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March 18, 2021

SUBMITTED BY

Nicole Dupuis, Director of Health Promotion

DATE

March 18, 2021

SUBJECT

Ontario Active School Travel Fund Awarded to Windsor-Essex County 


BACKGROUND

Active school transportation (AST) plays an important role in helping to increase students’ activity levels and associated improvements in mental and physical health. Common modes of active school transportation include walking, cycling, skateboarding, or scootering to and from school. Using active transportation for school travel can add two bouts of physical activity to a student’s day, helping them accumulate the recommended 60 minutes of activity daily from the Canadian 24 hour movement guidelines. Additionally, when more families use active transportation, there are fewer vehicles accessing the school zone leading to improvements in safety and air quality in the school community. 

In October 2020, Green Communities Canada (GCC) a leading organization promoting active school travel, invited communities in Ontario to apply for their third round of grants under the Ontario Active School Travel Fund (OAST).  The OAST fund was created in 2018 to support active travel initiatives in selected communities across the province and has previously supported the following regions with grants under the previous two funding cycles:

  • Ajax
  • Hamilton
  • Sarnia
  • Ottawa
  • Niagara
  • London
  • Toronto
  • Stratford

Funded prrojects are expected to have a significant and lasting impact in their communities by establishing a foundation for continuing growth in the area of active school travel. Between 2018-2020, Green Communities Canada awarded $2.1 million from the OAST Fund, supporting a number of projects across the province.  Previous applications for In Windsor and Essex County, led by community groups and organizations have been unsuccessful in securing funding in previous rounds. In response to the call for applications for the third round of funding, the Windsor-Essex County Health Unit (WECHU) worked with key community partners to develop and submit an application for the OAST Fund in November 2020. As the lead applicant and coordinating organization, the WECHU submitted the grant on behalf of the partnership which involved the following organizations and community groups:

  • The Greater Essex County School Board
  • Windsor Essex Student Transportation Services
  • The City of Windsor
  • Windsor Police Services
  • Bike Windsor Essex
  • County of Essex – County Wide Active Transportation System (CWATS) program

In December 2020, the WECHU was notified by the OAST fund that the application was successful and would be receiving funding in the amount of $60,000 to be used toward active transportation initiatives for schools throughout Windsor-Essex County during 2021 into early 2022. 

CURRENT INITIATIVES:

The WECHU is in the initial stages of planning and establishing a Transfer Payment Agreement with Green Communities Canada. Upon finalizing the transfer of funding partners will reconvene to discuss project timelines, assign roles and select pilot sites. The committee’s work will focus on policy development and collaboration with pilot schools to implement interventions and assess their impact, with the ultimate goal of establishing sustainable policy and facilitating a more supportive environent for active school travel across the region. Specific projects associated with the grant application for which the funding will be utilized are described below:

  • Hiring and training of a Active Travel Planner to assist schools and boards in implementing plans and coordinate community education and outreach.
  • Establishing pilot school sites and create working groups to engage school community in planning of school-focused interventions.
  • Conducting walkability and safe route checks at each pilot school led by Windsor Police Services.
  • Conducting a scan of built environment and other policy initiatives related to each school community and determine existing resources.
  • Implementing safe active school travel training sessions with students through CAN Bike Safety and Education sessions led by Bike Windsor Essex.
  • Hosting AT community education events to highlight safe routes surrounding each pilot school and creative initiatives to engage students in active school travel.

Conducting baseline and post-intervention evaluation to determine intervention effectiveness in pilot schools and opportunities to scale up for board-wide implementation.


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SUBMITTED BY

Marc Frey, Manager, Planning and Strategic Initiatives Department

DATE

March 18, 2021

SUBJECT

Risk Management


BACKGROUND

The Windsor-Essex County Health Unit (WECHU) maintains a corporate risk registry. The Ministry of Health (MOH) requires yearly reporting on the ten (maximum) highest residual risks to the organization and the related operations. Residual risks are defined as the assessed risk level after consideration of associated mitigation strategies. The MOH requires the use of a specific template and consistent language to harmonize efforts in tracking risks across the province.

CURRENT INITIATIVES:

The WECHU enterprise risk registry monitors 29 risks across 14 risk categories. Based on the categorization and reporting requirements by the MOH, 8 of these risks were identified as being high residual risks. The high risks reported to the MOH are related to: funding, health system transformation, disasters/hazards, planning information and evaluation, work stoppage, privacy breaches, and local health disparities.

Each identified high risk includes documentation of current and future mitigation approaches. Some of the mitigation approaches are anticipated to be delayed due to the impact of the ongoing COVID-19 pandemic. The WECHU enterprise risk registry will be updated in the current year, based on the reported risk information to the MOH, with adjustments to the current status of risks and mitigation strategies.

RISK REPORTING

1: Funding

Description

CAUSE: Funding uncertainties.

EVENT: Hampered financial planning, monitoring, and decision making processes. Recent exogenesis factors, including the COVID-19 pandemic and the municipal cost-sharing changes have exacerbated funding uncertainties.

CONSEQUENCES:

  1. Inability to satisfy the WECHU's objectives (Strategic and Operational)
  2. Inability to meet the requirements of the Ontario Public Health Standards
  3. Cost reduction measures (i.e. headcount reductions; prioritization of expenditures) and resulting impact on staff morale
  4. If late approval or approval in excess of budget, lost opportunities if the WECHU is unable to act on plans
  5. Organization’s reputation is at risk
  • CATEGORY: Financial
  • IMPACT: 4
  • LIKELIHOOD: 5
  • OVERALL RATING: 20 - High

Key Risk Mitigations

CONTROL STRATEGY:

  1. Quarterly variance analysis comparing budget to actual financial results reviewed by Leadership Team and Board of Health (BOH) with forecast (Q3 and or Q4 only).
  2. Responsible budget process that balances finite resources with program/departmental priorities
  3. Identification of priorities (i.e. contract positions, operating expenditures) to be strategic with budget/planning reallocation when positive budget variances are realized
  4. Forecasting of expenditures on a quarterly basis

ACTION REQUIRED:

  1. Evaluation of budget (process and quality)

2: Health System Transformation

Description

CAUSE: Ministry mandated public health system changes.

EVENT: The WECHU may be at risk of significant disruptions and high opportunity costs related to health system transformation including the possibility of regionalization.

CONSEQUENCES:

  1. Inability to meet the requirements of the Ontario Public Health Standards
  2. Hampered ability to effectively respond to COVID-19 requirements/expectations
  3. Confusion of purpose
  4. Confusion within partnerships and working relationships
  5. The organization’s reputation is at risk
  • CATEGORY: Governance / Organizational
  • IMPACT: 5
  • LIKELIHOOD: 4
  • OVERALL RATING: 20 - High

Key Risk Mitigations

CONTROL STRATEGY:

  1. Working with regional leadership groups to identify local priorities
  2. Engaging with regional leadership groups to establish working relationships for priority areas

ACTION REQUIRED:

  1. Monitoring public health modernization developments
  2. Engagement in public health modernization efforts
  3. Change management planning based on public health modernization information

3: Disasters/Hazards

Description

CAUSE: Epidemiological, natural, and anthropogenic disasters or hazards. This current risk assessment incorporates consideration of the ongoing COVID-19 pandemic, as well as other potential disasters/hazards.

EVENT: The WECHU may be at risk of disrupted service delivery, modified program/service priorities, and/or novel requirements due to a disaster/hazard occurrence.

CONSEQUENCES:
1. Inability to meet the requirements of the Ontario Public Health Standards
2. Inability to satisfy the WECHU's objectives (strategic and operational)
3. Increased capital and human resource requirements, beyond budgeted allocations
4. Capacity constraints based on current assets and required actions
5. The organization’s reputation is at risk

  • CATEGORY: Environment
  • IMPACT: 5
  • LIKELIHOOD: 4
  • OVERALL RATING: 20 - High

Key Risk Mitigations

CONTROL STRATEGY:

  1. The WECHU works closely with community partners and the Ministry of Health (Emergency Management Branch) for any emergency notification and response
  2. A Continuity of Operations Plan (COOP), a Hazard Identification Risk Assessment (HIRA), and an Emergency Response Plan (ERP) have been developed
  3. N-95 Respiratory fit-testing occurs on regular intervals

ACTION REQUIRED:

  1. Long-term COVID-19 response plan development
  2. Increased resource allocation to address protracted COVID-19 response
  3. Forecasting for resource expectations for future disaster/hazard scenarios

4: Planning Information and Evaluation

Description

CAUSE: Capacity constraints and/or inability to access/collect information/data resources to inform program planning/operations.

EVENT: The inability to collect local data/information resources due to competing priorities (e.g., COVID-19 pandemic response) and the inability to access federal data resources (e.g., CCHS dataset access) affect organizational capacity to make evidence-based regarding program and service plans. Decreased capacity to plan and evaluate program/service operations to inform decision-making.

CONSEQUENCES:

  1. Programs and services that do not align with the needs of the community
  2. Inability to meet the requirements of the Ontario Public Health Standards
  3. Inability to address local emerging public health concerns (e.g., secondary impacts of COVID-19 on local health outcomes)
  4. Increased health disparity/inequity in Windsor-Essex health outcomes
  5. The organization’s reputation is at risk
  • CATEGORY: Information/Knowledge
  • IMPACT: 4
  • LIKELIHOOD: 5
  • OVERALL RATING: 20 - High

Key Risk Mitigations

CONTROL STRATEGY:

  1. Annual Service Plan development and submission to the Ministry of Health
  2. Program review based on COVID-19 requirements/expectations in 2021
  3. Existing data resources (e.g., the Windsor-Essex County Health Unity Community Needs Assessment 2019 Update)

ACTION REQUIRED:

  1. Development of standard program effectiveness measures to ensure fidelity of implementation with program plans/operations
  2. Program review and prioritization of interventions/services during the COVID-19 pandemic
  3. Ongoing collection and review of program effectiveness data to adjust program/service delivery based on community needs

5: Work Stoppage

Description

CAUSE: The WECHU and internal labour groups are unable to reach collective bargaining agreements.

EVENT: An extended work stoppage involving internal labour groups.

CONSEQUENCES:

  1. Service delivery to residents of Windsor-Essex County is negatively impacted
  2. Delivery of goods and services is impeded
  3. The organization’s reputation is at risk
  • CATEGORY: People/Human resources
  • IMPACT: 4
  • LIKELIHOOD: 3
  • OVERALL RATING: 12 - High

Key Risk Mitigations

CONTROL STRATEGY:

  1. Routine review of contingency plans to align with the expiration of labour agreements
  2. Routine review of plans with external stakeholders for outside services (e.g., deliveries)
  3. Established plans for work stoppage response (e.g., communication with WECHU staff, communication with vendors, and arrangements for service requirements)

ACTION REQUIRED:

  1. Review and update existing contingency plans
  2. Review and update work stoppage response plans

6: Strategic Priorities

Description

CAUSE: External pressures and resource uncertainty.

EVENT: The WECHU may be at risk of not accomplishing its strategic priorities.

CONSEQUENCES:

  1. The organization’s reputation is at risk
  2. Service delivery to residents of Windsor - Essex County is negatively impacted
  3. Inability to meet the requirements of the Ontario Public Health Standards (2018)
  • CATEGORY: Strategic/Policy
  • IMPACT: 3
  • LIKELIHOOD: 5
  • OVERALL RATING: 15 - High

Key Risk Mitigations

CONTROL STRATEGY:

  1. Implementation of 2017-2021 Strategic Plan and quarterly progress reporting (NB. These actions have been deferred throughout the COVID-19 pandemic)
  2. Completion and reporting on the Annual Service Plan (NB. Some of these actions have been deferred throughout the COVID-19 pandemic)
  3. Monitoring and review of changes to legislation, protocols, and guidelines
  4. Annual review and update of key policies and procedures

ACTION REQUIRED:

  1. Annual review of strategic plan and implementation of its objectives
  2. Prioritization of strategic plan efforts based on organizational capacity
  3. Review the impact of the COVID-19 pandemic on strategic priorities and directions

7: Privacy Breach

Description

CAUSE: Lack of knowledge, experience, and accountability related to personal information or personal health information of clients.

EVENT: Inappropriate collection, use, or disclosure of personal information or personal health information.

CONSEQUENCES:

  1. Risk of litigation and related financial consequences
  2. The organization’s representation is at risk
  3. Non-compliance with data sharing agreements
  • CATEGORY: Privacy
  • IMPACT: 4
  • LIKELIHOOD: 4
  • OVERALL RATING: 16 - High

Key Risk Mitigations

CONTROL STRATEGY:

  1. Established protocols for some databases that hold personal health information
  2. Privacy policies and procedures
  3. Annually required privacy training
  4. Privacy Impact Assessment process and documentation
  5. Annual reporting to the Information Privacy Commission

ACTION REQUIRED:

  1. Privacy audits (NB. These actions have been deferred due to COVID-19 pandemic response)
  2. Training/standard operating procedures for newly implemented systems that hold personal health information
  3. Expand auditing procedures to new electronic systems

8: Local Health Disparities

Description

CAUSE: A decreased emphasis on local priority populations in program/service delivery due to operational pressures, capacity, and prioritization because of the COVID-19 pandemic.

EVENT: The WECHU may be at risk that its programs and services do not address the health disparities amongst local priority populations.

CONSEQUENCES:

  1. Inability to meet the requirements of the Ontario Public Health Standards
  2. Increased health disparity among local priority populations
  3. Increased burden of illness and poorer local health outcomes
  4. Decreased credibility/influence with local priority population groups
  5. The organization’s reputation is at risk
  • CATEGORY: Equity
  • IMPACT: 4
  • LIKELIHOOD: 4
  • OVERALL RATING: 16 - High

Key Risk Mitigations

CONTROL STRATEGY:

  1. Past corporate training/capacity building related to social determinants of health
  2. Health Equity Impact Assessment process for programs and services
  3. Annual Service Plan/operational planning includes identification of local priority populations

ACTION REQUIRED:

  1. Identification of health inequities/disparate health outcomes for local priority populations
  2. Language service provision plans/implementation to serve community language needs
  3. Development of standard priority population engagement approaches
  4. Development of indicators of success related to interventions targeting local priority populations
  5. Local planning for priority populations due to a protracted COVID-19 response

9: Program/Service Implementation

Description

CAUSE: Some programs/services may not occur as anticipated due to operational pressures, capacity, and prioritization of the COVID-19 pandemic response.

EVENT: The WECHU may be at risk that its programs and services do not occur as anticipated based on operational plans and the requirements specified in the Ontario Public Health Standards.

CONSEQUENCES:

  1. Inability to meet the requirements of the Ontario Public Health Standards
  2. Decreased effectiveness of long-term interventions on local health outcomes
  3. Increased burden of illness and poorer local health outcomes
  4. Potential damage to partner relationships related to program/service delivery
  5. Potential opportunity cost related to lack of intervention during periods of time where individuals are seeking public health support (i.e., due to reallocation of resources to support the COVID-19 pandemic response)
  6. The organization’s reputation is at risk
  • CATEGORY: Operational/Service Delivery
  • IMPACT: 4
  • LIKELIHOOD: 4
  • OVERALL RATING: 16 - High

Key Risk Mitigations

CONTROL STRATEGY:

  1. Annual Service Plan development and submission to the Ministry of Health
  2. Program review based on COVID-19 requirements/expectations in 2021
  3. Identification of program/service implementation based on priority areas/legal requirements
  4. Monthly engagement with the Board of Health regarding service expectations during the COVID-19 pandemic

ACTION REQUIRED:

  1. Development of standard program effectiveness measures to ensure fidelity of implementation with program plans/operations
  2. Program review and prioritization of interventions/services during the COVID-19 pandemic
  3. Ongoing collection and review of program effectiveness data to adjust program/service delivery based on community needs

MOH Risk Category:

  • Compliance Legal
  • Environment
  • Equity
  • Financial
  • Governance / Organizational
  • Information / Knowledge
  • Operational / Service Delivery
  • People / Human resources
  • Political
  • Privacy
  • Security
  • Stakeholder / Public Perception
  • Strategic / Policy
  • Technology

View Document page

Board Members Present:

Gary McNamara, Tracey Bailey, Joe Bachetti, Rino Bortolin, Fabio Costante, Judy Lund, Gary Kaschak, Ed Sleiman, Larry Snively

Administration Present:

Theresa Marentette, Dr. Alexa Caturay (AMOH, Toronto Public Health), Lorie Gregg, Nicole Dupuis, Dr. Felicia Lawal, Kristy McBeth, Dan Sibley, Lee Anne Damphouse

Administration Regrets:

Dr. Wajid Ahmed


QUORUM:  Confirmed

  1. Call to Order
    Board Chair, Gary McNamara, called the meeting to order at 4:07 p.m.
  2. Agenda Approval

    Moved by:  Rino Bortolin
    Seconded by: Ed Sleiman
    That the agenda be approved.
    CARRIED

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

      G. McNamara introduced Dr. Alexa Caturay, AMOH from Toronto Public Heath, who has stepped in as Acting MOH to cover for Dr. W. Ahmed who is on a two-week leave of absence.  Dr. Caturay provided an update of COVID-19 cases in Windsor-Essex, currently averaging about 34 cases a day.  This is a little higher than the entire Southwest Region, but on average with the provincial average.  As we come out of the second wave, the increase in cases is concerning, and we are seeing an increase of 4% in young adults between the ages of 18-34 years.  The Windsor-Essex region is also trending upward for school-aged children when compared to the average population. 

      T. Marentette said that K. McBeth and L. Gregg have been very instrumental in the vaccine rollout. L. Gregg has been keeping track of the vaccine inventory and updating reports to the Ministry of Health, and K. McBeth has been involved on the operational side with the mass and mobile clinics. 

      Currently, there are two main mass vaccination sites, the WFCU Centre in East Windsor and the 
      Nature Fresh Farms Recreation Centre on Sherk Street in Leamington.  The Libro Centre in Amherstburg will come on board on March 29.  Bookings in the county will be scheduled across both Leamington and Amherstburg, based on supply.  

      We are moving forward with the 80+ group and anticipate that there are 16,000 people in this age category. Those that have pre-registered will be vaccinated by late next week.  We then hope to move to the 75+ age group. The Ministry has launched a provincial vaccine booking system, but we are currently using our own.  We are somewhat ahead of the province, as they are still vaccinating the 80+ group, and if we were on that booking system, we would not be able to move out of that priority.

      Windsor Regional Hospital (WRH) is vaccinating health care workers at the St. Clair College SportsPlex, starting with the Highest Priority, Very High Priority, and then High Priority, as well as adult recipients of chronic home care.  In Phase 2, eligibility will include individuals with highest risk and high risk medical conditions.  WRH is also assisting with the 80+ age group and has opened up a site in downtown Windsor at Windsor Hall.

      Windsor-Essex is also part of the Ministry’s AstraZeneca pharmacy rollout.  Locally, we have 57 pharmacies participating, including large corporate pharmacies as well as independents.  The priority group will be for individuals 60-64 years.

      We are also working with Family Health Teams across the region and the Windsor Essex Community Health Centre.   They were instrumental in assisting with COVID testing early on in the pandemic, and have now been provided with a supply of the vaccine for the 80+ within their practices.  They will also be moving to immunize patients with medical conditions.  We are also working with an Allergy Specialist for those at risk for possible adverse effects or allergic reactions. 

      Mobile teams EWEMS are also assisting with reaching the most vulnerable by immunizing in homeless shelters. WECHU has a small mobile team who continue to vaccinate in LTCH/RHs. As well, we are working with Windsor Essex Community Housing Corporation and EMS to vaccinate the 80+ group in seniors’ buildings. 

      We are using all of our allotment of weekly vaccine.  Our current allocation of the Pfizer vaccine is 14,000 doses per week, decreasing to 10,000 a week in a couple of weeks.  We are also receiving 2,000 to 3,000 doses of Moderna each week.  

      Dr. A. Caturay said we are seeing an uptick of cases in the younger 18-34 age group, and we are watching to see if this trend continues.  One-third of cases usually stem from household contacts, another one-third from the community, and one-third are unknown. 

      R. Bortolin asked what the plan is to address congregate living settings.  T. Marentette said that congregate settings are in Phase 2 of the Ministry’s plan. We are still in Phase 1 but are making good progress toward Phase 2.  Phase 1 includes the seniors over 80, congregate settings of the over 80 population, individuals in LTCH/RHs and the highest priority health care workers.  

      Priority will continue to be age-based in 5 year increments and next would be the at risk populations, i.e. medical conditions and congregate settings.  These will be handled by our health unit nurses, via mobile teams with EMS, but congregate settings are not an automatic eligibility at this time. 

      Our farms and greenhouses will also be a priority at some point, and all of this will be based on vaccine supply.  We are also getting questions around those who are unable to attend a clinic and asking if we would attend private homes with EMS to vaccinate.  At this time, we are not able to safely transport the vaccine in individual doses.    

      L. Snively asked if there were any adverse reactions to the AstraZeneca vaccine here in Canada, since Europe has placed a hold on using it.  T. Marentette advised that there have been no adverse reactions reported. All adverse events following immunization are reported to our health unit and Health Canada. 

      Dr. A. Caturay said the best vaccine to receive is the one that is available to you.  All of the vaccine data is reviewed very closely by Health Canada and they are deemed safe and effective.  Europe also came out with a statement that AstraZeneca is safe to use in all of Europe.

      T. Marentette said there is information on our WECHU website on the vaccines and our managers have done an exceptional job updating it daily as information changes.  We continue to share current and relevant information on YouTube, and through questions from the media.  We are actively promoting and answering any questions around vaccine safety.

      E. Sleiman asked if it is possible to contract COVID-19 between first and second doses of receiving the vaccine.  Dr. A. Caturay said that it is possible, but the likelihood is low as the first dose offers some good protection, i.e. upwards towards 80%. 

      E. Sleiman asked if it would be possible at some point for individuals in the same household to book their appointments at the same time.  T. Marentette said as we roll out the booking schedule we are looking at ways to accommodate couples, but for the 80+ age group it was not possible. 

      G. McNamara noted that we are fortunate to have a team in place that has done phenomenal work putting our region farther ahead along in the process than the rest of the province.

      Moved by:    Rino Bortolin
      Seconded by:  Larry Snively
      That the information be received.
      CARRIED

  5. Approval of Minutes
    1. Regular Board Meeting:  Special Board Budget Meeting: March 4, 2021

      Moved by:  Rino Bortolin
      Seconded by:  Larry Snively
      That the minutes be approved.
      CARRIED

  6. Business Arising – None
  7. Consent Agenda
    1. INFORMATION REPORTS
      1. Ontario Active School Travel Fund Awarded to Windsor-Essex County (N. Dupuis)
        Brought to the Board for information.
      2. Risk Management (T. Marentette/M. Frey)

        T. Marentette said that the Risk Management summary is sent to the Ministry of Health along with our budget submission. 

        M. Frey, Manager of Planning and Strategic Initiatives, walked through the Risk Management presentation, explained the Scoring and went through each category. He also discussed some of the impacts the pandemic had on WECHU’s Strategic Plan.

      3.  January/February Communications Recap
        Brought to the Board for information.

         

        Moved by: Tracey Bailey
        Seconded by:  Ed Sleiman
        That the information reports be received.
        CARRIED

    2. RECOMMENDATION REPORTS - None
  8. New Business - None
  9. Other Board of Health Resolutions/Letters
    1. Kingston, Frontenac & Lennox and Addington Public Health – Letter to Hon. Doug Ford – Mandatory Sick Leave for Ontario Workers
    2. Kingston, Frontenac & Lennox and Addington Public Health – Letter to The Right Hon. Justin Trudeau – Land and Water Border Restrictions 

    3. Peterborough Public Health – Letter to Hon. Doug Ford, the Hon. Christine Elliott and the Hon. Monte McNaughton – Paid Sick Leave During an Infectious Disease Emergency

    4. Letter from the Municipality of Chatham-Kent Public Health – Letter to the Hon. Doug Ford – Paid Sick Leave during COVID-19 Pandemic and Beyond

    5. Letter from Queen’s Park, Peggy Sattler, MPP, London West – Private Members Bill – Bill 239 – Stay Home if you are Sick ActAdvocating for paid sick days for Ontario workers to alleviate the spread of COVID-19

    6. Windsor-Essex County Health Unit – Letter to the Hon. Doug Ford – Mandatory Paid Sick Leave for Ontario Workers

    Moved by:  Tracey Bailey
    Seconded by: Ed Sleiman
    That the information be received.
    CARRIED

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

    The Board moved into Committee of the Whole at 5:20pm
    The Board moved out of Committee of the Whole at 5:40 pm

  11. Next Meeting: At the Call of the Chair, or April 15, 2021 – Via Video
  12. Adjournment

    Moved by:  Rino Bortolin
    Seconded by:  Ed Sleiman
    That the meeting be adjourned.
    CARRIED

    The meeting adjourned at 5:44 pm.

RECORDING SECRETARY:

SUBMITTED BY:

APPROVED BY:


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February 4, 2021

January 21, 2021

Meeting held via video.

  1. Call to Order
  2. BOARD ELECTIONS
  3. Agenda Approval
  4. Announcement of Conflict of Interest
  5. Update (W. Ahmed)
    1. COVID-19 Update
  6. Approval of Minutes
    1. Regular Board Meeting: December 17, 2020
  7. Business Arising
  8. Consent Agenda
    1. INFORMATION REPORTS
      1. Mosquito Surveillance and Control Program 2020 (K. McBeth)
      2. First Responder Curriculum Project – Mental Health Literacy and Resiliency – Building (N. Dupuis)
      3. December Communications Recap
    2. RECOMMENDATION REPORTS
  9. New Business
    1. Budget Timing (T. Marentette/L. Gregg)
    2. CTS Update – Next Steps (T. Marentette)
    3. W-E Vaccine Rollout Plan (T. Marentette)
  10. Other Board of Health Resolutions/Letters – For information
    1. Town of Kingsville – Letter to The Hon. Doug Ford, The Hon. Minister Christine Elliott, Medical Officer of Health, Dr. Wajid Ahmed and the Windsor-Essex County Board of Health – Resolution in Support of Small Businesses to remain open
    2. Town of Essex – Letter to The Hon. Doug Ford, The Hon. Minister Christine Elliott, Chief Medical Officer of Health, Dr. David Williams, Medical Officer of Health, Dr. Wajid Ahmed, and CEO Theresa Marentette, Windsor-Essex County Health Unit – Resolution requesting that immediate action be taken to deem Small Businesses as Essential Services
  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 February 18 , 2021 – Via Video
  13. Adjournment

View Document page

DATE

January, 2021

SUBJECT

First Responder Curriculum Project – Mental Health Literacy & Resiliency-Building


BACKGROUND - The First Responder Mental Health Coalition (FRMHC)

In recent years, there has been a growing recognition among national policy makers and legislators that first responders’ unique experiences result in mental health needs distinct from many other occupational groups. In 2016, the Ministry of Labour (MOL) amended the Workplace Safety & Insurance Act, Post-Traumatic Stress Disorder (1997) with Bill 163, Supporting Ontario’s First Responders Act, Post-Traumatic Stress Disorder (2016). Under Bill-163, all employers of first responders are required to develop, sustain, and implement post-traumatic stress disorder prevention plans.

In support of these legislative changes, the MOL issued a call for proposals for the 2017-2018 Occupational Health, Safety, and Prevention Innovation Program (OHSPIP). First responder organizations and other supporting agencies in Windsor-Essex County (WEC), including the Windsor-Essex County Health Unit (WECHU), formed a First Responder Mental Health Coalition (FRMHC) to prepare and submit a successful OHSPIP proposal.

In 2020, a five year sustainability plan was developed by the FRMHC for 2020-2025 to maintain the coalition beyond the OHSPIP grant and to build on the initiatives and programs established to date. In 2021, membership on the FRMHC includes all first responder organizations in WEC representing policing/law enforcement, fire and rescue, emergency medical services (EMS), and emergency healthcare, as well as several local partner agencies with a vested interest in promoting and supporting first responder mental health at the local level. These partner agencies include:

  • Canadian Mental Health Association – Windsor-Essex County Branch (CMHA-WECB)
  • Family Services Windsor-Essex (FSWE)
  • Windsor-Essex County Health Unit (WECHU)
  • Occupational Health Clinics for Ontario Workers (OHCOW)
  • St. Clair College

THE FIRST RESPONDER CURRICULUM PROJECT

As part of the 2017-2018 OHSPIP proposal, six project commitments were identified for the partnership to promote and support first responder mental health in WEC. The WECHU has taken a lead role in fulfilling the second project commitment outlined through the OHSPIP proposal:

“Work with representative(s) from St. Clair College to investigate the feasibility of developing a common mental health module to be included in all First Responder programs offered by the college (i.e., Pre-Service Firefighter Education and Training, Police Foundations, Paramedics)”.

The First Responder Curriculum Project was initiated by the WECHU in 2018 as a means to fulfill this project commitment. The purpose of the First Responder Curriculum Project is to develop a mental health literacy and resiliency-based curriculum module that can be embedded into local post-secondary programs for first responder students and allied health professionals, including firefighters, paramedics, police officers, nurses, and physicians.

Prior to the development of curricular content, the WECHU conducted a needs assessment to determine the key training needs and opportunities surrounding mental health literacy and resiliency-building for student and early-career first responders. The WECHU presented the final needs assessment results to the FRMHC on December 10th of 2020. Key informant interviews were conducted with 29 local representatives from the policing/law enforcement, fire and rescue, paramedic, emergency healthcare, and higher educational professions (n=28 interviews). The data was analyzed and key themes were identified that will drive the development and implementation of the curriculum module(s):

  • Curriculum Topics – The main training needs and opportunities for student and early-career first responders as related to personal/professional mental health literacy and resiliency include:
    • Resiliency-Building & Coping
    • Stigma Reduction & Help-Seeking Efficacy
    • Mental/Emotional Readiness for the Realities of the Role
    • Mental Health & Mental Illness – Theoretical, Conceptual, & Clinical Concepts
    • Strategic Uses of Social Supports
    • Early Intervention & Proactivity
    • Work-Life Balance
    • Team Building
  • Delivery Formats – Key themes supported the development of a hybrid online and in-person curriculum module with the embedment of lived experience from first responders in the profession (n=25).
  • Implementation Methods – Key themes supported the early and continual implementation of an adaptable, inter-professional curriculum module into the following post-secondary and new recruit training programs for local students and early-career first responders:
    • Pre-Service Firefighter Education & Training Program (St. Clair College)
    • Paramedic Program (St. Clair College)
    • Police Foundations Program (St. Clair College)
    • Bachelor of Nursing Program (St. Clair College & University of Windsor)
    • New recruit training programs at local first responder organizations in WEC, specifically volunteer recruit training programs at local fire departments

Current Initiatives

The WECHU is currently transitioning into the curriculum development and implementation phases of the project. In 2021, project leads at the WECHU will use the needs assessment findings to inform the development of educational and instructional components for the curriculum. The WECHU continues to consult and collaborate with local representatives on the FRMHC for knowledge, expertise, and support in solidifying key areas for curricular content, structural design, and student engagement in the curriculum module.

In collaboration with several interested members on the FRMHC, project leads at the WECHU plan to coordinate  follow-up meeting(s) with the first responder higher educational group at St. Clair College early in 2021 to update their team on the recent initiatives completed for this project and to solidify partnered strategies for implementation. Future consultations with leadership at St. Clair College, as well as representatives on the FRMHC, will inform the processes and operations undertaken in 2021-2022 to pilot, implement, and evaluate the curriculum module following its initial development and review.


View Document page

DATE

January 21, 2021

SUBJECT

Mosquito Surveillance and Control Program 2020


BACKGROUND

The Environmental Health Department conducts annual monitoring and testing of mosquito populations in Windsor and Essex County (WEC) as part of the WECHU’s Zoonotic and Vector-borne Diseases Program.

Mosquito Surveillance and Testing

Adult mosquito surveillance runs from May to early October every year and may extend depending on the weather and temperatures. Species-specific traps are deployed in various locations throughout WEC to capture mosquitoes for testing and identification to determine the presence of West Nile, Eastern Equine Encephalitis (EEE) Virus, and Zika Virus in our community. Invasive mosquito species Aedes aegypti (Yellow Fever Mosquito) and Aedes albopictus (Asian Tiger Mosquito) are also monitored each year through our Enhanced Mosquito Surveillance Program. These species are known carriers of diseases such as Zika, Malaria, Dengue, and Chikungunya. The WECHU received a federal grant from the Public Health Agency of Canada’s Infectious Disease and Climate Change Program (August 2019 to March 2022)  to study the effects of climate change and mosquito populations in our local communities. For the 2020 season, an additional 14 traps were placed in Leamington to monitor mosquito populations as part of this grant.

During this year’s season:

  • Total number of mosquitoes trapped: 205,569
  • Total number of pools tested: 2,052
  • Number of positive pools for West Nile virus : 30
  • Number of positive pools for Zika virus: 0
  • Number of positive pools for EEE virus: 0

Mosquito Control

The mosquito control program involves applying larvicide to catch basins and standing water sites such as ditches and lagoons that hold water. All municipalities in WEC have standing water by-laws in place. In 2020, over 135,000 treatments of larvicide were applied to roadside catch basins and standing water sites.

Human Cases

The WECHU follows up on all human cases of West Nile Virus. Cases are investigated to assess if additional mosquito control activities are required. In 2020, there were two confirmed and one probable case of WNV in WEC. To date, there have been no human cases of Zika Virus identified in WEC.

Education and Awareness Raising Activities

Fight the Bite public awareness campaign was launched in June and included key messages that focused on preventing mosquito bites, removal of standing water and the cause and symptoms of West Nile Virus. These messages were communicated through the WECHU website, radio, billboard and bus shelter ads, social media, and print materials.

CURRENT INITIATIVES

All activities, including monitoring and testing mosquitoes and education regarding personal protection from mosquito bites and removing standing water, will continue in 2021.  Targeted promotion and messaging will be used to reach priority populations and inform the public of hot spots identified through previous monitoring efforts.


View Document page

Board Members Present:

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

Board Member Regrets:

Administration Present:

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 4:02 p.m.
  2. BOARD ELECTIONS

    Nominations for Chair

    G. McNamara relinquished the Chair to T. Marentette, Board Secretary, to begin the election process. T. Marentette opened the floor for nominations for the position of Chair noting that Administration had received four (4) written nominations for Gary McNamara.  T. Marentette asked for further nominations from the floor (three times). Given that there were no further nominations, nominations for the position of Chair were closed. G. McNamara, having accepted the nomination, was appointed Chair by acclamation.

    Nominations for Vice-Chair

    The Chair opened the floor for nominations for the position of Vice-Chair noting that Administration had received four (4) written nominations for John Scott.  The Chair asked for further nominations from the floor (three times). Given that there were no further nominations, nominations for the position of Vice-Chair were closed. John Scott, having accepted the nomination, was elected Vice-Chair by acclamation. 

    Nominations for Treasurer

    The Chair opened the floor for nominations for the position of Treasurer noting that Administration had received four (4) written nominations for Tracey Bailey.  The Chair asked for nominations from the floor (three times). Given that there were no further nominations, nominations for the position of Treasurer were closed. Tracey Bailey, having accepted the nomination, was appointed Treasurer by acclamation.

  3. Agenda Approval

    Moved by:  Rino Bortolin
    Seconded by: Ed Sleiman
    That the agenda be approved.
    CARRIED

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

      Dr. Ahmed provided a presentation, and an update of positive COVID-19 cases in our community.  Dr. Ahmed noted that the WECHU has established a Vaccine Task Force to oversee parts of the rollout strategy and a Prioritization Committee for our community plan.

      With the current restrictions, lockdowns and the Stay at Home Order, we are seeing a slight downward trend resulting from these measures, and hope that people will take this as a sign to continue to follow public health measures. Our Percent Positivity Rate (PPR) was the highest in the province with a slight decline at 8.4% for our region.  We are still averaging about 10,000 tests per week in our community.  Cases broken down by municipality show the highest number of cases reported in Windsor, followed by Leamington, between the ages of 20 years to 60 years.  Case rates in the 0-19 ages range have decreased, due to school closures.

      The majority of residents in Long term Care Homes have received their first dose of the Moderna vaccine and we are hoping to start first rounds of the vaccine in Retirement Homes today. These settings have experienced the highest burden of outbreaks, and there are currently 19 homes in outbreak.

      We are expecting to receive another shipment of the Moderna vaccine on February 1, 2021. Without this shipment, we would not have a sufficient amount to administer all of the required second doses.  We have withheld some vials to ensure we can provide some of the second doses while awaiting the shipment. Our focus currently is on residents, staff and essential caregivers in LTCH/RHs. The hospital has been allocated the Pfizer vaccine and their shipment dates have also been impacted.

      R. Bortolin asked when the next shipment can be expected and what is Windsor-Essex’s allotment of the vaccine. Would this allotment cover remaining second doses and would it be enough for the next round of vaccinations. 

      T. Marentette said that due to security agreements this is some of the information that the health unit was asked not to disclose.  We should be able to complete all second doses for individuals that received their first dose, and there should be enough supply to complete both first and second doses in LTCH/RHs. For homes in outbreak residents and staff will need to be immunized once their outbreak has been rescinded.  We need to work together to protect this group, and will likely continue addressing LTCH/RHs into mid or late February 2021. 

      J. Lund inquired as to why our region has higher rates of the positive cases than other areas of the province, i.e. are individuals continuing to go to work while they have symptoms.  Dr. Ahmed noted we have been looking at the data. Once we pass a significant threshold of community spread, it can get out of control. There could be a number of reasons for the numbers, i.e. do individuals follow public health guidelines, do they have access to PPE, do they stay at home and isolate when required and do they have benefits through their workplace to accommodate this.  During case and contact management investigation, our team continues to provide education around mitigating the spread. 

      Dr. Ahmed said that there is a definite need for support from the Federal and Provincial government, and without it, it creates challenges for many. 

      E. Sleiman noted that the City is getting inquiries from individuals with disabilities dependent on PSWs for assistance, and are asking if they are in Phase 1 to receive the vaccine, but direction on prioritization is coming from the province. 

      G. McNamara asked where PSW’s who are not tied to LTCH/RHs would be in the queue, as many individuals in the community are depending on them for support. 

      Dr. Ahmed said this is a bigger discussion we are having with the province as well as our colleagues.  Adults receiving chronic home care will come after individuals in high risk settings.  The most significant predictor for people impacted by COVID-19 is their age.  If the vaccine were prioritized by age that would be the simplest solution, but we are going through this with a limited vaccine supply and recommendations by province.  Dr. Ahmed would like to prioritize immunizations by age, and believes this is the only way to protect individuals suffering the most severe complications.   There are no simple answers and we are speaking with the province to help the most vulnerable in the community.

      G. Kaschak asked if there were any concerns around the agri-sector and that he receives questions around housing/living conditions.  T. Marentette said there are currently cases among 11 farms and there are workers in isolation. There are 57 active cases in the agri-sector that we continue to follow, and numbers increase.  One case can spread to an entire bunkhouse.  F. Lawal is working directly with the farms and our public health inspectors are working with the Ministry of Labour when cases are identified. Dr. Ahmed said when a farms is ready for temporary foreign workers to come in and work, the farmers comply with public health regulations. Our public health inspectors do the inspection from a public health perspective, but the overall housing strategy is not something that the health unit can answer too.  G. Kaschak said he wants a better update at the next Board meeting. 

      J. Lund said individuals can be eligible for government support, but only if they have completed their income tax returns. The Canada Revenue Agency has a list of local agencies that can assist people in completing their tax returns to see if they are eligible for programs or grants. 

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

  6. Approval of Minutes
    1. Regular Board Meeting: December 17, 2020

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

  7. Business Arising – None
  8. Consent Agenda
    1. INFORMATION REPORTS
      1. Mosquito Surveillance and Control Program 2020 (K. McBeth)
        Brought to the Board for information.
      2. First Responder Curriculum Project – Mental Health Literacy and Resiliency – Building (N. Dupuis)
        Brought to the Board for information.
      3. December Communications Recap (L. Gregg)
        Brought to the Board for information.

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

    2. RECOMMENDATION REPORTS - None
  9. New Business
    1. Budget Timing (T. Marentette/L. Gregg)
      T. Marentette said the WECHU typically brings its annual budget to the Board for approval in October.  As we continue to focus on the pandemic and work to meet the needs of the Ministry and the community, we are asking that a Special Board Budget meeting be scheduled to present the Budget.  The Budget is due to the Ministry on March 1, 2021

    2. CTS Update – Next Steps (T. Marentette)

      N. Dupuis said as we continue to update the Board, we anticipated we would be further along in the process at the end of 2020.  We have assigned a Coordinator to use the criteria for site selection to start looking at listings in priority areas.  We are hoping to start this process in the next week or so and are reaching out to landlords and leaseholders and will lead the search for a potential property.

      R. Bortolin asked if WECHU is successful in finding a location and a conditional lease could be agreed upon, how long would you anticipate it would be before public consultation would begin. N. Dupuis said once a possible site is narrowed down we will revisit what public consultation would look like during COVID, and it will likely take a couple of months for us to get to the point of consultation. T. Marentette said that it’s hard to predict timelines due to the pandemic.  R. Bortolin noted that it could realistically take another year when looking at all the steps involved.

    3.  

      W-E Vaccine Rollout Plan (T. Marentette)
      T. Marentette said that the WECHU submitted its Vaccine Rollout Plan to the Ministry, which was due on January 20, 2021.

      We have been administering our allotment of vaccine in our community to LTCH/RHs and would like to acknowledge our staff in support of these homes.  It was quite an accomplishment and Windsor-Essex was one of the pilot sites.  The impact of the pandemic to LTCH/RHs in our region has been devastating and we are glad to be moving forward with immunizations for this vulnerable group.  

      Healthcare providers, physicians, nurse practitioners, walk-in clinics, family health teams have been administering the flu vaccine with over 104,000 doses this flu season, and pharmacies with 53,000 doses.  As the supply of COVID vaccine is received in our region we are anticipate that these healthcare providers will be actively involved in the roll out plan.  Other priorities in our plan include vaccine deliver models for the agri-sector, congregate settings, prioritized neighbourhoods and other groups considered at risk.  Mass immunization clinics will also be needed when there is a steady and reliable supply of vaccine. 

      With our strategy comes some challenges, one being the distribution of the vaccine. Once received, primary care providers and pharmacies need to maintain the cold chain to sustain effectiveness and to ensure every dose is used to mitigate vaccine wastage.  The other challenge is the Ministry’s reporting system, COVax, and we are working with the province as a pilot site to note issues and efficiencies.

      Other priorities we will focus on are adults in First Nations communities, Chronic Home Care, Low German Communities, Homeless individuals, Newcomers and workers in the Agri-Sector.  Next steps will include working with our partners to further develop our plans.  R. Bortolin asked how the priority would work, will individuals be put on the list and how will this be communicated. 

      T. Marentette said that this is a misconception, there is no list.   We would like to utilize our primary care provider network and stakeholders.  Physicians and pharmacies have their own lists of patients and they can prioritize by age through their existing networks to get these individuals vaccinated.  We are looking at mass immunizations sites once we receive more vaccine supply.  There is a lot of work that still needs to be done to ensure that all priority groups get included. Our efforts have focused on the vaccination or residents, staff and essential caregivers in LTCH/RHs. We are also working on a broader communication strategy regarding the vaccine rollout in WEC.

      T. Marentette noted that we have had meetings with the local municipal CAO’s around identifying possible mass immunization site locations in the county.  Leamington has been identified as one of the municipalities and Windsor will also require a mass clinic site.  More details will come, and this is all dependent on vaccine supply, but we will ensure that the process is in place and we are ready should supplies be shipped earlier than expected.  We were expecting to receive approximately 10,000 doses in February, but with delays in shipments, this is not going to happen.  We were also planning on allocations of the vaccine to double each month until June, and are still hoping for that.  

      In terms of inventory and supplies for immunizations, some supply is on hand and other various ancillary supplies will be ordered from the Ministry. 

      R. Bortolin said that this is a huge undertaking and understands how complicated this is.  The WECHU team has been working non-stop since March 2020, some with no days off.  The entire team merits a huge thank you.  This is an emotional issue as the vaccine is seen as “the end” of a difficult time, and the WECHU team has already proven they are ahead of the curve.

      Moved by:   Tracey Bailey
      Seconded by:  Ed Sleiman
      That the information be received. 
      CARRIED

  10. Other Board of Health Resolutions/Letters
    1. Town of Kingsville – Letter to The Hon. Doug Ford, The Hon. Minister Christine Elliott, Medical         Officer of Health, Dr. Wajid Ahmed and the Windsor-Essex County Board of Health – Resolution in Support of Small Businesses to remain open
    2. Town of Essex – Letter to The Hon. Doug Ford, The Hon. Minister Christine Elliott, Chief Medical Officer of Health, Dr. David Williams, Medical Officer of Health, Dr. Wajid Ahmed, and CEO Theresa Marentette, Windsor-Essex County Health Unit – Resolution requesting that immediate action be taken to deem Small Business as Essential Services

    Moved by:  Tracey Bailey
    Seconded by: Gary Kaschak
    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 5:34 pm
    The Board moved out of Committee of the Whole at 5:50 pm

  12. Next Meeting: At the Call of the Chair, or February 18, 2021 – Via Video
  13. Adjournment

    Moved by:  Rino Bortolin
    Seconded by:  Joe Bachetti
    That the meeting be adjourned.
    CARRIED

    The meeting adjourned at 5:52 pm.

RECORDING SECRETARY:

SUBMITTED BY:

APPROVED BY:


View Document page

December 17, 2020

Meeting held via video.

  1. Call to Order
  2. Introduction: Felicia Lawal, Acting Director, Health Protection
  3. Agenda Approval
  4. Announcement of Conflict of Interest
  5. Update (W. Ahmed)
    1. COVID-19 Update
  6. Approval of Minutes
    1. Regular Board Meeting: November 19, 2020
  7. Business Arising
  8. Consent Agenda
    1. INFORMATION REPORTS
      1. Healthy Families Department and Healthy Babies, Healthy Children Program Updates (N. Dupuis)
      2. Oral Health Program Update (N. Dupuis)
      3. Influenza Vaccine Update (K. McBeth)
      4. Q2 Financial Report (L. Gregg)
      5. November Communications Recap
    2. RECOMMENDTION REPORTS
      1. Bill 216 – An Act to amend the Education Act – Food Literacy (N. Dupuis)
  9. New Business
    1. Long-term Service Awards (T. Marentette)
    2. Records Management (L. Gregg)
  10. Other Board of Health Resolutions/Letters – For information
    1. WECHU Letter to The 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
  11. Committee of the Whole (Closed Session in accordance with Section 239 of the Municipal Act) 27
  12. Next Meeting: At the Call of the Chair January 21, 2021 – Via Video
  13. Adjournment

View Document page

DATE

December 17, 2020

SUBJECT

Influenza Vaccine Update


BACKGROUND

The Windsor-Essex County Health Unit (WECHU) plays a key role in the implementation of the Ministry of Health’s Universal Influenza Immunization Program (UIIP) which offers influenza vaccine free of charge each year to all individuals six months of age and older who live, work, or attend school in Ontario. The WECHU receives influenza vaccine shipments from the Ontario Government Pharmacy (OGP) and is responsible for the distribution to local health care providers and approved facilities in the community.  Allocation to providers is based on total community allocation, number of clients to be served, past usage by the provider, available fridge space, and the proportion of high-risk clients the provider is responsible for. As of December 1, 2020, there were no laboratory-confirmed cases of influenza in Windsor and Essex County.

SUMMARY OF VACCINE ALLOCATION & DISTRIBUTION

The WECHU received initial shipments of the influenza vaccine on September 28 and October 5.  In total, the WECHU received 127, 150 doses of the vaccine from the Ministry. Of these, 31,800 were the High Dose Trivalent Inactivated Vaccine (HD-TIV) for individuals 65 and over.

As of November 27, the WECHU has distributed 89% (113,960 doses) of our total allocation of the influenza vaccine, and 100% (31,800 doses) of the HD-TIV to the community, including 41 long-term care facilities and retirement homes, 4 hospitals, and approximately 200 healthcare providers. The OGP distributed the influenza vaccine directly to 101 pharmacies in WEC that were approved by the Ministry of Health, and at the time this report was written, pharmacies have administered 43,955 doses to WEC residents.

 

QIV

High Dose - TIV

Total

# of doses of flu vaccine the WECHU has received from the Ministry

97,850

31,800

127,650

# of doses of flu vaccine the WECHU has distributed to the Community

82,160

31,800

 

113,960

 

The initial supply of influenza vaccine is prioritized for the immunization of high-risk individuals, such as residents and staff of long-term care homes and retirement homes. Overall, the WECHU has distributed 5,655 influenza vaccine doses to 19 long-term care homes, and 2,240 doses to 22 retirement homes in WEC. A further breakdown is provided below:

 

QIV

High Dose – TIV

Total

# of doses of flu vaccine the WECHU has distributed to Long-Term Care Homes

3,000

2,655

5,655

# of doses of flu vaccine the WECHU has distributed to Retirement Homes

790

1,450

2,240

 

HIGH DOSE -TIV

On November 16th, the Ontario Ministry of Health notified all Health Units that Fluzone High Dose is out of stock, and will not be available for the remainder of the season. However the standard dose of Quadrivalent Influenza Vaccine (QIV) is still available, and there is no preferential recommendation for high dose over QIV.

ADVERSE EVENTS FOLLOWING IMMUNIZATION

Concerns were identified through the Adverse Events Following Immunization reporting system, and the administration of a specific lot of FluLaval Tetra was suspended. Investigation is underway nationally, and the WECHU has contacted all healthcare providers on record who had received the affected vaccine to halt its use until further notice. The WECHU will continue to update healthcare providers as more information is received from the Ministry of Health.

CURRENT INITIATIVES

Although the WECHU is not administering the influenza vaccine to clients this year, we continue to support widespread availability of the influenza vaccine in our community by working collaboratively with many community partners, including those in primary care, to identify service gaps and promote vaccine uptake.

The WECHU continues to raise awareness of the risks of contracting influenza (especially for high-risk groups), and the importance of being vaccinated amongst the COVID-19 pandemic through our social media platforms (i.e., Facebook, Twitter, and Instagram).


View Document page

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.


View Document page

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

 


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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


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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.


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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.


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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.

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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:

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APPROVED BY:


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