September 2022 Board of Health Meeting - Minutes

1. Call to Order

   Vice-Chair, Rino Bortolin, acting as Chair in G. McNamara’s absence, called the Regular meeting to order at  4:02 p.m.

2. Agenda Approval
   Motion: That the agenda be approved.
   CARRIED
3. Announcement of Conflict of interest – None
4. COVID-19 Update (Dr. S. Nesathurai)

   Dr. Nesathurai said we have to normalize our life with COVID. However, that does not mean we should normalize COVID’s impact or its burden. There have been 663 deaths in Windsor-Essex County since the beginning of the pandemic. In the past week there have been six deaths. Of those six deaths, four people had been living in the community. COVID affects those in long-term care homes and retirement homes but deaths do occur in those living in the community. There is now a Bivalent vaccine available for the highest risk populations. As the weeks progress the Bivalent vaccine will be available for everyone who wants the vaccine. 
   At the current time, there are 250k people who are eligible for the vaccine who have not been vaccinated. About 16% of people are up to date on their vaccines. Dr. Nesathurai said it is important for those eligible for vaccination to get up to date on their vaccines. When vaccinated people are less likely to be ill, pass away, or be hospitalized.
   Dr. Nesathurai said that there are multiple distribution channels for the vaccine and those distribution channels are pharmacies, physician offices, clinics, and the public health service. Up to this point in the pandemic 64% of vaccinations had been completed by the public health service. This is not sustainable due to competing priorities. It is important that physician offices and pharmacies and other additional distribution channels to assist with vaccination. 

   Dr. Nesathurai said that vaccines are probably one of the most effective treatments we have in medicine and are particularly effective in public health practice. In Ontario there is a very progressive piece of legislation called the Immunization of School Pupils Act (ISPA) and it provides the framework in which we can ensure that young people are vaccinated. It is a vaccine verification process which results in people becoming up to date in vaccines. This year there were 19k young people in grades 10 through 12 that needed to get up to date on vaccination; 18k have done so. The benefit for these young people once they leave high school they will be up to date on their vaccines and the vaccine verification process highlights the fact that there are some vaccines that are not part of ISPA but people do have an opportunity to receive those vaccines as well. This is a benefit for the public health service, the Board of Health, and for the community overall.

   Motion: That the information be received.
   CARRIED

5. Approval of Minutes
   1. Regular Board Meeting:  August 11, 2022
      Motion: That the minutes be approved. 
      CARRIED
6. Business Arising

   1. Charitable Status (L. Gregg)
      L. Gregg said as a follow up to the question asked of administration in July 2022 in regards to applying for charitable status and the report brought forward at that time; administration investigated the number of public health unit’s in Ontario that had charitable status. Of the 34 public health unit’s in Ontario there are 10 that are registered as charities – all of which had effective dates for charitable status prior to 2012. In 2012, there were amendments to the income tax act that allowed municipalities and municipal and public bodies performing the function of government in Canada to apply for what is called the qualified Donee status. The status is effectively similar to a charible status. Donee status allows an organization to issue official donation receipts for gifts it receives from individuals and corporations and the ability to apply for rebates and access grant opportunities. Of the 34 Public Health Units in Ontario there is one Public Health Unit that has Donee status and that is Southwest Public Health Unit. The WECHU reviewed other local entities to find out if there were any other qualified Donee status organizations. The City of Windsor, County of Essex, Townships of Essex, LaSalle, Leamington, Lakeshore, Tecumseh, Amherstburg, Pelee, Caldwell First Nation, the Windsor-Essex Community Housing Corporation, and the John McGivney Children’s Centre School Authority all have Donee status. As a result, the WECHU has drafted a letter to the Canada Revenue Agency to apply for Donee status as well.
      That the information be received.
      CARRIED

   2. Board of Health By-Laws (First Reading) and Policies (N. Dupuis/L. Gregg)
      N. Dupuis said that Board of Health by-Laws have been brought forward since April of 2022. These are the remainder of the outstanding by-laws. The format of the by-laws have been changed as per the direction received by the Board of Health early on. Previously, the by-laws were about 170 pages in length. The new format breaks the by-laws down into four (Governance, Finance, Human Resources, and Management of Real Property). Items that were procedural in nature have been moved to Board Policies and are also included for review and approval. All of these by-laws have been reviewed by WECHU’s legal council. The by-laws presented to the Board of Health today are merely the first reading. These by-laws would then be brought forward again in October for a second reading as per the current bylaws. This will provide the Board of Health with time to read the by-laws and report their feedback or any changes. Final approval of the by-laws is expected at the November Board of Health meeting. By-laws are to be reviewed by the Board of Health very 2 years. However, policies will be reviewed annually or as indicated (i.e. Whistleblowing).
       
      M. Ferrari said that normally when there is something that is this large that is undertaken on behalf of the Board of Health there is an ad-hoc committee or a standing committee on policy governance that handles the creation and monitors the fielding of governance related questions as part of the process. Has this Board of Health ever considered striking a policy governance committee and would that be helpful for the Board of Health to have more involvement?

      R. Bortolin said there has not been a policy governance committee in his time but it is a good suggestion. He noted that administration may be able to identify how the process was done in the past. 

      N. Dupuis said the by-laws have not been reviewed by a committee in her time at WECHU. The Board of Health by-laws have not been reviewed since 2017. The current by-laws were developed by WECHU legal council. Sections of the bylaw were brought to JBEC for review and discussion at meetings for over a year. Once completed they were brought to the full board for review and approval. N. Dupuis noted she cannot speak to processes prior to that time. This time administration identified the bylaws required updating and review and suggested an alternate format for the bylaws. Direction was given for administration to take on the task with legal counsel and bring to the board for review. 

      R. Bortolin suggested that a policy governance committee be struck after the local election has taken place. There will be new members assigned to the Board of Health at that time.

      M. Ferrari said that if a policy governance committee is developed is should happen before the next election term.  

      T. Bailey said that she would be willing to wait until the election is over in November to develop a policy governance committee. T. Bailey suggested having a report that comes back to the Board of Health that guides the new policy governance committee.

      Motion: To request a report from WECHU administration outlining what has been past practice and how to develop a Policy Governance Committee going forward that would begin at the start of the next term of the Board of Health committee after the fall election.
      CARRIED

      R. Bortolin said that the by-laws brought forward today will proceed once approved by the Board of Health. However, the motion to develop a Policy Governance committee will be for by-laws and other associated needs moving forward via the Board of Health.

      1. Public Attendance and Delegations at Board of Health Meetings

      2. Delegation of Duties
         N. Dupuis said there was no policy related to this item nor was it referenced in the previous by–laws. Any gaps for this item were corrected by borrowing language from other health units.

      3. Performance of Medical Officer of Health and Chief Executive Officer

      4. By-Law No. 1 – Governance

      5. By-Law No. 2 – Finance

      6. By-Law No. 3 – Human Resources

      7. By-Law No. 4 – Management of Real Property
         The Board of Health By-Laws will be brought back to the October 20, 2022 Board meeting for a second reading.  

         Motion: That the information be received. 
         CARRIED

7. Consent Agenda
   1. INFORMATION REPORTS
      1. Q2 Financial Report (L. Gregg)
      2. Windsor-Essex Health Status Indicator (WE-HSI) Dashboard (N. Dupuis/R. D’Souza)
      3. 2022 Board of Health Competency and Self-Assessment Report (N. Dupuis/M. Frey)
      4. WECHU Strategic Plan – 2022-2025 (N. Dupuis/M. Frey)
      5. Communications Report (July-September 2022) (E. Nadalin)

         Motion: That the information be received.  
         CARRIED

   2. CORRESPONDENCE
      1. Chatham-Kent Public Health – Letter to Hon. Doug Ford, Premier of Ontario – Support for alPHa Resolution A22-4 and Appendix A – that the drug poisoning crisis in Ontario be declared an emergency under the Emergency Management and Civil Protection Act, (RSO 1990) – For Support
      2. Sudbury & Districts Public Health – Letter to Ministry of Children, Community and Social Services – Healthy Babies Healthy Children Funding – For Support
      3. Niagara Board of Health – Letter to Hon. Dominic Leblanc, Minister of Intergovernmental Affairs, Infrastructure and Communities – Improving Air Quality to Sustainably prevent COVID-19 – For Information

         Motion: That the information be received.  
         CARRIED

8. Resolutions/Recommendation Reports

   1. Renewed Strategic Plan (N. Dupuis)
      N. Dupuis introduced Marc Frey, Manager of Planning & Strategic Initiatives, to present the Renewed Strategic Plan – See 9.4

      Motion: That the Renewed Strategic Plan be approved.
      CARRIED

   2. Signing Authority (L. Gregg)
      Motion: That the Signing Authority be approved
      CARRIED

9. New Business

   1. Bivalent Vaccine Update (K. McBeth)
      K. McBeth said doses of the Bivalent Moderna vaccine is available in Windsor-Essex County. The vaccine is available to six priority groups which include health care workers, indigenous community, immunocompromised individuals age 12+, long-term care home and retirement residents, staff, and one essential caregiver, pregnant individuals, and those aged 70+.

      Anyone is eligible to receive the Bivalent vaccine as long as they have had the primary series.  A minimum of 3 months since the last dose with a recommendation of six months is required for eligibility.

      K. McBeth said that currently there is a limited supply of the Bivalent vaccine and the focus is the high risk congregate living facilities. Mobile teams have been focused on these types of facilities (shelters, supporting housing, etc.).

      Starting the week of September 26th the province is expected to open up eligibility for the Bivalent vaccine to everyone in Ontario 18+. The same minimum and recommended time frame applies to this group as well.

      An updated vaccine recommendation statement for those 6 months to 5 years of age is expected soon for the newly approved infant pediatric Pfizer vaccine which will be arriving to the community next week.

      K. McBeth said there are 20 pharmacies in Windsor-Essex County that have received the Bivalent vaccine and they are also administering it to priority groups. WECHU is supporting any access to primary care that are interested in vaccinating clients from the priority groups for the next few weeks.

      K. McBeth said there has been a delay in the Pfizer Bivalent approval. Therefore, the Moderna Bivalent vaccine will be the vaccine with the most ready access at this time.

      Motion: That the information be received
      CARRIED

   2. WE-HSI Dashboard – Presentation (R. D’Souza)
      N. Dupuis introduced Ramsey D’Souza, Manger of Epidemiology and Evaluation, to present the Windsor-Essex Health Status Indicator (WE-HSI) Dashboards. 

      R. D’Souza said WECHU embarked on an ambitious journey to reimagine how we would conduct our public health surveillance at WECHU. 

      Prior to the pandemic WECHU developed large scale reports such as the Community Needs Assessment and Oral Health Report. These reports were well developed but also time consuming.
      From conceptualization to the final product it could take 3-6 months on the topic area and sometimes up to 1 year. 

      Pandemic Challenges & Solutions
      Challenges
          - Population Health Assessment and Surveillance focus shifted to COVID-19 for 2.5 years
          - Need for timely data for evidence-informed decision-making for COVID-19

      Solutions
          - Development of interactive data visualization tools (dashboards)

      From Static to Routine Interactive Reporting
          - Build interactive dashboards by topic
          - Users can engage with the data
          - Routinely updated as newer data becomes available
            - Transition from 5-year to yearly (or as data is available) updates
          - Allows WECHU to be proactive and identify newer data sources
            - Similarly, identify gaps for primary data collection    

      R. D’Souza presented a demonstration of the live WE-HIS webpage on www.wechu.org.

      WE-HSI Next Steps
          - Develop 2021 Census dashboard by municipality
          - Connect with community partners for data sharing and developing a centralized health data portal
          - Conduct primary data collection to address data gaps (e.g. child and youth data, mental health, etc.)
          - Develop a health neighbourhood dashboard
            - Key population health indicators by smaller geographical areas
            - Will allow for targeted approaches for health interventions and programming.
          
          N. Dupuis said that R. D’Souza will also be presenting the WE-HSI dashboard to the OHT partnership table.
          
      Motion: That the information be received
      CARRIED

   3. 2022 Board of Health Competency Self-Assessment (M. Frey)
      M. Frey said the purpose of the Board of Health Competency Self-Assessment is to find areas of strength within the Board of Health that can be leveraged for future actions. The self-assessment also helps identify potential training opportunities for the Board of Health and whether the Board of Health perceives themselves as improving over time. This self-assessment is also a requirement of the Ontario Public Health Standards. The self-assessment consists of a series of questions dived up into 12 competencies. These competencies were identified and the questions were developed based on the Ontario Public Health Standards, Board of Health bylaws, and the alPHa Board of Health governance toolkit. Leadership and Governance was recognized as the greatest strength. Most of the scores fall under the satisfactory range. There were two competency scores that scored below satisfactory – Health Equity and Knowledge & Delivery of Public Health Programs/Services. 

      M. Frey said that questions about Board of Health Operations all scored similar – Agree or Strongly Agree. Scoring varied under – I feel the makeup of our board is reflective of the diversity of the Windsor-Essex community. There is disagreement regarding this question and the Board of Health composition meeting this requirement. 

      Overall recommendations included:
          - Providing training and education to the Board of Health, beginning in the areas with the lowest scores
          - Return to in-person Board of Health meetings when practical
          - Consideration of Board of Health diversity should be given when selecting or appointing new Board of Health members

      M. Ferrari said that it will be important for the Board of Health to complete this competency self-assessment again once new board members are appointed after the election.

      Motion: That the 2022 Board of Health Competency Self-Assessment be received.
      CARRIED

   4. Strategic Plan – Presentation (N. Dupuis)
      N. Dupuis introduced Marc Frey, Manager of Planning & Strategic Initiatives, to present the Renewed Strategic Plan. 

      M. Frey said that WECHU is required to by the Ontario Public Health Standards to produce and maintain a strategic plan. The current plan under review was developed to address the post pandemic challenges and opportunities. The lifespan of this plan is from 2022-2025. This timeframe was selected to address the acute need to have a plan in place post-pandemic. This timeframe also provides leeway to develop a longer term plan in the future. This plan included a lot of consideration from the previous strategic plan.

      The development process included interviews with the Board of Health and the Leadership Team, a survey conducted with local partner groups (N=37), 2-day Board of Health meeting to develop plan characteristics, a review and discussion period with the WECHU management team, an all staff survey (N=104), and lastly a survey issued to the Board of Health. The feedback received from the survey was incorporated into the strategic plan.
       
      Key highlights of the renewed strategic plan include:
          - Vision: Healthy people in a healthy community
          - Mission: The WECHU promotes, protects, and improves health and well-being for all people in our community
          - Values: Accountability, Empowerment, Leadership, Collaboration, and Equity
          - Priorities: Partnerships, Organizational Development, and Effective Public Health Practice

      This information will be published on www.wechu.org following this meeting. 

      J. Lund said in the strategic plan equity is references as one of the values. J. Lund said unless we are proactive in the area of diversity and inclusion the Board of Health needs to review how the BOH is assembled. 

      N. Dupuis said the current by-laws do allow for some consideration for outside members, not provincial appointees or elected officials appointed to the BOH. This could include indigenous representation or representation from other communities.

      Motion: That the Renewed Strategic Plan be approved.
      CARRIED

10. Committee of the Whole (CLOSED SESSION, in accordance with Section 239 of the Municipal Act)
    The Board moved into Committee of the Whole at 5:17 pm
    The Board moved out of Committee of the Whole at 5:43 pm
11. Next Meeting: At the Call of the Chair, Thursday, October 20, 2022 – Via Video
12. Adjournment
    Motion:  That the meeting be adjourned.   
    CARRIED

     

    The meeting adjourned at 5:47 pm.

RECORDING SECRETARY: K. Farrugia