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January 17, 2019

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

  1. Call to Order
  2. Introduction of New Board of Health Members
  3. Agenda Approval
  4. Announcement of Conflict of Interest
  5. Approval of Minutes
    1. Regular Board Meeting:  November 15, 2018
  6. Presentation:  Topical Issues – Influenza Update (Dr. W. Ahmed)
  7. Business Arising
  8. Board Correspondence – Circulated
  9. New Business
    1. INFORMATION REPORTS
      1. Q3 Financial Results (L. Gregg)
      2. Q3 Reporting (L. Gregg)
      3. Main Premises Replacement Project (T. Marentette) (with Hand-outs)
      4. Smoke-Free Ontario Act, 2017 Update (N. Dupuis)   20
      5. Bill S-228 (N. Dupuis)
      6. Media Recap (K. McBeth)
    2. RECOMMENDATION AND RESOLUTION REPORT
      1. Consumption and Treatment Services Application (T. Marentette)
    3. alPHa 2019 Winter Symposium on February 21, 2019 – Toronto (T. Marentette)
  10. Other Board of Health Resolutions/Letters – For Support/Information
    1. Peterborough Pulic Health – for Support
      Smoke-Free Ontario Act, 2017 – Letter to Hon. Caroline Mulroney (N. Dupuis)
    2. Thunder Bay District Health Unit – for Support
      Healthy Babies, Healthy Children (HBHC) Program – Letter to Hon. Lisa McLeod (N. Dupuis)
    3. Thunder Bay District Health Unit – for Support
      Ontario's Basic Income Pilot – Letter to Hon. Doug Ford (N. Dupuis)
  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 February 28, 2019, Essex Civic Centre
  13. Adjournment

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Prepared By:

Jennifer Jacob

Date:

November 5, 2018

Subject:

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

Background

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

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

Current Initiatives

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

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

Consultation:

The following individuals contributed to this report:

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

Approved by:

 Theresa Marentette, CEO

 


View Document page

Prepared By:

Lorie Gregg, Director of Corporate Services

Date:

December 18, 2018

Subject:

Q3 Financial Results

Background

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

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

Cost-Shared Program Financial Results

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

  2018 Budget YTD Budget YTD Actual 2018 Forecast 2018 YTD Actual 2017 Variance to Budget % Spent Forecasted Variance
Salaries 12,946,856 9,710,142 8,954,796 12,502,762 9,090,772 755,346 69% 444,094
Employee Benefits 3,331,935 2,498,951 2,505,941 3,238,253 2,365,440 - 6,990 75% 93,682
Travel and Meetings 39,650 29,738 8,615 23,821 17,010 21,123 22% 15,829
Mileage 198,531 148,898 124,601 181,681 132,737 24,297 63% 16,850
Professional Development 108,700 81,525 34,038 90,584 56,476 47,487 31% 18,116
Association and Memership Fees 45,000 33,750 35,102 44,458 42,592 - 1,352 78% 542
Office Supplies 35,000 26,250 21,896 28,368 27,829 4,354 63% 6,632
Program Supplies 655,847 491,885 388,058 788,264 497,411 103,827 59% (132,417)
Office Equipment Rental 144,000 108,000 97,408 144,000 99,421 10,592 68% -
Publications 500 375 897 897 - - 522 179% (397)
Purchased Services 105,000 78,750 62,193 111,155 105,216 16,557 59% (6,155)
Promotional 8,829 6,622 5,284 5,284 7,555 1,338 60% 3,545
Board Expenses 22,294 16,721 8,820 14,408 5,578 7,901 40% 7,886
Professional Fees 128,600 96,450 85,386 118,320 57,888 11,064 66% 10,280
Bank Charges 17,900 13,425 11,911 17,900 12,853 1,514 67% -
Rent 770,000 577,500 539,596 729,135 548,580 37,904 70% 40,865
Building Maintenance 145,200 108,900 105,874 151,297 93,994 3,026 73% (6,097)
Utilities 147,000 110,250 93,018 122,772 96,160 17,232 63% 24,228
Taxes 227,500 170,625 175,036 211,597 177,858 - 4,411 77% 15,903
Insurance 80,000 60,000 79,351 79,351 77,334 - 19,351 99% 649
Telephone 121,200 90,900 80,713 116,181 96,273 10,187 67% 5,019
Security 28,000 21,000 13,326 18,418 15,991 7,674 48% 9,582
Vehicle Expenses 2,100 1,575 479 1,311 1,024 1,096 23% 789
Postage and Freight 17,450 13,088 11,724 19,094 13,809 1,364 67% (1,644)
Parking 88,000 66,000 63,240 83,570 55,449 2,760 72% 4,430
  19,415,092 14,561,319 13,507,303 18,842,882 13,695,250 1,054,016 67% 572,210
 
Offset revenues - 179,175 - 134,381 - 125,190 - 270,098 - 66,613 - 9,191 70% 90,923
  19,235,917 14,426,938 13,382,113 18,572,784 13,628,637 1,044,825 137% 663,133
 
West Nile Virus 128,800 96,600 144,549 144,549 118,177 - 47,949 112% - 15,749
  19,364,717 14,523,538 13,526,662 18,717,333 13,746,814 996,876 249% 647,384

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

  • MOHLTC
  • Corporation of the City of Windsor
  • Corporation of the County of Essex
  • $10,290,451
  • $2,237,274
  • $1,662,188
  • $14,189,913

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

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

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

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

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

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

Healthy Babies Healthy Children Program Financial Results

  2018 Budget YTD Budget YTD Actual 2018 Forecasted 2018 YTD Actual 2017 Variance to Budget % Spent Forecasted Variance to Budget
Salaries and benefits 2,623,390 1,967,543 1,826,354 2,623,390 1,836,288 141,189 70% -
Mileage and travel 60,000 45,000 36,443 55,538 37,258 8,557 61% 4,462
Professional Development 13,400 10,050 7,678 8,124 5,472 2,372 57% 5,276
Program Supplies 38,251 28,688 21,408 54,699 29,299 7,280 56% (16,448)
Purchased Services 15,000 11,250 6,425 8,290 13,042 4,825 43% 6,710
Professional Fees 5,800 4,350 4,350 5,800 - - 75% -
  2,755,841 2,066,881 1,902,658 2,755,841 1,921,359 164,223 69% 0
 
Funding - MCYS (2,755,841) (2,066,881) (2,066,885) (2,755,841) (2,066,885) 4 70% -
  - - (164,227) (0) (145,526) 164,227 139% 0

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

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

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

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

Nurse Practitioner Program Financial Results

  2018 Budget YTD Budget YTD Actual 2018 YTD Forecasted 2018 YTD Actual 2017 Variance to Budget % Spent Forecasted Variance to Budget
Salaries and benefits 139,000 104,250 101,671 139,000 105,005 2,579 73% 144,210
  139,000 104,250 101,671 139,000 105,005 2,579 73% 144,210
Funding - MCYS (139,000) (104,250) (104,254) (139,000) (104,254) 4 75% (139,000)
  - - (2,583) - 751 2,583 148% 5,210

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

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

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

Financial Information for Related Programs Funded 100% by the MOHLTC

  2018 Budget YTD Budget Accruals YTD Actuals no accruals YTD Actual 2018 Forecasted 2018 YTD Actual 2017 YTD Variance to Budget % Spent Forecasted Variance to Budget
Salaries and Benefits 1,206,022 904,517 - 822,211 822,211 1,190,006 774,701 82,306 68% 16,016
Admin and Accommodation 33,149 24,862 - 16,575 16,575 65,032 37,500 8,287 50% (31,883)
Travel and Meetings 8,000 6,000 - 693 693 1,024 1,548 5,307 9% 6,976
Mileage 10,000 7,500 - 9,346 9,346 13,291 8,881 (1,846) 93% (3,291)
Professional Development 5,100 3,825 - 3,892 3,892 5,100 3,113 (67) 76% -
Association and Memership Fees 300 225 - 546 546 638 443 (321) 182% (338)
Office Supplies 4,500 3,375 - 441 441 889 379 2,934 10% 3,611
Program Supplies 100,229 75,172 - 107,330 107,330 178,204 49,641 (32,158) 107% (77,975)
Purchased Services 162,400 121,800 - 50,455 50,455 81,816 44,200 71,345 31% 80,584
 
Total expenditures 1,529,700 1,147,275 - 1,011,489 1,011,489 1,536,000 920,406 135,786 66% (6,300)
Offset revenue - - (6,300) - (6,300) (6,300) - 6,300 0% 6,300
Funding - MOHLTC (1,529,700) (1,147,275) - (1,147,281) (1,147,281) (1,529,700) (831,600) 6 75% -
  - - (6,300) (135,792) (142,092) (0) 88,806 142,092 -9% 0

 

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

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

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

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

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

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

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

 

  2018 Budget YTD Budget YTD Actual 2018 Forecasted 2018 YTD Actual 2017 YTD Actual Variance to Budget % Spent Forecasted Variance to Budget
Salaries and benefits 519,217 389,412.75 377,224 517,238 373,392 12,189 73% 1,979
Mileage 35,800 26,850 23,122 31,490 22,900 3,728 65% 4,310
Travel and Meetings 6,245 4,683.75 2,795 4,937 2,657 1,889 45% 1,308
Professional Development 5,500 4,125 4,717 4,676 1,095 (592) 86% 824
Association and Membership Fees 156 117 - -   117 0% 156
Program Supplies 44,582 33,437 16,405 47,218 17,504 17,032 37% (2,636)
Purchased Services 25,200 18,900 10,216 13,712 11,964 8,684 41% 11,488
Total expenditures 636,700 477,525 434,479 619,271 429,512 43,046 68% 17,429
Funding - MOHLTC (636,700) (477,525) (477,523) (636,700) (423,523) (2) 75% -
  - - (43,044) (17,429) 5,989 43,044 -7% 17,429

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

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

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

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

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

  2018 Budget YTD Budget YTD Actual 2018 Forecasted 2018 YTD Actual 2017 Variance to Budget % Spent Forecasted Variance to Budget
Chief Nursing Officer Initiative 121,500 91,125 82,045 121,500 83,168 9,080 68% -
Enhanced Food Safety - Haines Initiative 53,800 40,350 21,904 53,800 14,951 18,446 41% -
Enhanced Safe Water 32,900 24,675 1,450 32,900 9,533 23,225 4% -
Harm Reduction Program Enhancement 250,000 187,500 171,195 250,000 67,626 16,305 68% -
Infection Prevention and Control Nurses Initiative 90,100 67,575 69,711 103,955 6,667 (2,136) 77% (13,855)
Infectious Diseases Control Initiative 461,700 346,275 334,100 461,700 336,322 12,175 72% -
Needle Exchange Program Initiative 63,000 47,250 47,250 63,000 - - 75% -
Social Determinants of Health Nurses Initiative 180,500 135,375 137,364 207,041 142,608 (1,989) 76% (26,541)
Total expenditures 1,253,500 940,125 865,020 1,293,896 660,875 75,105 69% (40,396)
Funding - MOHLTC (1,253,500) (940,125) (940,147) (1,253,500) (864,143) 22 75% -
  - - (75,127) 40,396 (203,268) 75,127 -6% (40,396)

A description of other related programs is included below:

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

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

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

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

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

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

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

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

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

Financial Information for Related Programs Funded 100% by the MOHLTC

  2018 Budget YTD Actual 2018 Forecasted (March 31, 2019) Variance to Budget % Spent Forecasted Variance to Budget
Mandatory Programs: Potassium Iodide Distribution Program 167,000 34,714 167,000 132,286 21% -
Mandatory Programs: Public Disclosure System 20,000 8,548 20,000 11,452 43% -
Capital: Windsor Office Project 275,000 51,351 113,809 223,649 19% 161,191
Needle Exchange Program Initiative 10,100 10,100 10,100 - 100% -
Public Health Inspector Practicum 20,000 20,000 20,000 - 100% -
Vector-Borne Diseases Program: Enhacned Mosquito Surveillance 46,700 34,798 46,700 11,902 75% -
  538,800 159,511 377,609 379,289 30% 161,191

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

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

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

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

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

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

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


Approved by:

 Theresa Marentette, CEO


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Prepared By:

Lorie Gregg, Director of Corporate Services

Date:

December 13, 2018

Subject:

Q3 Reporting

Background

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

Q3 Reporting

The Q3 reporting to the Ministries include the following:

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

Approved by:

 Theresa Marentette, CEO


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Prepared By:

Eric Nadalin, Manager, Chronic Disease and Injury Prevention 

Date:

January 9, 2019

Subject:

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

Background

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

Places of Use

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

Table 1: SUMMARY OF REGULATION CHANGES RELATED TO PLACES OF USE
Topic/Regulation Former Smoke-Free Ontario Act/Electronic Cigarettes Act NEW:
Smoke-Free Ontario Act 2017
Impact on Municipal Bylaws

Prohibited Products

  • Smoke or hold lighted tobacco.
  • Smoke or hold lighted tobacco.
  • Smoking or vaping of cannabis.
  • Use of an electronic cigarette.

Inclusion of smoking or vaping of cannabis and use of an electronic cigarette.

 

Smoke-free Bylaws Impacted:

Municipality of Leamington

Bylaw: 311-13

Smoking/Vaping Prohibition on

School Grounds

  • The property of a school as defined in The Education Act.
  • A school as defined in The Education Act.
  • Public areas within 20m of any point on the perimeter of school property.
  • Inclusion of Smoking or vaping of cannabis and use of an electronic cigarette.

School property not referenced in any local municipal Bylaws.

 

Smoke-free Bylaws Impacted:

None.

Smoking/Vaping Prohibition on Children’s Playgrounds and Play Areas

  • Children’s playgrounds
  • Public areas within 20m of any point of the perimeter of a children’s playground.
  • No change for prohibited spaces.
  • Inclusion of Smoking or vaping of cannabis and use of an electronic cigarette.

 

 

These regulations will continue to supersede outdoor smoking Bylaws in municipalities which provide exemptions for parking lots or designated smoking areas within 20m from the perimeter of playgrounds and play areas.

 

Smoke-Free Bylaws Impacted:

Town of Amherstburg

Bylaw: 2016-113

 

Town of Essex

Bylaw: 1228

 

Town of Tecumseh

Bylaw: 2014-60

 

City of Windsor

Bylaw: 113-2006

 

Town of LaSalle

Bylaw: 7775

 

Smoking/Vaping Prohibition for Sporting Areas

  • Sporting areas
  • Spectator areas
  • Public areas within 20m of any point on the perimeter of a sporting area or spectator area.
  • No change for prohibited spaces.
  • Inclusion of smoking or vaping of cannabis and use of an electronic cigarette.

 

These regulations will continue to supersede outdoor smoking Bylaws in municipalities which provide exemptions for parking lots or designated smoking areas within 20m from the perimeter of sporting areas or spectator areas.

 

Smoke-Free Bylaws Impacted:

Town of Amherstburg

Bylaw: 2016-113

 

Town of Essex

Bylaw: 1228

 

Town of Tecumseh

Bylaw: 2014-60

 

City of Windsor

Bylaw: 113-2006

 

Town of LaSalle

Bylaw: 7775

 

Smoking/Vaping Prohibition on

Recreation Centre Property

  • No provincial regulations, but most municipal recreation centers are covered in Smoke-Free Bylaws.
  • The outdoor grounds of a community recreation facility and public areas within 20m of any point on the perimeter of the grounds.
  • Inclusion of smoking or vaping of cannabis and use of an electronic cigarette.

 

These regulations will supersede outdoor smoking Bylaws in municipalities which provide exemptions for parking lots or designated smoking areas on recreation centre property or within 20m of any point on the perimeter of the property.

 

Smoke-Free Bylaws Impacted:

Town of Amherstburg

Bylaw: 2016-113

 

Town of Essex

Bylaw: 1228

 

Town of Tecumseh

Bylaw: 2014-60

 

City of Windsor

Bylaw: 113-2006

 

Town of LaSalle

Bylaw: 7775

Smoking/Vaping Prohibitions of Restaurant and Bar Patios

  • Restaurant and bar patios

 

  • Restaurant and bar patios
  • Public areas within 9m of any point on the perimeter of a restaurant or bar patio.
  • Inclusion of smoking or vaping of cannabis and use of an electronic cigarette.

These regulations will supersede outdoor smoking Bylaws in municipalities which provide exemptions for designated smoking areas within 9m of any point on the perimeter of a bar or restaurant patio, such as those which are in operation as part of a fair or festival.

 

Smoke-free Bylaws Impacted:

Town of Amherstburg

Bylaw: 2016-113

 

Town of Essex

Bylaw: 1228

 

Town of Tecumseh

Bylaw: 2014-60

 

City of Windsor

Bylaw: 113-2006

 

Town of LaSalle

Bylaw: 7775

Display and Promotion

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

Registration of Tobacconists and Specialty Vape Stores

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

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

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

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

  • The retailer must not permit someone under 19 years old or appears to be under the age of 25 (without proper identification) to enter their store.
  • The place of business must be a building or located within a building.
  • Customers can enter the store only from the outdoors or from the areas of an enclosed shopping mall.
  • The place of business must be a building or located within a building.
  • No more than two patrons are permitted to sample a vapour product within the store at any given time.   

Current Initiatives

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

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

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

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

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

The package included:

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

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

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

References

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

 

Approved by:

 Theresa Marentette, CEO


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Board Members Present:

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

Board Member Regrets:

Gary McNamara

Administration Present:

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

QUORUM:  Confirmed


  1. Call to Order
    In the absence of the Board Chair, Vice Chair, Ken Blanchette, called the meeting to order at 4:02 p.m.
  2. Introduction:
    Vice Chair, Ken Blanchette, introduced and welcomed the newest WECHU Board of Health County representatives Larry Snively, Mayor, Town of Essex, and Tracey Bailey, Deputy Mayor, Town of Lakeshore.

     

    Ken Blanchette advised the Board that City of Windsor representation to the Board of Health has not yet been determined.  Therefore, the following 2 items on the agenda have been deferred until such time as city representation has been put in place:

    • Item 9.1.3 – Main Premises Replacement Project (deferred to April)
    • Item 9.2.1 – Consumption and Treatment Services Application (deferred to April)

  3. Agenda Approval
    It was moved
    That the agenda be approved - CARRIED
  4. Announcement of Conflicts of Interest – None.
  5. Approval of Minutes
    1. Regular Board Meeting: November 15, 2018
      It was moved
      That the minutes be approved - CARRIED
  6. Presentation – Topical Issues:  Dr. Wajid Ahmed
    Influenza Update

     

    Dr. Wajid Ahmed provided an update on this year’s Influenza season.  All confirmed cases (100%) have been identified as Influenza A with a predominant H1N1 strain.  A good portion of these cases, or 42%, were identified as children 10 years and under.  The WECHU prepared more communication and media around absenteeism in schools and increased awareness of the importance of receiving the flu shot. Last year a different strain had a different impact with 28% of confirmed cases affecting individuals 60 years and older.    This year’s vaccine has been a good match so far for Influenza A.

    It was moved
    That the presentation be received - CARRIED

  7. Business Arising – None  
  8. Board Correspondence – Circulated
  9. New Business
    1. INFORMATION REPORTS
      The following information reports were presented to the Board.
      1. Q3 Financial Results (L. Gregg)
        The Leadership Team of the Windsor-Essex County Health Unit monitors financial results on an on-going basis for the following programs (L. Gregg walked through these programs with the Board):
        • Mandatory programs funded to a maximum of 75% (“Cost-Shared”) by the Ministry of Health and Long-Term Care (“MOHLTC”) and the Corporation of the City of Windsor, the Corporation of the County of Essex and the Corporation of the Township of Pelee
        • Related programs such as Vector-Borne Diseases and Small Drinking Water Systems, funded on a cost-shared basis to a maximum of 75% by the MOHLTC and certain surrounding municipalities within the geographic boundaries of Windsor and Essex County
        • Related programs funded 100% by the MOHLTC
        • Related programs funded 100% by the Ministry of Children and Youth Services (“MCYS”)
        • One-time business cases
      2. Q3 Reporting (L. Gregg)
        The WECHU administers programs funded in whole or part by the MOHLTC and the MCYS.  Quarterly the WECHU is required to report to these Ministries the year-to-date budget to actual financial results for those programs, as well as provide forecasted annual financial results.  L. Gregg walked through these reports with the Board.

        Q3 Reporting to the Ministries include:
        • Q3 2018 Standards Activity Reports – at September 30, 2018 – submission to MOHLTC
        • Healthy Babies, Healthy Children Quarterly Financial Reports – 2018 Q3 – submission to the MCYS
        • Prenatal and Postnatal Nurse Practitioner Program Financial Report – 2018 Q3 – submission to the MCYS

      3. Main Premises Replacement Project (Deferred)
        This item on the agenda will be deferred until City of Windsor representatives to the Board of Health have been determined.
      4. Smoke Free Ontario Act, 2017 Update
        N. Dupuis introduced Eric Nadalin, WECHU Manager, Chronic Disease and Injury Prevention, who provided an update on the Smoke-Free Ontario Act, 2017 (SFOA), i.e. the legislation enforced by the WECHU.
        We will be looking to support our municipalities with their bylaws in regard to Cannabis.
      5. Bill S-228
        The Windsor-Essex County Board of Health passed a resolution in December 2016 to support federal legislation prohibiting all forms of commercial food and beverage marketing to children under 17 years old. Bill S-228 has undergone several amendments since it was tabled in Senate in 2016, and the version that was passed in the House of Commons only protects children under 13 years old from commercial marketing of unhealthy foods and beverages.

        The WECHU remains committed to protecting all children under 17 years old from all forms of commercial food and beverage marketing, and our dieticians continue to provide expert consultation to Health Canada for their Healthy Eating Strategy.  WECHU will also be developing a local strategy to limit children’s exposure to commercial food and beverage marketing in child-care centres, schools and recreational facilities to provide more comprehensive protection than provided by Bill S-228.

      6. Media Recap
        An overview of topics in the media related to public health for November and December were briefly discussed.

      It was moved
      That the information reports be received - CARRIED

    2. RECOMMENDATION AND RESOLUTION REPORTS
      The following Recommendation/Resolution Report will be deferred.
      1. Consumption and Treatment Services Application (T. Marentette) – (Deferred)
        This item on the agenda will be deferred until City of Windsor representatives to the Board of Health have been determined.
        It was moved
        That the recommendation/resolution report be deferred - CARRIED
    3. alPha 2019 Winter Symposium on February 21, 2019 – Toronto
      The Association of Public Health Agencies (alPHa) 2019 Winter Symposium is scheduled for Thursday, February 21 in Toronto.  A Board of Health Orientation Session is also being offered, and if any WECHU Board members which to attend, please advise L. Damphouse regarding registration.
  10. Board Correspondence/Other Health Unit Letters/Resolutions
    1. Peterborough Public Health – For Support
      Smoke-free Ontario Act, 2017 – Letter to Hon. Caroline Mulroney
    2. Thunder Bay District Health Unit – For Support
      HBHC Program – Letter to Hon. Lisa McLeod
    3. Thunder Bay District Health Unit – for Support
      Ontario’s Basic Income Pilot – Letter to Hon. Doug Ford
      (The WECHU also sent its own letter to Premier Ford on this issue)

      It was moved
      That the above correspondence be supported - CARRIED

  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 5:04 p.m. - CARRIED

    It was moved
    That the Board move out of Committee of the Whole at 5:13 p.m. - CARRIED

  12. Next Meeting: At the Call of the Chair, or February 28, 2019 in Essex, Ontario
  13. Adjournment
    The meeting adjourned at 5:15 pm.

RECORDING SECRETARY:

SUBMITTED BY:

APPROVED BY:


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November 15, 2018

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

  1. Call to Order
  2. Agenda Approval
  3. Announcement of Conflict of Interest
  4. Approval of Minutes
    1. Regular Board Meeting:  October 18, 2018
  5. Presentation – Topical Issues: Dr. W. Ahmed
  6. Consent Agenda
    1. INFORMATION REPORTS:
      1. Q3 Strategic Plan Report/Q3 Strategic Plan Progress Report
      2. Q3 Planning Report
      3. BOH Education Sessions – Summer 2019
      4. Risk Management
  7. Business Arising
  8. Board Correspondence – Circulated
  9. New Business
  10. Other Board of Health Resolutions/Letters – For Support/Information
    1. alPha – Update to BOH Members – For Information
      October 26, 2018 – various links and items of interest
    2. Opioid Crisis – National Drug Strategy – For Support
      Southwestern Public Health – Oxford, Elgin, St. Thomas –
      Letter to Hon. Premier Doug Ford
  11. Committee of the Whole (Closed Session in accordance with Section 239 of the Municipal Act) 77
  12. Next Meeting: At the Call of the Chair, or December 20, 2018 –  Windsor
  13. Adjournment

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2018 Q3 WECHU Strategic Plan Progress - At a Glance

Communication and Awareness

Objective

2018 Q1

2018 Q2

2018 Q3

1.1. 60% of survey respondents are aware of the programs and services offered by the WECHU by 2021.

Progressing Progressing Progressing

1.2 60% of survey respondents have seen or heard about the WECHU by 2021.

Progressing Progressing Progressing

1.3 60% of survey respondents are satisfied with internal communication efforts in the WECHU by 2021.

Progressing Progressing Progressing

Partnerships

Objective

2018 Q1

2018 Q2

2018 Q3

2.1. 100% of program/service driven departments implement a formal feedback process with at least one external partnership by 2021.

Work Needed Progressing Progressing

2.2. At least 20% of activities in the operational plan identify formal internal partnerships by 2021.

Progressing Progressing Progressing

Organizational Development

Objective

2018 Q1

2018 Q2

2018 Q3

3.1. A minimum of 2 organization-wide quality improvement activities will occur annually through to 2021.

Objective Met Objective Met Objective Met

3.2. 100% of the WECHU staff are trained in change management strategies by 2021.

Progressing Progressing Progressing

3.3. 100% of corporate risks identified as high have mitigation strategies developed and implemented by 2021

Progressing Progressing Progressing

3.4. 80% of the WECHU staff have a positive view of organizational culture by 2021.

Progressing Progressing Progressing

Evidence-based Public Health Practice

Objective

2018 Q1

2018 Q2

2018 Q3

4.1. 100% of departments collect corporate level client satisfaction data by 2021.

Progressing Progressing Progressing

4.2. 100% of the Ontario Public Health Standards (OPHS) 2018 program areas have at least one activity focused on healthy public policy development by 2021.

Progressing Progressing Progressing

4.3. 100% of the OPHS population health assessment requirements (7), the research, knowledge exchange, and communication requirements (3) and the related protocols are being addressed by 2021.

Objective Met Objective Met Objective Met

4.4. 100% of our programs and service departments have adopted a health equity approach to an activity by 2021.

Progressing Progressing Progressing

Communication and Awareness

OBJECTIVE

GOAL

Q3 UPDATE

1.1 Strengthen the community’s awareness of our programs and services by developing and implementing a corporate communications strategy.

60% of survey respondents are aware of the programs and services offered by the WECHU by 2021.

The marketing and communications plan is still to be developed. Five policies and procedures have been developed and are currently under review. The policies address elements of organizational branding across media channels. Work is being done to define the WECHU’s programs and services in order to build the marketing and communications plan.

1.2 Increase the WECHU’s visibility by developing and implementing a community engagement approach.

60% of survey respondents have seen or heard about the WECHU by 2021.

The community engagement plan is still to be developed. An enhanced focus on organizational branding has been implemented.

1.3 Improve communication within the WECHU by developing and implementing an internal communication strategy.

60% of survey respondents are satisfied with internal communication efforts in the WECHU by 2021.

The employee engagement strategy is currently being implemented. Measurements associated with internal communication will be generated in Q4

Partnerships

OBJECTIVE

GOAL

Q3 UPDATE

2.1 Increase the effectiveness of partnerships through formal feedback mechanisms.

100% of program/service driven departments implement a formal feedback process with at least one external partnership by 2021.

The partnership tool has been developed and finalized. Training for management and staff will begin in November.

2.2 Increase the number of internal partnerships.

At least 20% of activities in the operational plan identify formal internal partnerships by 2021.

19% of work plans included in the 2018 Operational Plan referenced internal partnerships.
The updated planning tool now includes more detail about internal partnerships for the 2019 planning cycle.

Organizational Development

OBJECTIVE

GOAL

Q3 UPDATE

3.1 Improve performance by striving towards operational excellence and a focus on continuous quality improvement.

A minimum of 2 organization-wide quality improvement activities will occur annually through to 2021.

Four corporate level quality improvement activities have been identified for 2018 and progress for each is as follows:
1. The Risk Registry was updated with mitigation plans incorporated into the 2019 planning approach. 
2. The planning system has been updated to incorporate ministry requirements, and training has been provided to all teams. 
3. Background work on our quality improvement plan approach is in progress. 4. Proposals for potential approaches to maintain AODA adherence have been developed.

3.2 Increase our readiness to adapt to internal and external factors through effective change management practices.

100% of the WECHU staff are trained in change management strategies by 2021.

Exploring options related to ongoing change management training.

3.3 Enhance our understanding and monitoring efforts of identified corporate risks to embrace opportunities, create flexibility, and preserve organizational assets.

 

100% of corporate risks identified as high have mitigation strategies developed and implemented by 2021

A draft risk management template has been released by the MOHLTC regarding risk identification and mitigation strategies. Their template has the same columns as the WECHU’s internal template. Risk identification practices will continue as planned. Key risk indicators have not been developed as of yet.

3.4 Improve organizational culture through people development and employee engagement strategies.

80% of the WECHU staff have a positive view of organizational culture by 2021.

The employee engagement strategy is currently being implemented. Baseline measures for employee engagement are currently being collected. Measurements associated with employee engagement will be generated in Q4.

Evidence-Based Public Health Practice

OBJECTIVE

GOAL

Q3 UPDATE

4.1 Establish organizational supports for client-centered service strategies.

100% of departments collect corporate level client satisfaction data by 2021.

New methods and technologies are being considered in order to offer health unit clients the opportunity to share their feedback. A survey on the health unit website continues to draw client satisfaction responses at the corporate level. 

4.2 Develop and implement a framework to support healthy public policy.

100% of the Ontario Public Health Standards (OPHS) 2018 program areas have at least one activity focused on healthy public policy development by 2021.

There were four activities focused on healthy public policy completed in Q3 under the Chronic Diseases and Well-being Standard, and the Substance Use and Injury Prevention Standard. There are activities focused on healthy public policy in progress under the Chronic Diseases Prevention and Well-being Standard, Substance Use and Injury Prevention Standard, and the Healthy Environments Standard.

4.3 Enhance local data collection efforts and analysis to support knowledge exchange both internally and externally.

100% of the OPHS population health assessment requirements (7), the research, knowledge exchange, and communication requirements (3) and the related protocols are being addressed by 2021.

The way in which this objective is measured and reported upon is currently under review.

4.4 Develop and implement protocols that ensure all programs and services are using a health equity approach.

100% of our programs and service departments have adopted a health equity approach to an activity by 2021.

100% of departments received a presentation for the launch of the corporate Health Equity Strategy. A narrated video of the presentation was prepared and posted to the intranet.
A 1.5-hour health equity education session was delivered to the Board of Health.
A Health Equity Strategy Communication Plan draft was completed and will be presented to the Leadership Team. 
A Health Equity Strategy Measurement and Reporting Plan is in development.


View Document page

Prepared By:

Communications Department

Date:

November 5, 2018

Subject:

October Media Relations Recap Report

October Media Coverage

Total Media Coverage

56

Interview Requests

27

Mentions (In the news without direct interviews)

29

October 2018 Media Relations Recap - Media Coverage

Story Source

October 2018 Media Relations Recap - Story Source

Media Coverage

Outlet

Number of Stories

AM 800

12

Blackburn

9

CBC

10

CBC – London

1

CBC – Radio Canada

2

CTV

4

Newswire

1

OurWindsor.ca

2

Rivertown Times

1

St. Clair College

1

Windsor Star

8

windsorite.ca

5

TOTAL

56

News Release and Media Advisories

Date Type Headline Response

October 4, 2018

News Release

Health Unit Launches Cannabis Use Prevention and Safety Campaign

6 Stories Reported

October 5, 2018

News Release

Vote for Health: Municipal Candidates Views on Local Health Issues

1 Story Reported

October 11, 2018

Media Advisory

Oral Health Workshop - A Tale of Two Countries: Access to Oral Health Care in Canada and the U.S.A.

2 Stories Reported

October 12, 2018

Media Advisory

Potassium Iodide (KI) Pill Distribution to Start in Secondary Zone

4 Stories Reported

October 15, 2018

News Release

Potassium Iodide (KI) Pill Distribution to Start in Secondary Zone

4 Stories Reported

October 17, 2018

News Release

Supervised Injection Services - What Do You Think?

5 Stories Reported

October 17, 2018

Media Advisory

Windsor-Essex County Health Unit Board of Health Meeting at Essex Office - October 2018

3 Stories Reported

October 18, 2018

News Release

Local Workplaces Recognized for Commitment to Employee Health and Wellness

0 Stories Reported

October 19, 2018

Media Advisory

Free Parent Information Event during National Teen Driver Safety Week

2 Stories Reported

October 23, 2018

News Release

Protecting Ontarians with Revitalized Smoke-free Ontario Act 2017

5 Stories Reported

October 24, 2018

News Release

It’s Flu Season! Lower Your Risk, Get Immunized.

3 Stories Reported

October 26, 2018

News Release

Food System Community Conversation

1 Story Reported

Stories Reported by the Media

AM 800

Publish Date

Title

October 3, 2018

City Councillor Questions Health Unit Over Restaurant Closure

October 4, 2018

Local Medical Officer Of Health Defends Health Inspectors

October 4, 2018

Health Unit Wants To Answer Your Questions About Pot

October 15, 2018

Health Professional Emphasize Need For More Dental Care For Adults And Seniors

October 15, 2018

Health Unit Preparing For Legal Weed

October 15, 2018

Windsor Essex Residents To Get Radiation Protection

October 18, 2018

Are Supervised Injection Sites Needed In Windsor-Essex?

October 18, 2018

Health Unit Recommends Windsor-Essex Say No To Retail Pot Stores

October 22, 2018

Health Unit Approves 2019 Budget Increase

October 23, 2018

Stern Message For Parents Of Teen Drivers

October 25, 2018

Smoking Banned From All City Rec Centres

October 29, 2018

WECHU Wants You To Be Prepared For Flu Season

Blackburn News

Publish Date

Title

October 4, 2018

Union Local Providing 600 Area Families With Thanksgiving Dinner

October 7, 2018

Health Unit Wants To Answer Your Questions About Legal Cannabis

October 8, 2018

Local Candidates Prioritize Local Health Spending In Survey

October 11, 2018

Cannabis information cards being sent to your home

October 15, 2018

KI Pill Distribution Now Expanded

October 15, 2018

Radioactive Prevention Pills To Start Across Windsor-Essex & Chatham-Kent

October 17, 2018

What Do You Think Of Supervised Injection Sites

October 25, 2018

Stricter Smoking Rules Outside Recreational Facilities

October 27, 2018

WRH Prepared For this Flu Season; Are You?

CBC News

(CBC London and CBC Radio-Canada are included in this list)

Publish Date

Title

October 4, 2018

Have A History Of Mental Illness? Pregnant? Avoid Cannabis Altogether, Says Health Unit

October 4, 2018

3 Highlights From Windsor's 1st All-Candidate Mayoral Debate

October 15, 2018

Health Unit Taking Requests For Potassium Iodide Pills This Week

October 17, 2018

Heath Unit Community Survey On Supervised Consumption Site Now Open

October 19, 2018

Windsor-Essex Health Unit Recommends Opting Out Of Private Retail Pot

October 25, 2018

Full Smoking Ban Outside All Public And Private Recreation Facilities

October 28, 2018

Quebecers indifferent to dangers of radon, need to protect their homes, expert warns

Note: Six requests (not listed) from CBC did not result in a reported story that mentioned the Health Unit

CTV News

Publish Date

Title

October 4, 2018

Cannabis Use Prevention And Safety Campaign Launched By Health Unit

October 17, 2018

Anti-Radiation Pill Distribution Begins In Secondary Zone For Windsor-Essex

October 18, 2018

Health Unit Wants Feedback On Supervised Injection Services

October 31, 2018

Feedback wanted on Windsor-Essex food system

Newswire

Publish Date Title

October 3, 2018

CUPE City Workers Team up With Windsor-Essex Food Bank To Deliver Thanksgiving Dinner

OurWindsor.ca

Publish Date Title

October 18, 2018

Windsor Police Join Community Partners During National Teen Driver Safety Week

October 24, 2018

Windsor Recreational Properties Now Completely Smoke Free

Rivertown Times

Publish Date Title

October 15, 2018

Are You Prepared? Sign up to request your Potassium Iodide (KI) pills

Windsor Star

Publish Date Title

October 9, 2018

Four-Plant Limit Won't Limit Giant Pot Harvests, Local Grower Shows

October 12, 2018

Windsor-Essex Health Unit Survey Finds Adults' Oral Health Worse Than Children

October 15, 2018

Essex County Residents Can Obtain Pills To Protect Against Radiation In Nuclear Disaster

October 18, 2018

Health Unit Asks Windsor For 5 Percent Increase, Payne Objects

October 23, 2018

Teens Driving High Should Concern Parents, Health Unit Says

October 25, 2018

Blanket Smoking Ban Outside City Recreation Buildings Applies To Spits Games

October 25, 2018

Health Unit Urging People To Get Flu Shots

October 25, 2018

Windsor Spitfire Fans React To New Smoking Ban At WFCU Centre

Windsorite.ca

Publish Date Title

October 4, 2018

Local Health Unit Launches Cannabis Use Prevention and Safety Campaign

October 5, 2018

Local Municipal Candidates Offer Views on Health Issues

October 15, 2018

Potassium Iodide Pill Distribution To Start For Windsor And Essex County Wednesday

October 17, 2018

Health Unit Wants To Know What You Think Of Supervised Injection Services

October 24, 2018

All Recreational Properties Now Completely Smoke Free

Note: The request from St. Clair College did not result in a publicly available reported story.

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


View Document page

Prepared By:

Dave Jansen, Performance Improvement and Accountability Coordinator, Planning and Strategic Initiatives Department

Date:

November 5, 2018

Subject:

Risk Management

Background

In spring 2018, the Planning and Strategic Initiatives Department was tasked to maintain the corporate risk registry. The new risk registry was approved by the Leadership Team, and an Information Report was submitted to the Board of Health in March 2018 to detail the updates.

Current Initiatives

As part of the Q3 Financial Report to the Ministry, health units have been asked to submit a list of corporate risks and mitigation strategies. The Ministry developed a template to harmonize efforts in tracking risk across the province, using consistent language in documenting corporate risk.

This process builds upon the risk management system the WECHU already has in place. The WECHU risk registry identified 36 risks across 14 categories, with 18 risks scoring “high” before consideration of mitigation strategies. The Ministry requires reporting of up to 10 highly ranked risks. The WECHU’s submission includes the highest ranking risks.

As part of the 2019 operational planning process, work plans were created across the organization for risk mitigation in identified areas. Development of key risk indicators and the commencement of departmental risk categorization will occur next year.

Consultation:

The following individuals contributed to this report:

  • Marc Frey, Planning and Strategic Initiatives
  • Kristy McBeth, Knowledge Management

Approved by:

 Theresa Marentette

 


View Document page

Prepared By:

Dave Jansen, Performance Improvement and Accountability Coordinator, Planning and Strategic Initiatives Department

Date:

November 5, 2018

Subject:

Board of Health Education Sessions – Summer 2018

Background

As per the Ontario Public Health Standards, the Board of Health is required to ensure that board members are aware of their roles and responsibilities and emerging issues and trends by ensuring the development and implementation of a comprehensive orientation plan for new board members and a continuing education program for board members. To this end, the WECHU provides various education sessions to the board of health membership. Topics and frequency are chosen based on identified and perceived need. Two education sessions were held this past summer, on the topics of health equity and the departmental programming updates under the new standards. This report is a summary of the post-session evaluations.

Current Initiatives

July Board of Health Education Session: Health Equity

The first education session was delivered to increase board awareness and competency on the topic of health equity. Health equity was identified as an area needing improvement on the 2017 Board of Health competency-based self-assessment. Objectives of the session were to enhance Board of Health members’ knowledge of key concepts and increase their ability to take health equity promoting approaches. Twelve Board of Health members attended this education session.

After the education session, a survey was distributed to determine if objectives were met, obtain feedback to inform and enhance future sessions, and assess and reinforce key session content. Eleven of the 12 attending board members filled out this survey, all of whom strongly agreed or agreed that the session was worthwhile, stated objectives were met, and the session increased their understanding of ways to help promote health equity.

Furthermore, 91% of respondents strongly agreed or agreed that the session helped them better understand what things make it harder for people to be healthy, and where to find more information about health equity. They also strongly agreed or agreed that the session informed them on approaches the WECHU is taking to reduce health inequities, and increased their confidence to take action in addressing health inequities.

Nearly two thirds (64%) of the respondents indicated that they planned to take action based on what they learned from the session within the next three months. These respondents were prompted to share comments of how they planned to take action, which included actions related to board roles as well as work outside of the organization. Responses included ensuring the WECHU’s operating budget supports programs and services consistent with the Health Equity Plan. There was also discussion on sharing health equity promoting concepts with municipal and workplace colleagues, as well as raising awareness through conversations with other institutions. Respondents also suggested they would act on advancing health equity policies, incorporating knowledge into strategic planning, and incorporating session materials and knowledge into their own presentations.

When asked how they would rate the training overall, all respondents indicated that the training was excellent or very good, and that the speaker presented effectively. Positive remarks about the preparation, knowledge, and enthusiasm conveyed throughout the presentation were shared.

August Board of Health Education Session: Department Updates

The second education session provided an update on recent initiatives in six different health unit departments. Presentations were given by health unit staff on various topics, including the public disclosure system, West Nile Virus/enhanced mosquito surveillance, potassium iodide distribution, school suspensions, school-aged health promotion, migrant farm TB and STBBI testing, mental health, and oral health programming. Eight board of health members attended this session, including one by teleconference. All eight members completed the post-session evaluation survey, on which they all reported the education session was excellent or very good.

Seven of the eight respondents strongly agreed or agreed that the education session was worthwhile, the information was presented clearly and effectively, and that the stated objectives were met. The same number of respondents strongly agreed or agreed that the session satisfied their personal expectations, was relevant to their role as board members, and provided them with new knowledge, which they intended to use.

Five respondents strongly agreed or agreed that the session provided them with new skills, and seven respondents strongly agreed or agreed that they plan to use the skills they’ve learned.

Six respondents (75%) said the session was well organized. When asked what the most useful part of the session was, a common theme was clarity. Respondents wrote that the clarification on roles, responsibilities, and tasks that the WECHU staff undertake was useful, and that it was a good reminder of how much happens at the health unit and the passionate staff at work. Also mentioned was the material that covered relevant legislation, and the information provided about migrant farm workers. 

Respondents were asked how they will apply what they’ve learned to their role on the Board of Health. Respondents said the education session helped them understand what public health does, which will help them in better board decision making, and enrich their discussions at board meetings and with the community. When asked to share any additional comments or suggestions, one said it was a lot of information to pack into one session, since they already have board information reports for each board meeting, there may be the ability to condense. Another said more detail would have been helpful for the number of positive results of zoonotic diseases, in addition to the number of cases investigated. Others commented on the improvement over prior presentations, and complimented the health unit for keeping the board up to date on issues that affect the health and safety of the public.

Lastly, respondents were asked to identify any additional training aspects that would be of interest in their capacity as a Board of Health member. Two respondents suggested a greater explanation of the functions of the board of health after the municipal election takes place, including topics of board governance, board bylaws, Roberts Rules of Order, legislative requirements, and ways to support WECHU leadership and staff. One respondent said that public health represents a huge piece of health care and it deserves a broad educational piece so that the board can appreciate its diversity of programs. Another suggested using the extra time after short meetings for staff to make presentations, whether it’s a new topic or to reinforce what is already known. There was also one comment on having a built environment bike tour around the city to go see the local active transportation facilities and learn about associated health impacts.

Consultation:

The following individuals contributed to this report:

  • Marc Frey, Planning and Strategic Initiatives
  • Jennifer Johnston, Planning and Strategic Initiatives
  • Kristy McBeth, Knowledge Management

Approved by:

 Theresa Marentette

 


View Document page

Prepared By:

Tiffany Gartner-Duff, Performance Improvement & Accountability Coordinator (PIAC), Planning & Strategic Initiatives Department

Date:

November 5, 2018

Subject:

Quarter #3 Planning Report

Background:

Public health units are required to submit an Annual Service Plan (ASP) to the Ministry of Health and Long Term Care (MOHLTC) each year. The Ontario Public Health Standards (OPHS) requires that “the board of health shall develop and implement a Board of Health Annual Service Plan and Budget Submission to include all programs and services delivered by boards of health and program costing for ministry-funded programs”. The Planning and Strategic Initiatives (PSI) department worked with the Information Technology (IT) department to align our planning system with the MOHLTC requirements to ensure a single, integrated approach to planning for 2019.

Current Initiatives:

Beginning in June 2018, the PSI department provided planning training sessions with staff and management from all divisions. The PSI department then worked with departments to align the 2019 organizational planning outcomes with the MOHLTC requirements, and to ensure consistency in the work plans across the organization. Staff members developed and entered their work plans for 2019; the work plans were then reviewed and approved by the leadership team.

During this quarter, the WECHU received feedback from the MOHLTC from the 2018 ASP submission and was able to incorporate suggested changes for improvement into the 2019 ASP. The MOHLTC has yet to provide the complete standard reporting structures for the 2019 ASP. Pending the receipt of the updated templates, the PSI department will work with IT to integrate these requirements into the planning system.

Consultation:

The following individuals contributed to this report:

  • Kristy McBeth, Knowledge Management
  • Marc Frey, Planning and Strategic Initiatives

Approved by:

 Theresa Marentette

 


View Document page

Prepared By:

Tiffany Gartner-Duff, Performance Improvement & Accountability Coordinator (PIAC), Planning & Strategic Initiatives Department

Date:

November 5, 2018

Subject:

Q3 Strategic Plan Report 

Background:

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

The Ontario Public Health Standards (2018), under the Good Governance and Management Practices Domain states that “the Board of Health shall provide governance direction to the administration and ensure that the board of health remains informed about the activities of the organization on the following: organizational effectiveness through evaluation of the organization and strategic planning”.  In alignment with fulfilling this Ministry requirement, in early 2018 the Planning and Strategic Initiatives department implemented a corporate tracking system to monitor Strategic Plan performance and to provide quarterly and annual updates to the Board of Health. In the first and second quarters of 2018, progress was made on a number of objectives, while more work was needed to move others forward.

Current Initiatives:

The 2018 Q3 Strategic Plan Progress Report provides the objectives under each strategic priority with corresponding Q3 updates to measure our advancement towards achieving the goal. The colour-coded state for most of the objectives remained consistent from Q2, however progress has continued on most of the strategic objectives. Many are new initiatives which are multi-year strategies and difficult to achieve 100% compliance at this point in time. That being said, the WECHU is on-track towards achieving all objectives by 2021.

Consultation:

The following individuals contributed to this report:

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

Approved by:

 Theresa Marentette

 


View Document page

Board Members Present:

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

Board Member Regrets:

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

Administration Present:

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

Administration Regrets: 

Nicole Dupuis, Kristy McBeth

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

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

  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: October 18, 2018
      It was moved
      That the minutes be approved - CARRIED
  5. Presentation – Topical Issues: Dr. Wajid Ahmed
    Opioid Related Morbidity and Mortality in Windsor-Essex County
    Dr. Wajid Ahmed provided information to the Board on problematic drug use in our communities, noting the sudden spike in the use of various drugs.  How did this happen?  The sudden increase stems from several factors, one being psychological, social and biological risk factors like genetics, mental health, early life experiences, trauma, poverty, lack of secure housing and other determinants of health.  Another factor is the misunderstanding of the addictive risk of prescribed opioids.  Previously, in the 1990’s, pharmaceutical companies designed opioids that reduced pain and symptoms, though lack of awareness of alternative treatments for pain led to, in some cases, over-prescribing, as well as unintended consequences such as addiction.

    The lack of access to prescribed opioids has led to theft of prescription opioids by friends and family members and illicit opioid use.  Illegal drugs are frequently laced with other substances like fentanyl leading to serious, and sometimes fatal, consequences.

    Addiction vs Dependence
    Addiction
    A chronic, relapsing disorder characterized by compulsive drug seeking and use despite harmful consequences, as well as the drug providing desired euphoric effects

    Dependence
    A condition that can occur with regular use of drugs even if prescribed and used as prescribed. Characterized by withdrawal symptoms when stopped – a person can be dependent without being addicted but dependence sometimes leads to addiction

    Public health’s role in this complex problem is leveraging our partnerships. By collaborating and coordinating with other various organizations we can all be part of the solution through harm reduction activities, i.e. clean needle distribution, naloxone distribution, SIS/Consumption sites, and the advocacy piece for more funding and more resources for our communities.  Data collection from various agencies pulled together help to paint a better picture of what is happening in our region. Short term steps are sharing data with relevant agencies and advocating for funding for treatment and rehabilitation/harm reduction services.

    What is happening here is a significant problem and it is happening across the country.  In 2016, WECHU formed the Windsor Essex Community Opioid Strategy Leadership Committee (WECOS-LC) to develop community wide response focusing on opioid related morbidity and mortality, and to ensure implementation across multiple sectors and address the following four pillars of the WECOS:
    1) Prevention/Education
    2) Harm Reduction
    3) Treatment
    4) Enforcement

    This leadership is tasked with ensuring the feasibility of suggested interventions as well as assisting in the implementation of effective, local and sustainable solutions for opioid use and overdose prevention.  Effort was made to include people with lived experience to ensure they have direct input into the high-level planning of the strategy.

    T. Marentette is currently conducting Key Stakeholder Interviews as part of the Supervised Injection Services Community Consultation study.  The purpose of this study is to:
    • Look at how the community in Windsor view supervised injection services and identify any concerns
    • Explore potential clients’ willingness to use supervised injection services
    • Identify how the services should be delivered to meet the needs of people who inject drugs

    This study will help with decisions about supervised injection services and identify any questions or concerns.

    Various discussion continued on Naloxone distribution.  EMS are equipped with Naloxone but Fire and Police Services do not. In order to save lives First Responders need to be equipped with Naloxone and we need to be able to provide services where people can safely inject drugs – Windsor is not one of those sites that have been approved.

    Rapid Action Addition Medicine Clinics (RAAM) are medical clinics for individuals who are looking for help in regards to their substance use. The doctors at these clinics have experience treating individuals struggling with alcohol or opioid use. Doctors assess each individual and develop a treatment plan accordingly, and referrals to community organizations for further support can be arranged.  These clinics have been implemented in many communities, but not in Windsor.  We need to increase our budget to cover costs within our communities, and when we do request more funding/resources we need to have a game plan and accurate data.  The Board of Health will be kept informed of any progress and if further funding from the Ministry is not forthcoming, we may need to speak with our local funders.

    In closing Dr. Ahmed noted that the Windsor-Essex region needs more treatment and rehabilitation services so people who need them can be guided to treatment.

  6. Consent Agenda:
    1. Information Reports
      The following information reports were presented to the Board.
      1. Q3 Strategic Plan Report/Q3 Strategic Plan Progress Report
      2. Q3 Planning Report
      3. BOH Education Sessions – Summer 2019
      4. Risk Management

      It was moved
      That the information reports be received. - CARRIED

  7. Business Arising – None
  8. Board Correspondence – Circulated
  9. New Business – None
  10. Board Correspondence/Other Health Unit Letters/Resolutions
    1. alPha – Update to BOH Members – For Information – October 26, 2018 – various links and items of interest
    2. Opioid Crisis – National Drug Strategy – For Support - Southwestern Public Health – Oxford, Elgin, St. Thomas – Letter to Hon. Premier Doug Ford
      It was moved
      That the above correspondence be Supported and Received - CARRIED
  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 4:57 p.m. - CARRIED
    It was moved
    That the Board move out of Committee of the Whole at 5:15 p.m. - CARRIED
  12. Next Meeting: At the Call of the Chair, or December 20, 2018 in Windsor, Ontario
  13. Adjournment
    The meeting adjourned at 5:20 pm.

RECORDING SECRETARY:

SUBMITTED BY:

APPROVED BY:


View Document page

October 18, 2018

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

  1. Call to Order
  2. Agenda Approval
  3. Announcement of Conflict of Interest
  4. Approval of Minutes
    1. Regular Board Meeting:  September 20, 2018
  5. Consent Agenda
    1. INFORMATION REPORTS:
      1. Budget – Recommendation Report  (L. Gregg)
        • Resolution Recommendation
      1. Cannabis – Recommendation Report (N. Dupuis)
        • Resolution Recommendation
      1. Vote for Health Survey Results (T. Marentette)
      2. Community Partners List 2018 (T. Marentette)
      3. September Media Relations Recap (K. McBeth)
  6. Business Arising
    1. PGC Capital Project Update (T. Marentette)
  7. Board Correspondence – Circulated
  8. New Business
    1. Staff Appreciation (D. Sibley)
  9. Other Board of Health Resolutions/Letters – For Support/Information
    1. Smoke-Free Ontario Act – For Support
      1. alPHa – Letter to Laura Pisko, MOHLTC
      2. Peterborough Public Health – Letter to Hon. Christine Elliott
    2. Ontario’s Basic Income Pilot – For Support/Information
      1. Windsor-Essex County Health Unit – For Information – Letter to Hon. Lisa McLeod
      2. Southwestern Public Health – For Support – Letter to Hon. Lisa McLeod
    3. Why Ontario Needs a Chronic Disease Prevention Strategy – For Support
      1. Kingston, Frontenac and Lennox & Addington Public Health – Letter to Hon. Christine Elliott
    4. Drug Policy – For Support
      1. Kingston, Frontenac and Lennox & Addington Public Health – Letter to Right Hon. Justin Trudeau
    5. Repeal of Section 43 of the Criminal Code of Canada – For Support
      1. Southwestern Public Health – Letter to Hon. Jody Wilson-Raybould
    6. Dedicated Funding for Local Public Health Agencies – Cannabis Sales – For Support
      1. Middlesex-London Health Unit – Letter to Premier Doug Ford
    7. Displays and Promotion of Vaping Products in Convenience Stores and Gas Bars – For Information
      1. Ontario Campaign for Action on Tobacco (OCAT) – Media Release
  10. Committee of the Whole (Closed Session in accordance with Section 239 of the Municipal Act) 77
  11. Next Meeting: At the Call of the Chair, or November 15, 2018 –  Windsor
  12. Adjournment

View Document page

Prepared By:

Melissa Valentik, Health Promotion Specialist

Eric Nadalin, Manager, Chronic Disease and Injury Prevention

Date:

October 5, 2018

Subject:

Non-Medical Cannabis Legalization

Background

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

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

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

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

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

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

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

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

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

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

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

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

WECHU Activities to Date

Internal Health Promotion Collaboration – WECHU Cannabis Legalization Working Group

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

Internal Staff Training and Knowledge Assessment

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

Community Environmental Scan

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

Cannabis Mass Media Campaign

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

Community Outreach and Presentations

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

Current and Future Initiatives

Windsor-Essex Cannabis Community of Practice

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

Municipal Engagement

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

Teachers, Schools, and School Boards

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

Employers and Workplaces

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

Social Service and Healthcare Providers

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

Ongoing Surveillance and Monitoring

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

Provincial Collaboration

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

Approved By:

Theresa Marentette, CEO

References

 

 


View Document page

Prepared By:

Jessica Kipping-Labute

Date:

October 18, 2018

Subject:

“Vote for Health” Municipal Election Survey Results

Background

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

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

Results Summary

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

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

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

Next Steps

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

Consultation:

The following individuals contributed to this report:

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

Approved By:

Theresa Marentette, CEO


View Document page

Prepared By:

Communications Department

Date:

October 1, 2018

Subject:

September Media Relations Recap Report

August Media Coverage

Total Media Coverage

45

Interview Requests

21

Mentions (In the news without direct interviews)

24

September 2018 Media Relations Recap - Media Coverage

Story Source

September 2018 Media Relations Recap - Story Source

Media Coverage

Outlet

Number of Stories

AM 800

8

Blackburn

11

CBC

7

CBC – Radio Canada

1

CTV

7

St. Clair College

1

Windsor Star

5

windsorite.ca

5

TOTAL

45

News Release and Media Advisories

Date Type Headline Response

September 4, 2018

Heat Warning

Windsor-Essex County Health Unit Issues Extended Heat Warning

2 Stories Reported

September 5, 2018

News Release

Vote for Health: Municipal Candidates Asked to Share Their Views on Local Health Issues

1 Story Reported

September 14, 2018

News Release

Death Related to West Nile Virus Confirmed

5 Stories Reported

September 18, 2018

Media Advisory

Windsor-Essex County Health Unit Board of Health Meeting

3 Stories Reported

September 19, 2018

News Release

Students in Senior Kindergarten to Grade 5 with Incomplete Immunization Records Suspended from School Today

9 Stories Reported

September 20, 2018

News Release

Register for the Screen-Free Meal Time Challenge today!

0 Stories Reported

September 21, 2018

News Release

Windsor-Essex County Health Unit Board of Health Confirms Selection of New Medical Officer of Health and Chief Executive Officer

3 Stories Reported

September 24, 2018

News Release

Windsor-Essex Joins World Rabies Day Activities By Offering Low-Cost Rabies Vaccine Clinics

3 Stories Reported

Stories Reported by the Media

AM 800

Publish Date

Title

September 10, 2018

Health Unit Looks For Feedback From Municipal Candidates

September 14, 2018

Windsor-Essex Resident Dies Of The West Nile Virus

September 18, 2018

Lynn Martin - 10AM – Immunization Deadline In Windsor

September 19, 2018

Parents Pack Health Unit To Update Immunization

September 24, 2018

A New Medical Officer Of Health For Windsor-Essex

September 25, 2018

Questions Remain Ahead of Pot Legalization

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

Blackburn News

Publish Date

Title

September 2, 2018

No swimming recommended at three local beaches this week

September 4, 2018

Stifling heat prompts extended heat warning

September 10, 2018

Suicide Awareness Raised In Windsor-Essex

September 12, 2018

No Swimming At Four Recommended At Four Local Beaches This Week

September 14, 2018

West Nile virus claims local victim

September 14, 2018

Hep A Scare In Michigan Prompts Vaccination Clinic In Windsor

September 14, 2018

Walk Promotes Suicide Prevention One Step At A Time

September 19, 2018

School Suspensions Start Today For Kids Who Are Not Vaccinated

September 20, 2018

Health Unit Seeks To Clear The Air On Weed Guidelines

September 23, 2018

Health Unit Make Top Executive Positions Permanent

September 25, 2018

Veterinarians Offer Low Cost Rabies Vaccine Clinics

CBC News

Publish Date

Title

September 4, 2018

Windsor's heat warning extended to Wednesday

September 10, 2018

Mosquito Trap Tests Positive For West Nile Virus In Chatham-Kent

September 17, 2018

Meet The People Running For Council In Windsor

September 21, 2018

Swimmers Beware, More Warnings For West Belle River Beach Than Others

September 19, 2018

578 Students In Windsor-Essex Suspended Due To Incomplete Immunization Records

September 21, 2018

8 Opioid-Related Deaths In Windsor-Essex January To March This Year

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

CBC - Radio Canada (French)

Publish Date

Title

September 19, 2018

Vaccination : près de 600 élèves suspendus dans Windsor-Essex

CTV News

Publish Date

Title

September 13, 2018

Time running out for parents to update immunization records

September 14, 2018

Windsor-Essex County Health Unit Confirms Death Related To West Nile Virus

September 14, 2018

Mosquitoes From Chatham-Kent Trap Test Positive For West Nile Virus

September 19, 2018

Over 500 Windsor-Essex Students Suspended Due To Incomplete Immunization Records

September 21, 2018

More Questions Than Answers About Legalized Marijuana

September 24, 2018

Used Needle Found By Students At Windsor School

September 28, 2018

Some Windsor-Essex Vets Offering Low-Cost Rabies Vaccine Clinics

Windsor Star

Publish Date Title

September 16, 2018

First Local West Nile Death Of The Year Confirmed

September 19, 2018

Hundreds Of Students Suspended For Incomplete Immunization Records

September 20, 2018

Students Discover Discarded Syringe In Schoolyard

September 24, 2018

$30 Rabies Shots Available For Dogs, Cats On World Rabies Day

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

Windsorite.ca

Publish Date Title

September 13, 2018

Final Weekend Beach Report: Swimming Not Recommended Four Local Beaches

September 14, 2018

One Person Dies From West Nile Virus

September 14, 2018

Health Unit Holding Hepatitis A Vaccination Clinic For Those Who Attended The Michigan Renaissance Festival

September 19, 2018

Over 500 Students Suspended For Incomplete Immunization Records

September 21, 2018

News Medical Officer Of Health And Chief Executive Officer Chosen To Lead Health Unit

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

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


View Document page

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

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

2019 Budget Report - PDF (PDF)
View Document page

Background

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

Demographics

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

Table 1: Respondents by position

Position

# of candidates

# of respondents

Mayor

19

8 (42%)

Deputy Mayor

16

11 (69%)

Councillor

139

68 (49%)

Total

174

87 (50%)

Table 2: Respondents by municipality

Municipality

# of candidates

# of respondents

Amherstburg

20

11 (55%)

Essex

19

8 (42%)

Kingsville

17

12 (71%)

Lakeshore

25

14 (56%)

Lasalle

12

5 (42%)

Leamington

19

10 (53%)

Tecumseh

12

9 (75%)

Windsor

50

18 (36%)

Total

174

87

Resource Allocation

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

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

Table 3: Average dollar amount per health issue

Health Topic

$

Mental illness

25.49

Substance misuse

16.21

Built environment

13.76

Food insecurity

13.28

Health inequity

13.14

Dental health

9.55

Climate change

8.57

Vote for Health - Total dollar amount per health issue

Candidate Actions

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

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

Actions selected by health topic

Table 4.1 Dental Health

Action

Yes

No

Put fluoride into the water in your community.

8.05%

91.95%

Increase support for dental health education and awareness.

59.77%

40.23%

Advocate for increased funding for dental health services and expansion of public dental programs.

63.22%

36.78%

Advocate for a provincially-funded dental health program for low income adults and seniors.

67.82%

32.18%

Table 4.2. Substance Misuse

Action

Yes

No

Advocate for sustained resources to address the rising rates of substance misuse.

73.56%

26.44%

Support local efforts to investigate the feasibility of safe injection sites.

27.59%

72.41%

Increase availability of naloxone and needle disposal bins in your community.

37.93%

62.07%

Advocate for increased timely access to treatment services and supportive housing for people struggling with addiction.

77.01%

22.99%

Table 4.3. Food Insecurity

Action

Yes

No

Implement, promote, and support the Living Wage program.

43.68%

56.32%

Support local programs, such as farmer’s markets, community gardens, and community kitchens.

83.91%

16.09%

Participate in the Windsor-Essex Food Policy Council to help shape a sustainable and healthy food system.

65.52%

34.38%

Implement a local food procurement policy for all municipally run facilities (e.g., recreation centres, day cares, etc.)

50.57%

49.43%

Table 4.4. Climate Change

Action

Yes

No

Advocate for ways to improve local air quality (e.g., anti-idling policies).

59.77%

40.23%

Provide support and resources to develop response plans for extreme weather events.

58.62%

41.38%

Prevent diseases such as Zika Virus, Lyme Disease, and West Nile Virus by allocating more funding and support for surveillance and education.

50.57%

49.43%

Advocate for increased education and support to protect our public beaches, preventing beach closures, as well as blue green algae.

65.52%

34.48%

Table 4.5. Mental Illness

Action

Yes

No

Advocate for funding for low- or no-cost mental health care, to increase local access to treatment.

88.51%

11.49%

Support training for first responders and front-line service providers to effectively help people living with mental illness.

87.36%

12.64%

Support local mental health awareness campaigns.

81.61%

18.39%

Table 4.6: Built Environment

Action

Yes

No

Advocate for investments in active transportation infrastructure (e.g., bike trails, walking paths, sidewalks) and public transit.

79.31%

20.69%

Support by-laws, policies, and planning that encourages healthy design characteristics (e.g., safe bike lanes, lighting, green space, parks, walkability).

71.26%

28.74%

Enhance neighborhood walkability by supporting higher residential density and mixed land use.

50.57%

49.43%

Advocate for increased natural and built shade structures.

58.62%

41.38%

Table 4.7: Health Inequity

Action

Yes

No

Ensure there is a wide range of safe and affordable housing options, including rental accommodations.

68.97%

31.03%

Expand opportunities for residents to gain safe and secure jobs with fair pay.

63.22%

36.78%

Increase access to affordable community and recreation programming.

64.37%

35.63%

Support the development and expansion of municipal social investment plans and poverty reduction strategies.

65.52%

34.48%

Table 5: Actions selected by percentage

Action

Selected

Advocate for funding of low- or no-cost mental health care, to increase local access to treatment.

88.51%

Support training for first responders and front-line service providers to effectively help people living with mental illness.

87.36%

Support local programs, such as farmer’s markets, community gardens, and community kitchens.

83.91%

Support local mental health awareness campaigns.

81.61%

Advocate for investments in active transportation infrastructure (e.g., bike trails, walking paths, sidewalks) and public transit.

79.31%

Advocate for increased timely access to treatment services and supportive housing for people struggling with addiction.

77.01%

Advocate for sustained resources to address the rising rates of substance misuse.

73.56%

Support by-laws, policies, and planning that encourages healthy design characteristics (e.g., safe bike lanes, lighting, green space, parks, walkability).

71.26%

Ensure there is a wide range of safe and affordable housing options, including rental accommodations.

68.97%

Advocate for a provincially-funded dental health program for low income adults and seniors.

67.82%

Participate in the Windsor-Essex Food Policy Council to help shape a sustainable and healthy food system.

65.52%

Advocate for increased education and support to protect our public beaches, preventing beach closures, as well as blue green algae.

65.52%

Support the development and expansion of municipal social investment plans and poverty reduction strategies.

65.52%

Increase access to affordable community and recreation programming.

64.37%

Advocate for increased funding for dental health services and expansion of public dental programs.

63.22%

Expand opportunities for residents to gain safe and secure jobs with fair pay.

63.22%

Increase support for dental health education and awareness.

59.77%

Advocate for ways to improve local air quality (e.g., anti-idling policies).

59.77%

Provide support and resources to develop response plans for extreme weather events.

58.62%

Advocate for increased natural and built shade structures.

58.62%

Implement a local food procurement policy for all municipally run facilities (e.g., recreation centres, day cares, etc.)

50.57%

Prevent diseases such as Zika Virus, Lyme Disease, and West Nile Virus by allocating more funding and support for surveillance and education.

50.57%

Enhance neighborhood walkability by supporting higher residential density and mixed land use.

50.57%

Implement, promote, and support the Living Wage program.

43.68%

Increase availability of naloxone and needle disposal bins in your community.

37.93%

Support local efforts to investigate the feasibility of safe injection sites.

27.59%

Put fluoride into the water in your community.

8.05%


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