Board of Health Meeting Documents

ISSUE

The Healthy Babies Healthy Children program is a mandated program under the Ontario Public Health Standards (OPHS), and is funded 100% through the Ministry of Children Community and Social Services (MCCSS). In 2020, due to the COVID-19 pandemic, HBHC program services were significantly altered across the province as staffing resources were redeployed to support the COVID response.

The HBHC program is an evidence based early intervention home visiting program designed to improve outcomes for children at risk of poor growth and development. The HBHC program aims to support the most vulnerable and marginalized families in our community through blended home visiting including nursing, social work and peer support. Entry into the HBHC programs occurs through screening and referral at three stages: Prenatal; Postpartum; and Early Identification. The HBHC screen identifies a family experiencing a need, issue or risk that may compromise healthy child development; and/or parenting ability; and who may benefit from a more thorough evaluation and receipt of HBHC program services or other community services. HBHC staff utilize standardized assessments and evidence-based interventions to work on family centred goals and develop a Family Service Plan that monitors the progress and achievement of those goals. The HBHC program staff support families with:

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

BACKGROUND

In March 2021, the WECHU received communication from the MCCSS requesting the restoration of HBHC services for the 2021-2022 fiscal year. Health Units were asked to submit their service delivery plans and financial forecast to MCCSS by April 14, 2021 for review and consideration. Where staff were redeployed to other services supporting the pandemic, health units were asked to consider alternative staffing models including the use of social workers and other professional staff to support program delivery and identified service goals.

The WECHU’s service delivery plan recognizes the continued redeployment of nursing staff to support COVID-19 vaccination and case and contact management well into the 2021 calendar year. As such an alternate model of blended home visiting will be implemented utilizing social workers as the family case coordinators supporting all family service plans and goals. Limited nursing staff, including a registered lactation consultant will be incorporated into blended home visiting related to: prenatal health, healthy attachment, optimal growth and development, and breast feeding goals and will consult as an expert related to screening and assessment. Other supports for blended home visiting include a registered dietician to support nutrition and food security and family home visitors.

The WECHU has retained minimum service levels for HBHC over the course of the pandemic. Key priorities for families in Windsor-Essex remain as mental health, substance use and housing stability. HBHC staff have reported an increase in mental health complexity among clients and increased severity for those with pre-existing anxiety and depression. This may be attributed, at least in part, to the financial strain, isolation, and general uncertainty caused by the pandemic, as reported by some clients. This interim model will allow the WECHU the opportunity to meet full program implementation while maintaining program fidelity and support increased risks associated with substance use and poor mental health.

2021/2022 Budget

The MCCSS funds not only the Healthy Babies Healthy Children Program Initiative but also the Nurse Practitioner Program Initiative.  The MCCSS has combined the budget for these program initiatives for purposes of reporting.  As such, the WECHU will adopt a consistent approach.

To address the continued need to have the WECHU nurses more focused on the COVID-19 case and contact management and vaccination efforts, the FTE composition of the Healthy Babies Healthy Children Program Initiative will change throughout the fiscal year.  Initially, the Program will be more heavily supported by social workers.  This support will shift as nursing support can be reintegrated in the latter part of 2021.

A summary of the FTEs by quarter are as follows:
FTE Q1 Q2 Q3 Q4
Manager 2 2 2 2
Health Promotion Specialist 1 1 1 -
Nutritionist 1 1 1 -
Public Health Nurse 6 grading down to 4 4 9 15
Family Home Visitor 4 4 4 4
Social Worker 2 grading up to 10 10 10 4
Support Staff 1.5 2.5 2.5 2.5

*FTE estimates are approximate and subject to change based on program needs and pressures throughout the year.

Regarding the Nurse Practitioner Program Initiative, one (1) nurse practitioner FTE will be retained throughout the entire year.  This FTE will provide limited support to COVID-19 vaccination efforts.  Quarterly reporting will reflect the reallocation of applicable salaries and benefits for time expended on Ministry of Health Programs.

The 2021/2022 expenditure budget for all programs funded by the MCCSS is detailed below:
Item April 1, 2021 to March 31, 2022 April 1, 2020 to March 31, 2021 Change
Salaries and benefits 2,639,041 2,722,600 (83,559)
Operating expenditures:      
    Mileage 60,000 63,000 (3,000)
    Professional development 25,000 10,400 14,600
    Program supplies 150,000 83,841 66,159
    Purchased services 20,800 15,000 5,800
Total operating expenditures 255,800 172,241 83,559
Total budget 2,894,841 2,894,841 -

For the 2021/22 fiscal year, the fluent staffing complement results in a change in the salaries and benefits financial statement caption of $83,559.  Offsetting this are is an increase in the operating budget, most notably the following financial statement captions:

  • Professional development of $14,600 – Increase in professional development to address the needs of FTEs that are new to the Healthy Babies Healthy Children Program Initiative as well as the needs of those returning to this program in the latter part of 2021.
  • Program supplies of $66,159 – Increases in program supplies for the Healthy Babies Healthy Children Program Initiative to address the need to review and refresh resources and revitalize the program.  Additionally, there will be an augment in information technology hardware and software to address increased FTEs.  The program area will also continue to review equipment requirements for work-from-home as well as ensuring field staff are more mobile, in that they can document client interactions in the field.

PROPOSED MOTION

Whereas, the Windsor-Essex County Health Unit receives grants from the Ministry of Children, Community and Social Services to fund the Healthy Babies Healthy Children and Nurse Practitioner Program Initiatives, and

Whereas, the total budget for the Healthy Babies Healthy Children Program Initiative and the Nurse Practitioner Program Initiative combined is $2,894,841 for the period April 1, 2021 to March 31, 2022,

Now therefore be it resolved that the Windsor-Essex County Board of Health approve the budget as presented by Administration for the period April 1, 2021 to March 31, 2022.

Meeting held via video.

  1. Call to Order
  2. Agenda Approval
  3. Announcement of Conflict of Interest
  4. Update (W. Ahmed)
    1. COVID-19 Update
  5. Approval of Minutes
    1. Regular Board Meeting:  March 18, 2021   
  6. Business Arising
  7. Consent Agenda
    1. INFORMATION REPORTS
      1. March Communications Recap
    2. RECOMMENDTION REPORTS – None
  8. New Business
    1. CEO Quarterly Report (T. Marentette)
  9. Other Board of Health Resolutions/Letters
    1. Town of Kingsville – Letter to Hon. Doug Ford – Resolution - Health and Safety of our Communities 
  10. Committee of the Whole (Closed Session in accordance with Section 239 of the Municipal Act)
  11. Next Meeting: At the Call of the Chair May 20, 2021 – Via Video
  12. Adjournment

Board Members Present:

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

Board Member Regrets:

Judy Lund

Administration Present:

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


QUORUM:  Confirmed

  1. Call to Order
    Board Chair, Gary McNamara, called the meeting to order at 4:03 p.m.
  2. Agenda Approval

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

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

      Dr.  Ahmed noted the increase of COVID-19 cases across the province with approximately 4,700 reported in Ontario today. Windsor-Essex has seen an increase with 93 cases reported today and the Variants of Concern (VOC) pose an even bigger threat.  

      We are still seeing increases amongst school-aged children but it seems to be stabilizing.  We are hoping numbers will decrease over the next few weeks with the provincial mandated school closures. The majority of cases in children are through their family and household contacts and not from attending school. 

      Cases have decreased in the senior population due to the vaccine, with a shift to the younger population in the 0-19 and 20-29 year age groups. Household contacts and community transmission are the significant drivers, with more VOC being reported every day. 

      The province is seeing a sharp increase in hospitalizations and ICU admissions.  We are monitoring our ICU cases, but Windsor-Essex is not seeing the same trend as the province.  With the VOC contributing up to 30-50% of cases, this could lead to more hospitalization.  

      The case fatality rate is 1.9% across the province. Windsor-Essex’s case fatality rate is 2.8%, with the majority of fatalities coming from the community.  Our LTCH/RH fatality rate is lower than the provincial average.  R. Bortolin asked if there is any data showing if the vaccine is effective to the VOCs.  Dr. Ahmed said that PHO is analyzing that data at the provincial level and he can share that when received. 

      Our region has administered 124,578 doses of vaccine, with 112,027 residents receiving at least one dose.  The province has noted various hot spots in our region, some requiring more attention, i.e. the downtown Windsor core and the west area of Windsor where we would like to offer more opportunities to receive the vaccine. 

      J. Bachetti asked about the 80+ group of individuals who cannot leave their homes. What plans are in place to help vaccinate them. Dr. Ahmed said that adults in chronic home care who are registered with the LHIN will be vaccinated.  For others who are not, we are hoping to have primary care providers come onboard to help vaccinate these individuals. T. Marentette said  starting Monday there will be two teams that will assist with vaccinating between 100-300 home bound individuals, starting in hot spots, that are registered with the LHIN.  

      Dr. Ahmed advised that our current allotment of the Pfizer vaccine is 10,500 doses a week until at least mid-May, with 2,000 of Moderna earmarked for other priorities.  We have also received a large shipment of AstraZeneca which will flow through the pharmacy channels.
       
      R. Bortolin asked about individuals outside of Windsor-Essex booking vaccinations in our region, and is there a way to divert that.  Dr. Ahmed said that under the provincial booking system people can book anywhere across Ontario and there is nothing we can do to avoid that. There is also nothing stopping individuals from Windsor-Essex booking elsewhere across the province. 

      E. Sleiman asked if doses of the vaccine can be mixed, i.e. if you receive the AstraZeneca can you receive the Pfizer as the second dose.  Also, some of his constituents have been asking him about their second dose appointments.  Dr. Ahmed said there has been no recommendations yet around mixing doses.  T. Marentette said that second doses will begin the end of June, and we are working on a system internally to accommodate for this.

      Moved by: Ed Sleiman
      Seconded by: Rino Bortolin
      That the information be received.
      CARRIED

  5. Approval of Minutes
    1. Regular Board Meeting:  March 18, 2021
    2. Special Board Meeting:  Board Elections:  April 1, 2021
      Moved by: Judy Lund
      Seconded by: Joe Bachetti
      That the minutes be approved.
      CARRIED

  6. Business Arising - None
  7. Consent Agenda

    1. INFORMATION REPORTS - None
    2. RECOMMENDATION REPORTS - None

     

  8. New Business
    1. CEO Quarterly Report (T. Marentette)
      T. Marentette said that the WECHU is seeing consistent challenges as we continue to operate under a pandemic.  Many of our staff remain redeployed to Case and Contact Management, Vaccine Clinics and Outbreak. 

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

  9. Other Board of Health Resolutions/Letters
    1. Town of Kingsville – Letter to the Hon. Doug Ford – Resolution – Health and Safety of our Communities

      G. McNamara said what the Town of Kingsville is looking for around inspections is related to fire and building code safety, and is beyond the scope of the health unit.  

      T. Marentette explained the health unit’s process around migrant housing.  When Temporary Foreign Workers arrive on the farm premises, our WECHU Public Health Inspectors (PHI) inspect the bunkhouses in those congregate settings. Most of them are located in the vicinity of Leamington and Kingsville.  Our PHIs inspect and approve congregate settings based on public health requirements, but they may not pass building and fire regulations.  They have their own guidelines that must be followed.

      About a year ago, we collaborated with the municipalities and agreed to align our inspections if possible, but that does not always happen due to resources and/or scheduling.  If we conduct our inspection prior to fire or building inspections, we provide our report to the municipality.  We did speak to the CAO in Kingsville and were advised at that time that there were no issues.  

      R. Bortolin noted that even from a restaurant perspective they need various inspections, but they generally do not happen at the same time.  G. McNamara agreed that scheduling all inspections at the same time would be a daunting task, especially with seven municipalities in our region.

      Moved by:  Rino Bortolin 
      Seconded by: Ed Sleiman
      That the information be received.
      CARRIED

    2. Town of Essex – Letter to the Hon. Doug Ford, the Hon. Christine Elliott, Dr. Wajid Ahmed, Theresa Marentette – Letter in Support of Small Business

      Moved by:   Rino Bortolin 
      Seconded by:  Tracey Bailey
      That the information be received. 
      CARRIED

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

    The Board moved into Committee of the Whole at 4:52 pm
    The Board moved out of Committee of the Whole at 5:40 pm

  11. Next Meeting: At the Call of the Chair, or May 20, 2021 – Via Video 

  12. Adjournment

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

    The meeting adjourned at 5:45 pm.

RECORDING SECRETARY:

SUBMITTED BY:

APPROVED BY:

Board Members Present:

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

Board Member Regrets:

Judy Lund

Administration Present:

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


QUORUM:  Confirmed

  1. Call to Order
    Board Chair, Gary McNamara, called the meeting to order at 4:03 p.m.
  2. Agenda Approval

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

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

      Dr.  Ahmed noted the increase of COVID-19 cases across the province with approximately 4,700 reported in Ontario today. Windsor-Essex has seen an increase with 93 cases reported today and the Variants of Concern (VOC) pose an even bigger threat.  

      We are still seeing increases amongst school-aged children but it seems to be stabilizing.  We are hoping numbers will decrease over the next few weeks with the provincial mandated school closures. The majority of cases in children are through their family and household contacts and not from attending school. 

      Cases have decreased in the senior population due to the vaccine, with a shift to the younger population in the 0-19 and 20-29 year age groups. Household contacts and community transmission are the significant drivers, with more VOC being reported every day. 

      The province is seeing a sharp increase in hospitalizations and ICU admissions.  We are monitoring our ICU cases, but Windsor-Essex is not seeing the same trend as the province.  With the VOC contributing up to 30-50% of cases, this could lead to more hospitalization.  

      The case fatality rate is 1.9% across the province. Windsor-Essex’s case fatality rate is 2.8%, with the majority of fatalities coming from the community.  Our LTCH/RH fatality rate is lower than the provincial average.  R. Bortolin asked if there is any data showing if the vaccine is effective to the VOCs.  Dr. Ahmed said that PHO is analyzing that data at the provincial level and he can share that when received. 

      Our region has administered 124,578 doses of vaccine, with 112,027 residents receiving at least one dose.  The province has noted various hot spots in our region, some requiring more attention, i.e. the downtown Windsor core and the west area of Windsor where we would like to offer more opportunities to receive the vaccine. 

      J. Bachetti asked about the 80+ group of individuals who cannot leave their homes. What plans are in place to help vaccinate them. Dr. Ahmed said that adults in chronic home care who are registered with the LHIN will be vaccinated.  For others who are not, we are hoping to have primary care providers come onboard to help vaccinate these individuals. T. Marentette said  starting Monday there will be two teams that will assist with vaccinating between 100-300 home bound individuals, starting in hot spots, that are registered with the LHIN.  

      Dr. Ahmed advised that our current allotment of the Pfizer vaccine is 10,500 doses a week until at least mid-May, with 2,000 of Moderna earmarked for other priorities.  We have also received a large shipment of AstraZeneca which will flow through the pharmacy channels.
       
      R. Bortolin asked about individuals outside of Windsor-Essex booking vaccinations in our region, and is there a way to divert that.  Dr. Ahmed said that under the provincial booking system people can book anywhere across Ontario and there is nothing we can do to avoid that. There is also nothing stopping individuals from Windsor-Essex booking elsewhere across the province. 

      E. Sleiman asked if doses of the vaccine can be mixed, i.e. if you receive the AstraZeneca can you receive the Pfizer as the second dose.  Also, some of his constituents have been asking him about their second dose appointments.  Dr. Ahmed said there has been no recommendations yet around mixing doses.  T. Marentette said that second doses will begin the end of June, and we are working on a system internally to accommodate for this.

      Moved by:    Ed Sleiman
      Seconded by:  Rino Bortolin
      That the information be received.
      CARRIED

  5. Approval of Minutes
    1. Regular Board Meeting:  March 18, 2021
    2. Special Board Meeting:  Board Elections:  April 1, 2021

      Moved by:  Joe Bachetti
      Seconded by:  Larry Snively
      That the minutes be approved.
      CARRIED

  6. Business Arising – None
  7. Consent Agenda
    1. INFORMATION REPORTS - None
    2. RECOMMENDATION REPORTS - None
  8. New Business
    1. CEO Quarterly Report (T. Marentette)

      T. Marentette said that the WECHU is seeing consistent challenges as we continue to operate under a pandemic.  Many of our staff remain redeployed to Case and Contact Management, Vaccine Clinics and Outbreak. 

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

  9. Other Board of Health Resolutions/Letters
    1. Town of Kingsville – Letter to the Hon. Doug Ford – Resolution – Health and Safety of our Communities 
      G. McNamara said what the Town of Kingsville is looking for around inspections is related to fire and building code safety, and is beyond the scope of the health unit.  

      T. Marentette explained the health unit’s process around migrant housing.  When Temporary Foreign Workers arrive on the farm premises, our WECHU Public Health Inspectors (PHI) inspect the bunkhouses in those congregate settings. Most of them are located in the vicinity of Leamington and Kingsville.  Our PHIs inspect and approve congregate settings based on public health requirements, but they may not pass building and fire regulations.  They have their own guidelines that must be followed.

      About a year ago, we collaborated with the municipalities and agreed to align our inspections if possible, but that does not always happen due to resources and/or scheduling.  If we conduct our inspection prior to fire or building inspections, we provide our report to the municipality.  We did speak to the CAO in Kingsville and were advised at that time that there were no issues.  

      R. Bortolin noted that even from a restaurant perspective they need various inspections, but they generally do not happen at the same time.  G. McNamara agreed that scheduling all inspections at the same time would be a daunting task, especially with seven municipalities in our region.
      Moved by:  Rino Bortolin 
      Seconded by: Ed Sleiman
      That the information be received.
      CARRIED

    2. Town of Essex – Letter to the Hon. Doug Ford, the Hon. Christine Elliott, Dr. Wajid Ahmed, Theresa Marentette – Letter in Support of Small Business
      Moved by:   Rino Bortolin 
      Seconded by:  Tracey Bailey
      That the information be received. 
      CARRIED

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

    The Board moved into Committee of the Whole at 4:52pm
    The Board moved out of Committee of the Whole at 5:40 pm

  11. Next Meeting: At the Call of the Chair, or May 20, 2021 – Via Video
  12. Adjournment

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

    The meeting adjourned at 5:45 pm.

RECORDING SECRETARY:

SUBMITTED BY:

APPROVED BY:

  1. Period covered by this report:  January 1, 2021 to March 31, 2021
  2. 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; 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:

On March 17, 2020, the Province of Ontario enacted the Emergency Management and Civil Protection Act, R.S.O. 1990, c. E.9. (“the Act”), to support efforts to contain the spread of COVID-19, in our communities.  The Act supports public health units to, regardless of their collective bargaining agreements, suspend services, redeploy staff as deemed appropriate, modify hours of work, cancel and or defer vacations, utilize part-time/contract staff to perform the duties and responsibilities of bargaining unit staff and suspend the grievance process. 

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;

Date:   April 15, 2021

Theresa Marentette, CEO

Meeting held virtually.

  1. Call to Order
  2. Agenda Approval
  3. Announcement of Conflict of Interest
  4. Board Elections - Vice Chair
  5. Committee of the Whole (Closed Session in accordance with Section 239 of the Municipal Act)
  6. Next Meeting: At the Call of the Chair April 15, 2021 – Via Video
  7. Adjournment

Meeting held via video.

  1. Call to Order
  2. Agenda Approval
  3. Announcement of Conflict of Interest
  4. Update (W. Ahmed)
    1. COVID-19 Update
  5. Approval of Minutes
    1. Special Board Budget Meeting: March 4, 2021
  6. Business Arising
  7. Consent Agenda
    1. INFORMATION REPORTS
      1. Ontario Active School Travel Fund Awarded to Windsor- Essex County (N. Dupuis)
      2. Risk Management (T. Marentette/M. Frey)
      3. January/February Communications Recap
    2. RECOMMENDTION REPORTS – None
  8. New Business
  9. Other Board of Health Resolutions/Letters
    1. Kingston, Frontenac & Lennox and Addington Public Health – Letter to Hon. Doug Ford, Premier of Ontario – Mandatory Sick Leave for Ontario Workers
    2. Kingston, Frontenac and Lennox & Addington Public Health – Letter to The Right Hon. Justin Trudeau – Land and Water Border Restrictions
    3. Peterborough Public Health – Letter to The Hon. Doug Ford, The Hon. Christine Elliott and The Hon. Monte McNaughton – Paid Sick Leave During an Infectious Disease Emergency
    4. Letter from the Municipality of Chatham-Kent Public Health – Letter to The Hon. Doug Ford – Paid Sick Leave during COVID-19 Pandemic and Beyond
    5. Letter from Queen's Park, Peggy Sattler, MPP, London West – Private Members Bill – Bill 239 – Stay Home if you are Sick Act – Advocating for paid sick days for Ontario workers to alleviate the spread of COVID-19
    6. Windsor-Essex County Health Unit – Letter to The Hon. Doug Ford – Mandatory Paid Sick Leave for Ontario Workers
  10. Committee of the Whole (Closed Session in accordance with Section 239 of the Municipal Act)
  11. Next Meeting: At the Call of the Chair April 15, 2021 – Via Video
  12. Adjournment

SUBMITTED BY

Marc Frey, Manager, Planning and Strategic Initiatives Department

DATE

March 18, 2021

SUBJECT

Risk Management


BACKGROUND

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

CURRENT INITIATIVES:

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

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

RISK REPORTING

1: Funding

Description

CAUSE: Funding uncertainties.

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

CONSEQUENCES:

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

Key Risk Mitigations

CONTROL STRATEGY:

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

ACTION REQUIRED:

  1. Evaluation of budget (process and quality)

2: Health System Transformation

Description

CAUSE: Ministry mandated public health system changes.

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

CONSEQUENCES:

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

Key Risk Mitigations

CONTROL STRATEGY:

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

ACTION REQUIRED:

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

3: Disasters/Hazards

Description

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

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

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

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

Key Risk Mitigations

CONTROL STRATEGY:

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

ACTION REQUIRED:

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

4: Planning Information and Evaluation

Description

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

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

CONSEQUENCES:

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

Key Risk Mitigations

CONTROL STRATEGY:

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

ACTION REQUIRED:

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

5: Work Stoppage

Description

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

EVENT: An extended work stoppage involving internal labour groups.

CONSEQUENCES:

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

Key Risk Mitigations

CONTROL STRATEGY:

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

ACTION REQUIRED:

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

6: Strategic Priorities

Description

CAUSE: External pressures and resource uncertainty.

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

CONSEQUENCES:

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

Key Risk Mitigations

CONTROL STRATEGY:

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

ACTION REQUIRED:

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

7: Privacy Breach

Description

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

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

CONSEQUENCES:

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

Key Risk Mitigations

CONTROL STRATEGY:

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

ACTION REQUIRED:

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

8: Local Health Disparities

Description

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

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

CONSEQUENCES:

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

Key Risk Mitigations

CONTROL STRATEGY:

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

ACTION REQUIRED:

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

9: Program/Service Implementation

Description

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

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

CONSEQUENCES:

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

Key Risk Mitigations

CONTROL STRATEGY:

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

ACTION REQUIRED:

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

MOH Risk Category:

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

SUBMITTED BY

Nicole Dupuis, Director of Health Promotion

DATE

March 18, 2021

SUBJECT

Ontario Active School Travel Fund Awarded to Windsor-Essex County 


BACKGROUND

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

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

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

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

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

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

CURRENT INITIATIVES:

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

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

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

SUBMITTED BY

Communications Department

DATE

March 18, 2021

SUBJECT

February 2021 - Communications Update


February Metrics

SOURCE DECEMBER JANUARY DIFFERENCE

News Releases Issued

1

5

+4

Media Advisories Issued

2

1

-1

Media Statements or Notifications

32

35

+5

Media Requests Received1

71

47

-24

AM 800 Morning Segments2

11

11

0

YouTube Live Media Briefing Videos3

21

18

-3

Wechu.org/cv/local-updates page views4

451,327

298,116

-153,211

YouTube Channel Subscribers

1,269

1,381

+112

Email Subscribers5

3,466

4,237

+771

Emails Distributed

38

44

+6

 

Facebook Fans

17,207

17,392

+185

Facebook Posts

114

154

+40

Twitter Follower

5,943

6,161

+218

Twitter Posts

111

149

+38

Instagram Followers

1,027

1,052

+25

Instagram Posts

10

19

+9

LinkedIn Followers

745

775

+30

LinkedIn Posts

79

74

-5

Media Exposure8

1,146

937

-208

Media Monitoring Highlights

This is a complex graphical representation of data. Please contact us for detail

Trending Themes

This is a complex graphical representation of data. Please contact us for detail

Top Sources

This is a complex graphical representation of data. Please contact us for detail

Media Participating in Teleconference for YouTube Live

  • AM 800 CKLW, Blackburn News, CBC Windsor, CTV Windsor and The Windsor Star join every day.

Current Notable Projects

  • Developing weekly communication plans for ongoing vaccine rollout in the region.
  • We continue to make improvements to our daily COVID-19 public health updates for the community.
  • Regular communication with the Ministry of Health about provincial initiatives and their planned launch dates.

Data Notes:

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

1. Media requests received is a compiled list of documented requests we captured for interviews, data clarification, or general request for information from the media. Given the volume of requests during COVID-19, many exchanges with the media through text messages or quick phone calls to correct errors may not be captured. In many instances, each request led to multiple interactions with reporters.

2. Dr. Ahmed joined Mike and Lisa on the AM 800 Morning Drive every morning at 8:06 a.m. starting on Wednesday, March 17. On August 17, we went to a Monday, Wednesday, and Friday schedule with holidays off. He continues to do join Mike and Lisa every other morning to keep the community informed.

3. We changed the platform we broadcasted live videos from Facebook to YouTube at the end of June. YouTube Live videos started on June 23, 2020. Prior Public Health Update videos on YouTube were exported videos recorded through Facebook Live.

4. Website analytics are provided by Siteimprove. The metric provided is for page views to COVID-19 Local Updates Page. During the COVID-19 pandemic, changes were made to landing pages. For consistency in reporting, the most popular page was selected.

6. Email subscribers are those individuals who signed up to receive promotional emails from the Windsor-Essex County Health Unit over the last 30 days. The analytics are provided through Mailchimp.

7. Social media metrics are provided through Hootsuite.

8. Graphs and media exposure information in this report were generated using Meltwater Media Monitoring Solution. Significant changes in numbers can be partially attributed to configuration changes made to the new service to better monitor and report media activity. News stories may be duplicates or missing as the platform is currently being optimized to better track Windsor-Essex County Health Unit mentions in the media landscape.

SUBMITTED BY

Communications Department

DATE

March 18, 2021

SUBJECT

January 2021 - Communications Update


January Metrics

SOURCE DECEMBER JANUARY DIFFERENCE

News Releases Issued

6

1

-5

Media Advisories Issued

1

2

+1

Media Statements or Notifications

42

32

-10

Media Requests Received1

71

71

0

AM 800 Morning Segments2

11

11

0

YouTube Live Media Briefing Videos3

19

21

+2

Wechu.org/cv/local-updates page views4

478,984

451,327

-27,657

YouTube Channel Subscribers

1,094

1,269

+175

Email Subscribers5

1,549

1,734

185

Emails Distributed

52

38

-14

 

Facebook Fans

16,848

17,207

+359

Facebook Posts

157

114

-43

Twitter Follower

5,563

5,943

+380

Twitter Posts

156

111

-45

Instagram Followers

969

1,027

+58

Instagram Posts

27

10

-17

LinkedIn Followers

719

745

+26

LinkedIn Posts

96

79

-17

Media Exposure8

2,024

1,146

-878

Media Monitoring Highlights

This is a complex graphical representation of data. Please contact us for detail

Trending Themes

This is a complex graphical representation of data. Please contact us for detail

Top Sources

This is a complex graphical representation of data. Please contact us for detail

Media Participating in Teleconference for YouTube Live

  • AM 800 CKLW, Blackburn News, CBC Windsor, CTV Windsor and The Windsor Star join every day. On occasion, Radio Canada will also join the briefing.

Current Notable Projects

  • Developing a marketing and communications campaign for the vaccine rollout as the region moves through each phase of the provincial COVID-19 vaccine rollout plan.
  • Website updates will be coming with more information on the COVID-19 vaccines and the Windsor and Essex County moving to the Red-Control level of the provincial framework.
  • We continue to make improvements to our daily COVID-19 public health updates for the community.

Data Notes:

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

1. Media requests received is a compiled list of documented requests we captured for interviews, data clarification, or general request for information from the media. Given the volume of requests during COVID-19, many exchanges with the media through text messages or quick phone calls to correct errors may not be captured. In many instances, each request led to multiple interactions with reporters.

2. Dr. Ahmed joined Mike and Lisa on the AM 800 Morning Drive every morning at 8:06 a.m. starting on Wednesday, March 17. On August 17, we went to a Monday, Wednesday, and Friday schedule with holidays off. He continues to do join Mike and Lisa every other morning to keep the community informed.

3. We changed the platform we broadcasted live videos from Facebook to YouTube at the end of June. YouTube Live videos started on June 23, 2020. Prior Public Health Update videos on YouTube were exported videos recorded through Facebook Live.

4. Website analytics are provided by Siteimprove. The metric provided is for page views to COVID-19 Local Updates Page. During the COVID-19 pandemic, changes were made to landing pages. For consistency in reporting, the most popular page was selected.

6. Email subscribers are those individuals who signed up to receive promotional emails from the Windsor-Essex County Health Unit. The analytics are provided through Mailchimp.

7. Social media metrics are provided through Hootsuite.

8. Graphs and media exposure information in this report were generated using Meltwater Media Monitoring Solution. Significant changes in numbers can be partially attributed to configuration changes made to the new service to better monitor and report media activity. News stories may be duplicates or missing as the platform is currently being optimized to better track Windsor-Essex County Health Unit mentions in the media landscape.

Board Members Present:

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

Administration Present:

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

Administration Regrets:

Dr. Wajid Ahmed


QUORUM:  Confirmed

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

         

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

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

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

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

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

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

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

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

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

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

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

    The meeting adjourned at 5:44 pm.

RECORDING SECRETARY:

SUBMITTED BY:

APPROVED BY:

Meeting held via video.

  1. Call to Order
  2. BOARD ELECTIONS
  3. Agenda Approval
  4. Announcement of Conflict of Interest
  5. Update (W. Ahmed)
    1. COVID-19 Update
  6. Approval of Minutes
    1. Regular Board Meeting: December 17, 2020
  7. Business Arising
  8. Consent Agenda
    1. INFORMATION REPORTS
      1. Mosquito Surveillance and Control Program 2020 (K. McBeth)
      2. First Responder Curriculum Project – Mental Health Literacy and Resiliency – Building (N. Dupuis)
      3. December Communications Recap
    2. RECOMMENDATION REPORTS
  9. New Business
    1. Budget Timing (T. Marentette/L. Gregg)
    2. CTS Update – Next Steps (T. Marentette)
    3. W-E Vaccine Rollout Plan (T. Marentette)
  10. Other Board of Health Resolutions/Letters – For information
    1. Town of Kingsville – Letter to The Hon. Doug Ford, The Hon. Minister Christine Elliott, Medical Officer of Health, Dr. Wajid Ahmed and the Windsor-Essex County Board of Health – Resolution in Support of Small Businesses to remain open
    2. Town of Essex – Letter to The Hon. Doug Ford, The Hon. Minister Christine Elliott, Chief Medical Officer of Health, Dr. David Williams, Medical Officer of Health, Dr. Wajid Ahmed, and CEO Theresa Marentette, Windsor-Essex County Health Unit – Resolution requesting that immediate action be taken to deem Small Businesses as Essential Services
  11. Committee of the Whole (Closed Session in accordance with Section 239 of the Municipal Act)
  12. Next Meeting: At the Call of the Chair February 18 , 2021 – Via Video
  13. Adjournment

DATE

January 21, 2021

SUBJECT

Mosquito Surveillance and Control Program 2020


BACKGROUND

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

Mosquito Surveillance and Testing

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

During this year’s season:

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

Mosquito Control

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

Human Cases

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

Education and Awareness Raising Activities

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

CURRENT INITIATIVES

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

DATE

January, 2021

SUBJECT

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


BACKGROUND - The First Responder Mental Health Coalition (FRMHC)

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

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

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

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

THE FIRST RESPONDER CURRICULUM PROJECT

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

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

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

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

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

Current Initiatives

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

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

Board Members Present:

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

Board Member Regrets:

Administration Present:

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


QUORUM:  Confirmed

  1. Call to Order
    Board Chair, Gary McNamara, called the meeting to order at 4:02 p.m.
  2. BOARD ELECTIONS

    Nominations for Chair

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

    Nominations for Vice-Chair

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

    Nominations for Treasurer

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

  3. Agenda Approval

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

    3.  

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

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

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

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

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

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

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

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

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

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

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

    Moved by:  Tracey Bailey
    Seconded by: Gary Kaschak
    That the information be received.
    CARRIED

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

    The Board moved into Committee of the Whole at 5:34 pm
    The Board moved out of Committee of the Whole at 5:50 pm

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

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

    The meeting adjourned at 5:52 pm.

RECORDING SECRETARY:

SUBMITTED BY:

APPROVED BY:

Meeting held via video.

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

DATE

December 17, 2020

SUBJECT

Influenza Vaccine Update


BACKGROUND

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

SUMMARY OF VACCINE ALLOCATION & DISTRIBUTION

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

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

 

QIV

High Dose - TIV

Total

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

97,850

31,800

127,650

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

82,160

31,800

 

113,960

 

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

 

QIV

High Dose – TIV

Total

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

3,000

2,655

5,655

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

790

1,450

2,240

 

HIGH DOSE -TIV

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

ADVERSE EVENTS FOLLOWING IMMUNIZATION

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

CURRENT INITIATIVES

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

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

PREPARED BY

Lorie Gregg, Director of Corporate Services

DATE

December 17, 2020

SUBJECT

Q2 Financial Results


BACKGROUND

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

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

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

Of noteworthy mention is the following:

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

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

HEALTHY BABIES HEALTHY CHILDREN PROGRAM INITIATIVE

 

 

Annual Budget

Budget at 09 30 2020

Actual 09 30 2020

Variance – Budget from Actual

Salaries and benefits

2,583,600

1,311,695

1,067,842

176,209

Operating expenditures:

 

 

 

 

     Mileage

60,000

30,000

9,233

20,638

     Travel and meetings

3,000

1,500

3,000

1,500

     Professional development

10,400

5,200

10,400

5,200

     Program supplies

83,841

22,026

44,051

17,599

     Purchased services

15,000

7,500

15,000

6,382

Total operating expenditures

172,241

66,226

132,451

51,319

Total budget

2,755,841

1,377,921

2,755,841

227,528

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

PRENATAL AND POSTNAL NURSE PRACTITIONER PROGRAM INITIATIVE

 

Annual Budget

Budget at  09 30 2020

Actual 09 30 2020

Variance – Budget from Actual

Salaries and benefits

139,000

69,500

71,179

1,679

Total budget

139,000

69,500

71,179

1,679

The Nurse Practitioner Program Initiative supports 1.0 FTE (nurse practitioner).  The objectives of the program are to promote healthy pregnancy, birth and infancy for children, improve parenting and family supports, strengthen early childhood development, learning and care.  Total funding envelope for this program is $139,000.