Board of Health Meeting Documents

SUBMITTED BY:

Oral Health Department

DATE:

December, 2021

SUBJECT:

BACKGROUND

In the fall of 2019, the Ministry of Health launched the Ontario Seniors Dental Care Program (OSDCP) to improve access to regular dental care for low-income seniors. Locally, the Windsor-Essex County Health Unit (WECHU) is implementing the OSDCP through the Leamington and Windsor oral health clinics and in partnership with the Southwest Ontario Aboriginal Health Access Centre (SOAHAC). The OSDCP provides free dental care to low-income seniors who are age 65 years and older, and have no access to other dental benefits.

Services covered under the OSDCP include:

• Preventive services (e.g., cleanings)
• Restorative services to repair broken teeth and cavities (e.g., crowns)
• Oral surgery services to remove teeth or abnormal tissue
• Endodontic services to treat infection and pain (e.g., root canals)
• Periodontal services to treat gum conditions and diseases
• Dental prosthetics (prosthodontic services), including dentures (partially covered)

In order to be eligible for the OSDCP, seniors must also have an annual net income of $22,200 or less, or a combined annual net income of $37,100 or less for senior couples (one or both people aged 65 or older). Lastly, the program is restricted to those who are not covered by dental benefits, including private insurance, Ontario Works, Ontario Disability Support Program, or Non-Insured Health benefits.

CURRENT INITIATIVES

The WECHU began to operationalize the OSDCP protocols in January 2020 with an 8:30 a.m. to 8 p.m. clinic in its downtown Windsor office and an 8:30 a.m. to 4:30 p.m. clinic at its county location in the downtown core of Leamington. The OSDCP funding currently supports three dental assistants, three dental hygienists, 1.5 dentists, one part-time denturist, two clerks, one manager and one health promotion specialist. With early implementation hindered by service alterations caused by COVID-19, the clinic has now resumed full operation and is being promoted throughout the region through the WECHU.org website, a local magazine targeting those over the age of 55, and referrals from partnering agencies.

Prior to the WECHU’s implementation of the OSDCP, the Oral Health Department’s clinic exclusively treated eligible children and youth (under 17) who qualified for the Healthy Smiles Ontario (HSO) program. With the seniors program now in full operation servicing 810 unique clients in 2021, the proportion of WECHU dental clients is now split relatively evenly between the two client groups.  Although the characteristics of the clients between the two programs are quite different, the types of treatment offered to clients under both the HSO and OSDCP are similar with the exception of certain services offered exclusively to seniors (i.e., dental prosthetics). The total number of procedures and appointments for both programs are outlined in Table 1 below:

Table 1: Services Offered to Oral Health Department Clients (January 1st – November 29th, 2021)

* Refers to number of appointments rather than individual procedures

With respect to the figures in Table 1, the WECHU anticipates the need for services will continue to increase for the senior population as only an estimated 22% of all eligible seniors in Windsor and Essex County have accessed the program to date.

Future Plans

After its first year of full operation of the OSDCP, ongoing planning regarding the best staffing model, space utilization, and resource allocation continue to be a priority of the WECHU management and leadership team. Currently, the clinics are booking appointments approximately 2 months into the future for appointments with our dental hygienist or denturist and potential for up to 5 months to see a dentist for treatment. Future directions aim to improve this wait time through a number of different program modifications:

• Exploring the provision of service in Long-term Care Homes:
  • A needs assessment survey will be distributed for those residents of long-term care homes to determine whether or not expansion into this setting is appropriate and feasible given the current funding provided.
• Expanding Clinic Capacity:
  • One large dental operatory will be split to provide an additional space for client service.
• Increasing the number of appointment times:
  • Reducing the requisite time between appointments by enhancing air filtration to allow for more appointment times throughout the day.
• Improving efficiency of professional staffing resources:

Decreasing wait times for services which can only be completed by dentists by increasing denturist time.

Board Members Present:

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

Board Member Regrets:

Robert Maich

Administration Present:

Nicole Dupuis, Dr. Shanker Nesathurai, Lorie Gregg, Felicia Lawal, Kristy McBeth, Eric Nadalin, Dan Sibley, Lee Anne Damphouse

QUORUM:  Confirmed

The Board moved into Committee of the Whole at 4:02 pm
The Board moved out of Committee of the Whole at 4:14 pm

RECORDING SECRETARY: L. Damphouse

SUBMITTED BY: N. Dupuis

APPROVED BY: WECHU Board of Health, January 20, 2022

Meeting held via video: https://youtu.be/3amhiiN2J90

SUBMITTED BY

Epidemiology and Evaluation Department

DATE

November, 2021

SUBJECT

COVID-19 Surveillance and Epidemiology – October, 2021

BACKGROUND

Overview

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

Trends

In the month of October (2021), the health unit reported 808 confirmed cases of COVID-19. This is a 47.6% decrease in case counts compared to the previous month of September (2021). Similarly, the monthly case rate for October was 186.95 cases per 100,000 population, which is lower compared to the monthly rate in September (356.8 cases per 100,000 population). In Ontario, during the month of October, the case rate was 91.5 cases per 100,000 population. This is approximately 2.0 times lower compared to the rate of Windsor-Essex County.

Age and Gender

Approximately 51% (413) of the cases were among males and 49% among females. A disproportionately (28.6%) higher number of cases, in October 2021,  were reported among those 0 to 18 years of age, followed by 15.6% among those 30 to 39 years of age, and 15.3% in the 19 to 29 year age group. Comparatively, from the onset of the pandemic locally (March 1, 2020 to October 31, 2021), approximately 15% of our cases were in the 0 to 19 age group.

Municipal Distribution

The Town of Leamington had the highest case rates (403.1 cases per 100,000 population), followed by Essex (349.8 cases per 100,000 population), Tecumseh (199.5 cases per 100,000 population), and the city of Windsor (17.1 cases per 100,000 population). However, looking at the distribution of cases, 49% of cases were from the City of Windsor, 15% from Leamington, and 9% from Essex.

Risk Factors

For the month of October 2021, the top five risk factors reported were being an elementary or secondary student (19.1%), being a resident of congregate living setting (5.0%), being a health care worker (2.4%), being a farm worker (2.1%), and being an educational staff member (1.9%).

Variants of Concern (VOCs)

Of the 1,542 cases reported in the month of October, genomic sequencing results were available for 718 cases (89% of cases). Overall, 69% of cases reported were due to the Delta variant (B.1.617.2), 7% of cases reported results without a variant, and 24% were not sequenced to identify a mutation or a VOC.

Source of Acquisition

Approximately, 38% of cases in October 2021 acquired COVID-19 from their household contact, 20% from a close contact outside of their household, 5% due to being related to an outbreak, and 4% from travel-related outside of the province (e.g., to another province and/or outside of Canada).

Outcome Status

Of the 808 cases reported in October 2021, 72% (582) had their infection resolved, 194 cases (24%) were active and being followed by the health unit, and 2.6% (21) of cases were lost to follow-up. Six deaths were reported in October (2021) due to COVID-19.

Vaccination Status

21,889 doses were administered to Windsor-Essex County residents in the month of October compared to over 34,500 doses in the month of September. This represents a 36% decrease for the month of October (2021). Approximately 62% of the doses administered were second doses to complete a vaccination series, 32% were first doses to individuals who were previously unvaccinated, and 6% were among those in the highest risk priority groups (e.g., residents of long-term care and retirement homes).

Among the 808 cases reported in October 2021, 63% were unvaccinated (or not eligible to receive a vaccine), 29% were fully vaccinated, 6% were partially protected with one dose, and 2% were not yet protected after receiving the first dose. Among the 356 unvaccinated cases, approximately 58% were among those 0 to 18 years of age which includes children who were ineligible to receive the vaccine.

CURRENT INITIATIVES

The health unit will continue to monitor and provide epidemiological expertise on COVID-19 to internal leadership, community partners, and residents to support evidence-informed decision-making. This includes daily epidemiological updates, weekly epidemiological presentations to the community and supporting policy decisions through data driven approaches

SUBMITTED BY

Communications Department

DATE

November, 2021

SUBJECT

October 2021 - Communications Update

October Metrics

Media Monitoring Highlights

Facebook Highlights

Twitter Highlights

Media Participating in Media Briefings

• AM 800 CKLW, Blackburn News, CBC Windsor, CTV Windsor, CFTV and the Windsor Star join regularly.

Current Notable Projects

• Maintaining marketing and communication efforts regarding ongoing vaccine rollout in the region by public health and our partners.
• Shift of media responses from media requests to proactive recorded media sessions in order to reduce burden on Communications and Leadership Team staff while maintaining and improving responsiveness to inquiries.
• Maintaining and updating website as new information changes regarding COVID-19.

Data Notes:

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 answer questions 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, 2020. On August 17, 2020, we went to a Monday, Wednesday, and Friday schedule with holidays off. On July 19, 2021, Dr. Ahmed continued to join Mike and Lisa Monday and Wednesday mornings to keep the community informed. On September 16, 2021, Nicole Dupuis and Dr. Nesathurai were conducting interviews with Mike and Lisa on Monday and Wednesday mornings.

3. YouTube Live videos started on June 23, 2020. Prior Public Health Update videos on YouTube were exported videos recorded through Facebook Live. In July 2021, YouTube Live broadcasts were scaled down to Fridays only from a Monday, Wednesday, and Friday rotation. In September 2021, media briefings were increased to Monday, Wednesdays and Fridays and streamed live. On September 20, 2021, media briefings were recorded and then posted to YouTube.

4. Website analytics are provided by Site improve. The metric provided is for page views to wechu.org. Previously, we were reporting on the local-updates webpage only.

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. 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.

ISSUE

The Windsor-Essex County Health Unit (WECHU) requires the Board of Health to approve the annual operating budget, as this budget forms the basis of the Annual Service Plan and Budget Submission to the Ministry of Health (MOH).

BACKGROUND

The WECHU is a publicly funded organization; as such, the WECHU has a responsibility to spend funds prudently with the objective of providing public health programs and services as required by the Health Protection and Promotion Act (HPPA) and the Ontario Public Health Standards:  Requirements for Programs, Services, and Accountability (OPHS).

The WECHU receives funding in the following manner:

• The Province of Ontario, more specifically the Ministry of Health, annually grants the WECHU funding to a maximum of 70% of admissible expenditures for its Mandatory Program.  In addition, the WECHU receives required contributions for the Corporation of the City of Windsor, The Corporation of the County of Essex, and the Corporation of the Township of Pelee (hereinafter collectively referred to as the Obligated Municipalities) at a minimum of 30% of admissible expenditures.
• The Ministry of Health annually provide grants for certain related health protection and promotion programs at a rate of 100% of admissible expenditures.  More specifically this includes the Ontario Seniors Dental Care Program and the AMOH/MOH Compensation Initiative.
• The Ministry of Children, Community and Social Services (MCCSS) provides annual grants to fund the Healthy Babies Healthy Children Program Initiative and the Nurse Practitioner Program Initiative at a rate of 100% of admissible expenditures.

On an annual basis, the WECHU prepares its operating budgets for review and approval by the Board of Health.  This budget approval than becomes the foundation of the Annual Service Plan and Budget Submissions to the Ministry of Health.  The due date for the 2022 Annual Service Plan and Budget Submission to the Ministry of Health is tentatively set for March of 2022. 

The operating budgets for programs funded by MCCSS will be reported to the Board of Health in a separate report in March of 2022.

Mandatory Program

The Mandatory Program budget supports 151.98 FTEs, more specifically:

• Leadership Team 6.75 FTEs
• Management Team 9.60 FTEs
• Coordinators 5.75 FTEs
• Administrative support staff (all departments) 25 FTEs
• Communications staff 4.0 FTEs
• Oral health staff 13.50 FTEs
• Nursing staff (all) 32.50 FTEs
• Enforcement staff (Public health inspectors and Tobacco and Vaping Enforcement officers) 22 FTEs
• Corporate services staff including Human Resources 13 FTEs
• Health promotion and mental health specialists 14.88 FTEs
• Other program staff 5.00 FTEs

The following represents a summary of changes in the 2022 Mandatory Program budget compared to 2021:

• Salaries and employee benefits decreased $876,716.  In 2022, the Mandatory Program budget supported 152.23 FTEs as compared to 164.50 FTEs in 2021.  In 2022, additional human resource capacity was shifted from Mandatory Programs to support the COVID-19 activities and recovery activities.
• Increase in other operating costs of $34,499.  The most notable changes are as follows:
  • A decrease in office equipment rental of $19,000 due to the decline in rental fees in the latter part of the agreement. 
  • A net decrease in professional fees of $34,100, namely legal fees.
  • An increase in purchased services of $161,358. The WECHU will employ third party consultants/services to support the Corporate Services division, namely in the areas of Finance and Facilities.  From a Facilities perspective, these services will be focused on the Windsor Facility Project. 
  • A decrease in building occupancy costs of $99,514.  In 2022, the WECHU will only lease two (2) office facilities (Windsor and Leamington), as compared to three (3) in 2021 (Windsor, Essex and Leamington).

Vector-Borne Diseases Programs

Included within the Mandatory Program budget are costs associated with the Vector-Borne Diseases Program (VBD).

The VBD Program is further divided into three sub-programs, the West Nile Virus Program, the Enhanced Mosquito Surveillance Program and the Tick-Borne Disease Program.

In totality, these programs support the salaries and benefits of five (5.0) public health inspection student FTEs and one-half (0.5) of a public health inspector FTE.

COVID-19 Program

The COVID-19 Program budget includes activities to support the response to COVID-19 pandemic in Windsor and Essex County including vaccination efforts. This budget supports 62.04 FTEs, more specifically:

• Leadership Team 1.00 FTE
• Management Team 7.00 FTEs
• Coordinators, including Performance Improvement and Accountability Specialists 1.25 FTEs
• Administrative support staff (all departments) 4.50 FTEs
• Communications staff 1.00 FTEs
• Nursing staff (all) 34.50 FTEs
• Enforcement staff (Public health inspectors and Tobacco and Vaping Enforcement officers) 7.00 FTEs
• Corporate services staff 1.25 FTEs
• Other program staff 4.54 FTEs

The COVID-19 Program budget has decreased $3,245,937 over 2021 primarily due to the following:

• Decrease in salaries and employee benefits of $1,971,404.
• Decrease in operating expenditures of $1,274,533.  This is attributed to:
  • Decrease in Mileage of $125,448.  The 2021 COVID-19 Program budget contemplated additional mileage costs associated with multiple mass vaccination sites operating throughout Windsor and Essex County.  In 2022, only one mass vaccination site will be in operation supplemented by mobile vaccination events.
  • Decrease in Program supplies of $441,670.  The 2021 COVID-19 Program budget contemplated expenditures on such items as personal protective equipment (PPE), information equipment and medical supplies.  In 2021, vaccine administration supplies including PPE were provided by the MOH with vaccine deliveries.  Additionally, iPads, and other information technology accessories, were provided to public health units to support mass vaccination centres and other related efforts.  Nominal expenditures associated with Program supplies are anticipated for 2022.
  • Decrease in Purchased services of $703,415. In 2021, the WECHU employed a third party provider to support case and contact management ($549,504).  This support is not anticipated to continue in 2022. 

The WECHU will include the COVID-19 Program budget as a one-time request for funding from the MOH.

Recovery

The Recovery Program budget includes activities related to recovery from the COVID-19 pandemic in the community of Windsor and Essex County as well as catch-up efforts.  This budget supports 22.73 FTEs, more specifically:

• Management Team 1.40 FTEs
• Coordinators, including Performance Improvement and Accountability Specialists 2.50 FTEs
• Administrative support staff (all departments) 0.50 FTEs
• Communications staff 1.00 FTEs
• Nursing staff (all) 9.50 FTEs
• Corporate services staff 1.00 FTEs
• Epidemiology and evaluation staff 5.00 FTEs
• Other program staff 1.83 FTEs

The WECHU will include the Recovery Program budget as a one-time request for funding from the MOH.

Ontario Seniors Dental Care Program

The Ontario Seniors Dental Care Program (OSDCP) supports eleven and one-half (16.5) FTEs comprised of one and one-half (1.5) manager FTEs; one and one-half (1.5) dentist FTEs, one (1.0) denturist FTE, five (5) dental assistant FTEs, four (4) dental hygienist FTEs, one (1.0) health promotion specialist FTE, and two and one-half (2.5) support staff FTEs.  The ODSCP expenditure budget is funded in its entirety by the MOH.

The OSDCP budget has increased $706,678 over 2021 primarily due to the following:

• Increase in salaries and employee benefits of $547,050. This is attributed to the following:
  • one (1) denturist FTE ($121,845)
  • two (1) dental assistant FTEs ($174,760)
  • one (1) dental hygienist FTE ($97,138)
  • one-half (0.5) health promotion specialist FTE ($53,903)
  • one-half (0.5) support staff FTE ($36,487)
  • other salaries and benefits increases ($62,917)
• Increase in operating expenditures of $159,628.  This is primarily attributed to an increase in professional services of $150,000.

FUNDING

Administration has arrived at three funding scenarios for consideration by the Board of Health. The purpose of these scenarios is to define the financial risk to the WECHU and the Obligated Municipalities for the 2022 Budget, if additional funding is not available for COVID-19 related expenditures or to support recovery efforts.

SCENARIO 1

Under scenario 1, the Mandatory funding approval from the MOH for 2022 would be $16,301,232.  It anticipates a two (2) percent increase in the 2021 funding approval of $15,981,600.  Additionally, this scenario contemplates the opportunity for one-time funding for costs in excess of the Mandatory funding approval, funded at a rate of one hundred (100) percent.  Total contributions from the Obligated Municipalities for 2022 would be $6,986,242 (Table 1).  These contributions do not contemplate the Mitigation funding approval for 2022 in the amount of $1,260,800.  Such Mitigation funding will be apportioned to the Obligated Municipalities during the 2022 settlement process, if eligibility requirements have been met.

Table 2 below summarizes total funding compared to total budgeted expenditures for all programs except OSDCP, as this program is funded entirely by the MOH.

SCENARIO 2

Under scenario 2, total contributions from the Obligated Municipalities for 2022 would be $8,664,410 or 30% of total 2022 expenditures as noted in table 2 above of $28,881,369.  Similar to Scenario 1, contributions do not contemplate the Mitigation funding approval for 2022 in the amount of $1,260,800.  Such Mitigation funding will be apportioned to the Obligated Municipalities during the 2022 settlement process, if eligibility requirements have been met.

SCENARIO 3

Under scenario 3, total contributions from the Obligated Municipalities for 2022 would be $12,580,137. This represents the Obligated Municipalities 30% share of the Mandatory program funding plus 100% of costs in excess of the Mandatory program budget.  Similar to Scenarios 1 and 2, contributions do not contemplate the Mitigation funding approval for 2022 in the amount of $1,260,800.  Such Mitigation funding will be apportioned to the Obligated Municipalities during the 2022 settlement process, if eligibility requirements have been met.

RISK ASSESSMENT

The inherent risk associated with the budget process is other than low, due to the number of factors:

• Mandatory Funding approval from the MOH.  A risk exists that the Mandatory funding approval for 2022 will be greater than or less than 2021 approval of $15,981,600.  If less, the Obligated Municipalities will be required to increase their contributions to fund programs and services in excess of the required 30%.  If greater, Obligated Municipalities will be required to increase their contributions to bring their funded portion of the WECHU’s budget to 30%.  Should Obligated Municipalities not increase their contributions in response to changes in funding by the MOH, the WECHU would be required to curtail programs and services.
• One-time Funding approval from the MOH.  A risk exists that the MOH will not provide on-going financial support to public health units for expenditures incurred on account of COVID-19 response, including vaccination.  In addition, there is a risk that the MOH will not provide financial support to public health units for program restart and program development as we enter Recovery.
• The future state of the COVID-19 pandemic continues to be the most substantial risk impacting public health.  The question of whether the COVID-19 pandemic will transition from a pandemic to an endemic disease state in 2022, remains unknown.
• Costs associated with capital projects.  Except for project management costs, no other costs associated with the capital project have been contemplated in the 2022 budget.  Administration will investigate capital funding opportunities through the Health Capital Investment Branch of the MOH to mitigate the WECHU’s exposure to this financial risk.
• Other operating costs.  In arriving at budgeted operating costs, Administration attempted to factor in the impact of external pressures, such as inflation and market pressures.  Administration will mitigate these risks by ensuring appropriate procurement processes and procedures have been followed.  Additionally, the WECHU will actively monitor budget to actual financial results and implement mitigation strategies when required.

MOTION

Whereas, the Windsor-Essex County Health Unit receives grants annually from the Ministry of Health to a maximum of 70% of admissible expenditures associated with the Mandatory Program.  In addition, the WECHU receives required contributions from the Obligated Municipalities at a minimum of 30% of admissible expenditures, and

Whereas the Ministry of Health annually provides grants for certain related health protection and promotion programs at a rate of 100% of admissible expenditures,

Now therefore be it resolved that the Windsor-Essex County Board of Health approve the 2022 Mandatory Program budget, requiring $16,301,232 in base funding from the Ministry of Health and $6,986,242 in contributions from the Obligated Municipalities, the Corporation of the City of Windsor, the Corporation of the County of Essex and the Corporation of the Township of Pelee, be approved.

FURTHER THAT the Windsor-Essex County Board of Health approve the 2022 Mandatory Program budget with total expenditures of $20,261,732 and offset revenue of $147,724, and

FURTHER THAT the Windsor-Essex County Board of Health approve the 2022 COVID-19 Program budget with total expenditures of $6,289,784, and

FURTHER THAT the Windsor-Essex County Board of Health approve the 2022 Recovery Program budget with total expenditures of $2,329,853, and

FURTHER THAT the Windsor-Essex County Board of Health apply for one-time funding for costs in excess of the Mandatory funding approval, funded at a rate of one hundred (100) percent in the amount of $5,593,895 associated with the 2022 COVID-19 Program budget and the 2022 Recovery Program budget.

ISSUE

On Thursday October 28, 2021, Chief Medical Officer of Health Dr. Kieran Moore indicated during a news briefing that the Province of Ontario would not be adding COVID-19 to the list of nine diseases that public school students must be immunized against.

Currently, there is no requirement for eligible students to provide proof of vaccination against COVID-19 for school attendance. Schools are a high-risk setting for COVID-19 and other communicable diseases as they bring together large numbers of individuals for long and extended periods of time increasing the likelihood transmission of certain diseases. As of November 15th, there have been more than 450 cohorts of students dismissed through schools and daycares due to COVID-19 exposure. The Immunization of School Pupils Act (Ministry of Health, 2021)requires that children and youth attending school be immunized against designated diseases, unless they have a valid exemption. The addition of COVID-19 as a ”designated disease” within the Immunization of School Pupils Act would support a number of important public health priorities including:

• Increased uptake of the vaccine, providing protection for those who are too young or medically unable to be vaccinated in school communities and beyond. This will result in a safer learning environment for students, staff, their families and the broader community.
• A systematic framework for parental vaccine education. 

BACKGROUND

Vaccines are the safest and most efficient way to guard against communicable diseases and prevent outbreaks. The Immunization of School Pupils Act (ISPA) R.S.O. 1990 (Ministry of Health, 2021) requires that specified vaccines to be given for a child to attend school in Ontario making sure that all school aged children are protected from vaccine preventable diseases. Currently under the ISPA, students must be immunized against measles, mumps, rubella, diphtheria, tetanus, meningococcal, varicella and polio, or have a valid Medical, or Conscience or Religious Belief exemption on file at the Health Unit. There is no cost for vaccines covered by the publicly funded immunization program in Ontario.

MOTION

Whereas available COVID-19 vaccines have been approved by Health Canada to be safe and effective for students born in 2009 or earlier; and

Whereas additional approval by Health Canada to vaccinate individuals born after 2009 with COVID-19 vaccine is anticipated by the end of 2021; and

Whereas the COVID-19 pandemic is a global pandemic;

Whereas the Windsor-Essex region has been disproportionately affected by the COVID-19 pandemic; and

Whereas the Windsor-Essex region has lower rates of vaccination against COVID-19 particularly among eligible children and youth; and

Whereas the purpose of the Immunization of School Pupils Act is to increase the protection of the health of children against the diseases that are designated diseases; and

Whereas the IPSA requires that students be immunized for “designated diseases”: diphtheria, measles, mumps, poliomyelitis, rubella, and tetanus, unless a specific exemption is sought through the act.

Now therefore be it resolved that the Windsor-Essex County Board of Health recommends that the Province of Ontario amend the Immunization of School Pupils Act to include COVID-19 as a “designated disease”.

References:

Ministry of Health. (2021, April 19). Immunization of School Pupils Act, R.S.O. 1990, c. | .1. Retrieved from Government of Ontario Laws: ontario.ca/laws/statute/90i01

Meeting held via video: https://youtu.be/ihy4DY9cdU8

SUBMITTED BY:

Ramsey D’Souza, Manager of Epidemiology and Evaluation

DATE:

October 2021

SUBJECT:

COVID-19 Surveillance and Epidemiology

BACKGROUND

Overview

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

Trends

In the month of September 2021, the health unit reported 1,542 confirmed cases of COVID-19. This is a 14% decrease in case counts compared to the previous month of August 2021. Similarly, the monthly case rate for September was 356.8 cases per 100,000 population, which is lower compared to the monthly rate in August (312.1 cases per 100,000 population). In Ontario, during the month of September, the case rate was 139.6 cases per 100,000 population. This is approximately 2.6 times lower compared to the rate of Windsor-Essex County.

Age and Gender

Approximately 51% (793) of the cases were among females and 48% among males. A disproportionately (26%) higher number of cases, in September 2021,  were reported among those 0 to 18 years of age, followed by 19% among those 19 to 29 years of age, and 17% in the 30 to 39 year age group. Comparatively, from the onset of the pandemic locally (March 1, 2020 to September 30, 2021), 14% of our cases were in the 0 to 19 age group.

Municipal Distribution

The Town of Leamington had the highest case rates (447.1 cases per 100,000 population), followed by the Town of Kingsville (443.0 cases per 100,000 population) and the City of Windsor (376.0 cases per 100,000 population). However, looking at the distribution of cases, 58% of cases were from the City of Windsor, 9% from Leamington and 8% from Lakeshore.

Risk Factors

For the month of September 2021, the top five risk factors reported were an elementary or secondary student (11.2%), farm worker (3.2%), healthcare worker (2.4%), resident of a congregate living setting (1.8%) and a student in a childcare setting (1.4%).

Variants of Concern (VOCs)

Of the 1,542 cases reported in the month of September, genomic sequencing results were available for 1,391 cases (90% of cases). Overall, 78% of cases reported were due to the Delta variant (B.1.617.2), 12% of cases reported results without a variant, and 10% were not sequenced to identify a mutation or a VOC.

Source of Acquisition

Approximately, 32% of cases in September 2021 acquired COVID-19 from their household contact, 17% from a close contact outside of their household, 7% due to being related to an outbreak, and 3% from travel-related outside of the province (e.g., to another province and/or outside of Canada).

Outcome Status

Of the 1,542 cases reported in September 2021, 76% (1,175) had their infection resolved, 268 cases (18%) were active and being followed by the health unit, and 5.4% (83) of cases were lost to follow-up. Seventeen deaths were reported in September 2021 due to COVID-19.

Vaccination Status

Over 34,500 doses were administered to Windsor-Essex County residents in the month of September compared to 31,700 doses in the month of August. This represents a 9% increase for the month of September 2021. Approximately 51% of the doses administered were second doses to complete a vaccination, 39% were first doses to individuals who were previously unvaccinated, and 10% among those in the highest risk priority groups (e.g., residents of long-term care and retirement homes).

Among the 1,542 cases reported in September 2021, 66% were unvaccinated (or not eligible to receive a vaccine), 23% were fully vaccinated, 6% were partially protected with one dose, and 4% were not yet protected after receiving the first dose. Among the 775 unvaccinated cases, approximately 48% were among those 0 to 18 years of age which includes children who were ineligible to receive the vaccine.

CURRENT INITIATIVES

The health unit will continue to monitor and provide epidemiological expertise on COVID-19 to internal leadership, community partners, and residents to support evidence-informed decision-making. This includes daily epidemiological updates, weekly epidemiological presentations to the community and supporting policy decisions through data driven approaches.

CONSULTATION:

The following individuals were contributed to this report: Bridget Irwin, Scott Miller, Karanveer Banipal, Anum Khan, Noor Al-Azary

SUBMITTED BY:

Kristy McBeth, Director, Health Protection

DATE:

October 2021

SUBJECT:

Infection Prevention and Control (IPAC) Hub

BACKGROUND

Ontario Health has identified organizations including hospitals, public health units and others from across the province to lead local Infection Prevention and Control (IPAC) Hubs (Ministry of Health, 2020). These organizations work with partners from across the local health system who have IPAC expertise to ensure that this specialized guidance and support is available to local congregate living settings though a one-window model.

IPAC Hubs:

• Identify and monitor IPAC training and practice needs within their catchment area - including in congregate living settings funded and overseen by the Ministry of Health (MOH), Ministry of Long-Term Care (MLTC), Ministry of Seniors and Accessibility (MSAA), Ministry of Municipal Affairs and Housing (MMAH) and the Ministry of Children, Community & Social Services (MCCSS).
• Strengthen current partnerships and broker new ones; supporting a network of IPAC service providers and experts; working to align local resources to meet IPAC needs within congregate living settings for both prevention and response. Services will be allocated according to a risk-based framework.
• Bring forward and escalate issues of concern that are outside of the scope of IPAC through established mechanisms with ministry partners.

Local public health and Public Health Ontario (PHO) are key partners in each local IPAC Hub. Working in coordination with the IPAC Hub, public health partners support the provision of IPAC knowledge, training and expertise, and build on existing local partnerships. In addition to contributing to IPAC Hubs as experts, the local public health unit retains the responsibility to oversee the management of outbreaks. Local public health units also have a key linkage to Ministry of Labour, Training, and Skills Development (MLTSD), but does not replace the duties employers of congregate living organizations have to notify the MLTSD as required under the Occupational Health and Safety Act, 1990 and other relevant requirements.

CURRENT INITIATIVES

In collaboration with our local IPAC Hub members, and the current Hub lead Windsor Regional Hospital (WRH), it has been determined that in order to most effectively utilize existing and future human and financial resources, that the WECHU would transition to the role of IPAC Hub for lead for Windsor-Essex effective October 2021. Funding for this initiative, received through Ontario Health, will be allocated to the WECHU to support program deliverables starting in October 2021. This work will be performed through augments to staffing in the Environmental Health Department and will also include FTE allocations from existing staff including Public Health Inspectors. The WECHU’s IPAC Hub program will be an inter-disciplinary team of Public Health Inspectors and Public Health Nurses under the management of a certified Infection Control Practitioner. The current funding for this Hub program is in place until March 31, 2022.

Some of the main WECHU Responsibilities as the local IPAC Hub lead for Windsor and Essex County include:

• The creation of implementation targets and monitoring of progress;
• The establishment of local IPAC Hub priorities for service delivery;
• Leading communication with Hub Partners (Public Health Ontario, hospitals and other providers) and congregate living settings in our defined catchment area
• Maintaining detailed financial records of expenses and supporting weekly reporting requirements.

The WECHU will continue to work collaboratively with partners in the Hub framework with the new model in place in order to facilitate enhanced local supports for infection prevention and control strategies within congregate settings of our community.

DOCUMENTS:

Ministry of Health. (2020, September). Infection Prevention and Control Hubs. Retrieved from IPAC Hub Program Description:
https://www.health.gov.on.ca/en/pro/programs/publichealth/coronavirus/d…

Board Members Present:

Gary McNamara, Joe Bachetti, Tracey Bailey, Rino Bortolin, Fabio Costante, Gary Kaschak (4:07 pm), Judy Lund, Robert Maich (4:12 pm), Ed Sleiman, Larry Snively

Administration Present:

Nicole Dupuis, Dr. Shanker Nesathurai, Felicia Lawal, Kristy McBeth, Eric Nadalin, Dan Sibley, Lee Anne Damphouse

Administration Regrets:

Lorie Gregg

QUORUM:  Confirmed

RECORDING SECRETARY: L. Damphouse

SUBMITTED BY: N. Dupuis

APPROVED BY:

1. Period covered by this report:  July 31, 2021 to September 30, 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: September 30, 2021

Signature(s):

Nicole Dupuis, Chief Executive Officer

1. Period covered by this report:  April 1, 2021 to June 30, 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:   June 30, 2021                    

Signature(s):   

Nicole Dupuis, Chief Executive Officer
Lorie Gregg, Director, Corporate Services
Dan Sibley, Director, Human Resources

Meeting held via video.

PREPARED BY:

Lorie Gregg, Director of Corporate Services

DATE:

September, 2021

• Mandatory and related programs funded to a maximum of 70% (“Cost-Shared”) by the Ministry of Health (“MOH”) and 30% by  the Corporation of the City of Windsor, the Corporation of the County of Essex and the Corporation of the Township of Pelee (hereinafter referred to as the “Obligated Municipalities”).
• Related programs funded 100% by the MOH.  More specifically, this includes the Ontario Seniors Dental Care program and the AMOH/MOH Compensation Initiative.
• Related programs funded 100% by the Ministry of Children, Community and Social Services (“MCCSS”). 
• One-time business cases funded 100% by the MOH.

The second quarter financial report to the Board includes a budget to actual comparison and narrative for material variances for all programs listed above, except related programs funded 100% by the Ministry of Children Community and Social Services (MCCSS).  Forecasted financial results will be provided with the Q3 and Q4 financial report.

Related programs funded 100% by the MCCSS will be reported on in November of 2021.

COST-SHARED PROGRAM FINANCIAL RESULTS

At June 30, 2021, the variance from budget to actual total expenses amounts to $810,141. Specific variances are as follows:

• Salaries and Benefits:  Expenditures in these financial captions relate to salaries and benefits paid to the WECHU staff in service of the Mandatory Cost-Shared Program. Cumulatively, these financial captions are $519,587.  Substantial human resources were deployed to support COVID-19 Response and COVID-19 Vaccination Programs.  Salaries and benefits allocated to the Mandatory Program are not entirely an accurate depiction of the human resources working on Mandatory Programs at June 30, 2021.  A secondary analysis is being compiled for the purposes of Q2 reporting to the MOH delineating resources in a more granular fashion.  This report will be brought to the Board in October of 2021.
• Mileage, Professional development, and Travel and meetings:  Expenditures in these financial captions support WECHU staff in the completion of their public health responsibilities.  Cumulatively, these financial captions are $97,640 underspent at June 30, 2021. Mandatory program activities continue to be impacted by COVID-19 Pandemic.  A substantial portion of the WECHU staff continue to work-from-home and employ virtual means to interact with clients, partners, etc.  Professional development is completed on an “as needed basis” taking into consideration staff capacity.
• Association and Membership Fees:  Expenditures in this financial caption relate to memberships in an association or other group by virtue of professional requirements or to support initiatives associated with Public Health.  The majority of Association and Membership Fees are paid in the early in the fiscal year.  While overspent at June 30, 2021, the WECHU anticipates that this financial statement caption will remain within its overall budget for fiscal 2021.
• Program supplies:   Expenditures in this financial caption support the functions of departments, those that directly support public health programs as well as those that support corporate service departments such as Information Technology and Communications.  Cumulatively the Program supplies financial caption is underspent $93,385.  Program related expenditures continue to be underspent due to the on-going focus on the COVID-19 Pandemic (underspent $186,196).  Corporately, the budget is overspent $93,111, which is primarily to the prepayment of Information Technology software licensing for calendar years 2021 and 2022. 
• Professional fees:  Expenditures in this financial caption include legal, audit, consulting fees and dentistry services.  At June 30, 2021, this caption is underspent $83,004.  This variance is primarily associated with the variance in dentistry fees paid on account of the Healthy Smiles Ontario Program (HSO).  In February of 2021, the WECHU successfully recruited a second dentist FTE, whose time would be allocated evenly between the ODSCP and the HSO Program, reducing the requirement subcontracted dentistry services.
• Building Maintenance:  Expenditures in this financial caption include costs to maintain Windsor, Essex and Leamington locations.  More specifically, these costs relate to building and equipment maintenance, grounds keeping and housekeeping supplies.  The variance here relates primarily to:  i) Costs incurred to install electrical for 12 desks in the Leamington office in the amount of $5,662;  ii)  Prepayment of certain maintenance costs for calendar years 2021 and 2022. 
• Insurance:  Expenditures in this financial caption include costs associated with general liability insurance, property insurance, director and office insurance coverage as well as cyber coverage.   Insurance premiums are paid at the beginning of the year.  The WECHU anticipates that the budget for this financial statement caption will remain underspent for 2021. 
• Utilities:  Expenditures in this financial caption include utility costs for the Windsor and Leamington offices.  Utilities are underspent $29,462 due to lower than anticipated utilization (i.e. staff working from home; environmental factors).
• Vehicle:  Expenditures in this financial caption include vehicle maintenance, repair and fuel.  The WECHU incurred augmented fuel costs on account of: 1. Vaccine delivery to retirement homes, long-term care homes, pharmacies and physicians; 2. Supplies delivery to mass vaccination sites. It is anticipated that this financial caption will remain within budget for 2021.
• Offset revenue:  Revenues included in the financial caption relate to interest, proceeds on sale of tangible capital assets, parking revenue, vaccine recoveries, sales of contraceptives as well as course fees relating to the food handler course and examination.  At June 30, 2021, offset revenue is under budget by $21,165.  More specifically:  i) nil interest was earned (under budget $2,500).  ii) Nil was earned on account of food handler courses (under budget $5,000).  iii) Nil was earned on account of vaccine recoveries (under budget $18,844).  iv)  $618 was earned on account of the sale of contraceptives (under budget $6,382). v)  $14,186 was earned on account of parking revenues (over budget $686).  vi)  $34,708 was earned on account of seasonal housing inspections (over budget $7,622).  vii)  Sale of tangible capital assets of $4,759 (over budget $4,259). viii)  $1,280 in user fees (under budget $970).

COVID-19 RESPONSE PROGRAM

The COVID-19 Response Program was established to respond to the on-going impact of the COVID-19 Pandemic in Windsor and Essex County.  The budget for this program included 30 FTEs, more specifically: one (1) director FTE, five (5) Manager FTEs, nine (9) Registered Practical Nurse FTEs, seven (7) Public Health Nurse FTEs, four (4) Public Health Inspector FTEs, one (1) Epidemiologist FTE and three (3) Support Staff FTEs.

Variances from budget at June 30, 2021 are as follows:

• Salaries and benefits are underspent $382,882:  The staffing complement of this program has evolved from January to June of 2021, in response to the changes in local case counts.  Additionally, the Province of Ontario provided human resource support for case and contact management at no cost.  This provided the WECHU the opportunity to deploy nursing resources to support COVID-19 Vaccinations in March of 2021.

Programs supplies

• Communication and awareness is underspent $23,100: At June 30, 2021, $ nil was spent on communication and awareness campaigns associated with the COVID-19 Pandemic (excluding vaccine).  The WECHU has determined that there is a greater need for human resource capacity to support the Communications Department and, by extension, the messaging and media associated with public health measures as well as COVID-19 vaccination efforts.  As such, these financial resources will be expended on staffing to support this area.  Recruitment will occur in Q3 of 2021.

Purchased services

• Case and contact management support is overspent $132,884:  At June 30, 2021, 6,645 hours were acquired from Global Excel Management to support case and contact management.   The budget for case and contact management support of $549,504 was intended for a 6-month period. While on a pro-rata basis, the budget for case in contact management is overspent, the amount expended at June 30, 2021, is within the budgeted amount for the initial term of the contract.
• Translation and interpretation is underspent $34,600:  Translation and interpretation costs were lower than anticipated in the area of case and contact management.  Higher than anticipated translation and interpretation costs were experienced as for the COVID-19 Vaccination Program.

COVID-19 VACCINE PROGRAM

As per the approved budget (March of 2021), the COVID-19 Vaccine Program supports 63 FTEs comprised of two (2) manager FTEs, one (1) health promotion specialist FTE, ten (10) public health nurse FTEs, forty (40) registered practical nurses FTEs and ten (10) support staff FTEs.  Similar to the COVID-19 Response Program, the composition of the COVID-19 Vaccination Program evolved with vaccination requirements, as well as the availability of vaccine within Windsor and Essex County. 

Variance from budget at June 30, 2021 are as follows:

• Salaries and benefits are overspent $471,784: Additional human resource capacity was added at all levels to support three mass immunization clinics, mobile vaccination events as well as vaccine distribution to physicians and pharmacies in Windsor and Essex County. 
• Mileage is overspent $24,297:  The budget for this financial caption did not contemplate the additional human resource capacity (in excess of 63 FTEs) as well as the length of time mass vaccination sites would remain in operation.

Program supplies

• Communications and awareness is underspent $33,937:  At June 30, 2021, a nominal amount was expended on account of communication and awareness campaigns associated with COVID-19 Vaccinations.  The WECHU leveraged its YouTube broadcasts, media releases, website and social media (relatively in expensive), for communicating messaging.  Similar to the discussion noted under the COVID-19 Response Program, the WECHU has determined that there is a greater need for human resource capacity to support the Communications Department and, by extension, the messaging and media associated with public health measures as well as COVID-19 vaccination efforts. As such, these financial resources will be expended on staffing to support this area.  Recruitment will occur in Q3 of 2021.
• Information technology is overspent $75,773: Additional hardware was acquired to support COVID-19 Vaccination staff.  Computer hardware such as laptops, monitors, keyboards, mice, printers and cables were acquired ($97,721).  Tablets were acquired to support the check-in and queuing process at each of the mass clinics ($10,137).  Upgraded temperature control and monitoring equipment was acquired for the WECHU vaccine fridges and freezers ($4,975).
• Medical equipment is overspent $32,076:  This financial caption includes the cost of acquiring medical equipment and supplies to support COVID-19 vaccinations in various settings (i.e. long-term care and retirement homes; mobile events; mass clinics; physician offices).    Supplies included: Epi pens, needles, syringes, drape sheets, bandages, alcohol swabs, etc.  In the latter part of Q1, the Province of Ontario included vaccine administration supplies with its shipment of vaccine.  The WECHU continued to acquire and use its own needles and syringes for the administration of Moderna up to June 30, 2021, as our vaccination supplies more consistently drew additional doses per vial of Moderna.  This was critical at this time due to the limited supply of vaccine in Windsor and Essex County.
• Personal protective equipment is underspent $ 31,875:  This financial caption includes costs associated with rental and or purchase of isolation gowns, the purchase of N95 masks, and the purchase of nitrile gloves, hand sanitizer and similar supplies to support COVID-19 Vaccinations in various settings.  In the latter part of March 2021, certain personal protective equipment were distributed with vaccine shipments, eliminating the need for the WECHU to continue to acquire these supplies.
• Other is overspent $69,892:  This financial caption included:  Tents, generator and security for pop-up events ($6,080); Office supplies ($19,570); Licensing for scheduling application ($35,839); Copier/printer charges for printing resources ($9,388); Calibration and electrical for vaccines freezers ($5,418); other general supplies ($6,317).

Purchased services

• Other is overspent $224,250:  This financial caption includes amounts paid to independent contractors and paid volunteers (immunizers) augmenting the WECHU capacity to administer COVID-19 Vaccinations in various settings.  More specifically:
  • Total hours incurred on account of direct client service at a mass vaccination clinic were 7,109 hours or $199,937. 
  • Total hours incurred on account of call centre activities, support booking vaccination appointments were 1,637 hours or $100,681. 
  • Total hours incurred on account of other activities associated with planning were 216 hours or $6,520.
    In addition, costs were incurred on account of legal, namely the writing and review of legal agreements with the COVID-19 Vaccination Program totaling $33,075.
• Transportation is underspent $115,187:  The budget for this financial caption was developed based on the WECHU’s COVID-19 Vaccination plan submitted to the Ministry of Health in January of 2021.  The WECHU plan focused on the distribution and administration of vaccines through physicians and pharmacies thus resulting in the WECHU incurring additional costs associated with transportation (couriers).  The provincial vaccination plan varied from the WECHU plan, with a focus on vaccine administration at mass vaccination clinics.  Physicians and pharmacists were on-boarded later on in the process.
• Translation and interpretation was overspent $38,699:  This financial caption includes translation and interpretation costs to support mass vaccination clinics and mobile clinics.  The budget did not appropriately contemplate the volume of vaccinations to be delivered in a mass vaccination setting.

ONTARIO SENIORS DENTAL CARE PROGRAM

The Ontario Seniors Dental Care Program (OSDCP) supports eleven and one-half (11.5) FTEs comprised of one and one-half (1.5) manager FTEs, one and one-half (1.5) dentist FTEs, three (3.0) dental hygienist FTEs, three (3.0) dental assistant FTEs, one (1) health promotion specialist FTE and two (2) support staff FTEs.

Variances from budget at June 30, 2021 are as follows:

• Salaries and benefits are underspent $69,813 - This variance predominantly relates to: i) Deployment of one (1) manager FTE for the period January 1, 2021 to April 30, 2021, to support COVID-19 Response, representing a decrease in salaries and benefits of $43,571; ii) Delay in the recruitment of a second dentist supporting the OSDCP, and Healthy Smiles Ontario Program, representing a decrease in salaries and benefits of $8,600.
• Mileage, Travel and meetings, Professional Development are underspent $6,317 - These financial captions continue to be underutilized due to the on-going impact of the COVID-19 Pandemic.   Virtual or telephone conferencing continues to be leveraged to engage with clients and/or partners.  Professional development is completed on an “as needed basis”.
• Clinical supplies and other are underspent $57,747 - This financial caption is directly impacted by client volumes/visits.  For the period January to June 2020, the WECHU dental clinic had 272 visits from 148 OSDCP clients.  For the period January to June 2021, the WECHU dental clinic had 1,590 visits from 582 OSDCP clients.  Year-over-year increase in expenses is reasonable.  In terms of the variance from budget, the WECHU is relatively early in its experience administering the OSDCP.  The WECHU will continue to collect data on the experience/utilization of supplies to support a more accurate estimate of expenditures in future budget processes.
• Professional services are overspent by $7,746 - This financial caption includes translation and interpretation costs, fees paid on account of a denturist and dentist, lab fees and fees paid on account of oral surgery referrals.  In terms of the variance from budget, and similar to clinical supplies and other, the WECHU is still relatively early in its experience administering the OSDCP.  The WECHU will continue to collect data and experience to support more accurate estimates of professional services expenditures in subsequent budgeting processes.  Details of Professional services as at June 30, 2021 are as follows:

FINANCIAL INFORMATION FOR RELATED PROGRAMS FUNDED 100% BY THE MOHLTC

Note:  All funding approvals are for the period April 1, 2021 to March 31, 2022.

Public Health Inspector Practicum Program:  This one-time funding supports the hiring of two Public Health Inspector Practicum positions.  Eligible costs include student salaries, wages and benefits, transportation expenses associated with practicum positions.  At June 30, 2021, a recruitment for public health inspector practicum students had not yet been completed.

School-Focused Nurses Initiative:  This funding supports the hiring of 19 nurses to creating additional capacity to provide rapid-response support to school boards and schools, facilitating public health and preventative measures related to the COVID-19 Pandemic.  At June 30, 2021, $339,892 were incurred on account of salaries and benefits. The WECHU anticipates being on-budget for this program initiative at March 31, 2022.

Approved by: Nicole Dupuis

Board Members Present:

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

Border Member Regrets:

Gary Kaschak

Administration Present:

Nicole Dupuis, Dr. Shanker Nesathurai, Lorie Gregg, Felicia Lawal, Kristy McBeth, Eric Nadalin, Dan Sibley, Lee Anne Damphouse

QUORUM:  Confirmed

RECORDING SECRETARY:

SUBMITTED BY:

APPROVED BY:

ISSUE

The WECHU, in partnership with representatives on the advisory committee and the Windsor-Essex Community Opioid & Substance Strategy, launched a site-specific community consultation on June 17th of 2021 to gather community feedback about two candidate locations for a local Consumption and Treatment Services (CTS) facility. The purpose of the site-specific community consultation was to understand community perceptions about the feasibility and acceptability of a potential CTS facility at either of the candidate locations. The comprehensive community consultation plan encompassed several components for engaging the community: 

• A widely promoted public survey with a total of 448 survey responses
• 13 key informant interviews with businesses and agency stakeholders within a defined radius from the sites
• 7 focus groups with area stakeholder groups
• 3 Virtual Town Hall meetings that allowed community members to ask questions and voice concerns to a panel of eight expert speakers. Fifty-three (53) community members registered to participate.

BACKGROUND

After an extensive search and consultation with local property owners, the WECHU with support of the CTS advisory committee, identified two candidate locations for a potential CTS facility in Windsor’s downtown core - 101 Wyandotte Street East and 628 Goyeau Street. Both of the candidate locations satisfied each of the mandatory and complementary requirements for an eligible site, and both are situated in the preferred neighbourhood (N9A) identified through the initial Safe Injection Services Community Consultations Report. Prior to facilitating the community consultation process, crime prevention through environmental design audits (CPTED) were completed by Windsor Police Services in order to determine the safety of the candidate locations, and to guide any mitigating interventions for improving the surrounding safety of the sites and discouraging criminal activity. Through the CPTED audits, it was determined that the placement and orientation of both site locations would lend themselves sufficiently to establishing a manageable “Safe Consumption Zone” whereby public safety can be maintained with any risks identified to be mitigated. The WECHU proposed the two candidate locations to the Board of Health on June 17th of 2021, and a resolution was passed in support of the completion of the site-specific community consultation as focused to the assessment of these two potential sites.

The results from the community consultation yielded local support for a potential CTS facility at both of the candidate locations. A majority of survey respondents indicated that they would provide at least some degree of support for a CTS facility at 101 Wyandotte Street East (67%) and/or 628 Goyeau Street (68%). Relatedly, respondents most frequently indicated that they would provide equal support for a CTS facility at both of the candidate locations (39%), while 19% preferred 628 Goyeau Street and 13% preferred 101 Wyandotte Street East. Nineteen percent (19%) of all survey respondents did not support or prefer either location. Survey respondents who identified as living, working, owning a business, or going to school in the N9A postal code area (N=126) responded with similar perceptions to the full sample, with 33% providing equal support for both locations, 22% preferring 628 Goyeau Street, and 13% preferring 101 Wyandotte Street East. Nineteen percent (19%) of respondents in the N9A postal code area did not support or prefer either location.

Majority of the key informant interview and focus group participants demonstrated openness or support to a CTS facility at one or both of the proposed locations, with few expressing strong opposition to either location. Although many of the participants noted minimal differences between the two locations, the primary differentiators in terms of perceived benefits and concerns were tied to the traffic flow surrounding the locations and the visibility of the sites. Many of the participants cited that 628 Goyeau Street is a less visible and lower traffic area compared to 101 Wyandotte Street East, with the perceived advantages of being a safer site option with less risks of pedestrian and vehicular-related injuries or traffic disruptions. Many participants also referenced that 628 Goyeau Street would provide improved privacy for potential service users, many of whom are socially stigmatized and may be deterred by a highly visible and higher traffic location, such as 101 Wyandotte Street East. In contrast, some of the participants highlighted that the visibility of 101 Wyandotte Street East would be particularly advantageous for enhancing observation capabilities and ensuring the safety and security of the surrounding areas.  Overall, five of the seven focus groups reached a consensus of 628 Goyeau Street being the preferred or superior location, while 31% of key informants equally supported both locations, 31% preferred 628 Goyeau Street, and 23% preferred 101 Wyandotte Street East. Fifteen percent (15%) of key informants did not prefer either location.

The results collected through the consultation will be interpreted extensively by the WECHU and the CTS Stakeholder Advisory Committee to inform mitigating strategies to address the cited concerns.

PROPOSED MOTION

Whereas, Opioid overdose and opioid related mortality has been declared a public health crisis, and

Whereas, Opioid overdose and opioid related mortality is at an all time high in Windsor-Essex, and

Whereas, Consumption and Treatment Services have the potential to address opioid overdose and opioid related mortality, and

Whereas, the WECHU is required to submit an application for a CTS that includes a site location and an accompanying community consultation, and

Whereas, the CTS advisory committee has identified a preferred site based on the results of a comprehensive community engagement process led by the WECHU,

Whereas, a formal request to City Council is required in order to present the results of the evaluation and is necessary for an extended presentation time,

Now therefore be it resolved that the Windsor-Essex County Board of Health support the recommendation from the CTS Advisory Committee that the WECHU move forward with their application for the site located at 628 Goyeau Street, and

FURTHER THAT, the Board of Health support administration to continue with the next steps of the application process which includes seeking City of Windsor council approval for the proposed site, and

FURTHER THAT, administration enter into an agreement with the proposed landlord to secure the site for submission of an application.

ISSUE

The Windsor-Essex County Health Unit (WECHU), in response to the resignation of the Medical Officer of Health (MOH), is required to recruit an Acting MOH.  This individual shall perform the duties of, and have the authority to exercise the powers of the MOH in accordance with the requirements of Section 69(2) of the Health Protection and Promotion Act, R.S.O. 1990

BACKGROUND

Part II, Section 4 of the Board of Health for the Windsor-Essex County Health Unit Consolidated By-laws (By-laws) speaks to the appointment of an Acting MOH by the Board.  The By-law requires that any appointments of greater than six (6) months be subject to approval in writing from the Ministry of Health and the Chief Medical Officer of Health. 

In addition, the Policy Framework on Medical Officer of Health Appointments, Reporting and Compensation established by the Ministry of Health indicates, “A board of health shall appoint forthwith a physician as acting medical officer of health”.  The Minister’s approval is not required for these appointments, as they are meant to be short-term in nature to permit boards of health to recruit the MOH position with a qualified physician on a full-time basis.

PROPOSED MOTION                                               

Whereas, the Medical Officer of Health has resigned effective September 12, 2021, and

Whereas, the WECHU has commenced a recruitment process in accordance with the By-laws, and

Whereas, an Acting Medical Officer of Health will be required to fulfill the duties of the Medical Officer of Health during the recruitment process

Now therefore be it resolved that the Windsor-Essex County Board of Health authorize and approve the Director of Human Resources and the Chief Executive Officer to communicate with the Ministry about a potential secondment and/or recruit a local physician for the role of Acting Medical Officer of Health.

Meeting held via video.

SUBMITTED BY

Communications Department

DATE

July 2021

SUBJECT

June 2021 - Communications Recap

June Metrics

Media Monitoring Highlights

Trending Themes

Top Sources

Media Participating in Teleconference for YouTube Live

• AM 800 CKLW, Blackburn News, CBC Windsor, CTV Windsor, CFTV and the Windsor Star join every day. Radio Canada joined us in June on a few occasions.

Current Notable Projects

• Maintaining marketing and communication efforts regarding ongoing vaccine rollout in the region.
• Developing promotional campaign and engagement strategy encouraging more youth 12 to 17 years of age to get vaccinated.
• Developing marketing and communication plans to launch public health programs that were on hold during the pandemic.

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 answer questions 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, 2020. On August 17, 2020, 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. 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 wechu.org. Previously, we were report on the local-updates webpage only.

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.