Board of Health Meeting Documents

Call to Order
Board of Health Chair, Fabio Costante, called the Regular meeting to order at 3:30 p.m.

Dr. Nesathurai shared some of his experiences specifically regarding individuals with a history of alcohol abuse who were admitted to hospitals and cared for by hospital staff. Many individuals who smoke may acquire various diseases attributed to smoking and are also provided hospital care.  Our community is dealing with challenges around opioid use and, as a doctor or health care provider, managing people with substance abuse is what we do, and we treat these patients without judgement.  Opioid substance abuse is staggering.  In 2021 approximately 2,900 people died of opioid related deaths in Ontario, and there are six times more people dying from opioid use than those involved in car accidents.  These are people from all walks of life, they are mothers, fathers, brothers, nephews, the affluent, the poor, from cities and from rural areas. 

In Windsor-Essex we estimate that approximately eighty people per year are dying in our region from opioid use.  That is one to two individuals per week dying from opioid disorder, and many of these people die in the prime of their life.  The Consumption and Treatment Services Site on Wyandotte Street will provide safe injection supplies, clean needles, screening for HIV and advocate for education and access to mental health and counselling services. Like alcohol or tobacco substance abuse, our compassionate mission is what it has always been, and that is to keep people alive with the resources we have and to provide tools for long-term recovery.

In 2022, our Epidemiology Department advised that we had nine cases of whooping cough, in Windsor-Essex and we are already seeing cases this year. Typically, it affects those that are unvaccinated or insufficiently vaccinated and it is a preventable disease.  One core message is that we encourage everyone to participate in the vaccine program to protect not only the children but those who surround them.
Motion: That the information be received.  
CARRIED

1. Regular Board Meeting:  January 19, 2023

2. Ad Hoc Board Meeting:   February 3, 2023
   Motion: That the minutes be approved.
   CARRIED

1. Board of Health Self-Assessment Survey (K. Blanchette)
   K. Blanchette informed the Board that the Board of Health Self-Assessment Survey has been completed and thanked everyone on the Board for participating.

1. INFORMATION REPORTS

   1. Communications Report November – January 2023 (E. Nadalin)
      This report is brought to the Board for information.
      Motion: That the information be received.
      CARRIED

2. CORRESPONDENCE
   1. Public Health Sudbury & Districts – Letter to Directors of Education, Local School Boards, Sports and Recreation Organizations and Early Learning Centres – Physical Literacy for Healthy Active Children – for support

      Motion: That the Board support correspondence distributed by Public Health Sudbury & Districts.    
      CARRIED

1. Seasonal Housing Compliance Inspections – Fee Increase for Service Program (K. McBeth)

   K. McBeth introduced WECHU Environmental Health Manager, Elaine Bennett, should any questions arise concerning the fee increase for Seasonal Housing Compliance Inspections.  In 2020 we introduced a fee model on Seasonal Housing Compliance Inspections, wherein the WECHU charges $75 per annual inspection.  Windsor-Essex has one off the highest numbers of Temporary Foreign Workers in the province and WECHU inspects approximately 1,330 seasonal housing units per year.

   We have looked to other regional health units and are recommending an increase from $75 per inspection to $100 per inspection to assist in cost recovery and demand on administrative resources in our WECHU Leamington office.  The actual cost for this inspection service is in the range of $100 - $125 per inspection.  The remainder, or overage, is covered by our cost-share budget. We are bringing this recommendation for a fee increase to the Board for approval. H. MacDonald noted that these inspections of temporary foreign worker accommodations is instrumental in keeping all workers safe and is in favour of the increase.
   Motion:  That the fee for Seasonal Housing Inspections be increased to $100 annually
   CARRIED 

2.  

   SafePoint Consumption Services at 101 Wyandotte Street East, Windsor, On (K. Blanchette)
   K. Blanchette noted the Resolution from the February 3, 2023 Board of Health meeting regarding the SafePoint Site. The City of Windsor reached out for further information regarding the financial piece and we are working to provide them with what they are requesting.  Various members of the WECHU Leadership Team will be in attendance at the Monday, February 27, 2023 City Council meeting to answer any questions about SafePoint. 

   F. Francis asked about the status on Federal Approval for the site, and K. Blanchette advised that we are looking at a tentative date at the beginning of March for a site inspection, and it could take up to 30 days for approval. The expected timeline for Provincial approval is mid-summer 2023, but there are no guarantees around approval dates.  The WECHU provided a robust 400-page application to the Province, and the Federal government will need to conduct an onsite visit/review to see the layout, the flow and operational piece.  The Provincial timeline is approximately one year on average, and we are already seven to eight months into the process. 

   A. Marignani asked how confident the WECHU is that it is meeting both Federal and Provincial criteria to open the site.  K. Blanchette advised that the process with the applications is going well, dialogue has been very positive, and we feel very confident at this time.  The projected goal is to open the site in March 2023.  The High Priority Community funding we obtained should cover any costs for the operational piece and we front-loaded a significant amount of supplies for the year from that funding.  Part of our budget accounted for the gap between opening the site and the expected Provincial approval mid-summer.  At that point the Provincial funding would take over the costs. 

   H. MacDonald asked if there is an expectation for the City and the County to fill in funding gaps and if so, what would dollar amounts look like for the municipalities until Provincial funding takes over.  K. Blanchette noted that beyond the budget piece the only expectation from the municipalities would be on a per month basis after July, 2023 of approximately $60k in total operating costs. This cost would be shared amongst all municipalities if we were to operate at the current hours we are looking at. As noted in our Resolution on February 3, 2023, we continue to look at further funding from High Priority Community funding, or philanthropic funding, to help mitigate the costs from municipalities. We applied last summer and we will report back to the Board if there are any significant delays and review this together to ensure that we have the operational funding.  F Costante said he understands that it would be highly irregular if we did not be approved for funding as we are already seven to eight months into the process which typically take a year. In a worse case scenario, this may be a one-time disbursement of funds split by the City and the County which would have no impact on the tax levy if needed. 

   F. Frances said that we passed the Resolution to get the site open and operational.  From a procedural and operational standpoint by waiting for provincial and federal approvals and filing in gaps would it make sense to wait until we receive Provincial funding and then open the doors.  Or we open in March and fill in the gaps until August.  If for some reason the funding is not available is there a potential of closing the facility in the summer.  We would not like to see disruption of services and what is the best way to stay open once we do open the doors to the community.  

   E. Nadalin said we are required to notify the Federal government of any unplanned closure of the site, but operating under Federal approval does seem to expedite Provincial approval based on data we  have collected from the province.  Those who have seen approval on a shorter timeline have operated under the Urgent Public Health Need Site federal model prior to doing so. 

   K. Blanchette said once opening the site it will continue to monitor and provide feedback to the Board.  If we find there may be a shortfall of a month or two waiting for the Provincial funding we could also look at hours of operations to maximize efficiencies to remain open.  There are many possibilities and our focus is to open as soon as possible to those who need it.  F. Francis noted that this is contingent on Federal approval which we have not yet received.  K. Blanchette said that was correct, and we are confident in what we have submitted and are looking for Federal approval in March 2023.  

   R. Agostino said the number one goal is to help as many suffering from addictions as soon as possible.  Is it possible to operate on less hours on a lower budget until we obtain approval.  WECHU administration advised that they want to be respectful of finances and the entire project will always be under review for optimization, impact, community concerns, and we fully plan to adopt our operational pieces to ensure we have the highest level of efficiency and highest level of respect for our citizens and our businesses in the area. 

   F. Costante noted that we may learn after opening that we may have to change operational times and we have full discretion on that.  We are not locked in and being adaptable is an important piece.
   Motion:    That the information be received.
   CARRIED

1. CEO Report (K. Blanchette)

   K. Blanchette provided a verbal report to the Board. He noted that he was recently contacted by Michael Tibbolo, Associate Minister of the Ministry of Mental Health and Addictions, to participate on a task force for mental health and additions.  We are confident that this partnership will result in a stronger relationship and higher profile with the Ministry.  Chair, Fabio Costante, congratulated K. Blanchette in his appointment to this task force and it will be beneficial to have local representation.

   K. Blanchette mentioned WECHU’s partnership with the University of Windsor and he and University of Windsor President Dr. Robert Gordon have developed a Steering Committee that meets regularly to enhance public health in Windsor-Essex communities.  There is a Think Tank scheduled for mid-April and the WECHU will be bringing three or four items to this Think Tank in which community partners and University professors will participate in to discuss key elements to enhance public health content in Windsor-Essex.

   The WECHU has also been contacted by the Acute Care Hospital and the WE Ontario Health Team to help and assist with asylum seekers in our community and we will be a part of the team on the ground to help administer vaccines and provide family care.

2. Board of Health Orientation Modules (K. Blanchette)
   Learning modules have been created for the Board of Health based on feedback provided to us by Board member on various elements.  This will go out in a link to Board members to participate and will provide education on what the Board had identified as gaps.  The learning modules will take approximately 30 minutes to complete and help in decision making as Board of Health members. 
   Motion:    That the information be received.
   CARRIED

Dr. K. Blanchette asked if there were any nominations for the position of Chair for the Board of Health. One nomination was put forward for Board member Fabio Costante, and was seconded. F. Costante stands and accepted the nomination for the position of Chair.

K. Blanchette asked for further nominations from the floor (three times). Given that there were no further nominations, nominations for the position of Chair were closed. F. Costante having accepted the nomination, was appointed Chair by acclamation. K. Blanchette passed the chair to F. Costante.

Nomination for Vice-Chair
Chair F. Costante opened the floor for nominations for the position of Board of Health Vice-Chair. One nomination was put forward for Board member Joe Bachetti, and was seconded. J. Bachetti stands and accepted the nomination of Vice-Chair. F. Costante asked for further nominations from the floor (three times). Given that there were no further nominations, nominations for the position of Vice-Chair were closed. J. Bachetti having accepted the nomination, was appointed Vice-Chair by acclamation.

Nominations for Treasurer
Chair F. Costante opened the floor for nominations for the position of Board of Health Treasurer. One nomination was put forward for Board member Hilda MacDonald, and was seconded. H. MacDonald stands and accepted the nomination of Treasurer. F. Costante asked for further nominations from the floor (three times). Given there were no further nominations, nominations for the position of Treasurer were closed. H. MacDonald having accepted the nomination, was appointed Treasurer by acclamation.

Motion: That the nominations for the positions of Chair, Vice-Chair and Treasurer stand
CARRIED

Nominations for Project Governance Committee Members
F. Costante passed the chair to K. Blanchette who advised that recent municipal elections resulted in two vacancies on the Project Governance Committee, being one representative from the City of Windsor and one representative from the County of Essex. K. Blanchette opened the floor for volunteers or nominations.

One nomination was put forward for Board member Rob Shepley, and was seconded. R. Shepley stands and accepted the nomination as a Project Governance Committee member from the County of Essex. K. Blanchette asked for further nominations from the floor, and given there were no further nominations, nominations for a county representative for the Project Governance Committee were closed. R. Shepley having accepted the nomination was appointed to the Project Governance Committee by acclamation.

K. Blanchette asked if there were any nominations for a City of Windsor representative for the Project Governance Committee. There were no nominations. R. Agostino volunteered to sit on the committee as a representative for the City of Windsor. R. Agostino was appointed to the Project Governance Committee by acclamation.

Motion: That the nominations/volunteer for the positions of Project Governance Committee members stand
CARRIED

1. Regular Board Meeting: November 10, 2022
   Motion: That the minutes be approved.
   CARRIED

1. INFORMATION REPORTS
   1. ISPA Catch-up and Enforcement in Elementary Schools and Grade 7 in-school immunizations (K. McBeth)
      This report is brought to the Board for information.
   2. Communications Report November – December 2022 (E. Nadalin)
      This report is brought to the Board for information.

       

      Motion: That the information be received.
      CARRIED

2. CORRESPONDENCE – None

1. CEO Quarterly Report (K. Blanchette)
   K. Blanchette noted that there was nothing outstanding to report from a CEO perspective and this has been brought to the Board for information.
2. Board of Health Assessment Survey (K. Blanchette)
   K. Blanchette advised that the Board of Health Assessment Survey will be sent out electronically to Board members within the next couple of weeks. We encourage all Board members to complete the survey to help us meet our public health mandate. Please let us know if you have any questions or require any assistance.
3. alPHa Winter Virtual Symposium – February 24, 2023 (K. Blanchette)
   The Association of Local Public Health Agency (alPHa) which is our provincial advocacy body is holding their Annual Winter Symposium on February 24, 2023. This conference will be held virtually and we encourage our board members to attend.
4. February 16, 2023 Board of Health Meeting Time (K. Blanchette)
   K. Blanchette noted that the February 16, 2023 Board of Health meeting will be held (virtually) at 3:30 pm in order to better accommodate some of our Board members’ schedules.
5. 2023 Annual Service Plan Presentation – Program and Community Needs Overview (K. McBeth/E. Nadalin)
   The Ministry of Health requires that the development of the Annual Service Plan must be based on the Ontario Public Health Standards and related legislation. All 34 Ontario Health Units must abide by these standards and the Annual Services Plans are tied to our Budgetary and Strategic Plans. The development of program plans are based on local priority populations and local public health needs. Over the last couple of years through the pandemic, over half of our population are living in high priority post code areas. We develop these plan to ensure we remain flexible and locally responsive from a public health perspective and community needs.

    

   4:31 pm – R. Maich joined the meeting – quorum maintained

   K. McBeth and E. Nadalin provided a high level description of the following Program Standards:

   -Chronic Disease Prevention and Well-Being
   -Healthy Growth and Development
   -Food Safety
   -Safe Water
   -Healthy Environments
   -Infections and Communicable Disease Prevention and Control
   -Immunization
   -School Health
   -Substance Use and Injury Prevention

   The link to the Annual Service Plan Presentation is provided for your information.

   Chair, F. Costante noted the excellent work undertaken by health unit staff, and the local touch and evidence-based approach to this Annual Service Plan.

   A board member thanked the health unit for their guidance and support in managing Covid-19 outbreaks in the schools and noted that we should lobby the province to make the Covid-19 vaccine mandatory under the Immunization of School Pupils’ Act (ISPA).

   K. Blanchette noted this presentation is only a highlight of the work of public health. The pandemic created a heightened awareness of what the Windsor-Essex County Health Unit can do to create a higher standard of public health in our communities.

   5:08 pm – J. Lund left the meeting – quorum maintained

6. 2023 Budget Presentation (L. Gregg/K. Blanchette)
   L. Gregg provided some background on the WECHU’s budget process. On an annual basis, and to support our responsibilities as outlined in the Health Protection and Promotion Act and Ontario Public Health Standards, health unit administrations establishes an operating budget to support the programs that were discussed above in the Annual Service Plan presentation. The budget forms the basis of the Annual Service Plan submission to the Ministry of Health.

   The health unit has 5 different streams of funding as follows:
   1. The Ministry of Health – funds on a cost shared basis at 70%
   2. Ministry of Health – funds certain programs at 100%
   3. Ministry of Children, Community and Social Services – funds certain programs at 100%
   4. Obligated Municipalities – funds our mandatory programs at 30%
   5. Other Smaller Funding Allotments – grants such as Infection Prevention and Control (IPAC) Hub funding; High Priority Community funding, and various offset revenue, i.e. user fees, vaccine reimbursement, parking recoveries, inspection fees (fluctuates on an annual basis)

   L. Gregg provided 3 different scenarios that could arise based on Ministry funding which would ultimately have an impact on funding by the obligated municipalities. There are programs that are funded 100% by the Ministry of Health, bearing no burden on obligated municipalities, including:

   -Ontario Seniors Dental Care Program
   -Associate Medical Officer of Health/Medical Officer of Health
   -One-time Business Cases such as:
             -Covid-19 (general and vaccination)
             -Public Health Inspection Student Practicum
             -School-focused Nurses
             -Vaccine Fridge Replacement
             -Small Capital Funding projects, etc.

   We will bring any one-time business cases that may fall into our Annual Service Plan submission, which is due March 2023, to the Board for review and approval at our February 2023 Board of Health meeting. They do not pose a burden on the obligated municipalities.

   The link to the Budget Presentation is provided for your information.

   Our total Mandatory Program Budget is $23,428,882, a $495,626 increase over our 2022 Budget. The rationale for the increase is an increase of full-time employees assigned to programs compared to the 2022 year, along with contractual obligations.

   Other Operating Costs have increased such as Program Supplies, Information Technology, WECHU Corporate Public Awareness Program, and Epidemiology and Evaluation to support the acquisition of local data.

   Other net increases to the budget are costs incurred are on account of the WECHU’s Capital Project Redevelopment Costs for relocation of the Windsor office. We will be submitting a one-time business case to the Ministry of Health to support some of the capital costs. To support us from a cash flow perspective, there will be a request to the municipalities to fund us in the interim until we receive that approval of approximately $185,000.

   From a funding perspective, in developing funding assumptions for the current year, we assumed a 1% increase in funding from the Ministry of Health. That 1% increase would bring the total Base Funding to $16,302,915. We have assumed a 2% increase in funding from the obligated municipalities bringing the total contribution to $7,125,967.

   There were no questions from the Board regarding any of the above items.

   Motion: That the Board move into Committee of the Whole at 5:35 pm
   CARRIED

   Motion: That the Board move out of Committee of the Whole at 5:42 pm
   CARRIED

1. 2023 Budget (L. Gregg/K. Blanchette)
   A recommendation report on the 2023 Budget was brought to the Board for approval.

   Motion: That the Board approve the 2023 Budget as presented.
   CARRIED unanimously