Board of Health Meeting Documents

Prepared By:

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

Date:

April 1, 2019

Subject:

Background:

The 2017-2021 WECHU Strategic Plan identifies key roles, priorities, and directions for the organization. It sets out what we plan to do, how we plan to do it, and how we will measure our progress. The Strategic Plan outlines opportunities to enhance our delivery of quality public health programs and services to all residents in Windsor and Essex County. The current strategic plan is based on four strategic priorities: Communication and Awareness; Partnerships; Organizational Development; and Evidence-Based Public Health Practice.

As outlined in the 2017-2021 Strategic Plan under “Implementation and Monitoring”, the plan is to be reviewed and its progress measured and reported to the BoH annually. The annual review process consists of a meeting with the Strategic Planning Committee (SPC), during which the plan elements are discussed, reviewed and altered where necessary. After the SPC review, a strategic plan report is prepared and presented to the BoH for consideration. This year-end report is in addition to quarterly tracking and reporting implemented by the Planning and Strategic Initiative department in early 2018.

Current Initiatives

The 2018 Strategic Plan Year-End Report provides the objectives under each strategic priority and summarizes the progress our organization made during the second year (2018) of implementation and provides evidence of our commitment to quality, excellence, and accountability. It includes previous years’ measures (where established), 2018 measures/results, and next steps. The report also identifies changes made under Objectives 1.3, 3.4 and 4.4 as a result of discussions at the annual SPC review meeting.

The colour-coded state for all of the objectives either remained consistent or moved forward. In some cases, the goal for the measure of an objective was reached (e.g., under Objective 1.2) yet the work necessary to fully achieve the objective was not complete. In these cases, the colour-coded state of the objective remained yellow (progress being made but objective not met). Overall, progress has continued on all of the strategic objectives.

In Q1 of 2019, the PSI department will work with the Communication department to re-launch communication efforts internally about the strategic plan to ensure ongoing understanding of WECHU’s strategic objectives and allow departments to better understand their role in meeting them. These efforts will include a web update, the development of a new strategic plan e-learning module for staff and the BoH, and plans for mid-point activities to highlight WECHU’s progress on the 5-year plan.

Consultation:

The following individuals contributed to this report:

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

Approved by:

 Theresa Marentette

Prepared By:

Communications Department

Date:

March 6, 2019

Subject:

February Media Relations Recap Report

February Media Coverage

Story Source

Media Coverage

News Release and Media Advisories

Stories Reported by the Media

AM 800

Blackburn News

CBC News

Note: Digital stories were not available for five of CBC’s requests.

Chatham Daily News

CTV News

Note: Digital stories were not available for two of CTV’s requests.

Windsor Star

Windsorite.ca

Note: Digital stories were not available for National Post and The MediaPlex (St. Clair College).

The following individuals contributed to this report:

Jennifer Jershy, Marc Tortola, and Michael Janisse

Prepared By:

Communications Department

Date:

April 3, 2019

Subject:

March Media Relations Recap Report

February Media Coverage

Story Source

Media Coverage

News Release and Media Advisories

Stories Reported by the Media

AM 800

Blackburn News

CBC News

(also includes CBC Radio and Radio-Canada)

Note: Digital stories were not available for one of CBC’s requests.

CTV News

Note: Digital stories were not available for two of CTV’s requests.

Newswire

TVO

Windsor Star

Windsorite.ca

Note: Digital stories were not available for the Toronto Star and The MediaPlex (St. Clair College).

The following individuals contributed to this report:

Jennifer Jershy, Marc Tortola, and Michael Janisse

2018 WECHU Strategic Plan Progress - At a Glance

Communication and Awareness

Partnerships

Organizational Development

Evidence-based Public Health Practice

Introduction

Our strategic plan allows our organization to identify key roles, priorities, and directions across 2017 to 2021. It sets out what we plan to accomplish as an organization, how we plan to do it, and how we will measure our progress toward our goals. The current strategic plan is based on four strategic priorities: Communication and Awareness; Partnerships; Organizational Development; and Evidence-Based Public Health Practice.

As outlined in the 2017-2021 Strategic Plan under “Implementation and Monitoring”:

In order to support a framework of continuous improvement, the strategic plan will be reviewed and its progress will be measured and reported to the BoH annually. The annual review process will consist of a meeting with the SPC, with an attempt to have all previous committee members involved, during which the plan elements, including goals and indicators will be discussed and reviewed. At that time, based on consensus discussion and decision making, elements of the plan, specifically objectives, goals and indicators, may be altered to account for changes in the internal and external environment. The mission, vision, values statements, and priorities will remain consistent throughout the duration of the plan to ensure a consistent focus is maintained. After the SPC review, a strategic plan report will be prepared and presented to the BoH for consideration.

This report provides the objectives under each strategic priority, summarizes the progress our organization made during the second year of implementation (2018) and provides evidence of our commitment to quality, excellence, and accountability. The report also identifies changes made as a result of discussions at the annual SPC review meeting and includes previous years’ measures (where established), 2018 measures/results, and next steps.

Communication and Awareness

Partnerships

Organizational Development

Evidence-Based Public Health Practice

Board Members Present:

Joe Bachetti, Tracey Bailey, Dr. Ken Blanchette, Judy Lund, Gary McNamara, John Scott, Ed Sleiman, Larry Snively, Michelle Watters, Rino Bortolin, Fabio Costante

Board Member Regrets:

Dr. Deborah Kane, Dr. Carlin Miller

Administration Present:

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

Invited Guest Present:

Mr. J.P. Karam, Willis Law, WECHU Legal Representative

QUORUM:  Confirmed

RECORDING SECRETARY:

SUBMITTED BY:

APPROVED BY:

April 1, 2019

Issue

Increasing rates of opioid overdose across Canada have prompted action at all levels of government.  In addition to the broad increases in opioid-related emergency department (ED) visits, hospitalizations, and deaths noted at the provincial level (Ontario Agency for Health Protection and Promotion (Public Health Ontario), 2017), a recent report identified Windsor-Essex having an increased burden of opioid-related harms (Windsor-Essex County Health Unit, 2017) relative to other regions in Ontario. 

In October 2018, after a provincial review of existing Supervised Consumption Services (SCS) and Overdose Prevention Sites (OPS), the Government of Ontario announced its commitment to fund a re-purposed version of the Consumption and Treatment Services (CTS) program. The CTS program supports local organizations to address physical and mental health as well as social needs of people addicted to opioids and other drugs. In December 2018, organizations and communities considering a CTS who did not currently have one were encouraged to submit an application well in advance of April 2019.  In order to apply, organizations need to ensure the provision of treatment and rehabilitation services, and offer connections to health and social services, including primary care, mental health supports, housing, and employment. Before and after each site is selected, community consultations are needed to ensure the voices of residents are heard. Applying organizations must also have a plan in place to ensure community concerns are addressed on an ongoing basis.

An opportunity exists to address opioid overdoses in Windsor-Essex with strategies driven by community need and a community focused approach to overdose prevention and harm reduction. The process of assessing local need for CTS, collaboratively developing an application, and supporting the implementation, operation, and evaluation of CTS requires an organization with a broad understanding of and connection to local need, to take a lead role in the successful completion and submission of an application for CTS.

Background

The rate of opioid use in Windsor-Essex is the 7th highest in the province. Opioid-related emergency department visits have increased by 3.6 times since 2003. Opioid related deaths in the City of Windsor are significantly greater than the rest of the county, with 19 out of 24 deaths county-wide occurring in the City in 2015.  Based on the morbidity and mortality data in this region, the burden of illness for opioid misuse is disproportionately greater among the working-age (20-64 years-old) population (primarily males) in the City of Windsor (Windsor-Essex County Health Unit, 2017).

There are also significant public health concerns related to needle sharing and public injection and discarding of needles. The number of hepatitis C cases, a blood-borne infection, increased from 143 reported cases in 2016 to 181 reported cases in 20176. In 2017, 62% (101 cases) of the 164 confirmed hepatitis C cases that reported at least one risk factor other than unknown, reported injection drug use7. There have been 167 documented needle-related calls from January 1, 2014 to February 5, 2018 to local municipal services (3-1-1), predominantly in downtown Windsor8. The number of needle-related calls have significantly increased, from 43 in 2016 to 121 in 20178.

In December of 2016, the Windsor-Essex Community Opioid Strategy Leadership Committee (WECOSS-LC) was formed, bringing together leadership and key stakeholders across many sectors to collectively address rising rates of opioid use in Windsor and Essex County. The WECOSS-LC is committed to the ongoing development and implementation of the Windsor-Essex Community Opioid Strategy. As part of this strategy, community organizations are having conversations about consumption and treatment services including a safe injection site (SIS). As a result, in October 2018, the Windsor-Essex County Health Unit (WECHU) launched a community consultation regarding SIS. The goal of the consultation is to assess the need and acceptability of SIS in WEC.

Proposed Motion

Whereas, the Government of Ontario announced its funding commitment and endorsement of Consumption and Treatment Services in October 2018, and

Whereas, Windsor and Essex County is experiencing significant public health concerns related to the use of opioids and other substance use, including illnesses, deaths, blood borne infections, and public discarding of used needles, and

Whereas, Consumption and Treatment Services have the potential to address such public health issues, in addition to reducing health care costs.

Whereas, the Windsor-Essex County Health Unit’s (WECHU) lead role in the Windsor-Essex Community Opioid Strategy and understanding of harm-reduction services in the community, creates an opportunity for the WECHU to lead the successful completion of a comprehensive and collaborative application for Consumption and Treatment Services in our community.

Now therefore be it resolved that the Windsor-Essex County Board of Health supports ongoing public health led assessment of the need for and feasibility of Consumption and Treatment Services, and.

FURTHER THAT, should Consumption and Treatment Services be identified as a local need, as a result of such assessments, that, the Windsor-Essex County Health Unit,  take a lead role to facilitate the completion of an application, in collaboration with key community partners and stakeholders, to the provincial government for Consumption and Treatment Services in Windsor-Essex.

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

Prepared By:

Phil Wong, Manager, Environmental Health Department

Date:

January 23, 2019

Subject:

Disclosure Requirement UPDATE

Background

Since 2009, the Safe Food Counts disclosure program has provided the public access to online inspection reports for all food premises in the City of Windsor and Essex County. In addition to online reports, signage called Star Signs were distributed and displayed on site to direct the public to safefoodcounts.ca for further details on reports. Although all food premises inspected received Star Signs during each compliance inspection, not every municipality had by-laws in place to require posting.

In 2018, amendments were made to regulations under the Health Protection and Promotion Act, which made disclosure signage mandatory for a number of inspected facilities such as food premises, personal service settings and recreational water facilities. Public Health Inspectors enforce the new requirements across the province of Ontario. Furthermore, amendments made in 2018 to the Ontario Public Health Standards: Requirements for Programs, Services, and Accountability 2018 (OPHS) made it mandatory for local boards of health to have online disclosure of inspection reports and enforcement activity for the following provincial protocols:

• Food Safety Protocol, 2018;
• Health Hazard Response Protocol, 2018;
• Infection Prevention and Control Complaint Protocol, 2018;
• Infection Prevention and Control Disclosure Protocol, 2018;
• Infection Prevention and Control Protocol, 2018;
• Recreational Water Protocol, 2018;
• Safe Drinking Water and Fluoride Monitoring Protocol, 2018;
• Tanning Beds Protocol, 2018;
• Tobacco Protocol, 2018;
• Electronic Cigarettes Protocol, 2018.

Current Initiatives

In February 2019, the Windsor Essex County Health Unit (WECHU) will be launching the new disclosure website www.wechu.org/inspections. The new website will replace the Safe Food Counts website and contain inspection reports and enforcement activity for a variety of inspected facilities. Some of these include but are not limited to,

• Food Premises (restaurants, take-out, fast food, cafeterias, bakeries etc.)
• Personal Service Settings (ex. tanning, hair, tattoo and nail salons etc.)
• Licensed Child Care Centres
• Public Pools, Spas and Splash Pads
• Campgrounds
• Small Drinking Water Systems
• Legal Activity (ex. orders, closures, tickets and advisories)

The Environmental Health Department will continue to disclose the following on the WECHU website:

• Infection Prevention and Control (IPAC) Lapses in clinics, non-regulated and personal service settings;
• Outbreaks in Long-term Care Homes and Nursing Homes;
• Interactive Public Beach Map and Water Results;
• Food and Product Recalls;
• Extreme Weather Alerts.

The online disclosure program promotes transparency of inspection reports and allows the public to make informed decisions when visiting inspected facilities in the City of Windsor and Essex County.

Approved by:

 Theresa Marentette, CEO

Prepared By:

Karen Bellemore, Public Health Nutritionist
Jennifer Johnston, Health Promotion Specialist, SDOH

Date:

February 28, 2019

Subject:

Living Wage 2019, Windsor-Essex County Living Wage Program

Background

Income inequality has been recognized as one of the most significant social determinants contributing to poorer population health outcomes. As such, many communities across Ontario, nationally, and internationally have implemented living wage programs aimed to raise awareness, encourage adoption, and advance healthy public policy. In 2017, the Windsor-Essex County Health Unit (WECHU) agreed to take over the administration of the local living wage program from Pathway to Potential; Windsor and Essex County’s Social Investment Plan. The program re-launched in March 2018, and as of December 2018 there are 19 Certified Living Wage Employers locally.

The living wage program aims to promote social conditions that influence improvements in population health and quality of life.  This aim is aligned with the objectives outlined in the Ontario Public Health Standards (2018), as well as the vision, mission, values, and strategic priorities of the WECHU (2017-2021).

Currently the Living Wage program is administered through WECHU’s Chronic Disease and Injury Prevention department. The Living Wage program is included as part of the Working Toward Wellness (WTW) initiative and is imbedded as part of the Gord Smith Healthy at Work Awards.

Current Inititives

The 2019 Living Wage calculated for Windsor and Essex County is $15.15/hour for full and part time employees that do not receive health benefits from their employer. This represents a 0.34 cent per hour increase over the 2018 Living Wage. The 2019 Living Wage for full and part time employees who do receive health benefits from their employer remains at $14.00/hour, the current provincial minimum wage. 

The purpose of the Living Wage program is to raise awareness about the true cost of living in Windsor and Essex County, and to advance policies, partnerships, and practices that promote health and well-being for our community.

Objectives:

• To increase community awareness of the purpose and importance of paying a living.
• To increase the number of employers who become Certified Living Wage Employers through active recruitment and formal acknowledgement.
• To contribute to individuals’ ability to reach their health and well-being goals in the face of rising costs of living by promoting and encouraging Windsor-Essex employers to pay their employees a Living Wage on an ongoing basis.

Key Program Deliverables:

Each year the living wage calculation is updated and shared with the community. See the appendix A, 2019 Living Wage Calculation Summary Report.

The living wage certification program includes:

• Promotion and recruitment activities;
• An online intake and enrollment process;
• Verification that applicants meet program eligibility criteria;
• Support for employer implementation;
• An employer Living Wage Certification package;
• Program evaluation and reporting activities to support quality improvement; and,
• Recognition at the annual Gord Smith Healthy Workplace and Bike Friendly Awards.

This year the WECHU, along with a Community Advisory Committee (CAC) will explore strategies to increase knowledge and uptake of the living wage program among community employers.

Key Calculation Changes for 2019:

In order to better support local communities in the Living Wage Calculation process, the Ontario Living Wage Network (OLWN) reviewed and updated the living wage calculation methodology in 2018.  This change allows local communities to spend less time calculating the living wage and helps standardize calculations throughout the province. See Appendix B “Amendments to the 2018 Ontario Living Wage Calculation Methodology” for the calculation change rationale. 

Some highlights include:

• The OLWN recognized that there are items that must be sourced at a local level (e.g., food, shelter, childcare, public transportation).  However, there are items that make up a small portion of family expenses (e.g., clothing and footwear, car ownership, household supplies, minimal recreation) that are no longer sourced locally.  This allows for greater consistency across the province.
• A 35-hour workweek is used to determine the living wage.  In previous calculations, a 37.5-hour workweek was used; however, data from Statistics Canada indicated that the most common number of hours worked per week in Ontario is 35.
• Utilizing a weighted average for rural/urban transportation.  Transportation requirements in an urban setting with a transit system are very different then that of rural communities. Therefore, a weighted average based on population is used to calculate transportation costs for the whole community.  The assumption is that the urban family would have one vehicle and one adult accessing public transportation, whereas the rural family would have two vehicles.    

Appendices

• Appendix A – 2019 Living Wage Calculation Summary Report
• Appendix B – Ontario Living Wage Network – Amendments to the 2018 Ontario Living Wage Calculation Methodology
• Appendix C – 2018 Living Wage Evaluation Report

Consultation:

In the winter of 2017 a number of key stakeholders in the community, representing diverse sectors were invited to join the Windsor-Essex County Living Wage Program Community Advisory Committee (CAC). Members of the CAC serve in a consultative capacity, providing recommendations and advice to the WECHU Living Wage program team.  The CAC first convened on February 27th, 2018. A second CAC meeting was held on December 11th, 2018. At that meeting, the WECHU team delivered a presentation outlining the 2019 Living Wage calculation and relevant changes. They also shared the 2018 Living Wage evaluation report.  The plan for promoting and recruiting Living Wage employers for 2019 was discussed.  Group feedback and discussion resulted in valuable input and advice that in most cases were incorporated into the 2019 plan.

Community Advisory Committee Membership:

• Judy Lund, representative, Working Toward Wellness Committee
• Michelle Suchiu, Executive Director, Workforce Windsor-Essex
• Stephen Lynn, Coordinator of Social Planning, City of Windsor
• Jelena Payne, Commissioner of Community Development and Health, City of Windsor
• Luciano Carlone, Director of Finance and Corporate Services, Canadian Mental Health Association - Windsor-Essex County Branch
• Lorraine Goddard, CEO, United Way/Centraide Windsor-Essex County
• Robert Ross, Co-Chair, Windsor-Essex Food Policy Council
• Greg Schlosser, Director, Human Resources, County of Essex

The following individuals contributed to this report:

• Nicole Dupuis, Director of Health Promotion
• Kristy McBeth, Director of Health Protection
• Neil Mackenzie, Manager, Chronic Disease & Injury Prevention
• Ramsey D’Souza, Manager, Epidemiology and Evaluation
• Saamir Pasha, Epidemiologist
• Marc Frey, Manager, Planning and Strategic Initiatives

Approved by:

Theresa Marentette, CEO

Appendix A – Calculating a Living Wage for Windsor and Essex County 2019

Background

A living wage is the minimum amount a person must earn to afford to live and participate in a specific community. It is not the same as the minimum wage, which is the lowest rate an employer can legally pay for work performed. The living wage takes into consideration basic level of economic security and quality of life for most two-parent families (but it is designed to support most other types of households as well) within a given community context, meaning it is different for each community. Receiving a living wage affords individuals and families increased opportunity to live with dignity and participate as active citizens in our society.

Calculating the Living Wage for Windsor-Essex County

How is the Living Wage Calculated?

The living wage is based on the Canadian Living Wage Framework and the Canadian Centre for Policy Alternatives Ontario Family Expense Workbook. Use of these tools helps keep calculations consistent and comparable across Canada. To determine the living wage for Windsor and Essex County, the following reference household scenario is used:

A healthy family of four:

• Two adults, both age 35 and both working full time (35 hours per week).
• One child age 3; requires 251 days of full-day childcare.
• One child age 7; requires 50 days of full-day childcare in the summer and 187 days of before-and-after-school care.

The living wage is calculated based on how much a family spends on necessities (annual family expenses), plus how much they pay towards taxes and premiums (employment insurance and pension plan), minus eligible tax credits and other subsidies (government transfers). The living wage is traditionally calculated every year.

What does the Living Wage Calculation include and what it does not include.

The data used in the calculation comes from a variety of local, provincial, and national sources. Where feasible, the living wage calculation prioritizes the use of the most recent local data to determine the cost of living within our community. The data sources used for this calculation include:

• Government of Canada
• Government of Ontario
• Canada Mortgage and Housing Corporation (CMHC)
• Market Basket Measure
• Statistics Canada’s Survey of Household Spending (SHS)
• Windsor-Essex County Nutritious Food Basket
• Local quotes of goods and service providers

Summary of the 2019 Windsor-Essex Living Wage Calculation

The following tables provide a breakdown of the estimates and explanations of annual family expenses, premiums and taxes, and government transfers. It is anticipated that knowledge of this living wage calculation can inform public policy debate in areas such as affordable housing, transportation, and education.

Note: Values rounded to the nearest whole dollar.

* Statistics Canada Market Basket Measure (MBM) calculates ‘Other’ expense at 75.4% of the combined expense for ‘Food’ & ‘Clothing and footwear’

Note: Values rounded to the nearest whole dollar.

Note: Values rounded to the nearest whole dollar.

• $15.15 per hour for workers whose employers do not provide health benefits.
• $14.00 per hour for workers whose employers do provide health benefits.

The total household expenses increased to $67,800 in 2019 from $66,374 in 2018 for the Living Wage calculation. The differences in household expenses between the current and previous year were associated with changes in the sources of expense costs and calculation methodology. Of significance, communities whose public policy provide greater income and service support such as an affordable transit passes, rent supplements, childcare subsidies and/or subsidized recreation programs will facilitate a lower living wage.

Amendments to the 2019 Calculations

1. Assuming a 35-hour workweek – In previous calculations across Ontario, a standard workweek was assumed to be 37.5 hours. Given data from Statistics Canada and to better align with other provinces’ living calculation methodologies, Ontario living wage calculations now assume a 35-hour workweek.
2. Weighted Average for Rural/Urban Transportation – The requirements for transportation in an urban setting compared to a rural community is very different. To reflect the actual costs of these differences a weighted average for transportation was used. Urban communities use the cost of one car and one adult transit pass whereas rural communities require both parents to have a vehicle to get to and from work. Calculating transportation expenses applied an online CAA tool to estimate car ownership and maintenance costs instead of relying on local estimates (e.g., oil changes, maintenance, fuel) or the Market Basket Measure. This source provided a more realistic and consistent cost of transportation in rural communities.
3. Childcare – The number of required childcare days do not consider the 2-week family vacation or Professional Development days during the school year. To account for these additional days, the full day childcare has changed from 260 days of required care to 251. The before and after care requirement has been adjusted from 195 to 187 while the day camp requirement has been updated to 50 days from 65.
4. Other Expenses - The 2019 Living Wage Calculator workbook included costs of clothing and footwear to permit consistency across all communities in the Living Wage Network. In addition, the cost of other expenses (e.g., toiletries, furniture, recreation) was defined as 75.4% of the combined expense for food, clothing and footwear (Statistics Canada.  Table 11-10-0223-01).
5. Government Transfers - The amount of government transfers changed due to the inclusion of GST/HST credit and the Ontario Trillium Benefit. Further, the Childcare subsidy now assesses eligibility based on families previous year’s net income and not total income.

Appendix B - Amendments to the 2018 Ontario Living Wage Calculation Methodology

In 2018 the Ontario Living Wage Network reviewed and updated the methodology for calculating the living wage in Ontario. At a network meeting in February of 2018 it was decided that the calculation process should be streamlined so that local communities will spend less time calculating the living wage and have more time to engage with employers and advocate for decent work.

The following principles were outlined at the meeting:

1. A living wage need to come in above $15 an hour to be a credible indicator of a wage that allows one to both meet basic needs and participate in community.
   1. The living wage is based on the principle that if you work full-time, full-year you should earn enough to make ends meet and participate in your community.
   2. The campaign for a $15 minimum was based on the contention that if you work full-time, full-year you should earn enough to be above the poverty line (make ends meet). In technical terms, that means a minimum wage should get you 10% above the Provincial poverty line; which is the low-income measure. That was part of the justification for the target of $15 an hour as it was shown that if someone worked 35 hours a week, full-year at $15 an hour, they would earn about 10% above the before tax low income measure.
2. Living wage rate provides a modest income. The living wage represents the base wage for the lowest paid worker in an organization.
3. Local communities are looking for calculations that can help in policy advocacy, whether at the provincial, national or local level. The following items are considered to be important to be based on local costs:
   • Housing
   • Food
   • Transportation
   • Hydro
   • Health insurance
   • Child care (and local summer recreation/child care programs)
4. There are other expenses that are not as influenced by public policy and/or for which there is not easily accessible local data:
   • Clothing and Footwear
   • Household items and furniture
   • 2 week family vacation
   • Monthly family dinner and movie out
   • Personal care
   • Recreation
   • Reading and entertainment supplies
   • Laundry
   • Life and disability insurance
5. It was decided that living wage rates for communities across Ontario should be released at the same time to help create consistency in data collection across the province.

Update of the Tax and Transfer Calculator

The new living wage calculation methodology was tested and provided good results when the 2017 Tax and Transfer Calculator was used to calculate living wage rates. The update for 2018 was completed by Iglika Ivanova from the Canadian Centre for Policy Alternatives in British Columbia. In the review and update process a few issues were found in previous versions of the calculator tool.

In previous versions of the Tax and Transfer Calculator the child care subsidy uses the total employment income as the basis for assessing eligibility. In actuality, the previous year’s net income is used to assess eligibility and this change has been made in the 2018 version of the calculator.

In addition, the medical expense tax credit was set to use the Critical Illness expense instead of the non-OHIP medical expense. As the Critical Illness is much lower this resulted in a difference in both federal and provincial taxes owing. In addition, the 2017 version of the calculator assigned the medical expense tax credit to the higher income parent but the value is a lot higher when the credit is assigned to the lower income parent.

Listed below are additional, less significant amendments to the Tax and Transfer Calculator:

• Added option of eligibility for Northern Ontario Energy Credit
• Added Trillium benefit to refundable tax credits
• Changed the treatment of the GST/HST credit so that it’s counted as a refundable tax credit (instead of being subtracted from federal tax owing)
• Removed public transit and tuition tax credits that ended in 2017 tax year
• Update CPI and EI to 2018 rates
• Split the tuition amount between the two parents

These issues have been resolved in the 2018 version of the calculator. These changes in the calculator resulted in significantly lower living wage rates. 

Updated Methodology for Calculating a Living Wage in Ontario

The principals of a community living wage calculation as laid out in the Canadian Living Wage Framework by the Canadian Centre for Policy Alternatives remain the same. As do the items listed in the basic living wage calculation formula. However, some of the items that amount to a small portion of the family expenses are no longer sourced locally. These changes have been made to create greater consistency in living wage calculations across the province and to provide local community organizers with the opportunity to spend less time sourcing information for a calculation and more time advocating for a living wage, decent work and good public policy.

The following items continue to be sourced at the local level:

• Shelter
• Food
• Childcare
• Public transportation
• Communications
• Non-OHIP Health Insurance – Through the calculation process it has become clear that the Blue Cross Balance Plan is standard across the province.

The following items are already sourced for communities:

• Originally the cost of car ownership for the 2018 calculation was sourced through the Market Basket Measure for rural communities in ON (which represents the costs of owning and operating a second-hand car), adjusted by the CPI to 2017 prices. This cost is much lower than what was calculated through the old methodology where communities were asked to source oil changes, maintenance, gas, etc. Changes to the methodology need to be easily explained by local communities doing the living wage calculation. If an expense rises or falls drastically a reasonable explanation should be provided. After calculating the expense for the car using the old methodology for 2018 and feedback from rural communities, it has been determined that the MBM number does not accurately reflect the costs of car ownership. We will now be using an online tool provided by CAA to determine the expense of owning and operating a vehicle in Ontario. The number provided is much closer to that in the 2017 methodology. More information on how the CAA calculates the cost of car ownership and why this source was chosen will be available in the OLWN Report on Calculating the Living Wage in Ontario. A reference to this new source has been included in the Calculation Resource Folder. The MBM reference was from a different source year so CPI numbers have been changed in the workbooks so as not to alter the current cost of car ownership.
• Cost of clothing and footwear are obtained from the Survey of Household Spending (SHS) (2016), Table: 11-10-0223-01 (formerly CANSIM Table 203-0022), 3rd Quintile. The estimates from the SHS are from 2016 and have been adjusted for inflation, using CPI data from Table: 18-10-0005-01 (formerly CANSIM Table 326-0021).
• The Statistics Canada Market Basket Measure (MBM) calculates the Other expense at 75.4% of the combined expense for Food and Clothing and Footwear. This amount is intended to cover toiletries and personal care, furniture, household supplies, laundry, school supplies and fees, bank fees, some reading materials, minimal recreation and entertainment, family outings (for example to museums and cultural events), birthday presents, modest family vacation and some sports and/or arts classes for the children. This approach is used for calculating the living wage in British Columbia by Living Wage for Families.

Amendments to address the low living wage rates due to updated 2018 calculator:

Our goal is to have accurate living wage rates across the province. However, we know that at least $15 an hour is required to lift an individual 10% above the Low-Income Measure in Canada. As the Living Wage is a ‘participation wage’ meant to provide more than just the basics, it stands that living wage rates should not be lower than $15 per hour. In addition, the living wage is a tool for employers. We need to provide living wage rates that accurately reflect the cost of living in a community and any changes are reasonable and can be clearly explained to employers. As tested rates with the updated 2018 calculator came in significantly lower, the following additional adjustments have been made to the methodology.

1. Move to 35-hour work week. In previous Ontario calculations a 37.5 hour work week has been used to determine the living wage. Living Wage for Families in British Columbia and Fight for $15 and Fairness both use a 35-hour workweek. Data from Statistics Canada indicates that the most common numbers of hours worked per week in Ontario is 35. For these reasons in the 2018 calculation of the living wage in Ontario, we have made the change to a 35-hour workweek.
2. Weighted Average for Rural/Urban Transportation. It is apparent that the transportation requirements in an urban setting with a transit system are very different then that of rural communities. In an attempt to highlight this difference and reflect the actual costs of residence in a community a weighted average for transportation is highly suggested. Urban communities use the cost of one car and one adult transit pass. In rural areas, both parents will require a vehicle to get to and from work. The use of public transit by one adult in the family where available reflects the idea that a living wage is still a modest wage. If this concern affects your community, you will find the calculation outlined in the Community Specific Amendments and Questions section below.

Using the 35-hour workweek and a weighted average for rural vs urban transportation has helped to raise the low living wage rates provided in the 2018 calculator to rates similar to those of our original test calculations. 

Workbook and Data Source Amendments:

The following changes will be made to each community workbook and have been noted for amendment to the workbook for the future.

1. CPI number for food. In the food worksheet, the number listed in the column labeled CPI Source Year is the CPI rate for 2016. The number listed in the column labeled Current CPI is the CPI rate for 2017. Unless otherwise noted, communities have access to the Nutritious Food Basket numbers from 2017. The CPI Source Year numbers have been changed to the 2017 amount so that both are equal and reflect no change of the food expense entered in the workbook.
2. Childcare. The numbers provided in the workbook for the number of required childcare days do not consider the 2-week family vacation or Professional Development days during the school year. In order to account for these additional days the full day childcare is changed from 260 days of required care to 251. The before and after care requirement has been changed from 195 to 187. And the day camp requirement has changed from 65 to 50. For more info on where these numbers come will be provided in the OLWN Report on Calculating the Living Wage in Ontario. As the worksheet for childcare is currently locked, you can find the calculations for childcare in the section below titled Community Specific Amendments and Questions. The total number for childcare has been entered on the Main worksheet of your workbook.

Appendix C – 2018 Living Wage Evaluation Report

The Windsor and Essex County Living Wage Program was adapted from the previous Pathway to Potential Living Wage Program, and is aligned with many of the key principles from the provincial and national living wage programs. The purpose of the program is to raise awareness about the true cost of living in Windsor and Essex County, and to advance policies, partnerships, and practices that promote health and wellbeing for our community.

The program re-launched in March 2018 and as of December 2018, we have 19 Certified Living Wage Employers. Of those 19 certified employers, there are nine different employment sectors represented including construction, energy, government, healthcare, manufacturing, non-profit, professional services, finance/banking and workforce development. When asked why organizations were supportive of the living wage program, the top five reasons were employee morale, employee retention, employee recruitment, aligns with organizational values and employee loyalty. 

The Living Wage program was also intergraded into the Gord Smith Healthy Workplace and Bike Friendly Awards program.  Twelve of the nineteen certified workplaces, applied for a Gord Smith award.  Eight of those workplaces were able to receive the diamond or platinum level award because of the living wage certification.  The other four workplaces certified Living Wage did not require it for their award level.

Under the Pathway to Potential Living Wage program, there were 43 certified Living Wage Employers.  With the help of WorkForce WindsorEssex, all of these previous employers were contacted to encourage them to sign-up for the new program.  At present, six of these employers have re-certified with the new program. This represents a favourable opportunity, for further engagement with past Living Wage Employers.

Application Statistics

• Current number of Certified Living Wage Employers – 19
• Total number of applications in 2018 - 20
• Which sector best describes your organization?

• Sectors not yet represented:
  • Agriculture
  • Charity
  • Creative Industry
  • Education
  • Tourism & Hospitality
• Has your organization been certified as a Windsor-Essex County Living Wage employer in the past?
  • Yes – 6 (30%)
  • No – 14 (70%)
• Please tell us why your organization is supportive of paying a living wage:
  • Employee morale – 18 (90%)
  • Employee retention – 18 (90%)
  • Employee recruitment – 17 (85%)
  • Aligns with organizational values – 17 (85%)
  • Employee loyalty – 16 (80%)
  • Employee heath – 14 (70%)
  • Positive brand association – 13 (65%)
  • Workplace productivity – 12 (60%)
  • Workplace profitability – 6 (30%)
  • Other – 2 (10%)
    • Unionized facility
    • Multiple collective bargaining units
• Living Wage and the Gord Smith Awards
  • 5 did not receive Gord Smith Awards
  • 8 needed the LW to receive their Gord Smith Diamond or Platinum level
  • 4 received LW and GS, but the LW was not required for the GS level they received
• Therefore, 12 organizations received both LW and GS awards this year.

Living Wage Website Statistics:

• Visits: A visit is defined as a series of page requests from the same uniquely identified visitor with a time of no more than 30 minutes between each page request.
• Page views: A page view is a count of how many times a page has been viewed on a website or the chosen group within the chosen period of time. All page views are counted no matter how many times a user has visited the website in the chosen period of time.
• Interactions: Number of times users clicked on or scrolled up/down this page during the selected time period.

Hot spots on the main page include:

• Benefits of a Living Wage
• Employer Directory
• Apply Now
• Read the Report (summary report)

Total Downloads:

• Infographic – 101
• Promotional Flyer – 95

Living Wage resources page saw <0.1% of the total page views

Prepared By:

Karen Bellemore, Public Health Nutritionist
Neil Mackenzie, Manager, Chronic Disease & Injury Prevention (CDIP)

Date:

February 28, 2019

Subject:

2018 Nutritious Food Basket Report (NFB)

Background

Household food insecurity occurs when food quality and/or quantity are compromised, typically associated with limited financial resources (Tarasuk, V. 2009), negatively influencing physical, mental, and social health (PROOF Food Insecurity Policy Research, 2018). In Windsor-Essex County nearly 11% (10.8%) of households and 27.4% of low-income households, self report being moderately or severely food insecure. Moreover, one in 10 (10.8%) adults state they are food insecure and nearly ten percent (9.7%) of Windsor-Essex County Children are reported to be food insecure (WECHU, 2016).

In the 2016 Community Needs Assessment conducted by WECHU, more than half of all survey respondents (54%) identified more affordable healthy food options as the top issue that needs to be addressed to improve the health of their family and/or community (WECHU, 2016).  That same report identifies the need to advocate for policies and built environment changes within WEC that make it easier for residents to make healthy choices, including improved access to affordable healthy foods.

As part of the new Population Health Assessment and Surveillance Protocol, 2018, under the modernized Ontario Public Health Standards (OPHS), boards of health are required to monitor food affordability at a local level. The Ministry of Health and Long Term Care provides guidance for determining the Nutritious Food Basket in its guidance document: Monitoring Food Affordability Reference Document, 2018 (MOHLTC, 2018).

The Windsor-Essex County Nutritious Food Basket (NFB) is a tool that allows for improved understanding of the Real Cost of Eating a basic nutritious diet for a reference family and those of different ages, gender, and physiological status (i.e., pregnant, breast feeding) within Windsor-Essex. 

Current Initiatives

Each year the WECHU releases its calculation for the Nutritious Food Basket. Food costing tools, such as the Nutritious Food Basket (MOHLTC, 2008), measure the cost of basic healthy eating representing current nutrition recommendations and average food purchasing patterns. Each year, over a two-week period in May, the WECHU’s Registered Dietitians (RD) survey nine different grocery stores within the city and county. Stores are selected following the NFB protocol, ensuring representation of all types of grocery stores (i.e., high-end, discount, community based). Using the NFB costing tool, the average cost of the lowest price available for 67 different food items is calculated. It is important to note that the NFB does not include items such as spices, sauces, condiments, processed and ready-to-eat foods, baby food and formula, personal hygiene, and cleaning products. Once the average price is determined, different income and family scenarios for our local community are calculated.

2018 Nutritious Food Basket Report

The cost of eating healthy in Windsor-Essex County decreased by $2.24 in 2018 from 2017, according to the 2018 Nutritious Food Basket Survey results. The cost of healthy eating for a family of four in Windsor-Essex is $194.04 per week. Although this is a small decrease in the cost of the basket, healthy eating is still unattainable for many in our community. For example, a family of four* on Ontario Works (OW) has an average monthly household income of $2,582. When rent and the cost of the Nutritious Food Basket are accounted for, the same family is left with only $706.81 to cover all other remaining expenses including utilities, transportation costs, medical expenses, clothing, etc. For a single male living on Ontario Works, the reality is much worse. After accounting for rent and the Nutritious Food Basket expenses, the individual may be left with no money at all to cover all remaining expenses.  See the Real Cost of Eating Well in Windsor-Essex report (appendix A) for more income scenarios.

According to the Community Needs Assessment report (2016), the proportion of individuals living in low-income households is greater in WEC compared to the provincial average. Poverty has a direct impact on an individual’s ability to access healthy food because when income is too low, people do not have enough money for rent, bills, and food. As such, oftentimes individuals will manage food insecurity through compromising quality and quantity of food as resources become scarce (ODPH, 2015).

The purpose of NFB data is to increase awareness about the cost of healthy eating in our community.  This data can be used to assist policy and decision makers to advocate for improved social assistance rates, living wage policies, more affordable housing policies, and accessible and affordable child care. All of which increase the likelihood that families and individuals will have enough income to afford to meet all of their fixed costs while having enough money available to meet their basic nutrition needs.

*Family of four = a man and woman each aged 31 to 50 years; a boy, 14 to 18 years of age; and a girl, four to eight years old.

Nutritious Food Basket Usage and Dissemination

The NFB has been used as an essential local component in the calculation of the Windsor-Essex County Living Wage for 2018 and 2019.

The NFB 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 advocacy efforts.  

Appendices

• Appendix A - The Real Cost of Eating Well in Windsor-Essex, 2018 Report
• Appendix B – Food Security in Windsor-Essex

Consultation:

The following individuals were consulted in the preparation of this report:

• Nicole Dupuis, Director of Health Promotion
• Alicia Chan, Public Health Nutritionist
• Heather Nadon, Public Health Nutritionist
• Mariel Munoz Tayraco, Public Health Nutritionist
• Jennifer Jacob, Public Health Nutritionist

Approved by:

Theresa Marentette, CEO

Appendix A - The Real Cost of Eating Well in Windsor-Essex, 2018 Report

Visit the report summary page.

References

• Ministry of Health Promotion. Nutritious Food Basket Guidance Document. May 2010.
• Ontario Dietitians in Public Health, Food Insecurity Workgroup. Position Statement on Responses to Food Insecurity. https://www.odph.ca/upload/membership/document/2016-02/position-statement-2015-final.pdf. Published November 2015.
• PROOF Food Insecurity Policy Research. (2018). Retrieved from https://proof.utoronto.ca/  January 4, 2019.
• Tarasuk V.  Health implications of food insecurity.  In Social Determinants of Health: Canadian Perspectives, 2nd ed. Raphael, D., Ed.; Canadian Scholars’ Press Inc.: Toronto, 2009; Chapter 14 Downloaded from the Web January 4, 2019
• Windsor-Essex County Health Unit. (2016). Active Living and Healthy Eating in Windsor and Essex County. Windsor, Ontario.
• Windsor-Essex County Health Unit (2016). Community Needs Assessment Report. Windsor, Ontario

Prepared By:

S. Manzerolle and L. Piccinin

Date:

January 24, 2019

Subject:

Influenza Update

Background

The Windsor Essex County Health Unit distributes influenza vaccine to healthcare providers, agencies, and pharmacies as part of the Ministry of Health and Long-Term Care’s Universal Influenza Immunization Program (UIIP).

Current Initiatives

Influenza Vaccine Distribution: To date, more than 113, 000 doses of flu vaccine have been distributed to 234 healthcare providers in WEC. In addition, approximately 31, 000 doses of flu vaccine have been administered through 93 pharmacies this flu season.

With increased access to the influenza vaccine, the Health Unit provided one public influenza clinic at the University of Windsor in November, 2018. Nearly 700 people received the vaccine, with the clinic targeting international students and their families.

Influenza Cases: For the 2018/19 influenza season, there have been 102 confirmed cases, 100% of which have been identified as Influenza A with a predominant H1N1 strain. 

Facility Outbreaks: No influenza outbreaks have been declared in WEC Long-Term Care, rest or retirement homes this flu season, as compared to 18 influenza outbreaks in the 2017/18 season.

Approved by

Theresa Marentette, CEO

Board Members Present:

Joe Bachetti, Tracey Bailey, Dr. Deborah Kane, Judy Lund (via phone), Gary McNamara, John Scott, Ed Sleiman, Michelle Watters 

Board Member Regrets:

Dr. Ken Blanchette, Dr. Carlin Miller, Larry Snively

Administration Present:

Dr. Wajid Ahmed, Nicole Dupuis, Lorie Gregg, Theresa Marentette, Kristy McBeth, Dan Sibley, Elspeth Troy

QUORUM:  Confirmed

RECORDING SECRETARY:

SUBMITTED BY:

APPROVED BY:

Issue

Recent updates to the Health Hazard Response Protocol, 2018 and Healthy Environments and Climate Change Guideline, 2018 now require public health units to coordinate the monitoring and surveillance of environmental exposures of public health significance, such as radon, and provide the public with education and mitigation options.

Radon is a radioactive gas produced when naturally occurring uranium, found in soil and rock, decays. It can’t be seen, smelled or tasted and is in nearly every home across Canada. Long-term exposure to radon is the second leading cause of lung cancer after smoking and is the primary cause for non-smokers. It is estimated that 16% of lung cancers are from radon exposure, resulting in more than 3,200 deaths in Canada each year. People who smoke and are also exposed to radon have an even higher risk of lung cancer. Health Canada has set the Canadian guideline for indoor radon levels in the home at 200 Becquerels per cubic metre (Bq/m3). 

Background

In a cross-Canada study released by Health Canada in 2012, 13.8% of homes tested in Windsor and Essex County (WEC) had radon levels at or above 200 Bq/m3 compared to 8.2% in Ontario. To gain a better understanding of radon levels in WEC, and to educate the general public about radon risks and how to test their homes, the WECHU conducted a 3-year Radon: Know Your Level study. Results from the study were comparable to the cross-Canada study and found that 11% of homes tested in Windsor-Essex County (n=2,364) had levels at or above 200 Bq/m3.

The health risk from radon is long-term, not immediate. Techniques to lower radon levels are effective and can be done for about the same cost as other common home repairs such as replacing the furnace or air conditioner.  The only way to know what the radon level is in a home or building is to test for it. The higher the radon level, the sooner it needs to be fixed. 

Proposed Motion

Whereas, long-term radon exposure is the second leading cause of lung cancer in Canada after smoking and the primary cause of lung cancer in non-smokers; and

Whereas, approximately 11% of homes in Windsor-Essex County have levels at or above Health Canada’s guideline of 200 Bq/m3, and

Whereas, testing is the only accurate way to know a home or building’s radon level, and

Now therefore be it resolved that the Windsor-Essex County Board of Health will support education and advocacy efforts related to radon testing, prevention, and mitigation in Windsor-Essex County; and

FURTHER THAT, the Windsor-Essex County Board of Health encourages local municipalities to update their municipal bylaws to include requirements for radon testing or rough-ins for radon mitigation systems in all new residential and commercial builds; and

FURTHER THAT, the Windsor-Essex County Board of Health supports local municipalities to develop and adopt policies that will require radon testing in existing municipally owned public buildings or buildings with on-site municipal staff; and

FURTHER THAT, the Windsor-Essex County Board of Health encourages school boards, licensed child care centres, and public libraries to develop and adopt policies that require radon testing in current and future facilities; and

FURTHER THAT, the Windsor-Essex County Board of Health encourages the provincial government to adopt amendments to the Ontario Building Code requiring all newly built homes and buildings to not exceed indoor radon levels above 200 Bq/m3.

Issue

The behaviours initiated in youth create a foundation for health through the life course (Toronto Public Health, 2015). Enabling Ontario’s children and youth to reach their full potential and reduce the current and future burden of disease, is a vision shared across multiple sectors including health and education. Addressing the health of this age group requires a comprehensive approach, involving strategies built upon evidence that includes local population health data. Collecting, analyzing and reporting these data at the local level is essential for planning, delivering and evaluating effective and efficient services that meet the unique needs of children and youth and to ensure the responsible public stewardship of the resources allocated to these services (Windsor-Essex, 2017).

At present, there are approximately 50 federal programs collecting health data on the Canadian population, many of which include school age children and youth (Public Health Agency of Canada, 2013). Notable programs operating in Canada include the National Longitudinal Survey of Children and Youth (NLSCY) (Statistics Canada, 2010), the COMPASS study (Leatherdale et al., 2014), the McMaster University Ontario Child Health Study (OCHS) (Statistics Canada, 2015), the Ontario Student Drug Use and Health Survey (OSDUHS) (Centre for Addiction and Mental Health, 2013), the Canadian Student Tobacco, Alcohol and Drugs Survey (CSTADS) (University of Waterloo, 2017), and the Health Behaviour in School Age Children (HBSC) survey. Notwithstanding the number of sources, data collected from these surveys are not always collected in a way that provides representative results at the regional and local levels, thus creating challenges for public health units and related stakeholders to generate meaningful information on their specific population of interest. This often results from insufficient sample sizes at the sub-provincial level, and the prohibitive cost of purchasing additional local data (i.e. oversamples) from  national or provincial sources (Windsor-Essex County Health Unit, 2017). Understanding trends and differences at the local level is a necessary foundation on which to build tailored intervention strategies that improve health and well-being outcomes. 

The lack of a well-coordinated system for monitoring of child and youth health in Ontario at the local and regional level contributes to disorganization, duplication of efforts and inefficiency of population health assessment initiatives created to fill these gaps (Windsor-Essex County Health Unit, 2017). These issues not only affect local public health units, but other stakeholders as well, including provincial-level government institutions, schools, researchers, and end-users of data due to a lack of interface or forum for stakeholder to communicate and collaborate (PHO, 2013; PHO, 2015; Windsor-Essex County Health Unit, 2017).

Further coordination and improvement of Ontario’s system for child and youth health monitoring would deliver:

• Greater impact and use of public funds
• Improved evidence in decision-making at all levels (local, regional, provincial)
• Better efficiency, accountability, and collaboration between sectors
• Improved health and well-being of children and youth

Background

The Ontario Public Health Standards (OPHS) require that Boards of Health collect and analyze health data for the purpose of monitoring trends over time and informing programs and services tailored to local needs (OPHS, 2018). The results of the 2017 report, Children Count: Assessing Child and Youth Surveillance Gaps for Ontario Public Health Units, which surveyed 34 of 36 health units and over 377 professionals and key informants, found that public health units (PHU) need  better local data on mental health, physical activity and healthy eating for children and youth (Windsor-Essex County Health Unit, 2017). Key stakeholders in education, academia and government validated these data needs. Additionally, the 2017 Annual Report of the Ontario Auditor General acknowledged that children and youth are a public health priority population, and that epidemiological data on children are not readily available to public health units for planning and measuring effective programming for this population (Office of the Auditor General of Ontario, 2017).

The 2017 Children Count report recommended expanding or augmenting existing monitoring efforts, and improving collaboration on child and youth health monitoring between public health, education and academic sectors (Windsor-Essex County Health Unit, 2017). This recommendation included the development of a task force, comprised of key stakeholders from across Ontario and sectors who were able to identify tangible next steps for system improvements for monitoring child and youth health and well-being in Ontario. 

With modest funding from Public Health Ontario, the Children Count research team established the Children Count Task Force with leaders from public health, education, non-governmental organizations (NGOs), government agencies, academia and provincial ministries. The Children Count Task Force met four times from June 2017 to January 2018 to: 1) review and discuss the 2017 Children Count report findings and recommendations; 2) review current systems and assess opportunities to find and improve system-wide efficiencies; and 3) construct and refine recommended actions that would improve monitoring of children and youth health and well-being in Ontario.

The Children Count Task Force recommendations were released in spring 2018 to key Ministry representatives and provincial stakeholder groups, such as the Council of Directors of Education (CODE) and Council of Medical Officers of Health (COMOH). In fall 2018; following consultation with the Children Count Task Force, recommendations were re-released with further minor revisions in January 2019.

The five recommendations of the Task Force are:

Overarching Recommendation: Create a secretariat responsible for overseeing the implementation of the systems, tools, and resources required to improve the surveillance of child and youth health and well-being. The secretariat shall be enabled to:

1. Guide the implementation of the five recommendations of the task force.
2. Develop a process to ensure that assessment and surveillance systems remain effective and relevant over time by addressing emerging issues and data gaps.

Recommendation 1: Create an interactive web-based registry of database profiles resulting from child and youth health and well-being data collection in Ontario schools.

Recommendation 2: Mandate the use of a standardized School Climate Survey template in Ontario schools and a coordinated survey implementation process across Ontario.

Recommendation 3: Develop and formalize knowledge exchange practise through the use of centrally coordinated data sharing agreements.

Recommendation 4: Develop and implement a centralized research ethics review process to support research activities in Ontario school boards.

Recommendation 5: Work with the Information and Privacy Commissioner (IPC) of Ontario to develop a guideline for the interpretation of privacy legislation related to student health and well-being data collection in schools.

The Children Count Task Force recommendations represent key steps to improving the system of data collection and assessment for child and youth well-being in Ontario. The recommendations will better enable public health units, boards of education and related stakeholders to improve the planning, implementation and evaluation of local programs and services that meet the diverse and unique needs of children and youth across the province.

Proposed Motion

Whereas, boards of health are required under the Ontario Public Health Standards (OPHS) to collect and analyze health data for children and youth to monitor trends overtime, and

Whereas, boards of health require local population health data for planning evidence-informed, culturally and locally appropriate health services and programs, and

Whereas, addressing child and youth health and well-being is a priority across multiple sectors, including education and health, and

Whereas, Ontario lacks a single coordinated system for the monitoring and assessment of child and youth health and well-being, and

Whereas, there is insufficient data on child and youth health and well-being at the local, regional and provincial level, and

Whereas, the Children Count Task Force recommendations build upon years of previous work and recommendations, identifying gaps and priorities for improving data on child and youth health and wellbeing,

Now therefore be it resolved that the Windsor-Essex County Board of Health receives and endorses the recommendations of the Children Count Task Force, and

FURTHER THAT, the Windsor-Essex County Board of Health urges the provincial government to take steps to improve the ways in which population health data for children and youth is currently collected and reported in Ontario.

• Leatherdale, S.T., Brown, K.S., Carson, V., Childs, R.A., Dubin, J.A., Elliott, S.J., Faulkner, G., Hammond, D., Manske, S., Sabiston, C.M., Laxer, R.E., Bredin, C., Thompson-Haile, A. (2014). The COMPASS study: a longitudinal hierarchical research platform for evaluating natural experiments related to changes in school-level programs, policies and built environment resources. BMC Public Health, 14:331.
• CAMH. (2013). Centre for Addiction and Mental Health. Retrieved August 2017, from Centre for Addiction and Mental Health: http://www.camh.ca/en/research/Pages/research.aspx
• Children Count Task Force. (2019). Children Count: Task Force Recommendations. Windsor, ON: Windsor-Essex County Health Unit.
• Office of the Auditor General (2017). Annual Report 2017. Toronto: Queen’s Printer for Ontario.
• Ministry of Health and Long-Term Care. (2018). Ontario Public Health Standards: Requirements for Programs, Services, and Accountability. Toronto: Queen’s Printer for Ontario.
• PHAC. (2013). Retrieved August 2017, from Public Health Agency of Canada: https://www.canada.ca/en/public-health.html
• Population Health Assessment LDCP Team (2017). Children Count: Assessing Child and youth Surveillance Gaps for Ontario Public Health Units. Windsor, ON: Windsor-Essex County Health Unit
• Public Health Ontario. (2015). Child and Youth Health Data Sources Project: Summary of findings. Toronto: Queen’s Printer for Ontario.
• Public Health Ontario, Propel Center for Population Health Impact. (2013). Youth Population Health Assessment Visioning: recommendations and next steps. Toronto. Queen’s Printer for Ontario.
• Statistics Canada. (2010). List of Surveys in Collection. Retrieved August 2017, from Statistics Canada: http://www.statcan.gc.ca/eng/survey/list
• Toronto Public Health. (2015). Healthy Futures: 2014 Toronto Public Health Student Survey. Toronto: Toronto Public Health

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

Prepared By:

Jennifer Jacob

Date:

November 5, 2018

Subject:

Bill S-228, an Act to amend the Food and Drugs Act (prohibiting food and beverage marketing directed at children), awaiting Royal Assent.

Background

On December 15, 2016, the Board of Health passed a resolution to support federal legislation prohibiting all forms of commercial food and beverage marketing to children less than 17 years old. This past September, Bill S-228, an Act to amend the Food and Drugs Act (prohibiting food and beverage marketing directed at children), was passed in the House of Commons and is now awaiting Royal Assent from the Senate. All three local Members of Parliament, Cheryl Hardcastle, Brian Masse, and Tracey Ramsey, voted in favour of this bill. 

Unfortunately, Bill S-228 has undergone several amendments since it was tabled in the Senate in 2016.  These amendments have weakened the originally proposed marketing restrictions and removed all protection for children 13-17 years old. The version of Bill S-228 that was passed in the House of Commons will only help protect children under 13 years old from commercial marketing of unhealthy food and beverages.

Current Initiatives

The Health Unit remains committed to protecting all children under 17 years old from all forms of commercial food and beverage marketing. Our position remains in-line with the expert recommendations endorsed by the Stop Marketing to Kids Coalition. Using these recommendations and current research findings, our dietitians will continue to provide expert consultation to Health Canada for their Healthy Eating Strategy, including the proposed regulations to limit marketing to children under Bill S-228.

The Health Unit will also be developing a local strategy to limit children’s exposure to commercial food and beverage marketing in childcare centers, schools, and recreation facilities, as part of our Take Charge initiative, to provide more comprehensive protection than that provided by Bill S-228. 

Consultation:

The following individuals contributed to this report:

•  Mariel Munoz Tayraco RD, Public Health Nutritionist, Healthy Schools Department 

Approved by:

 Theresa Marentette, CEO

Prepared By:

Lorie Gregg, Director of Corporate Services

Date:

December 18, 2018

Subject:

Q3 Financial Results

Background

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

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

Cost-Shared Program Financial Results

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

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

At September 30, 2018, budget to actual variances for financial statement captions that exceed 75%, are detailed below:

• Association and Membership Fees:  Expenditures in this financial caption relate to memberships in an association or other group by virtue of professional requirements or to support initiatives associated with Public Health.  The majority of Association and Membership Fees are paid earlier in the fiscal year.  For the remainder of the year, fees will be lower and thus tracking will be in line with budget as the year progresses.
• Publications:  Expenditures in this financial caption include costs of subscriptions.  The dollar value of this negative variance is not material and will be monitored and offset by other underutilized financial captions as the fiscal year progresses.
• Taxes:  Expenditures in this financial caption include property taxes for the Windsor and Leamington offices.  Windsor property taxes are paid on an installment basis, 6 times per year while Leamington taxes are paid monthly.  The year-to-date variance/overspend results from the payment of four of six installments for the Windsor office and 10 of twelve installments for the Leamington office.
• Insurance:  Expenditures in this financial caption include costs associated with general liability insurance, property insurance, director and office insurance coverage as well as cyber coverage.   Insurance premiums are paid at the beginning of the year.  There will be no further insurance premiums in 2018 and this financial caption should remain underspent at year-end.

In addition to the budget to actual analysis above, the WECHU has provided forecasted financial results for the year-ended December 31, 2018.  These forecasted financial results consider actual year-to-date results at November 30, 2018, as well as estimates of expenditures for the remaining 31-day period.  Total forecasted expenditures for the year-ended December 31, 2018 are anticipated to be $663,133 underspent when compared to budget.  Material variances between forecast to budgeted financial results are detailed below:

• Salaries and Employee Benefits:  For the year-ended December 31, 2018, salaries and employee benefits are forecasted to be $537,776 underspent.  This is attributed to:
  • Gapping resulting from vacancies (i.e. extended recruitment processes; voluntary departures; unpaid leaves; back-filling positions for unpaid leaves);
  • Gapping resulting from variances in pay rates and utilization (i.e. recruitment of staff at pay lower pay rates compared to their predecessors; variance in budgeted versus actual overtime);
  • Impact of unsettled labour agreements.
• Travel and Meetings:  For the year-ended December 31, 2018, travel and meetings are forecasted to be underspent by $15,829.   It is the WECHU’s practice to evaluate all travel and meetings expenditures to determine whether attendance at meetings can be achieved remotely, that there is sufficient capacity within the department to support attendance and that attendance supports Public Health initiatives.
• Professional Development:  For the year-ended December 31, 2018, professional development is forecasted to be overspent by $18,116.  The WECHU approach to approving professional development is similar to that which was detailed above relating to Travel and Meetings.  In addition, the WECHU makes attempts to provide professional development on a group basis to achieve the needs of the WECHU in a cost-effective manner.
• Program Supplies:  For the year-ended December 31, 2018, program supplies are forecasted to be overspent by $132,417.  This is attributed to:
  • Acquisition of equipment to support visual health supports and vision screening as required under the Child Visual Health and Vision Screening Protocol, 2018 (“the Protocol”), amounting to $46,152.  As a function of the Q3 reporting, the WECHU submitted a one-time funding request to the Ministry of Health and Long-Term Care for $58,942.  This request is inclusive of both the cost of equipment as well as the staff time associated with coordination and training to support the Protocol.
  • Engagement of a third party consultant to conduct analysis and reporting to support the consultation project relating to Supervised Injection Services amounting to $22,800.
  • Acquisition of Information Technology hardware including computers and mobile phones of approximately $32,000.
• Board expenses:  For the year-ended December 31, 2018, Board Expenses are forecasted to be $7,886 underspent.  The budget for this financial statement caption contemplated additional meetings of the Project Governance Committee in support of the Windsor Office Project, which did not occur.  Additionally, the WECHU has made a concerted effort to monitor meal costs associated with the Board of Health meetings. 
• Professional fees:  For the year-ended December 31, 2018, Professional Fees are forecasted to be underspend by $10,280. Budgeted Professional Fees contemplated using third party legal services to support collective bargaining.  The WECHU bargaining team was formed of members of the Leadership Team and did not require the support of legal counsel in 2018.
• Rent:  For the year-ended December 31, 2018, Rent is forecasted to be underspent in the amount of $40,865.  Annually a general provision is included in rent to account for unanticipated circumstances (i.e. increases in additional rent per square foot for the Leamington location, etc.). 
• Utilities:  For the year-ended December 31, 2018, Utilities are forecasted to be underspent in the amount of $24,228.  Annually, a general provision is included in Utilities to account for the impact in the changes in utility rates as well as environmental factors that may/may not come to fruition.
• Taxes:  For the year-ended December 31, 2018, Taxes are forecasted to be underspent in the amount of $15,903.  Annually a general provision is included in Taxes to account for changes in the mill rate and or property values associated with the Windsor and Leamington offices.  The budget for Taxes is established in advance of the tax rates for the respective municipalities.
• Security:  For the year-ended December 31, 2018, Security expenditures are forecasted to be underspent by $9,582.  During fiscal 2018, the WECHU undertook to review its practices of having a third party service provider on-site after hours.  Changes were made such that security services are only required on those evenings when events are scheduled to occur and in circumstances where on-call staff are required to be present at the Windsor office after normal business hours.
• Offset revenues:  For the year-ended December 31, 2018, Offset revenues are forecasted to be $90,923 over budget.   Additional offset revenues were realized associated with the changes in certain requirements for Food Handler Training administered by the WECHU (increase of $52,501 over budget); sale of oral contraceptives, not funded by the changes in OHIP plus (increase of $17,433 over budget); interest income earned in the year (increase of $15,660 over budget).

As disclosed in previous quarterly reporting, the following financial risks exist that could have a material impact on the financial results of the WECHU at December 31, 2018:

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

Healthy Babies Healthy Children Program Financial Results

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

At September 30, 2018, the HBHC program is $164,223 underspent.  Primarily this results from staffing vacancies associated with leaves of absences (i.e. maternity leaves, unpaid absences, etc.), not only having an impact on salaries and benefits, but also other financial captions such as mileage and travel and professional development. 

The forecasted financial results for the year-ended December 31, 2018, anticipate that this funding will be fully expended.  In Q4 of 2018, favourable variances within operating expense financial captions (i.e. Mileage and Travel, Professional Development, Purchased Services) are being redeployed to cover unfavourable variances in the Program Supplies financial captions.  The Salaries and benefits budget variance of $141,189 is anticipated to be absorbed by the Cost-Shared Program as the body of work completed by the Healthy Families staff for this program initiative is more heavily weighted to support this program. 

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

Nurse Practitioner Program Financial Results

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

Actual results at September 30, 2018, generated an unfavourable variance compared to budget of $2,583.  Forecasted results at December 30, 2018, estimate that the unfavourable variance compared to budget will increase to $5,210.  The unfavourable variance will be funded from the Cost-Shared Program.

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

Financial Information for Related Programs Funded 100% by the MOHLTC

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

At September 30, 2018, the net underspent budget amounted to $135,786.  Material variances are detailed below: 

• The base funding approval of $120,900 included an addition of 1 FTE (dental assistant) of $71,471 Salaries and benefits that the WECHU would not operationalize until such time as an approval was received.  The budget impact of this deferral resulted in an approximate underspend of $35,735.  The additional FTE commenced late August of 2018.

• In Q2 of 2018 additional Program Supplies costs of $16,425 were incurred on account equipment replacements.  In Q3 of 2018 additional Program Supplies costs of $20,646 were incurred on account of equipment replacements.

• Purchased services were underspent at September 30, 2018, due to the following:  i) The May 7th, 2018 augment to base funding included additional funding for purchased services of $36,400 for contract dentistry.  In the latter part of Q3, 2018, the WECHU completed the requisite policy work to procure and procured the services of a contract pediatric dentist. ii) The WECHU had only 2 contract dentists for Q1.  A third contact dentist was added in March of 2018 servicing our Leamington dental clinic; iii) Fees paid to contract dentists are typically one month behind.

• Offset revenue of $6,300 was earned in Q1 of 2018 on account of the sale of three autoclaves using a third party auction site as required by the WECHU policies and procedures for disposing of tangible capital assets.

Forecasted financial results for the year ended December 31, 2018, indicate that funding for the Healthy Smiles Ontario program to be fully expended.  Certain of the initiatives undertaken to support spending in the final quarter of the fiscal include:  i) Additional human resources in the dental clinic amounting to $19,139   ii) Equipment replacement amounting to $24,215; iii) Acquisition of various dental supplies (both direct service and promotional) to be used in fiscal 2019.

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

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

At September 30, 2018, the total unspent budget amounted to $43,046.  The most notable variance related to:

• Salaries and benefits of $12,189 – reduction in salaries and benefits compared to budget due to a reduction in overtime; unpaid leave of absence resulting in a reduction of approximately $7,476; unresolved labour agreement resulting in unpaid salaries of $2,523.
• Program Supplies of $17,032 – due to timing of purchases. 
• Purchased Services of $8,684 – this represents legal services acquired to prosecute violations of the Smoke-Free Ontario Act, the frequency of which can vary depending upon the number of infractions.

Forecasted financial results as at December 31, 2018, anticipate that $11,488 of the total funding of $636,700, will remain unspent.  This variance is anticipated in the Purchased Services financial caption and, as indicated above, is dependent upon the number of infractions subject to prosecution.  Important to note in this circumstance, is the fact that the funding assigned to this financial statement caption (total approval of $25,200), can only be utilized to support prosecution activities.   Forecasted financial results for other financial captions are anticipated to offset and funding approvals spent by year-end.

A description of other related programs is included below:

Chief Nursing Officer Initiative:  Under the Organizational Requirements of the Ontario Public Health Standards, the Chief Nursing Officer role serves to enhance health outcomes of the community at individual, group and population levels:  i) Through contributions to organizational strategic planning and decision making; ii) By facilitating recruitment and retention of qualified, competent public health nursing staff; iii) By enabling quality public health nursing practice.  This funding envelope supports 1 FTE meeting certain qualifications as required by the Ontario Public Health Standards.  At September 30, 2018, there are no negative variances to report on.  Forecasted financial results for the year-ended December 31, 2018, show this funding as fully expended.

Enhanced Food Safety – Haines Initiative:  Base funding for this initiative supports the enhancement of the Board of Health’s capacity to deliver the Food Safety Program as a result of the Provincial Government’s response to Justice Haines’ recommendations in his report “Farm to Fork:  A Strategy for Meat Safety in Ontario”.  At September 30, 2018, there are no negative variances to report on.  Forecasted financial results for the year-ended December 31, 2018, show this funding as fully expended.

Enhanced Safe Water:  Base funding for this initiative supports the enhancement of the Board of Health’s capacity to meet the requirements of the Safe Water Program Standard under the Ontario Public Health Standards.  At September 30, 2018, there are no negative variances to report on.  Forecasted financial results for the year-ended December 31, 2018, show this funding as fully expended.

Harm Reduction Program Enhancement:  Base funding for this initiative supports the Board of Health in the activities associated with its Local Opioid Strategy.  More specifically it supports 2.5 FTEs dedicated to working on activities associated with:  i) Our local opioid response; ii) Naloxone Distribution and Training; iii) Opioid Overdose Early Warning and Surveillance.   At September 30, 2018, there are no negative variances to report on.  Forecasted financial results for the year-ended December 31, 2018, show this funding as fully expended. 

Infection Prevention Control Nurses Initiative:  Base funding for this initiative supports one additional infection prevention and control nursing FTE having certain qualifications.  At September 30, 2018, negative variances of $2,136 have resulted as salaries and benefits for this position have exceeded the approved funding.  Forecasted financial results for the year-ended December 31, 2018, show this funding as fully expended resulting in a negative variance of $13,855.  This negative variance will be absorbed by the Cost-Shared Budget.  Note: The budget to actual variance at September 30, 2018, is lower that the actual variance for this program initiative.  Given that no further funding was granted to the WECHU in the May 8, 2018 funding approval, actual financial results were adjusted such that the overage in this program initiative were being accounted for in the Cost-Shared Program financial results.  The forecasted financial results column represents the actual cost of the Program to the WECHU for the year-ended December 31, 2018, with any overage being addressed/funded through the Cost-Shared Program.

Infectious Disease Control Initiative:  Base funding for this initiative supports the hiring of infectious diseases control positions (4.5 FTEs) and supporting these staff to monitor and control infectious diseases.  They serve to enhance the Board of Health’s ability to handle and coordinate increased activities related to outbreak management.  At September 30, 2018, there are no negative variances to report on.  Forecasted financial results for the year-ended December 31, 2018, show this funding as fully expended.

Needle Exchange Program Initiative:  Base funding for this initiative supports the purchase of needles and syringes, and their associated disposal costs, for the Board of Health’s Needle Exchange Program.  At September 30, 2018, there are no negative variances to report on.  Forecasted financial results for the year-ended December 31, 2018, show this funding as fully expended.

Social Determinants of Health Nurses Initiative:  This initiative was established to support 2 public health nursing FTEs with specific knowledge and expertise in social determinants of health and health inequities issues, and to provide enhanced supports internally and externally to the Board of Health to address the needs of priority populations impacted most negatively by the social determinants of health.  At September 30, 2018, negative variances of $1,989 have resulted as salaries and benefits for these positions have exceeded the approved funding.  Forecasted financial results for the year-ended December 31, 2018, show this funding as fully expended resulting in a negative variance of $25,541.  This negative variance will be absorbed by the Cost-Shared Budget.  Refer to the note in the Infection Prevention Control Nurses Initiative discussion above regarding the Budget to Actual.

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

Financial Information for Related Programs Funded 100% by the MOHLTC

Mandatory Programs:  Potassium Iodide Distribution Program:  One-time funding to improve nuclear emergency preparedness and increase knowledge amongst residents living within the primary and secondary zone of the Fermi 2 nuclear generating station.  Eligible costs include Potassium Iodide pill packs, and staff salaries, project materials, printing and postage associated with the distribution of KI packs and ongoing communication campaigns.  At September 30, 2018, $34,714, of the total approval of $167,000, had been expended.  In Q4 of 2018 into Q1 of 2019, activities will be focused on promotion and distribution of potassium iodide pills.  It is anticipated that funds will be fully expended by March 31, 2019.

Mandatory Programs:  Public Disclosure System:  One-time funding must be used to update software and inspection forms to meet the new disclosure requirements under the Ontario Public Health Standards.  Eligible costs include software update, disclosure, and migration.   At September 30, 2018, $8,548 of the funding approval had been expended.  In mid-November, the software was implemented for use by the public health inspectors to complete their inspection activities.  Work continues on the public disclosure component.  It is anticipated that the remaining funding will be fully expended by March 31, 2019.

Needle Exchange Program Initiative:  One-time funding for extraordinary costs associated with delivering the Needle Exchange Program.  Eligible costs include purchase of needles/syringes and associated disposal costs.  At September 30, 2018, this funding was fully expended.

Public Health Inspector Practicum Program:  One-time funding must be used to hire the approved Public Health Inspector Practicum positions.  Eligible costs include student salaries, wages and benefits, transportation expenses associated with practicum positions, equipment and educational expenses.  The practicum placements commence in May and conclude in August annually.  At September 30, 2018, this funding was fully expended.

Vector-Borne Diseases Program:  Enhanced Mosquito Surveillance:  One-time funding must be used for an enhanced surveillance program.  Eligible costs include salaries for students, supplies and additional equipment, identification and testing expenses, promotional costs and mileage.  At September 30, 2018, $34,798 of the total funding approval was expended.  It is anticipated that the remaining funding will be fully expended by March 31, 2019.

Capital:  One-time funding must be used to assist with costs to complete the capital planning requirements for a Stage 2 – Business Case submission.  Utilization of these funds is dependent upon the status of the work being completed internally and by third party consultants based upon the direction from the WECHU’s Board. At September 30, 2018, $51,351 of the funding approval had been expended.  It is anticipated that $113,809 of the total funding approval will be expended by December 31, 2018.  On October 31, 2018, the WECHU submitted a request to extend the deadline to expended funding to December 31, 2019 or March 31, 2020.  As at the date of this report, the WECHU has not received approval for this funding extension. 

As reported in October of 2018, the Capital funding has yet to be cash flowed to the WECHU.  It is our understanding that the request was resubmitted for review to the new Provincial Government.

Approved by:

 Theresa Marentette, CEO

Prepared By:

Lorie Gregg, Director of Corporate Services

Date:

December 13, 2018

Subject:

Q3 Reporting

Background

The Windsor-Essex County Health Unit (“the WECHU”) administers programs that are funded in whole or in part by the Ministry of Health and Long-Term Care and Ministry of Children and Youth Services (hereinafter referred to collectively as “Ministries”).  Quarterly, the WECHU is required to report to the Ministries the year-to-date budget to actual financial results for those programs as well provide forecasted annual financial results.

Q3 Reporting

The Q3 reporting to the Ministries include the following:

• Q3 2018 Standards Activity Reports as of September 30, 2018 submission to the Ministry of Health and Long-Term Care;
• Healthy Babies Healthy Children Quarterly Financial Report – 2018 3rd quarter submission to the Ministry of Children and Youth Services;
• Prenatal and Postnatal Nurse Practitioner Program Financial Report – 2018 3rd quarter submission to the Ministry of Children and Youth Services.

Approved by:

 Theresa Marentette, CEO

Prepared By:

Eric Nadalin, Manager, Chronic Disease and Injury Prevention 

Date:

January 9, 2019

Subject:

Smoke-Free Ontario Act 2017 – Updated Regulations for Tobacco and Smoking in Ontario

Background

The Smoke-Free Ontario Act (SFOA) came into effect in May of 2006 imposing regulatory changes which led to significant reductions in smoking and tobacco use across Ontario. These changes led to over 180,000 less smokers across the province, including nearly 13,000 fewer in Windsor-Essex County alone (Canadian Community Health Survey, 2014). In the spring of 2017, the Minister of Health and Long-Term Care and the government of Ontario committed to the modernization of the Smoke-Free Ontario Act in order to update smoking and vaping laws in Ontario and address emerging smoking products which continue to come to market. The new Smoke-Free Ontario Act 2017 (SFOA 2017) was set to come into effect on July 1, 2018 but was delayed and revised with the introduction of a new provincial government. After revisions were applied, the Act ultimately came into effect on October 17th to align with the federal legalization and provincial regulation of cannabis. The resulting SFOA 2017 repealed the previous SFOA and the Electronic Cigarettes Act, 2015 (ECA) combining the two Acts under one singular legislative framework.

Places of Use

The SFOA, 2017 prohibits the smoking of tobacco or cannabis and the vaping of any substance in all enclosed public spaces and workplaces, as well as additional prohibited places, such as children’s playgrounds and sporting fields, which were prohibited under the former SFOA. The SFOA 2017, further protects Ontarians from second hand smoke and vapour by prohibiting the smoking of tobacco or cannabis and the vaping of any substance in additional places that were not previously prohibited under the SFOA. A summary of these prohibitions and a comparison to the previous version and municipal bylaws can be found in Table 1 below. Enforcement of SFOA 2017 prohibitions related to places of use is the responsibility of the Windsor-Essex County Health Unit’s Tobacco Enforcement Officers, in addition to police services and any other provincial offenses officer authorized by the Ministry of Health and Long-term Care.

Display and Promotion

The SFOA, 2017 also prohibits the display of vapour products, branded tobacco product accessories, and the display and promotion of tobacco products at places where they are sold or offered for sale. While these regulations were in place for tobacco products under the previous legislation, the regulations related to electronic cigarettes are new and specific to SFOA 2017.

Registration of Tobacconists and Specialty Vape Stores

Regulations under the SFOA 2017 also require the registration of Tobacconists and Specialty Vape retailers with the Windsor-Essex County Health Unit on an annual basis in order to operate under an exemption to the display and promotion restrictions described above. Prior to the passing of the SFOA 2017, these businesses registered with the Ministry of Health and Long-term Care and public health units were notified of the exemption for businesses which were located in their regions.

A tobacconist is a business which primarily sells specialty tobacco products and tobacco product accessories (e.g., cigars, pipes, humidors). These businesses are permitted to display and promote specialty tobacco products inside their stores if a minimum of 85 per cent of the store's revenues or inventory is dedicated to speciality tobacco products. The remaining 15 per cent of store's revenue/inventory can be dedicated to items associated with the use of tobacco (e.g., cigar clips, humidors, pipes, etc.) or branded with the name of the tobacconist or a brand of tobacco. Additional conditions which must be met in order to operate under a tobacconist exemption are:

• Specialty tobacco products and promotional material must not be visible from outside the place of business of the tobacconist at ay time of day.
• The retailer must not permit someone under 19 years old or appears to be under the age of 25 (without proper identification) to enter their store.
• Customers can enter the store only from the outdoors or from the areas of an enclosed shopping mall.
• The place of business of the tobacconist must be a building or located within a building.
• The store is not a thoroughfare (e.g., passageway).
• Required signage is posted.

A specialty vape store is a business which primarily sells electronic cigarettes, component parts, or associated products and substances (e.g., e-juice). These businesses are permitted to display and promote specialty vape products as well as allow customers to view, handle, and sample vapour products prior to purchasing them. Similar to tobacconists, specialty vape stores are required to have vapour products account for a minimum of 85 per cent of the stores total sales or inventory with the remaining 15 per cent consisting of items associated with a vapour product or brand of vapour product (e.g., batteries, coils, chargers, etc.). Additional conditions which must be met in order to operate under a specialty vape store exemption are:

• The retailer must not permit someone under 19 years old or appears to be under the age of 25 (without proper identification) to enter their store.
• The place of business must be a building or located within a building.
• Customers can enter the store only from the outdoors or from the areas of an enclosed shopping mall.
• The place of business must be a building or located within a building.

• No more than two patrons are permitted to sample a vapour product within the store at any given time.   

Current Initiatives

Prior to the implementation of the SFOA 2017, the health unit connected through formal letter and an offer to provide further education to relevant effected stakeholders (i.e., municipalities, school boards, bar/restaurant owners, e-cigarette retailers). More specifically, meetings were held with municipal recreation and facilities administrators to educate them on the impact that the Act will have on their facilities, sporting areas, parks and playgrounds and the interaction of the new regulations with existing smoke-free outdoor space bylaws.

Written and in person support to vendors who sold e-cigarettes, as well as tobacconists, and speciality vape shops was provided to provide guidance on how to comply with the new Act. Restaurant and bar owners and operators were notified of the restrictions around smoking within 9 metres of patios and the scope of their role in ensuring compliance. Local school boards were notified through the public health school board liaison committee in which all boards were provided education and enforcement expertise regarding the prohibition of smoking/vaping within 20 metres of school property.

Owners of medical cannabis vape lounges were informed that their current operations were not compliant with SFOA 2017 and these businesses have since ceased all non-compliant operations. A media release was distributed to provide information to the general public on the new regulations and how they can comply.

Following the introduction of the Act, the Chronic Disease and Injury Prevention department staff continue to review existing board resolutions, education materials, web content, and outreach campaigns to ensure they are revised to reflect the changes under the new SFOA 2017. In particular, the resolutions related to smoke-free multi-unit dwellings and smoke-free outdoor spaces require revisions in order to include new language which encourages the restriction of electronic cigarette use and the smoking of cannabis. In addition, signage has been ordered from the Ministry of Health and Long-term Care to support local businesses in meeting their requirement of posting signage in all enclosed workplaces and indoor public spaces. This ministry-provided signage will be given to every enclosed workplace and public place free of charge through the health unit.

In addition to informing relevant stakeholders like municipalities, school boards, and bar/restaurant owners, staff within the Chronic Disease and Injury Prevention Department have established a process which notifies existing tobacconists and speciality vape stores of their requirement to register with the Windsor-Essex County Health Unit. In particular the owners and operators were notified of this new requirement through the in-person delivery of a registration package by a Tobacco Enforcement Officer.

The package included:

• A formal letter signed by the manager of the Chronic Disease and Injury Prevention Department.
• A Fact Sheet describing the new regulations and their requirements to comply.
• The registration paperwork (provided by the Ministry).
• Contact information for the manager of Chronic Disease and Injury Prevention for further questions.

The deadline for the submission of all paperwork required to register was established by the Windsor-Essex County Health Unit as January 31st, 2019. This deadline was later supported by the Ministry of Health and Long-term Care and has since been applied province-wide.

The coming months will bring increased opportunity for public education on the prohibitions in outdoor spaces as the volume of use of these spaces increases with the changing seasons. The Windsor-Essex County Health Unit works with regional partners in order to make the best use of collective resources in educating the public on new regulations and will be working with partnering health units to develop an education campaign for residents.

References

Canadian Community Health Survey. (2014). Tobacco Informatics Monitoring System. Retrieved May 29, 2018, from http://tims.otru.org

Approved by:

 Theresa Marentette, CEO

Board Members Present:

Joe Bachetti, Tracey Bailey, Dr. Ken Blanchette, Dr. Deborah Kane, Judy Lund, Dr. Carlin Miller, John Scott, Ed Sleiman, Larry Snively, Michelle Watters (via phone)

Board Member Regrets:

Gary McNamara

Administration Present:

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

QUORUM:  Confirmed

RECORDING SECRETARY:

SUBMITTED BY:

APPROVED BY: