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December 17, 2020

PREPARED BY

Lorie Gregg, Director of Corporate Services

DATE

December 17, 2020

SUBJECT

Q2 Financial Results

BACKGROUND

The Leadership Team of the Windsor-Essex County Health Unit (“the WECHU”) monitors financial results on an on-going basis for related programs funded 100% by the Ministry of Children, Community and Social Services (“MCCSS”).  These programs are:

  • Healthy Babies Healthy Children Program;
  • Prenatal and Postnatal Nurse Practitioner Program.

The budgets for these programs were approved by the Board of Health for the WECHU on May 21, 2020.  On October 30, 2020, the budgets were formally submitted to the MCCSS along with financial information for the period April 1, 2020 to September 30, 2020.  Details of that submission is included in the narrative below.

Of noteworthy mention is the following:

  • The MCCSS required that financial information for the aforementioned programs, both budget and year-to-date actuals, be reported on a combined basis.  For consistency with the WECHU’s presentation of the 2020/2021 budgets on May 21, 2020, the WECHU has continued to report these programs separately.
  • The prior year’s comparative information for the aforementioned programs has not been presented due to the change the MCCSS change in fiscal years (was January to December; now April to March).

On September 30, 2020, the MCCSS launched the Transfer Payment Ontario (TPON) system.  The TPON will enhanced transfer payment business processes and reduce administrative burden on service providers, enhance efficiency and improve outcomes and the overall client experience.  More specifically, transfer payment recipients such as the WECHU will be able to submit financial and non-financial reporting requirements to the MCCSS on-line.

HEALTHY BABIES HEALTHY CHILDREN PROGRAM INITIATIVE

 

 

Annual Budget

Budget at 09 30 2020

Actual 09 30 2020

Variance – Budget from Actual

Salaries and benefits

2,583,600

1,311,695

1,067,842

176,209

Operating expenditures:

 

 

 

 

     Mileage

60,000

30,000

9,233

20,638

     Travel and meetings

3,000

1,500

3,000

1,500

     Professional development

10,400

5,200

10,400

5,200

     Program supplies

83,841

22,026

44,051

17,599

     Purchased services

15,000

7,500

15,000

6,382

Total operating expenditures

172,241

66,226

132,451

51,319

Total budget

2,755,841

1,377,921

2,755,841

227,528

The Heathy Babies Healthy Children Program Initiative supports 26 FTEs comprised of managers (2), nurses (16), family home visitors (4), social worker (1.0) and support staff (3.0).  The objective of the program is to ensure a healthy future for children and their families.  Total funding envelope for this program initiative is $2,755,841. 

PRENATAL AND POSTNAL NURSE PRACTITIONER PROGRAM INITIATIVE

 

Annual Budget

Budget at  09 30 2020

Actual 09 30 2020

Variance – Budget from Actual

Salaries and benefits

139,000

69,500

71,179

1,679

Total budget

139,000

69,500

71,179

1,679

The Nurse Practitioner Program Initiative supports 1.0 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.  Total funding envelope for this program is $139,000.

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DATE

December 17, 2020

SUBJECT

Oral Health Program Update

BACKGROUND

The novel Coronavirus (COVID-19) has affected many public health services, including the WECHU’s oral health program. Those services include the Healthy Smiles Ontario (HSO) and the Ontario Seniors Dental Care Program (OSDCP) dental clinics, as well as in-school dental and vision screening programs.

ORAL HEALTH

Following guidance from the Royal College of Dental Surgeons of Ontario (RCDSO) and the Ministry of Health, the WECHU suspended all non-essential and elective dental services on Monday, March 16, 2020 and redeployed oral health staff to the COVID-19 response.  Dental screenings in schools were suspended and the clinic remained open in Windsor for emergency services only until June 22, providing 79 office visits from March.

Due to the shutdown, 2,377 OSDCP and HSO appointments had to be cancelled. Following the health care sector restart guidance from the Ministry of Health, the Windsor clinic resumed full operations at the end of June, while the reopening of the Leamington clinic was gradual and operational at the end of August. All oral health staff have returned to the department, while continuing to support the COVID-19 call centre as part of their regular duties. As of November 26, 2020, 93% of the 2,377 appointments have been contacted and rescheduled.

All dental screening and vision screening programs have been suspended at this time.

In the 2019/20 school year:

  • 73 schools of the 123 schools required for dental screening were completed
  • 8,300 children screened, approximately 6,673 children were un-screened under the oral health screening program
  • 2,840 (68%) of SK students attending 78 Windsor-Essex elementary schools received vision screening. 35 schools were not completed.

CURRENT INITIATIVES

COVID-19 has affected many public health programs and services, including future program operations. In addition, infection prevention and control measures call for limiting the number of essential visitors in the school. As a result, school dental and vision screening may not resume in 2020-2021.

The WECHU has partnered with the Southwest Ontario Aboriginal Health Access Centre (SOAHAC) to provide free oral health screenings for First Nation, Métis, and Inuit (FNMI) people and their families. A Registered Dental Hygienist (RDH) from the WECHU works at the SOAHAC Windsor location bi-weekly, providing dental screenings and oral hygiene instruction to their clients. This service had been shut down due to COVID-19 but was reinstated on November 23, 2020.

ORAL HEALTH PROGRAMS

Baby Oral Health Program (BOHP)

Parents of babies born at Windsor Regional Hospital usually receive an infant dental education kit. Despite being put on hold due to COVID-19, this service resumed in July. So far this year, 1,802 bags were delivered to the hospital for distribution.

WECHU Healthy Smiles Ontario and Ontario Seniors Dental Care Plan

PROGRAM

# of CLIENTS

# of VISITS

OSDCP (WECHU)

408

1,392

OSDCP (CKPHU)

26

76

HSO – EESS

379

769

HSO – CORE

727

1,062

HSO - PSO

846

1,229

TOTAL

2,386

4,528

We have a high patient volume and due to reduced clinical services for four months, we have experienced a slight backlog in treatment. Approximately 40-45 HSO and OSDCP clients are seen daily across the two clinic locations. We are currently booking into March 2021 for certain dental procedures. From January 2020 to November 2020 the WECHU saw 2,386 HSO and OSDCP clients for 4,528 appointments.

The OSDCP began at the WECHU in January 2020, providing free, routine dental services for low-income seniors 65 years of age or older. Since the program’s provincial implementation in November 2019, 1,002 seniors from the Windsor-Essex area enrolled in the program. Each client requires a new patient exam. To date we have completed 405 new patient exams therefore, we can determine that we have seen 40% of the seniors that have enrolled into the OSDCP program in this region. Our contract denturist has completed 88 denture consultations.

Currently, we have one full-time dentist, four contract dentists and a contract denturist. We plan to bring on a second full-time dentist in 2021.

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DATE

December 17, 2020

SUBJECT

Healthy Families Department and Healthy Babies, Healthy Children Program Update

BACKGROUND

Healthy Babies, Healthy Children Program (HBHC) is a provincial home visiting program designed to help children get a healthy start in life through nursing and peer support. The program supports the most vulnerable and marginalized families in our community with the goal of improving developmental outcomes. HBHC has three entry stages namely; Prenatal; Postpartum; and Early Identification; and requires screening to identify a family at risk (screen score 2 or >). The HBHC screen identifies a family experiencing a need, issue or risk that may compromise healthy child development; and/or parenting ability; and who may benefit from a more thorough evaluation and receipt of HBHC program services or other community services. HBHC staff utilize standardized assessments and evidence-based interventions to work on family centred goals and develop a Family Service Plan that monitors the progress and achievement of those goals. HBHC is a free voluntary home-visiting program compromised in WECHU of 16 nurses, 4 Family Home Visitors (lay providers) and Social Workers (SW) that support families with:

  • healthy pregnancy and prenatal care
  • developing a positive relationship with their child
  • promoting child’s growth and development
  • connecting families to resources and programs within their community
  • working together with families to help give their child the best start in life

PROGRAM UPDATE

As a result of COVID-19, pandemic-related redeployment significant adjustments were made to service delivery.  Beginning in March 2020, in-person home visits with families were discontinued due to the COVID-19 pandemic. Two nurses and one social worker continued to support 138 existing HBHC families. All visits with families moved to virtual and phone support and any new qualifying parents who wished to participate in the program were placed on a waitlist until June (48). These forms of communication have inherent limitations (e.g., inability to provide hands-on demonstration or effectively observe the home environment) and many clients did not have access to the technology needed to facilitate meaningful interactions. To maintain engagement and support client progress, staff needed to customize service delivery to meet client needs. The HBHC Social Worker has since worked to improve client access to the internet via financial aide.

The Healthy Family’s department hotline has remained operational, triaging calls on healthy growth & development, community resources and breastfeeding. The Lactation Consultant (LC) was also available to provide breastfeeding support over the phone or virtually to both HBHC clients and community members. Due to the cancellation of services and limited supports available to new mothers during the pandemic, the Healthy Families department prioritized calls to all mothers the HF within 48-72 hours of birth.

Lack of departmental engagement of physicians and midwives during this time likely contributed to the significant reduction in referrals to the HBHC program. Overall, referrals decreased by 14% over the pandemic compared to the same period in 2019. This may also be in part due to the absence of HBHC Hospital Liaison nurse.  Prenatal referrals have been the most significantly affected. Only 22 prenatal referrals were received during this time, compared to 160 in 2019. This change warrants further investigation since prenatal intervention within the HBHC program can improve pregnancy outcomes and better prepare families to navigate the challenging newborn stage of parenting.

Currently, HBHC has six (6) public health nurses supporting 161 clients on caseload. Staff have reported an increase in mental health concerns among their clients and increased severity for those with pre-existing anxiety and depression. This may be attributed, at least in part, to the financial strain, isolation, and general uncertainty caused by the pandemic as reported by some clients. In response, WECHU has hired an additional Social Worker for the HBHC program to focus on mental health-related issues. This Social Worker will consult with HBHC staff regarding mental health challenges, provide brief counselling directly to clients, and help clients access appropriate supports within the community.

Additionally, staff have reported that clients continue to struggle to afford healthy food for their families and access affordable housing. Pandemic-related income loss, along with the simultaneous increase in the price of food and housing have placed excessive strain on the program’s low-income families. This strain has left some families looking for ways to save on groceries, including prematurely discontinuing the use of infant formula. Transitioning from infant formula to fluid cow’s milk before nine months is linked to nutrient deficiency that can hinder a child’s lifelong growth and development potential. To ensure that clients have access to the funds they need to afford infant formula or support a nutritious diet for the breastfeeding mother, the department’s Registered Dietitian and HBHC Social Worker are developing a procedure to ensure clients are able to access the province’s Special Diet Allowance in a timely manner. The Special Diet Allowance provides additional funds to families on social assistance who are pregnant, breastfeeding, or reliant on infant formula.  The Social Worker is also continuing to investigate actions to improve access to affordable housing.  

During these unprecedented times, HBHC staff have remained committed to providing the best possible service to the most vulnerable families within our community. We have continued to work and develop processes with our community partners to ensure wrap around care for our families. Outreach to local midwives and physicians has begun with regard to increasing our Prenatal and Early-ID referrals. Additionally, Policies and Procedures have been prepared to safely reinitiate in-person home visits, on a case-by-case basis, in an on-going effort to improve client engagement and adequately address their needs.

COMPARISON OF WITH RISK SCREENS, 2019 & 2020

Entry Level into HBHC- April 1st-November 25, 2019/2020

Screens Completed

Screens with Risk >2

2019

2020

2019

2020

Prenatal

160

22

122

22

Postpartum

2564

2344

1203

1017

Early Identification-18 Month Screening Assessment

75

58

70

37

 

View Document page

Board Members Present:

Gary McNamara, Joe Bachetti, Rino Bortolin, Fabio Costante, Dr. Debbie Kane, Gary Kaschak, Judy Lund, John Scott, Ed Sleiman, Larry Snively 

Board Member Regrets:

Tracey Bailey

Administration

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

QUORUM:  Confirmed

  1. Call to Order
    Board Chair, Gary McNamara, called the meeting to order at 4:01 p.m.

  2. Introduction:  Dr. Felicia Lawal, Acting Director, Health Protection

  3. Agenda Approval

    Moved by:  Judy Lund 
    Seconded by: Rino Bortolin
    That the agenda be approved.
    CARRIED

  4. Announcement of Conflicts of Interest – None
  5. Update (Dr. W. Ahmed)
    1. COVID-19 Update

          Dr. W. Ahmed provided an update on the status of COVID-19 cases in our region and some context on the situation globally. Many countries are experiencing a second wave of the virus, worse than the first, and are implementing more restrictions.  France has had a huge surge and went into complete lockdown in October and numbers reduced.  Case counts in the USA continue to rise and the USA leads in the number of deaths worldwide.  Sweden did not implement many restrictions during the first wave and had the mindset that everyone would contract the virus and that they would then all recover.  That strategy failed and now they are calling for more restrictions as conditions worsen.  Germany stayed strong in the first wave, but continue to see more cases during the second.  Canada is on a steady pathway to see more cases with the second wave than the first, and in Ontario cases continue to climb, including Windsor-Essex. 

      September and October showed a slight decline in our region, but in November and December there was a significant increase.  The Epi curve is steep, with 1,000 cases in the last 10 days.  We may see our case doubling rates happen very quickly.

      When looking at our municipalities from November 1 to today, Leamington has led the way based on their population. In the last 30 days, Windsor leads with 71% of positive cases.

      We have seen a shift in ages with a rise in cases from 0-20 years, which are linked to school cases.  More community transmission is happening with cases coming from every direction.

      The Effective Reproduction Rate is high at 1.36, meaning each case can make 1.36 other cases.  This is of significant concern as Windsor-Essex cases are increasing higher than the provincial rate, putting us just behind the Region of Peel.   We will likely continue to see significantly more cases in Windsor-Essex moving forward.

      R. Bortolin asked with case numbers trending in a negative way how likely are we to see a change in plans other than Grey (Lockdown) for more stringent measures if numbers continue to rise.  Closing schools in our region before Christmas was a local decision, but as Medical Officer of Health (MOH) do you foresee more restrictions coming from the province. Also, are there discussions around travel and restricting movement around the province. 

      Dr. Ahmed said that we are in discussions with other MOH’s whose health units are either in Lockdown or in Red category for a little more consistency across the province instead of being fragmented.  The province share their mobility data from Blue Dot which tracks cell signals.  These signals show that in the GTA area, which is in Lockdown, people are still out.  We are attempting to obtain data around our Canada/USA border but it’s hard to say who is going where and travel is still happening, which is contributing to higher number of cases in the second wave. 

      J. Bachetti said that we often hear in the media about the number of cases under investigation and asked for clarity on what that means.  Dr. Ahmed said that anything we are reporting is a confirmed case even when it is reported as under investigation. A case reported as under investigation, means we do not yet know the source of the exposure.  It could be via close contact, from an outbreak or part of community transmission.  It takes time to conduct interviews by trained nurses to identify the source of exposure based on behaviour and activity over the last 14 days.  

      J. Lund asked about community transmission.  As many people have to attend their place of work, do we have a sense of how much of the population at work are wearing masks and staying socially distant.  Is this part of community transmission or is it individuals who are not masking or following public health guidelines.  

      Dr. Ahmed said that an individual has to have the virus to pass it on.  When we establish the link then we can identify close contacts through investigation which can be linked to wearing or not wearing masks.

      E. Sleiman inquired around the number of cases and capacity at our hospitals. Dr. Ahmed said that the hospitals are stretched and are scaling back elective procedures because of that.  We work with our hospital partners on various issues, but we are not directly involved in operations or their pressures and challenges. R. Bortolin asked about capacity and staffing within the health unit.   Where are the gaps and are we falling behind due to the sheer volume of work. 

      T. Marentette said that pressures are keeping staff very busy and we are stretched to capacity. Case interviews alone include case management and initial calls, discussing signs and symptoms, providing education around the virus, medical follow, lists of contact as well as isolation requirements. Contract tracing is the next piece.  All of this takes a significant amount of time and with the number of positive cases coming in daily, our current resources are not enough.  The City of Windsor has offered to deploy some of their staff to the health unit to assist, but intensive training is required, and interviews and documentation for contact tracing is usually done by medical professionals. We will be discussing this further in Committee of the Whole.

      G. Kaschak asked about further Canada/USA border restrictions and does WECHU know if there has been any more discussions on that.  There seems to be more individuals crossing the international border, not just essential workers.  Dr. Ahmed said he will answer G. Kaschak’s question once he returns to the meeting.  Dr. Ahmed excused himself from the meeting for a brief call.

      4:25 pm – Dr. W. Ahmed left the meeting for a call with the Ministry of Health

      G. McNamara said with 51 nurses, an average of 200 new cases per day, and the complexity to do a proper investigation can easily take up a significant amount of time and would like further discussion around the additional resources required.  Given recent trends, cases are just going to increase.  Dr. D. Kane said there were five retired colleagues that offered to assist, RNs from the Ministry, but the commitment needs to be full time, given the amount of training and time intensive work involved. 

      5:00 pm – Dr. W. Ahmed returns to the meeting 

      In response to G. Kaschaks’ question above, Dr. Ahmed said that we have raised this issue with the Chief Medical Officer of Health for the province, Dr. David Williams, to ask the Federal government to put more restrictions in place around who is crossing border for reasons other than essential workers, namely not health care, and if they are crossing that they consider putting them in a 14-day quarantine.  We have not heard back from the province or anyone else on this issue.  The Federal government controls the Canada/US border so there is not much we can do locally.  Other than that, we have no other updates.  

      Moved by:    Rino Bortolin
      Seconded by:  Judy Lund
      That the information be received.
      CARRIED

  6. Approval of Minutes
    1. Regular Board Meeting: November 19, 2020

      Moved by:  Rino Bortolin
      Seconded by:  Fabio Costante 
      That the minutes be approved.
      CARRIED

  7. Business Arising – None
  8. Consent Agenda
    1. INFORMATION REPORTS

      Moved by:  John Scott
      Seconded by:  Debbie Kane 
      That the information reports be received.
      CARRIED

      1. Healthy Families Department and Healthy Babies, Healthy Children Program Updates (N. Dupuis)
        Brought to the Board for information.
      2. Oral Health Program Update (N. Dupuis)
        Brought to the Board for information.
      3. Influenza Vaccine Update (K. McBeth)
        Brought to the Board for information.
      4. Q2 Financial Report (L. Gregg)
        Brought to the Board for information.
      5. November Communications Recap (L. Gregg)
        Brought to the Board for information.
    2. RECOMMENDATION REPORTS

      1. Bill 216 – An Act to Amend the Education Act – Food Literacy (N. Dupuis)
        The WECHU is requesting a recommendation from the Board.  If implemented this brings food literacy throughout the curriculum from grade 1 to grade 12.  Food skills are connected to healthy eating and will help to curb disease in future.
            
        Moved by:  Rino Bortolin 
        Seconded by:  Joe Bachetti 
        That the recommendation report be received and that the Recommendation be approved.
        CARRIED

  9. New Business

    1. Long Term Service Awards (T. Marentette)
      T. Marentette announced the names of WECHU staff that have more than 20 years of service at the health unit.  G. McNamara and the Board extend their best wishes with heartfelt congratulations.  WECHU staff eligible for long-term service awards are recognized and acknowledged for their years of service annually at December Board of Health meetings.

    2. Records Management (L. Gregg) 
      L. Gregg and N. Dupuis have been looking into an electronic medical records software tool to promote efficient and effective interaction with clients.  The software has several tools that help with client interaction that we can use in several of our departments, oral health, healthy families, IDP, via video.  The software has a referral process imbedded into it and is being utilized by a number of organizations in W-E.  We are bringing this to the Board for approval, and are looking to do this in accordance with our procurement policy.   This software would increase our licensing costs to $15,000 per year for a 100-user model, and in the first year we would incur a one-time cost up front of approximately $10,000. Training would take place virtually.  G. McNamara believes that this is a good investment and use of public health funds, and requested a motion be brought to the Board for approval. 

      Moved by:  Rino Bortolin 
      Seconded by:  Joe Bachetti
      That the Board approve the purchase of an electronic records management system
      CARRIED

      4:54 pm – Chair, G. McNamara, left the meeting – Vice-Chair, J. Scott, assumes the Role of Chair

  10. Other Board of Health Resolutions/Letters
    1. WECHU Letter to The Right Honourable Justin Trudeau – Federal Government Supervision of Self-Isolation Period for Arriving Migrant Workers
    2. Grey-Bruce Public Health Unit – Letter from Board Chair Mitch Twolan – Public Health Regionalization  
    3. Timiskaming Health Unit – Letter to The Honourable Stephen Lecce, The Honourable Christine Elliott, The Honourable Ernie Hardeman – Bill 216 Food Literacy for Students Act 2020

    Moved by: Ed Sleiman
    Seconded by: Judy Lund
    That the information be received.
    CARRIED

  11. Committee of the Whole (CLOSED SESSION, in accordance with Section 239 of the Municipal Act)

    The Board moved into Committee of the Whole at 5:03 pm
    The Board moved out of Committee of the Whole at 6:02 pm

  12. Next Meeting: At the Call of the Chair, or January 21, 2021 – Via Video
  13. Adjournment

    Moved by:  Rino Bortolin
    Seconded by:  Judy Lund
    That the meeting be adjourned.
    CARRIED

    The meeting adjourned at 6:17 pm.

RECORDING SECRETARY:

SUBMITTED BY:

APPROVED BY:

View Document page

November 19, 2020

Meeting held via video.

  1. Call to Order
  2. Agenda Approval
  3. Announcement of Conflict of Interest
  4. Update (W. Ahmed)
    1. COVID-19 Update
  5. Approval of Minutes
    1. Regular Board Meeting: October 15, 2020
  6. Business Arising
  7. Consent Agenda
    1. INFORMATION REPORTS
      1. Student Immunization Catch-up Plan (Grade 7/8) (K. McBeth)
      2. Potassium Iodide (KI) Tablet Distribution Continues during COVID-19 Pandemic (K. McBeth)
      3. Consumption and Treatment Services Site – Application Status (T. Marentette)
      4. October Communications Recap
    2. RECOMMENDTION REPORTS – None
  8. New Business
    1. CEO Quarterly Reports (T. Marentette)
    2. 2021 Board of Health Meeting Schedule
  9. Other Board of Health Resolutions/Letters – For information
    1. WECHU Letter to The Right Honourable Justin Trudeau and The Right Honourable Chrystia Freeland – Basic Income During and After the COVID-19 Pandemic
    2. Grey-Bruce Public Health Unit – Letter to The Honourable Patty Hajdu, the Honourable Marilee Fullerton and Ontario's Long- Term Care COVID-19 Commission – COVID-19 and Long-Term Care Reform – Supporting Simcoe Muskoka District Health Unit's letter regarding same 19
    3. Grey Bruce Public Health Unit – Letter to the Honourable Patty Hajdu and The Honourable Christine Elliott – Municipal Drug Strategy Coordinators Network Ontario, Safe Supply 23
  10. Committee of the Whole (Closed Session in accordance with Section 239 of the Municipal Act)
  11. Next Meeting: At the Call of the Chair December 17, 2020 – Via Video

  12. Adjournment

View Document page

SUBMITTED BY:

Healthy Schools Department (Immunization)

DATE:

November 9, 2020

SUBJECT:

Student Immunization Catch-Up Plan (Grade 7/8)

BACKGROUND

By law, the Immunization of Schools Pupils Act (ISPA) R.S.O.1990 requires children and adolescents attending primary or secondary school to be appropriately immunized against designated diseases, unless they have a valid exemption. Local public health units are mandated to keep and assess immunization records for every student attending school in their region, and provide provincially funded immunization programs through school-based clinics.

Due to COVID-19, a novel highly contagious respiratory virus, the Ontario Government closed all publicly funded schools from March to September 2020.  As a result of these closures, the Windsor-Essex County Health Unit (WECHU) could not implement the spring school-based immunization clinics scheduled for grade 7/8 students. In order to support widespread availability of publicly funded vaccines to protect children from Hepatitis B, HPV, and Meningococcal Disease (Men-C-ACYW135), the WECHU has been working collaboratively with local healthcare providers to ensure students have access to these vaccines in the community. Since May 2020, the WECHU vaccine distribution team has fulfilled school-based vaccine orders from community healthcare providers to administer catch-up vaccines for 1383 students.

CURRENT INITIATIVES

The WECHU will be hosting a series of catch-up clinics beginning on November 2, 2020 to service families with children born in 2006/2007 that were not able to receive their school-based immunizations from the WECHU in spring 2020 or their primary healthcare provider during the on-going COVID-19 pandemic. These clinics are part of a larger Healthy Schools Department strategy aimed at reducing barriers for clients, especially priority populations; and ultimately decreasing the number of students that are behind on their vaccinations. Families will be able to book an appointment during the day, afternoons, evenings, and weekends at the Windsor or Leamington office, or a convenient location in the community. The WECHU will be preparing tailored communications to update families, healthcare providers, school board liaisons, and school administrators regarding options available to students who require immunizations.

The WECHU is also in the process of adapting the delivery method of our immunization education sessions under the Immunization of School Pupils Act (ISPA) to an e-Learning format. Since 2017, a mandatory immunization education session has been a requirement under the ISPA O.Reg 645 for parents seeking a non-medical exemption for their child. These education sessions were historically required to be delivered in-person, but the Ministry of Health has recently eliminated this requirement. Currently, there are about 50 clients on our waiting list. 

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SUBMITTED BY:

Communications Department

DATE:

November 9, 2020

SUBJECT:

October Communications Recap

October Metrics

SOURCE

SEPTEMBER

OCTOBER

DIFFERENCE

News Releases Issued

0

3

+3

Media Advisories Issued

6

1

-5

Media Statements or Notifications

21

35

+14

Media Requests Received 1

46

47

+1

AM 800 Morning Segments 2

12

12

0

YouTube Live Media Briefing Videos3

22

16

-5

Wechu.org/cv/local-updates visits 4

201,598

166,394

-35,204

YouTube Channel Subscribers

620

669

+49

Email Subscribers 5

1,400

1,400

0

Emails Distributed

38

39

+1

SOCIAL MEDIA6

Facebook Fans

15,639

15,753

+114

Facebook Posts

123

115

-8

Twitter Follower

4,613

4,728

+115

Twitter Posts

114

105

-9

Instagram Followers

778

803

+25

Instagram Posts

10

18

+8

LinkedIn Followers

663

682

+19

LinkedIn Posts

76

73

-3
Media Exposure7 844 661 -183

Media Exposure

Graph display media exposure numbers

Trending Themes

Wordcloud displaying trending themes

Top Sources

Chart displaying top traffic sources

Media Participating in Teleconference for YouTube Live

  • AM 800 CKLW, Blackburn News, CBC Windsor, and The Windsor Star join every Monday, Wednesday, and Friday. On occasion, CTV Windsor and windsoriteDOTca will also join the briefing.

Current Notable Projects

  •  Microsoft Power BI was implemented on the COVID-19 Local Data webpage led by the Epidemiology and Evaluation department. Continuous Improvements occur to the webpage.
  • We helped launch the COVID-19 Monitoring Indicators for Windsor-Essex to align with the province’s Framework for Reopening our Province. The 3 colour system is used to help residents know the current local pandemic status.
  • Radon – Know Your Level messages are being promoted on social media throughout the month of November.
  • We are working on a local flu shot campaign to complement the provincial roll out of their upcoming campaign.

Data Notes:

Most requests are related to the local COVID-19 pandemic.

  1. Media requests received is a compiled list of documented requests we captured for interviews, data clarification, or general request for information from the media. Given the volume of requests during COVID-19, many exchanges with the media through text messages or quick phone calls to correct errors may not be captured. In many instances, each request led to multiple interactions with reporters.
  2. Dr. Ahmed joined Mike and Lisa on the AM 800 Morning Drive every morning at 8:06 a.m. starting on Wednesday, March 17. On August 17, we went to a Monday, Wednesday, and Friday schedule with holidays off. He continues to do join Mike and Lisa every other morning to keep the community informed.
  3. We changed the platform we broadcasted live videos from Facebook to YouTube at the end of June. YouTube Live videos started on June 23, 2020. Prior Public Health Update videos on YouTube were exported videos recorded through Facebook Live.
  4. Website analytics are provided by Siteimprove. The metric provided is for page views to COVID-19 Local Updates Page. During the COVID-19 pandemic, changes were made to landing pages. For consistency in reporting, the most popular page was selected.
  5. Email subscribers are those individuals who signed up to receive promotional emails from the Windsor-Essex County Health Unit. The analytics are provided through Mailchimp.
  6. Social media metrics are provided through Hootsuite.
  7. Graphs and media exposure information in this report were generated using Meltwater Media Monitoring Solution. Significant changes in numbers can be partially attributed to configuration changes made to the new service to better monitor and report media activity. News stories may be duplicates or missing as the platform is currently being optimized to better track Windsor-Essex County Health Unit mentions in the media landscape.
View Document page

DATE:

November, 2020

SUBJECT:

Consumption and Treatment Services Site – Application Status

BACKGROUND

On April 1, 2019  the Board of Health of the Windsor-Essex County Health Unit (WECHU) passed a resolution in support of public health-led assessment of the feasibility of a Consumption and Treatment Services (CTS) site in the City of Windsor. In September of the same year, following the release of the Supervised Injection Services Community Consultations Report, the Board of Health subsequently resolved in support of the submission of an application for the creation of a site in the City of Windsor. This application to the provincial Ministry of Health would be accompanied by a corresponding submission to the Federal Government for an exemption to the Controlled Drugs and Substances Act, an additional necessary component for the legal operation of a CTS site. In addition, the September resolution supported the completion of a comprehensive community consultation to determine a suitable and accessible location for a CTS site in the City of Windsor

In order to facilitate this process, a CTS Stakeholder Advisory Committee was created including membership from the following agencies representing the multiple sectors with vested interest in the creation of a CTS:

  • The City of Windsor
  • The AIDS Committee of Windsor (Pozitive Pathways Community Services)
  • Windsor-Essex Community Health Centre
  • Hotel-Dieu Grace Healthcare
  • Canadian Mental Health Agency – Windsor-Essex County
  • Windsor Police Services
  • Windsor Downtown Mission

The WECHU also hired a Substance Use Coordinator to lead the site selection process and completion of the application. The coordinator role was initially responsible for facilitating the decision-making process amongst the Stakeholder Advisory Committee ultimately establishing the criteria and requirements for an eligible site. These requirements acomplement the mandatory criteria set out in the federal and provincial application documents and are outlined below:

  • Site must be 200m from a sensitive land use (e.g. parks, daycare centers, and schools) as well as 600m from other CTS sites OR If  located within 200m of a sensitive land use, application must include plans on how to address community concerns
  • Site must be easily accessible by public transit
  • Site must be within walking distance to areas known to be frequented by people who use drugs
  • Space should be greater than 590ft2 (for six consumption booths) or 385ft2 (for three booths)

Using these criteria, and in consultation with WECHU legal representation and procurement procedures, the WECHU issued a Request for Expressions of Interest (RFEOI) through the MERX Online Public Tenders solicitation database. With an expiry period of one week, the initial RFEOI did not result in any responses. A second, more widely promoted RFEOI was issued and received media coverage from all local major media outlets. Per the health unit’s standard procurement process the WECHU hosted an information Session with two interested parties to answer questions and provide further information on the site criteria and selection process. Ultimately, however this tender also expired without any submissions.

CURRENT INITIATIVES

With the RFEOI process not yielding any potential locations, the WECHU is once again consulting with the CTS Stakeholder Committee and working through the Substance Use Coordinator to determine if there is mutual interest in a shared space among partners. In addition, the WECHU will be reviewing eligible properties and hiring a Real Estate representative in order to guide an equitable and transparent strategy for proactively contacting property owners and managers who appear to meet the set criteria.

Prior to community consultations, environmental audits will be completed by Windsor Police Services in order to determine the safety of the area and guide any mitigating interventions which can improve the safety of the areas surrounding the site and discourage criminal activity.

Community consultations may include open Town Hall Meetings to all residents, as well as targetted meetings in the neighbourhoods in which the sites reside, and online surveys for residents who are unable to attend in-person meetings. Following the consultation process, any decisions regarding the site will require both Board of Health approval and the approval of the Municipality prior to the submission of the final CTS application.

View Document page

SUBMITTED BY:

Environmental Health Department

DATE:

November 9, 2020

SUBJECT:

Potassium Iodide (KI) Tablet Distribution Continues during COVID-19 pandemic

BACKGROUND

The Windsor and Essex County (WEC) region is located within the primary and secondary zones of two (2) nuclear installations – the Enrico Fermi 2 and the Davis-Besse. Although both installations are not located within Canadian borders, the impact they have on our region is the same in the event a nuclear emergency occurs.

According to the Canadian Nuclear Safety Commission (CNSC), all nuclear installations must ensure that potassium iodide tablets are pre-distributed and that pre-distribution includes a public education plan. Potassium iodide tablets are a stable iodine salt that blocks the thyroid from absorbing radioactive iodine during a nuclear incident. In the improbable event of a nuclear emergency, residents will receive instructions from local and provincial authorities to take their tablets to prevent the long-term development of thyroid cancer.

Since the Enrico Fermi 2 Nuclear Generating Station and the Davis – Besse Nuclear Power Station are not regulated by the CNSC, the responsibility for potassium iodide tablet distribution falls on the Windsor-Essex County Health Unit (WECHU), the Municipalities of Windsor and Essex County, and the Ministry of Health. In 2018, the WECHU acquired over 17,000 potassium iodide (KI) kits and coordinated a multi-phase approach that involved distribution to primary and secondary zone residents. Almost 3600 kits were distributed to residents during the first two phases, with an online registration and distribution method implemented for the 2019 season. A targeted communication campaign was completed in 2019, which focused on families with young children in the primary and secondary zone resulting in the distribution of an additional 6500 potassium iodide (KI) kits within the community.

CURRENT INITIATIVES

The ongoing distribution plan for KI tablets in 2020 was met a number of challenges due to the COVID-19 pandemic including post office delays and lack of volunteers to support community pick up centres. Despite some of these barriers, the WECHU has disseminated kits to over 10,600 households in our region this year. Distribution for the 2020 season ended in October due to temperature changes in the environment and will resume in the spring of 2021. The 2021 season, will see additional engagement with stakeholders such as schools, businesses and municipally owned buildings to discuss supply planning and storage in the event of a nuclear emergency.

View Document page

Board Members Present:

Gary McNamara, Tracey Bailey, Joe Bachetti, Rino Bortolin, Fabio Costante, Dr. Debbie Kane, Gary Kaschak (via phone), Judy Lund, John Scott, Ed Sleiman, Larry Snively

Board Member Regrets:

N/A

Administration

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

QUORUM:  Confirmed

  1. Call to Order
    Board Chair, Gary McNamara, called the meeting to order at 4:01 p.m.
  2. Agenda Approval
    Moved by: Judy Lund
    Seconded by: Rino Bortolin
    That the agenda be approved.
    CARRIED
  3. Announcement of Conflicts of Interest – None
  4. Update (Dr. W. Ahmed)
    1. COVID-19 Update

      Dr. W. Ahmed provided an update on the status of COVID-19 cases in our region and noted that cases are increasing worldwide. Canada is responding well to the pandemic compared to some countries, but there is a lockdown in Europe, and we seem to be heading in that direction. Ontario case counts were close to 650 per day, but has now more than doubled up to approximately 1,500 per day. Data around hospitalizations and admissions to ICU is showing that we are moving in the wrong direction in respect to morbidity and mortality rates.

      Locally, we saw an increase in cases in November, likely due to Halloween parties and social gatherings, and are averaging about 20 cases a day. The virus is spreading in different sectors likely now through community spread, and we are coming closer to numbers that we have seen in the first wave. Hospitalization was more manageable through the first wave, but admissions to hospitals and ICU due to COVID-19 is increasing.

      From an exposure perspective the highest number of cases is through close contact, followed by community transmission and then travel related. Transmission through close contacts is higher than in the first wave and is a concerning trend, likely related to social gatherings. We currently have three Long-Term Care homes in outbreak, two schools and one farm, the trend is showing that the positivity rate is also increasing. As of November 14, 2020, our positivity rate is at 2.9%, which is considered high for our region.

      Our health system capacity is at 92%. Recognizing that most COVID patients admitted are placed in isolation rooms this is increasing pressure on hospitals. The ICU is close to 80%, triggering a shift in the acute care system and ventilator capacity is currently at 40%. Public health is running at 86% capacity in contacting cases within 24 hours, but with the surge in cases, there is now a slight decline sometimes taking up to 48 hours, signaling pressures on our health unit.

      Dr. Ahmed said that if there is a case in the school and a cohort is dismissed home they are advised to self-isolate. Anyone else in the household or cohort is deemed high risk and is advised to self-monitor. Testing is recommended 5-7 days later or if an individual becomes symptomatic. Parents of student cohorts would be considered a contact of a contact and unless they become a case would not be of concern.

      J. Bachetti said when school started in September there was a lot of anxiety and wanted to compliment the public health staff assigned to the school. They did a fabulous job with school staff, parents and children and he wanted to say thank you.

      F. Costante asked when the province determines regional status, how much emphasis is place on the capacity of the health care system.

      Dr. Ahmed said the first thing the province looks at is the case counts and moving averages. Based on that they look at the Person Positivity Rate then the Effective Reproduction Rate, i.e. meaning how many cases occur from one positive case. If that data is pointing to any pressure in any of these areas, they then look at capacity.

      Dr. Ahmed said that the WECHU does get some notice from the province if our region is changing levels. The province will reach out for more information and details if they see a concerning trend and ask for our local perspective. With this framework they know what the thresholds are and we have specific conversations on how it affects us locally. Decisions made are forwarded to Cabinet and then to the Premier to make an announcement.

      We are currently in Yellow status and if we move to Orange, the extra restrictions would commence this coming Monday at 12:01 am. Just looking at the increase in the number of cases in our region, I believe we will be moved up another level to Orange, but that decision is ultimately made by the province. Before any announcement is made, they will connect with us for our perspective.

      Moved by: Ed Sleiman
      Seconded by: Larry Snively
      That the information be received.
      CARRIED

  5. Approval of Minutes
    1. Regular Board Meeting: October 15, 2020
      Moved by: John Scott
      Seconded by: Joe Bachetti
      That the minutes be approved.
      CARRIED
  6. Business Arising – None
  7. Consent Agenda
    1. INFORMATION REPORTS
      1. Student Immunization Catch-up Plan (Grade 7/8) (K. McBeth)
        Brought to the Board for information.
      2. Potassium Iodide (KI) Tablet Distribution Continues during COVID-19 Pandemic (K McBeth)
        Brought to the Board for information.
      3. Consumption and Treatment Services Site – Application Status (T. Marentette)
        Brought to the Board for information. R. Bortolin asked if there were any discussion around working with partners on a possible location. T. Marentette said that WECHU emailed WECOSS partners to determine if there was any interest in a shared space or other location. WECHU will be working with legal to move forward to next steps in securing a real estate agent.
      4. October Communications Recap (L. Gregg)
        Brought to the Board for information.

      Moved by: Rino Bortolin
      Seconded by: John Scott
      That the information reports be received.
      CARRIED

    2. RECOMMENDATION REPORTS – None
  8. New Business
    1. CEO Quarterly Reports (T. Marentette)
      T. Marentette said that the 2020 CEO Quarterly Reports are up to date, highlight issues around the pandemic, and note that most public health programs have been suspended. Most WECHU staff has been redeployed to work on COVID-19 and the CEO Report has identified these circumstances. G. McNamara commended the MOH and CEO and the entire WECHU staff for their efforts.
      Moved by: Rino Bortolin
      Seconded by: Judy Lund
      That the information be received.
      CARRIED
    2. 2021 Board of Health Meeting Schedule (T. Marentette)
      Gary McNamara advised that the WECHU is planning Board of Health meetings for 2021 and is looking to the Board for approval to commence holding monthly Board meetings every 3rd Thursday of the month.
      Moved by: Debbie Kane
      Seconded by: Ed Sleiman
      That the WECHU Board of Health monthly meetings for 2021 be held on the 3rd Thursday of each month.
  9. Other Board of Health Resolutions/Letters – For Information
    1. WECHU Letter to The Right Honourable Justin Trudeau and The Right Honourable Chrystia Freeland – Basic Income During and After the COVID-19 Pandemic

      G. McNamara said that this has been on the Board’s radar prior to the pandemic. R. Bortolin said that this might tie into something not directly related to public health but more political. He asked if we are advocating because other health units are leading the charge and would this happen at a Board level or be lead by Dr. Ahmed. N. Dupuis said that our Board has supported a Resolution on this in the past and has formally endorsed. We have a Resolution standing and have sent letters in the past. Food insecurity has a common link with social determinants of health.

      G. McNamara said that social determinants are nutrition, living capabilities, etc. and all play into building a healthy society. It can difficult for many to properly feed their families. Basic income is to support the basic requirements of society to sustain themselves in better way. The Board of Health has supported this pre-COVID so that people living in poverty can get to a level where they can get proper nutrition and we advocate for that. Social determinants have a reflection on public health and we would support moving people out of poverty the best we can. This is a basic need and is in everyone’s best interest, and should be supported by all health units.

    2. Grey-Bruce Public Health Unit – Letter to The Honourable Patty Hajdu, The Honourable Marilee Fullerton and Ontario’s Long-Term Care COVID-19 Commission – COVID-19 and Long-Term Care Reform – Supporting Simcoe Muskoka District Health Unit’s letter regarding same
    3. Grey-Bruce Public Health Unit – Letter to The Honourable Patty Hajdu and The Honourable Christine Elliott – Municipal Drug Strategy Coordinators Network Ontario, Safe Supply

    Moved by: Rino Bortolin
    Seconded by: Debbie Kane
    That the information be received.
    CARRIED

  10. Committee of the Whole (CLOSED SESSION, in accordance with Section 239 of the Municipal Act)
    Moved by: John Scott
    Seconded by: Judy Lund
    That the board move into Committee of the Whole.
    CARRIED
    The Board moved into Committee of the Whole at 4:41 pm
    The Board moved out of Committee of the Whole at 5:05 pm
  11. Next Meeting: At the Call of the Chair, or December 17, 2020 – Via Video
  12. Adjournment
    Moved by: John Scott
    Seconded by: Judy Lund
    That the meeting be adjourned.
    CARRIED
    The meeting adjourned at 5:06 pm.

RECORDING SECRETARY:

SUBMITTED BY:

APPROVED BY:

View Document page

October 15, 2020

Meeting held via video.

  1. Call to Order
  2. Agenda Approval
  3. Announcement of Conflict of Interest
  4. Update (W. Ahmed)
    1. COVID-19 Update
  5. Approval of Minutes
    1. Regular Board Meeting: September 17, 2020
  6. Business Arising
  7. Consent Agenda
    1. INFORMATION REPORTS
      1. Q3 Quarterly Report (L. Gregg)
      2. Influenza Season 2020/2021 (K. McBeth)
      3. Safe Return to School – COVID-19 Engagement, Resources and Collaboration (N. Dupuis)
      4. September Communications Recap
    2. RECOMMENDTION REPORTS – None
  8. Board Correspondence – None
  9. New Business
  10. Other Board of Health Resolutions/Letters – For information
    1. Letter from the Ministry of the Solicitor General – Enforcement and Amendments under the Reopening Act, 2020 24
    2. Letter from Town of Lakeshore – Resolution passed – that Lakeshore Council request that the WECHU notify businesses prior to releasing names of businesses where persons with COVID-19 have attended 28
  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 November 19, 2020 – Via Video
  13. Adjournment
View Document page

Board Members Present:

Gary McNamara, Tracey Bailey, Joe Bachetti, Rino Bortolin, Fabio Costante, Dr.Debbie Kane, Gary Kaschak, Judy Lund, John Scott, Ed Sleiman

Board Member Regrets:

Larry Snively

Administration

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

QUORUM:  Confirmed

  1. Call to Order
    Board Chair, Gary McNamara, relinquished the Chair to Vice-Chair, John Scott, who called the meeting to order at 4:09 p.m. 
  2. Agenda Approval
    Moved by:  Judy Lund
    Seconded by: Fabio Costante
    That the agenda be approved.
    CARRIED
  3. Announcement of Conflicts of Interest – None  
  4. Update (Dr. W. Ahmed)
    1. COVID-19 Update

      Dr. W. Ahmed provided an update on the status of COVID-19 cases in our region.  The province has officially declared that it is in the second wave of the virus, notably in the GTA region.  We are seeing case counts of 700-800 cases per day in the Toronto, Peel, Ottawa, York and Hamilton regions, while we are reporting mostly single digits in Windsor-Essex.

      We have declared an outbreak in a bunkhouse at one farm.  The approximately 20 workers are no longer infectious and are going back to work.  The number of cases from close contacts is increasing, suggesting that people continue to gather, despite recommendations and restrictions.

      The Province has moved to testing based on appointments to help clear the current backlog of tests, and conduct direct testing for those who are symptomatic.   COVID testing is also available through three Shoppers Pharmacies in Windsor for residents with symptoms.

      The WECHU will be moving to a more interactive website, which will allow individuals different options on how to view the data.  We will continue to build on answering questions from the public as well as the media.

      School cases are still relatively low compared to other regions.  We are communicating regularly with the school boards and we currently have no outbreaks.  Moving forward we do anticipate there will be more cases in the community and will continue to work with the Agri-Sector and Long-Term Care/Retirement Homes to provide guidance to prevent cases in their high-risk settings.  Our WECHU team is working with about 65 active cases in our region.

      Moved by:    Fabio Costante
      Seconded by:  Judy Lund
      That the information be received.
      CARRIED

  5. Approval of Minutes
    1. Regular Board Meeting:  September 17, 2020
      Moved by:  Judy Lund
      Seconded by:  Rino Bortolin
      That the minutes be approved.
      CARRIED
  6. Business Arising – None
  7. Consent Agenda

    Moved by:  Ed Sleiman
    Seconded by:  Gary Kaschak
    That the information reports be received.
    CARRIED

    1. INFORMATION REPORTS
      1. Q3 Quarterly Report (L. Gregg)
        Brought to the Board for information.
        R. Bortolin asked if there have been further conversations with the Ministry providing coverage for overages around our deficit. T. Marentette said that the WECHU has submitted its extraordinary expenses related to COVID-19 to the Ministry.  The Ministry has responded back to health units with questions for clarity and we are in the process of completing this.  Further discussion on this will continue in Committee of the Whole.
      2. Influenza Season (2020/2021) (K .McBeth)
        Brought to the Board for information.
      3. Safe Return to School – COVID-19 Engagement, Resources and Collaboration (N. Dupuis)
      4. September Communications Recap (L. Gregg)
    2. RECOMMENDATION REPORTS – None
  8. Board Correspondence – None
  9. New Business – None  
  10. Other Board of Health Resolutions/Letters
    1. Letter from the Ministry of the Solicitor General – Enforcement and Amendments under the Reopening Act, 2020               
    2. Letter from Town of Lakeshore – Resolution passed – that Lakeshore Council request that the WECHU notify businesses prior to releasing names of businesses where persons with COVID-19 have attended.
       J. Lund asked if the WECHU will notify business when they will be included in a public announcement around possible COVID-19 exposure. T. Marentette advised that this is our practice and the Resolution from Lakeshore Council is likely in response to an earlier notification where the business was not aware of a prior announcement.  Our current practice addresses this issue and we will abide by this Resolution. 

       

       

       

      Moved by:  Gary McNamara
      Seconded by:   Joe Bachetti
      That the information be received.
      CARRIED

  11. Committee of the Whole (CLOSED SESSION, in accordance with Section 239 of the Municipal Act)
    The Board moved into Committee of the Whole at 4:22 pm
    The Board moved out of Committee of the Whole at 4:45 pm
  12. Next Meeting: At the Call of the Chair, or November 19, 2020 – Via Video
  13. Adjournment
    Moved by:  Joe Bachetti
    Seconded by:  Gary Kaschak
    That the meeting be adjourned.
    CARRIED

The meeting adjourned at 4:46 pm.

RECORDING SECRETARY:

SUBMITTED BY:

APPROVED BY:

View Document page

September 17, 2020

Meeting held via video.

  1. Call to Order
  2. Agenda Approval
  3. Announcement of Conflict of Interest
  4. Update (W. Ahmed)
    1. COVID-19 Update
  5. Approval of Minutes
    1. Regular Board Meeting: July 16, 2020
  6. Business Arising
    1. School-Focused Nursing Recruitment (D. Sibley)
  7. Consent Agenda
    1. INFORMATION REPORTS
      1. July, August Communications Recap
    2. RECOMMENDTION REPORTS – None
  8. Board Correspondence – None
  9. New Business
    1. WECHU 2020-21 Public Health Funding (T. Marentette/L. Gregg)
    2. Extraordinary Cost Reimbursement Process (L. Gregg)
  10. Other Board of Health Resolutions/Letters
    1. Simcoe-Muskoka District Health Unit – Letter to the Honourable Christine Elliott – urging the immediate provision of the funding allocations to local boards of health regarding the COVID-19 Extraordinary Expenses and for the School-Focused Nurses in order to enable a response by local public health units that is unobstructed by local financial shortfalls
    2. WECHU Response to Town of Kingsville, Town of Essex and Town of Amherstburg – Request for more detailed information and data regarding the spread of COVID-19 in Essex County – For information
  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 October 15, 2020 – Via Video
  13. Adjournment
View Document page

Board Members Present:

Gary McNamara, Tracey Bailey, Rino Bortolin, Fabio Costante, Dr. Debbie Kane, Judy Lund, John Scott, Larry Snively, Joe Bachetti (arrived at 5:05 pm)

Board Member Regrets:

Gary Kaschak, Ed Sleiman

Administration Present:

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

This meeting was held via video conference.

QUORUM:  Confirmed

  1. Call to Order
    Board Chair, Gary McNamara, called the meeting to order at 4:10 p.m.
  2. Agenda Approval
    Moved by: Judy Lund
    Seconded by: Rino Bortolin
    That the agenda be approved.
    CARRIED
  3. Announcement of Conflicts of Interest – None
  4. Update (Dr. W. Ahmed)
    1. COVID-19 Update

      Dr. W. Ahmed provided an update on the status of COVID-19 cases in our region, along with a presentation around the numbers and the increase of cases in the province. Graphs in the presentation show the overall rates, spikes in cases according to age and municipality, how the virus is being transmitted, and capacity in the health care system should we see a surge of cases requiring hospitalization. Our case fatality rate is at 3.0%, which is lower than the provincial average. Approximately 5,000 to 6,000 tests are being conducted weekly across our region, and positive case rates remain relatively low while the GTA and Ottawa regions are spiking.

      One student in a local school tested positive and their cohort was also advised to isolate for 14 days. Our data shows a spike in cases in the 0-19 age group over the last two weeks, and we take this information seriously with our messaging to the various school boards.

      The region seems to be moving in a stable direction in the Agri-sector. Positive cases amongst farm workers are low with some occasional travel related cases after arriving in Canada.

      G. McNamara said that the WECHU Epidemiology Department has done excellent work on the graphing and mapping. The recent roadmap created around the cluster of cases that happened recently was interesting to see, and shows how quickly the virus can spread. The province was impressed at how quickly we addressed the cluster by finding its origins and roots. Information like this is critically important to show residents how quickly the virus can easily get out of control by not following public health measures.

      Moved by: Fabio Costante
      Seconded by: John Scott
      That the information be received.
      CARRIED

  5. Approval of Minutes
    1. Regular Board Meeting: July 16, 2020
      J. Lund noted that Beach Testing (water sampling) was discussed at the July 16, 2020 Board meeting and that the WECHU was one of the only health units that still conducts the testing. She asked how other health units do beach testing. Dr. Ahmed said that water testing is done by their municipalities or contracted out to a third party.
      Moved by: Judy Lund
      Seconded by: Fabio Costante
      That the minutes be approved.
      CARRIED
  6. Business Arising
    1. School-focused Nursing Recruitment (D. Sibley)
      D. Sibley said that 18 of the 19 school nursing positions have been filled. Ten internal WECHU staff on lay off filled some of these positions and 8 new staff have been hired over the last couple of weeks. We are recruiting for 1 French speaking position. We have redeployed existing WECHU staff to be ready for the school year and all of these positions should be filled within the next two weeks.
      Moved by: Debbie Kane
      Seconded by: John Scott
      That the information be received.
      CARRIED
    2. Consumption and Treatment Services (CTS) Site Update (Addition to Agenda) R. Bortolin

      T. Marentette said that the health unit continues to work with a dedicated stakeholder group on the application submission for a CTS site in Windsor. The work was delayed for several months due to the pandemic and we recently moved forward around a site location, which is required prior to submitting the application. Criteria for the site was based on requirements in both Health Canada’s and the Ministry of Health’s applications.

      A Request for Expression of Interest (EOI) for interested landlords or property owners for a proposed site went out in August 2020. There was no interest. We reposted the information to the same website, did a media release and extended the timeline to September 4, 2020 and the process still did not generate any interest.

      We have reached out to our legal advisors for guidance on next steps and will reconvene our stakeholder group to determine how to proceed. Steps following the site selection would include a CPTED (Crime Prevention Through Environmental Design) audit on the site, a site inspection and a brief assessment. Consultations with the public would follow with extensive community engagement along with our Board of Health and the municipality of the site location.

      R. Bortolin asked if one submission was received, and the size and technical specifications are reached, would we go that route and what level of consideration is given to those items. T. Marentette said that there is criteria that must be met and we would work with our Environmental Health Department and Windsor Police Services, i.e. acceptable site, meeting mandatory requirements from Health Canada and the Ministry of Health, distancing from sensitive areas, etc., and it would be brought to the Stakeholder Advisory Committee.

      R. Bortolin asked about the public consultation phase and what that would look like when we are at the point of Board of Health approval of the potential site. He has received many questions from residents in his ward about the CTS site being located in the downtown Windsor core. T. Marentette advised that public consultations would occur prior to going to our Board or the municipality for site confirmation and approval. We were hoping to have 2 or 3 sites with extensive community consultation, and feedback, before moving forward. The public would have a say and will have the opportunity to voice their concerns prior to the site being confirmed.

      The process is presenting the sites that meet the criteria as well as meeting the needs of the people who would use the service. With the pandemic, there will be no gatherings in person. We will need to conduct consultations through surveys and virtual discussions, and there was talk of having a virtual Town Hall. All residents in the municipality can participate in the process, not just residents or businesses in that location.

      R. Bortolin said if the process goes through public consultation and is presented to our Board of Health and the municipality, does the municipality have the power to veto, or is it presented to the municipality simply for endorsement.

      T. Marentette noted that under the Health Promotion and Protection Act, (HPPA) the municipality must approve the site. R. Bortolin said that it would likely be through a Motion to the particular municipality’s council.

      R. Bortolin asked if WECHU has considered how many meetings should take place, that they are well publicized and that there are enough people on the calls to hear from residents instead of it being a one-way virtual meeting. T. Marentette said that this was all considered in the planning, we have people dedicated to the process, GANTT charts for timelines and that we recognize the need to make sure it is inclusive of everyone who wants to have a voice.

      R. Bortolin said that since there has been no interest from the EOI has there been any discussion around conversations with municipalities, other agencies or potential partners for space.

      T. Marentette advised that we have consulted with our legal advisors on this to make sure the process is transparent and adheres to any public protocol or disclosure and, based on feedback, we will reconvene the stakeholder group, and expect that the next step is to reach out to potential partners.

  7. Consent Agenda
    1. INFORMATION REPORTS
      1. July and August Communications Recap (L. Gregg)
        Brought to the Board for information.
        Moved by: Rino Bortolin
        Seconded by: Judy Lund
        That the information reports be received.
        CARRIED
    2. RECOMMENDATION REPORTS – None
  8. Board Correspondence – None
  9. New Business
    1. WECHU 2020-21 Public Health Funding (T. Marentette/L. Gregg)

      T. Marentette said that the WECHU received its Public Health Funding and Accountability Agreement for the 2020-2021 funding year on August 21, 2020 which provided our approved base and one-time funding. This includes the changes to the provincial/municipal cost-sharing agreement effective January 1, 2020, one-time mitigation funding and funding for public health programs and services.

      An overview of other one-time funding approvals include:

      • Public Health Inspector Practicum Program (one student) – $10,000
      • Seasonal Farm Contract Tracing under our TB Program – included on-site contact tracing, TB screening, translations services, salaries and mileage – $4,400
      • Vector-Borne Disease Program – this funding initiative is used to support staffing, mileage surveillance activities and an awareness campaign for enhanced surveillance for mosquitos – $40,000
      • Pandemic Pay for eligible nursing staff – this initiative provided additional support for eligible Board of Health employees dependent upon responsibilities for the period April 24, 2020 to August 13, 2020. Total funding received for our health unit was $161,700.

      In addition, an amended agreement was received by the Ministry related to the following:

      • School-focused nurses (19 in total) to support the reopening of schools (August 1, 2020 to March 31, 2021 and April 2021 to March 31, 2022)
      • Funding to support the new public health Case and Contact Management solution (CCM)

      Board of Health member L. Snively left the meeting at 4:59 pm

      L. Gregg advised that on August 21, 2020 the Ministry of Health issued WECHU’s 2020 Budget Approval. Total funding allocation is as follows:

      • $15,981,600 in base funding for the Mandatory programs – funded at a rate of 70% Ministry of Health and 30% Obligated Municipalities
      • $1,674,700 in base funding for the Ontario Seniors Dental Care Program funded 100% by the Ministry of Health

      The Ministry of Health approved mitigation funding of $1,260,800 to be used to offset the increased public health program costs to municipalities as a result of cost-sharing change from what was 75/25 to 70/30. An allotment of mitigation funding was approved for the period January 1, 2020 to December 31, 2020 and a second allotment in the same amount was approved for January 1, 2021 to December 31, 2021.

      Moved by: Judy Lund
      Seconded by: Rino Bortolin
      That the information be received.
      CARRIED

    2. Extraordinary Cost Reimbursement Process (L. Gregg)

      L. Gregg advised that on August 21, 2020 the Ministry of Health initiated a process for public health units to request reimbursements of one-time extraordinary expenses related to COVID-19. The deadline for this submission is September 18, 2020 for the timeframe of January 1, 2020 to December 31, 2020 and includes actual and forecasted costs. As with all submissions to the Ministry, it is subject to review and some expenditures may not be admissible. It is our understanding that additional requests for reimbursement may be available at a later date.

      Total forecasted salaries and benefits related to COVID-19 for calendar 2020 are $10,728,391. This excludes the School Nurse initiative, which will be funded through separate approval. R. Bortolin noted that many WECHU staff are unionized and eligible for overtime. He asked if this amount takes into account a provision for the WECHU Leadership Team who have been unable to take vacation or time off due to the workload with the pandemic. Their working ratio is likely 15%-30% higher than what they are receiving in salaries.

      L. Gregg advised there was a provision for vacations not taken by the WECHU Leadership Team but there was no augment in the number of hours the team has worked, and continues to work, in this analysis. The provision just includes their base salaries. There was a line-by-line analysis for all staff so there was a detailed review.

      R. Bortolin asked if WECHU should increase the ask in the submission to the Ministry to help cover compensation to the WECHU Leadership Team for unused vacations.

      T. Marentette said that there was no provision for compensation for the Leadership Team during the pandemic and if it is deemed not admissible by the Ministry it would likely fall on the municipalities and is included in this ask. R. Bortolin asked if WECHU can balance its budget for 2020 if the submission was approved. T. Marentette said that close to $3M has been submitted and if that is received from the Ministry than WECHU should be able to balance its budget. To our understanding, the province is not saying this is a 70/30 split.

      Moved by: Joe Bachetti
      Seconded by: John Scott
      That the information be received.

    3. Request from Ontario Health Team (W. Ahmed)

      Dr. W. Ahmed said that many Board of Health members are aware that the province, through Ontario Health, is creating Ontario Health Teams (OHT) to provide patient centered care in various regions of the province. OHTs are groups of health care providers and organizations that are clinically and fiscally accountable for delivering a full and coordinated continuum of care to a defined geographic population.

      The expectation is that the OHTs will enable patients, families, community agencies and healthcare providers to work together in a new way. Over time, it is expected that OHTs will develop innovative and locally driven solutions to meet the healthcare needs of their defined geographic population and will be accountable for the health outcomes and healthcare costs of that population.

      OHTs are being introduced to provide a new way of organizing and delivering care that is more connected to patients in their local communities. Under OHTs, health care providers (including hospitals, doctors and home and community care providers) work as one coordinated team. Public Health supported the local collaborative work to create a Windsor-Essex Ontario Health Team. The next stage of the OHTs development is a full application, which is currently being submitted.

      In the application, the OHT has to identify a priority population and the group decided to work with individuals with chronic diseases living in a congregate settings. There are 155 congregate living setting in our region and the team is planning to prioritize them based on the risk to these settings. For example, using EMS data to identify top 10 congregate living facilities in our region that receive the bulk of calls in the past 12 months.

      The OHT is leveraging on the existing relationship and partnership developed for COVID response in the region.

      The Windsor Essex OHT is comprised of over 45 local healthcare program and services providers including the three hospitals, primary care and community support providers, public health, municipalities, mental health and addictions agencies, Long-term care, and others social service providers in Windsor Essex.

      The Windsor Essex OHT is requesting their partner agencies submit a letter of support along with a sign off from their Board. WECHU is in support of the Windsor Essex OHT but we also recognize that the public governance and accountability are very different. We are governed under the HPPA and are accountable to our Board of Health.

      We are recommending that the WECHU submit a letter of support from the Medical Officer of Health and the CEO that we will continue to support and collaborate with the OHT. Due to our mandate and accountability, we do not believe that we require a formal board sign off and are looking to the Board for direction and support.

      Moved by: Tracey Bailey
      Supported: Rino Bortolin
      That the WECHU Medical Officer of Health and CEO submit a Letter of Support to continue to support and collaborate with the OHT and that formal Board of Health sign off is not required.
      CARRIED

  10. Other Board of Health Resolutions/Letters

    Moved by: Rino Bortolin
    Seconded by: John Scott
    That the information be received.
    CARRIED

    1. Simcoe-Muskoka District Health Unit – Letter to Honourable Christine Elliott – urging the immediate provision of the funding allocations to local boards of health regarding the COVID-19 Extraordinary Expenses and for the School-Focused Nurses in order to enable a response by local public health units that is unobstructed by local financial shortfalls – For information
    2. WECHU Response to Town of Kingsville, Town of Essex and Town of Amherstburg – Response to their request for more detailed information and data regarding the spread of COVID-19 in Essex County – For information
  11. Committee of the Whole (CLOSED SESSION, in accordance with Section 239 of the Municipal Act)
    The Board moved into Committee of the Whole at 5:14 pm
    The Board moved out of Committee of the Whole at 5:20 pm
  12. Next Meeting: At the Call of the Chair, or October 15, 2020 – Via Video
  13. Adjournment
    Moved by: Rino Bortolin
    Seconded by: Tracey Bailey
    That the meeting be adjourned.
    CARRIED

The meeting adjourned at 5:21 pm.

RECORDING SECRETARY:

SUBMITTED BY:

APPROVED BY:

View Document page

July 16, 2020

Meeting held via video.

  1. Call to Order
  2. Agenda Approval
  3. Announcement of Conflict of Interest
  4. Update (W. Ahmed)
    1. COVID-19 Update
  5. Approval of Minutes
    1. Regular Board Meeting: June 18, 2020
  6. Business Arising
  7. Consent Agenda
    1. INFORMATION REPORTS
      1. Effect of climate change of invasive mosquitoes, Zika Virus, and migrant worker health in Windsor-Essex
        (K. McBeth)
      2. June Communications Recap
    2. RECOMMENDTION REPORTS
      1. 2020 Budget Amendments (T. Marentette/L. Gregg)
  8. Board Correspondence – None
  9. New Business
    1. COVID-19 Task Force (T. Marentette)
  10. Other Board of Health Resolutions/Letters
    1. Resolution from Town of Essex – Spread of COVID-19 in our Farm Worker Population (T. Marentette)
  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 August 20, 2020 – Via Video
  13. Adjournment
View Document page

SUBMITTED BY:

Epidemiology and Evaluation Department

DATE:

July 16, 2020

SUBJECT:

Effect of climate change on invasive mosquitoes, Zika virus, and migrant worker health in Windsor and Essex County

BACKGROUND

Between 1941 and 2012, the annual average temperature for the City of Windsor increased by almost 1°C (City of Windsor, 2012). Windsor and Essex County (WEC) also experienced a 1-3% increase in rainfall per decade from 1970 to 2000 (City of Windsor, 2012), with level of precipitation and humidity expected to continue to increase in southern Canada in the coming decades (Ng et al., 2019).

One potentially dangerous effect of these climatic changes in Windsor and Essex County (WEC) is the proliferation of invasive mosquitoes. The past four years have seen the introduction of Aedes albopictus and Aedes aegypti, both carriers of the Zika virus, to WEC, and climatic changes are expected to encourage greater numbers of these mosquitoes in the coming decades (Ng et al., 2019). More specifically, rising temperatures combined with stagnant water from flooding are expected to facilitate the survival and proliferation of these species (Kovats et al., 2003). Indeed, the Aedes albopictus population in WEC (identified from trapping) increased from 17 in 2016 to 1,129 adult mosquitoes in 2018, thus demonstrating that these mosquitoes can reproduce rapidly. Furthermore, these mosquitoes spread out from one to seven different trapping locations from 2016-18.

One particular population that may be at risk for exposure to these mosquitoes are migrant farm workers. Leamington has over 8,000 migrant workers during the summer season who are housed in over 600 bunkhouses (Hennebry, McLaughlin & Preibisch, 2016). The majority of these migrant workers are from Mexico and nearby Caribbean countries, which are endemic for mosquito-borne diseases such as Zika. A recent survey in Ontario, however, found that less than a quarter of migrant farm workers saw a doctor for any health symptoms (Hennebry et al., 2016). Therefore, it is imperative that surveillance of Aedes mosquitoes and incidence of the Zika virus be increased in this area, not only to protect the health and well-being of migrants, but also the well-being of WEC as a whole.

CURRENT INITIATIVES

Funding for a three-year exploratory study (2019-2022) of invasive mosquito species in Leamington, Ontario was awarded to the Windsor-Essex County Health Unit by the Public Health Agency of Canada (PHAC) via the Infectious Disease and Climate Change Fund. The primary goal of the study is increased surveillance of invasive mosquito species in Leamington, including coordination with Parks Canada for surveillance and viral testing in Point Pelee National Park. An additional objective is to assess potential risks to the Leamington community, with special attention paid to vulnerable populations, such as migrant farm workers.

Prior to mosquito surveillance (scheduled to begin May 2020), a scoping review of all literature relating to climate change, Aedes mosquitoes, the Zika virus, and migrant workers was completed. From over 65,000 reviewed records, 88 were chosen to address the specific scoping review objectives. About two-thirds (65/88) of these records were empirical studies, and 23% (20/88) were done in Canada.

Results of the review revealed extensive information on Aedes mosquitoes, the Zika virus, and climate change in the United States and other parts of the world affected by these mosquitoes. However, there are gaps in the literature regarding how Aedes mosquitoes, Zika, and climate change may affect vulnerable populations. Empirical work, such as WECHU’s current PHAC grant, that examines how Aedes mosquitoes, Zika, and climate change interact in their effect on migrant workers in Canada is greatly needed.

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Board Members Present:

Gary McNamara, Joe Bachetti, Tracey Bailey, Rino Bortolin, Fabio Costante, Dr. Debbie Kane, Gary Kaschak (4:41 pm) Judy Lund, John Scott, Ed Sleiman

Board Member Regrets:

Larry Snively

Administration Present:

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

This meeting was held via video conference.

QUORUM:  Confirmed

  1. Call to Order
    Board Chair, Gary McNamara, called the meeting to order at 4:03 p.m.
  2. Agenda Approval
    Addition to agenda (Requested by Tracey Bailey):
    New Business, Section 9.2 – Resumption of Water Testing and Utilizing a Third Party Contract

    Addition to agenda (Requested by Tracey Bailey):
    Proposed Amendments to Enhance the Section 22 Class Order – to be discussed in-camera in Committee of the Whole
    Moved by: Tracey Bailey
    Seconded by: Ed Sleiman
    That the agenda be approved.
    CARRIED

  3. Announcement of Conflicts of Interest – None
  4. Update (Dr. W. Ahmed)
    1. COVID-19 Update

      Dr. W. Ahmed provided an update on the current status of COVID-19 cases in our region. We currently have 1,857 cases with 69 deaths. There are 6 workplace outbreaks, 1 being in manufacturing and 5 in the Agri-sector. There are four farms that have most of the cases amongst those in the Agri-sector with 143 active cases and solutions for isolation and accommodations are being discussed. Community transmission remains low, but it is still important to keep close contacts at a minimum. The messaging will be the same when Windsor-Essex moves to Stage 3.

      There are currently a number of partners (WECHU, OMAFRA, Ministry of Health, Ministry of Labour, Ontario Health, Canadian Red Cross) working together to build a system for testing, isolation and accommodations for the Agri-sector. The Canadian Red Cross is supporting 2 hotels in the region for self-isolation and we are participating in all conversations to provide our public health perspective. We are speaking daily with Dr. David Williams, the Chief Medical Officer of Health at the Ministry of Health, and are hoping to have a good strong system in place, and possibly some new initiatives for Ontario Health testing Agri-farm workers, in the next week.

      Dr. Ahmed noted that Dr. Alex Summers (AMOH, Middlesex-London Health Unit) has joined us in today’s Board of Health meeting and was working with us in Windsor to help support with protocol and assessing the farm situation. As a result of working together, we created an outbreak case and contact management document for our work with the Agri-farm sector and have shared it with the Ministry which they will use as a tool for the rest of the province. On behalf of the Board of Health, G. McNamara thanked Dr. Summers and his team for their assistance with the Agri-sector.

      Moved by: John Scott
      Seconded by: Tracey Bailey
      That the information be received.
      CARRIED

  5. Approval of Minutes
    1. Regular Board Meeting: June 18, 2020
      Moved by: John Scott
      Seconded by: Joe Bachetti
      That the minutes be approved as amended.
      CARRIED
  6. Business Arising – None
  7. Consent Agenda

    That the information reports be received.
    CARRIED

    1. INFORMATION REPORTS
      1. Effects of Climate Change on Invasive Mosquitos, Zika Virus, and Migrant Workers Health in Windsor-Essex (K. McBeth)
        Brought to the Board for information.
      2. June Communications Recap (L. Gregg)
        Brought to the Board for information.

      Moved by: Ed Sleiman
      Seconded by: Judy Lund

    2. RECOMMENDATION REPORTS
      1. 2020 Budget Amendments (T. Marentette/L. Gregg)

        T. Marentette noted that this is an amendment to the 2020 Budget. On March 20, 2020, the WECHU reported its first case of COVID-19, and we now have 1,857 cases and 69 deaths. We continue to have unique challenges in our health unit related to many bunkhouse inspections in farm operations, with 8,000 to 10,000 Temporary Foreign Workers across 176 farms in our region. Our public health inspectors inspect bunkhouses, over 900 so far, in addition to the 44 Long-Term Care Homes and Retirement Homes in our community.

        In May, the Ministry asked health units to follow up with positive cases within 24 hours. At that time, we had 656 cases and were already stretched for resources. We knew that as COVID progressed we did not have enough staff to continue with the requirements that were needed for the pandemic, wherein we made decisions under the Medical Officer of Health to defer or reduce some public health programming. We instituted an IMS Structure to respond to the pandemic. Under the Emergency Management and Civil Protection Act,we were able to redeploy approximately 80 staff across different programs and schedules to devote our resources where needed to protect the public, 2 shifts 7 days a week.

        In the last week of June, we reached out to other health units for assistance. Our HR and IT Departments assisted in onboarding and orientation (approximately 11 full time and 10 casual health unit staff). Dr. Alex Summers (Associate Medical Officer of Health, Middlesex London) attended on-site for two weeks and continues to support us remotely with the Agri-sector. In addition, we received the services of a field epidemiologist for three weeks through the Public Health Agency of Canada (PHAC).

        As we move forward with COVID-19, and with the province slowly reopening, it still remains the priority for 2020. With all of our resources stretched to capacity we are submitting a proposal requesting a full time Associate Medical Officer of Health (AMOH), a Manager for the COVID Response Team, Clerical Support, PHNs, RPNs, Public Health Inspectors and an Epidemiologist, to help meet the needs of the pandemic and allow for some staff to support other programs we need to reintroduce. E. Sleiman asked if the request for an AMOH is permanent or just through the pandemic. T. Marentette advised that the request is for a full time permanent AMOH. The work of COVID will not end after this year, and for a health unit of this size, it is in the best interest for our community.

        L. Gregg said that we have compiled our operating budget from September to fiscal 2020 and the total operating costs for 22 FTE is approximately $857,329. These FTEs would be deployed to work from home, so as to not incur infrastructure costs in office space. If the Ministry of Health does not fund any portion of these FTE’s, the increase in costs would be absorbed by municipalities. Contributions would be $466,726 from the City of Windsor; $390,098 from the County of Essex; and $505 from the Township of Pelee. Should the Ministry of Health come forward with funding for this particular initiative, and we use the funding allocation of 70/30, that would decrease contributions from the municipalities to $257,200 for the remainder of 2020.

        On an annual basis, under the scenario that the municipalities would bear the complete burden of the FTEs, the impact would be $2,208,953 resulting in an impact to the City of Windsor of $1,200,000 and $1,000,000 to the County of Essex and $1,300 to the Township of Pelee. Should the Ministry provide funding on the 70/30 basis those costs would decrease to $662,686 broken down to $360,000 to the City of Windsor, $301,000 to the County of Essex, and $390 to the Township of Pelee. In May of 2020, the WECHU submitted a business case to the Ministry similar to the 2020 Budget Amendment.

        T. Bailey said it is her understanding then that there is some surplus available for re-allocation and does the health unit have some sense there will be resources coming their way to take the pressure off municipal funding needed.

        L. Gregg noted there was a letter from the Ministry based on extraordinary costs related to the pandemic, and at some point in the year we would be asked to accumulate and submit those costs. At this time, we are not exactly sure what the Ministry would define as extraordinary costs.

        T. Bailey noted that the health unit has her support.

        R. Bortolin said that under these scenarios has there been any conversation with the Ministry where this shortfall could be made up by support from either the provincial or the federal governments through relief programs. G. McNamara noted that on talks yesterday with the province and other mayors the response was clear from all other jurisdictions around the province, i.e. that municipalities finance public health and other COVID affected areas and if the province wants to soften the burden to municipalities, they need to come through with more funding for health units.

        R. Bortolin asked if the $857,329 is a total surplus or just to cover costs for the new FTEs. Also, what is the overall deficit expected to be by the end of December.

        L. Gregg advised that we are currently working on that estimate and believe it was around mid-May timeframe that we anticipated approximately $1M in deficit factoring in a team such as this. The WECHU is looking to bring a report to the Board at a later date indicating the anticipated deficit.

        R. Bortolin noted to the Chair that he would like to put forward a friendly amendment to the motion included in the 2020 Budget Amendment Recommendation Report, indicating that final deficit numbers be forwarded to the Obligated Municipalities as soon as possible. In addition, a request to the Obligated Municipalities to write a letter to the Province of Ontario and the Ministry of Health for financial support to fund the shortfall.

        Chair, G. McNamara believes that this is a reasonable ask. There is no doubt that the municipalities need to push the provincial and federal governments for assistance and this was an ask by the majority of the municipal sectors, i.e. the Municipal Finance Officers Association (MFOA), the Federation of Canadian Municipalities (FCM) and the Association of Municipalities of Ontario (AMO).

        Moved by: Tracey Bailey
        Seconded by: Rino Bortolin
        That the 2020 Budget Amendment be approved to support the recruitment of 22 FTEs (the reference to 19 FTEs in the report was verbally corrected), including an Associate Medical Officer of Health; that the Windsor-Essex County Board of Health direct Administration to provide notice, as required under section 72(6) of the HPPA, to the Obligated Municipalities of the additional contributions required to fund the COVID-19 Response Team for the remainder of the 2020 fiscal year; that the final deficit numbers be provided to the Obligated Municipalities as soon as possible; that the Obligated Municipalities write to the Province of Ontario and the Ministry of Health requesting financial support for the shortfall.
        CARRIED

  8. Board Correspondence – None
  9. New Business
    1. COVID-19 Task Force
      T. Marentette noted that during the Committee of the Whole on June 18, 2020, the COVID-19 Task Force was discussed which includes the members of the Executive, namely the Chair, Vice Chair and Treasurer of the Board, the CEO and MOH, as well as Rino Bortolin, representing the City of Windsor. After consulting with legal counsel, it was determined that the formation of the COVID-19 Task Force should be discussed and membership approved by the Board as a whole in open session, similar to how other committees of the Board are formed.
      Moved by: Fabio Costante
      Seconded by: Ed Sleiman
      That the COVID-19 Task Force be approved.
      CARRIED
    2. Resumption of Water Testing and Utilizing a Third-party Contract – Addition to Agenda (T. Bailey)

      With the COVID-19 pandemic and resources at full capacity at the WECHU, the health unit was forced to make decisions on deferring programs, one of those programs being beach testing. T. Bailey put forth that the health unit fulfil their responsibilities for beach testing and contract out those services due to capacity issues. A letter will be forthcoming from the Town of Lakeshore and the Town of Essex who are conducting their own testing. Municipalities do not have the mechanisms for this and is looking for the Board to support moving forward in some way to keep beaches safe. Another barrier for municipalities is the communication piece with messaging to the public.

      Dr. W. Ahmed said that the pandemic has had a significant impact on staff at the WECHU. Our public health inspectors have been working to support the prevention of outbreaks in Long-Term Care Homes and Retirement Homes, supporting restaurants with the opening to Stage 2 and education and enforcement activities and Section 22 Orders if those served are not compliant. This decision was based fully on resources, and the WECHU is one of the few health units that still conducts beach testing. When beach sampling is conducted water samples are sent to the public health lab and it takes 2 days to receive results. This can bring a false sense of security with testing results, as water samples can change daily. G. McNamara asked if there was an opportunity through the Canada Summer Program for Biology Students from the University or College to assist with testing or to reach out to MPP’s for support. T. Marentette advised that we are using students for our vector-borne programs and enhanced surveillance, and beach sampling not only includes students but experienced public health inspectors as well as epidemiologists. All of the information is tracked and posted to our website which involves our communications team, making this a time and resource intensive program. If a sample identifies that we need to close the beach, that also requires resampling as well. To say it can be done easily with students, it’s just not that simple. Municipalities can consider signage on the beaches that they are not currently being tested.

      T. Bailey asked how challenging the communication piece would be for WECHU if the service was contracted out. T. Marentette advised that they have redeployed a Director for the communication piece for COVID which has taken a significant amount of time. We will need to have internal discussions of what we can and cannot do as the province reopens. We currently have 1,500 people on the waiting list for dental services and cannot go any leaner than we are. As we start to resume these services this will leave a gap in resources for COVID.

      T. Bailey said she would like to put forward a motion.

      Moved by: Tracey Bailey
      Seconded by: Gary Kaschak

      That the WECHU Board of Health make a decision whether or not to go forward to resume beach testing or contract out to a third-party.
      R. Bortolin said that although he understands the desire to reinitiate testing and that it is a valuable resource, he has concerns if we approve this motion as Dr. Ahmed and T. Marentette just mentioned that if we resume beach testing we would need to displace resources. He would like to see what program(s) would be displaced if the WECHU resumes beach testing. He asked T. Bailey as the mover of this motion would she consider an amendment or a deferral to understanding what public health programs will be displaced should beach testing resume before we consider or support this motion, and what the impact would be.

      G. McNamara noted that staff resources are also his concern. All public health programs are important, but if staff are working 7 days a week and the WECHU is saying that it needs 22 FTEs to deal with services to meet the challenges of the pandemic, adding more programs would create more challenges. G. McNamara agrees with what R. Bortolin is stressing, such as a good compromise or an amendment to the motion, and to continue the conversation to see what programs would need to be deferred should beach testing resume. Contracting out would likely be the solution if testing would resume, as WECHU cannot afford to pull away resources from COVID support.

      E. Sleiman asked what the cost would be to resume the testing. T. Marentette said she would not know the cost of contracting out beach sampling, as the costs for testing is embedded in the program where there are protocols and procedures, and getting samples securely to the public health lab. The public health inspectors are trained to do that. When recruiting public health inspection students we recruit them early on in the year, as they are in high demand across health units. Even if municipalities took on the responsibility of testing, public health would still need to be involved. E. Sleiman said it would be too difficult to vote on something without knowing the cost.

      G. McNamara said that if municipal water divisions sample the water and send it out for testing (as they do under the Safe Drinking Act), the health unit would still need to be involved at some point when results are received.

      T. Marentette let the Board know that the public health inspectors did an initial assessment of all the beaches at the beginning of the season, which typically runs from May to September. G. Kaschak said with only 6 weeks to the end of the season, that he would support that the public health inspectors resume the services of testing.

      J. Bachetti said that in terms of the motion this is a fair ask of the health unit and a decision needs to be made, but notes that COVID-19 is currently the priority and whatever the board decides on testing, the municipalities can inform their residents. Dr. Ahmed noted that most health units do not conduct beach testing and samples can change quickly. Some beaches are open, but it is “swim at your own risk”. In August, the health unit will be very much involved in plans for reopening schools and staff are currently working 24/7 on the pandemic. There are still a lot of unknowns to come. Even if the municipalities conduct their own testing, public health will still need to be involved. It is “all hands on deck” now for the health unit with COVID-19. He feels that going to the beach is a leisure activity, and is concerned about using health unit resources for this.

      J. Lund agreed with J. Bachetti and R. Bortolin that without knowing the cost and what programs will be displaced, she cannot support the resumption of beach testing. The WECHU needs to look at its priorities, which is the pandemic, and they are already looking at increasing staff to meet their current needs.

      F. Costante asked Dr. Ahmed and T. Marentette if the health unit resumed beach testing would that take away resources from COIVD-19 and is beach testing a priority over COVID. T. Marentette said that under the Emergency Management and Civil Protection Act, which has been extended to July 29, 2002, it notes that health units can cancel or postpone services that are not related to responding to, preventing or alleviating the outbreak of the virus. All of WECHU’s resources are focused on the virus, and the order talks about reallocation of resources and prioritization for COVID-19. The WECHU continues to work with many farms across Essex County to decrease the transmission of COVID-19 which includes our nursing staff, our public health inspection staff and our management staff so, yes, it will take away resources from COVID-19, and that beach testing is not a priority over the pandemic.

      F. Costante said that it is clear where the priorities are and may we have a vote on this.

      G. McNamara said that the Board would vote on R. Bortolin’s amendment to T. Bailey’s Motion, and then the Motion itself. That information would need to be brought back to WECHU’s August Board meeting. R. Bortolin said that he will rescind his amendment to T. Baily’s Motion as deferring until the August Board meeting will be untimely to resume testing beaches. He will let T. Bailey’s Motion stand as is.

      Moved by: Tracey Bailey
      That the WECHU Board of Health vote on whether to go forward to resume beach testing or contract out to a third-party.
      All in favour: 3
      Opposed: 7
      DEFEATED

  10. Other Board of Health Resolutions/Letters
    1. Resolution from Town of Essex – Request for Raw Data on Positive COVID-19 Cases in Essex County – That the Windsor Essex County Health Unit provide a detailed breakdown of data reporting on positive COVID-19 cases in our municipality and the region, based on classification relating to Travel, Close Contact, Community Contact and Agri-Farm as examples.
      Moved by: Rino Bortolin
      Seconded by: John Scott
      That the information be received.
      CARRIED
  11. Committee of the Whole (CLOSED SESSION, in accordance with Section 239 of the Municipal Act)
    The Board moved into Committee of the Whole at 5:15 pm
    The Board moved out of Committee of the Whole at 5:50 pm
  12. Next Meeting: At the Call of the Chair, or August 20, 2020 – Via Video
  13. Adjournment
    Moved by: Tracey Bailey
    Seconded by: Rino Bortolin
    That the meeting be adjourned.
    CARRIED

The meeting adjourned at 5:51 pm.

RECORDING SECRETARY:

SUBMITTED BY:

APPROVED BY:

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ISSUE 

On March 11, 2020, the World Health Organization (WHO) declared the global outbreak of COVID-19 a pandemic. On March 20, 2020, the Windsor-Essex County Health Unit (WECHU) announced its first confirmed case of COVID-19. Since then, Windsor and Essex County (WEC) has seen confirmed cases rise to one thousand eight hundred (1,800) (as at July 12, 2020), with sixty-eight (68) deaths.

WEC is home to one of the busiest border crossings in North America. Approximately six thousand (6,000) residents in WEC work in the state of Michigan, and in particular, seventeen hundred (1,700) in the health care industry. In addition, WEC is home to eight thousand (8,000) to ten thousand (10,000) seasonal workers, one hundred seventy-six (176) farms and over seven hundred (700) seasonal accommodations. WEC has forty-four (44) long-term care and retirement homes. These characteristics make our community unique and create dynamics that are challenging to manage from a public health perspective. Adding to this, are the complexities of the Ministry of Health (MoH) requirements and performance targets.

Approximately eighty (80) staff with the WECHU, of varying roles, have been redeployed to address the response to COVID-19 within our WEC region. Programs and services, which had previously been halted, are now restarting, as our community moves through the stages of reopening. It is imperative that the WECHU formulate a strategy that will not only return staff to their originating programs, but responsibly address the continuing needs of COVID-19, within our community. To that end, Administration is proposing an amendment to the 2020 Budget to account for the additional FTE requirements. 

BACKGROUND

In May of 2020, the MoH, in a memo regarding Case and Contact Management, required that public health units address certain questions. The following is a summary of the WECHU’s responses. 

  • If you believe you are currently able to connect with new cases within 24 hours of referral – Yes, initial contact with ALL positive cases of COVID-19 is completed within 24 hours. Since our first case of COVID-19 until now, the average number of new cases per day is 13.9. In situations where a positive case cannot be located by phone within 24 hours, a letter is delivered by WECHU staff under the signature of the Medical Officer of Health providing notification of positive test result with mandate to contact public health. (Response as at May 2020) 

  • If you believe you are currently able to connect with new contacts within 24 hours of referral or identification – Not for all contacts of confirmed cases. The ability to complete all contact tracing interviews within 24 hours is dependant upon how many contacts each case has. On average, each case in Windsor-Essex has 2 close contacts, others can have upwards of 10. The WECHU makes every effort to complete this within 24 hours. (Response as at May 2020) 

  • If you believe that your health unit can sustain that capacity within the near term for case management – No, the WECHU would not be able to absorb the additional/current COVID-19 case management work within the current complement of staff allotted to infectious disease management in conjunction with resumed operations of other areas within the health unit (i.e. school based immunization, UIIP). The WECHU currently has 656 positive cases of COVID-19. Since our first case of COVID-19 until now, the average number of new cases per day is 13.9. (Response as at May 2020) 

  • If you believe that your health unit can sustain that capacity within the near term for contact tracing - No, the WECHU would not be able to absorb the additional/current COVID-19 contact tracing work within the current complement of staff allotted to infectious disease management in conjunction with resumed operations of other areas within the health unit (i.e. school based immunization, UIIP). The WECHU currently has 656 positive cases of COVID-19. Since our first case of COVID-19 until now, the average number of new cases per day is 13.9. Applying an average factor of 2 contacts per case that requires approx. 28 people to be contacted in regards to COVID-19 follow-up per day. (Response as at May 2020) 

  • The WECHU provided the MoH with a summary of the staff complement dedicated to the WECHU’s COVID19 response. 

    In order to support the COVID-19 response in Windsor-Essex, a number of public health activities have been deferred/reduced including but not limited to: 

    • School based immunization 
    • Oral health programming (non-emergency) 
    • Health promotion programming and planning 
    • Vaccine Distribution Programming (i.e. routine inspections) 
    • Healthy Families programming (non-critical) 
    • Breastfeeding support 
    • Food Safety and other Environmental Health program training (in person courses) 

    In addition, other internal support programs have all had staff seconded to work exclusively on COVID-19 in the areas of epidemiology and evaluation, IT, communications, and planning. All of these come at a cost of progress and backlog in a number of public health programming areas. 
    The current COVID-19 response team, which was formed to supplement the Infectious Disease Team that existed prior to the pandemic (13 public health nurses, 3 clerical staff and 1 manager) consists of the following cohorts of staff to support direct case and contact management activities including contact tracing, daily PUI monitoring, testing and assessment, iPHIS entry and other COVID-19 client based work: 

    • 8 managers (health promotion and protection programing) 
    • 2 NPs (seconded from clinical services and family health programming) 
    • 35 RNs (seconded from healthy schools, healthy families, HBHC, and vaccine programming) 
    • 7 RPNs (seconded from vaccine programming) 
    • 2 Health Promotion Specialists (seconded from health promotion programming) 
    • 11 Dental Hygienists/Assistants (seconded from oral health programming) 
    • 1.5 Epidemiology Supports (seconded from health promotion and protection programming) 
    • 9 clerical staff (seconded from health promotion and protection programming) 
    • 3 Public Health Inspectors (seconded from environmental health programming) 

    The COVID-19 response for the WECHU is a 7 day per week operation that consists of 2 weekday shifts per day and one shift per day on the weekend. It is supported 24/7 by the WECHU’s on-call program.

Implementation of Public Health Mutual Assistance Agreements

Due to a significant increase in cases and contacts related to the agri-farm sector in WEC and associated demands on WECHU resources, the WECHU implemented its Public Health Mutual Assistance Agreements with the following health units: 

  • Chatham-Kent Public Health 
  • Sarnia-Lambton Health Unit 
  • Southwest Public Health 
  • Grey Bruce Health Unit 
  • Huron Perth Public Health 
  • Middlesex-London Health Unit 

Nursing staff from these health units were oriented and supported to work remotely to assist with contact management including daily monitoring of cases/contacts. Overall, approximately 11 FTEs and 10 casual nurses have been assisting our health unit since late June. In addition, Public Health Ontario has been working with our health unit to support iPHIS data entry requirements related to COVID-19.

The Ministry of Health also expanded the assistance available to the WECHU through a call out on June 28th to all health units in Ontario. In addition, Dr. Alexander Summers, Associate Medical Officer of Health, was seconded from Middlesex-London Health Unit, to assist in the short term and has been on-site for the past 2 weeks. He will continue to support remotely. Our health unit also received epidemiological support from a Field Epidemiologist through the Public Health Agency of Canada (PHAC). The Field Epi has been assigned to our health unit for approximately 4 weeks and is working with our manager of Epidemiology and Evaluation to support the work of COVID-19.

Both the Emergency Operations Centre (Minister of Solicitor General) and the Emergency Operations Centre (Ministry of Health) continue to support the work of COVID-19 in coordinating the measures needed to address the agri-farm sector outbreaks in WEC.

COVID-19 Response Team

To address the MoH’s requirements, including performance goals related to case and contact management (24-hour action timeline) and iPHIS contact and case management data entry requirements, the WECHU would require additional staff directly allocated to COVID-19 response to work within the current complement of infectious disease management and prevention. This includes: 

  • 1 FTE, Associate Medical Officer of Health 
  • 1 FTE, Program Manager 
  • 3 FTEs, Clerical Support Staff;
  • 2 FTEs, Public Health Nurses; 
  • 10 FTEs, Registered Practical Nurses; 
  • 4 FTEs, Public Health Inspectors; 
  • 1 FTE, Epidemiologist.

The following is a summary of the annual operating budget for the remainder of 2020 and one-time capital costs to support the proposed COVID-19 Response Team. 

  2020 Operating Budget
Salaries and benefits $679,337
Operating costs (mileage, program supplies, licensing) 73,602
Total 2020 Operating Costs $752,939
One-time capital costs $104,390
Financial impact – 2020 $857,329

This budget assumes a September 7, 2020, start date to allow for appropriate recruitment. One-time capital costs include the cost of information technology infrastructure, both to expand current system capacity, as well as support the COVID-19 Response Team. Augments in building occupancy costs as well as furniture and fixtures have not be contemplated as this staff would work-from-home.

Funding

The WECHU has not received any communications for the MoH regarding the funding of a COVID-19 Response Team. If the WECHU assumes that funding will not be received to support the COVID-19 Response Team, the contributions from the Obligated Municipalities for the remainder of 2020 would be as follows:

Municipality Funding ($)
Corporation of the City of Windsor $466,726
Corporation of the County of Essex 390,098
Corporation of the Township of Pelee 505
  $857,329

If the MoH does provide funding for a COVID-19 Response Team using a 70%/30% funding formula for this specific initiative, the contributions from the Obligated Municipalities for the remainder of 2020 would be as follows:

Municipality Funding ($)
Corporation of the City of Windsor $140,018
Corporation of the County of Essex 117,030
Corporation of the Township of Pelee 152
  $257,200

For information purposes, Administration quantified the annual operating costs for the COVID-19 response team. 

  2021 Operating Budget
Salaries and benefits $2,077,971
Operating costs (mileage, program supplies, licensing) 130,982
Total 2020 Operating Costs $2,208,953

Increase in contributions from the Obligated Municipalities for 2021 related to the addition of a COVID-19 
Response Team, assuming no funding is received from the MoH:  

Municipality Funding ($)
Corporation of the City of Windsor $1,202,543
Corporation of the County of Essex 1,005,109
Corporation of the Township of Pelee 1,301
  $2,208,953

Increase in contributions from the Obligated Municipalities for 2021 related to the addition of a COVID-19 response team, assuming this specific initiative is funded by the MoH at a rate of 70%/30%. 

Municipality Funding ($)
Corporation of the City of Windsor $360,763
Corporation of the County of Essex 301,533
Corporation of the Township of Pelee 390
  $662,686

PROPOSED MOTION

Whereas, the WHO declared the global outbreak of COVID-19 a pandemic on March 11, 2020, and

Whereas, the growing number of confirmed cases of COVID-19, the absence of a vaccine, coupled with movement of WEC through the stages of reopening and restarting of the WECHU programs and services, and

Whereas, the Windsor-Essex County Health Unit is responsible for promoting, protecting and improving the health and well-being of the community of WEC as required by the Health Protection and Promotion Act, R.SO. 1990 (the HPPA).

Now therefore be it resolved that the Windsor-Essex County Board of Health approve the amendment to the 2020 budget, resulting in the recruitment of a COVID-19 Response Team with an addition of 22 full-time equivalents, including an Associate Medical Officer of Health.

FURTHER THAT, the Windsor-Essex County Board of Health direct Administration to provide notice, as required under section 72(6) of the HPPA, to the Obligated Municipalities of the additional contributions required to fund the COVID-19 Response Team for the remainder of the 2020 fiscal year.

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June 18, 2020

Meeting held via video.

  1. Call to Order
  2. Agenda Approval
  3. Announcement of Conflict of Interest
  4. Update (W. Ahmed)
    1. COVID-19 Update
    2. Children Count Update (N. Dupuis)
  5. Approval of Minutes
    1. Regular Board Meeting: May 21, 2020
  6. Business Arising
  7. Consent Agenda
    1. INFORMATION REPORTS
      1. Cannabis Retail Applications & WECHU Response (N. Dupuis)
      2. WECHU WECHU Dental Services Restart (N. Dupuis)
      3. March, April, May Communications Recap
    2. RECOMMENDATION REPORTS
      1. 2019 Annual Financial Statements (L. Gregg)
  8. Board Correspondence – None
  9. New Business
    1. Environmental Health – Mosquito Tracking, Beach Testing (K. McBeth)
    2. Pandemic Pay (T. Marentette)
  10. Other Board of Health Resolutions/Letters
    1. Letter to CAO’s – Bars/Restaurants Outdoor Patio Space (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 July 16, 2020 – Via Video
  13. Adjournment
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Board Members Present:

Gary McNamara, Joe Bachetti, Tracey Bailey, Fabio Costante, Dr. Debbie Kane, Judy Lund, John Scott, Ed Sleiman, Larry Snively, Rino Bortolin

Board Member Regrets:

Gary Kaschak

Administration Present:

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

This meeting was held via video conference.

QUORUM:  Confirmed

  1. Call to Order
    Board Chair, Gary McNamara, called the meeting to order at 4:06 p.m.
  2. Agenda Approval
    Moved by: Fab Costante
    Seconded by: Rino Bortolin
    That the agenda be approved.
    CARRIED
  3. Announcement of Conflicts of Interest – None
  4. Update (W. Ahmed)
    1. COVID-19 Update

      Dr. W. Ahmed provided an update on the current status of COVID-19 in our region. We now have more than 1,200 with a significant number in the agri-farm sector. Community spread is decreasing but we are finding challenges within this sector. So far 346 workers have tested positive and we currently have 169 active cases across 8 farms. There have also been two deaths.

      Accommodations are a challenge along with compliance for self-isolation and a lack of understanding. From the employer’s end they are screening their workers, but once off the workplace some are not complying, i.e. physical distancing, congregating in numbers. Once in isolation the employers need to supply their workers with nutritious meals and basic supplies.

      EMS and ESHC have been attending on various farms and conducting in person health assessments based on referrals from our health unit, noting any further follow up. We issued Section 22 Orders on May 26 to all farms noting they keep their workers designated to working on one farm, as contract and temp agencies transport their workers to different farms, making tracking employees difficult. We strengthened the Section 22 Order on June 13 to include that employers provide access to workers via phone for case and contact management, and access to nutritious food and water. Once they are isolated or confirmed to be a case, the health unit calls them daily as we do with all cases and, if they are identified to need more medical assessment, they are referred to EMS or ESHC for a follow up in-person visit.

      There was testing launched by Ontario Health to have the Leamington Assessment Centre (Sherk Complex) bus employees from farms for asymptomatic surveillance testing. Testing numbers were low, as employers did not send their employees, but testing had expanded to farms who had symptomatic cases.

      Mandatory testing is not in place anywhere in Canada with any population for COVID-19 or any other diseases like HIV or TB. It is perceived that the recent COVID testing in Long-term care and Retirement Homes was mandatory, but it was not, and some residents and staff declined the testing. Mandatory testing goes into the area of being contradictory to the Human Rights Charter and we have not seen anyone use that authority, at any level, to suggest that a local Medical Officer of Health can use their power to force someone to get tested. This was also validated further by the Province and the Premier that it has to be voluntary. From a public health perspective we conducted random testing throughout all our municipalities, and over the course of 10 days we tested approximately 5,000 people.

      The Temporary Foreign Worker (TFW) Program is Federal. Workers are brought in for specific purposes, need to meet certain criteria and follow municipal requirements. Public health’s role is to ensure accommodations are in compliance with guidelines but not specific to COVID. The role for the municipality is to ensure that safety and fire guidelines are maintained. The Ministry of Labour and OGVG also play a role in representing the industry. From a disease perspective, an accommodation strategy to house 8,000 – 10,000 migrant workers is needed, both for the short and long term, to restrict the number of people living in congregate settings, and minimizing interaction. COVID is exposing health, income and housing inequities and a coordinated approach at various levels of government is needed to support them. When TFWs arrived they isolated for 2 weeks, tested negative then began working. Those who contracted COVID-19 were exposed here, they did not bring it here.

      From a public health perspective, our team is not immigration. Undocumented workers are treated as residents of Windsor Essex and we do our part through case and contact management to prevent the spread of disease. We spoke this morning with the Federal Health Minister, our Board Chair and other partners, that there has to be clear messaging from all levels of government to ensure that workers in isolation are getting paid either by their employer or through another mechanism.

      WECHU is also working with The Ontario Ministry of Agriculture, Food and Rural Affairs (OMAFRA) and the Ontario Greenhouse Vegetable Growers (OGVG). They have been very cooperative in working with the farms to protect their workers, and noted that it is becoming stressful for them from a food chain supply perspective. This is peak time for the agri industry, products are perishable, and it’s not the same as shutting down manufacturing. There needs to be a way to keep farms operational, contain the virus, and isolate those who need to get well.

      Moving from Stage 1 to Stage 2 is a provincial decision. We touch base weekly with the Chief Medical Officer of Health for the province and provide indicators for a sense of where we are heading and what the trajectory looks like. Combining that, the Ministry compares us to the rest of the province or other health units, along with health system capacity to manage a possible surge in cases, i.e. ventilators, ICU support. This is not something that WECHU decides.

      On sharing information, the WECHU website is updated daily with current numbers, and in addition, Dr. Ahmed and T. Marentette do a Q&A session with the media for 30 minutes daily. Media releases with relevant information is also on our website. Our call centre receives about 150 calls per day on various issues, and our staff does their best to answer any questions.

      Under the Emergency Order, the Canada/US Border remains closed except for essential workers, products and trade.

      Moved by: John Scott
      Seconded by: Rino Bortolin
      That the information be received.
      CARRIED

    2. Children Count Update (N. Dupuis)

      N. Dupuis noted WECHU’s Resolution related to the Children Count Tool-kit, which was acknowledged by Dr. David Williams, Chief Medical Officer of Health in Ontario, in a letter to Nicole Dupuis, Director of Health Protection. The Ministry of Education has also reached out to N. Dupuis advising that they will be using the Children Count Tool-kit as a framework for reopening schools in the fall. The WECHU has developed a two-page document for the Ministry to implement their reopening plan.

      Moved by: Dr. Debbie Kane
      Seconded by: Judy Lund
      That the information be received.
      CARRIED

  5. Approval of Minutes
    1. Regular Board Meeting: May 21, 2020
      E. Sleiman asked that the May 21, 2020 minutes be revised to show that he was present for the entire meeting. The minutes will be updated to reflect this change.
      Moved by: Judy Lund
      Seconded by: Ed Sleiman
      That the minutes be approved.
      CARRIED
  6. Business Arising – None
  7. Consent Agenda
    1. INFORMATION REPORTS
      1. Cannabis Retail Applications & WECHU Response (N. Dupuis)
        Brought to the Board for information.
      2. WECHU Dental Services Restart (N. Dupuis)
        Brought to the Board for information.
      3. March, April, May Communications Recap (L. Gregg)
        Brought to the Board for information.

      Moved by: Judy Lund
      Seconded by: Dr. Debbie Kane
      That the information reports be received.
      CARRIED

    2. RECOMMENDATION REPORTS
      1. 2019 Annual Financial Statement (L. Gregg)
        L. Gregg noted that the Audit Committee met on June 8, 2020 to discuss the Windsor-Essex County Health Unit December 31, 2019 financial statements, the Healthy Babies Healthy Children March 31, 2020 financial statements and the Nurse Practitioner Program March 31, 2020 financial statements and all have been brought to the Board for approval.
        Moved by: Joe Bachetti
        Seconded by: Ed Sleiman
        That the financial statements be approved as presented.
        CARRIED
  8. Board Correspondence – None
  9. New Business
    1. Environmental Health – Mosquito Tracking, Beach Testing (K. McBeth)
      K. McBeth advised that Environmental Health is in its fourth week of implementing its vector borne program tracking and larviciding of mosquitos. Beach testing will not be conducted by the health unit this summer due to capacity issues, but all nine beach have received an initial risk assessment. R. Bortolin said that municipalities may pay for testing if they are willing.
      Moved by: John Scott
      Seconded by: Judy Lund
      That the information be received.
      CARRIED
    2. Pandemic Pay (T. Marentette)
      T. Marentette noted that WECHU received $161,000 for this initiative but we are awaiting more information and guidance from the Ministry on how these funds will be applied. Health Units are listed as eligible organizations and RN’s, RPN’s and NP’s are listed as eligible employees to receive pandemic pay based on their risk of exposure of COVID-19. Some of our nursing staff work have worked extensively on random drive through testing, attending at long-term care homes, migrant farm testing and congregate settings. Environmental health also attended at these initiatives on the front lines, although public health inspectors are not identified as eligible. J. Lund requested that a letter be sent to the Ministry communicating that other public health staff worked on the front lines with COVID-19. T. Bailey said that the Ministry is still determining what pandemic pay will look like and feels a letter to the Ministry at this time may be premature.
      Moved by: Judy Lund
      Seconded by: John Scott
      That the Board follow up with a letter to the Ministry of Health on eligibility of pandemic pay.
      Opposed: Tracey Bailey
      CARRIED
      Moved by: Judy Lund
      Seconded by: Dr. Debbie Kane
      That the information be received.
      CARRIED
  10. Other Board of Health Resolutions/Letters
    1. Letter to CAO’s – Bars/Restaurants Outdoor Patio Space (N. Dupuis)
      The letter outlines the Province’s announcement to expanding outdoor patios for licensed establishments. This will require more signage and education and the health unit is here for support. R. Bortolin will continue conversations off-line with K. McBeth around various requirements and guidelines that will need to be followed.
      Moved by: Rino Bortolin
      Seconded by: Judy Lund
      That the information be received.
      CARRIED
  11. Committee of the Whole (CLOSED SESSION, in accordance with Section 239 of the Municipal Act)
    The Board moved into Committee of the Whole at 6:15 pm
    The Board moved out of Committee of the Whole at 7:27 pm
  12. Next Meeting: At the Call of the Chair, or July 16, 2020 – Via Video
  13. Adjournment
    Moved by: Tracey Bailey
    Seconded by: Rino Bortolin
    That the meeting be adjourned.
    CARRIED
    The meeting adjourned at 7:27 pm.

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