June 2018 Board Meeting - Minutes

The meeting was called to order at 4:00 p.m.

It was moved

That the agenda be approved

CARRIED

1. Regular Board Meeting: May 17, 2018.

   It was moved

   That the minutes be approved.

   CARRIED

1. Smoke-Free Ontario Act, Changes/Highlights (E. Nadalin)

   E. Nadalin, Manager Chronic Disease and Injury Prevention, provided an overview of the current legislation. The MOHLTC had committed to modernizing the Smoke-Free Ontario Act (SFOA) in the spring of 2017, and these changes will take effect July 1, 2018. The SFOA regulates the sale, supply, use, display and promotion of tobacco and vaping products, as well as smoking and vaping of cannabis. (Non-medical cannabis will fall under the Cannabis Act). Modernization of the SFOA includes smoking prohibitions within School Grounds, Playgrounds and Play Areas, and Sporting and Spectator Areas.

   Restrictions apply for E-cigarettes under the Electronic Cigarettes Act (ECA), and products for sale will not be openly displayed. The ECA also prohibits the sale and supply of e-cigarettes to persons who are less than 19 years old.

   WECHU’s role is to ensure pubic compliance with regulations of tobacco and E-cigarette sales through enforcement by WECHU’s Tobacco Enforcement Officers, to support municipalities and businesses to make sure they are aware of the legislation and are compliant, and to provide community education and outreach.

2. Association of Local Public Health Agencies (alPHa) BOH Conference Update (P. Borrelli)

   Board of Health member, P. Borelli, attended the alPHa Conference on June 10-12, 2018 in Toronto, and brought forward various points of interest. Due to the municipal elections taking place this fall, the next alPHa Conference is scheduled for February 2019.

   It was moved

   That the presentations be received for information.

   CARRIED

1. Information Reports

   The following information reports were presented to the Board.

   1. Q1 Reports Submitted to Ministry
   2. Changes in Public Health Disclosure Requirements
   3. Ticks and Lyme Disease Surveillance
   4. Baby Friendly Initiative – Journey to Designation
   5. Smoke-Free Ontario Act, 2017 – New Regulations
   6. Health Equity Strategy
   7. May 2018 Media Relations Recap

      It was moved

      That the information reports be received.

      CARRIED

2. Recommendation Reports
   1. Recommendation/Resolution Report – 2017 Annual Financial Statements – May 25, 2018
      

      ISSUE:

      Approval of the annual audited financial statements for the year-ended December 31, 2017 including:

      •Windsor-Essex County Health Unit (Appendix A)
      •Windsor-Essex County Health Unit Nurse Practitioner Program (Appendix B)
      •Windsor-Essex County Health Unit Healthy Babies Healthy Children Program (Appendix C) (hereinafter referred to collectively as “the annual financial statements”).

      BACKGROUND

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

      The annual financial statements audited by KPMG LLP, independent external auditors appointed by the Corporation of the City of Windsor. On May 25th, 2018, the Audit Committee of the Windsor-Essex County Health Unit convened to review the annual financial statements and audit findings report with Administration and KPMG LLP. The Audit Committee has recommended the financial statements for approval to the Board. KPMG LLP is prepared to issue, pending approval by the Board, an unmodified audit opinion on the annual financial statements.

      Windsor-Essex County Health Unit

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

      Statement of Financial Position:

      • Accounts receivable increased $423,766 over 2016. This increase is primarily attributed to: i) A net increase in amounts receivable from the Province of Ontario due to timing of 2017 approvals of $217,448; ii) Increase in other receivables in the amount of $201,799 as current year’s balance included amounts outstanding from third parties for wellness services rendered. For additional details, refer to note 3 to the annual financial statements of the Windsor-Essex County Health Unit.

      • Due to Province of Ontario increased $157,338. This increase is attributed to the following: i) Increase in the balance outstanding relating to the 2016 settlement. In the prior year an amount remained receivable from the Ministry of Health and Long-Term Care. This receivable balance was offset against the total amount payable to the Ministry of Health and Long-Term Care. The Ministry subsequently cash flowed this in Q1 of 2017; ii) The 2017 settlement amount of $67,898. This amount relates to 100% Related Program funding and 100% funded One-time business case funding that remain unspent at the settlement date. Currently the 2016 settlement is under review. Once the review is concluded, the Ministry of Health and Long-Term Care will issue a settlement letter and claw back funding during the remainder of 2018. The 2017 settlement is due to the Ministry of Health and Long-Term Care May 31, 2017. The timing of the review of that settlement is unknown. For additional details refer to note 4 to the annual financial statements of the Windsor-Essex County Health Unit.

      • Due to Municipalities increased $561,872. This net increase is attributed to the following: i) Repayment of amounts outstanding to 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”) in the amount of $144,349; ii) 2017 settlement to the Obligated Municipalities in the amount of $706,221. For additional details, refer to note 5 to the annual financial statements of the Windsor-Essex County Health Unit.

      • Tangible capital assets decreased $274,418. This net decrease is attributed to: i) Tangible capital asset additions of $197,409; ii) Amortization expense in the amount of $471,827. Of the tangible capital assets acquired in the year, $106,400 were funded by the Ministry of Health and Long-Term Care using 100% Related Program funding or 100% funded One-time business cases. Refer to note 9 for additional details.

      Statement of Operations and Accumulated Deficit:

      • Increase in Revenue from the Province of Ontario, Mandatory Programs, in the amount of $298,562. This increase is attributed to the year-over-year increase in the general program expenses. As you recall, the Ministry of Health and Long-Term Care funds the WECHU to a maximum of 75% of admissible expenditures. Admissible expenditures for the purposes of the Ministry of Health and Long-term Care Settlement Process is defined below:
       

      Total General Program expenses at December 31, 2017 $18,518,025
      Less: Non-admissible expenses
      Amortization (471,827)
      Change in Employee Future Benefits Liability (24,296)
      Other Accounting Adjustments (25,825)
      Plus: Tangible capital asset additions – Mandatory Program 91,009
      $ 18,087,086
      Less: Offset revenue (189,851)
      Total admissible expenditures $ 17,897,235
      Ministry portion (75%) $ 13,422,926
      Ministry approval $ 13,316,100
      Ministry funded expenditures $ 13,316,100

      • Increase in General Program Expenses in the amount of $739,870 is attributed to:
       •Net increase in permanent FTEs of 2 staff funded by the Cost-Shared Program;
       •Annual increases (cost of living and grid increases) as follows: i) ONA 2% annual; ii) CUPE 1.5% annual; iii) Non-union 2%;
       •Other employee obligations.

      Windsor-Essex County Health Unit Nurse Practitioner Program

      The Nurse Practitioner Program is funded by the Ministry of Children and Youth Services. The funding supports the salaries and benefits of the nurse practitioner whose role is to assist with promoting healthy pregnancy, birth and infancy for children, improve parenting and family supports, strengthen early childhood development, learning and care.

      Windsor-Essex County Health Unit Healthy Babies Healthy Children Program

      The Healthy Babies/Healthy Children Program is funded through the Ministry of Children and Youth Services. This program supports 27.0 FTEs comprised of managers (2), nurses (17), family home visitors (4), social worker (1), and support staff (3). The objective of the program is to ensure a healthy future for children and their families.

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

      Statement of Financial Position:

      •Due from the Windsor-Essex County Health Unit: Refer to the statement of cash flow for the decrease of $111,757 from December 31, 2016.

      •Accounts payable: The decline in accounts payable in the amount of $50,487. At December 31, 2015 $40,800 was payable to a third party provider for scanning services of client files.

      •Due to Ministry of Children and Youth Services in the amount of $64,399. The net decrease was as a result of the following: 1. 2015 and 2015 settlements being reclaimed in 2017 amounting to $32,721. 2. Settlement for 2017 in the amount of $27,793; 3. Reduction of other amounts owing from pre-2000 settlements of $59,471.

      Statement of Operations and Accumulated Deficit:

      •Program Supplies: The decrease in program supplies in the amount of $41,913. As indicated above under the Accounts Payable caption a scanning project was undertaken in 2016 to archive client files with significant retention periods. The project was substantially concluded in 2016.

      •Purchased Services: The increase in purchased services in the amount of $15,323 resulting from an increase in translation services from 2016.

      PROPOSED MOTION

      Whereas, at its May 25th, 2018, meeting of the Audit Committee reviewed the 2017 annual financial statements and recommended them to the Board for the Board’s approval,

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

      •Windsor-Essex County Health Unit 2017 audited annual financial statements

      •Windsor-Essex County Health Unit 2017 Nurse Practitioner Program financial statements

      •Windsor-Essex County Health Unit 2017 Healthy Babies/Healthy Children Program financial statements

      It was moved

      That the resolution be supported.

      CARRIED

1. Board of Health Retreat – February 21, 2019 (T. Marentette)

   Due to scheduling conflicts, the Board of Health Retreat originally planned for February 10, 2017 has been postponed and rescheduled to take place during the February 21, 2019 regular Board meeting. Board of Health members are highly encouraged to attend.

2. WECHU Letter in Support of Fluoride (W. Ahmed)

   The Board of Health requested that Dr. Ahmed write a letter to the leaders of various political parties to update their mandates in support of community water fluoridation, as opposed to placing the issue with municipalities. A letter via email was sent to the incoming Premier, and the Association of Local Public Health Agencies (alPHa) provided a letter of support to WECHU’s email.

3. Oral Health Report to Essex County Council (W. Ahmed)

   The WECHU attended and presented the Oral Health Report to Essex County Council on June 6. Although the report was well received, the underlying discussion was that fluoridation is something that the province should address. The WECHU will present the Oral Health Report to Windsor City Council on December 17. Board of Health member, J. Lund, asked if there were any long term comparisons that would help bear weight to this issue. WECHU has comparables, but they are not long term. WECHU’s goal is to make this an oral health issue, and not specifically a fluoride issue. The majority of areas across Ontario do have community water fluoridation. Board of Health member, G. Queen, noted that the County of Essex does not own or run their water treatment plants, and WECHU may need to promote this issue to the municipalities, and not to Essex County Council.

   It was moved

   That the information presented be received.

   CARRIED

1. Board of Health Education Sessions (T. Marentette)

   T. Marentette noted the upcoming Board of Health Education Sessions taking place in Windsor on July 19 (Health Equity overview) and August 16 (Program overview and changes). Board members are encouraged to attend.

1. Dedicated funding for Local Public Health Agencies from Cannabis Sales Taxation Revenue – Hastings Prince Edward Public Health – For Support
2. Mandatory Food Literacy Curricula in Ontario Schools – Kingston, Frontenac and Lennox & Addington Public Health – For Support

   It was moved

   That the Board support agenda items 10.1 and 10.2

   CARRIED

3. Canada Tobacco Strategy – alPHa – For Information

   It was moved

   That the Board receive the report for information

   CARRIED

It was moved

That the Board move into Committee of the Whole at 4:36 p.m.

CARRIED

It was moved

That the Board move out of Committee of the While at 4:52 p.m.

CARRIED

The meeting adjourned at 5:17 pm.