Minutes - November 18, 2021 - Board of Health Meeting

Members Present:

Ms. Maureen Cassidy (Chair)
Ms. Aina DeViet (Vice-Chair)
Mr. Matt Reid
Mr. John Brennan
Mr. Bob Parker
Ms. Kelly Elliott
Mr. Mike Steele
Mr. Aaron O’Donnell
Ms. Tino Kasi
Mr. Selomon Menghsha

Others Present:

Dr. Alexander Summers, Acting Medical Officer of Health
Ms. Stephanie Egelton, Senior Executive Assistant to the Medical Officer of Health/Associate Medical Officer of Health (Recorder)
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
Mr. Warren Dallin, Manager, Procurement and Operations
Mr. David Jansseune, Assistant Director, Finance
Ms. Shaya Dhinsa, Manager, Sexual Health
Mr. Jordan Banninga, Manager, Infectious Disease Control/COVID-19
Ms. Kendra Ramer, Manager, Strategy, Risk and Privacy
Mr. Pat Harford, Manager, Information Technology
Ms. Cynthia Bos, Manager, Human Resources

Chair Maureen Cassidy called the meeting to order at 7:03 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 Ms. Aina DeViet, that the AGENDA for the November 18, 2021 Board of Health meeting be approved.
Carried

Minutes

It was moved by Ms. Kelly Elliott, seconded by Mr. Mike Steele, that the MINUTES of the October 21, 2021 Board of Health meeting be approved.
Carried

It was moved by Ms. Elliott, seconded by Mr. Steele, that the MINUTES of the October 21, 2021 Governance Committee meeting be received.
Carried

Reports and Agenda Items

2022 Budget – PBMA Proposals (Revised) (Report No. 22-21FFC-R)

Chair Cassidy, Chair Matt Reid, Chair of the Finance and Facilities Committee and Ms. Emily Williams, Director, Healthy Organization/Interim Chief Executive Officer provided a brief summary of this report.

It was noted that this is a revised version of Report No. 22-21FFC, that was brought to the Finance and Facilities Committee on November 11, 2021.

Chair Cassidy noted that, due to labour relations matters with one proposal, discussion would begin in a confidential session.

At 7:06 p.m., it was moved by Mr. Reid, seconded by Mr. Bob Parker, that the Board of Health will move in-camera to consider matters regarding labour relations or employee negotiations and personal matters about identifiable individuals, including municipal or local board employees.
Carried

At 8:15 p.m., it was moved by Ms. Elliott, seconded by Ms. Tino Kasi, that the Board of Health rise and return to public session.
Carried

Ms. Williams provided a brief overview on planning assumptions for funding and expenses, and noted that in 2020 the Province shifted the funding breakdown for base budget expenses to a 70% provincial/30% municipal ratio. Directors provided further information on proposals being presented to the Board. A majority of the proposals would be funded by provincial extraordinary funds specific to the COVID-19 pandemic.

Ms. Williams presented Healthy Organization’s division proposals:
• Disinvestment of ASO Contribution - $150,000.
• Investment of 7 FTE COVID-19 Human Resources personnel - $496,611.
• Investment of 4 FTE COVID-19 Procurement and Operations personnel - $190,387.
• Investment of 4 FTE COVID-19 Informational Technology personnel - $214,186.
• Investment of 1 FTE COVID-19 Enhancement of Occupational Health and Safety - $107,532.
• Investment of 1 FTE COVID-19 Payroll and Benefits Administrator - $95,569.
• Investment of 1 FTE COVID-19 Communications Supervisor - $107,532.
• Investment of 0.5 FTE COVID-19 Program Assistant (Communications) - $34,191.

Ms. Mary Lou Albanese, Acting Director, Environmental Health and Infectious Diseases presented the proposals for the Environmental Health and Infectious Diseases division:
• Investment of 21 FTE for COVID-19 Vaccine Preventable Disease Enhancement - $1,782,720.
• Investment of 1 FTE COVID-19 Public Health Inspector - $85,296.

Dr. Alexander Summers, Acting Medical Officer of Health presented the Office of the Medical Officer of Heath’s division proposals:
• Investment of 4 FTE COVID-19 Informatics Support - $289,824.
• Investment of 1.6 FTE COVID-19 Active Screeners - $39,000 *to June 2022.
• Investment of 124 FTE COVID-19 Infectious Disease Control Enhancement - $12,327,601.
• Investment of 1 FTE COVID-19 Population Health Assessment and Surveillance Manager - $142,595.
• Investment of 3.5 FTE COVID-19 Client Service Representatives (CSR) - $189,818.
• Investment of 1.5 FTE COVID-19 Program Evaluator - $114,004.
• Investment of 1 FTE COVID-19 Epidemiologist - $120,514.
• Investment of 1 FTE COVID-19 Outreach Worker - $64,446.
• Investment of 0.5 FTE COVID-19 Program Evaluator - $42,585.

Ms. Heather Lokko, Director, Healthy Start/Chief Nursing Officer presented proposals for Healthy Start and the Office of the Chief Nursing Officer:
• Investment of 1 FTE COVID-19 Public Health Nurse for Early Years - $104,232
• Investment of 2 FTE for Anti-Black Racism, Diversity and Inclusion, and Indigenous Reconciliation Work - $226,588.
• Investment of 1 FTE Human Resources Specialist, Diversity and Inclusion - $93,598.
• Investment in Confidential Proposal - $74,523.

It was noted that the proposed funding increase requested of the municipalities in 2021 by MLHU was the first in 12 years. With the one-time disinvestment ($150,000), City of London increase ($610,000), County of Middlesex increase ($128,000) and investments (-$893,709), there was a shortfall of -$5,709 for the base budget, which will be managed through variance funds.

It was moved by Mr. Reid, seconded by Ms. DeViet, that the Board of Health:
1) Receive Report No. 22-21FFC-R 2022 Budget – PBMA Proposals;
2) Approve Appendix A, PBMA One-Time Disinvestment totaling $150,000 savings;
3) Approve Appendix B, PBMA Incremental Investments totaling $893,709 cost; and
4) Approve Appendix C, PBMA COVID-19 Investments totaling $16,506,058 cost.
5) Direct staff to implement approved PBMA proposals, effective January 1, 2022.
Carried

Finance and Facilities Committee Meeting Summary from November 11, 2021 (Report No. 50-21)

Mr. Reid, Chair of the Finance and Facilities Committee presented the Finance and Facilities Committee Summary from November 11, 2021.

It was moved by Mr. Reid, seconded by Mr. Parker, that the Board of Health receive Report No. 23-21FFC re: “IT Hardware: Preferred Recycling Process” for information.
Carried

Program Update 1: Finance

Mr. David Jansseune, Assistant Director, Finance provided an update on the Finance Team.

Highlights of this program’s goals included:
• Partner with stakeholders to deliver exceptional financial services in a timely and accurate fashion.
• Continue to improve efficiencies, reporting and financial controls to ensure sound financial stewardship.
• Focus on value-added activities to streamline existing financial processes.
• Build effective forecasts, transparent multi-year budgets and timely monthly reporting.
• Embrace diversity, appreciate others’ input, collaborate and strive for financial excellence.

Program Update 2: Information Technology

Mr. Pat Harford, Manager, Information Technology provided an update on the Information Technology Team.

It was noted that management of Information Technology focused on 5 Pillars:
• Technology Infrastructure.
• Business Continuity.
• Technology Applications.
• Telecommunications.
• Technology Organization (Operations).

Governance Committee Meeting Summary from November 18, 2021 (Verbal)

Mr. Parker, Chair of the Governance Committee presented the Governance Committee Summary from November 18, 2021.

It was moved by Mr. Parker, seconded by Mr. Steele, that the Board of Health:
1) Receive Report No. 23-21GC re: “Governance By-law and Policy Review” for information; and
2) Approve the governance policies appended to this report as amended.
Carried

Program Update 3: Infectious Disease Control/COVID-19

Mr. Jordan Banninga, Manager, Infectious Disease Control/COVID-19 provided an update on both the IDC Program and the COVID-19 Program.

Highlights of the IDC Program included:
• There are 55 reportable diseases managed by the team with PHI’s primarily investigating enteric diseases (salmonella, E. coli, Giardia) and PHNs investigating diseases such as tuberculosis, vaccine preventable diseases, Hepatitis A etc.
• Daily staff respond to questions that come in via intake line, email and by social media.
• Facilities are inspected to prevent food borne illnesses e.g. long-term care kitchens, and infectious diseases e.g. childcare facilities and personal services settings (hair, nail salons, barber shops, tattoo shops.)
• Work with retirement homes, long-term care homes, childcare facilities and schools to prevent and manage outbreaks such as influenza. All staff respond to community-wide outbreaks e.g. invasive Group A Strep., Hepatitis A.
• All complaints regarding the infection control practices of any location in Middlesex and London are investigated e.g. dental office, medical clinic, floatation tubs.

Highlights of the COVID-19 Program included:
• These teams provide comprehensive case investigation and follow-up of COVID-19 within our community.
• The team is responsible for outbreak investigation and management in all settings except for schools.
• They also provide comprehensive COVID-19 infection prevention and control to congregate settings (long-term care and retirement homes, group homes, shelters, etc.).
• The team operates 7 days per week from 9:00 a.m. to 8:00 p.m.
• Other team members coordinate with Ontario Health West and the Assessment Centre to ensure that appropriate case finding and testing is occurring within our region.

Program Update 4: Sexual Health

Ms. Shaya Dhinsa, Manager, Sexual Health provided an update on the Sexual Health Program.

Highlights of the Sexual Health Program included:
• Implement priority populations in the Sexual Health Clinic to align with the Ontario Public Health Standards and ensure clients who need access to sexual health services receive them.
• Increased rates of sexually transmitted infections prior to and during the pandemic. Campaign development has started to target the at-risk population to increase testing and condom use.
• Grant received from Ontario HIV Treatment Network to increase HIV testing in the Emergency Departments and Urgent Care in Middlesex-London over the next six to 12 months.
• MLHU is the Naloxone distributer for Middlesex-London to eligible organizations. Currently, there are 39 community organizations including EMS, hospital, police and fire in Middlesex and London distributing and or administering Naloxone.
• As part of a multi-prong approach to decreasing HIV and Hepatitis C rates, continue to work with RHAC and City of London with the Needle Recovery Coordinated Plan.

Verbal COVID-19 Disease Spread and Vaccine Update

Dr. Summers presented the verbal COVID-19 update.

Discussion about this verbal report included:
• Incident rate is starting to rise across the province, with MLHU rates declining.
• Neighbouring health units are seeing increased caseloads among unvaccinated individuals.
• Health Canada is going to potentially approve Pfizer for 5-11-year olds on November 19, 2021.
• MLHU is ready for the shift to paediatric vaccine.

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

Correspondence

No correspondence items were received for the month of November.

Other Business

The next Middlesex-London Board of Health meeting will be on Thursday, December 9th at 7 p.m.

Confidential

At 9:40 p.m., it was moved by Mr. Parker, seconded by Ms. Elliott, that the Board of Health will move in-camera to consider personal matters regarding identifiable individuals, including municipal or local board employees, labour relations and employee negotiations and to approve confidential minutes from previous Board of Health and Committee meetings.
Carried

At 10:05 p.m., it was moved by Ms. Elliott, seconded by Ms. Kasi, that the Board of Health rise and return to public session.

Adjournment

At 10:06 p.m., it was moved by Ms. Elliott, seconded by Mr. Reid, that the meeting of Board of Health be adjourned.
Carried

Maureen Cassidy
Chair

Alexander Summers for
Christopher Mackie, Secretary-Treasurer