Minutes - June 18, 2020 - Board of Health Meeting

Members Present:

Ms. Maureen Cassidy (Chair)
Ms. Aina DeViet (Vice-Chair)
Mr. John Brennan
Ms. Kelly Elliott
Mr. Bob Parker
Mr. Ian Peer
Mr. Matt Reid
Ms. Tino Kasi
Ms. Arielle Kayabaga

Others Present:

Dr. Christopher Mackie, Medical Officer of Health (Secretary Treasurer)
Ms. Elizabeth Milne, Executive Assistant to the Board of Health and Communications Coordinator (Recorder)
Dr. Alexander Summers, Associate Medical Officer of Health
Ms. Laura Di Cesare, Director, Healthy Organization
Ms. Heather Lokko, Director, Healthy Start
Ms. Maureen Rowlands, Director, Healthy Living
Mr. Stephen Turner, Director, Environmental Health and Infectious Disease
Dr. Michael Clarke, VP Modernization
Mr. Dan Flaherty, Manager, Communications

Chair Cassidy called the meeting to order at 7:05 p.m.

Disclosure of Conflict of Interest

Chair Cassidy inquired if there were any disclosures of conflicts of interest. None were declared.

Approval of Agenda

It was moved by Mr. Reid, seconded by Mr. Peer, that the AGENDA for the June 18, 2020 Board of Health meeting be approved.
Carried

Minutes

It was moved by Mr. Reid, seconded by Ms. Kasi, that the MINUTES of the May 21, 2020 Board of Health meeting be approved.
Carried

It was moved by Ms. Elliott, seconded by Mr. Parker, that the MINUTES of the May 28, 2020 Special Board of Health be approved.
Carried

It was moved by Ms. DeViet, seconded by Mr. Reid, that the MINUTES of the June 4, 2020 Finance and Facilities meeting be received.
Carried

Reports and Agenda Items

Finance and Facilities Committee Update (Report No. 026-20)

Ms. Elliott, Chair of the Finance and Facilities Committee noted that there was a report on the re-location of the Health Unit and that it was to be received for information by the Board of Health.

It was moved by Mr. Peer, seconded by Mr. Reid, that the Board of Health receive Report No. 026-20 re: “Finance & Facilities Committee Meeting – June 4, 2020” for information.
Carried

Governance Committee (GC) Update (Verbal)

Ms. DeViet provided this update.
She noted that there were three items on the June 18th GC agenda:

Governance By- Law Policy and Review – Whistleblower Policy. She noted that this was the only policy to be reviewed at this time as all other policies have been deferred for the time being.
Occupational Health and Safety Report for 2019 – Review of Health and Safety policies, a physical – policy review, physical demands review,
Ms. DeViet noted that Return to Operations would be addressed later in the agenda by Ms. Lokko

It was moved by Ms. DeViet, seconded by Mr. Brennan, that the Board of Health receive Governance Committee verbal update for information and approve the amended policy.
Carried

Public Health Inspector Enforcement Actions and Inspections Activities – Q1 of 2020 (Report No. 027-20)

Mr. Turner introduced this report. He noted that all Public Health inspection activities are available on the website. He also noted that there were fewer inspections due to the COVID-19 response, and that Q2 would have even fewer.

Ms. Kayabaga noted that she has received notice from two private properties downtown who are reporting feces in front of their businesses and wondering what the health unit can do. She advised that the problem is continuing even though it was reported more than once. Mr. Turner asked Ms. Kayabaga to speak to him offline. Reported issues like this are usually dealt with by a Public Health Inspector on a priority basis.

It was moved by Mr. Parker, seconded by Mr. Peer, that Report No. 027-20 re: “Public Health Inspector Enforcement Actions and Inspection Activities – Q1 of 2020” be received for information
Carried

Collection of Race and Other Social Determinants of Health Data During the COVID-19 Pandemic (Report No. 028-20)

Dr. Summers noted that this report was developed in order to provide the Board of Health with a picture of the collection and analysis of social determinants of health data, especially around race and income. Dr. Summers noted that more analysis is to come and will continue to work with the Population Health and Surveillance Team (PHAST) and Health Equity (HE) Team and will continue to collect this data after COVID. He noted that this is work that has been planned for some time. Dr. Summers advised that in early April, MLHU was one of the first public health agencies to collect this data, specifically for COVID patients. Staff were able to go back retrospectively and collect this data from early COVID patients. Requested data included race, total income, occupation, housing, and indigenous identity.

It was noted that this is great work from both teams to pull this together.

In response to a question, Dr. Summers noted that the Health Unit was already collecting the race related data that the Province recently mandated health units collect. The Health Unit does not currently collect this data for other diseases but will be rolling this out for all clients that staff interact with in the future.
It is anticipated that the Province will continue to request this important information.

In response to a question, Dr. Summers advised that in order to encourage people to provide this data, and assist with their reluctance, scripting will be developed to articulate why and how the Health Unit is collect the data. It will be meaningful, significant and dignified. It was noted that 87% of COVID cases reported answers to questions around race and income. Early analysis shows that 27% of confirmed positive COVID cases reported as a visible minority, which is higher that the visible minority at baseline in the Middlesex and London Region.

The COVID pandemic has prompted other health units to start collecting race related data. Dr. Summers will participate in meetings in regards to the collection. This collection supports the work that the Health Unit does.

Dr. Summers noted that the high trust that the community has for the Health Unit will help with the collection of the data. He noted that the data that was presented this evening is an early analysis and that it will continue to develop. The Health Unit is leading the way for others.
The Health Unit will work with the Black and Indigenous communities and organizations to learn more about their perspectives on collecting race-based data. It is important to note that this has been a request from the community.

For data gathering and what to do with it later, it would also be helpful to have conversations with key partners such as the City, Police and School Boards.
It was noted that the Health Equity Team has both indigenous and black members which is important to remind us to get more action and not just another 80 years of recommendations.

It was moved by Mr. Reid, seconded by Mr. Parker, that Report No. 028-20 re: “Collection of Race and Other Social Determinants of Health Data During the COVID-19 Pandemic” be received for information.
Carried

COVID-19 Update (verbal)

Dr. Summers provided an update on the current COVID situation.
He advised that the Middlesex-London count of positive cases has exceeded 600, however the number of new cases continues to drop and we are approaching the flattening of the curve. Dr. Summers noted that cases in both Long-Term Care Homes and Retirement Homes are slowing.

He noted that our region has moved into stage 2 of phase 2, and that this reopening has meant a lot of work for Health Unit staff.

There is a current recommendation to wear non-medical masks when physical distancing is not possible. Dr. Summers also noted that there is ongoing evidence that it will not cause harm to use a mask.
Staff are planning for a sustainable ongoing response to COVID-19. As the reopening has begun, so does the need to restart regular baseline work. Clinical services are starting to ramp up again.

Dr. Summers advised the Board that the Health Unit continues to be 100% compliant reporting case and contact investigation data to the Province.

There was discussion in regard to masking and whether or not MLHU will mandate the wearing of masks at all times as some other Health Units have. Both Drs. Mackie and Summers have been looking at the mask issue since the beginning and it was noted that data and evidence continue to evolve each week. Dr. Mackie noted that you need to have a strong case to mandate people to wear masks without stepping on people’s rights. The Health Unit will continue to strongly recommend the wearing of masks in certain circumstances and will revisit this if things turn and cases begin to rise.

Ms. Lokko provided an update on Return to Operations.

Since last BOH meeting, the Team has moved forward with developing a dashboard to engage in decisive decision making. The work that is being done by the recovery team is helping to identify the extent to which gaps related to and implications of COVID-19 will impact other Health Unit operations going forward.

There have been 297 interventions that were identified, and a few interventions have been prioritized for the next few weeks. These include things such as immunizations, inspections of restaurants, pools and personal service settings.

Organizational and individual assessments for wellness have been developed for MLHU staff. This survey will be open for 10 days to allow for all staff to participate.

A plan for second wave and/or new pandemic is being developed and draft recommendations will go to the Senior Leadership Team next week.

The Team is working to identify some things that were implemented for the COVID response that would be beneficial to carry forward post COVID.

It is anticipated that there will be more information to share with the Board in September.

Dr. Mackie noted that as we move to next stages and phases for reopening, it is not clear what will be expected from the Health Unit and whether or not there will be added responsibilities. It is anticipated that within the next few weeks, the Province will have more clarity of what will be expected from the Health Unit. He noted that the Board will receive a report next month highlighting what a Full Service COVID-19 Program would look like.

There is a significant amount of work being done with the Health System Leadership and Assessment Centres. More details will be provided at the next Board meeting.

Chair Cassidy noted her concern for staff going back to what they used to do. When the stress is gone, this is when people start to crash. She asked how people are doing across the organization, is there a plan to identify distress, and how can the Board of Health help. Dr. Mackie noted that vacations have resumed to almost normal vacation policy and the Leadership Team are encouraging staff to take vacation.
Ms. Lokko noted the organizational wide assessment survey will specifically ask what staff need to support themselves. She also noted that a couple of experts in the field will be available to assist. EFAP service provider has provided sessions for staff already and this issue is definitely on the Senior Leaders radar.

The question was asked “Once staff have gone back to their old job, how quickly can we get back to the COVID response”? Dr. Summers noted that over the summer a team of staff will be developing a tiered plan to do sustained baseline work and the development of a redeployment plan.

It was moved by Ms. DeViet, seconded by Ms. Elliott, that the Board of Health receive “COVID-19 Verbal Update” for information.
Carried

Medical Officer of Health Activity Report for June (Report No. 029-20)

Dr. Mackie noted that Chair Cassidy had asked him elaborate more on what he’s doing day to day other than what is noted in this report. He provided a couple of additional updates, noting the following:
The Health Unit is functioning at a high level of productivity, and he is trying to make sure that that is not disrupted by external changes. He is a representative for COMOH for the Ontario Health West COVID-19 response table. Dr Mackie also serves on the Public Health Measures Table which provides advice to Ontario’s Chief Medical Officer of Health. Conversations are open and quite frank. He believes that he CMOH and government are listening.
Ontario Health Team (OHT) Regional Leadership work is very involved and has just moved from meeting 5 days per week to 3 days. Dr. Mackie noted that he has seen health system working as a system and organization helping each other as not seen before. Public Health is now part of the decision making process.
More sub-region work, working within the old LHIN geography. This group implements OHT decisions and focusing on LTC and Retirement homes. Hospitals and primary care and other providers are working together.
He noted that there is still one prolonged outbreak in an LTC Home still to resolve.
Daily City media and weekly County calls. Ensuring partners are receiving up to date information. Many sidebar conversations come out of these meetings.

It was moved by Ms. Elliott, seconded by Mr. Peer, that the Board of Health receive Report No. 025-20 re: “Medical Officer of Health/CEO Activity Report for June” for information.
Carried

Correspondence

Chair Cassidy inquired if there were any questions, hearing none she asked for a mover and seconder.

It was moved by Mr. Parker, seconded by Mr. Reid, that the Board of Health receive items a) through c) for information.

Carried

Other Business

Next meeting – July 16, 2020

Update from IT regarding Multi-Factor Authentication (MFA) for Board Members
Mr. Cameron provided the update to the Board. He noted that using this process it is one more step in providing additional security to prevent phishing scams.

It was moved by Ms. DeViet, seconded by Mr. Peer, that the Board of Health receive this update for information.
Carried

Update –Motion passed unanimously at City Council that will aide the city in ending racism by not only recognizing the issue, but requesting the police board, the school boards and the health unit respond to the issue as well.
Chair Cassidy introduced this update, providing a brief recap of the meeting at City Hall. Dr. Mackie noted he continues to note in the media that racism is a public health issue. There remains a need to continue this conversation. Coming out of the request from the City, the Health Unit will make certain that we have our own house in order, we are following best practices, voices of colour reflected in our work, and use this opportunity to build a community strategy. SLT will further discuss at next Tuesday’s meeting.
It is important to have the Board’s perspective and support on this issue.
Ms. Kayabaga noted that she and Dr. Mackie had spoken earlier. Council directed the boards to come up with some things that Board can do to address the Black Lives Matter asks.
Mr. Parker wondered if setting up a sub-committee to work on this would be beneficial.

To answer a question from Ms. Kasi, Dr. Mackie noted that the motion was just received from the City today. He advised the Board that the Health Unit has people of colour on staff to work on this but that it is also important to have the perspective the black community. Staff Leads will be people of colour and will work with the Health Equity Team to engage in a thoughtful, deliberate and engaging process but not move too slowly.
Ms. Kasi noted that there are many leaders within the black community to consider but to also consider the youth as they have the energy and they know what’s going on so shouldn’t be overlooked.

It was moved by Ms. Kayabaga, seconded by Ms. DeViet, that the Board of Health endorse identifying racism as a Public Health crisis.
Carried

Confidential

At 8:37 p.m., it was moved by Mr. Reid, seconded by Mr. Peer, that the Board of Health move in-camera to consider matters regarding labour relations, identifiable individuals and advice that is subject to solicitor-client privilege, including communications necessary for that purpose, and to consider matters regarding a trade secret or financial information, supplied in confidence to the local board, which if disclosed, could reasonably be expected to prejudice significantly the competitive position or interfere significantly with contractual or other negotiations of a person, group of persons or organization, and a trade secret or financial information that belongs to the municipality or local board and has monetary value.
Carried

At 9:04 p.m. it was moved by Ms. DeViet, seconded by Mr. Parker, that the Board of Health return to public session.
Carried

At 9:04 p.m. it was moved by Ms. DeViet, seconded by Mr. Parker, that the Board of Health take a recess.
Carried

At 9:27 p.m. the Board of Health reconvened after a brief recess.

At 9:27 p.m. was moved by Ms. DeViet, seconded by Mr. Reid, that the Board of Health reconvene their meeting.
Carried

At 9:27 it was moved by Mr. Brennan, seconded by Mr. Peer, that the Board of Health move in-camera to consider matters regarding labour relations, identifiable individuals and advice that is subject to solicitor-client privilege, including communications necessary for that purpose.
Carried

At 11:15 it was moved by Mr. Reid, seconded by Ms. Elliott, that the Board of Health return to public session.

Adjournment

At 11:15 p.m., it was moved by Mr. Reid, seconded by Ms. Elliott, that the meeting be adjourned.
Carried

Maureen Cassidy
Chair

Christopher Mackie
Secretary-Treasurer