Board of Health Meeting Documents

Meeting held via video.

SUBMITTED BY

Marc Frey, Manager, Planning and Strategic Initiatives Department

DATE

March 18, 2021

SUBJECT

Risk Management

BACKGROUND

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

CURRENT INITIATIVES:

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

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

RISK REPORTING

1: Funding

Description

CAUSE: Funding uncertainties.

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

CONSEQUENCES:

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

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

Key Risk Mitigations

CONTROL STRATEGY:

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

ACTION REQUIRED:

1. Evaluation of budget (process and quality)

2: Health System Transformation

Description

CAUSE: Ministry mandated public health system changes.

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

CONSEQUENCES:

1. Inability to meet the requirements of the Ontario Public Health Standards
2. Hampered ability to effectively respond to COVID-19 requirements/expectations
3. Confusion of purpose
4. Confusion within partnerships and working relationships
5. The organization’s reputation is at risk

• CATEGORY: Governance / Organizational
• IMPACT: 5
• LIKELIHOOD: 4
• OVERALL RATING: 20 - High

Key Risk Mitigations

CONTROL STRATEGY:

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

ACTION REQUIRED:

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

3: Disasters/Hazards

Description

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

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

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

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

Key Risk Mitigations

CONTROL STRATEGY:

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

ACTION REQUIRED:

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

4: Planning Information and Evaluation

Description

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

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

CONSEQUENCES:

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

• CATEGORY: Information/Knowledge
• IMPACT: 4
• LIKELIHOOD: 5
• OVERALL RATING: 20 - High

Key Risk Mitigations

CONTROL STRATEGY:

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

ACTION REQUIRED:

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

5: Work Stoppage

Description

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

EVENT: An extended work stoppage involving internal labour groups.

CONSEQUENCES:

1. Service delivery to residents of Windsor-Essex County is negatively impacted
2. Delivery of goods and services is impeded
3. The organization’s reputation is at risk

• CATEGORY: People/Human resources
• IMPACT: 4
• LIKELIHOOD: 3
• OVERALL RATING: 12 - High

Key Risk Mitigations

CONTROL STRATEGY:

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

ACTION REQUIRED:

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

6: Strategic Priorities

Description

CAUSE: External pressures and resource uncertainty.

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

CONSEQUENCES:

1. The organization’s reputation is at risk
2. Service delivery to residents of Windsor - Essex County is negatively impacted
3. Inability to meet the requirements of the Ontario Public Health Standards (2018)

• CATEGORY: Strategic/Policy
• IMPACT: 3
• LIKELIHOOD: 5
• OVERALL RATING: 15 - High

Key Risk Mitigations

CONTROL STRATEGY:

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

ACTION REQUIRED:

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

7: Privacy Breach

Description

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

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

CONSEQUENCES:

1. Risk of litigation and related financial consequences
2. The organization’s representation is at risk
3. Non-compliance with data sharing agreements

• CATEGORY: Privacy
• IMPACT: 4
• LIKELIHOOD: 4
• OVERALL RATING: 16 - High

Key Risk Mitigations

CONTROL STRATEGY:

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

ACTION REQUIRED:

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

8: Local Health Disparities

Description

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

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

CONSEQUENCES:

1. Inability to meet the requirements of the Ontario Public Health Standards
2. Increased health disparity among local priority populations
3. Increased burden of illness and poorer local health outcomes
4. Decreased credibility/influence with local priority population groups
5. The organization’s reputation is at risk

• CATEGORY: Equity
• IMPACT: 4
• LIKELIHOOD: 4
• OVERALL RATING: 16 - High

Key Risk Mitigations

CONTROL STRATEGY:

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

ACTION REQUIRED:

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

9: Program/Service Implementation

Description

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

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

CONSEQUENCES:

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

• CATEGORY: Operational/Service Delivery
• IMPACT: 4
• LIKELIHOOD: 4
• OVERALL RATING: 16 - High

Key Risk Mitigations

CONTROL STRATEGY:

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

ACTION REQUIRED:

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

MOH Risk Category:

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

SUBMITTED BY

Nicole Dupuis, Director of Health Promotion

DATE

March 18, 2021

SUBJECT

Ontario Active School Travel Fund Awarded to Windsor-Essex County 

BACKGROUND

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

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

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

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

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

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

CURRENT INITIATIVES:

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

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

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

SUBMITTED BY

Communications Department

DATE

March 18, 2021

SUBJECT

February 2021 - Communications Update

February Metrics

Media Monitoring Highlights

Trending Themes

Top Sources

Media Participating in Teleconference for YouTube Live

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

Current Notable Projects

• Developing weekly communication plans for ongoing vaccine rollout in the region.
• We continue to make improvements to our daily COVID-19 public health updates for the community.

• Regular communication with the Ministry of Health about provincial initiatives and their planned launch dates.

Data Notes:

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

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

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

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

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

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

7. Social media metrics are provided through Hootsuite.

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

SUBMITTED BY

Communications Department

DATE

March 18, 2021

SUBJECT

January 2021 - Communications Update

January Metrics

Media Monitoring Highlights

Media Participating in Teleconference for YouTube Live

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

Current Notable Projects

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

Data Notes:

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

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

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

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

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

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

7. Social media metrics are provided through Hootsuite.

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

Board Members Present:

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

Administration Present:

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

Administration Regrets:

Dr. Wajid Ahmed

QUORUM:  Confirmed

RECORDING SECRETARY:

SUBMITTED BY:

APPROVED BY:

Meeting held via video.

DATE

January 21, 2021

SUBJECT

Mosquito Surveillance and Control Program 2020

BACKGROUND

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

Mosquito Surveillance and Testing

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

During this year’s season:

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

Mosquito Control

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

Human Cases

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

Education and Awareness Raising Activities

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

CURRENT INITIATIVES

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

DATE

January, 2021

SUBJECT

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

BACKGROUND - The First Responder Mental Health Coalition (FRMHC)

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

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

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

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

THE FIRST RESPONDER CURRICULUM PROJECT

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

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

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

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

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

Current Initiatives

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

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

Board Members Present:

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

Board Member Regrets:

Administration Present:

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

QUORUM:  Confirmed

RECORDING SECRETARY:

SUBMITTED BY:

APPROVED BY:

Meeting held via video.

DATE

December 17, 2020

SUBJECT

Influenza Vaccine Update

BACKGROUND

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

SUMMARY OF VACCINE ALLOCATION & DISTRIBUTION

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

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

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

HIGH DOSE -TIV

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

ADVERSE EVENTS FOLLOWING IMMUNIZATION

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

CURRENT INITIATIVES

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

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

PREPARED BY

Lorie Gregg, Director of Corporate Services

DATE

December 17, 2020

SUBJECT

Q2 Financial Results

BACKGROUND

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

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

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

Of noteworthy mention is the following:

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

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

HEALTHY BABIES HEALTHY CHILDREN PROGRAM INITIATIVE

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

PRENATAL AND POSTNAL NURSE PRACTITIONER PROGRAM INITIATIVE

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

DATE

December 17, 2020

SUBJECT

Oral Health Program Update

BACKGROUND

The novel Coronavirus (COVID-19) has affected many public health services, including the WECHU’s oral health program. Those services include the Healthy Smiles Ontario (HSO) and the Ontario Seniors Dental Care Program (OSDCP) dental clinics, as well as in-school dental and vision screening programs.

ORAL HEALTH

Following guidance from the Royal College of Dental Surgeons of Ontario (RCDSO) and the Ministry of Health, the WECHU suspended all non-essential and elective dental services on Monday, March 16, 2020 and redeployed oral health staff to the COVID-19 response.  Dental screenings in schools were suspended and the clinic remained open in Windsor for emergency services only until June 22, providing 79 office visits from March.

Due to the shutdown, 2,377 OSDCP and HSO appointments had to be cancelled. Following the health care sector restart guidance from the Ministry of Health, the Windsor clinic resumed full operations at the end of June, while the reopening of the Leamington clinic was gradual and operational at the end of August. All oral health staff have returned to the department, while continuing to support the COVID-19 call centre as part of their regular duties. As of November 26, 2020, 93% of the 2,377 appointments have been contacted and rescheduled.

All dental screening and vision screening programs have been suspended at this time.

In the 2019/20 school year:

• 73 schools of the 123 schools required for dental screening were completed
• 8,300 children screened, approximately 6,673 children were un-screened under the oral health screening program
• 2,840 (68%) of SK students attending 78 Windsor-Essex elementary schools received vision screening. 35 schools were not completed.

CURRENT INITIATIVES

COVID-19 has affected many public health programs and services, including future program operations. In addition, infection prevention and control measures call for limiting the number of essential visitors in the school. As a result, school dental and vision screening may not resume in 2020-2021.

The WECHU has partnered with the Southwest Ontario Aboriginal Health Access Centre (SOAHAC) to provide free oral health screenings for First Nation, Métis, and Inuit (FNMI) people and their families. A Registered Dental Hygienist (RDH) from the WECHU works at the SOAHAC Windsor location bi-weekly, providing dental screenings and oral hygiene instruction to their clients. This service had been shut down due to COVID-19 but was reinstated on November 23, 2020.

ORAL HEALTH PROGRAMS

Baby Oral Health Program (BOHP)

Parents of babies born at Windsor Regional Hospital usually receive an infant dental education kit. Despite being put on hold due to COVID-19, this service resumed in July. So far this year, 1,802 bags were delivered to the hospital for distribution.

WECHU Healthy Smiles Ontario and Ontario Seniors Dental Care Plan

We have a high patient volume and due to reduced clinical services for four months, we have experienced a slight backlog in treatment. Approximately 40-45 HSO and OSDCP clients are seen daily across the two clinic locations. We are currently booking into March 2021 for certain dental procedures. From January 2020 to November 2020 the WECHU saw 2,386 HSO and OSDCP clients for 4,528 appointments.

The OSDCP began at the WECHU in January 2020, providing free, routine dental services for low-income seniors 65 years of age or older. Since the program’s provincial implementation in November 2019, 1,002 seniors from the Windsor-Essex area enrolled in the program. Each client requires a new patient exam. To date we have completed 405 new patient exams therefore, we can determine that we have seen 40% of the seniors that have enrolled into the OSDCP program in this region. Our contract denturist has completed 88 denture consultations.

Currently, we have one full-time dentist, four contract dentists and a contract denturist. We plan to bring on a second full-time dentist in 2021.

DATE

December 17, 2020

SUBJECT

Healthy Families Department and Healthy Babies, Healthy Children Program Update

BACKGROUND

Healthy Babies, Healthy Children Program (HBHC) is a provincial home visiting program designed to help children get a healthy start in life through nursing and peer support. The program supports the most vulnerable and marginalized families in our community with the goal of improving developmental outcomes. HBHC has three entry stages namely; Prenatal; Postpartum; and Early Identification; and requires screening to identify a family at risk (screen score 2 or >). The HBHC screen identifies a family experiencing a need, issue or risk that may compromise healthy child development; and/or parenting ability; and who may benefit from a more thorough evaluation and receipt of HBHC program services or other community services. HBHC staff utilize standardized assessments and evidence-based interventions to work on family centred goals and develop a Family Service Plan that monitors the progress and achievement of those goals. HBHC is a free voluntary home-visiting program compromised in WECHU of 16 nurses, 4 Family Home Visitors (lay providers) and Social Workers (SW) that support families with:

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

PROGRAM UPDATE

As a result of COVID-19, pandemic-related redeployment significant adjustments were made to service delivery.  Beginning in March 2020, in-person home visits with families were discontinued due to the COVID-19 pandemic. Two nurses and one social worker continued to support 138 existing HBHC families. All visits with families moved to virtual and phone support and any new qualifying parents who wished to participate in the program were placed on a waitlist until June (48). These forms of communication have inherent limitations (e.g., inability to provide hands-on demonstration or effectively observe the home environment) and many clients did not have access to the technology needed to facilitate meaningful interactions. To maintain engagement and support client progress, staff needed to customize service delivery to meet client needs. The HBHC Social Worker has since worked to improve client access to the internet via financial aide.

The Healthy Family’s department hotline has remained operational, triaging calls on healthy growth & development, community resources and breastfeeding. The Lactation Consultant (LC) was also available to provide breastfeeding support over the phone or virtually to both HBHC clients and community members. Due to the cancellation of services and limited supports available to new mothers during the pandemic, the Healthy Families department prioritized calls to all mothers the HF within 48-72 hours of birth.

Lack of departmental engagement of physicians and midwives during this time likely contributed to the significant reduction in referrals to the HBHC program. Overall, referrals decreased by 14% over the pandemic compared to the same period in 2019. This may also be in part due to the absence of HBHC Hospital Liaison nurse.  Prenatal referrals have been the most significantly affected. Only 22 prenatal referrals were received during this time, compared to 160 in 2019. This change warrants further investigation since prenatal intervention within the HBHC program can improve pregnancy outcomes and better prepare families to navigate the challenging newborn stage of parenting.

Currently, HBHC has six (6) public health nurses supporting 161 clients on caseload. Staff have reported an increase in mental health concerns among their clients and increased severity for those with pre-existing anxiety and depression. This may be attributed, at least in part, to the financial strain, isolation, and general uncertainty caused by the pandemic as reported by some clients. In response, WECHU has hired an additional Social Worker for the HBHC program to focus on mental health-related issues. This Social Worker will consult with HBHC staff regarding mental health challenges, provide brief counselling directly to clients, and help clients access appropriate supports within the community.

Additionally, staff have reported that clients continue to struggle to afford healthy food for their families and access affordable housing. Pandemic-related income loss, along with the simultaneous increase in the price of food and housing have placed excessive strain on the program’s low-income families. This strain has left some families looking for ways to save on groceries, including prematurely discontinuing the use of infant formula. Transitioning from infant formula to fluid cow’s milk before nine months is linked to nutrient deficiency that can hinder a child’s lifelong growth and development potential. To ensure that clients have access to the funds they need to afford infant formula or support a nutritious diet for the breastfeeding mother, the department’s Registered Dietitian and HBHC Social Worker are developing a procedure to ensure clients are able to access the province’s Special Diet Allowance in a timely manner. The Special Diet Allowance provides additional funds to families on social assistance who are pregnant, breastfeeding, or reliant on infant formula.  The Social Worker is also continuing to investigate actions to improve access to affordable housing.  

During these unprecedented times, HBHC staff have remained committed to providing the best possible service to the most vulnerable families within our community. We have continued to work and develop processes with our community partners to ensure wrap around care for our families. Outreach to local midwives and physicians has begun with regard to increasing our Prenatal and Early-ID referrals. Additionally, Policies and Procedures have been prepared to safely reinitiate in-person home visits, on a case-by-case basis, in an on-going effort to improve client engagement and adequately address their needs.

COMPARISON OF WITH RISK SCREENS, 2019 & 2020

Board Members Present:

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

Board Member Regrets:

Tracey Bailey

Administration

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

QUORUM:  Confirmed

RECORDING SECRETARY:

SUBMITTED BY:

APPROVED BY:

Meeting held via video.

SUBMITTED BY:

Communications Department

DATE:

November 9, 2020

SUBJECT:

October Communications Recap

October Metrics

Media Exposure

Media Participating in Teleconference for YouTube Live

• AM 800 CKLW, Blackburn News, CBC Windsor, and The Windsor Star join every Monday, Wednesday, and Friday. On occasion, CTV Windsor and windsoriteDOTca will also join the briefing.

Current Notable Projects

•  Microsoft Power BI was implemented on the COVID-19 Local Data webpage led by the Epidemiology and Evaluation department. Continuous Improvements occur to the webpage.
• We helped launch the COVID-19 Monitoring Indicators for Windsor-Essex to align with the province’s Framework for Reopening our Province. The 3 colour system is used to help residents know the current local pandemic status.
• Radon – Know Your Level messages are being promoted on social media throughout the month of November.
• We are working on a local flu shot campaign to complement the provincial roll out of their upcoming campaign.

Data Notes:

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

1. Media requests received is a compiled list of documented requests we captured for interviews, data clarification, or general request for information from the media. Given the volume of requests during COVID-19, many exchanges with the media through text messages or quick phone calls to correct errors may not be captured. In many instances, each request led to multiple interactions with reporters.
2. Dr. Ahmed joined Mike and Lisa on the AM 800 Morning Drive every morning at 8:06 a.m. starting on Wednesday, March 17. On August 17, we went to a Monday, Wednesday, and Friday schedule with holidays off. He continues to do join Mike and Lisa every other morning to keep the community informed.
3. We changed the platform we broadcasted live videos from Facebook to YouTube at the end of June. YouTube Live videos started on June 23, 2020. Prior Public Health Update videos on YouTube were exported videos recorded through Facebook Live.
4. Website analytics are provided by Siteimprove. The metric provided is for page views to COVID-19 Local Updates Page. During the COVID-19 pandemic, changes were made to landing pages. For consistency in reporting, the most popular page was selected.
5. 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.
6. Social media metrics are provided through Hootsuite.
7. 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.

DATE:

November, 2020

SUBJECT:

Consumption and Treatment Services Site – Application Status

BACKGROUND

On April 1, 2019  the Board of Health of the Windsor-Essex County Health Unit (WECHU) passed a resolution in support of public health-led assessment of the feasibility of a Consumption and Treatment Services (CTS) site in the City of Windsor. In September of the same year, following the release of the Supervised Injection Services Community Consultations Report, the Board of Health subsequently resolved in support of the submission of an application for the creation of a site in the City of Windsor. This application to the provincial Ministry of Health would be accompanied by a corresponding submission to the Federal Government for an exemption to the Controlled Drugs and Substances Act, an additional necessary component for the legal operation of a CTS site. In addition, the September resolution supported the completion of a comprehensive community consultation to determine a suitable and accessible location for a CTS site in the City of Windsor

In order to facilitate this process, a CTS Stakeholder Advisory Committee was created including membership from the following agencies representing the multiple sectors with vested interest in the creation of a CTS:

• The City of Windsor
• The AIDS Committee of Windsor (Pozitive Pathways Community Services)
• Windsor-Essex Community Health Centre
• Hotel-Dieu Grace Healthcare
• Canadian Mental Health Agency – Windsor-Essex County
• Windsor Police Services
• Windsor Downtown Mission

The WECHU also hired a Substance Use Coordinator to lead the site selection process and completion of the application. The coordinator role was initially responsible for facilitating the decision-making process amongst the Stakeholder Advisory Committee ultimately establishing the criteria and requirements for an eligible site. These requirements acomplement the mandatory criteria set out in the federal and provincial application documents and are outlined below:

• Site must be 200m from a sensitive land use (e.g. parks, daycare centers, and schools) as well as 600m from other CTS sites OR If  located within 200m of a sensitive land use, application must include plans on how to address community concerns
• Site must be easily accessible by public transit
• Site must be within walking distance to areas known to be frequented by people who use drugs
• Space should be greater than 590ft2 (for six consumption booths) or 385ft2 (for three booths)

Using these criteria, and in consultation with WECHU legal representation and procurement procedures, the WECHU issued a Request for Expressions of Interest (RFEOI) through the MERX Online Public Tenders solicitation database. With an expiry period of one week, the initial RFEOI did not result in any responses. A second, more widely promoted RFEOI was issued and received media coverage from all local major media outlets. Per the health unit’s standard procurement process the WECHU hosted an information Session with two interested parties to answer questions and provide further information on the site criteria and selection process. Ultimately, however this tender also expired without any submissions.

CURRENT INITIATIVES

With the RFEOI process not yielding any potential locations, the WECHU is once again consulting with the CTS Stakeholder Committee and working through the Substance Use Coordinator to determine if there is mutual interest in a shared space among partners. In addition, the WECHU will be reviewing eligible properties and hiring a Real Estate representative in order to guide an equitable and transparent strategy for proactively contacting property owners and managers who appear to meet the set criteria.

Prior to community consultations, environmental audits will be completed by Windsor Police Services in order to determine the safety of the area and guide any mitigating interventions which can improve the safety of the areas surrounding the site and discourage criminal activity.

Community consultations may include open Town Hall Meetings to all residents, as well as targetted meetings in the neighbourhoods in which the sites reside, and online surveys for residents who are unable to attend in-person meetings. Following the consultation process, any decisions regarding the site will require both Board of Health approval and the approval of the Municipality prior to the submission of the final CTS application.