Minutes - September 15, 2022 - Board of Health Meeting

Members Present:

Mr. Matt Reid (Chair)
Ms. Kelly Elliott (Vice-Chair)
Ms. Mariam Hamou
Ms. Maureen Cassidy
Ms. Aina DeViet
Mr. Selomon Menghsha

Regrets:

Ms. Tino Kasi
Mr. Michael Steele
Mr. John Brennan

Others Present:

Ms. Carolynne Gabriel, Executive Assistant to the Board of Health and Communications Coordinator (Recorder)
Dr. Alexander Summers, Medical Officer of Health
Dr. Karalyn Dueck, Acting Associate Medical Officer of Health
Ms. Emily Williams, Chief Executive Officer
Ms. Maureen MacCormick, Director, Healthy Living
Ms. Heather Lokko, Chief Nursing Officer
Ms. Jennifer Proulx, Acting Director, Healthy Start
Ms. Kendra Ramer, Manager, Privacy, Risk and Project Management
Dr. Damilola Toki, Acting Manager, Healthy Beginning Visiting and Group Programs
Ms. Lindo Stobo, Manager, Chronic Disease Prevention and Tobacco Control
Ms. Anita Cramp, Manager, Young Adult
Mr. Dan Flaherty, Manager, Communications
Mr. Alex Tyml, Online Communications Coordinator
Mr. Parthiv Panchal, Information Technology, End User Support Analyst

Chair Matt Reid called the meeting to order at 7:01 p.m.

Disclosure of Conflict of Interest

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

Approval of Agenda

Ms. Maureen Cassidy requested a walk-on report be added to the agenda to discuss the Chief Executive Officer Performance Appraisal Form.

It was moved by Ms. Aina DeViet, seconded by Ms. Kelly Elliott, that the AGENDA for the September 15, 2022 Board of Health meeting be approved, as amended.
Carried

Chair Reid provided an update that the Ministry of Health has officially appointed Dr. Alexander Summers as Medical Officer of Health for the Middlesex-London Health Unit.

Approval of Minutes

It was moved by Ms. Mariam Hamou, seconded by Ms. Cassidy, that the Board of Health approve the MINUTES of the July 14, 2022 Board of Health meeting.
Carried

It was moved by Ms. DeViet, seconded by Ms. Cassidy, that the Board of Health receive the:

Carried

Reports and Agenda Items

Finance & Facilities Committee Meeting – August 4, 2022 (Report No. 49-22)

This report was introduced by Ms. Elliott. The Finance and Facilities Committee met on August 4, 2022. One report was brought forward regarding the 2022 Q2 Financial Update and Factual Certificate.

It was moved by Ms. Elliott, seconded by Ms. Hamou, that the Board of Health receive Report No. 14-22FFC re: “2022 Q2 Financial Update and Factual Certificate” for information.
Carried

Governance Committee Meeting – September 15, 2022 (Verbal Update)

This report was introduced by Ms. DeViet, Chair of the Governance Committee.

The Governance Committee met on September 15, 2022 immediately preceding the Board of Health meeting. One report was brought forward from Ms. Emily Williams, Chief Executive Officer and Ms. Kendra Ramer, Manager, Privacy, Risk, and Project Management providing an update on the 2021-22 Provisional Plan.

One goal associated with a project was identified as having problems which have surfaced due to the prioritization of resources to other projects; however, these problems are considered manageable.

It was moved by Ms. DeViet, seconded by Ms. Cassidy, that the Board of Health receive Report No. 12-22GC, re: “2021-22 Provisional Plan Progress Update” for information.
Carried

MLHU’s Smart Start for Babies (SSFB) Program: Implementation Update (Report No. 50-22)

This report was introduced by Ms. Jennifer Proulx, Acting Director, Healthy Start who introduced Dr. Damilola Toki, Acting Manager, Healthy Beginning Visiting and Group Programs.

Dr. Toki shared a PowerPoint presentation. Highlights of this report included:

Smart Start for Babies (SSFB) is a Canada Prenatal Nutrition Program designed for pregnant individuals who are at risk for poor birth outcomes due to multiple factors.
SSFB provides access to healthy foods, prenatal and nutrition education, life skills development, and referrals to available community supports and resources.
The program is funded by the Public Health Agency of Canada (PHAC) with a current annual level of $152,430 with in-kind staffing support from MLHU. In-kind space and personnel support is also received from several community partners.
Between March 2020 to September 2021, the SSFB program was suspended as part of MLHU’s COVID-19 pandemic response and staff redeployment.
Between September 2021 and April 2022, there was a gradual resumption of SSFB programming with a focus on program planning, consultation with partners and the development of a new hybrid model.
Between May 2022 and September 2022, there were incremental increases in programming and the number of sites, including South London Neighbourhood Resource Centre (English and Arabic Speaking sessions), Family Centre Carling Thames, and Family Centre Argyle.
The SSFB autumn 2022 schedule consists of Family Centre Carling Thames, Thursday, 1:30-3:00 p.m.; South London Neighbourhood Resource Centre, Tuesday, 1:00-2:30p.m.; South London Neighbourhood Resource Centre Arabic Speaking Class, Thursday, 1:00-3:00p.m.; and Family Centre Argyle, Tuesday, 6:00-7:30p.m.
Next steps between September 2022 to January 2023 include a further expansion and exploration of new partners and locations, with a focus on the resumption of youth programming, Middlesex County residents, and residents in the Limberlost community.

Mr. Selomon Menghsha noted there is a focus on Arabic speaking clients and inquired if support for other languages is available. It was indicated that there is a plan to provide classes for Spanish speakers in the coming weeks. Dr. Alexander Summers, Medical Officer of Health added that the initial focus on Arabic speakers was based upon local demographic data which shows that Arabic is the second most common language spoken in the Middlesex-London region. Additionally, there is a policy and procedures in place to ensure services can be delivered in all languages.

Mr. Menghsha inquired if the timing of the classes being on Tuesdays and Thursdays, primarily in the middle of the day caused any accessibility issues for individuals who may work during the day. Dr. Toki indicated that prior to resuming services, consultations were held with community partners to determine the most appropriate times for clients. Additionally, the majority of the clients are currently “stay at home moms” and so the mid-day times are tailored to the demography of the clients. With the new hybrid model, classes are also available in the evenings.

Ms. DeViet requested additional information on the planned approach for focusing on Middlesex County residents, who the community partners might be, and how many of the six classes proposed for expanding the services will occur in Middlesex County. Ms. Proulx indicated that SSFB services have been offered out of the Strathroy office and other potential partners in the County could be local libraries. In the past, there have been challenges with insufficient registrants in the County and instead of providing SSFB classes in the County, services have been provided directly in the client’s home through Home Visiting. When MLHU receives a referral, the team develop creative solutions to provide the service.

It was moved by Ms. DeViet, seconded by Ms. Hamou, that the Board of Health receive Report No. 50-22, re: “MLHU’s Smart Start for Babies (SSFB) Program: Implementation Update” for information.
Carried

Feedback on Proposed Tobacco Product Labelling Requirements Under the Tobacco and Vaping Products Act (Report No. 51-22)

This report was introduced by Ms. Maureen MacCormick, Director, Healthy Living who introduced Ms. Linda Stobo, Manager, Chronic Disease Prevention and Tobacco Control.

Highlights of this report included:

Canada has a history of being a global leader in pictorial health warnings on tobacco products. Canada was the first country to require the graphic picture warnings on cigarette packages in 2001. Since then, more than 100 countries and territories have adopted similar legislations.
The proposed amendments, which were opened to public consultations by the Federal Government, would: extend labelling requirements to all tobacco products, including small cigars with a filter (cigarillos) or other forms of tobacco product like pipe tobacco or loose tobacco; implement periodic rotation of messages; and require warnings to be on each individual cigarette so that those who do not see the packaging will see the warning.
The industry probably sees this legislative change differently than those in public health, so it is important to work collaboratively with public health partners to ensure the health benefits of these changes were communicated through this public consultation process.
To comply with the deadlines for the consultation, this response has already been submitted but the team wanted to provide the report to the Board of Health for information.

It was moved by Ms. Cassidy, seconded by Ms. Hamou, that the Board of Health receive Report No. 51-22, re: “Feedback on Proposed Tobacco Product Labelling Requirements Under the Tobacco and Vaping Products Act” for information.
Carried

Supporting Students’ Development of a Positive Relationship with Food in Schools (Report No. 52-22)

This report was introduced by Ms. MacCormick who introduced Ms. Anita Cramp, Manager, Young Adult Team.

Highlights of this report include:

Evidence indicates that traditional healthy eating messages and practices implemented in schools, such as framing certain foods as good or bad/healthy or unhealthy, and tracking foods and calories, can cause harm by potentially triggering disordered eating behaviours, adversely impacting diet, and promoting a dieting culture.
Recently, there has been a rise in eating disorders in young adults.
Implementing a neutral strategy for teaching food and nutrition has students learning about nutrients, tasting different foods, and reflecting on foods and individual eating habits. This approach promotes eating competence and a positive relationship with food, as well as supports food acceptance over time.
Registered dietitians on the Child Health and Young Adult teams are leading a shift to a neutral food education approach which is culturally sensitive, developmentally appropriate, protective against disordered eating, and promotes overall health and wellbeing. This is a very significant change in the approach to teaching about food and nutrition.
Next steps include: reviewing and updating internal nutrition resources and messages to ensure alignment with this approach, and discontinuing the use of programs and resources which do not align; enhancing the promotion of existing internal programming and resources that align with this approach, including food literacy programming; developing new resources to support educators and staff as appropriate; developing and facilitating training for MLHU staff working in schools on this approach, and orientating new staff; working closely with school partners to increase awareness about the evidence linking traditional healthy eating educational approaches to eating disorders / disordered eating; promoting the discontinuation by school boards and school partners of curriculum, programs and resources that do not align with this approach; exploring external training opportunities for educators and community stakeholders; fulfilling a leadership role in advocating to school staff, community partners, public health professionals, and relevant provincial organizations on this approach; and sharing this approach with other health units for consideration to ensure consistent messaging.

Chair Reid requested comment on the possibility of changing food and nutrition curricula which is set by the Province. Ms. Cramp indicated that changing provincially-set curricula is challenging. Sometimes it is not the content of the curricula which is misaligned with the neutral approach, but rather how the curriculum is taught and the language which is used; for example, the curriculum might direct learning about food patterns, but this is taught through having students download an app and track their food and calories.

Ms. Cassidy inquired if Ms. Cramp is aware of changes to curricula to focus on learning about how food is grown and where it comes from. Ms. Cramp indicated this is becoming more common, for example seeing more grow towers in schools and school gardens. Ms. Cassidy inquired if there is a potential role for community organizations to assist with school gardens and greenhouses, for example, a partnership with the London Food Bank where the students learn about growing the food, and some of the food is then donated to the Food Bank. Ms. Cramp indicated that the program is always open to community partnerships and is interested in ways partnerships can strengthen initiatives. She added that recently food literacy has been included in the Science and Technology curriculum up to grade nine, which expands food and nutrition education beyond its traditional place in the physical education curriculum.

Ms. MacCormick commented that Ms. Kim Loupos, a dietitian with MLHU, is on the Board of Directors of the London Food Bank and provides a connection between the organizations. MLHU is also very involved with the London Food Policy Council.

It was moved by Ms. Elliott, seconded by Ms. Cassidy, that the Board of Health receive Report No. 52-22, re: “Supporting Students’ Development of a Positive Relationship with Food in Schools” for information.
Carried

Infection Prevention and Control (IPAC) Hub Update and 2022-23 Funding Agreement (Report No. 53-22)

This report was introduced by Ms. Mary Lou Albanese, Director, Environmental Health and Infectious Diseases.

Highlights of this report include:

Ontario Health identified that organizations in Ontario would be local lead IPAC hubs. In the Southwest region Southwestern Public Health is the lead and through them MLHU has received funding to help support initiatives which include in-person inspections in high-risk settings (Long-term care homes, retirement homes, congregate settings, shelters, and group homes).
The aim is to support these settings through COVID-19 and other respiratory illnesses. It can be hard for these settings to do a lot of IPAC work, so for MLHU to be able to support these settings is looked upon positively by these settings.
IPAC in community settings is a fundamental component of public health work, but the Health Unit does not always have the funding to do it to the scope desired. This funding has come in an indirect way. The amounts are not added to the Health Unit’s base funding, but rather come from the Ministry of Health, through to Ontario Health, and then distributed to identified IPAC Hubs. In other areas of the province these Hubs are hospitals or other health units. The program is currently being evaluated at the provincial level.

It was moved by Ms. Hamou, seconded by Ms. DeViet, that the Board of Health receive Report No. 53-22 re: “Infection Prevention and Control (IPAC) Hub Update and 2022-23 Funding Agreement,” for information.
Carried

Current Public Health Issues (Verbal Update)

This verbal report was provided by Dr. Summers, who shared a PowerPoint presentation.

Highlights of this report included:

An update on Monkeypox in London and Middlesex County. To date, 15 cases have been identified in the region and nearly 1000 vaccines have been delivered. Locally and provincially, the outbreak is waning.
An update on the COVID-19 pandemic including local case counts, cases by reported date, percent positivity rates, and vaccine coverage data as of September 14.
An update that the mass COVID-19 vaccination clinic at the Western Fair District Agriplex will be moving to a new location in the Western Fair District’s main building on the north side of Florence St. The last day of clinic operations at the Agriplex will be Thursday, September 29th and the clinic will reopen in its new location on Monday, October 3.

Ms. Cassidy inquired how many COVID-19-related deaths have occurred in the region since the beginning of the pandemic and how the current mortality rate compares with earlier waves. Dr. Summers indicated that the number of COVID-19-related deaths in 2022 will be higher than seen in 2021 and 2020. The prevalence and incidence of COVID-19 in 2022 is dramatically more than seen prior to the arrival of the Omicron variant, so even with the success of the COVID-19 vaccines, due to the prevalence, the number of deaths will be higher than in previous years. The individuals who are dying with or because of COVID-19 lately are severely vulnerable due to age or health conditions. This is different than during earlier waves when there was limited or no vaccine protection and when some deaths were occurring in people in their 40s and 50s. If dramatic actions had not been taken in 2020 and 2021 to protect a vulnerable, vaccine-naïve population, the mortality rate due to COVID-19 earlier in the pandemic would have been considerably higher. Going forward there will continue to be mortality due to COVID-19. Continued steps should be taken to prevent mortality, including IPAC in high-risk settings, vaccinations, masking, and staying home when ill.

Ms. DeViet requested comment on the recent changes to self-isolation recommendations. Dr. Summers commented that the recent change in self-isolation guidance highlights a change in strategy and a change in risk tolerance societally. With the most recent guidance for self-isolation, if an individual has COVID-19 but they are feeling better and do not have a fever, they can stop isolating; however, they are still at risk of transmitting COVID-19 for several days afterwards. The risk of transmission has not changed, but the tolerance to that risk has changed. The general guidance for the general public is: if you feel unwell due to a respiratory illness, stay home. You can leave when you have been feeling better for 24 hours and do not have a fever, but you are encouraged to wear a mask and avoid high-risk settings. It is not advised that individuals should test for COVID-19 if they have respiratory symptoms because it does not change the actions to be taken.

It was moved by Ms. Hamou, seconded by Ms. Cassidy, that the Board of Health receive the Verbal update re: “Current Public Health Issues” for information.
Carried

Medical Officer of Health Activity Report for July and August (Report No. 54-22)

It was moved by Ms. DeViet, seconded by Mr. Selomon Menghsha, that the Board of Health receive Report No. 54-22 re: “Medical Officer of Health Activity Report for June” for information.
Carried

Chief Executive Officer Activity Report for July and August (Report No. 55-22)

It was moved by Ms. Cassidy, seconded by Ms. Elliott, that the Board of Health receive Report No. 55-22 re: “Chief Executive Officer Activity Report for June” for information.
Carried

Performance Appraisal Tool (Walk-on Report)

This verbal report was introduced by Ms. Cassidy, Chair, Performance Appraisal Committee. Ms. Cassidy provided an update as to the work undertaken by the Performance Appraisal Committee to date and the next steps in the Performance Appraisal process. She also indicated that the CEO Performance Appraisal Tool approved by the Board of Health this year is different than the one used in 2021, and recommended that the CEO Performance Appraisal Tool from 2021 be used in this year’s Performance Appraisal process as well.

It was moved by Ms. Cassidy, seconded by Ms. DeViet, that the Board of Health adopt the 2021 Performance Appraisal Tool for use in the 2022 Performance Appraisal Process of the Chief Executive Officer.
Carried

Correspondence

It was moved by Ms. Elliott, seconded by Ms. Cassidy, that the Board of Health receive items a), b) and c).
Carried

Other Business

The next meeting of the Middlesex-London Board of Health is Thursday, October 20 at 7:00 p.m.
Carried

Confidential

At 8:12 p.m., it was moved by Ms. Hamou, seconded by Ms. Elliott, that the Board of Health will move in-camera to approve previous confidential Board of Health and Committee minutes, to consider matters regarding personal matters about an identifiable individual, including municipal or local board employees, labour relations or employee negotiations, litigation or potential litigation, including matters before administrative tribunals, affecting the municipality or local board and advice that is subject to solicitor-client privilege, including communications necessary for that purpose.
Carried

At 8:55 p.m., it was moved by Ms. Elliott, seconded by Ms. DeViet, that the Board of Health return to public session from closed session.
Carried

Adjournment

At 8:55 p.m., it was moved by Ms. Cassidy, seconded by Ms. Elliott, that the meeting be adjourned.
Carried

Matt Reid
Chair

Emily Williams
Secretary

Date of creation: October 13, 2022
Last modified on: February 22, 2023