Board of Health Meeting Documents

PREPARED BY:

Healthy Schools Department – Immunization

DATE:

October 20, 2022

SUBJECT:

Immunization of School Pupils Act (ISPA) Enforcement in Secondary Schools and Grade 7 In-School Immunizations

BACKGROUND/PURPOSE

In Ontario, the Immunization of School Pupils Act (ISPA) R.S.O. 1990, requires children and adolescents attending primary or secondary school to be immunized against mumps, rubella, diphtheria, tetanus, meningococcal, varicella and polio, or have a valid Medical, Conscience or Religious Belief exemption on file at the Health Unit. As outlined in the Ontario Public Health Standards (OPHS), health units in Ontario are required to have a complete immunization record, or a valid exemption on file, for every student attending school in their area.

DISCUSSION

ISPA Enforcement in Secondary Schools

Beginning in the spring, the WECHU reviewed immunization records for students attending secondary school in Windsor and Essex County, as mandated by the ISPA. In June 2022, 13,254 secondary school students had incomplete immunization records and were either overdue for one or more vaccines or had not submitted their updated records to the WECHU. These students received an immunization notice in June, informing them of their missing vaccines along with information on how and where to receive any missing vaccinations and/or how to update their records. A suspension order was then mailed in early August to any secondary student who had not yet submitted the required immunization information to the WECHU.

Throughout the summer, the WECHU hosted catch-up immunization clinics in all municipalities in Windsor and Essex County, to ensure that these students had the opportunity to complete their vaccine series prior to the 2022/2023 school year and to avoid suspension. The WECHU also worked with local health care providers to provide them with the necessary vaccines and ensure their patients’ records were updated.

In addition to the secondary school student immunization record review, an immunization record review was also conducted for children in kindergarten to grade 3 in early 2022. 8,687 immunization notices were sent to parents informing them of the student’s missing vaccines and encouraging them to get their child vaccinated. The enforcement process (i.e., issuing suspension notices and suspension) for elementary students will begin in 2023.

Prior to enforcing the ISPA through the suspension process, the WECHU worked with local school boards to host onsite immunization clinics in local secondary schools, in addition to the clinics in each municipality and WECHU offices. As part of the strategy to promote these clinics, the WECHU developed a detailed communications plan that included news releases, social media posts, paid Facebook and SnapChat ads, a 211 email blast, and radio ads. From June 1st to August 31st, 54 organic Facebook, Twitter, Instagram messages were posted ranging from general messaging about the benefits of vaccination, to where to find an immunization clinic and how to update a student’s immunization clinics.

In August, 7,554 secondary students still had incomplete immunization records and were mailed suspension orders. As of the suspension deadline on Monday, September 12th, there were 1,519 secondary students who had not provided updated records to the WECHU. These students were suspended on September 14th, 2022. The WECHU has continued to provide walk in clinics and updated records with information received by health care providers and online submissions through ICON.

In order for a student to return to school after being suspended, the student or parent/guardian must provide the WECHU with an updated immunization record. Clinics for students who were suspended have been operational at both WECHU locations with evening and weekend appointment availability to ensure every student has the opportunity to receive their vaccine. Additionally, WECHU nurses have been contacting every student on the suspension list and reviewing their immunization records with them to ensure they are complete. Once the student’s immunization record is up-to-date with the WECHU, the school principal is informed that the student can return to school. This process involves sending a daily up-dated suspension list to every secondary school in Windsor and Essex County. As of October 3rd, 49 students are still suspended for incomplete immunization records.

Grade 7 School Immunization Clinics

Due to the ongoing COVID-19 pandemic and the disruption of regular public health and education services, the WECHU was unable to fully implement in-school immunization programs over the last two years, in particular to students in grades 7 for Hepatitis B, Human Papillomavirus (HPV), and Meningococcal Disease. These vaccines were made available to local health care providers to administer free of charge to eligible patients. However, some families have not been able to visit their health care providers to update their child’s vaccinations due to the pandemic or other external factors.

School-based immunization clinics for Grade 7 students will return to the normal pre-pandemic schedule in the 2022-2023 school year. In-school clinics are being offered starting October 20th to all local schools. As of September 28th, there are 4,455 students eligible for the HPV vaccine, 3,941 students eligible for the Hep-B vaccine, and 4,308 students eligible for the Men-C-ACYW-135 vaccine. Given the student’s previous vaccination history, they may be eligible for one or more of these vaccines. These clinics will be offered this fall and a second round of clinics will be scheduled next spring. These publicly-funded vaccines are free of charge, to eligible Grade 7 students. Parents of Grade 7 students will receive a letter informing them of the date for their school’s clinic. Parents will complete an online consent for the vaccines they want their child to receive and will be informed that the meningococcal vaccine is a required vaccine under the ISPA.

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PREPARED BY:

Chronic Disease and Injury Prevention

DATE:

October 20, 2022

SUBJECT:

Nutritious Food Basket & Food Insecurity

BACKGROUND

Household food insecurity refers to the inadequate or insecure access to food due to financial constraints. When an individual or family struggles to put food on the table, it is a sign of overall deprivation due to inadequate or unstable incomes. In these cases, food is often sacrificed to pay for other costs of living. Food insecurity has severe negative impacts on physical health, mental health, the healthcare system, and overall social well-being1. For children, living in a food insecure household is associated with childhood mental health issues, like hyperactivity, inattention, and greater risks of disordered eating, depression and suicidal ideation in adolescence and early adulthood2.

Household food insecurity status is determined through a survey of eighteen questions, ranging from experiences of anxiety that food will run out before there is money to buy more, to modifying the amount of food consumed, to experiencing hunger, and in the extreme, going a whole day without eating2. In 2021, it was reported that 48% of food insecure households in Ontario have a household member who earns their main source of income through wages, salaries or self-employment. However, the jobs are often precarious and low-paying (minimum wage), requiring a person to have more than one job to make ends meet. The results of this survey highlights that food insecurity extends beyond people who receive social assistance. Income solutions preserve dignity, address the root case of the problem, and ensure the basic right to food2.

Since 1998, the Ontario Public Health Standards have mandated local health units to monitor food affordability through population health assessments and surveillance using the Nutritious Food Basket (NFB) tool. Food costing tools, such as the NFB3, measure the cost of basic healthy eating that represents current nutrition recommendations and average food purchasing patterns. The 2019 NFB cost was $211.20. However, The NFB tool was recently modified to capture Health Canada’s 2019 update of the National Nutritious Food Basket, the current market availability of many products, and the ability to find the price of foods through online grocery platforms - reflecting modern consumer purchasing behaviour. Due to this update, any NFB basket completed before 2020 cannot be compared to the 2022 NFB value.

CURRENT INITATIVES

Between May 16 and June 24, 2022, the WECHU and 27 other Public Health Units participated in a pilot to test the new NFB costing tool using a hybrid model of in-store and online data collection. Using the updated NFB costing tool, the average cost of the lowest price available for 61 different food items was calculated. Once the average basket price was determined for different age groups and genders based on the scenario, a 5% buffer was added to the final basket amount. This accounted for miscellaneous items not included in the calculation such as spices, hygiene products, and other household needs. Using these final numbers, a variety of income and family scenarios for our local community were calculated.

The 2022 cost of healthy eating for a family of four in our area is $241.66 per week. A sample of three income scenarios from the 2022 Real Cost of Eating Well in Windsor-Essex report can be seen in below (Table 1). This table compares monthly income received to the cost of rent and the 2022 NFB.  As noted, a single male living on Ontario Works (a social assistance benefit program) could spend close to his entire income on the rent for a bachelor apartment, leaving a shortage of $291.61 after other expenses. This highlights how the inability to purchase food is less about food prices being too high and more about people with low incomes not having enough income to cover the costs of basic living, including purchasing nutritious food.

Table 1. Income scenarios adapted from the 2022 Real Cost of Eating Well in Windsor-Essex report.
  Family of Four:
Ontario Works		 One Person:
Ontario Works		 One Person:
Old Age Security/GIS
Income
Total Monthly Income (Including benefits and credits) $2,760.00 $863.00 $1,885.00
Expenses
Estimated Monthly Rent $ 1,367.00 $ 775.00 $ 976.00
Healthy Food (NFB, 2022) $ 1,046.39 $ 379.61 $ 267.64
Monthly Income Remaining for All Other Expenses
  $346.61 $ -291.61 $641.36

The NFB data has been used as an essential local component in the calculation of the Windsor-Essex County Living Wage. This data can also be used as an advocacy tool toward ends which enhance priority groups’ ability to purchase healthy food by:

  • Setting a minimum wage rate that more closely aligns with costs of living in Ontario
  • Lowering the income tax rate for the lowest-income households
  • Developing a poverty reduction strategy that includes targets for reduction of food insecurity as well as policy interventions that improve the financial circumstances of very low-income households.
  • Commiting to ongoing analysis of disaggregated race-based food-insecurity data, including Indigenous Peoples and Black communities in Ontario 

The 2022 Real Cost of Eating Well in Windsor-Essex report will be disseminated to local social planners, anti-poverty advocates, Registered Dietitians, and other community partners who will benefit from using this data within their program planning and advocacy efforts. To view the full report, visit www.wechu.org/healthy-eating/nutritious-food-basket.

  1. Ontario Dietitians in Public Health, Food Insecurity Workgroup. Position Statement on Responses to Food Insecurity. https://www.odph.ca/upload/membership/document/2021-04/ps-eng-corrected-07april21_3.pdf. Published December 2020.
  2. Tarasuk V, Li T, Fafard St-Germain AA. (2022) Household food insecurity in Canada, 2021. Toronto: Research to identify policy options to reduce food insecurity (PROOF). Retrieved from https://proof.utoronto.ca/  September 2, 2022.
  3. Ministry of Health Promotion. Nutritious Food Basket Guidance Document. https://www.health.gov.on.ca/en/pro/programs/publichealth/oph_standards/docs/mhp/NutritiousFoodBasket.pdf May 2010.
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PREPARED BY:

Planning and Strategic Initiatives Department

DATE:

October 20, 2022

SUBJECT:

Renewal Plan Q3 Reporting

BACKGROUND/PURPOSE

At the May 2022 Board of Health meeting, a Renewal and Transformation plan was presented to the Windsor-Essex County Health Unit (WECHU) Board of Health, detailing the short-term priorities and planning expectations for the WECHU for 2022. This plan includes 5 priority renewal efforts in response to the stabilization of the COVID-19 Pandemic response requirements. Those 5 priorities are: Health Assessment and Surveillance, Addressing Backlog of Services, Mental Health and Substance Use, Healthy Growth and Development, and Capacity Building. Beyond these priorities, the plan outlines sustained COVID-19 response efforts as required, based on local needs and Ministry of Health requirements.

DISCUSSION

Since the release of the Renewal and Transformation Plan, departments have developed operational plans aligning with key areas. The progress made on these plans to date includes work spanning from May 2022 until the end of Q3 (September 30th). Overall, 39% of project objectives are complete, 46% of project objectives are in progress, and 15% or project objectives had no progress. Additional reporting on the progress related to the Renewal and Transformation plan will occur in January 2023 and outline the progress made in Q4 of 2022.

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Board Members Present:

Gary McNamara, Joe Bachetti, Tracey Bailey, Rino Bortolin, Aldo DiCarlo, Gary Kaschak, Judy Lund, Robert Maich

Board Member Regrets:

Fabio Costante, Ed Sleiman

Administration Present:

Dr. Ken Blanchette, Dr. Shanker Nesathurai, Lorie Gregg, Kristy McBeth, Eric Nadalin, Dan Sibley, Lee Anne Damphouse

Guests:              

Marc Frey, WECHU Manager, Planning and Strategic Initiatives

QUORUM: Confirmed

 

  1. Call to Order

    Board Chair, G. McNamara, called the Regular meeting to order at 4:01 p.m. The Chair welcomed new WECHU CEO, Dr. Ken Blanchette, to the team and the Board wished him well in his new role.

  2. Agenda Approval
    Motion: That the agenda be approved.
    CARRIED
  3. Announcement of Conflict of interest – None
  4. Topical Update (Dr. S. Nesathurai)

    Dr. Nesathurai respectfully addressed the Board noting that COVID cases are increasing in our region.  Approximately 40% of our Long-Term Care Homes (LTCH) are in outbreak and hospitals are saturated with capacity rates over 100%.   Our Ambulatory services have experienced Code Black status, and influenza and respiratory diseases are on the rise.  Care of the overall community is a priority for public health and public health messaging around masking, staying home when you are sick and ensuring that vaccinations are up to date continues.  Flu shots are available at most pharmacies and primary care givers, and those who are eligible should ensure that they are protected.  COVID-19 and influenza vaccines can also be co-administered.

    G. McNamara noted that Code Black status in ambulatory services have increased 300% since September 2022, and there needs to be a solution to reduce the impacts on our emergency system. Offloading EMS patients and over capacity at hospitals is contributing to the situation.  The Ministry is aware of the issue and it is not unique to Windsor-Essex, but has become a problem across the province.  There are any individuals with multi-symptom diseases who may not have access to primary care physicians and are seeking treatment at emergency rooms.

    Part of the messaging to the community is to self-protect and communication is timely around instilling various public health measures.  Dr. Nesathurai noted the lack of ambulatory services as catastrophic and asked that all Board members speak publically to this.

    Motion: That the information be received.
    CARRIED

  5. Approval of Minutes
    1. Regular Board Meeting:  September 15, 2022
      Motion: That the minutes be approved. 
      CARRIED
  6. Business Arising

    1. Board of Health By-Laws and Policies (Second Reading) (L. Gregg)
      The By-laws presented to the Board of Health today are for second reading.  A question arose at the September 15, 2022 Board of Health meeting on implementing a Policy Governance Committee.  It was suggested by K. Blanchette that a Recommendation for a policy committee be brought forward after the municipal elections.
      Motion: That the information be received.
      CARRIED

      1. Public Attendance and Delegations at Board of Health Meetings
        To be brought to the November Board of Health meeting for final approval. 

      2. Delegation of Duties
        To be brought to the November Board of Health meeting for final approval.
      3. Performance of Medical Officer of Health and Chief Executive Officer
        To be brought to the November Board of Health meeting for final approval.
      4. By-Law No. 1 – Governance
        To be brought to the November Board of Health meeting for final approval.
      5. By-Law No. 2 – Finance
        To be brought to the November Board of Health meeting for final approval.
      6. By-Law No. 3 – Human Resources
        To be brought to the November Board of Health meeting for final approval.
      7. By-Law No. 4 – Management of Real Property
        To be brought to the November Board of Health meeting for final approval.
        Motion: That the information be received. 
        CARRIED
  7. Consent Agenda
    1. INFORMATION REPORTS

      1. ISPA Enforcement (K. McBeth)
        K. McBeth advised that the suspension deadline for immunization has expired and the number of students on the suspension list is under 50.  Many are on this list because they were difficult to contact, and there are less than 15 students who are non-compliant. G. McNamara asked how we fair in comparison to other jurisdictions, and K. McBeth noted that Public Health Ontario is working on an updated report and once statistics are up to date we will bring this back to the Board in the form of an information report.  This report will be brought to the Board for information.

      2. Nutritious Food Basked (E. Nadalin)
        E. Nadalin said that the estimated costs of healthy eating is in the range of $241.66 per week.  When looking at most vulnerable populations, this most certainly impacts overall income.  Additional helpful information to healthy eating tips is posted on our WECHU website under Real Cost of Eating Well in Windsor-Essex.  This report will be brought to the Board for information.

      3. Q3 Renewal Priority Reporting (K. McBeth)
        More information was provided in the form of a presentation by Marc Frey, WECHU Manager, Planning and Strategic Initiatives, in agenda item 9.4.  This report will be brought to the Board for information.

      4. Communications Report (September 2022) (E. Nadalin)
        This report will be brought to the Board for information.
        Motion: That the information be received.  
        CARRIED
    2. CORRESPONDENCE - None
  8. Resolutions/Recommendation Reports

    1. CEO Transition (D. Sibley)
      D. Sibley advised that WECHU CEO, Dr. Ken Blanchette, has started in his new role effective Monday, October 17, 2022, as opposed to November 28, 2022.  G. McNamara thanked the hiring committee for their work on the CEO recruitment process. 

      Motion: That the information be received.
      CARRIED

    2. Healthy Smiles Ontario Program and Translation Supports (E. Nadalin)
      The Healthy Smiles Ontario (HSO) program is a publically-funded dental care program for children and youth (17 years old and under) which provides free preventive, routine, and emergency dental services to those who can not otherwise afford it. The Healthy Smiles Ontario Schedule of Dental Services and Fees for Dentist Providers (HSO Fee Guide) is an administrative tool distributed to dentists, so that they can provide services to clients in the HSO program and bill for these services. 

      Although limited English language skills have been identified as a key barrier to preventive dental health care utilization, language interpretation and translation services are not included in the HSO Fee Guide. Almost a quarter (22%) of Windsor and Essex County’s population is comprised of immigrants or refugees (‘newcomers”) (Statistics Canada, 2016), with 14% of residents most often speaking a language outside of English at home (Statistics Canada, 2021).  

      Motion: That the WECHU Board of Health recommend the province of Ontario include billing options for translation and interpretation services in the Health Smiles Ontario Fee Guide, and remote interpretation services, accessible 24/7 from a phone, mobile device, or computer should be considered as a useful and affordable option. 
      CARRIED

    3. Risk Registry Update and Presentation (K. McBeth/M. Frey)
      K. McBeth introduced M. Frey who provided a Risk Management Reporting Summary presentation to the Board noting highest risks, the potential impacts and our mitigation approaches.  The Ministry requires that we report our highest risks in Q3 Reporting.  Currently we have seven areas of risk, many of them impacted by COVID-19 response. 

      Reported risks are as follows: 
      •    Staff Engagement – risk of disengagement in work function
      •    Work Disruption – operations may be at risk during extended work stoppage or absenteeism
      •    Succession Planning – that the organization is unable to attract, retain proper human resources for succession planning 
      •    Information – risk due to incomplete or inadequate information to make evidence-based decisions or plan programs and services
      •    System Outages – risk of system outages impacting productivity or business continuity
      •    Work – staff risk as their health and safety (physical and mental) may be compromised when working in the community
      •    Privacy Requirements – risk or non-compliance to privacy requirements

      We continue to update and monitor these risks, act on mitigation strategies and will develop key risk indicators to keep our approaches on track. 

      Motion: That the information be accepted as presented.
      CARRIED

  9. New Business

    1. CEO Quarterly Report – July to September 2022 (K. Blanchette)
      K. Blanchette advised that former Interim CEO, Eleanor Groh, has signed off on the CEO Quarterly Report from July to September 2022, and has nothing further to add.

      Motion: That the information be received
      CARRIED

    2. Board of Health Meeting Locations (L. Gregg)
      We are planning to hold our Board of Health meetings in-person commencing January 2023, on the third Thursday of each month.  Arrangements have been made to hold our Board of Health meetings at the University of Windsor at Alumni Hall in the McPherson Lounge, with the exception of Thursday, June 15, 2023 and Thursday, June 19, 2023, as our meeting have been scheduled at the Essex Civic Centre. Once municipal elections are held and our Board compliment is complete, calendar invites with appropriate details will be sent to Board of Health members. 

      With municipal elections taking place on Monday, October 24, it was suggested that our November Board of Health meeting be rescheduled to one week earlier on Thursday, November 10, 2022 to ensure we obtain quorum. T. Bailey noted that there is an ERCA Board meeting that same evening and it was suggested that the November 10 meeting commence to 3:30 pm to avoid any scheduling conflicts.  A Doodle Poll will be sent after today’s Board meeting requesting Board availability on November 10, 2022.  

      Delegation of Authority was briefly discussed.  K. Blanchette will bring forward more information at the November Joint Board Extension Committee Meeting.

      Motion: That the dates and locations of 2023 Board of Health meetings presented be accepted by the Board. 
      CARRIED

    3. Board of Health Education/Engagement 
      More information will be forthcoming after the municipal election on the Board education and orientation piece.  The WECHU Leadership Team will focus on key elements the Board requires and enhance this piece throughout the 2023 year.

      Motion: That the information be received.
      CARRIED

    4. Q3 Renewal Priority Reporting – Presentation (K. McBeth/M. Frey)
      M. Frey walked through a presentation and provided WECHU’s Short-Term Renewal Priorities. Plans have been implemented to the end of 2022, as well as fulsome planning for 2023 and beyond.  We identified the need to put in place a short-term plan with a focus on renewal from the impacts of COVID-19.  We have identified the following key areas of focus: 
      •    Health Assessment and Surveillance
      •    Addressing Backlog of Services
      •    Mental Health and Substance Use
      •    Healthy Growth and Development
      •    Capacity Building
      •    COVID 19

      M. Frey provided a very high level overview of progress to date, and will bring forward more information when it is available. 

      Motion: That the plan be accepted as presented. 
      CARRIED

    5. November and December 2022 Board Meetings
      Board of Health meetings were discussed above in item 9.3.

  10. Committee of the Whole (CLOSED SESSION, in accordance with Section 239 of the Municipal Act)
    The Board moved into Committee of the Whole at 5:08 pm
    The Board moved out of Committee of the Whole at 5:30 pm
  11. Next Meeting: At the Call of the Chair, Thursday, November 10, 2022 – Via Video
  12. Adjournment
    Motion:  That the meeting be adjourned.   
    CARRIED
    The meeting adjourned at 5:30 pm.

RECORDING SECRETARY: L. Damphouse

SUBMITTED BY: K. Blanchette

APPROVED BY: WECHU Board of Health, November 10, 2022

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PREPARED BY:

Planning and Strategic Initiatives Department

PERIOD:  

JULY 1, 2022 TO SEPTEMBER 30, 2022

  1. 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 were two unplanned termination. The first was a non-union employee who chose not to follow WECHU’s updated immunization policy and resigned. The employee has since filed a constructive dismissal claim based on the policy. The second was a non-union staff person with continued performance concerns.
      11. there have been no claims made pursuant to any insurance policies maintained by the Health unit, except as noted below, 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:
      The WECHU continues through the Organizational Emergency Response. As such, operations are shifted, including redeployments to meet the needs of the organization. Operational plans and finances are shifted in accordance with current public health demands including the ongoing COVID-19 pandemic.

      Item (x). In the period between July 2022 and September 30, 2022 there was an unplanned termination of one non-union position.

Date:   September 23, 2022

Nicole Dupuis,
Chief Executive Officer

I certify that there are no additions to the above compliance report between the period end September 23rd, 2022 and September 30th, 2022.

Date: September 30, 2022

Eleanor Groh
Interim Chief Executive Officer

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October 20, 2022

BACKGROUND

An enterprise risk management framework and corresponding risk registry are important foundational elements in managing risk from an organizational governance perspective. The Ontario Public Health Standards (OPHS) specifies that “the board of health shall have a formal risk management framework in place that identifies, assesses, and addresses risks”. The Ministry of Health (MOH) requires yearly reporting on the highest residual risks to the organization and the related operations. Residual risks are defined as the assessed risk level after consideration of associated mitigation strategies.

The Windsor-Essex County Health Unit (WECHU) maintains a corporate risk registry; this risk registry monitors 26 risks across 12 risk categories. Based on the categorization and reporting requirements by the MOH, 7 of these risks were identified as being high residual risks. The high residual risks to be reported to the MOH for 2022 are related to: People/Human Resources, Knowledge/Information, Technology, Security, and Privacy. Each identified high risk includes documentation of current and future mitigation approaches.

PROPOSED MOTION

Whereas, the Ontario Public Health Standards requires the identification, assessment, and mitigation of enterprise risks; and

Whereas, the Ministry of Health requires yearly reporting on the highest residual risks to the organization; and

Whereas, the Windsor-Essex County Health Unit identifies and establishes risk mitigation approaches;

Now therefore be it resolved that the Windsor-Essex County Board of Health accepts the risk assessment outlined in the WECHU Risk Registry and the proposed mitigation approaches;

FURTHER THAT, risk mitigation approaches will be adopted and monitored by the organization and reported to the Board of Health on a yearly interval

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October 20, 2022

ISSUE/PURPOSE

The Healthy Smiles Ontario (HSO) program is a publically-funded dental care program for children and youth 17 years old and under which provides free preventive, routine, and emergency dental services to those who can not otherwise afford it. The Healthy Smiles Ontario Schedule of Dental Services and Fees for Dentist Providers (HSO Fee Guide) is an administrative tool distributed to dentists, so that they can provide services to clients in the HSO program and bill for these services.

Although limited English language skills have been identified as a key barrier to preventive dental health care utilization (Mehra, Costanian, Khanna, et al, 2019), language interpretation and translation services are not included in the HSO Fee Guide. Almost a quarter (22%) of Windsor and Essex County’s population is comprised of immigrants or refugees (‘newcomers”) (Statistics Canada, 2016), with 14% of residents most often speaking a language outside of English at home (Statistics Canada, 2021). 

The impact of language as a barrier to accessing dental care may be reduced by having access to language interpretation and translation services (Reza, Amin, Srgo et al., 2016). As community dentists are not required to accept HSO as a form of payment, this can already be a significant barrier to accessing services. In Windsor and Essex County, patients have been turned away due to an inability to access translation services. This is understandable, as a patient or guardian needs to be able to provide consent and understand what is involved in treatment. Changes to the funding for HSO, by covering the costs associated with remote interpretation services (i.e., interpretation services that are accessible from a phone, mobile device, or computer) would remove one more of the existing barriers to service.

BACKGROUND

Oral health is important to overall health and well-being for children and youth. Poor dental health can lead to negative health and social outcomes for young people, and is important to many aspects of a child’s development (Rowan-Legg, 2013). One significant oral health concern in children is early childhood caries (ECC) which is decay involving the primary teeth in children younger than 6 years of age. Ethnicity and newcomer status are considered risk factors for ECC with evidence demonstrating that children of recent immigrants and refugees have higher rates of caries and lower rates of preventative dental visits, compared to Canadian-born children (Reza, Amin, Srgo et al., 2016). Newcomer families may lack knowledge about publicly funded dental programs, lack dental health insurance, and have poor oral hygiene, which together can increase the risk and prevalence of oral health issues (Salami, Olukotun, Vastani, et al. 2022). Newcomers may also frequently face other social, cultural, economic, and language barriers to preventive dental health care utilization (Mehra, Costanian, Khanna, et al, 2019). Specifically, limited English skills have been associated with less use of dental care services, as well as challenges with communication with healthcare providers. Language issues may also interact with other known barriers to dental care for newcomers, such as household income and parental education (Reza, Amin, Srgo et al., 2016).

The impact of language, as a barrier to dental health care may be reduced by having access to language interpretation and translation services (Reza, Amin, Srgo et al., 2016). It has been suggested that both dental visits and other oral health promotion efforts for newcomer families would be more impactful if public health organizations and private dental offices, could have access to interpreting services (Amin, Elyasi, Schroth, et al., 2014).  Given the important role that parents and caregivers can play in a child’s oral health, any efforts to improve the oral health literacy of newcomer families, could be considered an important support for those seeking access to services through the HSO program. .

Expansion of public dental programs such as Healthy Smiles Ontario to priority populations has been identified as a key goal of the Windsor-Essex County Health Unit (WECHU). Given the growing urgent need and increase in dental decay among vulnerable children in Windsor-Essex (WECHU, 2018) and recognizing the existing barriers to access to care, the WECHU recommends that fees associated with language interpretation and translation services be included in publicly funded dental programs, such as the Healthy Smiles Ontario program.

PROPOSED MOTION

Whereas, oral health is important to overall health and well-being.  Access to preventive and treatment-based dental care is recognized as a basic human right for children and youth; and

Whereas, in Ontario, while many groups of children continue to have elevated rates of early childhood caries, specific groups of children are disproportionately affected, including those that are newcomers; and

Whereas, the publically funded Healthy Smiles Ontario dental program is intended to reduce overall inequity in access to preventative and affordable dental care for all young people under the age of 18, who do not have access to dental insurance or any other government programs; and

Whereas, the Windsor Essex County Health Unit recognizes the diversity of its residents, in that newcomers make up almost a quarter of the population in its jurisdiction and the important role that the HSO program plays in helping vulnerable children access preventative and emergency dental care; and

Whereas, numerous studies and research reports have indicated the urgent need to transform the current oral care health system, including providing equitable access to newcomers by addressing language obstacles;

Now therefore be it resolved that the Windsor-Essex County Board of Health recommends the province of Ontario include billing options for translation and interpretation services in the  Healthy Smiles Ontario Fee Guide; and

FURTHER THAT, while there is a variety of modalities of interpretation, it is remote interpretation services, accessible 24/7 from a phone, mobile device, or computer, that should be considered as a useful and affordable option; and

FURTHER THAT this resolution be shared with the Ontario Minister of Health, the Chief Medical Officer of Health, the Association of Public Health Agencies, Ontario Boards of Health, the Essex County Dental Society, the Ontario Association of Public Health Dentistry, the Ontario Dental Association and local municipalities and stakeholders.

References

Amin, M., Elyasi, M., Schroth, R., Azarpazhooh, A., Compton, S., Keenan, L., et al. (2014). Improving the oral health of young children of newcomer families: a forum for community members, researchers, and policy-makers. Journal of the Canadian Dental Association. Retrieved from https://jcda.ca/article/e64

Mehra, V.M., Costanian, C., Khanna, S. & Tamin, H. (2019) .Dental care use by immigrant Canadians in Ontario: a cross-sectional analysis of the 2014 Canadian Community Health Survey (CCHS). BMC Oral Health 19, 78. Retrieved from https://doi.org/10.1186/s12903-019-0773-x

Reza, M., Amin, M. S., Sgro, A., Abdelaziz, A., Ito, D., Main, P., & Azarpazhooh, A. (2016). Oral health status of immigrant and refugee children in North America: A scoping review. Journal of the Canadian Dental Association, 82(g3), 1488-2159. Retrieved from https://jcda.ca/g3

Rowan-Legg, A. (2013, January 11). Oral health care for children - a call for action. Paediatric Child Health, 37-43.

Salami, B., Olukotun, M., Vastani, M., Amodu, O., Tetreault, B., Obegu, P. O., Plaquin, J., & Sanni, O. (2022). Immigrant child health in Canada: a scoping review. BMJ global health, 7(4), e008189. Retrieved from https://doi.org/10.1136/bmjgh-2021-008189

Statistics Canada. (2017). Focus on Geography Series, 2016 Census. Retrieved from https://www12.statcan.gc.ca/census-recensement/2016/as-sa/fogs-spg/Facts-cma-eng.cfm?LANG=Eng&GK=CMA&GC=559&TOPIC=7

Statistics Canada. (2021). Census Profile, 2021 Census of Population. Retrieved from https://www12.statcan.gc.ca/census-recensement/2021/dp-pd/prof/details/page.cfm?Lang=E&SearchText=Essex&DGUIDlist=2021A00033537‍‌&GENDERlist=1,2,3&STATISTIClist=1&HEADERlist=0

Windsor Essex County Health Unit. (2018). Oral Health Report 2018 Update. Retrieved from https://www.wechu.org/resources/oral-health-report-2018

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November, 2022

ISSUE

Nicole Dupuis has officially left her role as Chief Executive Officer of the Windsor-Essex County Health Unit effective September 23, 2022. Eleanor Groh continues to be the interim Chief Executive Officer.

Upon Nicole Dupuis’s departure, and after a thorough recruitment process, Ken Blanchette will transition to the position of Chief Executive Officer, effective November 28, 2022. In this role, Ken Blanchette will have a direct reporting line to the Board of Health and have the ability to bind the Board of Health.

PROPOSED MOTION

Whereas, Ken Blanchette was the successful candidate of the Chief Executive Officer recruitment process for the Windsor-Essex County Health Unit,

Now therefore be it resolved that the Windsor-Essex County Board of Health approve the CEO Transition to Ken Blanchette, with a direct reporting line to, and ability to bind, the Windsor-Essex County Board of Health, to take place effective November 28, 2022 as presented by Administration.

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Meeting held via video: https://youtu.be/bNFT8Nk9xtY

  1. Call to Order
  2. Agenda Approval
  3. Announcement of Conflict of Interest
  4. COVID-19 Update (Dr. S. Nesathurai)
  5. Approval of Minutes
    1. Regular Board Meeting:  August 11, 2022
  6. Business Arising
    1. Charitable Status (L. Gregg)
    2. Board of Health By-Laws and Policies (N. Dupuis)
      1. Public Attendance and Delegations at Board of Health Meetings
      2. Delegation of Duties
      3. Performance of MOH and CEO
      4. By-Law No. 1 – Governance
      5. By-Law No. 2 – Finance
      6. By-Law No. 3 – Human Resources
      7. By-Law No. 4 – Management of Real Property
  7. Consent Agenda
    1. INFORMATION REPORTS
      1. Q2 Financial Report (L. Gregg)
      2. WECHU Strategic Plan – 2022-2025 (N. Dupuis)
      3. 2022 Board of Health Competency Self-Assessment Report (N. Dupuis)
      4. Windsor-Essex Health Status Indicator (WE-HSI) Dashboard (N. Dupuis)

      5. Communications Report (June-August, 2022)

    2. CORRESPONDENCE
      1. Chatham-Kent Public Health – Letter to Hon. Doug Ford, Premier of Ontario – Support for alPHa Resolution A22-4 and Appendix A – that the drug poisoning crisis in Ontario be declared an emergency under the Emergency Management and Civil Protection Act, (RSO 1990) – For Support

      2. Sudbury & Districts Public Health – Letter to Ministry of Children, Community and Social Services – Healthy Babies Healthy Children Funding – For Support

      3. Niagara Board of Health – Letter to Hon. Dominic LeBlanc, Minister of Intergovernmental Affairs, Infrastructure and Communities – Improving Air Quality to Sustainably to prevent COVID-19 – For Information
  8. RESOLUTIONS/RECOMMENDATION REPORTS

    1. Renewed Strategic Plan (N. Dupuis)

    2. Signing Authority (L. Gregg)

  9. New Business
    1. Bivalent Vaccine – Update (K. McBeth)
    2. Presentation – WE-HSI Dashboard (R. D'Souza)
    3. Presentation – Board of Health Competency Self-Assessment (M. Frey)
    4. Presentation – Strategic Plan (N. Dupuis)
  10. Committee of the Whole (Closed Session in accordance with Section 239 of the Municipal Act) 
  11. Next Meeting: At the Call of the Chair, or October 20, 2022 – Via Video

  12. Adjournment

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A by-law relating generally to the conduct of the affairs of the Board of Health for the Windsor-Essex County Health Unit (“Health Unit”) passed under the Health Protection and Promotion Act, R.S.O. 1990, c. H.7 (“HPPA”)

BE IT ENACTED as a by-law of the Health Unit as follows:

  1. ARTICLE 1: INTERPRETATION
    1. Definitions and Acronyms.
      The terms and acronyms apply to this bylaw and all other by-laws of the Health Unit, unless the context otherwise requires:

       

      Term Definition
      Agreement means the accountability agreement between the Health Unit and the Ministry of Health of Ontario as dated __, and as amended or superseded from time to time, is an agreement pursuant to both HPPA section 76 [Grants] and subsection 81.2 [Agreements].
      AMOH means Associate Medical Officer of Health as described in section 64 of the HPPA.
      Best Value means approach that aims to deliver products and services with a lower Total Life Cycle Cost while maintaining a high standard.
      Board means the board of health of the Windsor-Essex County Health Unit “the Health Unit”.
      By-law means this by-law and all other by-laws of the Corporation from time to time in force and effect.
      CEO means the Health Unit’s Chief Executive Officer as appointed by the board.
      Chair means the individual elected as chairperson of the Board as per Section 57 (2) of the HPPA.
      Committee means a committee of the Board, but does not include the Committee of the Whole.
      Council means the Council of the City/County/Township.
      Delegation means any member of the public who seeks to address the Board regarding an item of business on a Board meeting agenda.
      Employee means an employee of the Health Unit.
      Health Unit means The Board of Health for the Windsor-Essex County Health Unit/Conseil de santé de la circonscription sanitaire de Windsor-comté d’Essex
      HPPA means the Health Protection and Promotion Act, R.S.O. 1990, (HPPA) and its regulations and amendments thereto.
      Leadership Team means the CEO, MOH, AMOH, Directors and such other Health Unit senior administrative positions as from time to time designated by the CEO.
      Medical Officer of Health means a Medical Officer of Health (“MOH”) of a Board of Health and the role as defined by the HPPA.
      Member means a member of the Board.
      Ministry means the Ministry of Health.
      MFIPPA means Municipal Freedom of Information and Protections of Privacy Act, R.S.O. 1990, c.M.56.
      Officer means an officer of the Board, which officers include the Chair, Vice-Chair, Secretary and Treasurer.
      OPHS means Ontario Public Health Standards (current version) published by the Ministry of Health pursuant to HPPA section 7.
      Perquisite means a privilege that is provided to an individual or to a group of individuals, provides personal benefit, and is not generally available to others.
      PHIPA means Personal Health Information Protection Act, 2004, S.O. 2004, c.3, Sched. A.
      Policy means the policies approved and adopted by the Board.
      Purchasing means purchasing, renting, leasing, or otherwise acquiring deliverables; including all functions (that pertain to the acquisition, including requisition, budget confirmation, method of purchasing, receipt and payment).
      Purchasing Documents means Health Unit documents used in connection with the administration of a Purchasing process.
      PO means a standard Purchasing Document issued by the Health Unit to a Supplier to evidence an agreement for the purchase of Deliverables
      Quorum means a majority of the members of the Board.
      Risk means the expression of the likelihood and impact of an event with the potential to influence the achievement of the Health Unit’s mission and vision.
      Secretary means the secretary of the Board.
      Supplier means a person, corporation or other entity that responds, or intends to respond, to a solicitation issued by the Health Unit or provides Deliverables to the health Unit including, but not limited to, contractors, consultants, suppliers, service organizations, etc.
      Treasurer means the treasurer of the Board.
      Vice-Chair means the vice-chair of the Board.
    2. Interpretation
      In this By-law and all other By-laws of the Health Unit, unless the context otherwise requires:
      1. words importing the singular numbers shall include the plural number and vice versa;
      2. references to persons shall include individuals, firms, corporations or any other form of entity or organization;
      3. words importing one gender shall include all genders; and
      4. any reference to a statue shall mean the statute and includes the regulations made under it an any statute that may be substituted therefore, as from time to time amended.
  2. ARTICLE 2: AMENDMENT
    1. Introduction. New by-laws or proposed amendments to existing by-laws shall be introduced by a Board Member upon motion for leave specifying the general nature of the new By-laws or proposed amendments. Notice of new by-laws or proposed amendments to existing by-laws shall be provided in advance to the Board at a previous meeting. The notice must state the proposed amendment and must be seconded.
    2. Readings. New by-laws or proposed amendments to existing By-laws shall:
      1. Body. In the case of the body of the By-laws, have two readings. Each reading shall be at a different Board meeting unless the Board decides by a two-thirds vote at a properly constituted Board meeting to provide the two readings at one meeting. The first reading shall be decided without amendment or debate.
      2. Schedules. In the case of the schedules to a By-law, have one reading and such reading shall be subject to amendment and debate.
    3. Endorsements. By-laws shall be endorsed as follows:
      1. the date of each reading shall be indicated and endorsed by the Secretary to evidence such readings; and
      2. the date of adoption shall be indicated and endorsed by the Chair or chair of the meeting at which the by-laws were adopted and the Secretary to evidence such adoption,
    4. Records. All by-laws adopted by the Board:
      1. shall be kept with the corporate records of the Health Unit; and
      2. shall be posted to the Health Units website.
    5. Review. All by-laws shall be reviewed at least every two years or more often if necessary to respond to changing circumstances.
  3. ARTICLE 3: ROLE, DUTIES and RESPONSIBILITIES
    1. Role. The role of the Health Unit is to promote and protect public health and to ensure the provision of programs and services in accordance with the Health Protection and Promotion Act and other applicable laws.
    2. Duties and Responsibilities. Each Board Member shall:
      1. Ensure that he or she is familiar with the Health Unit including its programs and services;
      2. Prepare for Board meetings in advance by reviewing the agenda, any supporting materials;
      3. Attend Board meetings prepared to participate in the proceedings and when unable to attend review the minutes of missed meetings and take such other follow-up steps as may be appropriate;
      4. Act honestly, in good faith and in the best interests of the Health Unit.
      5. Only use information acquired as a Board Member for the purposes of fulfilling his or her duties as a Board Member;
      6. Keep confidential the confidential information of the Health Unit;
      7. Not make any improper use of his or her position as a Board Member;
      8. Develop and comply with Board bylaws.
  4. ARTICLE 4: ACCOUNTABILITY​​​​
    1. Code of Ethical Conduct. Board members shall adopt and comply with a Code of Ethical Conduct. The Board shall review the Code of Ethical Conduct on an annual basis.
    2. Conflict of Interest. Board members shall comply with the Municipal Conflict of Interest Act and with any conflict of interest policy adopted by the Board.
    3. Strategic Plan. The Board shall develop and adopt a strategic plan for the health unit in accordance with the Ontario Public Health Standards that establishes the strategic priorities of the health unit and shall have a three to five year outlook.
    4. Risk Management. The Board shall ensure that a risk management framework is developed and maintained for the Health Unit that creates a systematic approach to identifying and managing existing, emerging, internal and external risks and the effect of such risks on the Health Unit’s ability to achieve its mission and vision through its strategic plan.
    5. Whistle Blowing Policy. The Health Unit will have in place a Whistle Blowing Policy which shall be reviewed on an annual basis by the Board and staff of the Health Unit.
    6. By-laws. The Board shall establish and maintain the By-laws of the Health Unit and policies therein.
    7. Monitoring. The Board shall monitor the Health Unit’s compliance with its governance policies.
  5. ARTICLE 5: STRUCTURE OF THE BOARD
    1. Number. The Board shall be comprised of eight municipal appointees as required by the HPPA Regulation 559 and such additional appointees as may be appointed by the Lieutenant Governor in Council pursuant to the HPPA.
    2. Qualifications. No person whose services are employed by the Health Unit shall be qualified to be a Board Member.
    3. Competencies Matrix and Appointee Recommendations. If the appointing municipalities and/or the Lieutenant Governor in Council seek appointee recommendations, the Board shall develop a competencies matrix and make appointee recommendations based on the same. The Board shall update any such competencies matrix at least annually and otherwise when vacancies arise.
    4. Term. Board Members shall be appointed for terms as follows:
      1. Municipal Appointees. The term of a municipal appointee continues during the pleasure of the appointing municipal council, providing that it shall end with the term of office of the appointing municipal council.
      2. Appointees of the Lieutenant Governor in Council. The term of an appointee of the Lieutenant Governor in Council shall be for one, two or three years as appointed by the Lieutenant Governor in Council.
    5. Vacation of Office. The office of a Board Member shall be vacated:
      1. Municipal Appointees. In the case of municipal appointees for the same reasons that the seat of a member of council becomes vacant under section 259(1) of the Ontario Municipal Act, 2001.
      2. Death. Upon the death of the Board Member.
      3. No Longer Qualified. Upon a Board Member ceasing to be qualified pursuant the HPPA.
      4. Written Resignation. By the Board Member delivering notice of resignation in writing to the Secretary in which case, such resignation shall be effective at the next Board meeting or the time specified in the notice, whichever is later.
      5. Removal. Upon lawful removal.
    6. Filling of Vacancies. Vacancies on the Board shall be forthwith filled by the same person or body that appointed the Board Member whose position has been vacated.
  6. ARTICLE 6: OFFICERS OF THE BOARD
    1. Officers of the Board. The Board shall at the first Board meeting of each year appoint Officers as follows: from among the Board Members, a Chair, a Vice-Chair, and a Treasurer. There shall also be a Secretary who shall ex officio be the CEO (or in the event there is no CEO, the MOH).
    2. Duties. The duties of the Officers of the Board shall be as set out in the By-laws and related Policies.
    3. Removal of Officers. Officers of the Board shall be subject to removal by resolution of the Board at any time.
  7. ARTICLE 7: COMMITTEES OF THE BOARD
    1. Standing Committees. There may be such standing Committees for such purposes as the Board may determine from time to time.
    2. Ad Hoc Committees. There may be such ad hoc Committees for such purposes as the Board may determine from time to time.
    3. Committee Membership. Membership on Committees may, but need not, be restricted to Board Members.
    4. Terms of Reference. The Board shall establish terms of reference for every standing and ad hoc Committee that it appoints. Terms of Reference shall be reviewed at least once per year by the committee first and then approved by the Board.
  8. ARTICLE 8: ORIENTATION AND TRAINING
    1. Individual Board Member Responsibility. Each Board Member shall be individually responsible to take advantage of available orientation, training opportunities and resources and to ensure that he or she has the appropriate level of orientation and training necessary to fulfil his or her duties as a Board Member.
    2. Plan. The orientation and training plans for Board Members shall be as per the Board Members’ Orientation and Training Plan Policies. The Board shall annually review and amend the plans as appropriate to ensure orientation and training is: in accordance with the requirements of the Organizational Standards; timely; relevant; reflects the orientation and training needs of both individual Board Members and the Board as a whole; convenient in both format and location; and cost effective.
    3. Implementation. The Chair shall ensure that the orientation and training plans for Board Members are implemented.
    4. Training. The CEO and MOH or designate will, as appropriate, arrange for additional orientation to particular aspects of the Health Unit’s operations for one or more members of the Board, or the entire Board and upon request.
  9. ARTICLE 9: LIABILITY PROTECTION
    1. No Liability. No action or other proceeding for damages or otherwise shall be instituted against a Board Member and/or Officer for any act done in good faith in the execution or the intended execution of any duty or power under the HPPA or for any alleged neglect or default in the execution in good faith of any such duty or power.
    2. Indemnification. Every Board Member and/or Officer who has undertaken or is about to undertake any liability on behalf of the Health Unit and their heirs, executors and administrators, and estate and effects, respectively shall from time to time and at all times, be indemnified and saved harmless, out of the funds of the Health Unit, from and against:
      1. all costs, charges and expenses whatsoever which such Board Member sustains or incurs in or about any action, suit or proceeding which is brought, commenced, or prosecuted against her or him for or in respect of any act, deed, matter or thing whatsoever made, done or permitted by her or him in or about the execution of the duties of her or his office or in respect of any such liabilities; and
      2. all other costs, charges and expenses which she or he sustains or incurs in or about or in relation to the affairs thereof; except such costs, charges or expenses as are occasioned by her or his own willful neglect or default or that relate to her or his failure to act honestly and in good faith in performing her or his duties.
    3. Insurance. The Health Unit shall secure directors’ and officers’ insurance coverage that is consistent with sector norms for like organizations.
  10. ARTICLE 10: CALLING AND PROCEEDINGS OF MEETINGS
    1. Application. The provisions in the bylaws shall apply to the calling and proceedings of Board meetings and subject to any applicable terms of reference and with the necessary modifications to committee meetings, where at least fifty per cent of the committee composition is comprised of Board Members.
    2. Place. Board meetings shall be held at the Health Units offices or another location as agreed upon and determined by the board.
      A meeting of the Board may also be conducted by teleconference, videoconference or other means of distance communication, provided that the requirements of the Municipal Act, 2001 and amendments are complied with.
    3. Frequency. The Board shall meet with sufficient frequency to fulfil its governance responsibility, provided that it shall meet not less than six times in any twelve month period.
    4. Calling.
      1. Regular. The Board may appoint a day, time and place (or places changing on a periodic basis) for regular meetings.
      2. Special. Board meetings may otherwise be called by the Chair or any three Board Members.
    5. Meeting Agenda. Agendas for all Board meetings shall be subject to and in accordance with the following:
      1. Regular. Agendas for regular Board meetings shall be prepared by the Secretary or designate in collaboration with the Board Executive. The agenda and any supporting materials shall be given to Board Members by secure electronic folder at least seven Business Days in advance of the meeting. Further the agenda and supporting materials in respect of those items on the agenda for the open portion of the meeting, shall be posted on the Health Unit’s Website also at least seven Business Days in advance of the meeting.
      2. Special. Agendas for special Board meetings shall be prepared by the Secretary in collaboration with the individuals calling the meeting. In the case of special Board meetings, the agenda and any supporting materials shall be given to Board Members along with the notice of meeting. Further for special meetings the agenda shall be posted on the Health Unit’s Website when notice is given and in respect of those items on the agenda for the open portion of the meeting the supporting materials shall also be posted on the Health Unit’s Website when notice is given.
    6. Notice. Notice for Board meetings shall be subject to and in accordance with the following:
      1. For Regular Meetings Only. Notice of regular Board meetings shall be given or caused to be given by the Secretary by posting the regular appointed day, time and place(s) on the Health Unit Website and in a conspicuous place in the Health Unit’s reception area.
      2. For Special Meetings Only. Notice of special meetings shall be in accordance with the following:
        1. Responsibility. The Secretary shall give or cause to be given the required notice of special Board meetings.
        2. Amount of Notice. At least seven days’ notice of special Board meetings shall be given (exclusive of the day on which the notice is sent or delivered but inclusive of the day on which notice is given), provided that in the event circumstances arise needing the attention of the Board on a basis that makes it impossible to provide seven days’ notice then the greatest amount of notice practical in the circumstances shall suffice.
        3. Content and Format. Notice of special Board meetings shall include the date, time and place of the meeting.
        4. To Whom Given and Method. Notice of special Board meetings (whether open or closed) shall be given to:
          1. each Board Member by e-mail, failing which by personal delivery to the Board Member’s residence;
          2. each member of the Senior Leadership Team by e-mail, failing which by personal delivery to the Senior Leadership Team member’s residence; and
          3. the public by posting on the Health Unit Website and in a conspicuous place in the Health Unit’s reception.
    7. Anticipated Absence of Board Members. Board Members shall notify the Secretary as early as possible if they anticipate being unable to attend any Board meeting.
    8. Cancellation. Board meetings may be cancelled as follows:
      1. Regular. The Chair shall have the authority to cancel any regular Board meeting if it appears that quorum will not be met.
      2. Special. The Board Members who called a special Board meeting shall have the authority to cancel it, for any or no reason.
        Notice of cancellation shall be given in the same way as notice of meeting.
    9. Attendance and Participation.
      1. Board Members. Board members shall be entitled to attend all Board Meetings. Board members are entitled to participate by being heard (verbally or in writing), debating and voting.
      2. Senior Leadership Team. Members of the senior leadership team inclusive of the MOH and CEO shall be entitled to attend all Board meetings unless the Board requires withdrawal, in accordance with the HPPA. The Senior Leadership Team shall not be entitled to participate in Board meetings by voting or debating but shall be entitled to participate by being heard (verbally or in writing) if recognized by the Chair.
      3. Invited Guests. Invited guests shall be entitled to attend all Board meetings on invitation of the Board or with the consent of the meeting. Invited guests shall not be entitled to participate in Board meetings by voting or debating but shall be entitled to participate by being heard (verbally or in writing) if recognized by the Chair.
      4. Participation by Teleconference or Electronic Means. Attendance of Board members, Senior Leadership or invited guests may be in person or by teleconference or electronic means. Any attendance by teleconference, video conference or other means of distance communication shall:
        1. ensure they are alone in a secure location;
        2. refrain from using any electronic device other than the device used to connect to the meeting.
    10. Chair. The Chair shall chair Board meetings or if the Chair is absent, unable or unwilling, the Vice-Chair, or if both the Chair and Vice-Chair are absent, the Treasurer. If the Chair, Vice-Chair and Treasurer are absent, unable or unwilling to attend and/or Chair the meeting, Board Members present shall choose another Board Member to act as chair. The Chair shall preside over the conduct of the meeting, including the preservation of order and decorum, ruling on points of order and deciding all questions relating to the orderly procedure of the meeting, subject to an appeal by any Board Member to the Board from any ruling of the Chair.
    11. Order of Business. The Secretary will prepare the agenda for the regular Board of Health meetings in the following order:
      1. Call to Order
      2. Approval of the Agenda
      3. Declarations of Conflicts of Interest
      4. MOH Updates
      5. Approval of Minutes
      6. Business Arising
      7. Information Reports
      8. Resolutions/Recommendation Reports
      9. New Business
      10. Correspondence
      11. Next meeting
      12. Adjournment
        For all other meetings of the Board the secretary will prepare the agenda in the following order:
      13. Call to Order
      14. Declaration of Conflicts of Interest
      15. Approval of Agenda
      16. Approval of the Minutes
      17. Business Arising
      18. New Business
      19. Next meeting
      20. Adjournment
    12. Public Attendance and Delegations.
      In accordance with Board of Health policy, any member of the public may attend the regular meetings of the Board of Health, provided that the Board may, by resolution, declare any part of a regular meeting of the Board of Health to be closed to the public, in accordance with section 239(1) of the Municipal Act, 2001.
    13. Transaction of Business.
      1. Quorum. A majority of the Board shall form a quorum for the transaction of business by the Board. For greater clarity the following Board Members shall be counted in quorum:
        1. Chair.
        2. Any Board Member attending in person, by teleconference or electronic means.
        3. Any Board Member who has disclosed a direct or indirect pecuniary interest pursuant to the Municipal Conflict of Interest, unless prohibited by that Act.
        4. Any Board Member who has declared a conflict of interest or inability to exercise independent judgment at common law.
      2. Absence of Quorum. No business shall be transacted in the absence of quorum. If there is no quorum within thirty minutes after the time appointed for the meeting, the meeting shall then adjourn until the next regular meeting.
      3. Debate and Decorum.
        1. No Board Member shall speak:
          1. Unless recognized by the Chair.
          2. To a question at any one time for longer than five minutes.
          3. If to do so would interrupt a Board Member who is speaking except to raise a question of privilege or point of order.
        2. Board Members shall obey the rules of order and any direction of the Chair or of the Board.
        3. Board Members shall not criticize any decision of the meeting except for the purpose of moving that the question be reconsidered.
        4. Board Members shall not leave their seat or make any noise or disturbance while a vote is being taken and until the result is declared.
        5. Board Members shall conduct themselves with decorum.
      4. Voting.
        1. Every Board Member present at a meeting shall vote unless the Board Member has disclosed a direct or indirect pecuniary interest pursuant to the Ontario Municipal Conflict of Interest Act or has declared a conflict of interest or inability to exercise independent judgment at common law.
        2. Each Board Member shall be entitled to one vote. For greater clarity the Chair shall have a vote but shall not have a second or casting vote.
        3. Questions arising at any Board meeting shall be decided by a majority of votes, unless otherwise required by these By-laws or by law. For greater clarity, a tie vote shall be lost. In the event that a Board Member who is required to vote fails to vote, such Board Member shall be deemed to have voted in the negative.
        4. Voting shall in the first instance be by a show of hands unless a recorded vote be demanded by any Board Member. If a recorded vote be demanded and not withdrawn, the recorded vote shall be taken in such manner as the Chair shall direct.
        5. If a Board Member disagrees with the declaration of the Chair as to the result of a vote, the Board Member may immediately object and require that the vote be retaken.
        6. A declaration by the Chair that a resolution has been carried or not carried and an entry to that effect in the minutes of the meeting shall be admissible in evidence as prima facie proof of the fact without proof of the number or proportion of the votes accorded in favour of or against such resolution.
        7. Reconsideration of a Matter. After a question has been decided, any Board Member may move for reconsideration at any time and such motion and any subsequent reconsideration shall be decided by ordinary resolution, unless the question was originally decided by recorded vote. If the question was originally decided by recorded vote then only a Board Member who voted in favour of the question can move for reconsideration and no discussion of the question shall be allowed until the motion for reconsideration has carried by a two-thirds vote, and no such matter shall be reconsidered more than once in the same six-month period.
    14. Minutes. The Secretary shall keep or cause to be kept minutes of all Board meetings (regular and special, open and closed) subject to and in accordance the Municipal Act, 2001. Minutes shall include every declaration of interest.
    15. General Rules of Conduct. All persons present at and/or participating in Board meetings, including Board Members, shall conduct themselves with decorum and shall refrain from disturbing the proper conduct of the proceedings or otherwise conducting themselves in a disorderly or unseemly manner.
    16. Discipline. Any person present at and/or participating in a Board Meeting who breaches any provision of these By-laws may be ordered by the Chair to leave the meeting and if such person refuses to do so, the Chair may seek the assistance of the police.
    17. Recording of Meetings. Regular meetings of the Board of Health will be recorded electronically and posted to the Health Unit website for the public. Other meetings of the Board may be recorded for the purposes of accuracy and completeness of minutes. Recordings for the purposes of minute taking only will be deleted once the meeting minutes are approved.
    18. Attendance Tracking. The Secretary or the Secretary’s designate shall track individual attendance at Board and Committee meetings on an ongoing basis. Results of attendance tracking will be provided as per the Board Performance Management Policy.
  11. ARTICLE 11: EXTERNAL ADVISORS
    1. Board. If the Board resolves from time to time that it is necessary and/or appropriate to obtain the advice of external advisors in order to discharge its responsibilities, the Health Unit shall engage such advisors at the Health Unit’s expense.
    2. Committees. If, in the opinion of a Committee, it is necessary and/or appropriate from time to time to obtain the advice of external advisors in order to discharge its responsibilities, the Committee shall seek a resolution of the Board in that regard, and if the Board so resolves, the Health Unit shall engage such advisors at the Health Unit’s expense.
    3. Board Members. Subject to any indemnity obligations owed by the Health Unit to individual Board Members, individual Board Members may at their own discretion obtain the advice of external advisors subject to and in accordance with the following:
      1. The Health Unit shall not engage such advisors. The subject individual Board Member must engage any such advisors on his or her own behalf.
      2. Any associated expenses shall not be allowable expenses in connection with which the subject Board Member can seek direct payment by the Health Unit or claim for reimbursement.
      3. The individual Board Member shall ensure that any such advisors are bound to maintain confidentiality and shall not use any information provided, for any purpose other than providing advice to the subject Board Member.
  12. ARTICLE 12: INTERNAL CONFLICT MANAGEMENT
    1. When Conflict Arises. When conflict arises those involved shall seek to manage it informally through direct discussion, failing which the Chair, or if the Chair is involved in the conflict, a designated member of the Executive, or if the Executive is involved in the conflict, another Board Member selected by the Board; or if the entire Board is involved in the conflict a neutral facilitator selected by the Board, shall, in consultation with those involved in the conflict, select and implement a conflict management process appropriate to the nature and level of the subject conflict.
  13. ARTICLE 13: COMPLIANCE
    1. Compliance. Management of all operations by the CEO and MOH where applicable, shall, unless the Board approves otherwise, be undertaken in material compliance with the following:
      1. all laws, regulations, orders, judgments and decrees;
      2. the By-laws;
      3. all other Board resolutions; and
      4. all contractual obligations and commitments of the Health Unit.
    2. Notice of Non-compliance. Notice to the Board of any material non-compliance shall be provided by the MOH, if the non-compliance is in relation to the delivery of public health programs or services and otherwise by the CEO and shall additionally be reported by the CEO in the CEO Quarterly Compliance Report.
  14. ARTICLE 14: OPERATIONAL PLAN
    1. ​​​​​​​Development. The CEO and MOH shall develop and implement an operational plan that will be presented and approved annually by the Board. Inclusive in the operational plan, is the development of underlying programs and processes.
    2. Policies and Procedures. The CEO shall ensure the development of policies and procedures over:
      1. Health and Safety;
      2. Human Resource Management;
      3. Information systems and records management;
      4. Communications.
  15. ARTICLE 15: RESEARCH
    1. ​​​​​​​The Board of Health shall ensure that appropriate policies are in place with regard to research/evaluation activities, so that such research follows applicable legislative requirements, standards and codes of ethics, and does not interfere with the attainment of the Health Unit’s goals and objectives.
  16. ARTICLE 16: EXECUTION OF DOCUMENTS
    1. ​​​​​​​The Board may at any time and from time to time direct the manner in which and the person or persons who may sign on behalf of the Board for a particular agreement. More specifically:
      1. Agreements relating to the sale, acquisition, or lease of real property shall be signed by one of the Chair, Vice Chair or Treasurer and the CEO or designate.
      2. Agreements relating to borrowing (By-Law No. 2, Section 8: Borrowing) shall be signed by one of the Chair, Vice Chair or Treasurer and the CEO or designate.
      3. Agreements relating to the data sharing shall be signed by the MOH and the CEO or designate.
      4. All other agreements that are operational in nature shall be signed by the CEO or designate.
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A by-law respecting the human resources of the Board of Health for the Windsor-Essex County Health Unit (“Health Unit”) passed under the Health Protection and Promotion Act, R.S.O. 1990, c.H7 (“HPPA”).

  1. ARTICLE 1: HUMAN RESOURCE GOALS/STRATEGIC APPROACH.
    1. Human Resource Goals. In addition to the generalized goals of the operational plan, the Health Unit’s interrelated and sometimes competing human resources goals are as follows:
      1. Fair and Positive. Foster a work environmental that is fair and positive, creating a culture of integrity, supportive of the Code of Ethical Conduct.
      2. Attract and Retain Talent. Attract, recognize and retain talent.
      3. Effective Performance Management. Effectively manage individual performance, whether meeting or falling above or below expectations.
    2. Workforce Development. The Health Unit shall adopt a strategic approach to human resources management, having regard to the following:
      1. Workforce Assessment. An assessment of its workforce based on size, composition and competencies.
      2. Assessment of Future Workforce Needs. An assessment of the Health Unit’s future workforce needs.
      3. Projection of Workforce Supply. A projection of the future workforce supply, including consideration of the composition of the community served by the Health Unit.

        Based on the above and as part of its strategic approach, the Health Unit shall establish a workforce development plan, identifying the training needs of staff, including discipline specific and management training and encouraging opportunities for the development of core competencies and, when appropriate, partnerships with academic institutions. Further the Health Unit shall foster an interest in public health practice by future health professionals by supporting student placements.

  2. ARTICLE 2: POLICIES AND PROCEDURES
    1. Openness. Human resources policies and procedures shall be accessible to all individuals undertaking or participating in work activities on behalf of the Health Unit, including employees, student placements and volunteers.
    2. Content. The CEO shall ensure that the organization has human resources policies and procedures to address the following:
      1. Recruitment and Retention
      2. Orientation and Training
      3. Occupational Health and Safety
      4. Professional and leadership development
      5. Succession Planning
      6. Performance management
      7. Compensation
      8. Discipline
      9. Conflict Management
    3. Equity, Diversity and Inclusion. Policies and Procedures shall be open and fair and consider equity, diversity and inclusion.
    4. Employment Contracts. Terms of employment shall be documented in written employment contracts and/or collective agreements, as applicable. Employment contracts shall be presented at the time of any offer of employment and shall be finalized, signed and delivered to the Health Unit prior to any commitments of employment.
    5. Personnel Files. Separate personnel files shall be maintained for each Health Unit employee with a clear articulation as to what the file contents are to include and who shall have access to the files.
  3. ARTICLE 3: ROLES of the CEO and MOH
    1. CEO. The CEO shall, in addition to any specific duties assigned by the Board, be generally responsible for all Health Unit day to day operational matters, policies and directives, program and service delivery, matters of human resources and finances. As part of that, the CEO shall, with respect to operational matters:
      1. Ensure the implementation of the Board’s governance policies, as outlined in the By-laws and otherwise, through an operational plan by establishing and enforcing related operational policies, systems and procedures.
      2. Monitor compliance with operational policies, systems and procedures and address any non-compliance.
      3. Support the Board in satisfying the Board’s role by providing appropriate data, analysis and recommendations.
      4. Be accountable to the Board.
    2. MOH. The MOH shall, in addition to any specific duties assigned by the Board, be generally responsible for matters directly relating to public health programs and services and issues relating to the protection and promotion of the public’s health. As part of that, the MOH shall, with respect to operational matters directly related to the delivery of health programs and services:
      1. Support the Board in satisfying the Board’s role by providing appropriate data, analysis and recommendations
      2. Be accountable to the Board.
  4. ARTICLE 4: QUALIFICATIONS OF THE CEO and MOH
    1. CEO Qualifications. Minimum qualifications for the position of CEO, if one is appointed, shall include the following:
      1. Education and experience appropriate to the implementation of the strategic plan and consistent with that of chief executive officers at other health units.
      2. Emotional Intelligence. The CEO shall demonstrate emotional intelligence including self-awareness; self-regulation; motivation; empathy; and social skills.
    2. MOH Qualifications. Minimum qualifications for the position of MOH, shall include the following:
      1. Education and Experience. The MOH shall have at minimum the education and experience required by the HPPA and HPPA Regulation 566.
      2. Emotional Intelligence. The MOH shall demonstrate emotional intelligence, including self-awareness; self-regulation; motivation; empathy; and social skills.
    3. Job Description. The Board shall develop a job description for the CEO and MOH position. The Board shall review the job description regularly and revise as appropriate and in accordance with legislation and Ministry guidance.
  5. ARTICLE 5: RECRUITMENT OF THE CEO/MOH
    1. External Consultant or Recruitment Committee. In order to carry out tasks and make recommendations related to MOH/CEO recruitment and selection:
      1. a reputable, qualified external consultant shall be engaged; and/or
      2. the Board shall establish an ad hoc recruitment committee. Such committee composition shall contribute to the integrity of and confidence in the recruitment and selection process by:
        1. including stakeholder representation by not restricting composition to only Board Members but at the same time not including Health Unit staff or an existing MOH or CEO; and
        2. ensuring that each committee member is appropriately qualified including having human resources expertise. Establishment of the committee shall otherwise be in accordance with applicable by-law provisions including the requirement for terms of reference.
    2. Appointment. Subject to the approval by the Ministry of Health, the final MOH appointment decision shall remain with the Board. The final appointment decision of the CEO shall also remain with the Board. Both positions will be appointed through resolution by the Board.
  6. ARTICLE 6: RENUMERATION, PERFORMANCE AND DISCIPLINE
    1. Remuneration. Remuneration of both the MOH and CEO shall be in accordance with provincial legislation where applicable and external benchmarking.
    2. Performance Management. The Board will establish a policy and procedure for the regular performance management, monitoring and review of the CEO and the MOH. Performance shall be managed in accordance with the established policy adopted and approved by the board.
    3. Discipline. Any consideration of a proposal to discipline the MOH or the CEO, including dismissal, shall be subject to and in accordance with the following:
      1. Notice. Reasonable written notice of the time, place and purpose of the Board meeting at which the discipline is to be considered shall be given.
      2. Reasons. A written statement detailing the reasons for the proposed discipline shall be given along with the notice.
      3. Opportunity to be Heard. The MOH or CEO shall be given an opportunity to attend and to make representations to the Board at the meeting.
      4. Two-Thirds Decision. Any decision to discipline the MOH or the CEO shall be carried by a vote of two-thirds of the Board Members present at a properly constituted Board meeting, provided that if the decision is to dismiss, such decision shall also be subject to the consent in writing of the Ministry of Health (“The Ministry”) in the case of the MOH.
        The foregoing is provided that when it is not reasonably practicable for the Board to meet in a timely manner, both the Chair and Vice-Chair acting jointly, shall have the authority to suspend the MOH and/or the CEO with pay, pending Board determination.
  7. ARTICLE 7: CEO AND MOH SUCCESSION
    1. Preparedness. The Board shall ensure that the Health Unit is prepared for a change in CEO and/or MOH, whether such change is planned or unplanned through a successional planning framework.
    2. Un-Planned Transition. Unplanned transitions of the CEO and/or MOH, necessitating interim arrangements, shall be subject to and in accordance with the following:
      1. CEO. In the case of an unplanned transition of the CEO:
        1. The MOH and Corporate Services Director jointly or the Corporate Services Director alone if the position of MOH is also subject to an unplanned transition, shall act as CEO until an acting or permanent replacement is appointed by the Board.
        2. The Board shall meet as soon as reasonably practicable and shall forthwith appoint an acting CEO.
      2. MOH. In the case of an unplanned transition of the MOH:
        1. The AMOH, if there is one, shall act as MOH until a replacement is appointed.
        2. If there is no AMOH the Board shall forthwith appoint a physician as acting MOH.
      3. Communication Plan. The Board shall ensure there is a communication plan for the un-planned transition of the CEO and/or MOH that includes reassurance for both internal staff and external stakehold
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A by-law respecting the management of real property of the Board of Health for the Windsor-Essex County Health Unit.

  1. The Chief Executive Officer or designate, shall be responsible for the care and maintenance of all properties required by the Board (where they are owned not leased), including but not limited to, the following:
    1. The repair and maintenance of building systems such as heating and cooling systems, roof, structural work, plumbing, electrical systems;
    2. The repair and maintenance of the parking areas and exterior of buildings, where applicable;
    3. The care and upkeep of the grounds of the property, where applicable;
    4. The cleaning, maintaining, decorating, and repairing of the interior of the buildings, where applicable; and
    5. The maintenance of up-to-date fire and liability insurance coverage.
  2. Where a property required by the Board is a leased, not owned, property, the Board shall enter into a lease that addresses all maintenance, care and insurance requirements. The Chief Executive Officer shall be responsible for ensuring that the property is operated in accordance with the terms of any such lease.
  3. The Board shall ensure that all such properties comply with all applicable local, provincial and/or federal statutory requirements (I.e. Building codes and fire codes).
  4. The Board shall maintain and adopt policies with respect to the acquisition, sale and other disposition of real property. The Asset Management Policy will be reviewed on a three (3) year basis, or more frequently, if appropriate. The CEO shall report asset disposals to the Board annually as per the Health Unit’s Asset Management Policy.
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A by-law respecting the financial and asset management of the Board of Health for the Windsor-Essex County Health Unit (“Health Unit”) passed under the Health Protection and Promotion Act, R. S.O. 1990, c. H.7 (“HPPA”)

  1. FINANCIAL YEAR
    1. The financial year-end of the Health Unit shall be on December 31 of each year.
  2. APPOINTMENT of AUDITOR
    1. The Board shall annually appoint an auditor to audit the accounts of the Health Unit.
  3. FINANCIAL AFFAIRS and ASSET MANAGEMENT
    1. All matters related to the financial affairs and asset management of the Health Unit shall be carried out by the Chief Executive Officer or designate.
    2. The Chief Executive Officer (CEO) or designate shall ensure the:
      1. Maintenance of a system of internal controls designed to provide reasonable assurance that assets are safeguarded, transactions are properly authorized and recorded in compliance with legislative and regulatory requirements and reliable financial information is available on a timely basis.
      2. Preparation of an annual budget that complies with the requirements of the Ontario Public Health Standards: Requirements for Programs, Services and Accountability and the HPPA, for approval by the Board of Health.
      3. Reporting on financial information, more specifically, a statement of operating expenses, on a quarterly basis, commencing in the second quarter of the financial year. Reporting shall be in accordance with the Organization’s Budget Policy.
      4. Preparation of the annual financial statements in accordance with the prescribed financial reporting framework as established by the Chartered Professional Accountants of Canada. The Auditor shall audit the accounts, transactions, and disclosures included in the annual financial statements of the Health Unit in accordance with the prescribed auditing standards. The annual financial statements shall be recommended by the Audit Committee to be approved by the Board.
      5. Preparation of an Asset Management Policy and annual report of asset acquisition and disposal. The Asset Management Policy will be reviewed minimally on a three (3) year basis, or more frequently, if appropriate. For the purposes of the Asset Management Policy, assets mean an item, thing or entity that has potential or actual value to the Health Unit. It can be tangible or intangible, financial or non-financial, and includes considerations of risks and liabilities. It does not include real property.
  4. FUNDING
    1. Municipal funding shall be approved by the Board on an annual basis. Notices shall be delivered to The Corporation of the City of Windsor, The Corporation of the County of Essex and The Corporation of the Township of Pelee (collectively referred to as the Obligated Municipalities), representing their pro-rata share (based upon population data from the latest available Census) of contributions required to defray expenses for the Health Unit to perform its legislated functions and duties. Such notices shall include the amount and timing of the contributions.
    2. Additional notices shall be delivered to the Obligated Municipalities, in the event there are additional, unanticipated expenses identified and or incurred by the Health Unit to perform its legislated functions and duties. Additional contributions shall be approved by the Board of Health on an as needed basis. Notices shall include the Obligated Municipalities pro-rata share of the contributions required to defray such costs as well as the time of the contributions.
  5. PURCHASING
    1. The Board of Health shall adopt and maintain polices with respect to its procurement of goods and services. The Procurement Policy will be reviewed on a two (2) year basis, or more frequently, if appropriate.
  6. USER FEES
    1. The Board of Health shall adopt a policy to govern the establishment and maintenance of the Health Unit’s user fees that complies with the requirements of the Municipal Act, 2001. The User Fee Policy will be subject to review on a three year basis, or more frequently, if appropriate.
  7. BANKING
    1. The Board shall by resolution designate the financial institution in which the money or other financial instruments of the Health Unit shall be placed for safekeeping. The Health Unit shall periodically, but not longer than every ten years, select a financial institution in accordance with the requirements of the Health Unit’s Procurement Policy.
  8. BORROWING
    1. In accordance with the Health Unit’s Borrowing Policy, the Board of Health may approve the following transactions:
      1. Borrowing money upon the credit of the Board of Health;
      2. Issue, sell or pledge debt obligations of the Board of Health, including without limitation, bonds debentures, notes or other similar obligations of the Board of Health whether secured or unsecured;
      3. Charge, mortgage, hypothecate or pledge as or any currently owned or subsequently acquired personal or movable property of the Board of Health, including book debts, rights, powers, franchises and undertaking, to secure any such debt obligations or any money borrowed, or other debt or liability of the Board of Health.
  9. REMUNERATION for BOARD MEMBERS
    1. The Health Unit shall pay remuneration to each Board Member on a daily basis and all Board Members shall be paid at the same rate, provided that:
      1. Other than in the case of the Chair, no such remuneration shall be paid if the Board Member is a member of the council of a municipality and is paid annual remuneration by the municipality; and
      2. The rate of the remuneration shall not exceed the highest rate of remuneration of a member of a standing committee of a municipality within the County of Essex, but where no remuneration is paid to members of such standings committees the rate shall not exceed the rate fixed by the Ministry of Health.
    2. In determining whether and to what extent Board of Health Members should be compensated for their work beyond an applicable daily remuneration, the Board of Health shall give consideration to the current fiscal environment, and to whether the general population of the municipalities within the Health Unit served by the Board of Health would be supportive of such rewards for its members.
    3. The Health Unit shall pay directly or reimburse, as the case may be, the expenses of each Board Member provided that expenses are:
      1. approved in advance of being incurred;
      2. reasonable; and
      3. be in accordance with the Health Unit policies.
  10. SIGNING AUTHORITIES
    1. Any two of the CEO, Director of Corporate Services, Chair, Vice-Chair and Treasurer are authorized as signing authorities.
  11. INSURANCE
    1. With reference to insurance coverage, the CEO or their designate shall:
      1. Ensure adequate insurance coverage against insurance risks;
      2. Preserve the validity of insurance coverage;
      3. Review any significant changes to the operations of the Health Unit, at least annually, with the insurance broker. The insurance broker shall review the amounts and types of insurance maintained by the Health Unit and provide advice and recommendations.
      4. Annually, report
        1. significant changes to insurance coverage;
        2. any claims pursuant to the Health Unit’s insurance coverages maintained.
  12. INSURANCE BROKER
    1. The Board shall by resolution designate an insurance broker to:
      1. secure insurance coverage that is consistent with sector norms for like organizations;
      2. such other insurance related services as the CEO determines appropriate from time to time.
      3. The WECHU shall periodically, but not longer than every ten years, select an insurance broker in accordance with the requirements of the Health Unit’s Procurement Policy.
View Document Page

TITLE

CEO and MOH Performance Appraisals

APPROVED BY

Board of Health

DATE OF ISSUE

2022

ISSUED BY

Board Executive

Purpose

To ensure that regular performance appraisals are completed in a timely manner and in accordance with human resources best practices.

Policy

The Board of Health will conduct performance appraisals with both the Chief Executive Officer (CEO) and the Medical Officer of Health (MOH) individually, annually or more often as determined by the Board. The goals of the performance management shall be:

  • To maximize performance potential
  • Identify short term and long term strategic goals 
  • Identify strengths and weaknesses for the purpose of development efforts

Procedure

  1. In the first quarter of each year the MOH and CEO individually will complete a self-assessment report for the previous year and submit to the Board Chair.
  2. Each review will be conducted by the Chair and Vice-Chair of the Board. A meeting to discuss the review results. Following the meeting, the Board will be informed of the outcome of the review and discuss accordingly.
  3. Goals and objectives outlined in the review will be shared with the Board for discussion.
  4. The final review once approved will be stored in the employee’s personnel file.
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TITLE

Delegation of Duties: CEO & MOH

APPROVED BY

Board of Health

DATE OF ISSUE

2022

ISSUED BY

Board Executive Committee

Purpose

To outline the delegation of duties requirements and responsibilities for the positions of Chief Executive Officer (CEO) and Medical Officer Health (MOH).

Policy

The Board of Health recognizes that the duties of the Medical Officer of Health and the Chief Executive Officer are required to be carried out, even in the case of vacation and short leaves.

The Board of Health shall ensure that the Medical Officer of Health and Chief Executive Officer shall have coverage for his/her positions while away from the office on vacations and leaves.

Procedure

MOH Coverage:

If the Health Unit has an AMOH, the AMOH will be provide coverage for the MOH in his/her absence. If there is no AMOH, the Health Unit will establish arrangements with neighbouring Health Unit’s to request MOH coverage. The covering MOH will serve as Acting MOH for the WECHU during the absence of the MOH.

CEO Coverage:

The CEO will arrange for coverage from available Directors within the organization. Director(s) assigned will serve in the role of Acting CEO in the absence of the CEO and as such will have the delegated authority of the CEO.

View Document Page

TITLE

Public Attendance and Delegations at Board of Health Meetings

DEPARTMENT

Administration

APPROVED BY

Board of Health

DATE OF ISSUE

2022/09/16

ISSUED BY

Chief Executive Officer

Preamble

The Health Protection and Promotion Act (HPPA) requires Boards of Health to pass by-laws respecting the management of its property; banking and finance, the calling of and proceedings at meetings, the appointment of an auditor and any other matter necessary or advisable for the management of the affairs of the board of health.

The WECHU Board by-laws included a provision for public attendance and delegation at regular meetings of the board of health.

Purpose and Scope

The purpose of this policy is to outline the procedure and guidelines associated with public attendance and delegations at regular meetings of the WECHU Board of Health.

Policy

Members of the public are permitted to attend open portion meetings of the Board of Health. In order to be hears at a meeting (verbally or in writing) members of the public must register as a delegation or have the consent of the meeting.

Procedure

How to make a request for delegation:

  • Registration requests must be submitted by noon, at least three days preceding the day of the Board Meeting at which the delegation wishes to be heard (verbally or in writing). In the event of short notice meetings the three day time limit may be reduced accordingly.
  • To register the request shall be submitted via the delegation registration section of the Health Unit’s website.
  • Request may also be submitted in person by delivering the request in writing to the WECHU office located at 1005 Ouellette Ave, Windsor, Ontario.
  • Once a request for delegation is received, the WECHU board secretary will send an acknowledgement of the request.
  • Registration requests shall include the following information:
    • Name of Delegation
    • Contact information for the Delegation
    • Names of Delegation spokespersons, if any
    • Business item in connection with which Delegation wishes to be heard and whether Delegation intents to make a verbal presentation and whether the Delegation intends to use any audio visual equipment
    • Written materials, if any, shall: be limited to five 8.5”X11” pages; signed by the author, not contain any improper matter in the opinion of the Secretary and meet such other requirements from time to time set by the Board.

Timing for Verbal Presentations

  • Verbal presentations of Delegations shall be limited to five minutes, subject to that time being extended by the Chair for a further five minutes

Questions

  • Board Members may not ask any questions until all Delegations on the agenda item have been heard. Thereafter, Board Members may question Delegations.
  • No motions shall be recognized by the Chair during questioning of Delegations but once a motion has been accepted by the Chair, no further representation shall be permitted by or of Delegations.

Rules

Delegations shall be subject to the following rules:

  1. Delegations shall address only those items in connection with which they are registered or have the consent of the meeting.
  2. Delegations shall not enter into cross debate with other Delegations, Health Unit staff or Board Members.
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PREPARED BY:

Finance Department

DATE:

September 15, 2022

SUBJECT:

Registered Charity Status

BACKGROUND/PURPOSE

On July 14, 2022, Administration for the Windsor-Essex County Health Unit (WECHU) brought forward a recommendation to the Board of Health to support an application for charitable status for the WECHU.  The recommendation to move forward with registering as a charity was approved and Administration asked to report back to the Board on whether other public health units in Ontario are registered as a charity under Section 149 of the Income Tax Act.

DISCUSSION

Of the thirty-four (34) public health units in Ontario, ten (10) are registered charities.  The effective date of their charitable status is prior to 2012.  They include:

  • Board of Health for the Peterborough County – City Health Unit
  • Board of Health for the Algoma Health Unit
  • Brant County Health Unit
  • Kingston, Frontenac and Lennox and Addington Health Unit Charitable Organization
  • Haliburton, Kawartha, Pine Ridge District Health Unit
  • Middlesex-London Health Unit
  • North Bay Parry Sound District Health Unit
  • Northwestern Health Unit
  • Simcoe Muskoka District Health Unit
  • Eastern Ontario Health Unit

In 2012, there were amendments to the Income Tax Act, allowing municipalities, and municipal and public bodies performing a function of government in Canada, to apply for qualified donee status.  As a qualified donee, these entities would be eligible to issue official donation receipts, to receive gifts from registered charities, have the ability to apply for rebates (i.e. property taxes), and access other grant opportunities.    Of the thirty-four (34) public health units in Ontario, the Board of Health for Oxford Elgin St. Thomas Health Unit, is the only public health unit with qualified donee status.  Locally, the following public sector entities have the qualified donee status:

  • City of Windsor
  • County of Essex
  • Townships of Essex, LaSalle, Leamington, Lakeshore, Tecumseh, Amherstburg, and Pelee
  • Caldwell First Nation
  • Windsor Essex Community Housing Corporation
  • John McGivney Children’s Centre School Authority
View Document Page

PREPARED BY:

Communications Department

DATE:

September 15, 2022

SUBJECT:

May 15 – August 14, 2022 Communications Update

BACKGROUND/PURPOSE:

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

Data Notes can be provided upon request.

SOURCE MAY 15 – JUNE 14 JUNE 15 – JULY 14 JULY 15 – AUGUST 14
News Releases, Media Advisories and Statements, or Notices Issued 13 16 18
Media Requests Received 11 27 27
Wechu.org page views 148,952 171,443 193,890
YouTube Channel Subscribers 1,742 1,739 1,738
Email Subscribers 7,926 7,852 7,791
Emails Distributed 16 19 18
Facebook Fans 18,640 18,785 18,801
Facebook Posts 105 88 73
Twitter Followers 8,645 8,665 8,690
Twitter Posts 93 86 69
Instagram Followers 1,448 1,453 1,467
Instagram Posts 45 34 32
LinkedIn Followers 1,128 1,153 1,182
LinkedIn Posts 56 52 36

Media Exposure

 215 235 331

Media Exposure Overview Graph

May 15 - June 14

May 15 - June 14 2022 Media Exposure overview chart

June 15 - July 14

June 15 - July 14 2022 Media Exposure overview chart

July 15 - August 14

July 15 - August 14 2022 Media Exposure overview chart

Website Overview Graph

May 15 - June 14

May 15 - June 14 2022 Website Overview

June 15 - July 14

June 15 - July 14 2022 Website Overview

July 15 - August 14

July 15 - August 14 2022 Website Overview

DISCUSSION

May 15 – June 14 Notable Project thumbnail

May 15 – June 14 Notable Projects:

The Communication’s department launched the promotion of student catch-up immunization clinics. A news release was issued on June 2, 2022. The team has contacted school board and municipality communication representatives to share our messages, with support confirmed from all groups.

A guest column was published in the Windsor Star by Dr. Nesathurai regarding the importance of the HPV vaccine for youth. The social media post published with the link received the most reactions for the week. The article is available in our Newsroom.

June 15 – July 14 Notable Project thumbnail

June 15 – July 14 Notable Projects:

The Communication’s department launched the Fight the Bite campaign to raise awareness around West Nile virus. Components include radio ads, social media and digital ads, and TV display graphics which have been shared with various community partners. Two social media ads have reached a total of 14,378 users.

Acting Medical Officer of Health, Dr. Shanker Nesathurai, was asked by the Ontario Medical Association to provide a comment on the challenges faced by Ontario patients in terms of healthcare access and inequalities. His comment was published in the Ontario Medical Review at the end of June, 2022.

July 15 – August 14 Notable Project thumbnail

July 15 – August 14 Notable Projects:

The Communication’s department launched a campaign to raise awareness of sexually transmitted infections. Utilizing the Grindr platform, a location-based social networking and online dating application for gay, bi, trans, and queer people, the ad has garnered a total of 25,379 impressions and 2,695 link clicks in three weeks.

Additional components for this campaign also included paid ads on Facebook and Instagram, organic and boosted posts on @theWECHU social media channels, and a printed ad in the Windsor and Essex County Pride Fest 2022 magazine.

Both the print and digital ads directed users to a survey housed on WECHU.org, which has approximately 200 responses at the time of writing this summary.

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PREPARED BY:

Epidemiology & Evaluation Department

DATE:

September 15, 2022

SUBJECT:

Windsor-Essex Health Status Indicator (WE-HSI) Dashboard

BACKGROUND/PURPOSE

The focus of public health is to understand and address the health of the whole population. Through a population health approach and applying a social determinants of health lens, the goals of public health include improving health & quality of life, reducing morbidity and premature mortality, and reducing health inequities.

The Ontario Public Health Standards (OPHS; 2021) establish the requirements for public health programs and services and describe how those programs are to be implemented. The four domains of focus include: 1) Social determinants of health (SDOH); 2) Healthy Behaviours; 3) Healthy Communities; and 4) Population Health Assessment.

As the Windsor-Essex County Health Unit (WECHU) transitions into conducting non-COVID-19 programs and services, the Epidemiology & Evaluation (E&E) department will be responsible in conducting population level assessment and surveillance of Windsor-Essex County (WEC). Assuming that COVID-19 activity will ebb and flow locally, the transition to non-COVID work will not be linear and will require ongoing flexibility to adapt as required.

The E&E department will approach the renewal and transition phase of the pandemic by assessing the population’s health through a topical approach as identified in the OPHS (2021) through a phased approach in 2022 and into 2023.

DISCUSSION

The E&E department has applied Business Intelligence (BI) principles to WECHU’s renewal and transition efforts. As a result, dashboards will be focal point of deliverables, which will produce a visual and interactive deliverable to end users. The collection of topic based dashboards will provide internal WECHU staff, local stakeholders, policy and decision-makers, community partners and residents of WEC the resources to understand their community while aiding in program and policy decisions.

The following table identifies the topics the E&E team will produce over the course of 2022 and into 2023. Topics not identified are not due to exclusion, rather a lack of data availability (e.g., CCHS for indicators pertaining to healthy eating, physical activity, sleep, etc.). Where possible, alternative (or proxy) indicators will be identified.

Topics E&E will produce over 2022/2023 by month
Topic* Month
Infectious Disease (monthly and annual) June
Mental Health (including self-harm)
*assuming survey roll out		 June
Reproductive Health Outcomes July
All Cause Mortality August
Substance1 (hospital data on alcohol, cannabis, methamphetamines, etc.) August
Healthy Pregnancies, Preconception Health (Folic Acid) and Infant Feeding (BORN) September
All Cause Morbidity & Quality of Life October
Growth and Development October
Injury (including falls and concussion) October
Socio-Demographics – Based on 2021 Census release schedule November
Oral Health November
School Immunizations December
Cancer February 2023

*Topics not found on this list are due to existing data not being available. This includes sleep, healthy eating, physical activity and sedentary behaviour, etc.

1Excludes opioids which will have its own dashboard congruent with what is found on the WECOSS website.

Access the WE-HSI dashboards.

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Board Members Present:

Joe Bachetti, Tracey Bailey, Rino Bortolin, Aldo DiCarlo, Mark Ferrari, Judy Lund, Robert Maich, Ed Sleiman

Board Member Regrets:

Gary McNamara, Fabio Costante, Gary Kaschak

Administration Present:

Nicole Dupuis, Dr. Shanker Nesathurai, Lorie Gregg, Felicia Lawal, Kristy McBeth, Eric Nadalin, Dan Sibley, Konrad Farrugia

Guests:              

Ramsey D’Souza, Marc Frey

QUORUM: Confirmed

 

  1. Call to Order

    Vice-Chair, Rino Bortolin, acting as Chair in G. McNamara’s absence, called the Regular meeting to order at  4:02 p.m.

  2. Agenda Approval
    Motion: That the agenda be approved.
    CARRIED
  3. Announcement of Conflict of interest – None
  4. COVID-19 Update (Dr. S. Nesathurai)

    Dr. Nesathurai said we have to normalize our life with COVID. However, that does not mean we should normalize COVID’s impact or its burden. There have been 663 deaths in Windsor-Essex County since the beginning of the pandemic. In the past week there have been six deaths. Of those six deaths, four people had been living in the community. COVID affects those in long-term care homes and retirement homes but deaths do occur in those living in the community. There is now a Bivalent vaccine available for the highest risk populations. As the weeks progress the Bivalent vaccine will be available for everyone who wants the vaccine. 
    At the current time, there are 250k people who are eligible for the vaccine who have not been vaccinated. About 16% of people are up to date on their vaccines. Dr. Nesathurai said it is important for those eligible for vaccination to get up to date on their vaccines. When vaccinated people are less likely to be ill, pass away, or be hospitalized.
    Dr. Nesathurai said that there are multiple distribution channels for the vaccine and those distribution channels are pharmacies, physician offices, clinics, and the public health service. Up to this point in the pandemic 64% of vaccinations had been completed by the public health service. This is not sustainable due to competing priorities. It is important that physician offices and pharmacies and other additional distribution channels to assist with vaccination. 

    Dr. Nesathurai said that vaccines are probably one of the most effective treatments we have in medicine and are particularly effective in public health practice. In Ontario there is a very progressive piece of legislation called the Immunization of School Pupils Act (ISPA) and it provides the framework in which we can ensure that young people are vaccinated. It is a vaccine verification process which results in people becoming up to date in vaccines. This year there were 19k young people in grades 10 through 12 that needed to get up to date on vaccination; 18k have done so. The benefit for these young people once they leave high school they will be up to date on their vaccines and the vaccine verification process highlights the fact that there are some vaccines that are not part of ISPA but people do have an opportunity to receive those vaccines as well. This is a benefit for the public health service, the Board of Health, and for the community overall.

    Motion: That the information be received.
    CARRIED

  5. Approval of Minutes
    1. Regular Board Meeting:  August 11, 2022
      Motion: That the minutes be approved. 
      CARRIED
  6. Business Arising

    1. Charitable Status (L. Gregg)
      L. Gregg said as a follow up to the question asked of administration in July 2022 in regards to applying for charitable status and the report brought forward at that time; administration investigated the number of public health unit’s in Ontario that had charitable status. Of the 34 public health unit’s in Ontario there are 10 that are registered as charities – all of which had effective dates for charitable status prior to 2012. In 2012, there were amendments to the income tax act that allowed municipalities and municipal and public bodies performing the function of government in Canada to apply for what is called the qualified Donee status. The status is effectively similar to a charible status. Donee status allows an organization to issue official donation receipts for gifts it receives from individuals and corporations and the ability to apply for rebates and access grant opportunities. Of the 34 Public Health Units in Ontario there is one Public Health Unit that has Donee status and that is Southwest Public Health Unit. The WECHU reviewed other local entities to find out if there were any other qualified Donee status organizations. The City of Windsor, County of Essex, Townships of Essex, LaSalle, Leamington, Lakeshore, Tecumseh, Amherstburg, Pelee, Caldwell First Nation, the Windsor-Essex Community Housing Corporation, and the John McGivney Children’s Centre School Authority all have Donee status. As a result, the WECHU has drafted a letter to the Canada Revenue Agency to apply for Donee status as well.
      That the information be received.
      CARRIED

    2. Board of Health By-Laws (First Reading) and Policies (N. Dupuis/L. Gregg)
      N. Dupuis said that Board of Health by-Laws have been brought forward since April of 2022. These are the remainder of the outstanding by-laws. The format of the by-laws have been changed as per the direction received by the Board of Health early on. Previously, the by-laws were about 170 pages in length. The new format breaks the by-laws down into four (Governance, Finance, Human Resources, and Management of Real Property). Items that were procedural in nature have been moved to Board Policies and are also included for review and approval. All of these by-laws have been reviewed by WECHU’s legal council. The by-laws presented to the Board of Health today are merely the first reading. These by-laws would then be brought forward again in October for a second reading as per the current bylaws. This will provide the Board of Health with time to read the by-laws and report their feedback or any changes. Final approval of the by-laws is expected at the November Board of Health meeting. By-laws are to be reviewed by the Board of Health very 2 years. However, policies will be reviewed annually or as indicated (i.e. Whistleblowing).
       
      M. Ferrari said that normally when there is something that is this large that is undertaken on behalf of the Board of Health there is an ad-hoc committee or a standing committee on policy governance that handles the creation and monitors the fielding of governance related questions as part of the process. Has this Board of Health ever considered striking a policy governance committee and would that be helpful for the Board of Health to have more involvement?

      R. Bortolin said there has not been a policy governance committee in his time but it is a good suggestion. He noted that administration may be able to identify how the process was done in the past. 

      N. Dupuis said the by-laws have not been reviewed by a committee in her time at WECHU. The Board of Health by-laws have not been reviewed since 2017. The current by-laws were developed by WECHU legal council. Sections of the bylaw were brought to JBEC for review and discussion at meetings for over a year. Once completed they were brought to the full board for review and approval. N. Dupuis noted she cannot speak to processes prior to that time. This time administration identified the bylaws required updating and review and suggested an alternate format for the bylaws. Direction was given for administration to take on the task with legal counsel and bring to the board for review. 

      R. Bortolin suggested that a policy governance committee be struck after the local election has taken place. There will be new members assigned to the Board of Health at that time.

      M. Ferrari said that if a policy governance committee is developed is should happen before the next election term.  

      T. Bailey said that she would be willing to wait until the election is over in November to develop a policy governance committee. T. Bailey suggested having a report that comes back to the Board of Health that guides the new policy governance committee.

      Motion: To request a report from WECHU administration outlining what has been past practice and how to develop a Policy Governance Committee going forward that would begin at the start of the next term of the Board of Health committee after the fall election.
      CARRIED

      R. Bortolin said that the by-laws brought forward today will proceed once approved by the Board of Health. However, the motion to develop a Policy Governance committee will be for by-laws and other associated needs moving forward via the Board of Health.

      1. Public Attendance and Delegations at Board of Health Meetings

      2. Delegation of Duties
        N. Dupuis said there was no policy related to this item nor was it referenced in the previous by–laws. Any gaps for this item were corrected by borrowing language from other health units.

      3. Performance of Medical Officer of Health and Chief Executive Officer

      4. By-Law No. 1 – Governance

      5. By-Law No. 2 – Finance

      6. By-Law No. 3 – Human Resources

      7. By-Law No. 4 – Management of Real Property
        The Board of Health By-Laws will be brought back to the October 20, 2022 Board meeting for a second reading.  

        Motion: That the information be received. 
        CARRIED

  7. Consent Agenda
    1. INFORMATION REPORTS
      1. Q2 Financial Report (L. Gregg)
      2. Windsor-Essex Health Status Indicator (WE-HSI) Dashboard (N. Dupuis/R. D’Souza)
      3. 2022 Board of Health Competency and Self-Assessment Report (N. Dupuis/M. Frey)
      4. WECHU Strategic Plan – 2022-2025 (N. Dupuis/M. Frey)
      5. Communications Report (July-September 2022) (E. Nadalin)

        Motion: That the information be received.  
        CARRIED

    2. CORRESPONDENCE
      1. Chatham-Kent Public Health – Letter to Hon. Doug Ford, Premier of Ontario – Support for alPHa Resolution A22-4 and Appendix A – that the drug poisoning crisis in Ontario be declared an emergency under the Emergency Management and Civil Protection Act, (RSO 1990) – For Support
      2. Sudbury & Districts Public Health – Letter to Ministry of Children, Community and Social Services – Healthy Babies Healthy Children Funding – For Support
      3. Niagara Board of Health – Letter to Hon. Dominic Leblanc, Minister of Intergovernmental Affairs, Infrastructure and Communities – Improving Air Quality to Sustainably prevent COVID-19 – For Information

        Motion: That the information be received.  
        CARRIED

  8. Resolutions/Recommendation Reports

    1. Renewed Strategic Plan (N. Dupuis)
      N. Dupuis introduced Marc Frey, Manager of Planning & Strategic Initiatives, to present the Renewed Strategic Plan – See 9.4

      Motion: That the Renewed Strategic Plan be approved.
      CARRIED

    2. Signing Authority (L. Gregg)
      Motion: That the Signing Authority be approved
      CARRIED

  9. New Business

    1. Bivalent Vaccine Update (K. McBeth)
      K. McBeth said doses of the Bivalent Moderna vaccine is available in Windsor-Essex County. The vaccine is available to six priority groups which include health care workers, indigenous community, immunocompromised individuals age 12+, long-term care home and retirement residents, staff, and one essential caregiver, pregnant individuals, and those aged 70+.

      Anyone is eligible to receive the Bivalent vaccine as long as they have had the primary series.  A minimum of 3 months since the last dose with a recommendation of six months is required for eligibility.

      K. McBeth said that currently there is a limited supply of the Bivalent vaccine and the focus is the high risk congregate living facilities. Mobile teams have been focused on these types of facilities (shelters, supporting housing, etc.).

      Starting the week of September 26th the province is expected to open up eligibility for the Bivalent vaccine to everyone in Ontario 18+. The same minimum and recommended time frame applies to this group as well.

      An updated vaccine recommendation statement for those 6 months to 5 years of age is expected soon for the newly approved infant pediatric Pfizer vaccine which will be arriving to the community next week.

      K. McBeth said there are 20 pharmacies in Windsor-Essex County that have received the Bivalent vaccine and they are also administering it to priority groups. WECHU is supporting any access to primary care that are interested in vaccinating clients from the priority groups for the next few weeks.

      K. McBeth said there has been a delay in the Pfizer Bivalent approval. Therefore, the Moderna Bivalent vaccine will be the vaccine with the most ready access at this time.

      Motion: That the information be received
      CARRIED

    2. WE-HSI Dashboard – Presentation (R. D’Souza)
      N. Dupuis introduced Ramsey D’Souza, Manger of Epidemiology and Evaluation, to present the Windsor-Essex Health Status Indicator (WE-HSI) Dashboards. 

      R. D’Souza said WECHU embarked on an ambitious journey to reimagine how we would conduct our public health surveillance at WECHU. 

      Prior to the pandemic WECHU developed large scale reports such as the Community Needs Assessment and Oral Health Report. These reports were well developed but also time consuming.
      From conceptualization to the final product it could take 3-6 months on the topic area and sometimes up to 1 year. 

      Pandemic Challenges & Solutions
      Challenges
          - Population Health Assessment and Surveillance focus shifted to COVID-19 for 2.5 years
          - Need for timely data for evidence-informed decision-making for COVID-19

      Solutions
          - Development of interactive data visualization tools (dashboards)

      From Static to Routine Interactive Reporting
          - Build interactive dashboards by topic
          - Users can engage with the data
          - Routinely updated as newer data becomes available
            - Transition from 5-year to yearly (or as data is available) updates
          - Allows WECHU to be proactive and identify newer data sources
            - Similarly, identify gaps for primary data collection    

      R. D’Souza presented a demonstration of the live WE-HIS webpage on www.wechu.org.

      WE-HSI Next Steps
          - Develop 2021 Census dashboard by municipality
          - Connect with community partners for data sharing and developing a centralized health data portal
          - Conduct primary data collection to address data gaps (e.g. child and youth data, mental health, etc.)
          - Develop a health neighbourhood dashboard
            - Key population health indicators by smaller geographical areas
            - Will allow for targeted approaches for health interventions and programming.
          
          N. Dupuis said that R. D’Souza will also be presenting the WE-HSI dashboard to the OHT partnership table.
          
      Motion: That the information be received
      CARRIED

    3. 2022 Board of Health Competency Self-Assessment (M. Frey)
      M. Frey said the purpose of the Board of Health Competency Self-Assessment is to find areas of strength within the Board of Health that can be leveraged for future actions. The self-assessment also helps identify potential training opportunities for the Board of Health and whether the Board of Health perceives themselves as improving over time. This self-assessment is also a requirement of the Ontario Public Health Standards. The self-assessment consists of a series of questions dived up into 12 competencies. These competencies were identified and the questions were developed based on the Ontario Public Health Standards, Board of Health bylaws, and the alPHa Board of Health governance toolkit. Leadership and Governance was recognized as the greatest strength. Most of the scores fall under the satisfactory range. There were two competency scores that scored below satisfactory – Health Equity and Knowledge & Delivery of Public Health Programs/Services. 

      M. Frey said that questions about Board of Health Operations all scored similar – Agree or Strongly Agree. Scoring varied under – I feel the makeup of our board is reflective of the diversity of the Windsor-Essex community. There is disagreement regarding this question and the Board of Health composition meeting this requirement. 

      Overall recommendations included:
          - Providing training and education to the Board of Health, beginning in the areas with the lowest scores
          - Return to in-person Board of Health meetings when practical
          - Consideration of Board of Health diversity should be given when selecting or appointing new Board of Health members

      M. Ferrari said that it will be important for the Board of Health to complete this competency self-assessment again once new board members are appointed after the election.

      Motion: That the 2022 Board of Health Competency Self-Assessment be received.
      CARRIED

    4. Strategic Plan – Presentation (N. Dupuis)
      N. Dupuis introduced Marc Frey, Manager of Planning & Strategic Initiatives, to present the Renewed Strategic Plan. 

      M. Frey said that WECHU is required to by the Ontario Public Health Standards to produce and maintain a strategic plan. The current plan under review was developed to address the post pandemic challenges and opportunities. The lifespan of this plan is from 2022-2025. This timeframe was selected to address the acute need to have a plan in place post-pandemic. This timeframe also provides leeway to develop a longer term plan in the future. This plan included a lot of consideration from the previous strategic plan.

      The development process included interviews with the Board of Health and the Leadership Team, a survey conducted with local partner groups (N=37), 2-day Board of Health meeting to develop plan characteristics, a review and discussion period with the WECHU management team, an all staff survey (N=104), and lastly a survey issued to the Board of Health. The feedback received from the survey was incorporated into the strategic plan.
       
      Key highlights of the renewed strategic plan include:
          - Vision: Healthy people in a healthy community
          - Mission: The WECHU promotes, protects, and improves health and well-being for all people in our community
          - Values: Accountability, Empowerment, Leadership, Collaboration, and Equity
          - Priorities: Partnerships, Organizational Development, and Effective Public Health Practice

      This information will be published on www.wechu.org following this meeting. 

      J. Lund said in the strategic plan equity is references as one of the values. J. Lund said unless we are proactive in the area of diversity and inclusion the Board of Health needs to review how the BOH is assembled. 

      N. Dupuis said the current by-laws do allow for some consideration for outside members, not provincial appointees or elected officials appointed to the BOH. This could include indigenous representation or representation from other communities.

      Motion: That the Renewed Strategic Plan be approved.
      CARRIED

  10. Committee of the Whole (CLOSED SESSION, in accordance with Section 239 of the Municipal Act)
    The Board moved into Committee of the Whole at 5:17 pm
    The Board moved out of Committee of the Whole at 5:43 pm
  11. Next Meeting: At the Call of the Chair, Thursday, October 20, 2022 – Via Video
  12. Adjournment
    Motion:  That the meeting be adjourned.   
    CARRIED

     

    The meeting adjourned at 5:47 pm.

RECORDING SECRETARY: K. Farrugia

SUBMITTED BY: N. Dupuis

APPROVED BY: The Board of Health - October 20, 2022
 

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