils, the possibility of opting out on a temporary basis should be strongly encouraged. Such an opportunity would provide municipalities the opportunity to learn from others across the province who did not choose to opt out, learn more about their options upon the passing of the final provincial regulations, and consider (to the extent which is permitted by the provincial legislation) the possibility of establishing regulations at the local level to establish appropriate areas for retail storefronts in their communities. Additional advocacy activities should be implemented at the municipal level to provide for the opportunity for such regulations at the local level, rather than the black and white Opt in or Opt out model proposed at the provincial level. See the attached Board of Health Resolution for additional recommendations for provincial and municipal oversight.

In-kind resources have been allocated from the Windsor-Essex County Health Unit’s cost-shared budget to begin educating the public about the health implications of cannabis use, safer consumption practices, how to speak with children, impaired driving, and other key message areas ahead of legalization. Additionally, the Smoke-free Ontario Act 2017 is set to come into effect as well on October 17th. Recent amendments to this Act permit the consumption of medical and non-medical cannabis anywhere where the smoking of tobacco is permitted. This will add to the enforcement role and broaden the scope of responsibility for Windsor-Essex County Health Unit Tobacco Enforcement Officers. These two activities alone will burden the WECHU with additional costs tied to legalization, in addition to those which may be required to be added in the form of human resources to respond to cannabis legalization and address the potential harms to health and safety.

WECHU Activities to Date

Internal Health Promotion Collaboration – WECHU Cannabis Legalization Working Group

The Windsor-Essex County Health Unit’s Cannabis Legalization Working Group (CLWG) is a collaborative of staff from various departments that aims to mitigate the potential harms of cannabis legalization across broad target populations. The group convened in 2017 and is Chaired by the Chronic Disease and Injury Prevention department, with representation from Policy and Strategic Initiatives, Epidemiology and Evaluation, Communications, Healthy Schools, and Healthy Families departments. Guided by the findings of a situational assessment, the CLWG has established key messages and target populations for cannabis health promotion efforts.

Internal Staff Training and Knowledge Assessment

A survey was distributed to staff of the Windsor-Essex County Health Unit to assess their knowledge and confidence in speaking to clients or community partners related to key cannabis health messages. Findings were used to identify areas of training that would best prepare staff for engaging with their clients. Following this, training for all direct-client service departments provided an overview of the resources available, and WECHU’s key messages. Based on the unique populations served by staff in each department, additional information was provided (e.g., information regarding risks to pregnant and breastfeeding women for Healthy Families, youth-focused information for Healthy Schools).

Community Environmental Scan

In August, 2018, an environmental scan was disseminated to health and social service providers, school boards, law enforcement and emergency services to assess the work currently being done in Windsor-Essex County to address cannabis use disorders or prevention efforts, and gaps in efforts to reduce cannabis harms in Windsor and Essex County.

Cannabis Mass Media Campaign

A mass media campaign has been created to begin educating the public utilizing a variety of media to target priority populations. This campaign will largely make use of content housed on the WECHU website. The goal of WECHU’s Cannabis- Your Questions, Answered campaign is to direct residents to credible, evidence-informed information in a format that encourages sharing through online and social networks. The website contains information related to key messages, a directory of treatment options for cannabis use and other addictions, and resources for workplaces, healthcare providers, and educators. In addition, radio ads have been created to disseminate our key messages and expand the campaign reach, and billboards have been developed to promote safe driving.

Community Outreach and Presentations

As a supplement to the mass media campaign, WECHU staff have already begun delivering community presentations and distributing resources. For example, in June of 2018, two presentations were provided at the Erie St. Clair Regional Cancer Program Frontline Connect events. In addition, a presentation was given to attendees of the Working Toward Wellness Luncheon in June 2018, along with the hosting of an information and resource booth.

Current and Future Initiatives

Windsor-Essex Cannabis Community of Practice

The Windsor-Essex Cannabis Community of Practice will be led by WECHU and meet biannually, starting in 2019, for the purposes of information sharing, collaboration, and capacity building. Group members have been identified through the Environmental Scan with representatives from health, social and community services, and education and municipal services. Meetings of the Community of Practice will include provincial/federal updates related to cannabis legalization, information sharing among members on current community activities, identifying gaps in community services related to legalization, combining resources and identifying opportunities to collaborate, and building capacity to address cannabis use.

Municipal Engagement

Through connecting with representatives from the administration of each municipality, WECHU has provided recommendations on how they can address cannabis in their communities. Primarily, it is the goal of these engagements to encourage municipalities to opt out of retail establishments; however, in the event that this is not of interest, WECHU is committed to supporting municipalities through the development of local regulations which will place restrictions on the areas in which cannabis-related businesses are permitted to operate. Such regulations may involve licensing or zoning parameters, which restrict cannabis-related businesses to operate in areas near schools, addictions facilities, parks, playgrounds, and other areas that serve or are frequented by vulnerable populations.

Teachers, Schools, and School Boards

Ongoing discussion and meetings between WECHU and school board liaisons have led to the population of an online drop box with presentations, toolkits, curriculum supports, posters, resources, and background information on the dangers of cannabis consumption for young people. A letter of support was provided for School Board advocacy of zoning for the location of cannabis retailers and production facilities to have municipalities set minimum distance between such establishments and school property. Support has also been offered onsite at school events and during teacher professional development opportunities, with additional school-aged presentations planned for the 2018-2019 school year that focus on cannabis-impaired driving. Cannabis activities in the school setting have also been integrated with the Windsor-Essex Community Opioid and Substance Strategy through the development of a Youth Engagement Strategy as part of their work in general substance use prevention and education.

Employers and Workplaces

The WECHU has supported workplaces in preparing for legalization by attending community events and developing template resources for employers to utilize in setting up health-promoting education and environments for their employees. By communicating with employers through existing communication channels and continuing to attend community events, WECHU will provide resources for employers to utilize in making decisions related to cannabis and impairment in the workplace.

Social Service and Healthcare Providers

To support reproductive healthcare providers and reach clients through WECHU and community programs, WECHU has utilized resources developed by the Public Health Agency of Canada to their clients through various programs offered through WECHU’s Healthy Families Department (i.e., hospital liaison program, Physician Outreach Program, Healthy Babies Healthy Children, lactation support, Well Baby Clinics and Building Blocks for Better Babies). Additional resources developed by WECHU and gathered from external partners will be provided through other WECHU networks such as the Windsor-Essex Cannabis Community of Practice, and the Windsor-Essex Tobacco Cessation Community of Practice.

Ongoing Surveillance and Monitoring

Currently, WECHU staff contribute to the Ontario Public Health Collaboration on Cannabis Indicators Working Group which seeks to identify existing indicators for cannabis use and related health outcomes and support development of cannabis surveillance at regional and provincial levels. Locally, ongoing work is being done to assess existing local data for cannabis-related health outcomes that can be used to monitor cannabis health outcomes pre and post-legalization, and identify gaps and opportunities for new data collection methods.

Provincial Collaboration

The Windsor-Essex County Health Unit is a co-applicant for the Public Health Ontario Substance Use Locally Driven Collaborative Project. The focus of this project is to identify regional strategies employed by public health agencies and applicable partners in addressing cannabis use among 18-25 year olds. This age often represents the highest rate of cannabis use, is not protected by age restrictions under the federal Cannabis Act, and is still at risk for cognitive damage tied to consumption due to continued brain development at this age. In addition, WECHU attends bi-monthly meetings as part of the Ontario Public Health Collaboration on Cannabis and through this network of public health professionals working in cannabis health promotion, is able to share and gather information on existing strategies and key message areas with public health units across the province.

Approved By:

Theresa Marentette, CEO

References

• Best Start. (2017). Risks of cannabis on fertility, pregnancy, breastfeeding and parenting. Retrieved from https://www.beststart.org/resources/alc_reduction/RisksOfCannabis_A30-E.pdf
• Canadian Centre on Substance Use and Addiction [CCSA]. (2017). Cannabis: Canadian drug summary. Retrieved from https://www.cpha.ca/sites/default/files/uploads/resources/cannabis/ccsa-...
• Canadian Centre on Substance Abuse [CCSA]. (2016). Clearing the smoke on cannabis: Highlights.
• Federation of Canadian Municipalities [FCM]. (2017). Cannabis legalization primer: How municipalities can get ready. Retrieved from https://fcm.ca/Documents/issues/Cannabis_Legislation_Primer_EN.pdf
• Government of Canada. (2018). Cannabis legalization and regulation. Retrieved from http://www.justice.gc.ca/eng/cj-jp/cannabis/
• Government of Ontario. (2018). Cannabis legalization. Retrieved from www.ontario.ca/cannabis   
• National Academies of Sciences, Engineering, and Medicine. (2017). The health effects of cannabis and cannabinoids: The current state of evidence and recommendations for research. Retrieved from https://www.nap.edu/read/24625/chapter/1
• Parachute Vision Zero Network (2018). Cannabis and drug impaired driving: What’s happening in Canada right now? Retrieved from https://parachute.ca/wp-content/uploads/2019/06/Vision-Zero-Case-Study-4.pdf
• Smoke-Free Ontario Scientific Advisory Committee, Ontario Agency for Health Protection and Promotion (Public Health Ontario). Evidence to guide action: Comprehensive tobacco control in Ontario (2016). Toronto, ON: Queen's Printer for Ontario; 2017.
• Wettlaufer, A., Florica, R. O., Asbridge, M., Beirness, D., Brubacher, J., Callaghan, R., Fischer, B., Gmel, G. & Imtiaz, S. (2017). Estimating the harms and costs of cannabis-attributable collisions in the Canadian provinces. Drug and Alcohol Dependence, 173, 185-190.
• Windsor-Essex County Health Unit (2016). Community needs assessment report. Windsor, Ontario.

Prepared By:

Jessica Kipping-Labute

Date:

October 18, 2018

Subject:

“Vote for Health” Municipal Election Survey Results

Background

Municipal governments and elected representatives can shape the health of communities through the design and delivery of local policies, programs, and services. The Ontario Public Health Standards (OPHS) and the Windsor Essex County Health Unit’s (WECHU) Strategic Plan both include a focus on developing, supporting, and participating in local healthy public policy. The Ontario Public Health Standards (OPHS) specify that Public Health Units (PHUs) are to share healthy public policy recommendations, and participate with stakeholders in the development of public policy that reduces barriers to positive health outcomes. The OPHS also specifies that PHUs are to use data to influence and inform the development of local healthy public policies.

On September 5th, the WECHU launched a voluntary survey distributed to all local council and mayoral candidates running in the upcoming 2018 municipal election. The survey asked candidates how they would prioritize their efforts based on seven local public health priority areas. The priority areas were identified based on local data, results from the WECHU’s 2016 Community Needs Assessment, and the Association of Local Public Health Agencies’ (alPHa) Municipal Election Policy Priorities document. The results of the survey were posted on the WECHU’s website on October 5th.

Results Summary

Candidates were asked how they would spend $100 on the local public health issues. In total, 50% (87) of the candidates completed the survey. They were told that their answers should reflect the amount of time and resources they would give to each public health issue. All candidates that completed the survey said that they would allocate resources towards mental illness. On average, candidates provided 25% ($25.49) of their resources to mental health in the community. The second highest allocation (16%; $16.21) was towards substance misuse in the community.

When candidates gave resources to one of the local public health issues, they were then able to select actions they might take. The actions provided were evidence-supported ways to address the local public health issues.

• Mental illness had the most frequently selected actions – 89% of candidates said they would advocate for funding for low-or no-cost mental health care to increase local access to treatment; and 87% would support training for first responders and front-line service providers to help people living with mental illness.
• Food insecurity had the third most frequently selected action – 84% of candidates said that they would support local programs, such as farmer’s markets, community gardens, and community kitchens.
• Putting fluoride into community water was the least selected action by respondents, with 8% of supporting this action.
• Substance misuse had the second and third least frequently selected actions – 28% of respondents supported local efforts to investigate the feasibility of safe injection sites; and 38% supported increasing the availability of naloxone and needle disposal bins in the community.

Next Steps

The results from this survey were posted on the WECHU’s website to provide information to the public about municipal candidate stances on healthy public policy issues. The results from the survey will also be used to inform future planning and program development within the WECHU. In 2019 the WECHU will provide an opportunity to all elected municipal officials to meet with the organizations CEO to discuss local healthy public policy issues.

Consultation:

The following individuals contributed to this report:

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

Approved By:

Theresa Marentette, CEO

Prepared By:

Communications Department

Date:

October 1, 2018

Subject:

September Media Relations Recap Report

August Media Coverage

Story Source

Media Coverage

News Release and Media Advisories

Stories Reported by the Media

AM 800

Note: Two requests from AM 800 do not have a reported story. The station chose not to broadcast the stories.

Blackburn News

CBC News

Note: We were unable to conduct an interview for one of the requests from CBC.

CBC - Radio Canada (French)

CTV News

Windsor Star

Note: We were unable to comment on one interview request since it was outside the scope of public health.

Windsorite.ca

Note: The request from St. Clair College will not appear in their student media channels until October.

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

On an annual basis, the WECHU prepares its operating budgets for review and approval by its Board.  The budget approval then becomes the foundation for the Annual Service Plan and Budget Submissions to the MOHLTC and MCYS. The due date for the 2019 Annual Service Plan and Budget Submission to the MOHLTC is March 1, 2019. The due date for the Budget Submission to MCYS is April 30, 2019.

Should you require this report in an alternative format, please contact the Health Unit.

Background

On September 5th, the Windsor Essex County Health Unit (WECHU) distributed a voluntary survey to all local council and mayoral candidates running in the 2018 municipal election. The survey asked candidates how they would prioritize their efforts based on seven local public health priority areas. These areas included: dental health, substance misuse, food insecurity, mental illness, built environment, and climate change. These priority areas were identified based on local data, results from the WECHU’s 2016 Community Needs Assessment, and the Association of Local Public Health Agencies’ (alPHa) Municipal Election Policy Priorities document. This approach was adapted with permission from the Simcoe Muskoka District Health Unit, and was modified to address locally relevant issues. The results of the survey were posted on the WECHU’s website on October 5th.

Demographics

The survey was sent to all 174 mayoral and councillor candidates from Amherstburg, Essex, Kingsville, Lakeshore, Lasalle, Leamington, Tecumseh, and Windsor. In total, 50% (87) of the candidates completed the survey. There were more respondents from Essex County than the City of Windsor.

Table 1: Respondents by position

Table 2: Respondents by municipality

Resource Allocation

Candidates were asked how they would spend $100 on the identified local public health issues. They were told that their answers should reflect the amount of time and resources they would give to each topic in their community.

All candidates that completed the survey said that they would allocate resources towards mental illness. On average, candidates provided 25% of their resources to mental health in the community (in relation to the other six public health issue areas). The second highest allocation was towards substance misuse in the community; on average candidates provided 16% of their resources to the issue.

Table 3: Average dollar amount per health issue

Candidate Actions

When candidates gave resources to one of the local public health issues, they were then able to select actions they might take. These actions are evidence-supported ways to address the local public health issues.

• Mental illness had the two highest actions selected; where 89% of candidates said they would advocate for funding for low-or no-cost mental health care to increase local access to treatment, and 87% would support training for first responders and front-line service providers to help people living with mental illness.
• Food insecurity had the third highest selected action; where 84% of candidates said that they would support local programs, such as farmer’s markets, community gardens, and community kitchens. However, overall food insecurity had the fourth lowest average dollar amount ($13.28) allocated.
• Putting fluoride into community water was the least selected by respondents.
• Substance misuse had the second and third lowest selected action; about 28% of respondents supported local efforts to investigate the feasibility of safe injection sites, and 38% supported increasing the availability of naloxone and needle disposal bins in the community.

Actions selected by health topic

Table 4.1 Dental Health

Table 4.2. Substance Misuse

Table 4.3. Food Insecurity

Table 4.4. Climate Change

Table 4.5. Mental Illness

Table 4.6: Built Environment

Table 4.7: Health Inequity

Table 5: Actions selected by percentage

Board Members Present:

Joe Bachetti, Dr. Ken Blanchette, Mark Carrick, Dr. Deborah Kane, Judy Lund, Bill Marra, Gary McNamara, Dr. Carlin Miller, Hilary Payne, Gord Queen, John Scott, Michelle Watters​

Board Member Regrets:

Paul Borrelli, Richard Meloche, Ed Sleiman

Administration Present:

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

WECHU Presenters: 

Eric Nadalin, Manager, CDIP

RECORDING SECRETARY:

SUBMITTED BY:

APPROVED BY:

Proposed Motion

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

Whereas, the Ontario government has amended the provincial Cannabis Act, 2017 to permit a privatized retail model in Ontario, and

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

Whereas, increased density and clustering of cannabis retailers may result in increased access, consumption, and increased risk for chronic disease, mental illness, and injury, and

Whereas, Ontario municipalities will have the one-time opportunity to OPT OUT of cannabis retail outlets in their communities, and

Now therefore be it resolved that, the Windsor-Essex County Board of Health encourages all Windsor-Essex municipalities to OPT OUT of the cannabis retail model as proposed by the provincial government in their respective communities.

FURTHER that the Windsor-Essex County Board of Health encourages the provincial government to establish limits on the number of retailers in a geographic area to prevent clustering and reduce retail outlet density.

FURTHER that, the Windsor-Essex County Board of Health for the Windsor-Essex County Health Unit encourages provincial government to set additional regulations with respect to the proximity of retail outlets in relation to areas which may unfairly target vulnerable populations.

FURTHER that, the provincial government provide local public health units with dedicated funding for public education and health promotion activities as well as the enforcement of cannabis-related regulations under the Smoke-free Ontario Act and FURTHER that the Windsor-Essex County Board of Health for the Windsor-Essex County Health Unit encourages all Windsor-Essex municipalities to amend existing smoke-free by-laws to include “cannabis” in the definition, and expand spaces where the use of substances is prohibited (e.g., cannabis consumption venues or vape lounges).

FURTHER that, previous Resolutions passed by the Windsor-Essex County Board of Health are shared with the newly elected provincial government.

FURTHER that the Windsor-Essex Board of health suggests the province providing for the ability of municipalities to create licensing and zoning regulations, which would be reflective of the unique needs of individual communities in addition to increasing the number and distance of buffer zones proposed for retail outlets from vulnerable areas.

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

Appendix

Municipal engagement activities to date

Proposed Motion

The WECHU Leadership Team recommends:

That the 2019 Cost Share Budget, as presented, requiring a 3.23 percent increase in funding from the Ministry of Health and Long-Term Care and a 5 percent increase in funding from the Obligated Municipalities, the Corporation of the City of Windsor, the Corporation of the County of Essex and the Corporation of the Township of Pelee, be approved.

That total Cost Shared expenditures net of offset revenue for 2019, in the amount of $19,902,586, be approved.

That total expenditures for 2019 relating to the Vector-Borne Disease program, in the amount of $350,000, be approved.

That total Healthy Babies Healthy Children Program Initiative expenditures, in the amount of $2,755,841, be approved.

That total Nurse Practitioner Program Initiative expenditures, in the amount of $146,617, be approved.

That total Related Program expenditures, in the amount of $3,469,870, be approved.

2018 Q2 WECHU Strategic Plan Progress - At a Glance

Communication and Awareness

Organizational Development

Partnerships

Evidence-based Public Health Practice

Communication and Awareness

Partnerships

Organizational Development

Evidence-Based Public Health Practice

Prepared By:

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

Date:

July 12, 2018

Subject:

Strategic Plan Q2 Report

Background

The 2017-2021 WECHU Strategic Plan allows our organization to identify key roles, priorities and directions and sets out what we plan to accomplish, how we plan to do it, and how our progress will be measured. The plan is based on four strategic priorities: Communication and Awareness, Partnerships, Organizational Development, and Evidence-Based Public Health Practice.

In early 2018, the Planning and Strategic Initiatives department implemented a corporate tracking system to monitor Strategic Plan performance and to provide quarterly and annual updates to the BoH. In the first quarter of 2018, progress was made on a number of objectives, while more work was needed to move others forward. 

Current Initiatives

In the second quarter of 2018, progress continued on most of the strategic objectives.  The 2018 Q2 Strategic Plan Progress Report provides updates on each objective with corresponding next steps (see appendix A). 

Consultation

The following individuals contributed to this report:

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

Approved by:

Theresa Marentette

Prepared By:

Jenny Diep, Health Promotion Specialist

Date:

August 30, 2018

Subject:

Supervised Injection Services (SIS) Community Consultation Project

Background

Locally in Windsor-Essex County (WEC), we are facing increased morbidity and mortality related to the use of opioids and other drugs.  There were 382 opioid-related emergency department visits in WEC in 2015, which is 3.6-times greater than in 20031.  The rate of opioid-related emergency department visits in Windsor was 2.8-times greater than the rate in Essex County.  There were 24 opioid-related deaths in WEC in 2015; 19 deaths were in the city of Windsor¹. Furthermore, the number of hepatitis C cases, a blood-borne infection, increased from 143 reported cases in 2016 to 181 reported cases in 2017².  In 2017, out of the 164 confirmed cases that reported at least one risk factor other than unknown, injection drug use was reported by 62% of cases (101 cases)³.  There have been 211 documented needle-related calls from January 1, 2014 to February 5, 2018 to local municipal service (3-1-1), predominantly in downtown Windsor⁴.  Number of needle-related calls have significantly increased, from 43 in 2016 to 121 in 2017 (City of Windsor, 3-1-1 calls)⁴.

Overdose Prevention Sites (OPS) and Supervised Consumption Services (SCS)

In December 2017, in response to overdose-related deaths, Health Canada announced that it would provide temporary class exemptions to provinces and territories demonstrating evidence of an urgent public health need. This allowed for possession and use of controlled substances on exempted sites, known as OPS. This provided a space for people to consume drugs in a safe environment, where staff or volunteers can provide overdose response measures as required. This interim measure allowed communities to plan for a long-term solution, such as a SCS.

A SCS is a legally sanctioned site that provides a location where people can bring their own illicit substances to consume under safer conditions and supervised by trained workers who can respond to an overdose as needed⁵. A SCS includes SIS, and offers treatment, health, and social services for people who are ready to stop or reduce their drug use. An OPS may not have these services in place as a temporary site, while a SCS aims to connect people who use drugs to health and social services. A SCS reflects harm reduction principles, which recognizes that individuals with substance use issues may not wish or be able to abstain from substance use, and thus, seeks to minimize the harms associated with drug use⁶. It is a part of Health Canada’s Canadian drugs and substances strategy. Benefits of SISs, as acknowledged by the Government of Canada⁷, include:

• Reduced overdose-related morbidity and mortality^8,9;
• Reduced injecting and discarding of needles in public space⁹;
• No evidence of increased drug-related crime or loitering or rates of drug use⁹;
• Increased access to withdrawal management and treatment services and other health and social services^5,9;
• Reduced transmission of blood-borne infections, such as hepatitis C and HIV, through decreased needle sharing^8,9; and
• Reduced health care costs, ambulance calls, use of emergency departments, and hospital admissions^8,9.

Prior to the establishment of a supervised consumption site (SCS) and also a requirement of Health Canada’s application for exemption under Section 56.1 of the Controlled Drugs and Substances Act, community engagement is essential to informing the need and feasibility for a SIS and predicting its success⁵.  Similar projects have been conducted in London, Toronto, Hamilton, and Waterloo in Ontario.  These projects similarly reflect such projects in British Columbia.

Locally, organizations have expressed interest in applying for a SCS in Windsor.

Current Initiatives

As part of the Windsor-Essex Community Opioid & Substance Strategy (WECOSS) under the Harm Reduction Pillar, the Windsor-Essex County Health Unit (WECHU) is leading the Supervised Injection Services Community Consultation Project (SIS-CC) to assess the need and acceptability of SIS in WEC.  The study will:

• Explore the need for SIS in WEC;
• Explore the design, potential locations, and conditions under which an SIS would be preferred by potential clients and stakeholders in Windsor; and
• Assess community perceptions of SIS and identify any concerns and strategies to mitigate such concerns.

This project will involve a mixed methods approach (i.e., quantitative and qualitative):

1. Analysis of local surveillance data. Existing surveillance data regarding morbidity and mortality related to opioid and substance use, including hepatitis C rates, public discarding of needles, health care service use related to opioid use, and harm reduction service use.
2. In-person surveys with people who inject drugs (PWIDs). The 45-minute survey explores drug use and injection practices, perceptions of SIS and its implementation (e.g., policies, hours, location), experiences of overdose, health and drug treatment. Peer researchers will be trained to recruit and administer the survey. Peer researchers are hired staff who have had lived experience with injection drug use, and may more likely be able to build a rapport with potential participants to complete the survey.
3. Public Online survey with the Windsor-Essex County community. The 5-minute online survey involves questions related to perceptions of drug use and SISs and its implementation. This survey may identify additional needs outside of Windsor, and thus, inform future community consultation projects.
4. Interviews with key informants. A 30-minute interview will be conducted with identified key informants and community leaders including harm reduction service providers, local politicians, key leaders from community service agencies/organizations, advocacy groups and emergency services from Windsor.
5. Focus groups with key stakeholder groups. A 1.5-hour focus group will be conducted with individuals from key stakeholder groups that have an interest in drug-using populations and can be affected by or affect policy and implementation (or non-implementation) of SIS.  These include first responders (police, fire, and emergency medical services), representatives from municipal government departments, community services agencies/organizations, and community, neighbourhood and business groups from Windsor.

The project will be promoted through social media and the Health Unit and WECOSS websites, which is currently being developed.  More information about SIS, SCS, OPS, and the project will be provided on the WECOSS website.

An application to the University of Windsor Research Ethics Board (REB) has been submitted and pending final approval we expect to launch the survey in late September with data collection continuing to the end of 2018.

References

1. Windsor-Essex County Health Unit. (2017, June). Opioid misuse in Windsor-Essex. Retrieved from https://www.wechu.org/about-us/reports-and-statistics/opioid-misuse-windsor-essex-county.
2. Windsor-Essex County Health Unit. (2018). Monthly infectious disease report – February 2018. Windsor, ON: Windsor-Essex County Health Unit.
3. Data Source: Integrated Public Health Information System (iPHIS), Ministry of Health and Long-Term Care [extracted 2018 Jun 8]
4. Data Source: City of Windsor, 3-1-1 calls [extracted 2018 Feb 05]
5. Government of Canada. (2017, July 6). Supervised consumption site: Guidance for application form. Retrieved from https://www.canada.ca/en/health-canada/services/substance-abuse/supervised-consumption-sites/guidance-document.html.
6. Canadian Mental Health Association. (2018). Harm reduction. Retrieved from https://ontario.cmha.ca/harm-reduction/.
7. Government of Canada. (2017, May 26). Statement from the Minister of Health – Health Canada authorizes four new supervised consumption sites. Retrieved from https://www.canada.ca/en/health-canada/news/2017/05/statement_from_themi....
8. Ng, J., Sutherland, C., & Kolber, M.R. (2017). Does evidence support supervised injection sites. Canadian Family Physician, 63(11), 866.
9. Kennedy, M.C., Karamouzian, M., & Kerr, T. (2017). Public health and public order outcomes associated with supervised drug consumption facilities: A systematic review. Current HIV/AIDS Reports, 14(5), 161-183. https://doi.org/10.1007/s11904-017-0363-y

Approved by:

Theresa Marentette

Prepared By:

Jessica Kipping-Labute

Date:

September 10, 2018

Subject:

“Vote for Health” Municipal Election Survey

Background

Municipal governments and elected representatives can shape the health of communities through the design and delivery of local policies, programs, and services.  Working with partners and decision makers to achieve these outcomes is part of the Ontario Public Health Standards (OPHS), and is one objective of the Windsor-Essex County Health Unit’s (WECHU) 2017-2021 Strategic Plan. 

Under the Foundational Standard of the OPHS, Public Health Units (PHUs) are to share reports, advisories, and healthy public policy recommendations.  As well, PHUs are to contribute to policy work aimed at reducing barriers to positive health outcomes. Specifically, leading, supporting, and participating with stakeholders on policy development to decrease health inequities. In the Program Standards PHUs are to use data to influence and inform the development of local healthy public policies.

Current Initiatives

On September 5th, the WECHU launched ‘Vote for Health’, a voluntary survey distributed to all local council and mayoral candidates running in the upcoming 2018 municipal election. The survey asks about how municipal candidates would prioritize their efforts based on seven identified local health priority areas. These areas include dental health, substance misuse, food insecurity, mental illness, built environment, and climate change. These priority areas were identified based on local data, results from the WECHU’s 2016 Community Needs Assessment, and the Association of Local Public Health Agencies’ (alPHa) Municipal Election Policy Priorities document. This approach was adapted with permission from the Simcoe Muskoka District Health Unit and modified to specifically address locally relevant aspects. The results of the survey will be posted on WECHU’s website in late September. The information collected from municipal candidates does not necessarily reflect the views of the WECHU, but instead provides an opportunity for candidates to share their views on local public health issues with the community.

The purpose of the survey is to:

• Raise awareness of local public health issues.
• Provide an opportunity for municipal candidates to share their views on these public health issues.
• Provide residents with municipal candidate’s views on these public health issues to support informed decision-making when voting in the October municipal election.

Support the development of healthy public policy during and after the election period.

Consultation

The following individuals contributed to this report:

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

Approved by:

Theresa Marentette

Prepared By:

Communications Department

Date:

July 4, 2018

Subject:

June Media Relations Recap Report

June Media Coverage

Story Source

Media Coverage

News Release and Media Advisories

Stories Reported by the Media

AM 800

Blackburn News

Canada.com

CBC News

Chatham This Week

CTV News

Essex Free Press

Wallaceburg Courier Press

Windsor Star

Windsorite.ca

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

Prepared By:

Communications Department

Date:

August 1, 2018

Subject:

July Media Relations Recap Report

July Media Coverage

Story Source

Media Coverage

News Release and Media Advisories

Stories Reported by the Media

AM 800

Blackburn News

CBC News

CTV News

Prepared By:

Communications Department

Date:

September 7, 2018

Subject:

August Media Relations Recap Report

August Media Coverage

Story Source

Media Coverage

News Release and Media Advisories

Stories Reported by the Media

AM 800

Blackburn News

CBC News

CTV News

Windsor Star

Windsorite.ca

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

Prepared By:

Lorie Gregg, Director of Corporate Services

Date:

September 6, 2018

Subject:

Q2 Financial Results

Background

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

• Mandatory programs funded to a maximum of 75% (“Cost-Shared”) by the Ministry of Health and Long-Term Care (“MOHLTC”) and the Corporation of the City of Windsor, the Corporation of the County of Essex and the Corporation of the Township of Pelee (hereinafter referred to as the “Obligated Municipalities”);
• Related programs such as Vector-Borne Diseases and Small Drinking Water Systems, funded on a cost-shared basis to a maximum of 75% by the MOHLTC and certain surrounding municipalities within the geographic boundaries of Windsor and Essex County;
• Related programs funded 100% by the MOHLTC;
• Related programs funded 100% by the Ministry of Children and Youth Services (“MCYS”);
• One-time business cases.

The second quarter financial report to the Board includes a budget to actual comparison and narrative for material variances for all programs listed. Forecasted financial results will be presented as a part of the Q3 and Q4 reporting.

Cost-Shared Program Financial Results

The following is the financial information for the Cost-shared programs including Vector-Borne Diseases and Small Drinking Water Systems for the second quarter of 2018.

For the period January 1, 2018 to June 30, 2018, cash flows on account of the 2018 program year for this program are as follows:

For material variances where the financial captions percentage spent exceeds 50%, an explanation has been provided:

• Benefits: Expenditures in this financial caption relate to amounts paid/payable by the WECHU on account of medical, dental and extended health benefits as well as amounts paid on account of certain other payroll remittances (i.e. OMERS contributions, CPP, EI, EHT, WSIB). The dollar negative variance is not material and will be monitored over the remainder of the fiscal year with any remaining negative variances funded by the Salaries financial statement caption.
• 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 earlier in the fiscal year.  For the remainder of the year, fees will be lower and thus tracking will be in line with budget as the year progresses.
• Publications:  Expenditures in this financial caption include costs of subscriptions.  The dollar value of this negative variance is not material and will be monitored and offset by other underutilized financial captions as the fiscal year progresses.
• Building Maintenance:   Expenditures in this financial caption relate to amounts paid on account of building maintenance, grounds keeping and house keeping supplies.  At June 30, 2018, the negative variance of $9,254 resulted from:  i) annual elevator maintenance fees for the period May 1, 2018 to April 30, 2019 of $8,546 were paid; ii) grounds keeping costs for snow removal are typically higher in the first half of the fiscal year compared to the latter half (3 months of service from January to March of 2018 compared to 2 months of service from November to December of 2018); iii) additional costs incurred on account of unplanned HVAC repairs.  
• 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.  There will be no further insurance premiums in 2018 and this financial caption should remain underspent at year-end.

Risks:  Of noteworthy mention when considering the financial information above are the following:

• Status of collective bargaining agreements – Collective bargaining agreements with CUPE (contract expired December 31, 2017) and ONA (contract expired March 31, 2018) remain outstanding.  As such, the WECHU may be required, dependent upon the results of negotiations, to make retroactive payment for contractual increases not yet reflected in the year-to-date financial results disclosed above.
• Status of other labour related matters – Other labour related matters (i.e. pay equity; impacts associated with grievances) which remain unsettled, have not be reflected in the year-to-date financial results above given the uncertainty associated with the settlement of those matters.

Healthy Babies Healthy Children Program Financial Results

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

For the second quarter of 2018, the HBHC program is $92,277 underspent due in part to staffing vacancies associated with leaves of absence (i.e. maternity leaves, unpaid absences, etc.).  
Refer to the Risks discussion noted in the Cost-Shared Program Financial Results section of this report, as this would be relevant to this program.

Nurse Practitioner Program Financial Results

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

The 2018 budget submission to the MCYS includes a one-time grant request for $5,210 representing the forecasted overage in Salaries and Benefits for the year-ending December 31, 2018.  As at the date of this report, our one-time funding request has not been approved.  The WECHU will continue to monitor this unfavourable variance and anticipate that it will ultimately be funded by the Cost-Shared Budget.

Financial Information for Related Programs Funded 100% by the MOHLTC

The 2018 Annual Service Plan and Budget Submission included a budget of $1,529,700 for Healthy Smiles Ontario (“HSO”), inclusive of the $120,900 augment approved by the MOHLTC on May 7th, 2018.

At June 30, 2018, the net underspent budget amounted to $79,974.  Material variances are detailed below:

• The base funding approval of $120,900 included an addition of 1 FTE (dental assistant) of $71,471 Salaries and benefits that the WECHU would not operationalize until such time as an approval was received.  The budget impact of this deferral resulted in an approximate underspend of $35,735. 
• In Q2 of 2018 additional Program Supplies costs of $16,425 were incurred on account equipment replacements.
• Purchased services were underspent at June 30, 2018, due to the following:  i) The May 7th, 2018 augment to base funding included additional funding for purchased services of $36,400 for contract dentistry.  The WECHU is currently in the process of completing the requisite policy work to procure the services of a contract pediatric dentist.  It is anticipated that this dentist will be in place by Q4 of 2018.  ii) The WECHU had only 2 contract dentists for Q1.  A third contact dentist was added in March of 2018 servicing our Leamington dental clinic; iii) Fees paid to contract dentists are typically one month behind.
• Offset revenue of $6,300 was earned in Q1 of 2018 on account of the sale of three autoclaves using a third party auction site as required by the WECHU policies and procedures for disposing of tangible capital assets.

Refer to the Risks discussion noted in the Cost-Shared Program Financial Results section of this report, as this would be relevant to this program.

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

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

At June 30, 2018, the total unspent budget amounted to $17,135.  The most notable variance relates to the Professional Development financial caption.  In Q1 of 2018, an individual was sent to a non-violence conflict resolution train-the-trainer course amounting to $4,180.  The unfavourable budget variance in the Professional Development financial caption continues to be monitored with any remaining budget overage to be offset against the favourable variance Program Supplies financial caption.

Refer to the Risks discussion noted in the Cost-Shared Program Financial Results section of this report, as this would be relevant to this program.

A description of other related programs is included below:

Chief Nursing Officer Initiative:  Under the Organizational Requirements of the Ontario Public Health Standards, the Chief Nursing Officer role serves to enhance health outcomes of the community at individual, group and population levels:  i) Through contributions to organizational strategic planning and decision making; ii) By facilitating recruitment and retention of qualified, competent public health nursing staff; iii) By enabling quality public health nursing practice.  This funding envelope supports 1 FTE meeting certain qualifications as required by the Ontario Public Health Standards.  At June 30, 2018, there are no negative variances to report on.

Enhanced Food Safety – Haines Initiative:  Base funding for this initiative supports the enhancement of the Board of Health’s capacity to deliver the Food Safety Program as a result of the Provincial Government’s response to Justice Haines’ recommendations in his report “Farm to Fork:  A Strategy for Meat Safety in Ontario”.  At June 30, 2018, there are no negative variances to report on.  It is anticipated that these funds will be fully expended by Q4 of 2018.

Enhanced Safe Water:  Base funding for this initiative supports the enhancement of the Board of Health’s capacity to meet the requirements of the Safe Water Program Standard under the Ontario Public Health Standards.  At June 30, 2018, there are no negative variances to report on. It is anticipated that these funds will be fully expended by Q4 of 2018.

Harm Reduction Program Enhancement:  Base funding for this initiative supports the Board of Health in the activities associated with its Local Opioid Strategy.  More specifically it supports 2.5 FTEs dedicated to working on activities associated with:  i) Our local opioid response; ii) Naloxone Distribution and Training; iii) Opioid Overdose Early Warning and Surveillance.   At June 30, 2018, there are no negative variances to report on.

Infection Prevention Control Nurses Initiative:  Base funding for this initiative supports one additional infection prevention and control nursing FTE having certain qualifications.  At June 30, 2018, negative variances of $4,273 have resulted as salaries and benefits for this position have exceeded the approved funding.  Negative variances will be absorbed by the Cost-Shared Budget.

Infectious Disease Control Initiative:  Base funding for this initiative supports the hiring of infectious diseases control positions (4.5 FTEs) and supporting these staff to monitor and control infectious diseases.  They serve to enhance the Board of Health’s ability to handle and coordinate increased activities related to outbreak management.  At June 30, 2018, there are no negative variances to report on.
Needle Exchange Program Initiative:  Base funding for this initiative supports the purchase of needles and syringes, and their associated disposal costs, for the Board of Health’s Needle Exchange Program.  At June 30, 2018, there are no negative variances to report on.

Social Determinants of Health Nurses Initiative:  This initiative was established to support 2 public health nursing FTEs with specific knowledge and expertise in social determinants of health and health inequities issues, and to provide enhanced supports internally and externally to the Board of Health to address the needs of priority populations impacted most negatively by the social determinants of health.  At June 30, 2018, negative variances of $7,098 have resulted as salaries and benefits for these positions have exceeded the approved funding.  Negative variances will be absorbed by the Cost-Shared Budget.

Refer to the Risks discussion noted in the Cost-Shared Program Financial Results section of this report, as this would be relevant to these programs.

Financial Information for Related Programs Funded 100% by the MOHLTC

Mandatory Programs:  Potassium Iodide Distribution Program:  One-time funding to improve nuclear emergency preparedness and increase knowledge amongst residents living within the primary and secondary zone of the Fermi 2 nuclear generating station.  Eligible costs include Potassium Iodide pill packs, and staff salaries, project materials, printing and postage associated with the distribution of KI packs and ongoing communication campaigns.  It is anticipated that funds will be utilized by March 31, 2019.

Mandatory Programs:  Public Disclosure System:  One-time funding must be used to update software and inspection forms to meet the new disclosure requirements under the Ontario Public Health Standards.  Eligible costs include software update, disclosure, and migration.  Implementation of the disclosure system is planned for November of 2018 and will require 3rd party resources as well as internal resources for support (i.e. Information Technology; Healthy Environments).  It is anticipated that funds will be utilized by March 31, 2019.

Needle Exchange Program Initiative:  One-time funding for extraordinary costs associated with delivering the Needle Exchange Program.  Eligible costs include purchase of needles/syringes and associated disposal costs.  One-time funds were expended in Q3 of 2018.

Public Health Inspector Practicum Program:  One-time funding must be used to hire the approved Public Health Inspector Practicum positions.  Eligible costs include student salaries, wages and benefits, transportation expenses associated with practicum positions, equipment and educational expenses.  The practicum placements commence in May and conclude in August annually.  It is anticipated that these funds will be utilized in Q3 of 2018.

Vector-Borne Diseases Program:  Enhanced Mosquito Surveillance:  One-time funding must be used for an enhanced surveillance program.  Eligible costs include salaries for students, supplies and additional equipment, identification and testing expenses, promotional costs and mileage.  It is anticipated that these funds will be utilized by Q4 of 2018 with the conclusion of this year’s surveillance program.

Capital:  One-time funding must be used to assist with costs to complete the capital planning requirements for a Stage 2 – Business Case submission.  Utilization of these funds is dependent upon the status of the work being completed internally and by third party consultants based upon the direction from the WECHU’s Board. 

Approved by:

Theresa Marentette