Main Page Content

May 17, 2018

Prepared By:

Communications Department

Date:

May 16, 2018

Subject:

April Media Relations Recap Report

April Media Coverage

Total Media Coverage

25

Interview Requests

19

Mentions (In the news without direct interviews)

6

April 2018 Media Relations Recap - Media Coverage

Story Source

April 2018 Media Relations Recap - Story Source

Media Coverage

Outlet

Number of Stories

AM 800

5
CBC 5

CTV

5

Windsor Star

4

Blackburn

2
St. Clair College Media Plex News

1

Watertoday.ca

1

Windsorite.ca

1

Yahoo News

1

News Release and Media Advisories

Date Type Headline Response
March 13, 2018 News Release Windsor Express, Windsor Lancers, and 2 Stories Reported St. Clair Saints Battle It Out at Sliced

2018!
2 Stories Reported
March 14, 2018 Media Advisory Windsor-Essex County Health Unit Board of Health Meeting 3 Stories Reported
March 16, 2018 News Release Windsor-Essex County Health Unit Re-Launches Living Wage Program 5 Stories Reported
March 20, 2018 News Release Grade 11 & 12 Students with Incomplete Immunization Records Suspended Today 7 Stories Reported

Links to Stories

AM 800

Publish Date

Title

April 4, 2018

Lyme Carrying Deer Ticks Found At Ojibway Prairie Complex

April 6, 2018

Health Unit Asking Parents To Brush Up On The Facts

April 20, 2018

Health Unit Want To Reintroduce Fluoride Into The Drinking Water

April 29, 2018

Radon Study Results Worrying Health Unit

April 29, 2018

Health Unit Launches Campaign For Rabies Month

Blackburn News

Publish Date

Title

April 23, 2018

Health Unit Urging Reintroducing Fluoride

April 26, 2018

Amherstburg To Begin Ki Pill Distribution

CBC News

Publish Date

Title

April 20, 2018

Windsor Health Unit Wants Fluoride Put Back Into The Water

April 25, 2018

To Drink Or Not To Drink? Fluoride Debate Set To Hit Council, Again

April 26, 2018

Potassium Iodide Pills To Be Distributed To Amherstburg Residents In Fermi Nuclear Plant's 'Primary Zone'

CTV News

Publish Date

Title

April 8, 2018

'Deliverbae' Delivers

April 25, 2018

Amherstburg Residents Near Nuclear Plant To Get Anti-Radiation Pills

April 29, 2018

Health Unit Launches Campaign For Rabies Month

May 4, 2018

Essex County Dentists Want Fluoride Back In Drinking Water

Watertoday.ca

Publish Date

Title

April 25, 2018

How Health Units Across the Province Are Coping

Windsor Star

Publish Date

Title

April 4, 2018

Deer Ticks That Can Carry Lyme Disease Found At Ojibway

April 4, 2018

Use Of Vapes On The Rise By High School Students

April 19, 2018

Province Narrows Down Potential Sites For Cannabis Retail Store In Windsor

April 20, 2018

Health Unit's Oral Healthcare Plan Calls For Return Of Fluoridation

Windsorite.ca

Publish Date

Title

April 26, 2018

Potassium Iodide (Ki) Pill Distribution To Start In Amherstburg

Yahoo News

Publish Date

Title

April 20, 2018

Windsor Health Unit Wants Fluoride Put Back Into The Water

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


View Document page

Board Members Present:

Joe Bachetti, Mark Carrick, Dr. Deborah Kane, Judy Lund, Bill Marra, Gary McNamara, Richard Meloche, Dr. Carlin Miller, Hilary Payne, John Scott, Ed Sleiman, Michelle Watters

Board Member Regrets:

Gord Queen, Dr. Ken Blanchette

Administration Present:

Dr. Wajid Ahmed, Nicole Dupuis, Lorie Gregg, Theresa Marentette, Kristy McBeth, Dan Sibley, Konrad Farrugia (Recorder)

Administration Regrets:

None.

Introductions: 

L. Gregg introduced the Amy Wolters as the new Manager of Finance.
N. Dupuis introduced Kelly Farrugia as the new Co-Manager of Healthy Schools

  1. Call to Order
    The meeting was called to order at 4:03 p.m.
  2. Agenda Approval
    It was moved
    That the agenda be approved
    CARRIED
  3. Announcement of Conflicts of Interest – None.
  4. Approval of Minutes
    1. Regular Board Meeting: March 15, 2018.
      It was moved
      That the minutes be approved.
      CARRIED
  5. Presentations
    1. 1st Quarter Financial Results

      L. Gregg presented 1st quarter financial results to the Board of Health. The cost-shared financial results were reviewed in order to present a more wholesome view of WECHU’s programs. Specifically, L. Gregg provided explanations for variances related to Association and Membership Fees, Program Supplies, Publications, Taxes, and Insurance IT Licensing Fees, and Property Taxes.

      An overview of the 1st quarter financial results was also presented for the Healthy Babies
      Healthy Children Program and the Nurse Practitioner Program. It was noted that in the 2018 budget submission to the Ministry of Children and Youth Services included a one time grant request to cover forecasted overage in salaries and benefits or the Pre/Postnatal Nurse Practitioner Program.

      The budgeted amount for the Healthy Smiles Ontario program was discussed. An enhancement of $120,900 was received. There are items in the base funding that have not yet been operationalized.

  6. Consent Agenda
    1. Information Reports
      1. 1st Quarter Financial Results
      2. 1st Quarter Update – Strategic Plan
    2. Recommendation Reports
      1. Provincial Election Priorities

        Whereas, tobacco use remains the number one preventable cause of death in Ontario; and

        Whereas, oral diseases, including dental caries and periodontal disease, are among the most prevalent and preventable chronic diseases; and

        Whereas, Ontario’s universal health care system does not include dental care for adults and nearly 1 in 3 Windsor-Essex County residents report having no form of dental insurance coverage; and

        Whereas, rates of opioid use and opioid-related harms continue to increase in Windsor-Essex County and across the province; and

        Whereas, cannabis legalization presents a number of public health concerns and a comprehensive education, harm reduction, and regulatory framework would help to reduce risks associated with youth; and

        Whereas, 1 in 5 Canadians struggle with mental health issues and illness every year and the
        difference in funding between mental and physical health has led to a dearth of services available to those struggling with mental health issues and illness; and

        Now therefore be it resolved that the Windsor-Essex County Board of Health supports the Association of Local Public Health Agency’s five areas of provincial election priorities; and

        FURTHER THAT, the Windsor-Essex County Board of Health supports a provincial focus on the Tobacco Endgame, tobacco usage rate of less than 5% in Ontario by 2035, and a shift from tobacco “control” to a future that is free from commercial tobacco; and

        FURTHER THAT, the Windsor-Essex County Board of Health encourages the Ontario government to fund a, comprehensive, multifaceted action plan for the Ontario Opioid Strategy, including education, harm reduction and treatment. The action plan should include targets, deliverables, timelines and an evaluation component and be supported by Public Health Units and key community stakeholders; and

        FURTHER THAT, the Windsor-Essex County Board of Health encourages the provincial government to adopt and fund a comprehensive public health approach to cannabis legalization, regulation, restriction of access, education and harm reduction in Ontario. This approach should align the regulatory restrictions on cannabis with those on tobacco, as provided in the Smoke-Free Ontario Act; and

        FURTHER THAT, the Windsor-Essex County Board of Health supports CAMH’s request for the provincial government to address ongoing financial support inequities and “Erase the Difference” between physical and mental health funding in the Ontario.

        It was moved
        That the resolution be supported.
        CARRIED

    3. Media Coverage Summary Report
      It was moved
      That the consent agenda be received.
      CARRIED
  7. Business Arising
    1. Oral Health Presentation

      Dr. Ahmed updated the Board of Health on the City of Windsor council meeting that members of the Health Unit attended on May 7th. The Health Unit was on the agenda to present the Oral Health report. However, a City of Windsor councilor made a motion to have the Health Unit return to City of Windsor council after the provincial election takes place. The Health Unit is scheduled to bring forward the Oral Health report to Essex County council on June 6th.

      It was asked what the provincial government is doing to mandate fluoride throughout the
      province. N. Dupuis stated that the Board of Health submitted a letter to the province requesting that the province enact fluoride province-wide.

      G. McNamara, board chair, recommended that a letter in support of fluoride be issued to the current provincial political candidates. A letter to alPHa (Association of Local Public Health Agencies) should also be considered.

    2. KI Distribution Update

      Distribution of the KI pills in the Town of Amherstburg has started. Approximately 146 KI packages have been collected by Amherstburg residents. There are still a significant number of residents who have not yet picked up their KI package. Fire fighters in Amherstburg have now started going door-to-door to distribute KI packages. Once distribution in the primary zone has been completed distribution in the secondary zone will commence. Funding for the KI initiative has been secured until March 2019. G. McNamara thanked Dr. Ahmed and the now retired Deputy Fire Chief of Amherstburg Lee Tome for bringing this initiative forward.

  8. Board Correspondence – Circulated
  9. New Business
    1. Budget Update

      T. Marentette mentioned that the budget for 2018 was received from the Ministry of Health and Long-Term Care. T. Marentette notified all Board of Health members via email in advance of the board meeting. An increase of approximately $400k was received to the base funding for the cost-shared programs and $120k increase for Healthy Smiles Ontario. Five of ten one-time funding requests were approved. The one-time requests included the following:

      • Public Disclosure System
      • Potassium Iodide Distribution Program
      • Needle Exchange Program
      • Public Health Inspector Practicum Program
      • Vector-Borne Diseases Program: Enhanced Mosquito Surveillance

      Also, the Health Unit’s application for the Capital Project was pending approval. The funding for the Capital Project has now been received.

      T. Marentette mentioned that the budget submission is now tied to the Annual Service Plans. T. Marentette stated that the Health Unit did a great job articulating its needs to the Ministry of Health and Long-Term Care. The Health Unit remains underfunded yet continues to deliver great services.

    2. alPHa AGM/Conference – June 10-12, 2018

      T. Marentette mentioned that the alpha Annual General Meeting & Conference will be taking place in Toronto on July 10th-12th this year. An email went out to board members earlier. Any board member interested in attending should contact WECHU Administration. Currently, one board member has expressed interest and will be attending.

  10. Other Board of Health Resolutions/Letters – Circulated
  11. Committee of the Whole (CLOSED SESSION, in accordance with Section 239 of the Municipal Act)
    It was moved
    That the Board move into Committee of the Whole at 5:02 p.m.
    CARRIED
    It was moved
    That the Board move out of Committee of the While at 5:02 p.m.
    CARRIED
  12. Next Meeting: At the Call of the Chair, or May 17th in Windsor, Ontario
  13. Adjournment
    The meeting adjourned at 5:03 pm.

RECORDING SECRETARY:

SUBMITTED BY:

APPROVED BY:


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Issue

The upcoming provincial election presents the opportunity to promote the endorsement of healthy public policies to key stakeholders vying for seats in Ontario’s Legislative Assembly. The Association of Local Public Health Agencies (alPHa) has released a set of provincial election priorities, spanning across numerous public health topic areas, to call on candidates in the 2018 provincial election to commit their support for a healthier Ontario through a strong local public health system.  These priorities were previously shared with provincial party leaders in December of 2017. The promotion of these priorities is an important step in continuing to advance the profile of public health issues.  Topical public health issues which would benefit from increased regulation, funding, or renewed attention include, tobacco, oral health, opioids, cannabis, and mental health.

In addition, The Centre for Addiction and Mental Health (CAMH) has called upon the three main political parties to “Erase the Difference” in funding between physical health and mental health/addictions. This proposal, in recognition that mental health and addiction agencies currently receive only 6.5% of Ontario’s health budget, is supported by the disproportionately high rates of mental health issues or mental illness as well as the relative burden of these conditions.

Background

The Association of Local Public Health Agencies have outlined five key areas of election policy priorities that focus on improving Ontarians’ health:

  • Tobacco Endgame in Ontario
  • Oral Health for Adults in Ontario
  • Universal Pharmacare Program
  • Public Health Approach to Cannabis in Ontario
  • Opioid Strategy Action Plan for Ontario

Tobacco

Tobacco remains the leading cause of preventable death and illness in Ontario with approximately 36 deaths per day as a result of tobacco use or related conditions. As one of the primary causes of lung disease, heart disease, lung cancer and many other illnesses there is growing support in Canada and globally for a tobacco endgame, with the adoption of endgame targets in Ireland, Scotland, Finland, and New Zealand. A Steering Committee for Canada’s Tobacco Endgame was convened in 2015 and identified an endgame goal of less than 5% tobacco use by 2035.

Oral Health

According to the World Health Organization (WHO), oral health is essential to general health and quality of life. In spite of this, many low income, and middle income Canadians suffer from pain, discomfort, disability, and loss of opportunity because of poor oral health. With under one-third of Ontario workers without employer dental benefits, and 13.9% of the Ontario population living on a low income, there exist significant and impactful financial barriers which prevent many marginalized and low-income adults from accessing preventive and acute dental care. Many acute dental complications which result in emergency department visits are avoidable with timely preventive care such as cleanings and fluoride treatments as well as fillings and extractions. In order to address the underlying causes of the disproportionate number of low-income adults and seniors without access to preventative dental treatments, we recommend that the Ontario government commit to a provincially funded oral health program for low-income adults and seniors in Ontario before 2025.

Opioids

Ontario has one of the highest prescription rates in Canada for opioids, a class of drugs that includes pain relievers such as fentanyl, morphine and OxyContin.  While these drugs can be an effective part of pain management for some medically supervised patients, opioids can be harmful and result in addiction and overdoses. Over the past 13 years, the province of Ontario has experience increasing opioid overdose fatalities and opioids have risen to become the third leading cause of accidental death in the province. In June 2016, Ontario made naloxone, a medicine designed to quickly reverse the effects of opioid overdose, available without a prescription at pharmacies across the province. In October of the same year, Ontario announced its Opioid Strategy to prevent opioid addiction and overdose. Recognizing that lives can be saved through a coordinated prevention, treatment, harm reduction, and enforcement response, many health regions, including Windsor-Essex County, have adopted this four pillar approach in their communities.

Cannabis

Cannabis use carries health risks, including problems with brain functioning (e.g., drug-impaired driving), respiratory problems, and dependence. Canadian youth are among the top users of cannabis in the developed world. In April 2017, the federal government introduced Bill C-45, An Act respecting cannabis and to amend the Controlled Substances Act, the Criminal Act and other Acts. The Act seeks to legalize and regulate recreational cannabis in order to keep cannabis out of the hands of Canadian youth and to prevent organized crime from profiting from the illegal cannabis market.  As provinces and territories will be responsible for licensing and overseeing the distribution and sale of cannabis, there exists the opportunity to develop stringent regulations on promotions, advertising, and marketing, particularly to children and youth These policies have proven effective in tobacco control and should be applied to cannabis legalization. In addition, the government should develop a comprehensive framework to address and prevent cannabis-impaired driving. Indeed, the government should fund a public health approach to cannabis legalization including public education on: risk factors; safer consumption; and a strategy to address impaired driving; would help to mitigate concerns associated with the anticipated increased use as a result of legalization.

Mental Health (Erase the Difference)

Similar to physical health, mental health and illness can take many forms including anxiety disorders, depression/bipolar disorder, eating disorder, obsessive compulsive disorder, phobias/panic disorders, post-traumatic stress disorder, schizophrenia, and suicide. Mental health issues and mental illness affect one in five Ontarians every year however only 6.5% of Ontario’s health budget is allocated to the treatment of these conditions. Inadequate service systems and social alienation are a reality for those affected with poor mental health. A recognition of the importance and prevalence of mental illness and mental health issues warrants a reallocation of resources to help address the treatment “bottle neck”, which acts as a barrier to so many looking for help.

PROPOSED MOTION                       

Whereas, tobacco use remains the number one preventable cause of death in Ontario; and

Whereas, oral diseases, including dental caries and periodontal disease, are among the most prevalent and preventable chronic diseases; and

Whereas, Ontario’s universal health care system does not include dental care for adults and nearly 1 in 3 Windsor-Essex County residents report having no form of dental insurance coverage; and

Whereas, rates of opioid use and opioid-related harms continue to increase in Windsor-Essex County and across the province; and

Whereas, cannabis legalization presents a number of public health concerns and a comprehensive education, harm reduction, and regulatory framework would help to reduce risks associated with youth; and

Whereas, 1 in 5 Canadians struggle with mental health issues and illness every year and the difference in funding between mental and physical health has led to a dearth of services available to those struggling with mental health issues and illness; and

Now therefore be it resolved that the Windsor-Essex County Board of Health supports the Association of Local Public Health Agency’s five areas of provincial election priorities; and

FURTHER THAT, the Windsor-Essex County Board of Health supports a provincial focus on the Tobacco Endgame, tobacco usage rate of less than 5% in Ontario by 2035, and a shift from tobacco “control” to a future that is free from commercial tobacco; and

FURTHER THAT, the Windsor-Essex County Board of Health encourages the Ontario government to fund a, comprehensive, multifaceted action plan for the Ontario Opioid Strategy, including education, harm reduction and treatment.  The action plan should include targets, deliverables, timelines and an evaluation component and be supported by Public Health Units and key community stakeholders; and

FURTHER THAT, the Windsor-Essex County Board of Health encourages the provincial government to adopt and fund a comprehensive public health approach to cannabis legalization, regulation, restriction of access, education and harm reduction in Ontario. This approach should align the regulatory restrictions on cannabis with those on tobacco, as provided in the Smoke-Free Ontario Act; and

FURTHER THAT, the Windsor-Essex County Board of Health supports CAMH’s request for the provincial government to address ongoing financial support inequities and “Erase the Difference” between physical and mental health funding in the Ontario.

Approved by:

Theresa Marentette


View Document page

Issue

Approval of the annual audited financial statements for the year-ended December 31 2017 including:

  • Windsor-Essex County Health Unit (Appendix A)
  • Windsor-Essex County Health Unit Nurse Practitioner Program (Appendix B)
  • Windsor-Essex County Health Unit Healthy Babies Healthy Children Program (Appendix C)

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

Background

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

The annual financial statements audited by KPMG LLP, independent external auditors appointed by the Corporation of the City of Windsor.  On May 25th, 2018, the Audit Committee of the Windsor-Essex County Health Unit convened to review the annual financial statements and audit findings report with Administration and KPMG LLP.  The Audit Committee has recommended the financial statements for approval to the Board. KPMG LLP is prepared to issue, pending approval by the Board, an unmodified audit opinion on the annual financial statements. 

Windsor-Essex County Health Unit

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

Statement of Financial Position:

  • Accounts receivable increased $423,766 over 2016.  This increase is primarily attributed to:  i) A net increase in amounts receivable from the Province of Ontario due to timing of 2017 approvals of $217,448; ii) Increase in other receivables in the amount of $201,799 as current year’s balance included amounts outstanding from third parties for wellness services rendered.  For additional details, refer to note 3 to the annual financial statements of the Windsor-Essex County Health Unit.
  • Due to Province of Ontario increased $157,338.  This increase is attributed to the following: i) Increase in the balance outstanding relating to the 2016 settlement. In the prior year an amount remained receivable from the Ministry of Health and Long-Term Care.  This receivable balance was offset against the total amount payable to the Ministry of Health and Long-Term Care.  The Ministry subsequently cash flowed this in Q1 of 2017; ii) The 2017 settlement amount of $67,898.  This amount relates to 100% Related Program funding and 100% funded One-time business case funding that remain unspent at the settlement date. Currently the 2016 settlement is under review.  Once the review is concluded, the Ministry of Health and Long-Term Care will issue a settlement letter and claw back funding during the remainder of 2018.  The 2017 settlement is due to the Ministry of Health and Long-Term Care May 31, 2017.  The timing of the review of that settlement is unknown.   For additional details refer to note 4 to the annual financial statements of the Windsor-Essex County Health Unit.
  • Due to Municipalities increased $561,872. This net increase is attributed to the following:  i) Repayment of amounts outstanding to 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”) in the amount of $144,349; ii) 2017 settlement to the Obligated Municipalities in the amount of $706,221.  For additional details, refer to note 5 to the annual financial statements of the Windsor-Essex County Health Unit.
  • Tangible capital assets decreased $274,418.  This net decrease is attributed to:  i) Tangible capital asset additions of $197,409; ii) Amortization expense in the amount of $471,827.  Of the tangible capital assets acquired in the year, $106,400 were funded by the Ministry of Health and Long-Term Care using 100% Related Program funding or 100% funded One-time business cases. Refer to note 9 for additional details.

Statement of Operations and Accumulated Deficit:

  • Increase in Revenue from the Province of Ontario, Mandatory Programs, in the amount of $298,562. This increase is attributed to the year-over-year increase in the general program expenses.  As you recall, the Ministry of Health and Long-Term Care funds the WECHU to a maximum of 75% of admissible expenditures.  Admissible expenditures for the purposes of the Ministry of Health and Long-term Care Settlement Process is defined below:
Description Amount
Total General Program expenses at December 31, 2017 $18,518,025
Less:  Non-admissible expenses (471,827)
Less: Change in Employee Future Benefits Liability (24,296)
Less: Other Accounting Adjustments (25,825)
Plus: Tangible capital asset additions – Mandatory Program 91,009
  18,087,086
Less:  Offset revenue (189,851)
Total admissible expenditures $17,897,235
Ministry portion (75%) $13,422,926
Ministry approval $13,316,100
Ministry funded expenditures $13,316,100
  • Increase in General Program Expenses in the amount of $739,870 is attributed to:
    • Net increase in permanent FTEs of 2 staff funded by the Cost-Shared Program;
    • Annual increases (cost of living and grid increases) as follows:  i) ONA 2% annual; ii) CUPE 1.5% annual; iii) Non-union 2%;
    • Other employee obligations.

Windsor-Essex County Health Unit Nurse Practitioner Program

The Nurse Practitioner Program is funded by the Ministry of Children and Youth Services.  The funding supports the salaries and benefits of the nurse practitioner whose role is to assist with promoting healthy pregnancy, birth and infancy for children, improve parenting and family supports, strengthen early childhood development, learning and care. 

Windsor-Essex County Health Unit Healthy Babies Healthy Children Program

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. 

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

Statement of Financial Position:

  • Due from the Windsor-Essex County Health Unit:  Refer to the statement of cash flow for the decrease of $111,757 from December 31, 2016.
  • Accounts payable:  The decline in accounts payable in the amount of $50,487.  At December 31, 2015 $40,800 was payable to a third party provider for scanning services of client files.
  • Due to Ministry of Children and Youth Services in the amount of $64,399.  The net decrease was as a result of the following:  1.  2015 and 2015 settlements being reclaimed in 2017 amounting to $32,721. 2.  Settlement for 2017 in the amount of $27,793; 3.  Reduction of other amounts owing from pre-2000 settlements of $59,471.

Statement of Operations and Accumulated Deficit:

  • Program Supplies:  The decrease in program supplies in the amount of $41,913.  As indicated above under the Accounts Payable caption a scanning project was undertaken in 2016 to archive client files with significant retention periods.  The project was substantially concluded in 2016.
  • Purchased Services:  The increase in purchased services in the amount of $15,323 resulting from an increase in translation services from 2016. 

Proposed Motion

Whereas, at its May 25th, 2018, meeting of the Audit Committee reviewed the 2017 annual financial statements and recommended them to the Board for the Board’s approval,

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

  • Windsor-Essex County Health Unit 2017 audited annual financial statements
  • Windsor-Essex County Health Unit 2017 Nurse Practitioner Program financial statements
  • Windsor-Essex County Health Unit 2017 Healthy Babies/Healthy Children Program financial statements

View Document page

April 19, 2018

  1. Call to Order
  2. Agenda Approval
  3. Announcement of Conflict of Interest
  4. Approval of Minutes
    1. Regular Board Meeting:  March 15, 2018
  5. Presentation –  Radon Study (P. Wong)
    Oral Health (Dr. Ahmed)
  6. Consent Agenda
    1. Information Reports
      1. Radon (T. Marentette)
      2. Risk Management (L. Gregg/K. McBeth)
      3. Quarterly Planning Update (K. McBeth)
      4. Seasonal Housing (T. Marentette)
    2. Recommendation Reports
      1. Reserves (T. Marentette/L. Gregg)
      2. Oral Health (N. Dupuis)
    3. Media Coverage Summary Report
  7. Business Arising
  8. Board Correspondence - Circulated
  9. New Business
    1. Board of Health alPHa Fitness Challenge (K. McBeth)
  10. Other Board of Health Resolutions/Letters - Circulated
  11. Committee of the Whole (Closed Session in accordance with Section 239 of the Municipal Act)
  12. Next Meeting: At the Call of the Chair, or May 17, 2018, Windsor
  13. Adjournment

View Document page

Prepared By:

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

Date:

March 27, 2018

Subject:

Quarterly Planning Report

Background

In 2017, the WECHU introduced a new electronic planning system using project management principles to help us more closely align our planning strategies with operational activities. This system was developed with key public health program and service requirements in mind, and focused on embedding evidence-based approaches, health equity, privacy, ethics, and our strategic priorities into departmental work plans. Shortly after development, training, and implementation of the WECHU’s new planning system, the Ministry of Health and Long Term Care (MOHLTC) officially released the modernized Ontario Public Health Standards (OPHS) 2018.

With the introduction of the modernized standards, the MOHLTC included the requirement to complete an Annual Service Plan (ASP) in conjunction with the 2018 budget submission.  The ASP describes the programs and services that the WECHU plans to deliver based on provincial public health requirements, local needs, and budgets at the program level, and includes self-generated objectives and measures for monitoring program performance.

Following the completion of the 2018 planning cycle and the submission of the first ASP, the Planning and Strategic Initiatives (PSI) Department undertook an assessment of both processes and templates in order understand the challenges and successes of each process and to look for ways to better align our planning approach with the MOHLTC requirements.  Planning staff and managers took part in a multi-step feedback process, and the ASP was reviewed by the PSI department to compare its content to 2018 work plans previously completed by departments. This information will be used to inform the development of a new reporting structure for 2018 and beyond.

Current Initiatives

2018 Reporting Structure

The primary goals of the WECHU’s reporting structure (including both operational and strategic reporting) is to ensure ongoing quality improvement through monitoring and to provide organizational insight to the Leadership Team and the WECHU BoH to facilitate evidence driven decision making. A coordinated and consistent planning and reporting structure also provides timely identification of emerging issues and program/service gaps, and supports the values, priorities, and objectives of the WECHU’s strategic plan.

Over the next quarter, an updated reporting structure, reflective of new public health requirements, will be developed to monitor the objectives and indicators identified in the WECHU’s ASP, and to support the implementation of operational work plans as required.

Operational Planning/ASP Alignment

Based on the ASP and work plan comparison as well as feedback from the 2017 cycle, PSI staff will work with managers and departments to align the 2018 organizational planning outcomes with the MOHLTC requirements in order to maximize efficiency and ensure consistency across the organization.

Consultation

The following individuals contributed to this report:

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

Approved by:

Theresa Marentette                       


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Prepared By:

Phil Wong, Manager, Environmental Health Department

Mike Tudor, Manager, Environmental Health Department

Date:

April 19, 2018

Subject:

Seasonal Housing and Tenant Complaint Processes

Background

The Environmental Health Department’s (EHD) role can be divided into two distinct activities when discussing housing in the City of Windsor and Essex County. These activities include the inspection and assessment of boarding and lodging homes, which include the seasonal housing accommodation, and the investigation of tenant complaints. Both activities require high levels of collaboration with local municipalities, as well as provincial and federal agencies. All activities conducted by the EHD in relation to housing is mandated by Part III of the Health Protection and Promotion Act (HPPA) and the Ontario Public Health Standards: Requirements for Programs, Services and Accountability 2018 (OPHS) and its related protocols and guidelines.

Windsor and Essex County (WEC) leads the province of Ontario when it comes to agricultural activities, with a large number of greenhouses producing crops such as tomatoes and cucumbers. The greenhouse farm operations allow for high yields year round which is unique to this region.  Many of the seasonal agricultural workforce are offshore workers from Mexico and Caribbean countries. This large number of offshore workers adds to the vibrant multicultural communities in towns such as Leamington and Kingsville. It is essential from a public health perspective that seasonal workers are provided with a good standard of living and access to public health programs.

Currently, there are approximately 650 seasonal accommodations throughout WEC that are inspected annually. In 2017 Public Health Inspectors (PHIs) conducted close to 900 inspections, including re-inspections for the approval of these accommodations used to house foreign workers, as well as the investigation of health hazard complaints in these premises. Due to the steady growth of the agricultural sector in the last three years the number of staff hours dedicated to  seasonal housing accommodation inspections has almost doubled. The EHD works with Services Canada and the Foreign Agricultural Resource Management Services (FARMS) to approve all seasonal accommodations for occupancy. PHIs also work with local fire, building, and by-law enforcement to address issues that are associated with seasonal worker accommodations. The inspection and complaint process requires a great deal of coordination as multiple government agencies are involved with the entire process including the Mexican and Jamaican Consulates.

All complaints of potential health hazards are followed up by the EHD. All complaint investigations are required to be initiated within 24 hours and are addressed according to the Health Hazard Protocol 2018 and Health Protection and Promotion Act. The PHI investigating the complaint will collaborate with the local municipal departments that would have the primary role to deal with the identified hazard. This may include joint inspections with local building, fire, by-law enforcement, or public works departments. In 2017 PHIs followed up on over 1000 complaints in WEC of which 170 were related to residential settings. These complaints include but were not limited to mould, sewage, heating, pest, indoor air quality, hoarding, lack of potable water, etc.

Current Initiatives

The Health Hazard Response Protocol 2018 provides direction on the investigation, assessment, and management of mitigation strategies to prevent or reduce the burden of illness from potential, suspected, and/or identified health hazards. The protocol identifies facilities as a place with “public access and/or that serve priority or vulnerable populations in situations where they may present an elevated risk of exposure to health hazards to the public or priority populations. These facilities may include, but are not limited to ice arenas, seasonal farm workers’ housing, schools, childcare centres and other childcare facilities, shelters, and other facilities that may serve priority populations.

The EHD currently provides education, conducts inspections, surveillance, and monitoring, and has a 24/7 on call system in place to respond to all notifications of potential health hazards in the community. A response to all calls received will be initiated within 24 hours of the notification. It is a requirement under the OPHS that the EHD continues to work and collaborate with local municipalities and other community partners to develop effective strategies to reduce the exposures to health hazards.

Approved by:

Theresa Marentette                       


View Document page

Prepared By:

Karen Lukic, Health Promotion Specialist, Environmental Health Department

Date:

April 19, 2018

Subject:

Radon: Know Your Level Project

Background

Radon is a gas that is 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. When radon gets into buildings and homes, it can accumulate to levels high enough to cause an increase in lung cancer risk. According to Health Canada (2014), long- term exposure to radon is the second leading cause of lung cancer after smoking and the primary cause for non-smokers. Health Canada has set the Canadian guideline for radon levels in the home at 200 Bq/m3. It is recommended that if homes test at 200 Bq/m3 or higher, they should be remediated to reduce levels to as low as physically possible.

Unfortunately, many homeowners are not aware of radon or the level of radon exposure within their homes. A local telephone based survey conducted by the Windsor- Essex County Health Unit (WECHU) found the majority of respondents (62.3%) had no plans to have their dwelling tested with 17.0% of them believing radon testing is not important and there is no risk. In addition, 7.5% did not know how to test their home (RRFSS, 2017). In a cross- Canada study released by Health Canada in 2012, 13.8% of homes tested in Windsor- Essex County (WEC) had radon levels at or above 200 Bq/m3 (Health Canada, 2012). These numbers were comparable to the internal 2015/2016 and 2016/2017 radon studies completed by the WECHU which found 12.2% and 14.6% of homes respectively had levels above 200 Bq/m3 (WECHU, 2016 and 2017). In comparison, based on the Health Canada study in 2012, the proportion of homes in Lambton and Chatham-Kent counties with levels above 200 Bq/m3 were 8.5% and 18.4% respectively.

Public awareness initiatives such as the Radon: Know Your Level Project are put in place to address potential environmental exposures of health hazards to the general public such as radon gas. The WECHU’s Environmental Health Department (EHD) coordinates the monitoring, and surveillance of environmental exposures of public health significance and provides the public with education and mitigation options. These activities are required in the Health Hazard Response Protocol, 2018 and Healthy Environments and Climate Change Guideline, 2018.

The "Radon: Know Your Level" Project

The Radon: Know Your Level Project is a 3-year research study led by the EHD which began in 2015. The goals of the project are to increase awareness of radon and its association with lung cancer; provide the public with radon reduction resources on how to test and reduce the amount of radon in their homes and; determine areas in WEC with higher average indoor radon concentrations and home characteristics associated with higher risk.

During each year of this study, approximately 1000 local homeowners received a free radon testing kit for their homes. Promotion and test kit distribution was strategically implemented during the month of November which is Lung Cancer Awareness month and Radon promotion month in Canada. The kits were distributed equally across the WEC communities and to date, almost 3000 homes in Windsor-Essex have been tested for radon. This project was divided into two phases for each of the study years.

Phase 1

Promotion and Education

Begins in October with a press release announcing the launch of the study and application process, social media posts (Facebook and Twitter) that provide information about radon and promotion of the study, development of WECHU website articles, and posters are distributed throughout the community to notify the public. The WECHU utilizes different avenues to educate homeowners, targeting members of the community through online, in-person and telephone. 

Kit Distribution

The general public was invited to apply to be part of the study by completing a survey that determines eligibility and collects information about the applicant and their home. Phase 1 ends with the distribution of the radon kits to eligible applicants and the beginning of the approximate 3-month testing phase.

Phase 2

Kit Retrieval

This phase begins in March and involves the collection of test kits from study participants. Collected kits are shipped to an accredited laboratory for testing. Results are received within 6-8 weeks of the lab receiving the kits and relayed to the homeowner.

Data Analysis

All data is collected, processed and analyzed by the WECHU team to look for trends to report to the public. All data collected is used to inform future program planning. The data supports the development of strategies that further raises public awareness and reduces environmental health risks in our community.

Highlights of the 2016/2017 Study Report

  • 14.6% of homes in WEC had radon levels above 200 Bq/m³ (compared to 12.2% in the 2015/2016 study).
  • Essex County had a significantly greater proportion of homes with levels above the Canadian guideline (22%)  compared to the City of Windsor (8%).
  • The average indoor radon level for WEC from the 2016/2017 study results was 106 Bq/m³.
  • Amherstburg, Kingsville, Leamington, and LaSalle had average concentrations 20 to 33 Bq/m3 higher than the WEC average.
  • Newer builds (2011 or after) had the highest average indoor radon concentrations.
  • Homes with two levels (i.e., basement and main floor) had 21% higher average radon levels compared to one-level houses with a crawl space partially or completely under the house.

Current Initiatives

The final year of the Radon: Know Your Level project (2017/2018 Study) is nearing completion. Phase 2 was recently completed in March of 2018.  A total of 832 kits were received from the 947 that were distributed for a response rate of 88%.  A report with results from the 2017/2018 study and a final report summarizing all 3 years of the study will be completed in 4th quarter 2018.

Consultation:

The following individuals contributed to this report:

  • Theresa Marentette, Acting CEO and Director, Health Protection Division
  • Phil Wong, Manager, Environmental Health Department
  • Mike Tudor, Manager, Environmental Health Department
  • Saamir Pasha, Epidemiologist, Epidemiology and Evaluation Department

Data Sources:

Approved by:

Theresa Marentette


View Document page

Prepared By:

Dave Jansen, Performance Improvement & Accountability Coordinator (PIAC), Planning & Strategic Initiatives Department

Date:

March 19, 2018

Subject:

Risk Management

Background

In September 2017, a Risk Management Framework was presented to the Windsor-Essex County Board of Health along with a draft risk registry. In this framework, the Planning and Strategic Initiatives (PSI) Department was tasked to maintain the corporate risk registry and construct a plan for corporate risk reporting.

Current Initiatives

To begin the transition of risk management to PSI, the WECHU’s risk management framework was compared to the Association of Local Public Health Agencies’ (alPHa) three-phase implementation approach. This comparison highlighted the progress made to date and the actions necessary to develop risk preparedness. The alPHa documentation suggests that their approach should take approximately three years, with one year assigned to each phase. To summarize this comparison, the WECHU has completed most of the first phase actions, with some updates currently underway. The WECHU is now pursuing a number of items in the second phase, including the creation of a risk management review cycle, complete with key risk indicators, reporting mechanisms, and reporting timelines.       

The second phase of the implementation approach includes a structured and comprehensive risk registry. As such, the draft risk registry approved in September 2017 has been updated to allow for a more robust assessment of risk. Based on resources provided through alPHa, and using the Ontario Public Service Risk Framework, the risk registry was updated as follows:

Risk Identification

Many risks and their consequences were reshaped to better express the uncertainties each risk category brings. With these updates, the corporate risk registry was reduced to 29 risks.


Inherent Risk Assessment

This section still assesses the gross risk, or risk before controls. Each risk’s likelihood and impact are assessed on a scale of one to three, and the inherent risk score is a product of the two.


Controls

This section indicates the efforts we currently have in place to prevent, detect, or correct the risk.


Residual Risk Assessment

This new section measures exposure, that being the level of risk after evaluating the effectiveness of controls. If the control was preventative, the likelihood was reduced. If the controls are detective or corrective, the impact was reduced. The residual risk score is then the product of the two.

If that new score exceeds our risk tolerance or risk appetite, further mitigation actions were identified.


Risk Ownership

Each risk now identifies three separate ownership roles. First is the accountable person, who may approve or veto decisions regarding each risk. Second is the risk owner, who is responsible for the management of that risk. Third is the control owner, who ensures that the control strategies are appropriate and effective.


Risk Monitoring

This section will help monitor the status of risks and action plans, and measure the effectiveness of controls. Key Risk Indicators (KRI’s) will be developed in the near future along with specific timelines for each. Updates to the registry will be made using this data.


The following table provides two separate examples pulled from the updated risk registry.

Section

Subsection

Example A

Example B

Risk Identification

Risk ID

SDO1

F1

Risk

Program Planning. WECHU may be at risk of programs and services not being planned to address the needs of our community or public health requirements.

Funding. WECHU may be at risk that funding uncertainties will hamper the financial planning, monitoring, and decision making processes.

Consequences

  • Inability to meet the requirements of the Ontario Public Health Standards (2018).
  • Staff time and resources gathered through data collection and knowledge exchange wasted or not being used effectively.
  • Increased health disparity/inequity in Windsor-Essex.
  • Inability to satisfy the WECHU's objectives (Strategic and Operational).
  • Inability to meet the requirements of the OPHS.
  • Cost reduction measures (i.e. headcount reductions; prioritization of expenditures) and resulting impact on staff morale.
  • If late approval or approval in excess of budget, lost opportunities if the WECHU is unable to act on plans.
  • Organization’s reputation is at risk.

Inherent Risk Assessment

Likelihood (L)

2

3

Impact (I)

3

3

Score (L x I)

6

9

Controls

Control Type

Preventative & Corrective

Detective

Control Strategy

  • Annual Service Plan submitted to MOHLTC
  • WECHU Operational and Departmental Plans. 
  • Departmental and corporate planning support from Planning and Strategic Initiatives Department (PSI).
  • Monthly variance analysis comparing budget to actual financial results reviewed by Leadership Team (LT) and Board of Health (BoH).
  • Responsible budget process that balances finite resources with program/departmental priorities.
  • Identification of priorities (i.e. contract positions, operating expenditures) to be strategic with budget/planning reallocation when positive budget variances are realized.
  • Forecasting of expenditures on a quarterly basis (internal).

Residual Risk Assessment

Likelihood (L)

1

3

Impact (I)

2

2

Score (L x I)

2

6

Action Required

  • Continually review and update planning processes and procedures to meet changing public health requirements and organizational needs.
  • Expanded variance analysis to provide budget to actual, budget to forecast, and year-over-year variance analysis.
  • Evaluation of budget (process and quality).

 

Ownership

Accountable

CEO

CEO

 

Risk Owner

Director,

Knowledge Management

 

Director,

Corporate Services

Control Owner

Director,

Knowledge Management

Manager,

Accounting & Financial Reporting

Risk Monitoring

KRI’s

TBD

TBD

Reporting Period

TBD

TBD

The WECHU expects to begin the third phase of the risk management implementation approach by the end of the 2018, which will involve rolling out risk management to all operational levels.

Consultation:

The following individuals contributed to this report:

  • Lorie Gregg, Director, Corporate Services
  • Kristy McBeth, Director, Knowledge Management
  • Marc Frey, Manager, Planning & Strategic Initiatives

Approved by:

Theresa Marentette


View Document page

Prepared By:

Communications Department

Date:

April 4, 2018

Subject:

March Media Relations Recap Report

March Media Coverage

Total Media Coverage

40

Interview Requests

31

Mentions (In the news without direct interviews)

9

March Media Relations Recap - Media Coverage

Breakdown of Top Stories

Topic

Requests for Interviews

Mentions in the News (no interviews)

CHC Smoke-Free Housing Policy

2

1

Dental Health Coverage/NDP

1

0

Dental Health Survey

1

0

ER Trips For Kids With Severe Allergies

1

0

Flu Update

2

1

Health Needs/Town Of Amherstburg

1

0

Living Wage

3

2

Measles

2

0

Online Nutrition Challenge

1

0

Opioids

3

1

Sliced

1

1

Student Immunizations and Suspensions

11

2

Ticks

1

1

Vaping and Student Health

1

0

March Media Relations Recap - Story Source

Media Coverage

Outlet

Number of Stories

CBC

10

AM 800

7

CTV

7

Windsor Star

6

Blackburn

4

Windsorite.ca

3

Advocator.ca

1

Windsor Business Magazine

1

Yahoo News

1

News Release and Media Advisories

Date Type Headline Response
March 13, 2018 News Release Windsor Express, Windsor Lancers, and 2 Stories Reported St. Clair Saints Battle It Out at Sliced

2018!
2 Stories Reported
March 14, 2018 Media Advisory Windsor-Essex County Health Unit Board of Health Meeting 3 Stories Reported
March 16, 2018 News Release Windsor-Essex County Health Unit Re-Launches Living Wage Program 5 Stories Reported
March 20, 2018 News Release Grade 11 & 12 Students with Incomplete Immunization Records Suspended Today 7 Stories Reported

Links to Stories

AM 800

Publish Date

Story Link

March 7, 2018

Sad But Not Surprised: Local Reaction To Latest Stats On Opioid-Related Deaths

March 16, 2018

Living Wage In Windsor-Essex Is $14.81/Hour According To Local Health Unit

March 19, 2018

Health Unit Put Focus On Nutrition With Sliced Competition

March 20, 2018

388 High School Students Suspended In Windsor-Essex

March 27, 2018

Suspensions Down Due To Incomplete Immunization Records

Advocator.ca

Publish Date

Story Link

March 31, 2018

Deer Ticks Found at Ojibway Prairie Complex. Do They Carry Lyme Disease?

Blackburn News

Publish Date

Story Link

March 13, 2018

Over 800 Students Face Suspension Next Week

March 20, 2018

Nearly 400 Students Suspended

March 23, 2018

Flu Season Not Over Yet in Windsor-Essex

CBC News

Publish Date

Story Link

March 12, 2018

Flu has already caused 18 deaths and 31 outbreaks, and the season is not over yet

March 15, 2018

Windsor Essex Community Housing Corporation implements smoke-free policy

March 16, 2018

Health officials say $14.81/hr is what it costs to live comfortably in Windsor-Essex

March 16, 2018

Immunization deadline for grade 11 and students is Monday

March 16, 2018

Detroit measles exposure prompts health unit to remind people to be vaccinated

March 20, 2018

Almost 400 students suspended over incomplete immunization records

March 29, 2018

Ticks that can transmit Lyme disease found at Ojibway Prairie Complex

CTV News

Publish Date

Story Link

March 8, 2018

Opioid-related deaths up across province in 2017, including Windsor-Essex

March 13, 2018

Health Unit reminds residents of online immunization reporting tool

March 16, 2018

Health unit says living wage in Windsor-Essex is $14.81/hour

March 19, 2018

Suspensions expected as immunization deadline looms for high school students

Windsor Star

Publish Date

Story Link

March 2, 2018

Social housing starts forbidding smoking in units, with little protest

March 6, 2018

Guidelines released to combat opioid epidemic call on doctors, hospitals to join fight

March 15, 2018

Travellers at Detroit airport might have been exposed to the measles

March 15, 2018

Health unit calculates 2018 local living wage at $14.81 an hour

Windsorite.ca

Publish Date

Story Link

March 16, 2018

Health Unit Re-Launches Living Wage Program

March 17, 2018

Photos: Annual Sliced Competition Cooks Up A Storm At Devonshire Mall

March 20, 2018

Students With Incomplete Immunization Records Suspended Today

Yahoo News

Publish Date

Story Link

March 15, 2018

Windsor Essex Community Housing Corporation implements smoke-free policy

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


View Document page

Board Members Present:

Joe Bachetti, Dr. Ken Blanchette, Paul Borrelli, Mark Carrick, Judy Lund, Bill Marra, Gary McNamara, Richard Meloche, Dr. Carlin Miller, Hilary Payne, Gord Queen, Ed Sleiman

Board Member Regrets:

Dr. Deborah Kane, John Scott, Michelle Watters

Administration Present:

Dr. Wajid Ahmed, Nicole Dupuis, Lorie Gregg, Theresa Marentette, Kristy McBeth, Dan Sibley, Konrad Farrugia (Recorder)

Administration Regrets: 

None.

  1. Call to Order
    The meeting was called to order at 4:05 p.m.
  2. Agenda Approval
    It was moved
    That the agenda be approved - CARRIED
  3. Announcement of Conflicts of Interest - None
  4. Approval of Minutes
    1. Regular Board Meeting: March 15, 2018.
      It was moved
      That the minutes be approved - CARRIED
  5. Presentations
    1. Radon Study

      P. Wong provided background information on radon in the Windsor-Essex County region. A three-year study on radon in Windsor-Essex has concluded. The study began in 2015. Approximately 3,000 long-term radon test kits were distributed in Windsor-Essex during this period. The 2017/2018 radon study data will soon be received and analyzed by the Windsor-Essex County Health Unit.

    2. Oral Health

      Dr. Ahmed discussed the need for good oral health in our community. Oral health data representing children in JK, SK, and Grade 2 was presented. Promoting the need for increased oral health screening in the community needs to continue. Overall oral health in Windsor-Essex ranks poorly when compared to the rest of the province. Improving access to oral health services in the community for both children and senior residents is essential.

  6. Consent Agenda:
    1. Information Reports
      1. Information Report – Radon
      2. Information Report - Risk Management
      3. Information Report - Quarterly Planning Update
      4. Information Report - Seasonal Housing
        It was moved
        That the Media Coverage Summary Report be received - CARRIED
    2. Recommendation Reports
      1. Reserves

        At the last board meeting the Board of Health asked Administration to find out if other health units in the province had reserve funds. L. Gregg drafted a report and provided a few recommendations. The proposed motion seeks to request from the province that they consider revisiting the timelines for approval of grants to public health units. Should the province comply with this request a policy would be created outlining the reporting structure of reserve funds.

        It was moved
        That the resolution be supported. - CARRIED

        Whereas the Windsor-Essex County Health Unit is funded through grants from the Province of Ontario and required contributions from the Obligated Municipalities, and

        Whereas the Province of Ontario does not permit for unspent grants to be carried forward to the next fiscal year irrespective of the timing of approvals, and

        Whereas the Windsor-Essex County Health Unit presently does not have reserves and reserve funds that could be drawn upon to address the challenges associated with late funding approvals from the Province of Ontario as well as emergent public health needs, and

        Now therefore be it resolved that the Windsor-Essex County Board of Health direct Administration to send an appeal to the Province of Ontario requesting that they consider revisiting the timelines for approval of grants to public health units as approvals in recent years have hindered public health units to implement public health initiatives with approved funds. In addition, the appeal should request for the Province of Ontario to revisit its position on contribution of unspent grant funding into a reserve, recognizing that the Province of Ontario would need to provide appropriate policy and reporting structure over such reserve funds.

        FURTHER THAT the Board direct Administration to write a report, including a proposed policy and reporting framework, and present their request for the establishment of Reserves and Reserve Funds to the Administrations of the Obligated Municipalities for feedback and support, and

        FURTHER THAT the Board direct Administration to present a report to the Councils of the Obligated Municipalities for the establishment of Reserves and Reserve Funds for their consideration and approval.

      2. Oral Health

        The Board of Health discussed amending Administration’s recommended board motion as presented in the Oral Health Recommendation Report.

        Whereas Oral health is an essential part of overall health, and

        Whereas the Ontario Public Health Standards require the assessment, surveillance and reporting of Oral Health data to community partners including municipalities, and

        Whereas municipalities are in the position to create healthy public policies and bylaws that impact resident’s health and overall wellbeing, and

        Whereas the Oral health of residents in Windsor-Essex is much worse than Ontario and comparable communities and continues to worsen, and

        Now therefore be it resolved that the Windsor-Essex County Board of Health receive the Oral Health Report (2018) and supports the accompanying recommendations for:

        - Windsor-Essex municipalities to continue to or introduce community water fluoridation as a key prevention strategy for dental caries.
        - Ongoing support for oral health education and awareness in the community.
        - Improved access to oral health services within Windsor-Essex.
        - Advocacy efforts for improved funding and expansion for public dental programs such as Healthy Smiles Ontario.

        FURTHER THAT the Windsor-Essex County Board of Health share the Oral Health Report (2018) and this resolution with municipal and community partners, stakeholders, the general public and identified target groups, and

        FURTHER THAT the Windsor-Essex County Board of Health request through delegation to present the Oral Health report, its findings and recommendations at the whole of City of Windsor Council and the County of Essex Council in May/June of 2018, and

        FURTHER THAT the Oral Health Report (2018) and this resolution be shared with all other health units in the province of Ontario, the Minister of Health and Long Term Care, the Ontario Dental Association and local members of parliament.]

        After much discussion,

        It was moved

        That the City of Windsor reintroduce fluoridation in the water system; and further that the County municipalities reintroduce fluoridation in the water system.

        CARRIED

    3. Media Coverage Summary Report
      It was moved
      That the report be received - CARRIED
  7. Business Arising
  8. Board Correspondence – Circulated
  9. New Business
    1. Board of Health alPHa Fitness Challenge

      K. McBeth mentioned that this year alPHa (Association of Local Public Health Agencies) has included boards of health in the alPHa Fitness Challenge. The recommendation by Administration is to complete the challenge on the day of the next board meeting in May. Thirty minutes of physical activity is required in advance or after the meeting. However, if board members cannot participate on the day of the meeting they may complete thirty minutes of physical activity on any day in May prior to the board meeting. Board members are required to let the Health Unit know that they have completed the challenge.

  10. Other Board of Health Resolutions/Letters - Circulated
  11. Committee of the Whole (CLOSED SESSION, in accordance with Section 239 of the Municipal Act)
    It was moved
    That the Board move into Committee of the Whole at 5:43 p.m. - CARRIED
    It was moved
    That the Board move out of Committee of the While at 6:00 p.m. - CARRIED
  12. Next Meeting: At the Call of the Chair, or May 17th in Windsor, Ontario
  13. Adjournment
    The meeting adjourned at 6:13 pm.

RECORDING SECRETARY:

SUBMITTED BY:

APPROVED BY:


View Document page

Issue

Constrained financial resources coupled with late funding approvals from the Ministry of Health and Long-Term Care limits the ability of the Windsor-Essex County Health Unit to address public health needs within the Community of Windsor and Essex County.

Background

The Windsor-Essex County Health Unit (“WECHU”) is a publicly funded organization.  As such the WECHU has a responsibility to spend funds prudently and with the objective of providing public health programs and services as required under the Health Protection and Promotion Act, R.S.O. 1990 (“HPPA”) and the Ontario Public Health Standards:  Requirements for Programs, Services, and Accountability (“OPHS”). 

The WECHU is funded through grants from the Province of Ontario, more specifically the Ministries of Health and Long-Term Care (“MOHLTC”) and the Children and Youth Services (“MCYS”) (collectively referred to as “Ministries”).  As well it is funded through required contributions from the Corporation of the City of Windsor (“City”), the Corporation of the County of Essex (“County”) and the Corporation of the Township of Pelee (“Pelee”) (collectively referred to as “the Obligated Municipalities”). 

Programs funded by the Ministries through grants can be categorized as follows:

  • Public Health and Health Promotion Mandatory Programs funded to a maximum of 75% by the MOHLTC;
  • Public Health Mandatory Programs funded at a rate of 100% by the MOHLTC;
  • Health Promotion Programs funded at a rate of 100% by the Ministries
  • Public Health and Health Promotion one-time funding business cases funded by the MOHLTC;
  • Health Capital one-time funding business cases (historically funded at a rate of 100% but depends on the nature of the request) funded by the MOHLTC.

The budget for the Public Health and Health Promotion Mandatory Programs funded to a maximum of 75%, commonly referred to as the Cost Shared Program, is presented to the Board of Health for the Windsor-Essex County Health Unit in the November to January timeframe annually.  That budget forms the basis of the Annual Service Plan and Budget Submission to the MOHLTC. Approval of the Annual Service Plan and Budget Submission by the MOHLTC has historically been in the 4th quarter of the WECHU’s fiscal year (January 1 to December 31).  For example, the Cost Shared Program budget for the 2017 fiscal year was approved in December of 2016.  MOHLTC funding approvals were received mid-November 2017.

The delay in the approval process creates a number of challenges for the WECHU:

  1. Overspending – The delay in the approval process puts the WECHU at risk of overspending.  This circumstance can arise if the budget submission assumes an increase in MOHLTC funding that is subject to approval historically at a later date.  In this circumstance, the Obligated Municipalities would be required to fund a deficit that may arise from operationalizing the approved Cost Shared Budget.  This obligation is set out in the HPPA, in the following provision:
    Payment by obligated municipalities
    72 (6) Where additional expenses incurred
    If, after a notice is given by a board of health under subsection (5) in a respect of a year, additional expenses referred to in subsection (1) that were not anticipated at the time the notice was given are incurred during the year, the board of health may give another written notice to each obligated municipality in the health unit, specifying the additional amount for which the obligated municipality is responsible under this section and the time at which the addition amount must be paid.
  2. Underspending – This is the inability of WECHU to spend funding received from the Ministries and Obligated Municipalities. The following scenarios help articulate this challenge:
    1. Mandatory Programs – Human Resource Information System (“HRIS”):  The 2017 budget submission included a one-time business case to support WECHU acquiring and implementing a HRIS.  As approval of this business case was not received until mid-November of 2017, WECHU Administration was not able to embark upon the necessary activities to acquire and successfully implement the HRIS by March 31, 2018.  This funding will be returned to the MOHLTC.  A one-time business case for an HRIS was submitted to the MOHLTC with the 2018 Annual Service Plan and budget submission.
    2. Assumed increase in funding from the MOHLTC:   In recent history, the WECHU has integrated an assumed percentage increase in base funding from the MOHLTC.  Recognizing that the Obligated Municipalities bear financial risk in the event that the budgeted augment in funding is not approved, the WECHU proceeds cautiously during the fiscal year monitoring budget variances and identifying other operating efficiencies to ensure the budget is not overspent.  Administration recognizes and does its best to balance what is required of the WECHU under the HPPA with the fact that we operate using finite financial resources funded by the Community of Windsor-Essex County that we serve. 
  3. Re-prioritization of resources to address emerging public health needs – In 2017 in response to increasing opioid-related deaths in Windsor and Essex County as well as the Province of Ontario, WECHU reassigned already constrained resources to help support the development of a local opioid strategy.  In early 2017, the WECHU made certain decisions to defer activities associated with other public health needs to address this emergent issue.   The MOHLTC announced additional funding to support this initiative in June of 2017.

The above represent a few examples of the challenges faced by the WECHU associated with late funding approvals from the MOHLTC.  Like the other 36 public health units within Ontario we have expressed our concerns to the MOHLTC regarding late funding approvals.  We have made appeals to the MOHLTC for certain one-time 100% funded business cases to be extended to allow us the opportunity to establish these initiatives and expend funding.  In two instances in recent years we have been successful.  But this success likely represents a lost opportunity in future periods to redirect those funding asks and efforts to other public health needs.

Reserves and reserve funds

Reserve and reserve funds have historically been used by public sector entities to ensure that adequate financial resources exist to fund specific initiatives and/or circumstances that arise that were unforeseen in the current year’s budget.   Contributions to and utilization of reserves and reserve funds typically follow a prescribed methodology in accordance with an Organization’s Corporate By-Laws or approved policy. The Province of Ontario does not permit Public Health Units to contribute unspent grant funding into a reserve fund.  The following section within the 2014 Accountability Agreement dated January 1st, 2014, address this matter:

15.5 Carry Over of Grant Not Permitted.  The Board of Health is not permitted to carry over the Grant from one calendar year to the next, unless pre-authorized in writing by the Province.

Therefore, reserves or reserve funds held by a public health unit would need to be established through contributions from Obligated Municipalities or other funding sources.

The WECHU currently has the following reserve funds.  These reserve funds were not established using contributions from the Obligated Municipalities.  They have specified purposes for which funding can be utilized.

Employee future benefits fund:  This reserve fund was established as a result of the demutualization of Mutual Life to help defray the future employee benefit costs incurred by the WECHU.  At December 31, 2016, the balance of this reserve fund was $180,929.

Septic fund:  The Septic reserve fund was established from the Ministry of Environment for septic inspection services and have been retained in a reserve fund to help defray costs associated with septic inspection services.  At December 31, 2016, the balance of this reserve fund was $43,365.

The WECHU did an informal survey of 36 other public health units in Ontario to understand whether they do/do not have reserve funds and if so, are those reserve funds supported by policy.

The enclosed table summarizes the results from the respondents

Public Health Unit

Does your PHU have reserves?

Do you have Policy?

Types of Reserves?

Algoma Public Health

Yes

Yes

Working Capital Reserve, Land Control Reserve, Human Resources Management Reserve, Public Health Initiatives and Response Reserve, Corporate Contingencies Reserve, Facility and Equipment Repair and Maintenance Reserve

Chatham-Kent Public Health Unit

Administered by Municipality

-

-

Elgin-St. Thomas Public Health

Yes

Yes

Reserve funds are to be used for items such as employee pay equity adjustments, vacation and sick leave entitlements, capital repairs and replacements, unforeseen program and or corporate expenses, or any other items as deemed necessary by the Board of Health.

Grey Bruce Health Unit

Yes

No details provided.

No details provided.

Haliburton, Kwartha, Pine Ridge District Health Unit

Yes

Yes

Use at the discretion of the Board of Health and to be maintained at no less than 75% of one month’s operating expenses.

Halton Region Public Health

Administered by Municipality

-

-

Hastings Prince Edward Public Health

Yes

Yes

Operating Fund Reserve, Capital Fund Reserve

KFL&A Public Health

Yes

Yes

Board of Health Reserve Fund; Capital Fund Reserve; Excess recoveries for private sewage system programs

Lambton Public Health

Administered by Municipality

-

 

-

Middlesex-London Health Unit

Yes

Yes

Funding Stabilization Reserve, Dental Treatment Reserve Fund, Sick Leave Reserve Fund, Environmental Reserve - Septic Tank Inspections,  Technology & Infrastructure Reserve Fund, Employment Costs Reserve Fund

Niagara Region Public Health

Administered by Municipality

-

-

North Bay Parry Sound District Health Unit

Administered by Municipality

-

Examples of how reserves can be used:  i)  to address one-time short-term expenditures, planned or unplanned; ii) to match provincial dollars (25/75) or be used 100% toward the cost of the expenditure.

Ottawa Public Health

Yes

Yes

Technology Reserve

Perth District Health Unit

 

Yes

No details provided.

No details provided.

Peterborough Public Health

Yes

Practices in place but no specific policy.

Capital, Program, Contingency, Septic Program, Other

Public Health Sudbury & Districts

Yes

Yes

Working Capital, HR Management, Public Health Initiatives& Response, Corporate Contingencies, and Facility Equipment Repairs and Maintenance

Simcoe Muskoka District Health Unit

Yes

Yes

Sick Leave Reserve Fund, Contingency Reserve Fund, Capital Reserve Fund

Thunder Bay District Health Unit

Yes

Yes

Sick Leave Plan Allowance Reserve, Capital Expenditures Reserve, Land Development Reserve, Program Contingency Reserve, Benefit Cost Stabilization Reserve, SFH Training Reserve

Toronto Public Health

Administered by Municipality

-

-

Wellington-Dufferin Guelph Public Health Unit

Yes

Yes

Facilities Reserve, Contingency Reserve, Technology Reserve, Orangeville Facilities Reserve, Guelph Facilities Reserve, Fluoride Varnish Program Reserve, Poverty Elimination Task Force Reserve

Public Health Units that responded indicated that they either held reserves directly or that reserves were administered by their respective municipalities.  Furthermore, respondents indicated that reserves were supported by policy and or guidelines as established by corporate bylaws.  Certain of these Organizations have shared those policies with the WECHU and will serve as good resources to support our own policy development if directed by the Board to do so.

With a proper policy and reporting structure, the reserve fund mechanism funded through contributions from the Obligated Municipalities could provide the necessary resources to address the challenges identified above.  More specifically:

  • Reserve funds could assist in mitigating financial risk in future periods to the Obligated Municipalities in instances where the WECHU has overspent.
  • Reserve funds could serve to provide cash flow for implementation of 100% funded business cases in advance of MOHLTC approvals thus ensuring that funding approvals will be spent irrespective of the timing of those approvals.  Cash flows would then be returned to the reserve fund for future uses.
  • Reserve funds could serve to provide cash flow for emergent public health needs rather than re-prioritizing or deferring other public health activities.

Proposed Motion

Whereas the Windsor-Essex County Health Unit is funded through grants from the Province of Ontario and required contributions from the Obligated Municipalities, and

Whereas the Province of Ontario does not permit for unspent grants to be carried forward to the next fiscal year irrespective of the timing of approvals, and

Whereas the Windsor-Essex County Health Unit presently does not have reserves and reserve funds that could be drawn upon to address the challenges associated with late funding approvals from the Province of Ontario as well as emergent public health needs, and

Now therefore be it resolved that the Windsor-Essex County Board of Health direct Administration to send an appeal to the Province of Ontario requesting that they consider revisiting the timelines for approval of grants to public health units as approvals in recent years have hindered public health units to implement public health initiatives with approved funds.  In addition, the appeal should request for the Province of Ontario to revisit its position on contribution of unspent grant funding into a reserve, recognizing that the Province of Ontario would need to provide appropriate policy and reporting structure over such reserve funds.

FURTHER THAT the Board direct Administration to write a report, including a proposed policy and reporting framework, and present their request for the establishment of Reserves and Reserve Funds to the Administrations of the Obligated Municipalities for feedback and support, and

FURTHER THAT the Board direct Administration to present a report to the Councils of the Obligated Municipalities for the establishment of Reserves and Reserve Funds for their consideration and approval.


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Issue

Oral health is a key part of overall well-being and can directly impact a person’s quality of life. The Canadian Dental Association outlines oral health as a state that is linked to a person’s physical and emotional well-being (Canadian Dental Association, 2010). Good oral health means being free of mouth and facial pain, cavities, periodontal disease, and any other negative issues that impact our mouths (World Health Organization). Two of the most common oral health diseases are tooth decay (cavities) and periodontal disease (gum disease). In Canada, 57% of children, 59% of adolescents and 96% of adults have been affected by tooth decay.

Oral health has a direct as well as an indirect impact on a person’s overall health and quality of life. At a community level, complications from poor dental health may also have serious consequences for our healthcare system including unnecessary oral health related trips to our hospital emergency departments further adding to the existing long waits in the emergency rooms. In Ontario, over 60,000 emergency department visits were related to tooth pain. The Ontario medical system spends at least 38 million dollars per year treating oral health problems in emergency departments and physician’s offices. Prevention is critical to good health. Tooth decay and gum diseases are almost always preventable, with preventive oral health services/strategies that should be available to all individuals in our community. In Ontario, the majority of oral health care services are not publicly funded, which means that Ontarians are responsible for the costs of their own dental care. Ontario provides public dental coverage to children of low income families, but there are very few options for adults with low income, including seniors (Wellesley Institute, 2015).

Windsor-Essex County’s Oral Health 2016 report highlighted the oral health profile of our community and also made recommendations to improve the oral health status and access to oral health care in our community. Despite all these efforts, the oral health status of our community continues to remain a public health concern.

Background

Oral health and general health should not be thought of separately; oral health is one important component of overall health (Seto et al.2014). In recent years an increasing amount of research has shown an important link between oral health and overall health. Oral health issues have been linked to respiratory infections, cardiovascular disease, diabetes, as well as a potential link between maternal periodontal disease and babies with low birth weights.

Many of the same social and economic determinants of health (e.g., income, employment, education, access to health services, social support networks) also impact the oral health of people and communities. The World Health Organization states that oral health is an important determinant of the quality of life.

Oral Health Services in Windsor and Essex County:

There a many programs that operate in Windsor-Essex County with the aim of improving oral health, primarily among children. These include programs and services offered in collaboration between public health, school boards, primary care and others. The Windsor-Essex County Health Unit (WECHU) provides clinics in both Leamington and Windsor serving children and youth from 0-17 under the Healthy Smiles Ontario program (HSO). HSO is a government-funded dental program that provides free preventive, routine, and emergency dental services for children and youth 17 years old and under from low-income households. Over the past several years WECHU has seen an increase in the number of individuals requiring treatment as well as an increase in the wait times associated with services. As a result, the WECHU has increased their staffing and clinics with additional funding from the Ministry of Health and Long Term Care in order to address some of the increasing need. The WECHU has also worked closely over the past few years with the dental community and its community partners to increase oral health education including the introduction and implementation of the baby oral health program and fluoride varnish pilot.

Unlike those for children, there are very few publically funded programs available to adults, including seniors, in Ontario. Ontario Works and the Ontario Disability Support Program offer services to some adults, but are limited to very basic dental services (which are at the discretion of the municipality that funds these programs). In Windsor-Essex County there are two options available for adults and seniors who do not have insurance or the resources to pay for dental services (cleanings only). St. Clair College offers full mouth scaling by dental hygiene students. A second program offering dental services (cleanings only) is Street Health, a program of the Windsor Essex Community Health Centre.  Operation Smile is an event that is hosted by the Essex County Dental Society, in partnership with the St. Clair College dental clinic. The yearly one-day event is designed to promote oral health in the community and offers basic restorative and surgical services to people that might not otherwise have access to such services.

Oral Health Assessment and Surveillance Reporting in Windsor-Essex:   

The Windsor-Essex County Health Unit (WECHU) provides programs and services under the guidance and direction of the Health Promotion and Protection Act (HPPA) and the Ontario Public Health Standards (OPHS). The OPHS include a requirement for the assessment, surveillance and reporting of oral health data including information collected through school based screening conducted in accordance with the Oral Health Protocol. The information collected through school screening includes the number of decayed, missing and filled teeth (DMFT) for each child in JK, SK and grade 2 and is recorded in the Oral Health Information Support System (OHISS). The WECHU began reporting DMFT in OHISS in the school year 2011/2012 and has continued to screen and report since that time.

In keeping with population assessment and surveillance requirements identified in the OPHS and associated protocols, in 2015 the WECHU devised a plan to report oral health data to community stakeholders, the general public, and target populations for the purpose of knowledge exchange, informing healthy public policy and health service planning. This plan included the development of the first Oral Health Report released in 2016 with the intent to update every five years. The 2016 Oral Health Report provided a comprehensive view of the oral health status of residents in Windsor-Essex using the most current data available and accessible by the health unit for the past five years. In the beginning of 2016, Ontario made changes to all provincially funded oral health programs combining them into a newly launched Healthy Smiles Ontario (HSO). Due to the changes in how eligibility is assessed and services are provided under HSO it was determined that reporting data up to 2016 was a natural starting point for the Oral Health survey ensuring the five-year cycle from 2016 to 2021 would represent five years under the new HSO system.

Requests for Oral Health Assessment and Surveillance Data and Response:

In 2013 the City of Windsor council made a decision to discontinue the fluoridation of the water supply. This decision affected the communities of LaSalle, Tecumseh and the City of   Windsor. Specifically, the council decision was as follows:

That City Council PASS a by-law DIRECTING the Windsor Utilities Commission to CEASE the fluoridation of the City of Windsor water supply while ensuring continued regulatory compliance, and that the savings from this action BE DIRECTED to oral and health nutrition education in Windsor and Essex County, for a period of 5 years, to be spent at the discretion of the Community Development and Health Commissioner.

At that time the WECHU had agreed to look at its oral health data and that of the community for a period of five years beginning in 2013 and bring back a report on the oral health of the community in 2018. Since this time, the WECHU has continued to collect and analyze its oral health data and has consulted with experts in oral health research to best determine what is able to be reported given the data available and the time frame of collection. The Oral Health Report (2018, update) provides 6 years of school screening data and allows the WECHU to look at overall oral status of the community, compare with Ontario averages and determine the trends for oral health outcomes across Windsor-Essex.

Based on the findings detailed in the Oral Health report (2018 update) the WECHU recommends:

  • Windsor-Essex municipalities continue to or introduce community water fluoridation as a key prevention strategy for dental caries
  • Continued support for oral health education and awareness in the community
  • Improve access to oral health services within Windsor-Essex
  • Advocate for improved funding and expansion for public dental programs such as Healthy Smiles Ontario

Amended Motion

Whereas Oral health is an essential part of overall health, and

Whereas the Ontario Public Health Standards require the assessment, surveillance and reporting of Oral Health data to community partners including municipalities, and

Whereas municipalities are in the position to create healthy public policies and bylaws that impact resident’s health and overall wellbeing, and

Whereas the Oral health of residents in Windsor-Essex is much worse than Ontario and comparable communities and continues to worsen, and

Now therefore be it resolved that the Windsor-Essex County Board of Health receive the Oral Health Report (2018) and supports the accompanying recommendations for:

  • The City of Windsor to reintroduce fluoridation in the water system.
  • The County municipalities to reintroduce fluoridation in the water system.
  • Ongoing support for oral health education and awareness in the community.
  • Improved access to oral health services within Windsor-Essex.
  • Advocacy efforts for improved funding and expansion for public dental programs such as Healthy Smiles Ontario.

FURTHER THAT the Windsor-Essex County Board of Health share the Oral Health Report (2018) and this resolution with municipal and community partners, stakeholders, the general public and identified target groups, and

FURTHER THAT the Windsor-Essex County Board of Health request through delegation to present the Oral Health report, its findings and recommendations at the whole of City of Windsor Council and the County of Essex Council in May/June of 2018, and

FURTHER THAT the Oral Health Report (2018) and this resolution be shared with all other health units in the province of Ontario, the Minister of Health and Long Term Care, the Ontario Dental Association and local members of parliament.


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March 15, 2018

Introduction:  Board of Health Member, Judy Lund

  1. Call to Order
  2. Agenda Approval
  3. Announcement of Conflict of Interest
  4. Approval of Minutes
    1. Regular Board Meeting:  February 15, 2018
  5. Presentation - None
  6. Consent Agenda
    1. Information Report - Shared Calendar Project (N. Dupuis)
    2. Information Report –Windsor-Essex Community Housing Corporation Smoke-Free Policy (N. Dupuis)
    3. Information Report – Immunization of Schools Pupils Act Implementation Update (T. Marentette)
    4. Information Report – Windsor-Essex County Living Wage Program (N. Dupuis/K. McBeth)
    5. Media Coverage Summary Report
  7. Business Arising
    1. Reserves (G. McNamara)
  8. Board Correspondence - Circulated
  9. New Business
    1. Annual Service Plan - Handout (T. Marentette)
    2. Annual Service Plan – Resolution and Recommendation Report - Handout (T. Marentette/L. Gregg)
  10. Other Board of Health Resolutions/Letters - Circulated
  11. Committee of the Whole (Closed Session in accordance with Section   239 of the Municipal Act)
  12. Next Meeting: At the Call of the Chair, or April 19, 2018, Essex
  13. Adjournment
File icon Board Meeting Agenda - March 2018
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Board Members Present:

Joe Bachetti, Paul Borrelli, Mark Carrick, Dr. Deborah Kane, Judy Lund, Bill Marra, Gary McNamara, Richard Meloche, Carlin Miller, Gord Queen, Ed Sleiman, Michelle Watters

Board Member Regrets:

Dr. Ken Blanchette, Hilary Payne, John Scott

Administration Present:

Dr. Wajid Ahmed, Nicole Dupuis, Lorie Gregg, Theresa Marentette, Kristy McBeth, Dan Sibley, Rosanne St. Denis (Recorder)

Administration Regrets: 

None.

  1. Call to Order
    The meeting was called to order at 4:01 p.m. Judy Lund was welcomed as the latest addition to the board. Dr. Carlin Miller was welcomed having been reappointed by the province.
  2. Agenda Approval – Addition - 13.0 Other
    It was moved
    That the agenda be approved
    CARRIED
  3. Announcement of Conflicts of Interest– None
  4. Approval of Minutes
    1. Regular Board Meeting: February 15, 2018.
      It was moved
      That the minutes be approved.
      CARRIED
  5. Presentations – None
  6. Consent Agenda:
    There was no business arising from the consent agenda below.

     

    1. Information Report – Shared Calendar Project
    2. Information Report – Windsor-Essex Community Housing Corporation Smoke-Free Policy
    3. Information Report – Immunization of Schools Pupils Act Implementation Update
    4. Information Report –Windsor-Essex County Living Wage Program
    5. Media Coverage Summary Report
      It was moved
      That the consent agenda be received.
      CARRIED
  7. Business Arising
    1. Reserves

      At the last Board meeting, the topic of Reserves was briefly discussed and materials were subsequently distributed, at the request of the Chair, to the Board.

      Other public health units within the Province have reserves funded through contributions from their respective obligated municipalities as the Province of Ontario does not permit grant monies to be contributed to a reserve.   The Board Chair provided background on Health Unit funding, indicating that the WECHU receives a grant from the Ministry of Health and Long-Term Care (“the Ministry”) to a maximum of 75% for the Cost-Shared Program and that the Municipalities are obligated to fund public health.  Furthermore, the timing of budget approvals by the Ministry presents a challenge for public health units to spend their budget in a given year.

      Establishing municipal reserves would allow for the use of unspent municipal dollars already allocated to the Health Unit through the annual budget process.

      It was decided that the Board’s position be stated in the form of a resolution. Administration will bring forward a resolution recommendation to the April board meeting.  It was further requested that Administration’s report include information regarding the need for a reserve fund by the WECHU as well as a brief chronology of what has happened in the past for the benefit of new members and a refresh for past members.

      The Board discussed taking a more assertive approach to increasing Windsor-Essex’s base budget.

      In 2015, there was lobbying to increase this health unit’s base budget. As a result, approximately 1.2 million dollars was received. This additional funding translated to an 8% base budget increase. The Province did agree that Windsor-Essex received 80% of what it should be receiving in comparison to other health units. Of the 36 health units, this health unit still remains one of the lowest funded health units.

      It is the full responsibility of municipalities to pay for public health. The Ministry provides a grant of up to 75% of individual health unit budget requests while the municipalities are responsible for the remaining percentage. The Board has agreed that the funding model for health units is flawed. Furthermore, the Board needs to look at what is needed for to address public health needs in this community rather than getting fixated on the 75/25 funding formula. This Health Unit has different needs than some others because of its geographic location being a border community.

      With the recent introduction of the 2018 Standards, some of the mandates will require more resources and dollars.

      The Board Chair would like to see continued dialogue with the Province. It was further proposed by the Board that the WECHU needs to develop a three to four-year plan for increasing the base budget in advance so that the municipalities are aware of the plan and the strategies for moving forward.

  8. Board Correspondence – Circulated
  9. New Business
    1. Annual Service Plan
      Further to the WECHU’s 2018 budget submissions, the Ministry requested completion of an annual service plan. Public health units were asked to link relevant funding with program activities and staffing. The Annual Service Plan and Budget Submission was submitted to the Ministry by the March 1, 2018 deadline. Seventy-three program plans were submitted.

      The CEO reviewed the WECHU Annual Service Plan and Budget Submission 2018 document as distributed highlighting the ten base funding requests and ten one-time funding requests submitted.

    2. Annual Service Plan – Resolution and Recommendation Report
      Public Health Units are required to have a board resolution to support the submission of Annual Service Plan and Budget Submission.

       

      As presented by the WECHU in January of 2018, the 2018 Cost-Shared budget contemplated a base funding request of 3.23% or $429,974.  Of that, $355,528 related funding to address operational pressures allowing the WECHU to maintain current service levels in Windsor and Essex County.  The remaining $74,446 represented a staff augment relating to mental health requirements within the modernized OPHS.  The $74,446 request is included as part of the Mental Health Specialist full-time equivalent base funding request.  The $355,528 increase is included as part of the General Base Funding request of $1,026,092.  The remainder of the General Base Funding request or $670,574, represents an ask to help reduce the funding disparity that was highlighted in the global funding formula review of 2015.  The funding review indicated that the WECHU was not receiving its model share of public health funding.  Base funding requests put forward in the 2018 Annual Service Plan and Budget submission outside of the $429,974 contemplated in the January 2018 budget presentation, will not be operationalized until such time as approval is received from the Ministry of Health and Long-Term Care (“the Ministry”).

      L. Gregg provided a summary of the base funding and one-time funding requests. One-time funding request are typically funded at a rate of 100% by the Ministry.  Base funding requests can be funded to a maximum of 75% by the Ministry or at a rate of 100% depending upon their nature. In the budget presented in January of 2018, the Ministry’s funded share of the 2018 budget was 71.51%.  If the General Base Funding, Mental Health Specialist, School Screening, and Public Health Inspector full time equivalents base funding requests are approved, the Ministry’s funded shared of the 2018 budget would increase to 72.81%.

      A question was raised by the Board regarding the expected timing of Ministry approvals.  L. Gregg responded that approvals could be expected in late summer or early fall but reminded the Board that 2017 approvals were received as late as November of 2017.

      A motion to support the following 2018 budget requests (the first three were approved as part of the 2018 budget) is needed for submission to the Ministry.
      It was moved
      That the Windsor-Essex County Board of Health approve the following:

      i) Budget for Mandatory Cost-Shared Program of $19,222,184.
      ii) Budget for Vector-Borne Disease Cost-Shared Program of $128,000.
      iii) Budget for Small Drinking Water Systems Program of $13,733.
      iv) Budget for Mandatory 100% Funded Programs of $3,357,033.
      v) Additional Base Funding Requests of $1,678, 924.
      vi) One-Time Funding Requests of $724,888.

      CARRIED

  10. Other Board of Health Resolutions/Letters – Circulated
  11. Committee of the Whole (CLOSED SESSION, in accordance with Section 239 of the Municipal Act)
    It was moved
    That the Board move into Committee of the Whole at 5:15 p.m.
    CARRIED
    It was moved

     

     

    That the Board move out of Committee of the Whole at 5:40 p.m.
    CARRIED

  12. Next Meeting: At the Call of the Chair, or April 19, 2018, Windsor, Ontario
  13. Other
    Prior to adjournment board member G. Queen commented that he would be bringing forward a question regarding Seasonal Housing at the April board meeting.
  14. Adjournment
    The meeting adjourned at 5:44 p.m.

RECORDING SECRETARY:

SUBMITTED BY:

APPROVED BY:


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February 15, 2018

  1. Call to Order
  2. Agenda Approval
  3. Announcement of Conflict of Interest
  4. Approval of Minutes
    1. Regular Board Meeting:  January 18, 2018
  5. Presentation
    1. Opioid Overview (Dr. W. Ahmed)
  6. Consent Agenda
    1. Information Report – Opioid Strategy
    2. Information Report – Naloxone Distribution
    3. Media Coverage Summary Report
  7. Business Arising
  8. Board Correspondence Circulated
  9. New Business
    1. Reserves (G. McNamara)
    2. 2017 Strategic Plan Progress Update – Report  (K. McBeth)
    3. 2017 WECHU Operational Plan Annual Summary (K. McBeth)
  10. Other Board of Health Resolutions/Letters
  11. Committee of the Whole (Closed Session in accordance with Section 239 of the Municipal Act)
  12. Next Meeting: At the Call of the Chair or March 15 2018 in Windsor
  13. Adjournment
File icon Board Meeting Agenda - February 2018
View Document page

Board Members Present:

Gary McNamara, Dr. Ken Blanchette, Mark Carrick, Joe Bachetti, Dr. Deborah Kane, Richard Meloche, Hilary Payne, Gord Queen, John Scott, Ed Sleiman, Michelle Watters

Board Member Regrets:

Paul Borrelli, Bill Marra, Carlin Miller

Administration Present:

Dr. Wajid Ahmed, Lorie Gregg, Kristy McBeth, Lee Anne Damphouse

Administration Regrets: 

Theresa Marentette, Nicole Dupuis, Dan Sibley

  1. Call to Order
    The meeting was called to order at 4:05 p.m.
  2. Agenda Approval
    It was moved
    That the agenda be approved - CARRIED
  3. Announcement of Conflicts of Interest - None
  4. Approval of Minutes
    1. Regular Board Meeting: January 18, 2018.
      It was moved
      That the minutes be approved - CARRIED
  5. Presentation
    1. Opioid Overview

      Opioid misuse is a significant problem in our community that includes visits to emergency rooms and an increase in hospitalization over the years. Windsor-Essex is higher than the provincial average for overdoses. The number of fatalities from overdoses continue to increase.

      Dr. Ahmed discussed the Cycle of Addiction, Experimentation – Prescriptions – Dependence – Recovery – Abuse. Family history of addiction predisposes individuals to become addicted. Prevention is needed.  Individuals need to be directed to services. Better reporting is also required to identify areas to target and enhance harm reduction to reduce the transmission of disease. 

      The Windsor-Essex Community Opioid Strategy (WECOS) is based on 4 pillars and there are 4 sub-committees or working groups that have been formed to work on outcomes for these pillars. 

      Public health’s role is to form partnerships--do our part, avoid duplication, share data, develop early warning system(s), health promotion and disease prevention, harm reduction (support other agencies through naloxone distribution and training) and advocacy. 

      Windsor-Essex is working with our community partners to explore the idea of an Overdose Prevention Site (OPS). Any agency focused on harm reduction can apply for a temporary OPS through the Ministry of Health and Long-Term Care. The Ministry can fund an OPS site for a period of 3-6 months. Staff must be properly trained and must have a registered healthcare provider available to help users if needed. It is not the same as a safe injection site (SIS). 

      Next steps in the WECOS is to train and distribute naloxone to community agencies. The board asked questions about the idea of mobile supervised injection sites. Dr. Ahmed responded that in the absence of central supervised injection service, mobile sites may not be effective. The solution is comprised of many components and supervised injection is part of the solution not the only solution.

      Dr. Ahmed’s report will be forwarded to the Board.

  6. Consent Agenda:
    1. Information Report – Opioid Strategy
      It was moved
      That the Opioid Strategy Information Report be received - CARRIED
    2. Information Report – Naloxone Distribution
      It was moved
      That the Naloxone Distribution Information Report be received - CARRIED
    3. Media Coverage Summary Report
      It was moved
      That the Media Coverage Summary Report be received - CARRIED
  7. Business Arising - None
  8. Board Correspondence – Circulated
  9. New Business
    1. Reserves
      This was discussed at JBEC.

      The Health Unit meets the challenges of its budget every year. When the Health Unit does not have the ability to spend its budget allocation, funds are returned to the Ministry. The Province is not responsible for funding; however, municipalities are obligated to deliver dollars as required for public health services. What is received from the province is a grant which is always based on the previous year. The WECHU has 5-6 weeks to spend the money from the last budget. Because the agency was unable, monies had to be returned, otherwise they could have been held in a reserve to address specific needs.

      L. Damphouse will send the Board background information. Reserves will be brought forward to the next meeting for discussion. The Board was asked to consider the Health Unit having the ability. This reserve piece would good for strategic planning.

      H. Payne left 4:52 pm

    2. 2017 Strategic Plan Progress Update—Report

      Board members B. Marra and Dr. Ken Blanchette are members of the Strategic Planning Committee.   

      The committee met in January to look at goals and measures, and made revisions to the plan as needed.  

      Goals related to the Health Unit’s strategic priorities of Communication and Awareness, Partnerships, Organizational Development, and Evidence-Based Public Health Practice were reviewed. 

      Health equity education will be provided to the Board which came up in the board evaluation survey. 

      K. McBeth discussed the colour coded legend on page 3 of the update.  Red means there is more work needed towards achieving that objective and some of that work has been incorporated into operational plans for 2018. The agency continues to work on green and yellow to– enforce ongoing corporate dialogue to keep the strategic plan alive, develop a corporate tracking system so managers incorporate the objectives as appropriate and link it back to our strategic plan. Board will receive quarterly updates that is not redundant. 

      Dr. Blanchette congratulated K. McBeth for her leadership and everyone that was involved in the process.

      The strategic plan is a living document that is updated annually.

      It was moved
      That the report be received - CARRIED

    3. 2017 WECHU Operational Plan Annual Summary

      The agency continues to look at continuous quality improvement and also looks at whether we are achieving our activities as per the Ontario Public Health Standards. The focus is on project management. The report does not contain an exhaustive list of every activities, nor will it illustrate day to day activities. It will illustrate high level project activities with a focus on accountability, project management, and minimal resources required to perform these activities. M. Watters questioned benchmarking with other health units. K. McBeth explained that health units right now are at different stages in their planning and are very different in their planning system and it would be difficult to compare. Health units in the future will see a much more comparable system with the institution of the annual service plan.

      Seventy percent of activities identified in our operational plan were either completed or on target for 2017.  With the new electronic planning system (M-Files), the agency can be better aligned with operational activities.

      K. McBeth will forward her presentation to the Board.

      It was moved
      That the report be received - CARRIED

  10. Other Board of Health Resolutions/Letters
  11. Committee of the Whole (CLOSED SESSION, in accordance with Section 239 of the Municipal Act)
    It was moved
    That the Board move into Committee of the Whole at 5:11 p.m. - CARRIED
    It was moved
    That the Board move out of Committee of the Whole at 5:12 p.m. - CARRIED
  12. Next Meeting: At the Call of the Chair, or March 15, 2018, Windsor, Ontario
  13. Adjournment
    The meeting adjourned at 5:12 p.m.

RECORDING SECRETARY:

SUBMITTED BY:

APPROVED BY:


View Document page

January 18, 2018

  1. Call to Order
  2. Agenda Approval
  3. Announcement of Conflicts of Interest
  4. Board Elections – 2018
  5. Approval of Minutes
    1. Regular Board Meeting:  December 21, 2017
  6. Presentations
    1. 2018 Budget (L. Gregg)
    2. Influenza Update (Dr. W. Ahmed)
  7. Consent Agenda:
    1. Report Number 2018-R001-HPROT/HPROMO – 0118-TM/ND from Theresa Marentette, Acting CEO, Director, Health Protection and Chief Nursing Officer and Nicole Dupuis, Director, Health Promotion dated January 18, 2018; Health Protection and Promotion Divisions Report to the Board of Health
    2.  
    3. Report Number 2018-R002-KNMGMT– 0118-KM from Kristy McBeth, Director, Knowledge Management dated January 18, 2018; Knowledge Management Division Report to the Board of Health

    Moved by
    Seconded by
    That the reports listed on the Consent Agenda as items 7a) to 7b) be received for
    information.

  8. Reports and Questions
  9. Business Arising – None
  10. Media Coverage – Circulated
  11. Board Correspondence – Circulated
  12. New Business
    1. Financial Controls Checklist (L Gregg) 26
    2. 2017 Q4 Operational Plan Report (K. McBeth) Handout
    3. Board of Health Reports – New templates for 2018 (T. Marentette)
  13. Board of Health Resolutions/Letters – None
  14. Committee of the Whole (CLOSED SESSION, in accordance with Section 239 of the Municipal Act)  37  
  15. Next Meeting:  At the Call of the Chair, or February 15, 2017 – 4:00 pm – Location:  Essex
  16. Adjournment
File icon Board Meeting Agenda - January 2018
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Board Members Present:

  • Mr. Gary McNamara, Chair
  • Mr. Mark Carrick, Treasurer
  • Mr. Paul Borrelli
  • Mr. Richard Meloche
  • Mr. John Scott
  • Ms. Michelle Watters
  • Mr. Ken Blanchette, Vice-Chair
  • Mr. Joe Bachetti
  • Mr. Bill Marra
  • Dr. Carlin Miller
  • Mr. Ed Sleiman

Board Member Regrets:

  • Dr. Deborah Kane
  • Mr. Hilary Payne
  • Mr. Gord Queen

Administration Present:

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

  1. Call to Order
    With quorum officially met Chair, G. McNamara, called the meeting to order at 3:34 pm.
  2. Announcements of Conflict of Interest
    None declared.
  3. Agenda Approval
    The agenda was approved.
    It was moved
    That the agenda be approved.
    CARRIED
  4. Board Elections
    Nominations for Chair
    G. McNamara relinquished the Chair to T. Marentette, Board Secretary, to begin the election process. T. Marentette opened the floor for nominations for the position of Chair noting that Administration had received three (3) written nominations nominating Gary McNamara.  T. Marentette asked for further nominations from the floor (three times). Given that there were no further nominations, nominations for the position of Chair were closed. G. McNamara, having accepted the nomination, was appointed Chair by acclamation.
    Nominations for Vice-Chair
    T. Marentette relinquished the Chair to Chair Elect, G. McNamara.  The Chair opened the floor for nominations for the position of Vice-Chair noting that Administration had received three (3) written nominations for Dr. Ken Blanchette.  The Chair asked for further nominations from the floor (three times). Given that there were no further nominations, nominations for the position of Vice-Chair were closed.  Dr. Ken Blanchette, having accepted the nomination, was elected Vice-Chair by acclamation.
    Nominations for Treasurer
    The Chair opened the floor for nominations for the position of Treasurer noting that Administration had received three (3) written nominations for Mark Carrick.  The Chair asked for further nominations from the floor (three times). Given that there were no further nominations, nominations for the position of Treasurer were closed.  Mark Carrick, having accepted the nomination, was appointed Treasurer by acclamation.
  5. Approval of Minutes
    1. Regular Board Meeting: December 21, 2017
      It was moved
      That the meeting minutes presented be approved.
      CARRIED
  6. Presentations
    1. 2018 Budget (L. Gregg)

      L. Gregg provided an overview of the 2018 Budget for the Board.  The WECHU had received a zero increase from the Ministry and is asking for 4% from each of the municipalities and 3.23% from the province.  If funding approval is less than 3.23%, more funding from the municipalities would be required.  Items briefly discussed were professional development, program supplies, professional fees, building occupancy, and an increase in cost to staff parking. Regarding the Capital Project, WECHU has applied for a planning grant and are awaiting approval (likely April 2018 timeline).  The Ministry will determine the sum of the grant approval.
      It was moved
      That the Board move into Committee of the Whole at 4:04 pm
      CARRIED
      It was moved
      That the Board move out of Committee of the Whole at 4:13 pm
      CARRIED
      Board of Health members briefly discussed the Ministry’s funding process.  WECHU is recommending a request of 3.23% funding from the Ministry and 4% from the municipalities
      It was moved
      That the recommendation be approved and the 2018 Budget be accepted as presented.
      CARRIED
      Bill Marra arrived at 4:15 pm

    2. Influenza Update (Dr. W. Ahmed)
      Dr. W. Ahmed provided the Board with a brief overview of this year’s influenza season noting symptoms, how influenza is spread and the number of current outbreaks.  The province is seeing more Influenza A outbreaks, but our community is seeing more Influenza B.  Each year the vaccine is based on the circulating strain of the virus.
      It was moved
      That the presentation be received for information.
      CARRIED
  7. Consent Agenda
    It was moved
    That the reports listed on the Consent Agenda as Items 7a) to 7b) be received for information.
    CARRIED
    G. McNamara leaves the meeting at 4:46 pm – Relinquishes the Chair to Vice-Chair K. Blanchette
  8. Reports and Questions – None
  9. Business Arising – None
  10. Media Coverage – Circulated
  11. Board Correspondence – Circulated
  12. New Business
    1. Financial Controls Checklist (L. Gregg)
      L. Gregg provided a brief overview of the Financial Controls Checklist, the most common deficiency being the lack of segregation of duties.  The Organization does its best to segregate the initiation of purchasing from ordering and receipt. There are instances as a result of vacations, illnesses and other unplanned absence, that impact the Organization’s ability to segregate. To mitigate risk, the Organization segregates the approval function (both for purchase and for payment) from the purchasing and receipt function. The action plan for 2018 and going forward, the Organization will continue to look for different strategies to mitigate risks associated with the segregation of incompatible duties.
      The tracking of aging of accounts receivable is a manual function. As a result, risk exists that invoices may not be followed up on a timely manner.  The action plan for 2018, commencing in the 2nd quarter and moving forward, it is anticipated that the volume of invoicing prepared by the Organization will be reduced.  Manual tracking of aged invoices will remain until such time as a better systems solution can be identified.
      It was moved
      That the Financial Controls Checklist be received for information.
      CARRIED
    2. 2017 Q4 Operational Plan Report (K. McBeth)
      K. McBeth advised that the Board will receive the 2017 Annual Report at the February Board meeting as well as the Operational Plan.
      It was moved
      That the information be received.
      CARRIED
    3. Board of Health Reports – New Templates for 2018 (T. Marentette)
      T. Marentette noted that commencing in February that Board Reports will be AODA compliant and more useful to the Board.  The biggest change will be in the Consent Agenda section with the Leadership Team noting relevant topics which may or may not be aligned with presentations.
      It was moved
      That the information be received.
      CARRIED
  13. Board of Health Resolutions/Letters – None
  14. Committee of the Whole (CLOSED SESSION) in accordance with Section 239 of the Municipal Act
    It was moved
    That the Board move into Committee of the Whole at 5:02 pm
    CARRIED
    It was moved
    That the Board move out of Committee of the Whole at 5:03 pm
    CARRIED
  15. Next Meeting:  At the Call of the Chair or February 15, 2018 @ 4:00 pm in Essex
  16. Adjournment
    The meeting adjourned at 5:05 pm

RECORDING SECRETARY:

SUBMITTED BY:

Acting CEO, Director of Health Protection and Chief Nursing Officer, Board Secretary

APPROVED BY:

Chairperson

File icon Board Meeting Minutes - January 2018
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December 21, 2017