Board of Health Meeting Documents

PREPARED BY:
Planning and Strategic Initiatives

DATE:
November 20, 2023

The Ontario Public Standards requires the Board of Health to have a risk management framework in place that identifies, assesses, and addresses risks. The WECHU risk registry currently tracks 26 risks across 13 categories. Risk categories cover a diverse array of topics such as finances, security, service delivery, equity, and privacy, for example.

Health Units are also expected to submit a list of corporate risks and mitigation strategies to the Ministry of Health during Q3 Standards Activity Reporting.

DISCUSSION

The 2023 WECHU risk registry was reviewed and updated by risk owners in the organization. The risk registry review identified 13 risks scoring “high” before consideration of mitigation strategies and 7 remaining “high” after mitigation measures. 

The Ministry requires reporting of up to 10 highly ranked risks. The WECHU’s submission includes the following 7 high risk types for 2023: 

• Knowledge/Information-Information
• People/Human Resources-Work Disruption
• People/Human Resources-Succession Planning
• People/Human Resources-Staff Engagement
• Privacy-Privacy Requirements
• Security-Work
• Technology-System Outages

Additionally, as part of the 2023 operational planning process, the risk registry was migrated into the WECHU’s information management system. This project builds upon the risk management system the WECHU already has in place and will modernize it by improving automation and collaboration.

PREPARED BY: 
Environmental Health

DATE: 
November 20, 2023

The Environmental Health Department delivers various seasonal programs that are mandated under the Ontario Public Health Standards.  These programs include monitoring beach water quality and heat events, as well as surveillance of West Nile Virus (WNV), Eastern Equine Encephalitis (EEE), Zika Virus, and Lyme disease activity in Windsor and Essex County (WEC). This report provides a summary of these 2023 seasonal programs.

DISCUSSION

Beach Monitoring: The 2023 beach monitoring season ran for a total of 13 weeks, with weekly water sampling conducted from June 12, 2023 to September 5, 2023. There were 20 water quality warnings issued (201-999 E. coli/100ml), and 3 beach closures (≥1000 E. coli/100ml). This season had significantly less water quality issues when compared with 2022, which had 41 warnings and 13 closures. The permanent closure of Mettawas Beach partially accounts for this difference.

Harmonized Heat Warning Information System: Starting in May of each year, the WECHU monitors the Environment Canada and Climate Change’s forecast for heat events and issues heat warnings or extended heat warnings in accordance with the Ontario Harmonized Heat Warning and Information System (HHWIS). In 2023, there were no heat warnings (two consecutive days are forecasted to have a daytime high temperature greater than or equal to 31°C and a nighttime temperature greater than or equal to 21°C or a humidex greater than 42°C ) and three extended heat warnings (three or more than three consecutive days are forecasted to have a daytime high temperature greater than or equal to 31°C and a nighttime temperature greater than or equal to 21°C or a humidex greater than 42°C) issued. This summer had significantly less number of days under heat warning (11 days) as compared to 22 days in 2022. 

Mosquito Surveillance program: The Mosquito Surveillance Program ran for a total of 21 weeks from May 23 to Oct.13, 2023. Once a week, 41 mosquito traps (26 CDC light traps and 15 BGS 2 traps) were set up across WEC to collect mosquitoes for identification and viral testing.  

Number of Mosquitoes caught – 73,028 
Number of pools tested -1159 
Number of WNV positive pools - 11 
Number of WNV human cases - 1 
Number of Aedes albopictus caught -84

There were no positive pools or human cases for EEE or Zika identified this year.

Active Tick Surveillance: Active surveillance is used to assess the local distribution and incidence of black-legged ticks in WEC. It involves the dragging of a white cloth through grassy areas whereby ticks attach themselves to the fabric and can be easily spotted and identified. Any black-legged ticks identified are sent to an accredited laboratory for testing for Lyme disease. Tick dragging is performed twice yearly in the spring and the fall.

In 2023, tick dragging was conducted at 4 sites across WEC (Ojibway Prairie Nature Reserve, Ruscome Shores Conservation Area, Cipher Systems Green Way – Essex and Hilman Marsh Conservation Area) In May and October. 41 blacklegged ticks were found through tick dragging and have been sent to lab for testing. As of September 30^th, 2023, there were six human cases of Lyme disease reported in WEC.

PREPARED BY:
Planning and Strategic Initiatives

DATE:
November 20, 2023

The Ontario Public Health Standards (2021), under the Good Governance and Management Practices Domain, states: “the board of health shall have a self-evaluation process of its governance practices…”. 

In addition to a yearly self-evaluation process, the WECHU has developed a quarterly self-assessment survey for Board of Health (BoH) members. The survey provides an opportunity for feedback on BoH operations and is used to inform quality improvement efforts. 

DISCUSSION

Responses in the third quarter of 2023 related to BoH operations continued to be positive. In most cases, 80% or more of the responses were Agree or Strongly agree regarding the aspects queried. The one exception was related to the item ‘All material notices of wrongdoing or irregularities were responded to in a timely manner’, where 70% of the responses were Agree or Strongly Agree (20% of responses to this item were ‘Don’t Know/Unsure’). In terms of overall perceived BoH effectiveness, 70% of the responses were either a 9 or a 10 (on a 10-point scale), where the average score was 8.9. 

Suggestions for improvement included future quality improvement efforts related to BoH operations and increased engagement with members of the community in public health efforts. Other recommendations included collaboration with all levels of the government and flexible approaches/use of technology to allow the BoH to respond promptly and effectively to new challenges.

PREPARED BY:

Planning and Strategic Initiatives Department

DATE:

November 20, 2023

SUBJECT:

Annual Service Plan Q3 2023 Reporting

BACKGROUND/PURPOSE

In 2018, the Ontario Ministry of Health (MOH) introduced a new Annual Service Plan (ASP) that Health Units are required to submit each year. To ensure a single and integrated approach to evaluating progress on this requirement, the Planning and Strategic Initiatives (PSI) department worked with the Information Technology (IT) department to align our planning system with the provincial Ontario Public Health Standards requirements to provide quarterly progress reports. 

CURRENT INITIATIVES

Q3 Intervention Work Plan Progress

Project Leads have submitted individual progress reports for work plans in their programs for Q3, 2023. 

The 2023 Annual Service Plan - Q3 Status Report indicates:

• For external client facing programs, there are 139 workplans in progress, 4 were completed, and 77% are on target.
• For internal organizational programs, there are 36 workplans in progress and 67% are on target.

Annual Service Plan Development for 2024

Planning for 2024 began in July, 2023. Programs have been selected to be active in the WEHCU’s 2024 service plan and their descriptions updated. The Intervention Work Plans (IWP) that support these programs have been prepared and are currently being reviewed for final approval and budgeting.

2023 Operational Plan Reporting 
Q2 STATUS REPORT

Reporting Structure

This report provides a status summary for Intervention Work Plans (IWP) in the 2023 Annual Service Plan that were in active and in progress during Q3 (July 1 through September 30). 

The project lead for each active IWP was asked to provide a progress report on their work. The status updates consisted of the following categories:

• On Target (the intervention is progressing at the planned pace)
• Variance (the intervention is behind the planned pace)
• Complete (the intervention has been completed)
• Deferred (current work on the intervention has been stopped – with potential to continue next year)
• Cancelled (the intervention will no longer occur)

If the intervention was identified as ‘Variance’, ‘Deferred’, or ‘Cancelled’, a reason was provided. In these cases, the most relevant reason was selected from the following list:

• Adjusted Program Priorities (program priority alterations resulted in changes to the IWP)
• Human Resource Issue (staffing circumstances resulted in changes to the IWP)
• Partnership Limitations (external partner(s) did not to meet their obligations)
• Public Health Emergency (a significant emergency resulted in changes to the IWP)
• Internal Resource Limitation (financial, material, or internal support limitations resulted in changes to the IWP)
• External Resource Limitation (External financial, material, or internal support limitations occurred with partnerships, collaborations, funding, or regulations)

It is important to note that reporting reflects a snapshot summary of progress made on interventions based on the predetermined milestones for the intervention for this quarter. This does not necessarily represent the amount or scope of work captured under each program.

Part 1: External Community Facing Programs

Overall Quarterly Status Summary 

There were 139 active external interventions evaluated for progress in Q3 2023, and 99 of the interventions were reported to be on target. 4 workplans were completed this Quarter. Of all active interventions, 77% are currently on target.

Figure 1 displays the percentage of interventions that were reported on target, indicated a variance, deferred, cancelled, or were completed.

Board Members Present:

Fabio Costante, Renaldo Agostino, Mark Awuku, Joe Bachetti, Fred Francis,
Michael Horrobin, Judy Lund, Hilda MacDonald, Angelo Marignani, Robert Maich, Michael Prue, Rob Shepley

Board Member Regrets:

N/A

Administration Present:

Dr. Ken Blanchette, Dr. Mehdi Aloosh, Dan Sibley, Kristy McBeth, Eric Nadalin, Linda Watson, Lee Anne Damphouse

WECHU Guests:

William Willis, Willis Law

RECORDING SECRETARY: L. Damphouse

SUBMITTED BY: K. Blanchette

APPROVED BY: WECHU BOH – January 18, 2024

1. For the period covered by this CEO Quarterly Compliance Report:
   
   1. The undersigned has personal knowledge of the matters herein reported or has made due inquiry with respect to the same.
   2. Except as reported in any previous CEO Quarterly Compliance Report, the undersigned reports as follows:
      
      1. that the Health Unit has been in material compliance with all laws, regulations, orders, judgments or decrees applicable to it. Without limiting the generality of the foregoing the Health Unit is current in respect of all tax and related withholding and remittances required by law;
      2. the Health Unit has been in material compliance with its By-laws;
      3. the Health Unit has been in material compliance with all other Board resolutions;
      4. the Health Unit has been in material compliance with all contracts and commitments to which the Health Unit is a party including without limitation all funding and accountability agreements;
      5. the Health Unit is current with respect to the payment of all remuneration (including salary and benefits) to its employees;
      6. there are no material variances between what is contemplated by the Operational Plan and what in fact transpired or appears likely to transpire;
      7. more specifically, no material changes are required in respect of financial resource allocation plans to address shifts in need and capacity;
      8. no material adverse change has occurred in the operations of the Health Unit or its assets and liabilities taken as a whole;
      9. there have been no material breaches of the Ethics Code of Conduct by anyone who is subject to it;
      10. there have been no claims made pursuant to any insurance policies maintained by the Health Unit, except as noted below, and
      11. nothing has come to the attention of the undersigned which would materially adversely change any previous CEO Quarterly Compliance Report, except as detailed below:             

                  Items (vii), (viii) and (xi) have been revised due to the COVID -19 pandemic as follows:

• The Organizational Emergency Response that was reported on the previous CEO Compliance Report concluded on April 30, 2023.
• The WECHU continues to have operational plans and finances that are dedicated to the current public health demands related to the ongoing COVID-19 pandemic.  This includes:
  • Augmented staff to facilitate our response to the pandemic associated with case and contact management, outbreaks, and vaccinations.
  • Increased expenses related to case and contact management, outbreaks, and vaccination to address Ministry requirements.

Date:  November 20, 2023                 

Dr. Kenneth Blanchette    
Chief Executive Officer

BACKGROUND

An enterprise risk management framework and corresponding risk registry are important foundational elements in managing risk from an organizational governance perspective. The Ontario Public Health Standards (OPHS) specifies that “the board of health shall have a formal risk management framework in place that identifies, assesses, and addresses risks”. The Ministry of Health (MOH) requires yearly reporting on the 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 Windsor-Essex County Health Unit (WECHU) maintains a corporate risk registry; this risk registry monitors 22 risks across 12 risk categories. Based on the categorization and reporting requirements by the MOH, 10 of these risks were identified as being high residual risks.

The high residual risks to be reported to the MOH for 2024 are related to: Financial, People/Human Resources, Privacy, Security, and Technology. Each identified high risk includes documentation of current and future mitigation approaches in the registry.

PROPOSED MOTION

Whereas, the Ontario Public Health Standards requires the identification, assessment, and mitigation of enterprise risks; and

Whereas, the Ministry of Health requires yearly reporting on the highest residual risks to the organization; and

Whereas, the Windsor-Essex County Health Unit identifies and establishes risk mitigation approaches;

Now therefore be it resolvedthat the Windsor-Essex County Board of Health accepts the risk assessment outlined in the 2024 WECHU Risk Registry and the proposed mitigation approaches;

FURTHER THAT, risk mitigation approaches will be adopted and monitored by the organization and reported to the Board of Health on a yearly interval.

PREPARED BY:

Communications Department

DATE:

September 21, 2023

SUBJECT:

June 15, 2023 – July 14, 2023, Communications Update

BACKGROUND/PURPOSE:

Provide regular marketing and communication updates to the Board of Health.

Data Notes can be provided upon request

Media Exposure Overview Graph

Notes: Between June 15 – July 14, we experienced one large peak, and three smaller peaks in media exposure:

June 15 & 21 – Beach water results were shared via email and social media posts on these two dates, resulting in 11 and 5 stories, respectively.

June 28 – An air quality statement for our region was issued due to the forest fires in Northern Ontario and Quebec, as well as beach water testing results. Combined, this resulted in 21 news stories.

July 5 – We issued beach water testing results, a heat alert, and an opioid overdose alert, which resulted in 17 stories (total).

July 12 – Beach water testing results were issued, resulting in 8 stories.

Website Overview Graph

Notes: During the timeframe of June 14 – July 15, we saw similar website traffic as the previous period. There was a small uptick on July 5, corresponding with the release of the weekly beach water testing results.

Social Media Overview Graph

Note: Overall, our social media followers / fans remained consistent over the month.

DISCUSSION

The Communications Department worked closely with the Infectious Disease Prevention Department on a campaign to raise awareness of, and educate people about, MPox. The campaign was multi-faceted, including components such as paid social media posts and a full-page ad in Windsor Life magazine.

There were three paid posts on Facebook which resulted in 702 total link clicks, which took viewers to https://www.wechu.org/mpox. This achieved the goal of boosting web traffic.

Windsor Life magazine has a reach of 60,922 via the printed edition.

PREPARED BY:

Planning and Strategic Initiatives Department

DATE:

September 21, 2023

SUBJECT:

Annual Service Plan Q2 2023 Reporting

BACKGROUND/PURPOSE

In 2018, the Ontario Ministry of Health (MOH) introduced a new Annual Service Plan (ASP) that Health Units are required to submit each year. In order to ensure a single and integrated approach to planning the Planning and Strategic Initiatives (PSI) department worked with the Information Technology (IT) department to align our planning system with the provincial Ontario Public Health Standards requirements.

CURRENT INITIATIVES

Q2 Intervention Work Plan Progress

Project Leads have provided individual progress reports for work plans in their programs for Q2, 2023. The 2023 Operational Plan Reporting – Q2 Status Report indicates that:

• For external client facing programs, there are 138 workplans in progress and 83% are on track.
• For internal organizational programs, there are 38 workplans in progress, 2 were completed, and 63% are on track.

Plan Development for 2024

Planning for 2024 began in July, 2023. Program descriptions, planned major activities, and priority population groups have been updated. Program leads have also begun to create their individual workplans with expected completion this Fall.

2023 Operational Plan Reporting 
Q2 STATUS REPORT

Reporting Structure

This report provides a status summary for intervention work plans (IWP) in the 2023 Annual Service Plan that were in progress during Q2 (April 1 to June 20).

The project lead for each active IWP was asked to provide a progress report on their work. The status updates consisted of the following categories:

• On Target (the intervention is progressing at the planned pace)
• Variance (the intervention is behind the planned pace)
• Complete (the intervention has been completed)
• Deferred (current work on the intervention has been stopped – with potential to continue next year)
• Cancelled (the intervention will no longer occur)

If the intervention was identified as ‘Variance’, ‘Deferred’, or ‘Cancelled’, a reason was provided. In these cases, the most relevant reason was selected from the following list:

• Adjusted Program Priorities (program priority alterations resulted in changes to the IWP)
• Human Resource Issue (staffing circumstances resulted in changes to the IWP)
• Partnership Limitations (external partner(s) did not to meet their obligations)
• Public Health Emergency (a significant emergency resulted in changes to the IWP)
• Internal Resource Limitation (financial, material, or internal support limitations resulted in changes to the IWP)
• External Resource Limitation (External financial, material, or internal support limitations occurred with partnerships, collaborations, funding, or regulations)

It is important to note that reporting reflects a summary of progress made on interventions based on the predetermined milestones for the intervention. This does not necessarily represent the amount or scope of work captured under each program.

Operational Plan Status Summary

Part 1: External Community Facing Programs

Overall Quarterly Status Summary

There were 138 external interventions in progress in Q2 2023, and 115 (83%) of the interventions were on target.

Figure 1 displays the percentage of interventions that were on target, reported a variance, deferred, cancelled, or were completed.

PREPARED BY:

Communications Department

DATE:

September 21, 2023

SUBJECT:

July 15, 2023 – August 14, 2023, Communications Update

BACKGROUND/PURPOSE:

Provide regular marketing and communication updates to the Board of Health.

Data Notes can be provided upon request

Media Exposure Overview Graph

Notes: Between July 15 – August 14, we experienced one large peak, and a few smaller peaks in media exposure:

July 19 – Beach water results were shared via email and social media posts on these two dates, resulting in 6 stories.

July 21 – Dr. Mehdi provided guidance and an update on COVID-19 boosters in the fall, for 3 stories.

July 26 – An extended heat warning was issued. This resulted in 18 news stories.

August 2 – We issued beach water testing results and an opioid overdose alert, which resulted in 10 total stories. August 10 – Beach water testing results were issued, and stories around the need to recruit physicians to Windsor- Essex County, resulting in 10 stories.

Website Overview Graph

Notes: During the timeframe of July 14 – Aug 15, we saw similar website traffic as the previous period. Over this timeframe, our Safe Water pages consistently took spots in our weekly top ten (test results page as well as individual beach pages).

Social Media Overview Graph

Lighter blue line represents the current month, darker blue line represents the previous month.

Note: Overall, our social media followers / fans remained consistent over the month.

DISCUSSION

The Communications Department worked closely with the Infectious Disease Prevention Department on a campaign to reduce the stigma of sexually transmitted and blood borne infections. The campaign was multi- faceted, including components such as paid social media posts and a full- page ad in Biz X magazine.

There were two boosted posts on Facebook which reached 15,018 people and resulted in 215 total link clicks, which took viewers to https://www.wechu.org/STI.
 

BACKGROUND

Overview

• SafePoint officially opened on Wednesday, April 26th, 2023, serving clients 7 days per week between the hours of 10:00 a.m. – 6:00 p.m. daily.
• In order to ensure transparency related to SafePoint operations, the Board of Health will be provided with regular updates.

Application Status

• On July 21st, 2023, the WECHU received a letter from the federal government authorizing the requested Supervised Consumption Services (SCS) exemption.
• The SCS exemption granted by Health Canada has since been shared with the Ontario Ministry of Health, and in doing so, the WECHU confirmed with the provincial Ministry of Health that there are no elements outstanding in its application to operate a fully funded Consumption and Treatment Services (CTS) site.
• As it stands, the Ministry of Health application for CTS funding remains under review.

CURRENT INITIATIVES

Operational Data

It has been three months since SafePoint opened on April 26th and there have been 288 client visits amongst 93 unique client visits, with no overdoses reported on-site to date. Additional details about the services provided at SafePoint during the month of July are presented in Tables 1-3.

Client Experience Narrative

Beyond the number of client visits recorded in the month of July, SafePoint continues to demonstrate that the services being offered are having a positive impact on clients, as highlighted through the following client experience narrative:

Anonymous Client #1

SafePoint security staff witnessed a person using a substance in the area surrounding SafePoint and encouraged them to access the site. The person was informed that if they entered the site that the nursing staff would monitor them to reduce their risk of harm. After staff educated the client about the services available on site, the client agreed to remain inside and be monitored. The client was able to be monitored under the supervision of medically trained staff and was provided the option to access wraparound services.

FUTURE PLANS

As part of SafePoint’s continued commitment to community engagement, the WECHU will work closely with the SafePoint Advisory Committee members, including the Downtown Windsor Business Improvement Association (DWBIA), to expand efforts in offering support to surrounding businesses and address concerns related to the site's operations. A “SafePoint Toolkit” will be distributed as part of active outreach to area businesses, which contains resources that outline services offered at SafePoint, who to contact if a business-related concern is identified, and other supports made available to businesses as the site operates.

Since opening, SafePoint staff have attended 6 community events where resources and information about SafePoint have been shared. This has led to connections with various community partners for client referrals.

SafePoint has continued in its efforts to expand the wraparound services available on-site. The Recovery Education for Addictions and Complex Trauma (RE/ACT) team will now be on-site every Wednesday from 4:00          
p.m. – 5:00 p.m. to support clients through their holistic substance use recovery program. The program focuses on the numerous ways in which trauma shapes people’s lives, thought patterns, behaviours, and health. To view the full wraparound service schedule for the site, please visit the WECOSS webpage: Consumption and  Treatment Services Site.          
 

BACKGROUND

Overview

• SafePoint officially opened on Wednesday, April 26th, 2023, serving clients 7 days per week between the hours of 10:00 a.m. – 6:00 p.m. daily.
• In order to ensure transparency related to SafePoint operations, the Board of Health will be provided with regular updates.

Application Status

• The WECHU’s application to operate SafePoint under a Supervised Consumption Services (SCS) exemption was approved by Health Canada on July 21st, 2023.
• The SCS exemption was shared with the Ministry of Health immediately following approval and in doing so, the Ministry confirmed that there are no outstanding elements in the WECHU’s application to operate a fully funded Consumption and Treatment Services (CTS) site at SafePoint.
• As it stands, the Ministry of Health application for CTS funding remains under review.

CURRENT INITIATIVES

Operational Data

It has been four months since SafePoint opened on April 26th, 2023. From opening to August 31st, there have been 418 client visits amongst 119 unique clients, with no overdoses reported on-site to date. Additional details about the services provided at SafePoint during the month of August are presented in Tables 1-3.

Client Experience Narrative

Beyond the number of client visits recorded in the month of August, SafePoint continues to demonstrate that the services being offered are having a positive impact on clients, as highlighted through the following client experience narrative:

Anonymous Client #1

SafePoint staff connected with the Wellness Program for Extended Psychosis with the Transitional Stability Centre (TSC) on behalf of a SafePoint client. Staff walked with the client to the TSC so that they could be administered their medication that was overdue.

FUTURE PLANS

SafePoint has continued to expand the wraparound services available on-site. The Mobile Medical Support (MMS) Team and their Dental Hygienist will be on-site of SafePoint on Friday, September 8th, 2023 to provide clients with dental services. SafePoint has also developed a procedure with Family Services Windsor-Essex to dispatch Homelessness Outreach Workers to SafePoint as needed.

SafePoint is preparing to launch its business engagement strategy as part of the site’s ongoing commitment to community engagement. The business engagement strategy will involve regular outreach and resource distribution to the area businesses to learn about and address their concerns about the site.     
 

Prepared By:

Chronic Disease and Injury Prevention Department

Date:

September 21, 2023

Subject:

Windsor-Essex Community Opioid and Substance Use Strategy Update

BACKGROUND

The Windsor-Essex Community Opioid and Substance Strategy (WECOSS) was established in 2018 by the Windsor-Essex County Health Unit (WECHU) to bring together leadership representatives from across the region to address increasing rates of opioid use and overdose. The WECOSS is a four-pillar approach that leverages the knowledge and resources of more than 40 agencies and individuals with lived experience to address the harms of substance use at the community level through Prevention and Education, Harm Reduction, Treatment and Recovery, and Enforcement and Justice interventions.

Since the Strategy began, an Annual Report has been released as part of the WECOSS’ commitment to information sharing. The purpose of each Annual Report is to highlight the work being done to address substance use in the community through the collaborative efforts of our WECOSS partners. In 2021, an evaluation of the WECOSS was conducted by engaging members and the public to assess the level of awareness and early impact of the WECOSS in the community. The findings from this evaluation were used to form recommendations as presented in the WECOSS Modernization (2021) to guide the pathway forward for the WECOSS, including highlighting priority areas, and emphasizing a collective impact approach.

CURRENT INITIATIVES

Each of the four WECOSS pillars develops and implements at least one project per year, which are outlined in Annual Reports. In 2022, the development of these projects were guided by the six priority areas for focus and action. Future initiatives will continue to address and expand upon these priorities as the Strategy evolves.

The Addressing Substance Use in Corrections Reintegration Supports project was a key initiative undertaken in 2022 by the Enforcement and Justice Working Group. This involved collaborating with the South West Detention Centre, Windsor Probation and Parole, and the Canadian Mental Health Association Windsor-Essex County Branch. The goal of the project was to improve access to substance use and harm reduction supports and services for justice-involved individuals who had a history of problematic  substance use.

Through this project, 179 individuals were engaged, 138 of which were justice-involved individuals and 41 of which were justice system staff. This highlighted that justice-involved individuals released from custody required more knowledge and information in six (6) key areas:

• Housing support;
• Job skills or help getting a job;
• Community support groups;
• Help with obtaining identification;
• Referral to mental health and substance use services;
• Referral to withdrawal management or treatment for substance use

Additionally, justice-involved individuals expressed that their preferred methods for obtaining this information included one-on-one discussions with staff at intake, appointments, or during education sessions.

FUTURE PLANS

The findings from Addressing Substance Use in Corrections Reintegration Supports project resulted in the development of a wallet card resource containing information on more than 35 relevant supports and services. These will be distributed by various partners involved in the project and other relevant law enforcement partners to people involved with the justice system. There is also opportunity to work with partners to develop the necessary policies and procedures to facilitate discussions about relevant supports for successful reintegration. To support the educational needs of justice system staff, a hub of resources and educational materials was also compiled and will be made available through the WECOSS website.

Substance use supports and harm reduction approaches are critical for justice-involved individuals, especially during release from custody as this is when individuals are at an increased risk for drug-related deaths.¹ Additionally, addressing the basic needs of justice-involved individuals who use substances can aid in successful reintegration following incarceration.²

Subsequent work will focus on addressing barriers and building trust with people who use substances to enhance coordination between law enforcement and health services. To facilitate this, an online inventory of more than 200 local substance use, addictions, and mental health services will be designed through an ongoing WECOSS Treatment and Recovery Pillar Working Group project. The inventory will assist service providers in making referrals to relevant services for their clients.

References

1. Cooper, J. A., Onyeka, I., Cardwell, C., Paterson, E., Kirk, R., O’Reilly, D., & Donnelly, M. (2023). Record linkage studies of drug-related deaths among adults who were released from prison to the community: A scoping review. BMC Public Health, 23(1), 826. https://doi.org/10.1186/s12889-023-15673-0
2. McKiernan, A. (2017). Supporting reintegration in corrections by addressing problematic substance use: An environmental scan. Canadian Centre on Substance Use and Addiction. Retrieved from:   https://www.ccsa.ca/sites/default/files/2019-04/CCSA-Reintegration-Corr…- Environmental-Scan-2017-en.pdf
    

Prepared By:

Healthy Schools Department - Immunization

Date:

September 21, 2023

Subject:

Seasonal Influenza and COVID-19 Season 2023/2024

BACKGROUND

Influenza (flu) Vaccine

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.

Under the UIIP, the provincial supply of influenza vaccine doses is received from the Ontario Government Pharmacy (OGP) in predetermined increments dependent on vaccine availability. The WECHU receives influenza vaccine shipments from OGP and is responsible for the distribution to health care providers and 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. Community Immunization Providers (e.g., primary care providers, hospitals, long-term care homes (LTCH) and retirement homes (RH)) order influenza vaccine from the WECHU, starting in September.

COVID-19 Vaccine

In July 2023, the Ontario Ministry of Health, recommended that Ontarians aged 5 years and older delay getting a COVID-19 booster until the fall. Receiving a booster dose in the fall, as respiratory season commences, will maximize protection against COVID-19 outcomes when peak circulation of the virus is likely to occur with other seasonal respiratory viruses.

Currently, the WECHU is administering primary doses of COVID-19 vaccines at their in-house clinics at the Windsor and Leamington offices. The Healthy Schools Immunization Team is supporting families of school aged children this summer by offering COVID-19 education and immunizations to individuals who want to be vaccinated at upcoming School Readiness Events.

In addition, any pharmacy that is participating in the annual UIIP is encouraged to also participate in the COVID-19 vaccine administration program. Pharmacies who have been approved to administer COVID- 19 vaccine are required to have a cold chain inspection on the vaccine refrigerator(s) that will be storing publicly funded influenza vaccines.

CURRENT INITIATIVES

Throughout the year, the WECHU has completed 366 vaccine fridge inspections throughout Windsor and Essex County (WEC) for health care providers, pharmacies, agencies, long-term care and retirement homes planning to administer influenza and COVID-19 vaccines this fall.

Eighty-four out of 120 local pharmacies that applied to manage and administer fall vaccines were approved by the Ontario Ministry of Health to provide both influenza and COVID-19 vaccine. Thirty-six pharmacies that were approved to provide influenza did not apply to administer COVID-19 vaccine.
Participating pharmacists may only administer publicly funded influenza vaccine to individuals 2 years of age and older. While pharmacists can administer COVID-19 vaccine for individuals 6 months and older, they generally administer COVID-19 vaccine to individuals 2 years and older.

In preparation for, and over the course of the respiratory virus season, the WECHU maintains ongoing communication with all health care providers and pharmacies and relays information about the timelines for vaccine availability. Tailored information packages including vaccine product information, ordering information, and promotional materials are also compiled and distributed to providers by the WECHU each influenza season.

Community immunization providers are encouraged to help increase access and uptake of influenza and COVID-19 vaccines by offering co-administration of COVID-19 and influenza vaccine. To support widespread availability of both the influenza and COVID-19 vaccine in our community, the WECHU is working collaboratively with many community partners, including hospitals, operators of congregate living facilities, and primary care, to identify service gaps and opportunities to increase vaccine uptake. The WECHU will be supporting COVID-19 vaccine clinics, with a focus on prioritized populations and high-risk individuals; individuals attending these clinics will also have an opportunity to receive influenza vaccine at the same time.

The Ontario Ministry of Health has indicated that the timeline for the influenza and COVID-19 vaccine rollout will be aligned in the coming months. Initial inventory shipments are expected by the end of September/early October. The first allocation would target vaccine administration in hospitals, long-term care, and retirement homes. The second allocation would target high-risk groups for influenza and COVID- 19 related complications or hospitalization. The third allocation targets the entire population and is expected in November.

The WECHU will be running a communication campaign from October to December to raise awareness of the risks of contracting seasonal respiratory illnesses (e.g., influenza and COVID-19), and the importance of getting vaccinated, especially for individuals who are part of a high-risk group. Targeted, organic social media ads and print materials, and articles will be developed to communicate key messages.