Board of Health Meeting Documents

Prepared By:

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

Date:

March 19, 2018

Subject:

Risk Management

Background

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

Current Initiatives

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

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

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

Consultation:

The following individuals contributed to this report:

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

Approved by:

Theresa Marentette

Prepared By:

Communications Department

Date:

April 4, 2018

Subject:

March Media Relations Recap Report

March Media Coverage

Breakdown of Top Stories

Media Coverage

News Release and Media Advisories

Links to Stories

AM 800

Advocator.ca

Blackburn News

CBC News

CTV News

Windsor Star

Windsorite.ca

Yahoo News

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

Prepared By:

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

Date:

March 27, 2018

Subject:

Quarterly Planning Report

Background

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

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

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

Current Initiatives

2018 Reporting Structure

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

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

Operational Planning/ASP Alignment

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

Consultation

The following individuals contributed to this report:

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

Approved by:

Theresa Marentette                       

Prepared By:

Phil Wong, Manager, Environmental Health Department

Mike Tudor, Manager, Environmental Health Department

Date:

April 19, 2018

Subject:

Seasonal Housing and Tenant Complaint Processes

Background

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

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

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

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

Current Initiatives

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

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

Approved by:

Theresa Marentette                       

Board Members Present:

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

Board Member Regrets:

Dr. Deborah Kane, John Scott, Michelle Watters

Administration Present:

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

Administration Regrets: 

None.

RECORDING SECRETARY:

SUBMITTED BY:

APPROVED BY:

Issue

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

Background

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

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

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

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

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

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

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

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

Reserves and reserve funds

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

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

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

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

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

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

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

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

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

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

Proposed Motion

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

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

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

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

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

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

Issue

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

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

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

Background

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

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

Oral Health Services in Windsor and Essex County:

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

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

Oral Health Assessment and Surveillance Reporting in Windsor-Essex:   

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

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

Requests for Oral Health Assessment and Surveillance Data and Response:

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

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

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

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

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

Amended Motion

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

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

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

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

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

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

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

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

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

Introduction:  Board of Health Member, Judy Lund

Board Members Present:

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

Board Member Regrets:

Dr. Ken Blanchette, Hilary Payne, John Scott

Administration Present:

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

Administration Regrets: 

None.

RECORDING SECRETARY:

SUBMITTED BY:

APPROVED BY:

Board Members Present:

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

Board Member Regrets:

Paul Borrelli, Bill Marra, Carlin Miller

Administration Present:

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

Administration Regrets: 

Theresa Marentette, Nicole Dupuis, Dan Sibley

RECORDING SECRETARY:

SUBMITTED BY:

APPROVED BY:

Board Members Present:

Board Member Regrets:

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

Administration Present:

RECORDING SECRETARY: