September 2020 Board Meeting - Minutes

1. Call to Order
   Board Chair, Gary McNamara, called the meeting to order at 4:10 p.m.
2. Agenda Approval
   Moved by: Judy Lund
   Seconded by: Rino Bortolin
   That the agenda be approved.
   CARRIED
3. Announcement of Conflicts of Interest – None
4. Update (Dr. W. Ahmed)
   1. COVID-19 Update

      Dr. W. Ahmed provided an update on the status of COVID-19 cases in our region, along with a presentation around the numbers and the increase of cases in the province. Graphs in the presentation show the overall rates, spikes in cases according to age and municipality, how the virus is being transmitted, and capacity in the health care system should we see a surge of cases requiring hospitalization. Our case fatality rate is at 3.0%, which is lower than the provincial average. Approximately 5,000 to 6,000 tests are being conducted weekly across our region, and positive case rates remain relatively low while the GTA and Ottawa regions are spiking.

      One student in a local school tested positive and their cohort was also advised to isolate for 14 days. Our data shows a spike in cases in the 0-19 age group over the last two weeks, and we take this information seriously with our messaging to the various school boards.

      The region seems to be moving in a stable direction in the Agri-sector. Positive cases amongst farm workers are low with some occasional travel related cases after arriving in Canada.

      G. McNamara said that the WECHU Epidemiology Department has done excellent work on the graphing and mapping. The recent roadmap created around the cluster of cases that happened recently was interesting to see, and shows how quickly the virus can spread. The province was impressed at how quickly we addressed the cluster by finding its origins and roots. Information like this is critically important to show residents how quickly the virus can easily get out of control by not following public health measures.

      Moved by: Fabio Costante
      Seconded by: John Scott
      That the information be received.
      CARRIED

5. Approval of Minutes
   1. Regular Board Meeting: July 16, 2020
      J. Lund noted that Beach Testing (water sampling) was discussed at the July 16, 2020 Board meeting and that the WECHU was one of the only health units that still conducts the testing. She asked how other health units do beach testing. Dr. Ahmed said that water testing is done by their municipalities or contracted out to a third party.
      Moved by: Judy Lund
      Seconded by: Fabio Costante
      That the minutes be approved.
      CARRIED
6. Business Arising
   1. School-focused Nursing Recruitment (D. Sibley)
      D. Sibley said that 18 of the 19 school nursing positions have been filled. Ten internal WECHU staff on lay off filled some of these positions and 8 new staff have been hired over the last couple of weeks. We are recruiting for 1 French speaking position. We have redeployed existing WECHU staff to be ready for the school year and all of these positions should be filled within the next two weeks.
      Moved by: Debbie Kane
      Seconded by: John Scott
      That the information be received.
      CARRIED
   2. Consumption and Treatment Services (CTS) Site Update (Addition to Agenda) R. Bortolin

      T. Marentette said that the health unit continues to work with a dedicated stakeholder group on the application submission for a CTS site in Windsor. The work was delayed for several months due to the pandemic and we recently moved forward around a site location, which is required prior to submitting the application. Criteria for the site was based on requirements in both Health Canada’s and the Ministry of Health’s applications.

      A Request for Expression of Interest (EOI) for interested landlords or property owners for a proposed site went out in August 2020. There was no interest. We reposted the information to the same website, did a media release and extended the timeline to September 4, 2020 and the process still did not generate any interest.

      We have reached out to our legal advisors for guidance on next steps and will reconvene our stakeholder group to determine how to proceed. Steps following the site selection would include a CPTED (Crime Prevention Through Environmental Design) audit on the site, a site inspection and a brief assessment. Consultations with the public would follow with extensive community engagement along with our Board of Health and the municipality of the site location.

      R. Bortolin asked if one submission was received, and the size and technical specifications are reached, would we go that route and what level of consideration is given to those items. T. Marentette said that there is criteria that must be met and we would work with our Environmental Health Department and Windsor Police Services, i.e. acceptable site, meeting mandatory requirements from Health Canada and the Ministry of Health, distancing from sensitive areas, etc., and it would be brought to the Stakeholder Advisory Committee.

      R. Bortolin asked about the public consultation phase and what that would look like when we are at the point of Board of Health approval of the potential site. He has received many questions from residents in his ward about the CTS site being located in the downtown Windsor core. T. Marentette advised that public consultations would occur prior to going to our Board or the municipality for site confirmation and approval. We were hoping to have 2 or 3 sites with extensive community consultation, and feedback, before moving forward. The public would have a say and will have the opportunity to voice their concerns prior to the site being confirmed.

      The process is presenting the sites that meet the criteria as well as meeting the needs of the people who would use the service. With the pandemic, there will be no gatherings in person. We will need to conduct consultations through surveys and virtual discussions, and there was talk of having a virtual Town Hall. All residents in the municipality can participate in the process, not just residents or businesses in that location.

      R. Bortolin said if the process goes through public consultation and is presented to our Board of Health and the municipality, does the municipality have the power to veto, or is it presented to the municipality simply for endorsement.

      T. Marentette noted that under the Health Promotion and Protection Act, (HPPA) the municipality must approve the site. R. Bortolin said that it would likely be through a Motion to the particular municipality’s council.

      R. Bortolin asked if WECHU has considered how many meetings should take place, that they are well publicized and that there are enough people on the calls to hear from residents instead of it being a one-way virtual meeting. T. Marentette said that this was all considered in the planning, we have people dedicated to the process, GANTT charts for timelines and that we recognize the need to make sure it is inclusive of everyone who wants to have a voice.

      R. Bortolin said that since there has been no interest from the EOI has there been any discussion around conversations with municipalities, other agencies or potential partners for space.

      T. Marentette advised that we have consulted with our legal advisors on this to make sure the process is transparent and adheres to any public protocol or disclosure and, based on feedback, we will reconvene the stakeholder group, and expect that the next step is to reach out to potential partners.

7. Consent Agenda
   1. INFORMATION REPORTS
      1. July and August Communications Recap (L. Gregg)
         Brought to the Board for information.
         Moved by: Rino Bortolin
         Seconded by: Judy Lund
         That the information reports be received.
         CARRIED
   2. RECOMMENDATION REPORTS – None
8. Board Correspondence – None
9. New Business
   1. WECHU 2020-21 Public Health Funding (T. Marentette/L. Gregg)

      T. Marentette said that the WECHU received its Public Health Funding and Accountability Agreement for the 2020-2021 funding year on August 21, 2020 which provided our approved base and one-time funding. This includes the changes to the provincial/municipal cost-sharing agreement effective January 1, 2020, one-time mitigation funding and funding for public health programs and services.

      An overview of other one-time funding approvals include:

      • Public Health Inspector Practicum Program (one student) – $10,000
      • Seasonal Farm Contract Tracing under our TB Program – included on-site contact tracing, TB screening, translations services, salaries and mileage – $4,400
      • Vector-Borne Disease Program – this funding initiative is used to support staffing, mileage surveillance activities and an awareness campaign for enhanced surveillance for mosquitos – $40,000
      • Pandemic Pay for eligible nursing staff – this initiative provided additional support for eligible Board of Health employees dependent upon responsibilities for the period April 24, 2020 to August 13, 2020. Total funding received for our health unit was $161,700.

      In addition, an amended agreement was received by the Ministry related to the following:

      • School-focused nurses (19 in total) to support the reopening of schools (August 1, 2020 to March 31, 2021 and April 2021 to March 31, 2022)
      • Funding to support the new public health Case and Contact Management solution (CCM)

      Board of Health member L. Snively left the meeting at 4:59 pm

      L. Gregg advised that on August 21, 2020 the Ministry of Health issued WECHU’s 2020 Budget Approval. Total funding allocation is as follows:

      • $15,981,600 in base funding for the Mandatory programs – funded at a rate of 70% Ministry of Health and 30% Obligated Municipalities
      • $1,674,700 in base funding for the Ontario Seniors Dental Care Program funded 100% by the Ministry of Health

      The Ministry of Health approved mitigation funding of $1,260,800 to be used to offset the increased public health program costs to municipalities as a result of cost-sharing change from what was 75/25 to 70/30. An allotment of mitigation funding was approved for the period January 1, 2020 to December 31, 2020 and a second allotment in the same amount was approved for January 1, 2021 to December 31, 2021.

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

   2. Extraordinary Cost Reimbursement Process (L. Gregg)

      L. Gregg advised that on August 21, 2020 the Ministry of Health initiated a process for public health units to request reimbursements of one-time extraordinary expenses related to COVID-19. The deadline for this submission is September 18, 2020 for the timeframe of January 1, 2020 to December 31, 2020 and includes actual and forecasted costs. As with all submissions to the Ministry, it is subject to review and some expenditures may not be admissible. It is our understanding that additional requests for reimbursement may be available at a later date.

      Total forecasted salaries and benefits related to COVID-19 for calendar 2020 are $10,728,391. This excludes the School Nurse initiative, which will be funded through separate approval. R. Bortolin noted that many WECHU staff are unionized and eligible for overtime. He asked if this amount takes into account a provision for the WECHU Leadership Team who have been unable to take vacation or time off due to the workload with the pandemic. Their working ratio is likely 15%-30% higher than what they are receiving in salaries.

      L. Gregg advised there was a provision for vacations not taken by the WECHU Leadership Team but there was no augment in the number of hours the team has worked, and continues to work, in this analysis. The provision just includes their base salaries. There was a line-by-line analysis for all staff so there was a detailed review.

      R. Bortolin asked if WECHU should increase the ask in the submission to the Ministry to help cover compensation to the WECHU Leadership Team for unused vacations.

      T. Marentette said that there was no provision for compensation for the Leadership Team during the pandemic and if it is deemed not admissible by the Ministry it would likely fall on the municipalities and is included in this ask. R. Bortolin asked if WECHU can balance its budget for 2020 if the submission was approved. T. Marentette said that close to $3M has been submitted and if that is received from the Ministry than WECHU should be able to balance its budget. To our understanding, the province is not saying this is a 70/30 split.

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

   3. Request from Ontario Health Team (W. Ahmed)

      Dr. W. Ahmed said that many Board of Health members are aware that the province, through Ontario Health, is creating Ontario Health Teams (OHT) to provide patient centered care in various regions of the province. OHTs are groups of health care providers and organizations that are clinically and fiscally accountable for delivering a full and coordinated continuum of care to a defined geographic population.

      The expectation is that the OHTs will enable patients, families, community agencies and healthcare providers to work together in a new way. Over time, it is expected that OHTs will develop innovative and locally driven solutions to meet the healthcare needs of their defined geographic population and will be accountable for the health outcomes and healthcare costs of that population.

      OHTs are being introduced to provide a new way of organizing and delivering care that is more connected to patients in their local communities. Under OHTs, health care providers (including hospitals, doctors and home and community care providers) work as one coordinated team. Public Health supported the local collaborative work to create a Windsor-Essex Ontario Health Team. The next stage of the OHTs development is a full application, which is currently being submitted.

      In the application, the OHT has to identify a priority population and the group decided to work with individuals with chronic diseases living in a congregate settings. There are 155 congregate living setting in our region and the team is planning to prioritize them based on the risk to these settings. For example, using EMS data to identify top 10 congregate living facilities in our region that receive the bulk of calls in the past 12 months.

      The OHT is leveraging on the existing relationship and partnership developed for COVID response in the region.

      The Windsor Essex OHT is comprised of over 45 local healthcare program and services providers including the three hospitals, primary care and community support providers, public health, municipalities, mental health and addictions agencies, Long-term care, and others social service providers in Windsor Essex.

      The Windsor Essex OHT is requesting their partner agencies submit a letter of support along with a sign off from their Board. WECHU is in support of the Windsor Essex OHT but we also recognize that the public governance and accountability are very different. We are governed under the HPPA and are accountable to our Board of Health.

      We are recommending that the WECHU submit a letter of support from the Medical Officer of Health and the CEO that we will continue to support and collaborate with the OHT. Due to our mandate and accountability, we do not believe that we require a formal board sign off and are looking to the Board for direction and support.

      Moved by: Tracey Bailey
      Supported: Rino Bortolin
      That the WECHU Medical Officer of Health and CEO submit a Letter of Support to continue to support and collaborate with the OHT and that formal Board of Health sign off is not required.
      CARRIED

10. Other Board of Health Resolutions/Letters

    Moved by: Rino Bortolin
    Seconded by: John Scott
    That the information be received.
    CARRIED

    1. Simcoe-Muskoka District Health Unit – Letter to Honourable Christine Elliott – urging the immediate provision of the funding allocations to local boards of health regarding the COVID-19 Extraordinary Expenses and for the School-Focused Nurses in order to enable a response by local public health units that is unobstructed by local financial shortfalls – For information
    2. WECHU Response to Town of Kingsville, Town of Essex and Town of Amherstburg – Response to their request for more detailed information and data regarding the spread of COVID-19 in Essex County – For information
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 5:14 pm
    The Board moved out of Committee of the Whole at 5:20 pm
12. Next Meeting: At the Call of the Chair, or October 15, 2020 – Via Video
13. Adjournment
    Moved by: Rino Bortolin
    Seconded by: Tracey Bailey
    That the meeting be adjourned.
    CARRIED

The meeting adjourned at 5:21 pm.