Minutes - September 16, 2021 - Board of Health Meeting

Members Present:

Ms. Maureen Cassidy (Chair)
Ms. Aina DeViet (Vice-Chair) (arrived at 7:37 p.m.)
Mr. Matt Reid
Mr. John Brennan
Mr. Bob Parker
Ms. Kelly Elliott
Mr. Mike Steele
Ms. Tino Kasi (arrived at 8:23 p.m.)

Regrets:

Ms. Arielle Kayabaga
Mr. Aaron O’Donnell

Others Present:

Dr. Christopher Mackie, Medical Officer of Health (Secretary-Treasurer)
Ms. Stephanie Egelton, Executive Assistant to the Board of Health/MOH/AMOH and Communications Coordinator (Recorder)
Dr. Alexander Summers, Associate Medical Officer of Health
Ms. Emily Williams, Director, Healthy Organization/Interim Chief Executive Officer
Mr. Dan Flaherty, Manager, Communications
Ms. Carolynne Gabriel, Communications Coordinator/Executive Assistant to the Board of Health
Ms. Heather Lokko, Director, Healthy Start/Chief Nursing Officer
Ms. Mary Lou Albanese, Acting Director, Environmental Health and Infectious Disease
Ms. Ellen Lakusiak, Public Health Dietician
Mr. Christian Daboud, Manager, Health Equity
Ms. Donna Kosmack, Manager, Chronic Disease Prevention and Tobacco Control
Ms. Gali Katznelson, Medical Resident
Mr. Erich Nelson, Medical Resident

Chair Maureen Cassidy called the meeting to order at 7:02 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. Matt Reid, seconded by Mr. John Brennan, that the AGENDA for the September 16, 2021 Board of Health meeting be approved.
Carried

Minutes

It was moved by Mr. Mike Steele, seconded by Ms. Kelly Elliott, that the MINUTES of the July 15, 2021 Board of Health meeting be approved.
Carried

It was moved by Mr. Reid, seconded by Mr. Parker, that the MINUTES of the July 15, 2021 Finance and Facilities Committee meeting be received.
Carried

It was moved by Mr. Reid, seconded by Mr. Steele, that the MINUTES of the September 2, 2021 Finance and Facilities Committee meeting be received.
Carried

It was moved by Mr. Brennan, seconded by Mr. Parker, that the MINUTES of the September 2, 2021 Special Board of Health meeting be approved.
Carried

Reports and Agenda Items

Finance and Facilities Committee Meeting Summary from September 2, 2021 (Report No. 36-21)

Mr. Matt Reid, Chair of the Finance and Facilities Committee presented the Finance and Facilities Committee Summary from September 2, 2021.

It was moved by Mr. Reid, seconded by Mr. Steele, that the Board of Health receive report No. 20-21FFC re: “Financial Borrowing Update” for information.
Carried

It was moved by Mr. Reid, seconded by Mr. Parker, that the Board of Health approve the audited Consolidated Financial Statements of Middlesex-London Health Unit March 31st Programs, for the year ended March 31, 2021 as appended to Report No. 21-21FFC.
Carried

Governance Committee Meeting Summary from September 15, 2021 (Report No. 43-21)

Mr. Bob Parker, Chair of the Governance Committee presented the Governance Committee Summary from September 15, 2021.

It was moved by Mr. Parker, seconded by Mr. Reid, that the Board of Health receive Report No. 16-21GC re: “2021-22 Provisional Plan Status Update” for information.
Carried

It was moved by Mr. Parker, seconded by Mr. Steele, that the Board of Health refer to staff to review all policies and procedures within the Governance Manual for references to the MOH/CEO position and make recommendations on changes.
Carried

It was moved by Mr. Parker, seconded by Mr. Steele, that the Board of Health:
1) Receive Report No. 17-21GC re: “Governance By-law and Policy Review” for information; and
2) Approve the governance policies appended to this report (Appendix B).
Carried

Ms. Emily Williams, Director of Healthy Organization/Interim Chief Executive Officer explained Report No. 18-21GC titled “Board Development Proposal” to the Board. It was noted that this training date would be set in the coming days. This training would be from Mr. James LeNoury (a lawyer who presented at this year’s Association of Local Public Health Agencies of Ontario (alPHa)’s annual conference) regarding liabilities for board members, the Health Protection and Promotion Act and conflicts of interest.

It was moved by Mr. Parker, seconded by Mr. Reid, that the Board of Health:
1) Receive Report No. 18-21GC re: “Board Development Proposal” for information; and
2) Approve the professional development sessions offered by Mr. James LeNoury, LLB, as a Board development opportunity
Carried

Proposed 2022 Budget Process (Report No. 37-21)

Ms. Williams presented the Proposed 2022 Budget Process to the Board. It was noted that MLHU is proposing to shift the logistics of the budget process this year for a few reasons: the ongoing pandemic, uncertainty with funding, inflationary pressures, different operational states of programs and services, emerging needs of bringing COVID-19 into certain programs, recovery and strategic initiatives.

The proposed budget process was:
1) Programs offering full (or nearly full) service or program offerings will undertake the PBMA (program marginal budgeting analysis).

2) Programs offering expanded service or program offerings due to demands related to the COVID-19 pandemic or related MLHU provisional strategic plan goal will undertake the PBMA (program marginal budgeting analysis).

3) Programs offering reduced (or paused) service or program offerings due to staff redeployments to the COVID-19 CCM or Vaccine programs will undertake an Evaluation and Planning Exercise and undertake a zero-based budgeting exercise that will inform the 2023 budget.

4) Review of organization structure (such as supervisory/multidisciplinary roles and divisional/programmatic structures) as proposals come forward.

It was further noted that funding assumptions were unknown at this time for 2022 COVID-19 and vaccine funding, but the Ministry of Health has confirmed we will receive mitigation funding for 2022. The request for more mitigation funding will assist with the shortfall – it is unknown at this time the financial impacts of integration of health equity and COVID-19 aspects into programming.

It was moved by Mr. Reid, seconded by Ms. Kelly Elliott, that the Board of Health:
1) Approve the revised budget planning process for 2022 outlined herein;
2) Approve the PBMA criteria and weighting that is proposed in Appendix A to Report No. 37-21.;
3) Approve requesting the full amount of the provincial cost sharing reductions from the municipal funders, in the same amount as requested in 2021, recognizing there may be a request for additional funds to address any shortfall in surplus identified from the PBMA process; and
4) Approve MLHU staff and the Board of Health to partner with the municipality Government Relations leads to advocate for additional funding from the Provincial government to offset inflationary pressures.
Carried

Q2 Financial Update and Factual Certificate (Report No. 42-21)

Ms. Williams and Mr. Brian Glasspoole, Manager, Finance presented the Q2 Financial Update and Factual Certificate. It was noted that over 900 staff were examined to ensure that these roles were allocated appropriately into their budget codes.

Mr. Glasspoole provided an overview of the financial update. He noted that the Ministry of Health has asked for additional information due to COVID-19 activities. MLHU’s Finance department developed an allocation process in late 2020 to help managers understand variances, when so many of their staff had been seconded into pandemic work. The Ministry of Health has asked MLHU to identify the COVID related costs through seconded staff from paused programs to ensure funding is only counted once. It was also noted that the original budget submitted for COVID activities was $28.6 million, and the Ministry of Health provided MLHU in August with $13.86 million.

It was moved by Mr. Reid, seconded by Mr. Parker, that the Board of Health receive Report No. 42-21 re: “Q2 Financial Update and Factual Certificate” for information.
Carried

Feedback on Proposed Regulations for Supplemented Foods (Report No. 38-21)

Ms. Heather Lokko, Director, Healthy Start/Chief Nursing Officer, Ms. Donna Kosmack, Manager, Chronic Disease Prevention and Tobacco Control and Ms. Ellen Lakusiak, Public Health Dietician presented the report regarding Feedback on Proposed Regulations for Supplemented Foods.

MLHU was looking for Board of Health endorsement to provide comments to Health Canada on new regulations regarding supplemented foods. Ms. Kosmack noted that while MLHU was supportive of a more regulatory process for supplemented foods, it was noted that there were public health and marketing concerns, such as energy drinks being considered as supplemented foods. These guidelines do not align with Canada’s Food Guide and wished to provide comment to Health Canada on the matter.

It was moved by Mr. Reid, seconded by Mr. Parker, that the Board of Health:
1) Receive Report No. 38-21“Feedback on Proposed Regulations for Supplemented Foods” for information; and,
2) Direct the Medical Officer of Health to send a letter to Health Canada, responding to the public health concerns associated with these amendments, attached as Appendix A.
Carried

Submission to Health Canada’s Consultation on the Proposed Vaping Products’ Flavour Regulations and Order (Report No. 39-21)

Ms. Kosmack presented this report regarding the consultation to Health Canada on the Proposed Vaping Products’ Flavour Regulations and Order. It was noted that this submission has already been provided to Health Canada. Health Canada is proposing that flavours in vaping products be removed from distribution, which MLHU is supportive of. Further, it was provided to Health Canada that mint and menthol products be removed from distribution as well.

It was moved by Ms. Elliott, seconded by Mr. Parker, that the Board of Health receive Report No. 39-21 re: “Submission to Health Canada’s Consultation on the Proposed Vaping Products’ Flavour Regulations and Order” for information.
Carried

Diversity and Inclusion Assessment: MLHU Workforce Census (Report No. 40-21)

Ms. Lokko and Mr. Christian Daboud, Manager, Health Equity presented the MLHU Workforce Census (apart of the Diversity and Inclusion Assessment) and the 12 recommendations associated.

It was noted that the Workforce Census Report was completed by Turner Consulting. The purpose of the census was to look into diversity within the MLHU workforce as it compares to the Middlesex-London region, and provide recommendations to support this diversity. Mr. Daboud noted that women in leadership roles were underrepresented, along with employees whom identified as Indigenous. The importance of having the MLHU workforce reflecting the community to which the health unit serves was emphasized.

It was moved by Mr. Steele, seconded by Ms. Elliott, that the Board of Health:
1) Receive Report No. 40-21 re:“Diversity and Inclusion Assessment: MLHU Workforce Census” for information; and,
2) Endorse the recommendations within the Workforce Census Report for implementation at the Middlesex-London Health Unit.
Carried

Verbal COVID-19 Disease Spread and Vaccine Update

Dr. Alexander Summers and Dr. Chris Mackie presented the verbal COVID-19 update.

Discussion about this verbal report included:
• Low case counts in July, rising in August sharply and the fourth wave being fueled by the Delta variant and the effects on unvaccinated individuals.
• Continuing guidance of getting vaccinated, social distancing and wearing masks.
• Vaccination “passports” coming into effect.
• Approaching 740,000 vaccinations in the region (640,000 from MLHU and partners, and 100,000 from pharmacies).
• 84.7% vaccination coverage locally.
• Third dose for immunosuppressed individuals is underway.
• 94% of staff have had both doses of vaccine.
• Agriplex and Caradoc have changed hours of operations.
• Mobile clinics and mall clinics have been successful.

Mr. Matt Reid noted his concern for a lack of uniform workplace vaccination policy, and the confusion this has caused across workplaces and sectors. There was a brief discussion on the advocacy that the Board of Health could do to advocate for this action. It was also emphasized the work that the staff of MLHU were doing to support the important work of promoting vaccination and appreciation of all of the vaccine related work that they have done.

It was moved by Mr. Reid, seconded by Ms. Elliott, that the Board of Health direct the Chair to write to the Premier and Minister of Health to support a uniform policy for all public and private sector employees to have a mandatory vaccine policy in place as soon as possible and to avoid testing alternatives unless due to medical or human rights exemptions.
Carried

It was moved by Mr. Reid, seconded by Mr. Parker, that the Board of Health direct the Chair to write to Health Unit staff indicating our appreciation for 1) all of the vaccination work they have done, 2) all of the staff who have chosen to be vaccinated, and 3) all of the staff who have been instrumental in the development of the mandatory vaccination policies for the Middlesex-London Health Unit and other organizations.
Carried

It was moved by Mr. Reid, seconded by Ms. Aina DeViet, that the Board of Health receive the verbal report on COVID-19 Disease Spread and Vaccine Update for information.
Carried

Medical Officer of Health Activity Report for August/September 2021 (Report No. 41-21)

Dr. Mackie presented Medical Officer of Health Activity Report for August/September 2021.

It was moved by Mr. Parker, seconded by Mr. Steele, that the Board of Health receive Report No. 41-21 re: “Medical Officer of Health Activity Report for August/September 2021” for information.
Carried

Correspondence

It was moved by Ms. Elliott, seconded by Mr. Reid, that the Board of Health receive correspondence items a) through c).
Carried

Dr. Mackie noted to the Board of Health that a new Board Member had been appointed earlier in the day. Selomon Menghsha (provincial appointee) was appointed for a 2-year term.

Other Business

The next Middlesex-London Board of Health meeting will be on Thursday, October 21st at 7 p.m.

Confidential

At 8:55 p.m., it was moved by Mr. Reid, seconded by Ms. DeViet, that the Board of Health will move in-camera to consider matters regarding labour relations or employee negotiations, personal matters about identifiable individuals, including municipal or local board employees and security of the property of the local municipality or board.
Carried

At 9:28 p.m., it was moved by Mr. Steele, seconded by Ms. Kasi, that the Board of Health rise and return to public session.
Carried

Adjournment

At 9:28 p.m., it was moved by Mr. Steele, seconded by Ms. Kasi, that the meeting of Board of Health be adjourned.
Carried

Maureen Cassidy
Chair

Christopher Mackie
Secretary-Treasurer