Board of Health Meeting Documents

The accompanying financial statements of the Windsor-Essex County Health Unit (“Health Unit”) Ministry of Children, Community and Social Services Program Initiatives are the responsibility of the Health Unit’s management and have been prepared in compliance with legislation, and in accordance with Canadian public sector accounting standards for local governments established by the Public Sector Accounting Board of the Chartered Professional Accountants of Canada. A summary of the significant accounting policies are described in Note 1 to the financial statements. The preparation of financial statements necessarily involves the use of estimates based on management’s  judgment, particularly when transactions affecting the current accounting period cannot be finalized with certainty until future periods.

Period: April 1, 2022 to June 30, 2022

1. For the period covered by this CEO Quarterly Compliance Report:
   
   1. The undersigned has personal knowledge of the matters herein reported or has made due inquiry with respect to the same.
   2. Except as reported in any previous CEO Quarterly Compliance Report, the undersigned reports as follows:
      
      1. that the Health Unit has been in material compliance with all laws, regulations, orders, judgments or decrees applicable to it.  Without limiting the generality of the foregoing the Health Unit is current in respect of all tax and related withholding and remittances required by law;
      2. the Health Unit has been in material compliance with its By-laws;
      3. the Health Unit has been in material compliance with all other Board resolutions;
      4. the Health Unit has been in material compliance with all contracts and commitments to which the Health Unit is a party including without limitation all funding and accountability agreements;
      5. the Health Unit is current with respect to the payment of all remuneration (including salary and benefits) to its employees;
      6. there are no material variances between what is contemplated by the Operational Plan and what in fact transpired or appears likely to transpire;
      7. more specifically, no material changes are required in respect of financial resource allocation plans to address shifts in need and capacity;
      8. no material adverse change has occurred in the operations of the Health Unit or its assets and liabilities taken as a whole;
      9. there have been no material breaches of the Ethics Code of Conduct by anyone who is subject to it;
      10. there have been no unplanned terminations of any Health Unit employees;
      11. there have been no claims made pursuant to any insurance policies maintained by the Health unit, except as noted below, and,
      12. nothing has come to the attention of the undersigned which would materially adversely change any previous CEO Quarterly Compliance Report, except as detailed below:

              Items (vi), (vii), and (viii) have been revised due to the COVID -19 pandemic as follows:

• The WECHU continues through the Organizational Emergency Response. As such, operations are shifted, including redeployments to meet the needs of the organization. Operational plans and finances are shifted in accordance with current public health demands including the ongoing COVID-19 pandemic.
• The WECHU, in its response to COVID-19 within the communities of Windsor and Essex County has:
  • Redeployed staff as considered appropriate to facilitate our response to the pandemic including transition of staff from case and contact management to support the vaccination efforts as directed by the province.
  • Increased expenses related to vaccination to support resources required as per Ministry direction.

              Item (xi) notes the following claim:

• On June 6, 2022, an air conditioning unit was stolen from the WECHU office located at 1005 Ouellette Avenue, Windsor.  The WECHU facilities department filed a report with the Windsor Police.  The WECHU has filed a claim with its property insurer for replacement of the air conditioning unit.  The WECHU is currently compiling estimates for replacement of the unit.  The replacement value of the unit is estimated to be $6,000 to $10,000.

Date: June 30, 2022

Signature(s):

Nicole Dupuis, Chief Executive Officer

The accompanying financial statements of the Windsor-Essex County Health Unit (“Health Unit”) are the responsibility of the Health Unit’s management and have been prepared in compliance with legislation, and in accordance with Canadian public sector accounting standards for local governments established by the Public Sector Accounting Board of the Chartered Professional Accountants of Canada. A summary of the significant accounting policies are described in Note 1 to the financial statements. The preparation of financial statements necessarily involves the use of estimates based on management’s judgment, particularly when transactions affecting the current accounting period cannot be finalized with certainty until future periods.

JULY 14, 2022

ISSUE/PURPOSE

The Windsor-Essex County Health Unit (WECHU) is a statutory corporation created pursuant to the Health Protection and Promotion Act, R.S.O. 1990, c.H.7 (HPPA).  The WECHU is not a registered charity as defined by Section 149 of the Income Tax Act.  As such, the WECHU is not eligible for certain funding, fundraising and cost-savings opportunities available to a registered charity. 

BACKGROUND

In 2012, previous Administration explored the WECHU becoming a registered charity, however, the application remained incomplete and registered charity status was no longer pursued.

Over the next three (3) to five (5) years, the WECHU will continue to experience budget constraints as it navigates operations in a post-COVID-19 environment.  Adding to this are the financial pressures associated with the Windsor Office Redevelopment Project.  As such, the WECHU needs to seek funding, fundraising and other cost-saving opportunities to assist in managing financial pressures.  Details regarding the advantages and disadvantages of becoming a registered charity are as follows:

Advantages:

• Ability to apply for property tax rebates for owned or leased premises.
• Ability to attract donations/funding.
• Ability to receive rebates and deductions through participating third party vendors.
• Additional grant opportunities.

Disadvantages:

• Increased financial reporting responsibilities as the WECHU would be required to file an annual return.
• Ensuring that the WECHU satisfies the disbursement requirements to maintain registered charity status.

Administration has concluded that the advantages of registered charity status out way any disadvantages noted and is therefore recommending that the WECHU move forward with its application.

PROPOSED MOTION

Whereas, the WECHU is not a registered charity as defined by Section 149 of the Income Tax Act, and

Whereas, registered charity status could result in additional funding, fundraising and cost-savings opportunities to the WECHU, and

Now therefore be it resolved that the Windsor-Essex County Board of Health approve Administration to proceed with the process of investigating and applying for registered charity status for the WECHU.

JULY 14, 2022

ISSUE/PURPOSE

Approval of the annual audited financial statements.  This includes:

• The annual audited financial statements for the Windsor-Essex County Health Unit for the year-ended December 31, 2021 (Appendix A)
• The annual audited financial statements for the Windsor-Essex County Health Unit Ministry of Children, Community and Social Services Program Initiatives for the year-ended March 31, 2022 (Appendix B)

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

BACKGROUND

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

The annual financial statements are audited by KPMG LLP, independent external auditors appointed by the Corporation of the City of Windsor.  On June 16, 2022, the Audit Committee of the Windsor-Essex County Board of Health (Audit Committee) convened to review the annual financial statements and audit findings report with Administration and KPMG LLP.  The Audit Committee has recommended the financial statements for approval to the Board of Health (Board). KPMG LLP is prepared to issue, pending approval by the Board, an unmodified audit opinion on the annual financial statements. 

Windsor-Essex County Health Unit (WECHU)

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

Statement of Financial Position

• Cash and short-term investments increased $3,162,047.  Refer to the Statement of Cash Flows for details.
• Accounts receivable increased $148,637 primarily due to the following:  a) Decrease in grants receivable from the Province of Ontario of $207,303 over 2020.  This balance varies on an annual basis based upon the extent and timing of funding approvals for one-time business cases typically funded at a rate of 100%.  b)  Increase in other receivables of $314,542.  The most notable grants outstanding for the year-ended December 31, 2021, include $67,161 relating to the Infectious Disease and Climate Change Program and $266,547, relating to the IPAC Hub Funding. 
• Due to Province of Ontario increased $3,356,486.  This balance is comprised of:
  

  2021 Settlement	$2,880,732
  Prior Settlements (2020, 2019)	1,921,315
  Total	$4,802,047

Of noteworthy mention is the following:

• In the period January to March of 2022, $915,766 was clawed back by the Ministry of Health (MOH) on account of the 2021 settlement.  The remaining, will be clawed back upon completion of the settlement review.
• The 2019 settlement review is nearing completion with a final reconciliation notice to be issued by the MOH shortly.  The total amount remaining to be clawed back on account of the 2019 settlement is $518,577.
• The 2018 settlement of $213,422 was clawed back in 2021;
• Due to Municipalities decreased $949,475.  This balance is comprised of:
  

  2021 Settlement	$1,260,800
  Prior Settlements (2020, 2019)	1,621,433
  Total	$2,882,233

Of noteworthy mention is the following:

• The 2021 Settlement relates to the 2021 Cost-Sharing Mitigation Funding of $1,260,800;
• As noted in Due to Province of Ontario, the 2019 settlement review is nearing completion and will result in $1,285,794 being repaid to the Obligated Municipalities, based upon their pro-rata share of the population of Windsor and Essex County (2016 Census).
•  Due to Community Programs increased $518,817.  This financial statement caption includes amounts owing to the other WECHU administered programs not included in the WECHU financial statements.  More specifically, this include balances relating to the WECHU Healthy Babies Healthy Children Program and the WECHU Nurse Practitioner Program.  These Programs do not have separate bank accounts.  Funds received from the Ministry of Children, Community and Social Services (MCCSS) are included in the primary WECHU bank account and are reconciled regularly.
• Accrued payroll and deductions decreased $119,861.  The decrease in this financial caption primarily relates to the discharging of obligations on account of management overtime (2020 - $176,584).
• Deferred revenue increased $409,999.  Fluctuations in deferred revenue year-over-year typically relate to the nature and timing of grant funding.  At December 31, 2021, significant sources of deferred revenue include:  a) School-Focused Nurses funding of $439,134; b) Ontario Active Transportation grant of $24,000; c) Grant received from the Greater Essex County District School Board of $26,000 to support the Windsor-Essex Community Opioid and Substance Strategy.
• Tangible capital assets decreased $11,760.  The net decrease is attributed to:  i) Tangible capital asset additions of $294,788; ii) Amortization expense of $306,548.  Of the tangible capital assets acquired in the year, $231,024 were funded by the Ministry of Health using Mandatory Program funding (70%), and $63,764 were funded using Ontario Seniors Dental Care Program funding (100%). Refer to note 9 for additional details.

Statement of Operations and Accumulated Deficit:

• Increase in Revenue from the Province of Ontario of $6,758,354.  The increase is attributed to the following:
  • Increase in Ontario Seniors Dental Care Program (OSDCP) Funding in the amount of $557,562.  This increase is attributed to the OSDCP Program being in operation for a full fiscal year, impacted on a limited basis by COVID-19 restrictions.
  • Increase in Other of $6,203,821. This is attributed to:  a) COVID-19 Vaccination Program funding in the amount of $5,739,845; b) School-Focused Nurses Initiative funding in the amount of $1,425,807.
• The Ministry of Health funds the WECHU to a maximum of 70% of admissible expenditures.  Admissible expenditures for the purposes of the Ministry of Health Settlement Process is defined below:

• Increase in Expenses of $6,728,629.  Notable increases include:
  • Increase in Salaries and Benefits in the amount of $4,775,348.  Notable increases from 2021 include:
    • Increase in FTEs year-over-year.  At January 1, 2021, total FTEs amounted to 267.  At December 31, 2021, total FTEs amounted to 295.
    • One (1) percent cost of living increase for employees represented by the Canadian Union of Public Sector Employees (CUPE) and non-union staff and two (2) percent increase for employees represented by the Ontario Nurses Association (ONA).
    • Total payments on account of overtime, premium pay, and retroactive payments for the 2021 fiscal year amounted to $1,576,876.
  • Increase in Purchased Services in the amount of $1,559,727.  Notable increases from the prior year include:
    • Professional supports (immunizers) for mass vaccination clinics of $256,638;
    • Third party support for case and contact management of $698,476;
    • Third party support for call centre and other support services for case and contact management and vaccinations of $344,852.
  • Increase in Supplies and other in the amount of $420,131.  Notable increases from prior year include:
    • $134,974 increase in Mileage in 2021 incurred on account of staff working at mass vaccination clinics;
    • $285,157 increase in Supplies and other relate to program costs incurred on account of COVID-19 vaccination efforts.  Examples include:  a) Licensing for scheduling application and website support of $63,979; b) Personal Protective Equipment of $52,271; c) Sharps disposal costs of $41,438; d) Transportation of vaccines to health care providers of $10,452.

Windsor-Essex County Health Unit Ministry of Children, Community and Social Services Program Initiatives

The annual audited financial statements for the Windsor-Essex County Health Unit Ministry of Children, Community and Social Services Program Initiatives include financial information for the Nurse Practitioner Program and the Healthy Babies Healthy Children Program for the period April 1, 2021 to March 31, 2022.

The enclosed summary analytical review addresses material changes in financial statement captions year-over-year.

Statement of Financial Position:

• Due from the Windsor-Essex County Health Unit:  Refer to the statement of cash flow for details on the increase of $694,762 from March 31, 2022.
• Due to Ministry of Children, Community and Social Services:  The amount outstanding is as follows:
  • Settlement for the year-ended March 31, 2022, in the amount of $734,310;
  • Settlement for the year-ended March 31, 2021, in the amount of $581,637.  This settlement was clawed back in April of 2022.

Statement of Operations and Accumulated Deficit:

Year-over-year variations in the financial results are primarily due to the impact the COVID-19 pandemic had on service delivery for the period April 1, 2021 to March 31, 2022.  A substantial portion of the nursing staff that would historically support theses Programs were deployed to support the WECHU’s pandemic response including case and contact management and vaccinations.

A summary of the settlement with the Ministry of Children, Community and Social Services is as follows:

PROPOSED MOTION

Whereas, at the June 16, 2022, meeting, the Audit Committee of the Windsor-Essex County Board of Health reviewed the annual audited financial statements and recommended them to the Board for approval,

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

The annual audited financial statements of the Windsor-Essex County Health Unit for the year-ended December 31, 2021; and

The annual audited financial statements for the Windsor-Essex County Health Unit Ministry of Children, Community and Social Services Program Initiatives for the year-ended March 31, 2022.

Meeting held via video: https://youtu.be/KIRSwrSfXJ8

Changes to previous version

Changes in the Procurement Policy include the following:

• The five (5) core functions of the procurement process were consolidated into four (4), with Requisition and Method from the previous version combined under Execution.
• Removed list of all exceptions under the Canadian Free Trade Agreement (CFTA), replace with link and reference to current requirement as per CFTA.  Definitions have been updated to reflect current terms utilized in the Procurement Policy.
• Approval Authorities referenced in the previous Procurement Policy have been removed.  The Policy section of the current Procurement Policy summarizes estimated procurement values and provides guidance regarding the method of procurement that shall be undertaken.
• All dollar thresholds in the Procurement Policy have been updated/increased.
• Definitions, more specifically, Conflict of Interest, Fairness, Non-discrimination, and Settlements, have been updated to provide clarification.
• Roles and responsibilities have been updated to include responsibilities specific to the Director of Corporate Services and the Finance Department.
• The Execution section of the Procurement Policy provides additional guidance on the two types of non-competitive procurement and the circumstances in which either type would be considered acceptable.
• Award/Regret Notification – This chart has been updated to include specific details required to be disclosed on the Health Unit’s website.
• Other procurement circumstances provide guidance on approach to the procurement of real property, banking services, and insurance brokerage services.  Additional guidance has been included regarding use of the Vendor of Record with the Province of Ontario.
• Payments – The frequency of issuance of cheques by the Finance Department as well as the reference to cheque signing authorities have been updated.
• Removal of guidance on Request for Parking tokens and Cash on hand have been removed and will be addressed in a Cash Management Policy.

Purpose and Scope

As a publicly funded organization, the Windsor-Essex County Health Unit (Health Unit) is required to implement a Procurement Policy (the Policy).  The Policy shall support the strategic and operational requirements of the Health Unit; comply with legal and contractual obligations; manage and mitigate risk; create an environment of continuous improvement; yield the best value for money; be undertaken with fairness, honesty, and integrity; avoid the appearance of impropriety; be open and transparent; undertaken in a non-discriminative manner. 

Board Members and Health Unit staff must not:

• Acquire any goods and services for personal use in representation of the Health Unit
• Purchase or offer to purchase, on behalf of the Health Unit, any goods and services, except in a accordance with this Policy
• Knowingly cause, permit or omit anything to be done or communicated to anyone which is likely to cause any potential Supplier to have an unfair advantage or disadvantage in obtaining a Contract for the supply of a good or service to the Health Unit, or any other either jointly or in cooperation with the Health Unit;
• Knowingly cause, permit or omit anything to be done which will jeopardize the legal validity or fairness of a purchase under this policy, or which might subject the Health Unit to any claim, demand, action or proceeding as a result.

The WECHU should look to achieve some/all of the following goals in any procurement process:

• To procure by purchase, rental or lease the required quality and quantity of goods and/or services, including consulting services in an efficient, timely and cost effective manner;
• To consider all costs, including, but not limited to,  taxes, delivery, acquisition, operating, training, maintenance, quality, warranty, payment terms, disposal value and disposal costs, in evaluating bid submissions from qualified, responsive and responsible vendors
• To give full consideration to the annual aggregate value or to consider the total project cost of specific goods and services that will be required by each department and by the Health Unit as a whole prior to determining the appropriate acquisition method;
• When procuring goods, services and facilities, the Health Unit will comply with the requirements of the Ontarians with Disabilities Act 2001, the Accessibility for Ontarians with Disabilities Act, 2005 and its associated standards enacted through regulation, as well as related Health Unit polies and to encourage the procurement of goods and services with due regard for people with disabilities;
• To monitor and report on the economic climate and legislative changes which may have an impact on the Health Unit and to determine the appropriate actions to be taken through purchasing policies and procedures;
• To encourage the procurement of goods and services with due regard to the preservation of the natural environment, Suppliers may be selected  to supply goods made by  methods resulting in the least damage to the environment and supply goods incorporating recycled materials where practicable.
• To investigate the purchase of energy efficient/advanced technology equipment, vehicles, supplies, and appliances wherever possible.

The Procurement Policy applies to all procurements except: i) professional services; ii) employee expenses; iii) governmental charges; iv) settlements; v) low value purchases; vi) other exceptions as defined by the Canadian Free Trade Agreement (CFTA) and other governing legislation or Ministry directives that may be in place from time-to-time.

Policy

The procurement process is broken down into four (4) phases:

When procuring goods or services, Health Unit staff shall adopt the type of procurement available based upon an estimate of the procurement value of the goods or services being considered.  The following are the required approaches based upon the estimated procurement value of the goods or services. 

*While procurements with estimated procurement values of $7,500 or less can be undertaken in a non-competitive manner, WECHU staff should always consider obtaining a minimum of three (3) quotations from Suppliers to ensure the WECHU is yielding the best value for money and that WECHU staff undertaking procurements are not in conflict (actual or perceived).

Definitions

Roles and Responsibilities

The Chief Executive Officer (CEO) shall:

1. Be responsible for the establishment, implementation, monitoring and enforcement of the Procurement Policy.
2. Management of all operations in material compliance with all applicable laws, regulations, orders, judgements and decrees, the Health Unit By-laws, Board resolutions, and all contractual obligations and commitments of the Health Unit.
3. Provide notice to the Board of any material non-compliance with the above listed items forthwith and additionally in the CEO Quarterly Compliance Reporting.
4. On an annual basis, report to the Board of Health details of all contracts awarded in excess of $50,000 including amendments and renewals.  The report shall certify that the procurements were undertaken in compliance with the Purchasing Policy.

The Leadership Team and Management Team (LT and MT) shall: 

1. Abide by and enforce the Procurement Policy.
2. Provide oversight and accountability for all procurement activities in their areas of responsibility.
3. Provide notice of material non-compliance with the Procurement Policy to the director and/or the CEO, as appropriate.

The Director of Corporate Services, in addition to the responsibilities noted above, shall:

1. Provide purchasing advice to the Health Unit Staff on account of their procurement activities;
2. Ensure on-going training and education is administered to the Health Unit Staff with the Procurement Policy;
3. Present the findings of the Procurement audit to the CEO, LT and Board, as appropriate, on an annual basis.

The Finance Department shall:

1. Ensure procurement documentation (i.e. purchase or cheque requisitions) are appropriately supported and approved before processing for order or payment;
2. Complete the necessary follow-up if procurement documentation is incomplete;
3. Specifically, the Manager of Accounting and Financial Reporting shall audit, at least annual, procurements in accordance with Appendix Q, and report the findings of the Procurement Audit to the Director or Corporate Services.

The Health Unit Staff Shall:

1. Abide by the Procurement Policy;
2. Review the Procurement Policy annually and attend all required training.

Procedure

This section describes the four phases of the procurement process in further detail.

Planning:  In the planning phase, the Health Unit shall:

• Ensure that the procurement is appropriate, in that it supports the strategic priorities or operational requirements of the Health Unit.
• Determination if the procurement is or is not budgeted:  A manager, in consultation with their director, shall determine whether the procurement being undertaken is budgeted or unbudgeted.  Currently, the budgeting methodology does not require for each activity to be budgeted.  Therefore, for the purposes of understanding whether a procurement is or is not budgeted, reference should be made to the departmental budget line in totality.  For example, if Environmental Health is required to procure promotional items such as insulated bags, the Manager of that department would review their program supplies account to understand whether there is or is not sufficient dollars to procure these items, given all of the remaining activities to be addressed by the program.  If dollars do not exist, the Manager would consult with their director to understand whether additional funding exists at a corporate level that would permit the purchase. 
• Procurement requirements:  In order to proceed with budgeted or unbudgeted purchasing, it may be necessary to retain further information about the Health Unit’s purchasing needs, the marketplace, or to create a pool of qualified Suppliers (in advance of the specific purchase). The following tools are available to facilitate the gathering of information:
  • RFI/I – In the event of insufficient information to adequately state purchasing objectives or adequately translate such objectives into specifications, if it is unclear generally as to Supplier capacity to deliver on objectives or specifications, or in the event it is unclear as to Supplier interest in a contemplated purchasing opportunity, raising concerns about likely level of Supplier response or questions with respect to the best method of purchasing, an RFI/I shall be used to gather such information.  Refer to Appendix B.
  • RFSQ’s – In the event it is desirable to:  reduce the number of Suppliers  eligible to make a Submission in response to a contemplated RFS to those most qualified; or create a list of Suppliers to be used for one or more future purchases, an RFSQ shall be used.  Refer to Appendix C.
• Calculation of procurement value:  An estimate of the value of a procurement is required to determine the method of procurement.  When calculating the value of the procurement the following considerations must be understood:
  • Subdividing Purchasing:  It is not acceptable to take any action such as subdividing purchases to reduce the estimated Contract price or otherwise avoid or circumvent the application of any requirements.
  • Extensions and Renewals:  If a Contract includes a provision permitting extensions or renewals, the estimated Contract Price shall be based on the total term, including initial term and any possible extension or renewal term.  Extensions or renewals beyond what is provided for in the Contract shall be considered non-competitive Purchasing and appropriate approval authorities shall be required (i.e., approval by the Board).
  • Other incidentals:  If Contract includes a provision for other incidentals including installation, operation, maintenance or manufacture of such goods or travel costs, the Health unit shall consider including those costs in its evaluation.
  • Interim Increases:  In the event that an amount in connection with which an approval authority has been given increases after having been given but before it has been acted upon, then it shall be necessary to seek approval authority for the increased amount.
  • Standing Offers:  In connection with Standing Offers, the estimated total price of the  Deliverables over the course of the specified term of the Standing Offer shall be deemed to be the estimated Contract Price.
  • Taxes and Duties:  Threshold approval authorities for any of the functional roles as outlined in this Purchasing Policy or any other monetary thresholds described in this Purchasing Policy shall be exclusive of taxes and duties.

Execution:  The Purchasing method can broadly be divided into competitive purchasing and non-competitive purchasing.  It is non-competitive Purchasing when the Health Unit purchases from a single Supplier, without considering what any other suppliers in the marketplace may offer.  Non-competitive procurement can be further subdivided into single sourcing and sole sourcing.

The Health Unit may conduct a single source non-competitive procurement, provided that they do so not for the purposes of avoiding competition between suppliers or to discriminate against suppliers:

• Where an unforeseeable situation or urgency exists and the goods or services cannot be obtained in time by means of open procurement procedures.  Failure to plan and allow sufficient time for a competitive procurement process does not constitute an unforeseeable situation of urgency;
• Where goods or services regarding matters of a confidential or privileged nature are to be purchased and the disclosure of those matters through and open tendering process could reasonably be expected to compromise government confidentiality, cause economic disruption or otherwise be contrary to the public interest;
• Where construction materials are to be purchased and it can be demonstrated that transportation costs or technical consideration impose geographic limits on the available supply base, specifically in the case of sand, stone, gravel, asphalt, compound and pre-mixed concrete for use in the construction or repair of roads;
• Where compliance with the opening tendering provisions would interfere with the entities’ ability to maintain security or order or protect human, animal or plant life or health; and
• In the absence of a receipt of any bids in response to a call for proposals or tenders.

The Health Unit may conduct a sole-source non-competitive procurement, where only one supplier is able to meet the requirements of a procurement, provided that they do not do so for the purpose of avoiding competition between suppliers or to discriminate against suppliers:

• To ensure compatibility with existing products, to recognize exclusive rights, such as exclusive licenses, copyright and patent rights, or to maintain specialized products that must be maintained by the manufacturer or its representatives;
• Where there is an absence of competition for technical reasons and the goods or services can be supplied only by a particular supplier and no alternative or substitute exists;
• For the procurement of goods or services the supply of which is controlled by a supplier that is a statutory monopoly;
• For the purchase of goods on a commodity market;
• For work to be performed on or about a leased building or portions thereof that may be performed only by the lessor;
• For work to be performed on property by a contractor according to provisions of a warranty or guarantee held in respect of the property or the original work;
• For a contract to be awarded to a winner of a design contest;
• For the procurement of a prototype of a first good or service to be developed in the course of and for a particular contract for research, experiment, study or original development, but not for any subsequent purchases;
• For the purchase of goods under exceptionally advantageous circumstances such as bankruptcy or receivership, but not for routine purchases;
• For the procurement of original works of art;
• For the procurement of subscriptions to newspapers, magazines or other periodicals; and
• For the procurement of real property.

Competitive Purchasing is when the Health Unit selects from among multiple offers from different Suppliers.  Competitive Purchasing can further be divided into open and invitational Purchasing.  It is open Purchasing when the supply opportunity is advertised publicly, such as on MERX, making it available to all qualified Suppliers.  It is invitational Purchasing when only selected Suppliers are invited to make Submissions.

Non-competitive procurement for purchase values ranging from $500 to $7,500, the following steps  will be undertaken:

• Health Unit staff can solicit a quotation from one Supplier for the procurement.  The manner through which quotations are solicited, should be in writing, to ensure that specifications are clearly laid out.  The RFQ template (Appendix D) may be used but is not required.
• Once the quotation is received from the Supplier, Health Unit staff must review to ensure that the quotation aligns with the specifications.
• Health Unit staff must then complete a Purchase Requisition Form (Appendix E) and append the quotation to the form.  All fields in the form are required to be filled, including the name of the Supplier and all relevant contact information, the date, the program code and expense code, the quantity, description and price (per unit and aggregated), the sub-total, tax and after tax amounts.  Health Unit staff must identify themselves as the initiator of the purchase (signature, title, date).
• Forward the Purchase requisition form to the individual recommending the Purchase for approval, typically the Manager and/or Director.  The individual recommending the Purchase would reconcile the quotation to the Purchase requisition form and confirm there is sufficient budget dollars to satisfy the Purchase.  Furthermore, the individual recommending the Purchase must verify that the program code and account number are accurate and identified appropriately. 
• Forward the Purchase requisition form to the approver (Director).  The approver would confirm that the quotation reconciles to the Purchase Requisition form and flag any issues that he/she may be aware of for discussion with the individual recommending the Purchase before allowing it to proceed.    All procurement shall be reviewed by the Director of Corporate Services for reasonableness and appropriateness.

Non-competitive procurement for purchase values ranging from $7,501 and above, the following steps will be undertaken:

• Non-competitive procurements will involve Manager, the Director, the Director of Corporate Services and the CEO.  The Manager and/or Director will provide justification for pursuit of this type of procurement to both the CEO and the Director of Corporate Services.  The circumstances associated with the procurement will be reviewed by the Director of Corporate Services, who will confirm the method of procurement.  For procurements $7,501 to $10,000, the Director shall discuss the procurement with the CEO, and if determined appropriate, the CEO shall approve.  For procurements $10,001 and above, the Director of Corporate Services will draft a resolution discussing the nature and rationale for such a procurement for review by the  Board Executive and approval by the full Board of Health.  To support the resolution, Health Unit staff would have undertaken the enclosed process to support the procurement value in the Board resolution:
  • The Manager and/or Director shall solicit a quotation from one Supplier for the procurement.  A quotation should be solicited in writing, ensuring that specifications are clearly and consistently laid out. 
  • Once the quotation is received from the Supplier, the Manager and/or Director must review to ensure that the quotation aligns with their specifications.
  • Provision of qualitative information in support of pursuing a non-competitive procurement. 
• Once approval from the Board is received, the Manager and/or Director must then complete a Purchase Requisition Form (Appendix E) and append the quotation to the form.  Reference should be made in the description field of the Purchase Requisition of the Board’s approval, including the date of the meeting.  All fields in the form are required to be filled, including the name of the Supplier and all relevant contact information, the date, the program code and expense code, the quantity, description and price (per unit and aggregated), the sub-total, tax and after tax amounts.  The Manager or Director must identify themselves as the initiator of the Purchase (signature, title, date).
• The Purchase requisition form must be forwarded to the individual recommending the Purchase for approval; in this circumstance, the Director.  The individual recommending the Purchase would reconcile the quotation to the Purchase requisition form and confirm there is sufficient budget dollars to satisfy the Purchase.  Furthermore, the individual recommending the Purchase must verify that the program code and account number are appropriate.
• Forward the Purchase Requisition Form to the approver.  The approver would confirm that the quotation reconciles to the Purchase Requisition form and flag any issues that he/she may be aware of for discussion with the individual recommending the Purchase before allowing it to proceed.  For this type of procurement, the approver is the Director of Corporate Services.

Competitive procurement:  A competitive procurement is when the Health Unit selects from among multiple offers from different Suppliers.  Competitive procurement can further be subdivided into open and invitational Purchasing.

For invitational purchases, typically purchases valued between $7,501- $100,000, the Health Unit invites Suppliers to make quotations.  The Health Unit should ensure that its process around invitational competitive Purchasing is defensible.  When undertaking invitational competitive Purchasing, selection of Suppliers invited to respond must be defensible on the basis of merit.  For greater clarity, Health Unit staff responsible for issuing invitations shall not choose invitees based on personal reasons – to do so is acting in Conflict of Interest and is subject to discipline as such. 

The following steps will be undertaken:

• Health Unit staff shall solicit a minimum of three quotations from Suppliers for the procurement.  Quotations should be solicited in writing, ensuring that specifications are clearly and consistently laid out for all Suppliers.  For procurements $7,501 to $10,000, a written solicitation is appropriate (i.e., email).  For procurements $10,001 to $100,000, Health Unit staff shall communicate in writing.  The solicitation shall be made using the RFQ template (Appendix D).  Note:  The RFQ template is a good guideline to ensure that Health Unit specifications for those lower dollar procurements ($7,501 to $10,000) are of sufficient detail.
• Once Submissions have been received from the Suppliers, Health Unit staff would review the Submissions and determine the successful Supplier.  Given the nature of these procurements, the successful Supplier would be the Supplier with the lowest value bid that meets all of the Health Unit’s stated requirements.  For example, if the lowest bid Supplier is not able to deliver the product until after the Health Unit’s stated deadline requirements, the next lowest Supplier who meets all the requirements may be awarded the Contract.  Health Unit staff should consult with the Manager and/or Director if other criteria are used to evaluate a successful Supplier.  Those considerations/conclusions should be documented in the procurement documentation.  At all times, Health Unit staff shall be impartial and not extend preferential treatment to Suppliers when evaluating Submissions and identifying the successful Supplier (Health Unit Code of Conduct).
• Health Unit staff must then complete a Purchase Requisition Form (Appendix E) and append the successful Submission to the form.  All fields in the form are required to be filled, including the name of the Supplier and all relevant contact information, the date, the program code and expense code, the quantity, description and price (per unit and aggregated), the sub-total, tax and after tax amounts.  Health Unit staff must identify themselves as the initiator of the Purchase (name, title, date).
• Forward the Purchase requisition form to the individual recommending the Purchase for approval, typically the Manager and/or Director.  The individual recommending the Purchase would reconcile the quotation to the Purchase requisition form and confirm there is sufficient budget dollars to satisfy the Purchase.  Furthermore, the individual recommending the Purchase must verify that the program code and account number are accurate for the program of purchase.
• Forward the Purchase Requisition Form to the approver (Director).  The approver would confirm that the quotation reconciles to the Purchase Requisition Form and flag any issues that he/she may be aware of for discussion with the individual recommending the Purchase before allowing it to proceed. 
• Forward the Purchase Requisition Form to the Director of Corporate Services for additional review and approval, assessing the reasonableness and appropriateness of the procurement. 

For open purchasing, typically those purchases valued at $100,001 and greater, the procurement is advertised publicly, such as on MERX, Biddingo and the Health Unit Website, making it available for all qualified Suppliers.  The following steps will be undertaken:

• The Director will identify a “Procurement Lead”.  This individual will be responsible for:  understanding the procurement requirements, completing or facilitating completion of the RFS document (Appendix F), be involved with communications between the Health Unit and Suppliers (i.e. amendments, questions, awarding of Contract, debriefing), the evaluation of Submissions (both compliance and quality), monitoring of Supplier performance, and confirmation of completion of work.
• The Director, in consultation with the Procurement Lead, will identify the Evaluation Team.  All Evaluation Teams shall consist of the Procurement Lead, the Director of Corporate Services, and one other Health Unit staff (typically a content expert). 
• The Procurement Lead, in consultation with the Director and the Evaluation Team, will compile the RFS (Appendix F).  Enclosed within the RFS are timelines that both the Health Unit and Suppliers must abide by.  In the event a circumstance arises that compromises the Health Unit’s ability to comply or changes the requirements of the procurement, the Procurement Lead, in consultation with the Evaluation Team, must revisit the terms and issue an Addendum (Appendix G).
• The Procurement Lead, in consultation with the Evaluation Team, will compile the Evaluation Team Handbook (Appendix H), setting out the guidelines for the Evaluation Team’s approach to evaluating the individual Suppliers.  The Evaluation Team Handbook will also include a scoring tool to be populated when the Evaluation Team convenes.  This tool should be circulated to the Evaluation Team for review and approval prior to the closing date of the RFS.
• Any questions that arise in advance of the closing of the RFS but before the query deadline will be addressed by the Procurement Lead in consultation with the Evaluation Team using the Responses to Supplier Questions Template (Appendix I).  At this juncture, the Director of Corporate Services may, with the consent of the CEO, consult with legal counsel for clarification.  Approved query responses will be posted as Addendums to the public website for all proponents to view.   
• In the event RFS responses are required in “hard copy”, the Procurement Lead shall contact the Manager of IT/Facilities and provide the appropriate instructions on how documents will arrive and the expectations for those documents to be date stamped.  The Manager of IT will direct reception on the appropriate treatment of the responses from the Suppliers.
• Upon closing the RFS, the Procurement Lead will review the Submissions to ensure that Submissions are in compliance with the time stipulated by the RFS.  If received after the closing time, the Submission will not be opened and will be rejected.  The Procurement Lead will use the Late Supplier Notification Template to communicate with those suppliers that submit late (Appendix J).  If received before the closing time, the Submission will be accepted, opened, copied and distributed to the Evaluation Team.  Similar procedures should be followed if the Supplier responses are received digitally.
• The Evaluation Team will review the Supplier responses separately, first, for compliance with the requirements of the RFS, and secondly, for quality of the response.  These criteria should be clearly laid out in the Evaluation Team Handbook (Appendix H).
• The Evaluation Team will meet to review the Submissions collectively.  The first component of the discussion will be to examine compliance of the Suppliers with the RFS requirements.  If matters of non-compliance are identified, the Evaluation Team will conclude on whether the non-compliance will/will not result in the exclusion of the Supplier from the remainder of the process.  This determination can be risky.  If the Health Unit fails to disqualify a Supplier when it should, other Suppliers may have a claim against the Health Unit.  However, if the Health Unit incorrectly disqualifies a Supplier, then that Supplier may have a claim against the Health Unit.  If there is any doubt as to the correct approach, legal counsel should be consulted.  The second part of the process is the evaluation of the quality of the Submissions with reference to the scoring tool prepared.  The Evaluation Team will share rankings and discuss their justification for how they scored.  An average of the Evaluation Team’s score will be the overall ranking of the Supplier in that specific category. 
• Providing the RFS allows (which the template is designed to do), after compiling overall rankings, if it is determined that two or more Suppliers’ overall scores are within 10% or less, it is recommended that those Suppliers be invited for an interview (either in person or using electronic media).  The interview will be no more than 1 hour in length allowing 10 minutes for set up, 15 minutes for presentation and 30 minutes for questions from the Evaluation Team.  The majority of the questions shall be prepared in advance based upon the Supplier’s Submission.  Some flexibility should be given if content presented during the course of the Supplier’s presentation requires additional clarification.  Once all interviews are concluded, the Evaluation Team will meet to rank the Suppliers’ interview.  At this juncture, the overall ranking of the Suppliers will be updated to reflect interview scores.
• At the conclusion of the Evaluation Process, the Procurement Lead will calculate the overall score by Supplier and collectively conclude on the successful Supplier.  
• The Procurement Lead will use the Award Letter Template and Regret Letter Template as applicable and follow the policies set out in the applicable template (Appendices K and L respectively).  Furthermore, the Procurement Lead will post the Supplier name and if price was the only evaluation criterion, then also post the price on the Health Unit’s website. 
• After formal notification of the Award, the Procurement Lead will:
  • Ensure the RFS Exhibit B – Contract form is appropriately completed and signed by the CEO of the Health Unit as well as a signing officer of the Supplier with the authority to bind the corporation.   Two hard copies of the Contract should be exchanged for signature, one copy for each respective party to the Contract.
  • Obtain the WSIB Clearance Certificate or Equivalent from the Supplier.
  • Obtain a Certificate of Insurance from the Supplier.
  • Establish a planning meeting (either in person or via teleconference) to confirm logistics and kick off the assignment.

Debriefing.  Debriefing shall only be offered if the solicitation contemplates debriefing or the Director of Corporate Services authorizes it.  The Debriefing Handbook shall be used for debriefings and the policies in that Handbook shall be followed (Appendix M).

In a competitive Purchase (invitational or open) the following should be noted:

Supplier Communications in Context of Competitive Purchasing.

For solicitations valued at $100,001 or Greater:

• Meetings.  Supplier meetings for Purchasing valued at $100,001 and greater shall be managed as follows:
  • When meetings are part of the procurement requirements, there shall be a sign in process.
  • Any other requirements set out in the RFS, such as number of attendees from a bidder, shall be enforced.
  • Minutes of the Supplier meeting shall be recorded in the form of the Supplier Meeting Minutes Template (Appendix N) and posted on the Health Unit Website as soon as possible but in any event not later than four days prior to Closing.
  • If no meetings are contemplated by the RFS, then none shall be held.
• Supplier Questions.  Supplier questions for Purchasing valued at $100,001 and greater shall be managed as contemplated by the RFS, using the Responses to Information and Clarification Requests and Questions Template.

No other Supplier communications shall be had.

For solicitations valued at less than $100,000:  Supplier meetings and questions for purchasing valued at less than $100,000 shall be managed informally, having regard to the requirement that Health Unit staff shall be fair and impartial and not extend preferential treatment to any Supplier.

Amendments to Competitive Purchasing Solicitations.  Amendments to competitive Purchasing solicitations valued at:

• $100,001 or greater, shall be managed using the Addendum Template (Appendix G) and following the policies set out in that template; and
• Less than $100,000, shall be managed informally, having regard to the requirement that Health Unit staff shall be fair and impartial and not extend preferential treatment to any Supplier.

In either circumstance, it may be necessary to give Suppliers an extension to allow adequate time to modify and re-submit their proposals.

Termination of Competitive Purchasing Solicitations.  Termination of competitive purchasing solicitations valued at:

• $100,001 or greater, shall be managed using the Termination Template (Appendix O) and following the policies set out in that template; and
• Less than $100,000, shall be managed informally, having regard to the requirement that Health Unit staff shall be fair and impartial and not extend preferential treatment to any Supplier.

Closing Procedures in Context of Competitive Purchasing.  The closing date and time in the context of competitive purchasing are of critical importance, as submissions received after that time shall not be opened or considered.  To manage Closing:

• For solicitations valued at $100,001 or greater:
  • Submissions shall be date and time stamped immediately upon receipt and kept secure.
  • Suppliers whose submissions are late shall be notified with the Late Supplier Notification Template (Appendix J).
• For solicitations valued at less than $100,000, shall be managed informally, having regard to the requirement that Health Unit staff shall be fair and impartial and not extend preferential treatment to any Supplier.

Evaluation of Submissions in Context of Competitive Purchasing.  Submissions for purchasing valued at:

• $100,001 and greater, shall be evaluated as contemplated by the RFS, using the Submission Evaluation Handbook and following the policies set out in that Handbook.  The Purchase Lead shall:
  • Create an Evaluation Team Handbook using the Evaluation Team Handbook Template (Appendix H).
  • Distribute the Evaluation Team Handbook to the Evaluation Team.
• Less than $100,000, shall be managed informally, having regard to the requirement that Health Unit staff shall be fair and impartial and not extend preferential treatment to any Supplier.

Award/Regret Notification.  For competitive Purchasing notification of Award or regret, shall be undertaken as follows:

Other procurement circumstances

Banking services:  The Health Unit shall periodically, but not longer than ten (10) years, complete an open competitive procurement to secure the services of a financial institution in which the money or other financial instruments of the Health Unit shall be placed for safekeeping.

Insurance broker:  The Health Unit shall periodically, but not longer than ten (10) years, complete an open competitive procurement to secure insurance brokerage services that will facilitate the Health Unit to secure insurance coverage that is consistent with the sector norms for like organizations and other such services as determined from time to time by the CEO. 

Vendor of Record and Procurement through a Buying Group

A Vendor of Record (“VOR”) arrangement is a list of vendors resulting from a procurement process that meets the requirements of the government procurement directive.  This type of arrangement allows for one or more vendors to offer specific goods or services to buyers.  This arrangement is valid for a specified period of time under defined terms and conditions and is typically established through a request for proposal process through an electronic tendering system.  The Health Unit would qualify to use the Ontario VOR arrangements depending upon the nature of the arrangement.  Certain arrangements can allow the Health Unit to access pricing.  Certain of the arrangements allows the Health Unit to access vendors however it must enter into its own agreement based upon its procurement levels. In this instance the VOR listing would be used a pre-qualification listing for which the Health Unit would base their procurements upon.

Procurement through a Buying Group is permitted under the CFTA.  A Buying Group is defined as “a group of two or more members that combines the purchasing requirements and activities of the members of the group into one joint procurement process.  Buying groups include cooperative arrangements in which individual members administer the procurement function for specific contracts for the group and more formal corporate arrangement in which the buying group administers procurement for group members.  Buying groups may consist of a variety of entities, including any combination of procuring entities, private sector entities, or not-for-profit organizations.” [CFTA Article 520 – Government Procurement – Specific Definitions].  Depending on the nature and circumstances surrounding a procurement, there may be an opportunity for the Health Unit to leverage off of, or participate in, a Buying Group.  

A buying group shall publish a notice of each procurement, listing the participating procuring entities and outlining the potential for other procuring entities to participate after the procurement is put in place.

Contract/PO Management and Fulfillment

In order to ensure the Health Unit Purchasing expectations are met, it is critical that Contracts be pro-actively managed by the Health Unit.

Management goals – Contracts/PO’s shall be managed responsibly and effectively to:

• Ensure Deliverables delivered.
• Ensure timelines met.
• Ensure specifications met.
• Ensure performance evaluations conducted on a fair and timely basis.
• Identify performance issues on a timely basis.
• Resolve performance issues on a timely basis.
• Contribute to the process of continuous quality improvement.
• Maintain productive working relationships with Suppliers.
• Reduce the potential for disputes and legal action.
• Ensure accepted Deliverables are properly reflected in the Health Unit asset inventories as appropriate.

For procurements valued $500 to $25,000, the initiator of the Purchase, in conjunction with their Manager, are responsible for managing the Contract management goals.  If during the course of the Contract performance and quality issues are identified, the Manager shall consult with the Director of Corporate Services on how best to rectify deficiencies (i.e. return of goods; credit; etc.). 

For procurements valued $25,000 and greater, the Procurement Lead will be responsible for monitoring Supplier performance.  Having regard to the Contract management goals, the Procurement Lead shall monitor Supplier performance:

• As reasonably required, having regard to the value of the Purchase and associated risk if performance is not satisfactory;
• Upon completion of milestones related to the Purchase; and
• Prior to any payment being made to the Supplier.

The Procurement Lead shall report to the Director of Corporate Services upon becoming aware of any circumstances that have occurred or risks which look reasonably likely to occur, and are reasonably likely to have a material adverse impact.  Material adverse impacts are those that threaten the delay of purchase milestones by more than 10%; threaten to increase the cost by more than 10%; or threaten to create hazardous or dangerous conditions to health or safety either in the short, mid or long-terms.

Payment

As an organization funded by taxpayers with a mission to work with the community to promote, protect and improve health and well-being for all, it is critical that the Health Unit be a responsible steward of all funds entrusted to it and that payments made to Suppliers are appropriate and managed within the system that ensures the Health Unit’s responsible management of funds.  

To achieve this, the individuals involved with the procurement process must:

• Abide by the procurement policies, including ensuring that appropriate steps are taken to procure products or services and obtain appropriate approvals throughout the process;
• Monitor and/or review to ensure that the Supplier is abiding by the terms of the Contract.  This includes following up to ensure that the Supplier is abiding by timelines for delivery and reviewing the products and or services to ensure they meet the procurement specifications. 
• Communicate to the Finance Department that there were deficiencies with Deliverables and whether to proceed with payment or defer until deficiencies are rectified (e.g. through provision of appropriate product; provision of discount; etc.).

In summary, payment can be made in the following manner:

• Payment by corporate credit card – Payment of any procurement on the corporate credit card will be undertaken by the Corporate Services Division, more specifically the Finance Department and/or the Executive Assistants to the Leadership Team.  Payment must be supported as directed by the procurement method as discussed above.  On a monthly basis, all Purchases are reconciled by the Administrative Assistant to the Director of Corporate Services and subject to review and approval for payment, by the Director of Corporate Services and the CEO.  Payments on account of the corporate credit card are completed monthly by Pre-Authorized Payment (“PAP”) or more frequently using Electronic Funds Transfer (“EFT”).  These payments must be supported by a Corporate Card Payment Requisition signed by the Director of Corporate Services and the CEO.
• Payment by Cheque:
  • Payment by cheque or EFT supported by cheque requisition – These procurements must be supported by a cheque requisition signed by the appropriate signing authorities as well as the invoice.  All cheque requisitions must include the following sign offs:
    • Signature and title of the Initiator of the Purchase, as well as the date of completion of the cheque requisition by the Initiator.
    • Signature and title of the Recommender (typically the Manager or the Director) as well as the date of their review of the cheque requisition and support (i.e. invoice).
    • Signature and title of the Approver (typically the Director), as well as the date of their review of the cheque requisition and support (i.e. invoice).
  • Payment by cheque, supported by purchase requisition – These procurements must be supported by a purchase requisition signed by the appropriate signing authorities as well as the invoice in support.  If Health Unit staff, other than the Finance Department, receive invoices directly for items that have been procured through a purchase requisition, they should forward the invoice to the Finance Department for payment.  Finance will append the invoices to the approved purchase requisition.
  • Dollar variances in purchase requisitions – Each Manager(s) should make every effort to ensure that pricing information, as well as product codes, should be reflective of latest available information.  In the event that actual pricing differs from pricing on the requisition, the Finance Department will identify the variance on the pink copy of the purchase requisition form and return it to the Manager for review and to ensure that internal financial tracking is appropriately updated.  The pink copy of the purchase requisition will be returned, upon receipt of the final invoice for goods received or services rendered by the Finance Department.
  • Payments by cheque are issued by the Finance Department a minimum of twice monthly.
  • Cheques are signed by any two signing authorities, the Director of Corporate Services, the CEO, and Chair, Vice-Chair and Treasurer.  The Director of Corporate Services and CEO are responsible for ensuring that all documentation is reviewed and approved by all parties and that the expenses are appropriate, in that they help to achieve the Health Unit’s own objectives. 

Approach to procurements that fall under exceptions, excluding salaries

Authorization of these transactions typically occurs through contractual obligation.  The CEO is permitted to bind the Health Unit.  Review of contractual obligations will typically involve the relevant Manager and Director, and the Director of Corporate Services from a financial perspective.  Additional review may be required by legal counsel. 

In terms of billing, the following process has been established:

• The invoice or other supporting document (i.e. Contract, Oral Health Department DDS Time Sheet; Tobacco Test Shopper Time Sheets) submitted by Supplier to the Health Unit. 
• The Manager will review the invoice or supporting document for accuracy, completeness and achievement of all procurement management goals (refer to the definition in the Contract/PO Management and Fulfillment section of the policy).

• The Manager will complete a Cheque Requisition Form (Appendix P) and append the invoice or supporting documentation.  All fields prompted in the form are required to be filled, including the name of the Supplier and all relevant contact information, the date, the program code and expense code, the quantity, description and price (per unit and aggregated), the sub-total, tax and after tax amounts.  The Manager must identify themselves as the initiator of the Purchase (signature, title, date).
• Forward the Cheque Requisition Form to the individual with direct authority to recommend the Purchases, typically the Director.  The Director will review and confirm that the invoice or supporting documentation reconciles to the Cheque Requisition Form and flag any issues that he/she may be aware of before proceeding with payment.  The Director must identify themselves as the recommender of the Purchase (signature, title, date).
• Forward the Cheque Requisition Form to the approver.  For purchases of $0 to $10,000 the approver will be the Director of Corporate Services.  For purchases of $10,001 and above, the approver will be both the Director of Corporate Services and the CEO.  The approver will include their signature, as well as the date of their review of the Cheque Requisition form, invoice or other supporting documentation.

Delivery of goods

Goods can be ordered by Health Unit staff at the department level or by the Accounts Payable Clerk in the Finance Department.  When goods are ordered, it is imperative that Health Unit staff ask the following questions of the Suppliers:

• What is the size of the delivery (number of boxes; size of.)?
• How will it be delivered (individual boxes; skid; etc.)?
• When will the delivery arrive (date and approximate time)?

If Health Unit staff determine that the delivery is a significant volume (i.e. 100 boxes of product “x”), it is imperative that a ticket be logged with Facilities Department to advise them of the size of the order and the delivery date.  It is also imperative to advise the Facilities Department whether the goods are required to be maintained on site or in off-site storage.  The Health Unit needs to appropriately plan for large orders given the lack of on-site storage space. 

Review

The Procurement Policy shall be reviewed at a minimum of every two (2) years.  Revisions to the Procurement Policy shall be approved by the Board.

Retention

All procurement activities governed by Procurement Policy applies shall be documented and retained in accordance with the Health Unit’s Record Retention Policy. 

Audit

All procurement activities governed by the Procurement Policy shall be audited in accordance with the Audit Guidelines included in Appendix Q. Audit procedures shall be completed on a quarterly basis, with findings reported to the Board quarterly.

Compliance

Failure to comply with this Policy and any associated Procedures may result in appropriate disciplinary measures.  Please see WECHU’s Discipline Policy.

Related Documents

Canadian Free Trade Agreement https://www.cfta-alec.ca/canadian-free-trade-agreement/

PREPARED BY:

Communications Department

DATE:

June 16, 2022

Data Notes can be provided upon request.

Media Exposure Overview Graph

Website Overview Graph

DISCUSSION

Current notable projects that the Communication’s department is actively working on include the promotion of the active tick surveillance program. A media event took place on Wednesday, May 11 at Ojibway Nature Centre and a subsequent news release was issued following the event.

We placed a Windsor Star advertisement informing the community that between May 23 and October 31, 2022, a mosquito larviciding program will be conducted to reduce mosquito populations in Windsor and Essex County.

The Communications department is maintaining marketing and communication efforts regarding COVID-19 vaccinations in the region with our partners. In particular, the COVID-19 pop up clinics in the community and at WECHU offices.

PREPARED BY:

Chronic Disease and Injury Prevention

DATE:

June 16 2022

With a lease at 101 Wyandotte secured, the WECHU submitted an application for an exemption to the Controlled Drugs and Substances Act, to operate an Urgent Public Health Needs Site (UPHNS) at this location, which allows for supervised consumption in a designated facility during the period in which the CTS applications await federal and provincial approval.  Pending the approval of Health Canada for the UPHNS, the WECHU will collaborate with the Windsor-Essex Community Health Centre (WECHC) to establish and operate a temporary UPHNS at 101 Wyandotte Street East. UPHNS and CTS sites share a similar goal of reducing overdose deaths through the provision of supervised consumption services. UPHNS, however, can be established more immediately than CTS sites and are a short-term response to address an urgent public health need. Additionally, UPHNS are not mandated to offer the additional wraparound services that are required through the Ontario Ministry of Health’s CTS program model, which is inclusive of substance use treatment, mental health, primary care, and other health and social services. While these services are not required to operate the local UPHNS, the WECHU and the WECHC are currently collaborating with local community partners to assess opportunities to offer such services at the proposed UPHNS in order to increase access to immediate supports for people who use substances and to ensure a seamless transition of the site into the proposed CTS in the future. This process will include the development of Service Agreements and Memorandum’s of Understanding with participating community agencies and service providers.

Since the WECHU’s submission of the UPHNS application, a query was received from Health Canada with regards to additional information required for the application and the WECHU has begun work to address these queries. The WECHU is currently awaiting a response from Health Canada as it relates to this correspondence, and is committed to addressing any future needs that may arise throughout the application completion process. The UPHNS will be funded through the WECHU’s 2022 operating budget for mandatory programs and services with in-kind supports through the WECHC and other partners. The WECHU administration is currently working with legal services to develop a service agreement for the operations of the UPHNS.

Permanent Consumption and Treatment Services Site:

Once the resolution endorsing the CTS at 101 Wyandotte is received, the WECHU will update, finalize, and submit the provincial and federal CTS applications to the Ontario Ministry of Health and Health Canada for approval to establish a permanent CTS site at this location and application for funding. The application will include intent to apply for capital expenditures including plans for re-designing and renovating the space for the CTS operations (i.e., floor planning, capital budgeting). In addition, a plan will be developed for engaging the community on an ongoing basis regarding the operations of the CTS, developing ongoing communications and public education materials about the CTS (e.g., regular reports to the Board of Health, WECOSS website communications), and other key plans. Terms of Reference will be developed in order to sustain the operations of the CTS Stakeholder Advisory Committee on an ongoing basis and MOU’s with key service providers will be explored.

For additional information and ongoing updates regarding local CTS activities, please visit https://wecoss.ca/consumption-and-treatment-site/

PREPARED BY:                   

Environmental Health

DATE:                                 

June 16, 2022

The chart below is a summary of the number and type of public recreational water facilities that the Health Unit regularly inspects.

Recreational Water Facilities Inspections

The chart below is a summary of the number and types of inspections completed in 2021 and 2022 (up to May 24, 2022) at the various recreational facilities in WEC.

2021 Beach Testing Summary

The 2021 beach testing season was a total of 17 weeks long. Testing began on May 31, 2021 and concluded on September 20, 2021.  Public Health Inspectors completed 163 on-site beach inspections in 2021. There were 49 water quality warnings (>200/100 mL water) issued and 7 closures (>1000/100 mL water) issued.

DISCUSSION

EH Priority Areas and Activity Adjustments

As of May 2, 2022, the priority areas for Safe Water inspections are for beach testing, outdoor opening of pools/spas/splash pads (minimum of 1/year) and indoor operational pools/spas/splash pads (minimum of 2 per year).  The frequency of inspections will be adjusted due to staffing challenges and will be reassessed based on need throughout the season.

Beach Assessments and Testing

The 2022 pre-season beach assessments were completed at all nine public beaches on May 9, 2022 by Public Health Inspectors. Regular weekly water sampling began on May 24, 2022.

Beach water sampling takes place on Monday (or Tuesday if Monday is a holiday). Public Health Inspectors take five water samples from along the beachfront and submit these samples to the public health lab in London, Ontario for bacteriological testing.  Beach water quality results from Monday’s sampling are uploaded on Thursday to the Beach Water Testing page (https://wechu.org/your-environment/beaches-pools-and-spas/beaches) and on the Beach Hotline (ext. 426). If the beach is closed due to high E. coli levels (>1000/100 mL of water), the beach will be resampled on Wednesday of the same week and results made available by end of day Friday.

PREPARED BY:                   

Healthy Families Department

DATE:                                 

June 16, 2022

In February 2022, the Windsor-Essex County Health Unit (WECHU) in partnership with Connections Early Years Family Centre became the first organization in Canada to offer the Legacy for Children™ (Legacy) pilot program. Legacy is an evidence-based group intervention designed to improve child health and development by fostering positive parenting among low-income mothers of infants and young children. The Legacy model was developed by the Centres for Disease Control and Prevention (CDC) in the United States, and was modified by WECHU staff to apply to a Canadian audience. 

Legacy for Children™ is implemented over a three year period with mothers joining the program during their last trimester of pregnancy and continuing until their child is three years of age. Each year that participants are involved, they are offered three “blocks” of ten weekly sessions alternating between mother-only and mother-child sessions. Each session is facilitated by a WECHU Social Worker and Public Health Nurse who deliver educational messaging, tips, and tools related to attachment, language, social skills, discipline, literacy, health/safety, and play. Evidence from the United States has shown that participating in the Legacy program has led to:

• Increased parenting knowledge and information;
• Increased confidence among participants in their parenting responsibilities and abilities;
• Increased positive parenting practices among participants;
• Increased participants’ sense of community;
• Promoting optimal growth and development among participating children; and
• Promoting optimal social and emotional development among participating children.

Following the successful implementation of the first “Prenatal” block described below, the WECHU has continued to recruit families for participation in subsequent sessions.

DISCUSSION

Traditionally an in-person program, WECHU staff modified the initial “Prenatal Block” to be delivered online for a smaller group of program participants due to the COVID-19 pandemic. Through a series of promotional programs, community networks, and self-referrals, the WECHU screened eight interested pregnant mothers for eligibility, with three meeting the requirements to enter the program. Curriculum included in the Prenatal Block intended to start developing a sense of community and to build knowledge about responsible parenting behaviours. The topics covered during the block included, fetal development, physical changes pregnant women experience, exploring one’s beliefs and traditions about pregnancy, preparing for baby’s birth, labour and delivery, infant feeding, preparing for the hospital, and coming home after the hospital. Throughout the five session Prenatal Block participating mothers actively engaged in group discussions and activities, bonded with one another, validated each other’s concerns and feelings, and committed to staying in contact during breaks between blocks of the program. Initial feedback from the launch of the Prenatal Block was positive with one participant providing the below testimonial:

“As the time of my delivery was coming closer day by day, I was thinking a lot about what I have to do. I needed someone to help me and give me suggestions and advice, especially because due to [the] pandemic a lot of things have changed.  But because of these sessions and the guidelines from respective health unit organizers, everything's become easier for me, and I feel relief because I know I have support from all of them when I need any help.  I really appreciate your efforts and the guidelines which really help me before and after my delivery. “

Since the completion of the Prenatal Block, an additional seven referrals have been received through ongoing promotion and recruitment both within WECHU social media accounts and through partnering agencies. At the time of writing this report, the WECHU intends to offer a hybrid model for subsequent blocks of the program to accommodate participants who choose to attend in-person at the Connections Early Years Family Center with the online version still available for those who prefer this option. Connections Early Years Family Center will also provide childcare for in-person participants. To date, a total of seven participants are registered for the next block (Block One), and promotion is ongoing. Recruitment will end in January 2023 and eligibility is open to new moms who had a baby in March, April, or May 2022. The goal of Block One is to promote mothers’ sense of (parenting) community, supporting parental responsibility, parental investment, and a devotion of time and energy to parenting. Topics covered during Block 1 include, adjusting to life with the newborn, identifying parenting attributes, exploring challenges of parenting, infant states of awareness, regulating infants’ states, reading and responding to babies’ cues, infant feeding, self-care, and play.

Evaluation data will be collected at various points throughout this three year program, and from various evaluation tools including a Parent Satisfaction Survey, Parent Engagement Form, Parent Group Summary Form, and various Ages and Stages (developmental) questionnaires.

Board Members Present:

Gary McNamara, Joe Bachetti, Tracey Bailey, Rino Bortolin, Fabio Costante, Aldo DiCarlo, Mark Ferrari (4:13 pm), Judy Lund, Robert Maich, Ed Sleiman

Board Member Regrets:

Gary Kaschak

Meeting held via video: https://youtu.be/Z7PoGto0M6M

1. DEFINITIONS
   1. “Wrongdoing” for the purposes of this Policy includes the following:
      
      1. contravention of any law or regulation applicable to the Health Unit;
      2. act or omission that creates a substantial and specific danger to the life, health or safety of individuals other than a danger inherent in the performance of the duties or functions of an employee, external contract worker, student or volunteer, as the case may be;
      3. an act or omission that creates a substantial and specific danger to the environment;
      4. gross mismanagement of public funds or a public asset;
      5. material violation of Health Unit policies;
      6. contravention of any material contractual commitment of the Health Unit; and
      7. counselling an individual to commit any of the above,
         that has already occurred, is in the process of occurring or is about occur.
   2. “Reprisal” includes any adverse action taken against an employee, external contract worker, student or volunteer, as the case may be, who seeks advice on making a report of Wrongdoing, makes a report of Wrongdoing, or co-operates in an investigation of Wrongdoing, or declines to participate in a Wrongdoing.  Examples of Reprisal include:  a dismissal, layoff, suspension, demotion or transfer, discontinuation or elimination of a job, change of job location, reduction in wages, change in hours of work or reprimand, or any other adverse measure (e.g., bullying), and/or threats to do any of the foregoing.
2. PURPOSE
   1. Recognizing that whistle blowing is an important element of transparency and that transparency in turn contributes to accountability, the board of the Health Unit has enacted By-laws requiring the establishment of a transparency framework, including a whistle blowing policy.  The purposes of this Policy are to:
      
      1. Implement the By-law requirements.
      2. Facilitate the reporting of Wrongdoing.
      3. Protect those who report Wrongdoing, investigate Wrongdoing, or take action subsequent to a finding of Wrongdoing, so that such reporting, investigation and action can be undertaken without fear of Reprisal.
      4. Provide for the appropriate management of reports of Wrongdoing.
      5. Promote public confidence in the Health Unit.
3. APPLICATION
   1. Applies To.  This Policy applies to Health Unit board members, employees, external contract workers, students and volunteers.
4. GUIDING PRINCIPLES
   1. Implementation of this Policy will be guided by the following principles and policy statements:
      
      1. The Health Unit complies with all relevant laws and regulations.
      2. All policies support and embody the Health Unit’s core values.
      3. The Health Unit maintains high standards of business and ethical conduct and applies these standards to all matters of business.
      4. All reports of Wrongdoing will be dealt with promptly, be fully reviewed and/or investigated as appropriate in a fair and equitable manner, ensuring a respectful process is followed for all those involved.
      5. There will be no Reprisals against anyone reporting Wrongdoing in good faith under this Policy, investigating Wrongdoing or taking action subsequent to a finding of Wrongdoing.
      6. Confidentiality will be protected to the maximum extent possible.
5. INTERNAL REPORTING
   1. Reporting Responsibility.
      
      1. Individuals becoming aware of Wrongdoing must report the same as soon as possible.
      2. Reports of Wrongdoing should include the following:
         
         1. a description of the Wrongdoing;
         2. the name of the individual or individuals involved in the Wrongdoing;
         3. the date of the Wrongdoing; and
         4. any additional information that may reasonably be required in order to investigate the Wrongdoing.
   2. Acting in Good Faith.
      
      1. In making a report of Wrongdoing, an individual must act in good faith and on reasonable grounds.
      2. An individual who makes a report of Wrongdoing knowing it to be false or makes it with malicious intent, may be subject to discipline, up to and including termination.
   3. Confidentiality.
      
      1. Anyone involved in a report process will keep the matter confidential to the maximum extent possible, consistent with the Health Unit’s legal and ethical responsibilities, including the need to conduct an effective investigation and comply with the Municipal Freedom of Information and Protection of Privacy Act.
      2. Confidentiality may not mean anonymity.
      3. The Health Unit will accept reports under this Policy on an anonymous basis.
      4. The Health Unit will not tolerate any attempts to identify an individual who reports in good faith on a confidential or anonymous basis.
   4. Internal Reporting Targets and Investigation Responsibility
      

      1. “Individual” Being Reported	Reported To	Investigated By
         Chair	Reporter’s manager, Director, Human Resources , AMOH, MOH, CEO or board vice-chair	Committee of 3 appointed by the rest of the board based on skills/expertise, in consultation with qualified external party selected by the committee
         Board member (other than Chair)	Reporter’s manager, Director, HR Director, AMOH, MOH, CEO or board chair	Committee of 3 appointed by the rest of the board based on skills/expertise, in consultation with qualified external party as selected by the committee.
         Board as a whole	Reporter’s manager, Director HR Director, AMOH, MOH or CEO	CEO in consultation with qualified external party as selected by the CEO.
         CEO	Reporter’s manager, HR Director, AMOH, MOH (if different from CEO) or board chair	Committee of 3 appointed by the board based on skills/expertise, in consultation with qualified external party selected by the committee
         MOH	Reporter’s manager, Director, HR Director, AMOH, CEO (if different from MOH) or board chair	Committee of 3 appointed by the board based on skills/expertise, in consultation with qualified external party selected by the committee
         	Subject to professional obligations of the reporter and the nature of the report, report may also be required to The College of Physicians and Surgeons of Ontario.
         AMOH	Reporter’s manager, Director, HR Director, MOH, CEO or board chair	Committee of 3 appointed by the board based on skills/expertise, in consultation with qualified external party selected by the committee
         	Subject to professional obligations of the reporter and the nature of the report, report may also be required to The College of Physicians and Surgeons of Ontario.
         Directors	Reporter’s manager, HR Director (unless reporting HR Director), AMOH, MOH, CEO or board chair	Committee of 3 appointed by the board based on skills/expertise, in consultation with qualified external party selected by the committee
         Managers, other employees or external contract workers who are regulated health professionals and students studying to become regulated health professionals	Reporter’s manager, director, HR Director, AMOH, MOH or CEO	CEO in conjunction and consultation with such persons as the CEO determines appropriate.
         	Subject to professional obligations of the reporter, the status of the individual being reported as a regulated health professional and the nature of the report, report may also be required to the professional college of the individual being reported.
         Other employees, external contract workers, students and volunteers	Reporter’s manager, HR manager, AMOH, MOH or CEO	CEO in conjunction and consultation with such persons as the CEO determines appropriate.

      2. Any individual who receives a report of Wrongdoing shall notify:
         
         1. the chair, if the CEO is the subject of the report;
         2. the vice-chair, if the chair is the subject of the report;
         3. otherwise, the CEO.
   5. INVESTIGATION OF WRONGDOING
      1. Accountability.  Those who have an investigation responsibility as detailed above are accountable for ensuring a report of Wrongdoing is investigated in accordance with this Policy.
      2. Principles.  Investigations of Wrongdoing will be conducted based on the following principles:
         
         1. The investigation will be carried out fairly and without bias.
         2. Those involved in the investigation will be independent of both the person who made the report and any persons under investigation.  This means they should not either be reporting to, or supervising, any such persons.
         3. Appropriate action shall be undertaken to preserve evidence.
         4. Disclosure of information will be limited to those who need to be involved in order to carry out the investigation.
         5. The person who is the subject of the report is entitled to know the substance of the allegation(s) and have an opportunity to respond.  Knowing the identity of the person who made the report is not a part of this and should not be disclosed.
         6. Investigations will be conducted in a timely manner.
         7. Investigations will be conducted in a manner which is as sensitive as possible to any fears of Reprisal.
         8. Individuals are required to cooperate during any investigation.
      3. Report. Those who are responsible to investigate Wrongdoing shall conclude their investigation with a written report, including recommendations.  The report shall be submitted to:
         
         1. the CEO, unless the subject of the report is the CEO; and
         2. the Chair, if the subject of the report is the CEO, MOH, AMOH, Director or any member of the board.
   6. ACTION SUBSEQUENT TO INVESTIGATION
      1. Accountability.  Subsequent to any investigation pursuant to this Policy, the CEO is accountable for ensuring that appropriate action is undertaken in connection with any finding of Wrongdoing by any employee, external contract worker, student or volunteer.  The board is accountable for ensuring that appropriate action is undertaken in connection with any finding of Wrongdoing by any board member.
      2. Types of Action.  The actions that may be taken to address a Wrongdoing will depend on the particular circumstances, and consequences may include, but are not limited to, discipline up to and including termination.
      3. Communication with Reporter.  The individual who made the report of Wrongdoing should be notified that the investigation is complete, and what (if any) recommendations are made based on the findings of the investigation.
   7. PROTECTION FROM REPRISAL
      1. No Reprisal.  Individuals reporting Wrongdoing in good faith under this Policy will not suffer Reprisal, even if after the investigation has been completed the Wrongdoing has not been substantiated.
      2. Report Reprisal.  Individuals who experience any form of Reprisal before or after submitting a report of Wrongdoing should report the same as a further Wrongdoing.
      3. Consequences for Reprisal.  An individual who commits any form of Reprisal against another individual involved in reporting, investigating or taking subsequent action in connection with a Wrongdoing will be subject to discipline, which may include termination.
      4. Statutory Protection.  It is noted that:
         
         1. Criminal Code.  Section 425.1 of the Criminal Code makes it a criminal offence for employers, anyone acting on behalf of an employer, or a person in a position of authority over an employee, to adversely affect or threaten to adversely affect the employee’s employment, or threaten to, in order to force the employee to refrain from providing information to law enforcement officials about the commission of an offence by his or her employer or by an officer, employee or board member of the employer.  However, employees are only protected if they approach a person whose duties include law enforcement.  They are not given protection if they contact a media source or an outside agency or advocacy group.
         2. Other.  It is further noted that there are other statutory protections against Reprisal embedded in certain provincial legislation, including human rights, occupational health and safety and environmental protection legislation.
   8. RECORDS
      1. Separate and Secure.  Records of reports of Wrongdoing and related investigations must be clearly marked and kept separate from other records and stored in a secure location with access limited to those who have a need to know.
      2. Not in Personnel Files.  No records of Wrongdoing will be kept in any personnel files unless there has been a finding of Wrongdoing that results in disciplinary action.  In that case, the outcome of the investigation will be reflected in the personnel file.
   9. SUPPORT FOR INDIVIDUALS
      1. Anyone involved with reporting a Wrongdoing, investigating a Wrongdoing, taking subsequent action to a finding of Wrongdoing or is the subject of a report of Wrongdoing, is encouraged to use the confidential counseling service that is available to all individuals through the Health Unit’s employee assistance program.
   10. REPORTING
       1. The CEO shall report any finding of Wrongdoing to the board that is within the scope of the CEO’s reporting obligations pursuant to the By-laws.
   11. RELATED POLICIES
       1. Code of Conduct.

A by-law respecting the financial and asset management of the Board of Health for the Windsor-Essex County Health Unit (“Health Unit”) passed under the Health Protection and Promotion Act, R. S.O. 1990, c. H.7 (“HPPA”)

ENACTED by the Board this _____ day of  ______________, 2022                             

Chair

Secretary

To be reviewed no later than the _____ day of  ______________, 2024

A by-law respecting the management of real property of the Board of Health for the Windsor-Essex County Health Unit.

1. The Chief Executive Officer or their designate, shall be responsible for the care and maintenance of all properties owned by the Board), including but not limited to, the following:
   
   1. The repair and maintenance of building systems such as heating and cooling systems, roof, structural work, plumbing, electrical systems;
   2. The repair and maintenance of the parking areas and exterior of buildings, where applicable;
   3. The care and upkeep of the grounds of the property, where applicable;
   4. The cleaning, maintaining, decorating, and repairing of the interior of the buildings, where applicable; and
   5. The maintenance of up-to-date fire and liability insurance coverage.
2. Where a property is leased by the Board, the Board shall enter into a lease that addresses all maintenance, care and insurance requirements. The Chief Executive Officer shall be responsible for ensuring that the property is operated in accordance with the terms of any such lease.
3. The Board shall ensure that all such properties comply with all applicable local, provincial and/or federal statutory requirements (I.e.  Building codes and fire codes).
4. The Board shall maintain and adopt policies with respect to the acquisition, sale and other disposition of real property.   The Real Property Management Policy will be reviewed on a three (3) year basis, or more frequently, if appropriate.  The CEO shall report asset disposals to the Board annually as per the Health Unit’s Real Property Management Policy.

ENACTED by the Board this _____ day of  ______________, 2022                             

Chair

Secretary

To be reviewed no later than the _____ day of  ______________, 2024

PREPARED BY

Environmental Health Department

DATE

May 19, 2022

SUBJECT

2022 Vector-borne Surveillance Program

BACKGROUND/PURPOSE

The Environmental Health Department delivers a vector-borne surveillance program to monitor West Nile Virus (WNV), Eastern Equine Encephalitis (EEE), Zika Virus and Lyme disease activity in Windsor and Essex County (WEC). The program is required under the Health Protection and Promotion Act and provides the community with an early warning system for disease transmission through ticks and mosquitoes known as vector-borne diseases. This program is made up of the following components: mosquito larval surveillance and larviciding, adult mosquito trapping, human case surveillance for WNV and Lyme disease, public education, and active tick surveillance. The tasks of mosquito larval surveillance and control, along with mosquito identification and viral testing, are performed by contracted agencies on behalf of the WECHU.

DISCUSSION

Active Tick Surveillance

Lyme disease is a vector-borne disease caused by the bacterium Borrelia burgdorferi. It is transmitted to humans through the bite of infected black-legged ticks. The WECHU's role is to measure and evaluate the risk of this tick-borne disease in our area.

Active surveillance is used to assess the local distribution and incidence of black-legged ticks in WEC. It involves the dragging of a white cloth through grassy areas whereby ticks attach themselves to the fabric and can be easily spotted and identified. Any black-legged ticks identified are sent to an accredited laboratory for testing of Lyme disease. Tick dragging is performed twice yearly in the spring and the fall.

This year tick dragging will be conducted at the following four sites during the months of May and September:

• Ojibway Prairie Nature Reserve
• Chrysler Greenway
• Gesstwood Camp and Education Centre
• Ruscome Shores Conservation Area

Mosquito Surveillance

Adult mosquito surveillance is an important component of the vector-borne disease program and involves the deployment of black-light CDC traps and BG-Sentinel 2 (BGS-2) traps at various locations throughout WEC.

The CDC traps are equipped with light and dry ice that attracts and traps the mosquitoes. These traps capture mosquitoes for testing to determine the presence of WNV and EEE in our region. BG-Sentinel 2 (BGS-2) traps are species-specific traps set up to catch invasive species of mosquitoes (Aedes albopictus and Aedes aegypti) that were identified during routine WNV surveillance in WEC in 2016. These traps use a scent lure and dry ice to attract daytime mosquitoes and are set up in high-traffic areas (such as near transport routes and industrial cargo areas) as well as in residential homes. The trapped mosquitoes are sent to an accredited laboratory for identification and testing to determine if any of the mosquitoes carry the WNV, EEE or Zika virus.

The trap deployment will start on May 25, 2022, and run until mid-October. Once a week, 50 mosquito traps (26 CDC light traps and 24 BGS 2 traps) will be set up across WEC to collect mosquitoes for identification and viral testing. The weekly mosquito surveillance data will be made available on the WECHU's Mosquito Surveillance Dashboard.

Human case Surveillance

The human case surveillance program identifies human cases of WNV and Lyme disease in WEC to determine the source of the disease. Physicians and hospitals must report all probable and confirmed cases to the WECHU.

The health unit investigates all suspected, probable and confirmed WNV and Lyme disease cases among WEC residents based on case definitions developed by the Ministry of Health (MOH). Standardized medical information, including demographics, symptoms, risk factors (such as travel history or having received blood products) and test results, are entered into the MOH's Integrated Public Health Information System (iPHIS). Through case interviews and GIS mapping, the health unit identifies clusters and geographic areas that may need targeted intervention.

Fight the Bite! Campaign

Fight the Bite! Public awareness campaign will launch in July 2022. It will focus on the prevention of mosquito breeding sites, information on tick removal, signs and symptoms of WNV and Lyme disease, and personal protection. Messages and promotional materials will be developed to reach priority populations and inform the public of hot spots identified through previous monitoring efforts. This event is done in conjunction with health unit external stakeholders such as municipalities and other health units.

SUBMITTED BY

Communications Department

DATE

May 19, 2022

SUBJECT

March 15 – April 14, 2022 Communications Update

BACKGROUND/PURPOSE:

Provide regular marketing and communication updates to the Board of Health.

Data Notes can be provided upon request.

Media Exposure Overview Graph

Website Overview Graph

Discussion

Current notable projects that the department is working on.

We are promoting the arrival of the GO-VAXX bus for COVID-19 vaccinations in Leamington on May 2 and 3. This was a collaboration between the WECHU and the Municipality of Leamington through multiple media channels.

Food Handler Certification Examinations news release was issued on Tuesday, April 5.

The Communications department is maintaining marketing and communication efforts regarding COVID-19 vaccinations in the region with our partners. In particular, the COVID-19 pop up clinics in the community and at WECHU offices.

We continue to provide support for the Catch-Up Immunization Clinics for Students in Grades 7 to 12 that will occur until August in multiple locations throughout Windsor and Essex County.

PREPARED BY

Infectious Disease Prevention – COVID Response

DATE

May 19, 2022

SUBJECT

COVID-19 Case and Contact Management- Q1 2022 Report

BACKGROUND/PURPOSE

Due to the unique characteristics of the Omicron variant, the Case and Contact Management (CCM) guidelines and testing eligibility were revised to ensure that workers and families in highest risk settings are protected implementing changes to Ministry guidance documents. As a result of the changes to the provincial guidance in the context of Omicron, the WECHU is only investigated COVID-19 cases associated with highest risk settings (e.g. hospitals, congregate settings, long-term care homes). During Q1, Non-highest risk cases were contacted to ensure isolation was implemented and education and other resources provided. There was a need for redeployment of WECHU staff from various departments to manage this surge associated with the Omicron variant.

DISCUSSION

The Omicron surge brought with it changes to CCM and isolation guidelines to ensure those living, volunteering, and working in the highest risk settings continue to be protected. The CCM Team updated practice to align with the current Ministry guidance, including the creation of CCM tip sheets for various highest risk settings (e.g., Long-term Care Homes/Retirement Homes and hospitalized patients). To help residents navigate the various changes to COVID-19 testing and isolation requirements, the Team collaborated with the Communications Department to provide up-to-date content and guidance changes for the WECHU website. This included changes to workplace and school screening and instructions for non-highest risk settings (e.g., schools, daycares, workplaces).

In January 2022, the Province of Ontario updated its COVID-19 guidance for seasonal IAWs, in order to manage cases and close contacts and control the ongoing transmission of COVID-19 in farm operator-provided accommodations. This guidance required that third-party health assessments be provided for all IAWs exposed to, or testing positive for, COVID-19 and their close contacts. CCM staff collaborated with staff from the EH department to create the COVID-19 Farm Operator Communication Guidance document that summarized the recent changes and resulting process updates. This information was shared during a live webinar for farm operators and provided WECHU an opportunity to address any questions or outstanding issues.

Investigations Conducted

Despite the shift in case and contact management guidance to investigating only cases associated with highest risk settings, staff completed 14, 295 case investigations between January 1, 2022 to March 31, 2022.

Partnerships

Partnerships, both internally and externally, have been integral to CCM and have occurred throughout the pandemic. The WECHU has numerous community partners, including the City of Windsor, the Canadian Red Cross and the Windsor-Essex Emergency Medical Services (EMS) who together, ensure that individuals who need isolation support and health assessments receive these services (e.g., at the Isolation and Recovery Centre [IRC]).

The WECHU partnered with Community Living Windsor and Essex, to build the capacity of their staff to conduct COVID-19 testing on staff and residents. Windsor-Regional Hospital continues to partner in CCM, providing information required to complete case and contact investigations and infection prevention and control measures in outbreaks. Internally, the CCM staff work with the Outbreak Team/Infectious Disease Prevention Department, and the Environmental Health Department (EH) (i.e., Public Health Inspectors) to manage and identify outbreaks related to the highest risk settings.

SUMMARY

The COVID-19 pandemic has created opportunities for WECHU staff to work together to provide support and educational resources to a variety of sectors. The WECHU is committed to working with community partners and conducting CCM in a timely fashion to prevent the spread of COVID-19. The team will continue to revise plans as Ministry guidelines and direction change.

PREPARED BY

Epidemiology and Evaluation Department

DATE

May 4, 2022

SUBJECT

COVID-19 Surveillance and Epidemiology – April, 2022

BACKGROUND

Overview

The Epidemiology & Evaluation department conducts on-going population health assessment and surveillance. The data and surveillance for COVID-19 plays an integral role in understanding and managing the pandemic locally. The evidence provides information on how the pandemic has and is evolving, assessing the risk and severity, and assists in the development of timely interventions to limit further spread in the community.

Due to the recent surge in Omicron cases and changes in eligibility for testing, testing capacity is limited and case, contact, and outbreak management has been modified to focus on high-risk settings. As a result, case counts in the report are an underestimate of the true number of individuals with COVID-19 in Windsor-Essex County and may impact data completeness. Please interpret these data accordingly. Due to these changes, data from before December 31, 2021 should not be compared to data after the testing changes.

Trends

In the month of April, the health unit reported 3,131 confirmed high-risk cases of COVID-19. As the weeks progressed in April, the weekly high-risk incidence rate decreased from 187.6 cases per 100,000 population (Week 14) to 112.0 cases per 100,000 population (Week 17).  

In-Patient and ICU Admissions

In April, in-patient COVID-19 hospitalizations remained relatively stable in Windsor-Essex County although there was an increase at the beginning of the month. A total of 266 new COVID-19 related patients were admitted to local hospitals.

Percent Positivity

Locally, Windsor-Essex County continued to experience an incremental increase in percent positivity for the first three weeks in April, followed by a decrease during the last week. This is in contrast to week-to-week increase observed in March. The local percent positivity rate for COVID-19 declined to approximately 13.8% in the last week of the month. It is also important to note that these were for high-risk individuals that were eligible for testing.

Wastewater Surveillance

For the month of April, viral signal for COVID-19 in wastewater saw a significant increase for the first two weeks, followed by a decline during the last two weeks. Current levels are beginning to reach levels observed during the onset of the Omicron wave in December 2021.  

Outbreaks

In the month of April, 40 outbreaks were declared in high-risk settings compared to the 21 outbreaks in March. This includes 21 outbreaks in long-term care and retirement homes, 9 in hospital settings, and 10 in other congregate settings. As of April 30th, there were 29 active outbreaks in the Windsor-Essex County region.

Deaths

For the month of April 2022, 17 deaths were reported that were attributed to COVID-19. This is similar to the number of deaths reported in March.

DISCUSSION

With the changes in testing eligibility, and guidance with case, contact, and outbreak management, the health unit has modified its public reporting to better understand the burden of illness locally. New indicators, such as wastewater data, have been included as a proxy indicator for COVID-19 case counts, which are underestimated. The health unit will continue to monitor and provide epidemiological expertise on COVID-19 to internal leadership, community partners, and residents to support evidence-informed decision-making. This includes daily epidemiological updates, weekly epidemiological presentations to the community, and supporting policy decisions through data driven approaches.