Board of Health Meeting Documents

PREPARED BY:

Infectious Disease Prevention

DATE:

2024-05-16

SUBJECT:

Communicable Diseases and Outbreaks

BACKGROUND/PURPOSE

The Windsor-Essex County Health Unit’s (WECHU) Infectious Disease Prevention (IDP) department provides programs and services focused on addressing communicable disease prevention and control. Through case and contact management, the WECHU works to isolate and contain cases of disease from further impacting our community. The WECHU also uses methods of surveillance to identify trends of illness and inform decision making for public health interventions. Although the IDP department responds to all reports of diseases with public health significance, respiratory diseases have a greater potential to lead to outbreaks in congregate living spaces when cases peak during the respiratory season; which is observed primarily from early fall to late winter each year. 

DISCUSSION

COVID-19 

While COVID-19 continues to be a major cause of respiratory illness worldwide, the World Health Organization states that Covid-19 no longer qualifies as a global emergency. Decreasing number of COVID-19 cases and increased levels of immunity, have shifted the way that covid-19 illness is managed. Driven by provincial guidance, WECHU continues to focus its efforts on integrating Covid-19 as part of regular case and contact management activities, with COVID-19 becoming a part of long-term standardized processes for managing cases of respiratory illness. In the 2023-2024 season, cases of COVID-19 locally have decreased from 7,503 to 1,830, a 76% reduction from the previous season. The WECHU continues to receive positive COVID-19 reports for individuals in hospital or congregate living settings, and these facilities are provided guidance on respiratory infection control practices. 

Influenza Cases

As COVID-19 cases are decreasing, the WECHU has observed a rise in confirmed influenza cases this past respiratory season which is consistent with provincial data reports of influenza illness. During the 2022-2023 respiratory season, the reported case count for influenza was 407. However, in the 2023-2024 season, there has been a notable increase, with 686 confirmed cases reported from September 2023 to date.

Measles

Measles, a serious respiratory infection, was rare in Ontario, due in large part to the successful elimination of measles in Canada. However, in line with an increase in measles activity seen globally, Ontario has recorded 14 laboratory-confirmed cases of measles to date in 2024. Thirteen of these cases are linked to international travel and 8 were individuals not previously vaccinated for measles. 

Locally, the WECHU investigated 1 travel-related adult confirmed case of measles in January. No other cases have been confirmed to date in WEC. Case management and contact tracing efforts focused on ensuring the case remained isolated during the infectious period and minimizing the risk of exposure to our community.  

Outbreaks 

The WECHU investigates all reports of suspected and confirmed outbreaks in high risk congregate living settings including long-term care, retirement homes, supportive housing, shelters, and boarding homes. For the 2022-2023 season, the WECHU reported 239 total respiratory outbreaks. Of those, 193 (80%) were due to COVID-19. From Sept 2023 to date, the WECHU has seen a decrease in the number of respiratory outbreaks to 163 where 117 (71%) were due to COVID-19. Other respiratory infections such as Influenza, RSV, Metapneumovirus, Parainfluenza, and others, that were absent during the 2020 to 2021 outbreak season, where COVID-19 infection predominated, have now made a resurgence. 

While the impact of COVID-19 has decreased since the beginning of the 2020 pandemic, the WECHU continues to advise the public of precautionary measures for all respiratory illnesses, including influenza and measles. Promotional activities such as external messaging on social media platforms, or public health alerts have been aimed at the importance of vaccination, respiratory etiquette, hand hygiene, staying home when unwell, and wearing masks when the risk necessitates it. 

Infection Prevention & Control (IPAC) Hub 

WECHU continues in its commitment to support and strengthen infection control practices in our community through the IPAC Hub. Using a collaborative approach, WECHU nurses and Public Health Inspectors conduct supportive visits to congregate living facilities, targeting education to IPAC leads around infection control best practices. In an effort to build capacity and knowledge, facilities are encouraged to engage self-assessment questionnaires to review their internal IPAC practices and measure those practices against established standards. IPAC leads are also encouraged to participate in the Windsor-Essex IPAC Community of Practice (CoP) monthly forums. Recent topics of discussion have included: Outbreak Prevention, Internal Auditing of Hand Hygiene practices, and Waste Management. 

PREPARED BY:

Healthy Schools

DATE:

2024-05-16

SUBJECT:

Break the Vape Challenge

BACKGROUND/PURPOSE

While data tell us that over the past few decades, there has been a decline in the number of young Canadians smoking cigarettes and using tobacco products, the emergence of vapour products has caused a shift in the types of nicotine products youth are using. This increase is putting them at risk of becoming addicted to nicotine. The tobacco industry continues to target younger people with appealing flavours, packaging, and devices and vapour products are the most used nicotine product among youth (Physicians for Smoke-Free Canada, 2021). In Windsor-Essex 23.5% of students in grades 7 to 12 are daily vapers (Ontario Student Drug Use and Health Survey, 2023). The use of nicotine before age 25 can impact learning, memory, attention, and increase the risk for addiction to other substances. During the 2022-2023 school year, the Healthy School department had over 100 interactions with schools around support for vaping education and enforcement. As a result, the WECHU launched the Break the Vape Challenge as part of a wider strategy to bring raise awareness, educate with the intent of decreasing youth vaping.

The purpose of the Break the Vape Challenge was to engage Windsor and Essex County students in grades 6 to 12 with an opportunity to use their voice to learn about and raise awareness of the dangers of vaping.  Providing youth with evidence-based information increases their knowledge to make informed decisions to initiate or quit vaping. Students were asked to create and submit a 30 second Public Service Announcement (PSA) video that included at least one key message about the dangers of vaping and one call to action. The challenge used a full youth engagement approach, starting with the development of the challenge, to the selection of videos for public voting. This approach ensured the components of the challenge and messages resonated with youth, with the goal of having greater youth buy-in and increased awareness of the health effects of vaping and nicotine.  A panel of youth judges voted for their top 5 videos from each category to narrow the entries down for public voting. Prizes were awarded to students for the top voted videos, and to publicly funded schools with the highest participation rates. The winning PSA videos will be promoted to continue to raise awareness around the harms associated with vaping.

DISCUSSION

The submission period for the challenge took place from February 5 to March 8. To promote the challenge our Healthy School nurses conducted 19 lunch and learns at secondary schools focused on providing information about the contest and vaping resources. The challenge received 98 video submissions (57 for the grade 6 to 8 category and 41 for the grade 9 to 12) totaling 238 participating students. A total of 30 youth judges participated in scoring the qualified videos over 3 sessions. Videos were scored using 8 questions focused on the messaging and quality of the videos. The top five scoring videos from each category were then selected for public voting which took place from April 15 to April 26. Over 2,700 votes determined the winners. The winning videos were announced on May 3rd, the following videos and schools won the challenge:

Grade 6 to 8: 

• 1st place: Échappe le vape - Christina K., Alexandra K., Josephine L., and Sophie L.: École élémentaire catholique Saint-Edmond
• 2nd place: Escape the Vape -Joshua F., Sam L., and Chris H.: St. John the Baptist Catholic Elementary School
• 3rd place: Stop the Peer Pressure - Aeden A.B., Aidan C., Jaden L., and Leah B.: St. John the Baptist Catholic Elementary School
• Elementary school- Highest percentage of participating students prize: École élémentaire catholique Saint-Edmond 

Grade 9 to 12: 

• 1st place: Break the Vape for Mental and Physical Health - Julia P. and Kailey Y.: St. Thomas of Villanova Catholic Secondary School
• 2nd place: Anti-Vape PSA - Reihan P., Joshua P., and Cory L.: Catholic Central Highschool
• 3rd place: I was told it was trendy... - Timothy L.: Assumption College Catholic High School 
• Secondary school- Highest percentage of participating students’ prize: E'cole secondaire catholique EJ Lajeunesse 

Moving forward, the Healthy Schools department plans to use the winning videos to further promote awareness around the youth vaping issue and promote resources for those looking to quit. You can find more information about the challenge and view the winning videos on the Break the Vape Challenge web page.

PREPARED BY:

Planning and Strategic Initiatives

DATE:

2024-05-16

SUBJECT:

2024 Board of Health Assessment Survey

BACKGROUND/PURPOSE

The Ontario Public Health Standards (2021), under the Good Governance and Management Practices Domain, states: “the board of health shall have a self-evaluation process of its governance practices and outcomes that is completed at least every other year. Completion includes an analysis of the results, board of health discussion, and implementation of feasible recommendations for improvement, if any”. 

To meet this requirement, the WECHU developed a competency-based self-evaluation survey for Board of Health (BOH) members. The survey includes 12 competency areas used to identify the strengths of the BOH, as well as opportunities to provide additional training and support for the BOH. 

DISCUSSION

The survey was sent to current BOH members in February 2024. Analysis of the results from the 2024 BOH survey demonstrated that the top strengths of the BOH are:

• Leadership and Governance
• Community Partners and Stakeholder Engagement
• Human Resources

Identified areas of opportunity are:

• Knowledge of Public Health Programs and Services
• Health Equity
• Legal 

Future training opportunities will be provided to the BOH to support their efforts; as well, quarterly feedback opportunities will be provided to support effective BOH operations and decision-making. 

PREPARED BY:

Chronic Disease and Injury Prevention

DATE:

2024-05-16

SUBJECT:

Windsor Essex Community Opioid and Substance Use Strategy 2023

BACKGROUND/PURPOSE

The Windsor-Essex Community Opioid and Substance Strategy (WECOSS) is a collaboration of over 40 community partners and individuals with lived experience brought together to address the drug poisoning crisis. As the backbone agency, the Windsor-Essex County Health Unit (WECHU) is responsible for coordinating the Strategy, monitoring local data for trends in substance use events, supporting the development, implementation, and evaluation of projects, and building sustainable communication channels to disseminate evidence-based information to the public. Utilizing a four-pillar approach, the WECOSS works to address the harms of substance use at the community level through Prevention and Education, Harm Reduction, Treatment and Recovery, and Enforcement and Justice interventions.

DISCUSSION

Each of the four WECOSS pillars develops and implements at least one project a year, in addition to the ongoing work from previous year’s initiatives. These are captured in the WECOSS Annual Reports. The 2023 WECOSS highlights were as follows: 

Opioid and Substance Use Notification System (OSUNS)

The OSUNS monitors real-time trends in local data to identify spikes in opioid and other substance use-related events across Windsor-Essex County. An evaluation of the OSUNS was conducted which engaged 31 WECOSS members in a survey.

• 90% agree that the alerts increase their awareness of local substance use trends.
• 87% find the information in the alerts relevant to local needs.
• 71% use the alerts within the context of their work.

The recommendations for improvement included:

• More real-time monitoring
• Linking community substance programs to the alerts
• Expanding the knowledge of the public regarding the OSUNS

Enforcement and Justice

• 21 service providers surveyed to identify educational needs regarding substance use.
• Findings will be used to develop tailored workshops for service providers, corrections officers, and post-secondary students.

Treatment and Recovery 

• Online inventory of 187 substance use and mental health programs and services developed.
• Pilot testing and public launch in 2024 planned to assist residents to find and access services that best meet their needs. 

Prevention and Education

• 17+ lbs of unused/expired medication collected at medicine take-back event and brought to the pharmacy for safe disposal.
• Development of a community partner communications toolkit with integration of alcohol and cannabis messaging developed for distribution in 2024. The toolkit includes key messages and a dissemination plan to heighten the profile of the WECOSS strategy and increase recognition of its role in the community.

Harm Reduction

• Through the Needle Syringe Program delivered by Pozitive Pathways Community Services (PPCS) there were:
  • 20,870 client transactions across 4 NSP sites and mobile delivery programs.
  • 533,844 needles distributed.
• Promotion of SafePoint Safer Consumption Site including outreach to clients, community engagement, and mitigation strategy development to address needs of clients following pause in operations.

Substance Supports in Neighbourhoods Accessed Through Police Partnerships (SSNAPP)

In 2023, the Enforcement and Justice Working Group welcomed the Substance Supports in Neighbourhoods Accessed Through Police Partnerships (SSNAPP) initiative, led by the Windsor Police Service, the WECHU, and the City of Windsor. Aligned with the Windsor Essex Regional Community Safety and Well-Being Plan and the WECOSS, this initiative strengthened the ongoing efforts to address substance-related challenges within in our community, with the WECHU playing a crucial role in coordinating activities, offering public health expertise on substance use issues and related trends in our community, and supporting data collection and analysis efforts.

The impact of the SSNAPP initiative in 2023 is demonstrated through the following achievements: 

• Facilitated a Crime Prevention Through Environmental Design (CPTED) Workshop attended by 56 stakeholders representing 30 diverse social, health and business sectors.
  • 73% of survey respondents found the training highly relevant to their roles within the community.
• Supported Trauma Informed Training Sessions conducted by the Downtown Windsor Community Collaborative (DWCC), for both clients and frontline health and social service providers.
  • Included 4 client sessions with a total of 57 participants.
    • 58% of survey respondents discovered a new support.
  • Included 10 service provider sessions with a total of 302 participants.
    • 83% of survey respondents felt more equipped to engage with individuals affected by complex trauma. 
• Supported Community Engagement Events organized by the DWCC in high-priority neighbourhoods. 
  • Included a total of 4 events with approximately 200 community members in attendance per event.
    • 82% of survey respondents gained a deeper understanding of available community resources. 
• Hosted two ‘De-Escalating Potentially Violent Situations’ Workshops in collaboration with the Crisis and Trauma Training Resource Institute, catering to frontline health and social service providers.
  • A total of 122 participants from 35 organizations.
    • 93% of survey respondents expressed satisfaction with the course’s learning objectives.

The attached Annual Report provides greater detail on the work of the WECOSS in 2023 and will be disseminated through the committee and publically through organization’s social media and websites.

Purpose

To identify the BOH strengths and identify opportunities for training and support. 

• BOH is required to conduct a self-assessment.
• Questions related to 12 competencies.
• The 12 competencies and related questions were developed based on the Ontario Public Health Standards, BOH By-laws, and the alPHa BOH Governance Toolkit.

Results

• Current board membership includes 14 members, of which 13 completed the survey.
• There were 2 to 4 questions asked for each competency.
• Average scores were created for each competency.
• A satisfactory and optimal range was determined:
  • Satisfactory range (average score ≥2 and <3):BOH members have the necessary competencies to successfully complete tasks related to that topic but might require assistance from an expert at times.
  • Optimal range (average score ≥3):BOH members on average can perform actions related to these competencies without expert assistance.

Self-Assessment Scale

Areas of Competency

1. Communication and marketing:

Interacting with partners to promote programs/services.

2. Community partners and stakeholders engagement: 

Identifying key partners/stakeholders.

Establishing strong partnerships with other organizations.

Resolving conflicts between partners/stakeholders.

3. Health equity: 

Identifying barriers individuals face when accessing public health services.

Consideration of health inequities in program/services decision making.

4. Human resources: 

Attracting and retaining employees.

Assessing the work-related performance of employees.

Succession planning in an organization.

Addressing challenges in a unionized environment.

5. Financial management: 

Managing a budget within an organization.

Assessing financial information.

Creating innovative approaches to deal with fiscal restraints.

Re-allocating resources within an organization.

6.  Knowledge of delivery of public health programs/services: 

Implementation of the OPHS, developing evidence-based program/services, integrating client/customer needs into programs/services

7. Leadership and governance: 

Service on other boards or committees.

Decision-making that considers the impact on relevant stakeholders.

Leadership-level guidance of organizational operations.

Guiding an organization through change to reach their goals.

8. Legal: 

Managing organizational legal considerations, applying ministry level legal requirements in an org, adhering to ministry required BoH legal obligations

9. Performance mgmt. and quality improvement: 

Supporting an organizational culture of continuous quality improvement.

Making organizational decisions based on the quality of programs/services.

10. Political acumen: 

Understand the formal process for decision making at the municipal level.

Identifying key players in the political decision making process.

Developing healthy public policies (e.g., analyzing, planning, implementing, and evaluating policy).

Advocating for the passing and enforcement of healthy public policies.

11. Risk mgmt: 

identifying organizational risks, documenting the cause and consequence of identified organizational risks

12. Strategic and operational planning: 

Development of organizational strategic plans.

Working towards organizational strategic priorities.

Monitoring progress towards meeting a strategic plan.

Competency Assessment

Top Strengths/Opportunities

Overall Recommendations

• Provide training education sessions and e-learning modules to board members.
  • Beginning with the areas of opportunity (e.g., Health Equity, Knowledge and Delivery of Public Health Programs and Services, Legal).
• Quarterly opportunity to provide feedback in regards to BOH operations and decision-making.

Endorsement of CMOH Annual Report - An All of Society Approach to Substance Use and Harms

5/16/2024

BACKGROUND

In April 2024, Ontario’s Chief Medical Officer of Health (CMOH) Dr. Kieran Moore released his 2023 Annual Report, Balancing Act: An All-of-Society Approach to Addressing Substance Use and Harms. This report is his second as CMOH following the previous year’s Being Ready: Ensuring Public Health Preparedness for Infectious Outbreaks and Pandemics (2022). Highlighting recent trends and emerging or urgent public health matters, CMOH Annual Reports aim to set priorities for action across all levels of government. The 2023 report guides policy decisions and planning related to substance use and harm reduction interventions to reflect the increasing rates of overdose and death caused by substances prior to and throughout the COVID-19 pandemic. While this is the first report to focus solely on substance use, several previous CMOH annual reports have commented on its public health impact through the below 2015-2017 Annual Reports:

• Mapping Wellness: Ontario’s Route to Healthier Communities, 2015
• Improving the Odds: Championing Health Equity in Ontario, 2016
• Connected Communities: Healthier Together, 2017

The 2023 report provides 30 goals to guide action related to four specific substances: tobacco/vaping products, alcohol, cannabis, and opioids. These four substances combined account for thousands of emergency department visits hospitalizations and deaths in Ontario in addition to an economic impact of nearly $15 billion in costs attributable to healthcare, lost productivity, and the criminal justice system. When considering interventions at the local level, the report identifies the below strategies to address substance use across the prioritized four substances:

Tobacco/Vaping Products

1. Raise awareness of the risks of tobacco and vaping products.
2. Prevent/reduce vaping and nicotine use among youth and non-smokers.

• Advocate for expanding areas where smoking/vaping is prohibited (including apartment and condominium board policy), and include water pipes in bans.
  • Manage outlet density and hours of access.

3. Increase access to evidence-based smoking cessation therapies and supports.

Cannabis

1. Increase Awareness of Cannabis Harms.

• Promote Health Canada’s Low Risk Cannabis Guidelines​.
• Educate related to the risks of cannabis use including different forms and concentrations, during pregnancy, impaired driving, and polysubstance use.

2. Reduce risks to young children.

• Increase awareness related to the risk of pediatric poisonings from edibles.

Alcohol

1. Advocate for a comprehensive provincial alcohol strategy.
2. Increase awareness of alcohol-related harms.
3. Advocate for policies which limit access to prevent harm at the local level.
4. Enhance clinical services by promoting best practices, including screening and brief interventions and treatment access for people with alcohol use disorder.

Opioids

1. Advocate for increased access to resources that address determinants of health, including housing and access to  healthcare and social services.
2. Raise awareness of the risks associated with the toxic, unregulated drug supply.

• Inform communities about how to respond effectively (administering naloxone, calling 911).

3. Advocate for harm reduction service access, including naloxone, safer supply, supervised consumption (including for people who smoke drugs), and drug checking services and diversion program options.
4. Increase access to integrated, timely, low barrier, evidence informed treatment for people who use opioids. 
5. Address the impacts of grief and loss through services and support for families and friends of people who have died from toxicity and for support workers.

Since 2016 the WECHU has served as a central coordinating agency in Windsor and Essex County around many of the strategies referenced in the CMOH’s report. Through its leadership of the Windsor-Essex Community Opioid and Substance Strategy, its school and community-based health promotion activities, and its harm reduction programming (e.g., Ontario Naloxone Program implementation and Safer Consumption Site advocacy) several of the above-referenced strategies are currently in action. Planning and ongoing public health efforts will build upon the work already underway to align strategies with those prioritized provincially as indicated in the 2023 CMOH Annual Report. In this regard, ongoing partnerships with municipalities and partners in the addictions sector are necessary to take a comprehensive approach to mitigating and scaling back the escalating harms and impact of substance use in the region.

PROPOSED MOTION

Whereas, the CMOH has prioritized the prevention of harms associated with substance use as one of the biggest threats to what had previously been a steady increase in life expectancy in Ontario; and

Whereas, the CMOH calls on all levels of government to support public health efforts and contribute solutions through a comprehensive all-of-society approach to decreasing the impact of substance use on communities; and

Whereas, the impact of substance use on families, the health sector, and the provincial economy requires all partners to work collaboratively on solutions;

Whereas, the WECHU is a leading agency in the area of substance use prevention and harm reduction through its leadership and coordinating role in Windsor and Essex County;

Now therefore be it resolvedthat the Windsor-Essex County Board of Health endorses the 2023 Chief Medical Officer of Health’s Annual Report, Balancing Act: An All-of-Society Approach to Addressing Substance Use and Harms, to reaffirm its support for investment in public programming to mitigate the impact of substance use on Windsor and Essex County communities, and

FURTHER THAT, the Windsor-Essex County Health Unit shares the 2023 CMOH Annual Report as correspondence with local municipalities to inform healthy public policy development in Windsor and Essex County.

Canadian Substance Use Costs and Harms Scientific Working Group. Ontario Profile: Canadian Substance Use Costs and Harms (2007–2020) [Internet]. Ottawa, ON: Canadian Centre on Substance Use and Addiction; 2023. Available from: https://csuch.ca/substance-use-costs/provincial-territorial-costs/&nbsp;

Moore K. Being Ready: Ensuring Public Health Preparedness for Infectious Outbreaks and Pandemics. 2022 Annual Report of the Chief Medical Officer of Health of Ontario to the Legislative Assembly of Ontario. Toronto, ON: Queen’s Printer for Ontario; 2022. Available from: https://www.ontario.ca/page/chief-medical-officer-health-2022-annual-re… 

Williams D. Mapping wellness: Ontario’s route to healthier communities. 2015 annual report of the Chief Medical Officer of Health of Ontario to the Legislative Assembly of Ontario. Toronto, ON: Queen’s Printer for Ontario; 2017. Available from: https://www.simcoemuskokahealth.org/docs/default-source/hu-library/repo…; 

Williams D. Improving the odds: championing health equity in Ontario. 2016 annual report of the Chief Medical Officer of Health of Ontario to the Legislative Assembly of Ontario. Toronto, ON: Queen’s Printer for Ontario; 2018. Available from: https://www.simcoemuskokahealth.org/docs/default-source/hu-library/repo… 

Williams D. Connected communities: healthier together. 2017 annual report of the Chief Medical Officer of Health of Ontario to the Legislative Assembly of Ontario. Toronto, ON: Queen’s Printer for Ontario; 2019. Available from: https:// files.ontario.ca/moh-2017-annual-report-chief-medical-officer-health-en-2023-03-09.pdf

The conversations we had were important and it is through ongoing dialogue and collaboration that we will be able to maximize the opportunities that the Strengthening Public Health strategy presents to make our sector stronger.

We look forward to continuing these important discussions over the coming months.

Sincerely,

Dr. Kieran Michael Moore, MD, CCFP(EM), FCFP, MPH, DTM&H, FRCPC, FCAHS
Chief Medical Officer of Health and Assistant Deputy Minister, Public Health

c. Elizabeth Walker, Executive Lead, Office of the Chief Medical Officer of Health
Brent Feeney, Director, Accountability and Liaison Branch, Office of the Chief Medical Officer of Health
Dr. Wajid Ahmed, Associate Chief Medical Officer of Health, Office of the Chief Medical Officer of Health

14-075

We also respectfully request that the Chief Medical Officer of Health ensure proactive engagement in the sector-driven review of the Ontario Public Health Standards.

Sincerely,

Original signed by

Councillor Kathryn Wilson Chair,
Board of Health

/ag

cc:
Dr. Kieran Moore,Ontario Chief Medical Officer of Health Local MPPs
Ontario Boards of Health
Association of Local Public Health Agencies.

In 2023, the WECHU initiated a total of 207 Intervention Workplans (IWP). 

153 of the workplans were external (public facing) endeavors with work spanning across 6 external departments and 47 individual programs. 

54 workplans were internal which supported operations and initiatives within the WECHU.

As illustrated in Figure 1a, 110 of the external workplans were completed (72%), with 32 being deferred, and 11 cancelled.

Figure 1b depicts the internal workplans, of which 34 were completed (63%), 17 deferred, and 3 cancelled.

PREPARED BY:

Planning and Strategic Initiatives

DATE:

March 21, 2024

SUBJECT:

Q4 Board of Health Effectiveness Survey Summary

BACKGROUND/PURPOSE

The Ontario Public Health Standards (2021), under the Good Governance and Management Practices Domain, states: “the board of health shall have a self-evaluation process of its governance practices…”. 

In addition to a yearly self-evaluation process, the WECHU has developed a quarterly self-assessment survey for Board of Health (BoH) members. The survey provides an opportunity for feedback on BoH operations and is used to inform quality improvement efforts. 

DISCUSSION

Responses in the fourth quarter of 2023 related to BoH operations continued to be positive. In all cases, 100% of the responses were ‘Agree’ or ‘Strongly Agree’ regarding the aspects queried. In terms of overall perceived BoH effectiveness, 70% of the responses were either a 9 or a 10 (on a 10-point scale), where the average score was 9. 

Suggestions for improvement included support for additional BoH education, greater clarity on meeting agendas (including earlier provision of agendas), establishing consistent monthly BoH meetings, establishing a permanent location for BoH meetings, and extending electronic access to BoH materials to additional devices.

PREPARED BY:

Environmental Health

DATE:

March 21, 2024

SUBJECT:

2023 Vector Borne Disease Report

BACKGROUND/PURPOSE

Vector-borne diseases are caused by the transmission of parasites, viruses, and bacteria in humans by vectors. The most common vectors are mosquitoes and ticks and can transfer the pathogen from one host to another. Public health units in Ontario are required under the Health Protection and Promotion Act to conduct vector-borne disease surveillance to monitor trends for emerging diseases including factors that influence their occurrence. In 2023, the Environmental Health Department continued to implement 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). 

DISCUSSION

Active Tick 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 and is performed twice yearly in the spring and the fall. Any black-legged ticks identified are sent to an accredited laboratory for testing for Lyme disease. In 2023, tick dragging was conducted at four sites across WEC in May and October. A total of forty-four black-legged ticks were identified, with twenty ticks carrying the infectious agent that causes Lyme disease. In 2023, there were eight human cases of Lyme disease reported in WEC.

Mosquito Surveillance Program ran for a total of 21 weeks from May 23 to Oct.13, 2023. Once a week, forty-one mosquito traps (26 CDC light traps and 15 BGS 2 traps) were set up across WEC to collect mosquitoes for identification and viral testing.  In 2023, there were 11 WNV positive pools identified and one positive WNV human case was reported. There were no positive pools or human cases for EEE or Zika identified this year.

Mosquito Larviciding involves applying larvicides to catch basins, standing water sites, and lagoons that hold water where mosquitoes may breed. The WECHU and municipalities contracted a service provider to run larval surveillance beginning in May. Three rounds of roadside municipal catch basin larviciding were conducted and a total of 133,024 catch basin treatments were applied WEC. There were a few challenges identified during the larviciding season for catch basins and only one standing water complaint submitted by WEC municipalities. Prior to 2024 season, meetings will be set up with municipalities and vendor of record to look at processes as well as to address concerns from last season.

PREPARED BY:

Healthy Schools Department

DATE:

March 21, 2024

SUBJECT:

Comprehensive School Health – Health Promotion Program

BACKGROUND/PURPOSE

The WECHU Comprehensive School Health Program works to improve the health and well-being of school-aged students, staff, and their families in collaboration with the four schoolboards: Greater Essex County District School Board (GECDSB), Windsor Essex Catholic District School Board (WECDSB), Conseil scolaire catholique Providence (CSC Providence), and Conseil Scolaire Viamonde (Viamonde) as well as local private and faith-based schools. In total, the program supports 132 publicly funded schools, and 31 private or faith-based schools.

The program employs best practices and research and is directed by the School Health Standard and Guidelines of the Ontario Public Health Standards (2018), to provide comprehensive programming to support health and wellness topics as indicated in the Standards. Initiatives are planned using the Foundations for a Healthy School Framework, including curriculum, teaching and learning; school and classroom leadership; student engagement; social and physical environment; and home, school, and community partnerships. An inaugural  Strategic Partnership Agreement has been signed by the WECHU and all four schoolboards for the 2023-2024 school year (presented to the board in January 2024). This Agreement formalizes the collective actions by all parties to collaborate, cooperate and communicate regarding specific programming and planning activities to support the children and youth of WEC, through the creation of healthy school environments. The WECHU’s leadership of the School Board Liaison Committee is one important component of operationalizing this Agreement. 

Program interventions are equity-driven and varying levels of support are provided to schools based on a multi-factor assessment of needs and health priorities identified by schools. There are 70 publicly funded schools which have been identified as highest needs for the 2023-2024 school year. Need was based on combining data sets from the Ministry Education Opportunities Index, EQAO scores, oral health outcomes, immunization rates, and socially disadvantaged community regions. Highest needs schools complete a School Health Assessment survey and work with a dedicated public health nurse to co-develop and implement tailored interventions to meet the needs of the school and students, based on topics identified in the School Health Standard. The top health priorities identified by highest needs schools for 2023-2024 school year include mental health and substance use.

DISCUSSION - Program Highlights

All 163 schools in WEC receive evidence-based program support based on the Foundations for a Healthy School Framework, health topics identified in the School Health Standard, as well as emerging health needs identified by schools and in the larger community. Resources include foundational knowledge and educator tools to support health-related curricula, as well as supportive materials for students and families. Resources are developed and promoted throughout the school year, as well as by request from individual schools. A digital email monthly newsletter of emerging health topics and associated educator resources began in December 2023. All materials developed are readily available from the Healthy Schools section of the WECHU website. Schools, community partners, and caregivers of children and youth are encouraged to sign-up for the newsletter.

Mental Health Literacy Program
(School Health Standard Requirements 1, 2, 3, 4 and PPM 169)

The WECHU is using the Decider Skills Program as one of its mental health literacy approaches. It is a social emotional learning skills-based program that helps students recognize their own thoughts, feelings, and behaviours, enabling them to monitor and better manage their own emotions and mental health. During the 2022-2023 school year, four school nurses piloted the program at four schools, teaching 12 social-emotional learning skills in classrooms over a seven-week period. At the conclusion of the pilot sessions, the majority of students (67.5%) could name and explain and use at least two Decider Skills. 

Based on the evaluation, the program was condensed into five weeks and focused on Grade 4 students at higher needs schools for the 2023-2024 school year. Beginning October 2023, two Decider series of 5 weeks each were completed in 17 priority schools reaching 687 students. Two additional series are planned for this school year, where 16 more higher needs schools will participate. Program evaluation results will be released at the conclusion of the four sessions. 

Substance Use Prevention – Break the Vape Youth PSA Challenge 
(OPHS School Health Requirements 3 and 4)

Break the Vape Challenge is a contest for WEC students in grades 6 to 12. Students are asked to use their voice to create and submit a 30 second Public Service Announcement video to raise awareness to their peers about the dangers of vaping and the sneaky marketing tactics of the tobacco industry. Videos can be submitted in English or French and must include at least one key message about the dangers of vaping and one call to action. The contest was developed with youth, and students will be asked to watch and vote for their favourite video entries to determine the winners. Prizes will be awarded to students for the top voted videos, and to publicly funded schools with the highest participation rates. Entries will be accepted from February 5 to March 8 and voting begins April 16, 2024.

Food and Nutrition – Educator Toolkit for Supportive Food Environments
(OPHS School Health Requirement 4 and PPM 150)

To support a new approach to teaching and talking about food at school, the WECHU has developed a new resource: School Nutrition Toolkit - How to Create a Supportive Food Environment at School. The toolkit provides knowledge, helpful tips, and resources to increase the capacity of educators and school administrators to create supportive food environments at school. The evidence-based strategies promoted in the toolkit are known to help students foster positive relationships with food and their own bodies, which will increase healthy eating behaviours, body image, and self-esteem. 

PREPARED BY:

Planning and Strategic Initiatives

DATE:

March 21, 2024

SUBJECT:

2023 Annual Service Plan: Annual and 4th Quarter Report

BACKGROUND/PURPOSE

In 2018, the Ontario Ministry of Health (MOH) introduced a new Annual Service Plan (ASP) that Health Units are required to submit each year. To ensure a single and integrated approach to evaluating progress on this requirement, the Planning and Strategic Initiatives (PSI) department worked with the Information Technology (IT) department to align our planning system with the provincial Ontario Public Health Standards requirements to provide quarterly progress reports on the plan. 

DISCUSSION

2023 Annual Overview

72% of the WECHU’s external public-facing programming was completed as planned in 2023.

Several environmental factors led to adjustments throughout the year and affected completion rates of the plan. These factors included: The Provincial requirement to operate a local COVID-19 vaccination clinic; changes to the co-location partnership with the University of Windsor; and the revised Provincial funding formula that led to significant staffing and resource limitations during the 4th Quarter of 2023.

Q4 Intervention Work Plan Progress

Project Leads have submitted individual progress reports for work plans in their programs for Q4, 2023. 

The 2023 Annual Service Plan – Q4 Recommendation Report indicates:

• For external client facing programs, there were 124 active plans with 84% being completed.
• For internal organizational programs, there are 38 active workplans with 63% being completed.

Annual Service Plan Development for 2024

Activities in the Intervention Work Plans (IWP) have begun and detailed reporting on their progress will be submitted to the Ministry of Health in April as directed.

PREPARED BY:

Chronic Disease and Injury Prevention

DATE:

March 21, 2024

SUBJECT:

Nutrition Month and Nutrition Programming

BACKGROUND/PURPOSE

For the past 40 years, March has been celebrated as Nutrition Month across Canada. Nutrition month is a time to recognize the field of dietetics, to reflect on past practices, and to highlight nutritional needs in the community. Food and nutrition interact and intersect with almost every department within a public health unit. Public health nutrition uses population and health promotion approaches and strategies focused on the assessment, promotion, protection and enhancement of health, and the prevention of nutrition-related diseases. Public health nutrition requires the leadership of Registered Dietitians with expertise in nutrition and related public health sciences, as the field of nutrition constantly evolves and changes. Registered Dietitians ensure that best practices are consistently updated and applied to public health practice.

CURRENT INITIATIVES

Nutrition programing at the WECHU addresses barriers to achieving consistent eating behaviours with a focus on decreasing food insecurity and increasing food literacy in our community. Past and present interventions that support this work are described below. 

Nutrition Month – March 2024

To celebrate Nutrition Month, Dietitians of Canada is shining a spotlight on the dietetic profession to recognize and acknowledge the impact of dietitians nationwide. Locally, the WECHU is focusing on changing the current environment surrounding food and nutrition, through the education and promotion of using a food neutral approach to eating.

• A newsletter and social media campaign on food neutrality was promoted throughout March. 
• Food & Nutrition section of the WECHU website updated to reflect food neutral language change.
• Partnered with the University of Windsor’s student food pantry to provide sessions on food neutrality and how to nourish the body with a limited budget.
• Food neutrality online training will be released later this year, to continue to support community partners and community members in making this change.

Food Insecurity Initiatives

Food insecurity is a growing Public Health concern, because it is so tightly linked to adverse health outcomes, above and beyond the influence of other social determinants of health. 

• Monitoring Food Affordability: WECHU continues to release food affordability surveillance data to help inform decision making in our community. 
  • The Real Cost of Eating Report was released in November of 2023.
  • After presenting the findings of the 2023 report at a local Feed Ontario event, the CDIP Nutritionist was interviewed and quoted in 9 media reports. 
  • Briefing note on food insecurity sent to Senator Burey in September of 2023.
  • Data collection for 2024 will occur in May, with report findings to be released in the fall.
• Food Insecurity Screening: A food insecurity screening tool and associated trainings will be created by the WECHU in 2024.
  • Data on food insecurity in certain demographics is limited. 
  • Screening allows health care providers and community partners the ability to identify and support clients who are experiencing food insecurity, while providing accurate data to ensure supports are being utilized effectively. 

Food Literacy Initiatives

Food literacy impacts how easily a person can implement healthy eating behaviours. Food literacy includes interconnected attributes organized into the categories of food and nutrition knowledge; food skills; self-efficacy and confidence; food decisions; and ecologic (external) factors.

• You Can Cook Video Series: The You Can Cook video series is a virtual food skill program that teaches basic food skills in five minutes or less. There are 15 videos in the series, with each video building on the previous skills taught as the series progresses. 
  • Since 2022 the series has had over 4,600 views between all videos, and an additional 3,700 views of the series trailer. 
  • Community partners and other Health Units in Ontario are utilizing these videos to help support food skill building with their clients, and they will continue to be promoted throughout 2024. 
• You’re the Chef train the trainer program: Through key partner interviews, the need for hands on food skill training is high in our community. 
  • The You’re the Chef train the trainer program will be provided to community partners and teachers to facilitate their own, 6-week food-skill program. Training will occur throughout 2024.
• Food and Mental Health: In addition to food skills training, nutrition and mental health training was highlighted as a community need. 
  • Capacity building for service providers, as well as presentations for priority populations, around building positive relationships with food and body and the intersections between diet culture and food insecurity will be delivered. 
  • This education will also work to reduce the potential harm when providing care, while creating a safe, inclusive space for all.

The registered dietitians at WECHU are committed to continuing to advocate for equitable access to food and adequate incomes, improve physical and social food environments, and enhance the local food system.

PREPARED BY:

Communications Department

DATE:

February 20, 2024

SUBJECT:

January 15, 2024 – February 14, 2024, 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

From January 15 – February 14, we experienced three main peaks of media exposure:

January 26: Following our release about a possible measles exposure, 29 media stories were issued. 

January 30 – February 1 & February 5: The announcement of the decision to no longer relocate to the University of Windsor campus resulted in 16 stories. Overlapping this, our news release with an updated number of students with incomplete immunization records received 19 stories. The spike on February 5 was an echo effect of these two stories.

Website Overview Graph

Notes: From January 15 – February 14, we saw very similar website traffic patterns as the previous month, but an increase in traffic overall. This can be attributed to the lower viewership in December over the holidays, as well as a handful of large news stories which were issued in January, driving people to our website (e.g. News Releases around measles exposure, our office relocation, and student immunizations).

Social Media Overview Graph

Lighter blue line represents the current month, darker blue line represents the previous month. Notes: We saw some increases in followers over the month. 

Discussion – Student Immunizations

The Communications Department worked with the Healthy Schools department to communicate to families around the Immunization of School Pupils Act (ISPA) and the importance of keeping immunization records up to date. These communication pieces included a News Release which was issued on January 31, 2024, boosted (paid) social media posts and ads, as well as meetings with the school board communication representatives. 

The News Release had an open rate of 43% from the media audience. This resulted in 19 published news stories to help raise awareness of the various ways parents and guardians can update their child’s record or receive any necessary immunizations. 

Additionally, a webpage was created for school administrators which houses a variety of documents to support the ISPA enforcement process. Documents include a flow chart of next steps for parents, frequently asked questions and answers, and a communication guide with pre-created social media posts, emails, and voice recording scripts for schools to utilize. Through feedback from the communications representatives at the school boards, these documents have proven to be incredibly valuable and helpful for their administrative teams when speaking with parents and guardians. 

PREPARED BY: Communications Department 

DATE: January 22, 2024

SUBJECT: December 15, 2023 – January 14, 2024, 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

Notes: From December 15 – January 14, we experienced three main peaks of media exposure:

Dec 20 – A spike in media coverage followed a News Release issued around the emergence of nicotine pouches and their target of a youth population.

Dec 29 & Jan 3 – Media coverage over this timeframe focused on the pause in services at SafePoint which took effect on January 1, 2024.

Website Overview Graph

Notes: From December 15 – January 14, we saw very similar website traffic patterns as the previous month, but with lower traffic overall due to the holidays and fewer messages released to direct to our website.

Social Media Overview Graph

Lighter blue line represents the current month, darker blue line represents the previous month. Notes: We saw some small decreases in followers over the month, likely due to a decrease in posts over the holidays. 

Discussion

The Communications Department worked with the Chronic Disease and Injury Prevention on a series of digital images to raise awareness of safer gambling practices as part of a grant. The work was a partnership between the WECHU, Hotel-Dieu Grace Healthcare (HDGH), and the Lower-Risk Gambling Guidelines (LRGG) organization. The series of four posts were boosted on Facebook and were set as Google Display ads which appear on the webpages of members of the target audience.

The campaign offered tips to practice safer gambling, encouraged people to assess their risk level with a tool through the LRGG, and directed readers to local resources such as HDGH’s Centre for Problem Gambling and Digital Dependency.

The posts and Google ads performed better than expected (e.g., they were anticipated to have low engagement due to being launched over the holiday season where viewership is generally lower). The standout result of the posts was that they drove enough traffic to the webpage that it ended up in the top five visited pages for four straight weeks. Specifically, the four posts yielded a total of 577 link clicks on Facebook over the two-week duration.

PREPARED BY:

Planning and Strategic Initiatives

DATE:

March 21, 2024

SUBJECT:

2023 Privacy Summary Report

BACKGROUND/PURPOSE

The Windsor-Essex County Health Unit (WECHU) is a “health information custodian (HIC)” in accordance with section 3 of the Personal Health Information Protection Act (PHIPA), and an “institution” in accordance with section 2 of the Municipal Freedom of Information and Protection of Privacy Act (MFIPPA). Under this legislation the WECHU has obligations to ensure the rights of individuals with respect to privacy, access, and correction of records of personal information (PI) and personal health information (PHI), and access to general records that pertain to the WECHU operations and governance.

All institutions under MFIPPA, and HICs under PHIPA, are required to provide statistical reports to the Information and Privacy Commissioner of Ontario (IPC) on an annual basis with respect to:

• Confirmed privacy breaches under PHIPA (Appendix A)
• Access and correction requests under PHIPA (Appendix B)
• Access and correction requests under MFIPPA (Appendix C)

The WECHU submitted statistical reports for each category by the required deadline of March 1^st for PHIPA reports and March 31^st for MFIPPA. 

DISCUSSION

Privacy breaches

In 2023, the WECHU had 12 confirmed breaches. Privacy breaches in 2023 predominantly included incidents where Personal Information (PI) and/or Personal Health Information (PHI) was disclosed without authority and emailed or faxed to the wrong person and/or organization. 

The WECHU is looking at various ways to prevent breaches of this manner through training and investigating additional electronic information management systems. 

MFIPPA access and correction to information requests

In 2023, the WECHU received 18 formal Freedom of Information requests based on MFIPPA, compared to 22 in 2022. All requests were processed within the reporting year.

PHIPA access and correction to information requests

In 2023, the WECHU received 55 formal Freedom of Information requests based on PHIPA during the reporting year. This was a significant decrease from 2022 due to decreased involvement the WECHU’s support for validating proof of COVID-19 vaccination certification. 

CONCLUSION

In summary, all MFIPPA requests and all PHIPA requests were completed within the statutory time limits in 2023. Priorities for the coming year will include continued dedication of resources for the access to information and privacy program, including additional training, and updated workflows to improve request handling processes. These actions will improve records and information management (RIM) within the program and allow the WECHU to respond with increased efficiency to information requests.

1. Establishment.  By these terms of reference, the “Joint Board Extension Committee” is established as a standing committee of the Board pursuant to Article 7 of By-law #1 - Governance.
2. Name.  The name of the committee shall be the “Joint Board Extension Committee.”
3. Mandate.  The Joint Board Extension Committee shall act on behalf of the Board on those matters that are necessary to act when it is not reasonably practicable for the Board to meet in a timely manner.  Further the role of the Joint Board Extension Committee shall be to exercise any other authority delegated to it from time to time by the Board.
4. Composition.  Members of the  Joint Board Extension Committee will be as follows:
   
   1. Officers.  Three Officers of the Board of Health as follows:  Chair, Vice-Chair and Treasurer.  The Chair of the Board of Health shall be the Chair of the Joint Board Extension Committee, and the Vice Chair of the Board of Health shall be the Vice-Chair of the Joint Board Extension Committee.
   2. Leadership Team.  Members of the Leadership Team (as defined in Section 1.1 of By-law #1 – Governance) as selected from time to time by the CEO.
5. Frequency of Meetings. The Joint Board Extension Committee shall meet as often as is required in order to fulfil its mandate as determined by the Chair in consultation with the CEO, and otherwise whenever meetings are called in accordance with Section 6 of these Terms of Reference.
6. Calling of Meetings. Meetings of the Joint Board Extension Committee may be called by the Chair or any three Members of the Joint Board Extension Committee, providing at least one of those three members is an Officer identified in Section 4(a).
7. Place of Meetings.  Joint Board Extension Committee meetings shall be held at the Health Units offices or another location within Essex County as determined by the Chair in consultation with the CEO.   All, or any one or more, of the Members of the Joint Board Extension Committee can attend and participate electronically in a meeting of the Joint Board Extension Committee if permitted to do so by the Chair and in such case by such electronic means as is determined by the Chair from time to time. A Member of the Joint Board Extension Committee participating electronically in accordance with this Section 7 shall be counted in determining whether or not a quorum of Members is present at any point in time.
8. Notice.  Notice of meetings of the Joint Board Extension Committee shall be subject to and in accordance with the following:
   
   1. Responsibility.  The Chair shall give or cause to be given the required notice.
   2. Amount.  At least twenty-four (24) hours’ notice (exclusive of the day on which the notice is delivered or sent but inclusive of the day for which notice is given) shall be given.
   3. Content.  Include the date, time and place, as well as a description of the nature of the business to be transacted.
   4. To Whom Given.  Given to each member of the Joint Board Extension Committee.
9. Transaction of Business.  Transaction of business of the Joint Board Extension Committee shall be subject to and in accordance with the following:
   
   1. Chair.  The chair of the Joint Board Extension Committee shall be the Chair and in the absence or inability of the Chair, the Vice-Chair.
   2. Quorum.  Quorum shall be a majority of each of the Officer appointees and a majority of the Leadership Team appointees.
   3. Voting.  Questions arising at any Joint Board Extension Committee meeting shall be decided by a majority of votes.  Every Joint Board Extension Committee member that is an Officer shall have two votes and every Leadership Team shall have one vote except the chair of the Joint Board Extension Committee shall have a third and casting vote in the event of a tie.
10. External Advisors.  If, in the opinion of the Joint Board Extension Committee, it is necessary and/or appropriate from time to time to obtain the advice of external advisors in order to discharge its responsibilities, the Joint Board Extension Committee shall seek a resolution of the Board in that regard, and if the Board so resolves, the Health Unit shall engage such advisors at the Health Unit’s expense.
11. Record Keeping.
    
    1. Minutes.  The Secretary shall keep or cause to be kept minutes of all Joint Board Extension Committee meetings which shall include the following:
       
       1. name of the Committee;
       2. date, time and place of meeting;
       3. attendance at the meeting;
       4. declarations of conflict of interest or inability to exercise independent judgment;
       5. succinctly, accurately and clearly the material aspects of the Committee’s deliberations relative to the subject matter;
       6. precise wording of all motions but not the mover or seconder;
       7. whether the motion carried but not the number of votes for and against or which Member voted which way; and
       8. any objections or dissent requested by the maker to be put on record but otherwise shall not attribute specific comments to specific individuals.
    2. Keeping of Records.  All meetings shall be documented, with minutes circulated and preserved.
    3. Reporting and Accountability.  Minutes of Joint Board Extension Committee meetings shall be provided to the Board for information and the Joint Board Extension Committee shall at all times be accountable and subject to direction of the Board.