Minutes - February 16, 2023 - Board of Health Meeting

Members Present: 

Mike Steele (Vice-Chair)
Selomon Menghsha (attended virtually)
Skylar Franke
Michelle Smibert
Peter Cuddy
Mike McGuire (attended virtually)

Regrets:

Matt Reid
Aina DeViet
Tino Kasi

Others Present:

Stephanie Egelton, Executive Assistant to the Board of Health (recorder)
Emily Williams, Chief Executive Officer
Dr. Alexander Summers, Medical Officer of Health
Sarah Maaten, Acting Director, Office of the Medical Officer of Health
Amanda Harvey, Acting Manager, Program Planning and Evaluation
Maureen MacCormick, Director, Healthy Living
Julie Goverde, Acting Manager, Community Health Promotion
Mary Lou Albanese, Director, Environmental Health and Infectious Disease
Jennifer Proulx, Acting Director, Healthy Start
David Jansseune, Assistant Director, Finance
Dan Flaherty, Manager, Communications
Alex Tyml, Online Communications Coordinator, Communications
Parthiv Panchal, End User Support Analyst, Information Technology
Morgan Lobzun, Communications Coordinator, Communications

Vice-Chair Mike Steele called the meeting to order at 7:01 p.m.

Disclosure of Conflict of Interest

Vice-Chair Steele inquired if there were any disclosures of conflicts of interest. None were declared.

Approval of Agenda

The Vice-Chair noted that due to the cancellation of the February 16, 2023, Governance Committee meeting, that there were some time sensitive reports needing to be reviewed by the Board of Health that could not wait until the next Governance meeting.

It was moved by P. Cuddy, seconded by M. Smibert, that the February 16, 2023 Board of Health meeting agenda be amended to include the Annual Privacy Program Update and the 2021-22 Provisional Plan Progress Update.
Carried

It was moved by S. Franke, seconded by M. Smibert, that the February 16, 2023 Board of Health meeting agenda be amended to remove the Governance Committee standing update.
Carried

Vice-Chair Steele noted that the Board of Health had received a late item of correspondence from the Association of Local Public Health Agencies regarding provincial appointments. Vice-Chair Steele inquired if any Board members desired to make a motion to add this item of correspondence to the agenda. No motion was made, and the item was not added to the agenda.

It was moved by S. Franke, seconded by P. Cuddy, that the AGENDA for the February 16, 2023 Board of Health meeting be approved as amended.
Carried

Approval of Minutes

It was moved S. Franke, seconded by M. Smibert, that the MINUTES of the January 19, 2023 Board of Health meeting be approved.
Carried

It was moved by P. Cuddy, seconded by S. Franke, that the MINUTES of the January 24, 2023 Special Board of Health meeting be approved.
Carried

It was moved by M. Smibert, seconded by S. Menghsha, that the MINUTES of the February 2, 2023 Finance and Facilities  meeting be received.
Carried

New Business

Finance and Facilities Committee Meeting Summary (Report No. 10-23)

Mike Steele, Chair of the Finance and Facilities Committee introduced the summary for the February 2, 2023 Finance and Facilities Committee meeting. Chair Steele (in the capacity as Committee Chair) noted that the Committee recommended for the cadence of meetings to be adjusted to be in a two month on, one month off cadence along with being moved to the second Thursday of the meeting month to allow for more time and accuracy in compiling financial information for the Committee.

Chair (as the Committee Chair) Steele introduced Dave Jansseune, Assistant Director, Finance, to present the Q4 Financial Update, Financial Borrowing and Factual Certificate Update as it was presented at the Committee.

Shared Funded Programs
- Surplus of $2.1 million
- MLHU has $32.3 million in funding with $30.2 million in expenses.
- COVID-19 has resulted in a deficit of $2.1 million, with $17.9 million in funding and $20.0 million in expenses.

100% Funded Programs
- School Focused Nurses Initiative: funding of $1.6 million and expenditures totaling $1.1 million.
- Seniors Dental Program: funding of $2.2 million and expenditures totaling $1.8 million.
- Nurses Retention Incentive: funding of $1.2 million and expenditures totaling $1.1 million.
- CLIF – City of London Funding for Cannabis Legalization: funding of $416,000 and expenditures totaling $294,000. It is noted that the City of London approved carryover of these funds into 2023.
- Strathroy Capital for Seniors’ Dental project is actively underway with $1 million available for funding.

Board Member Peter Cuddy inquired about CLIF funding and how the Health Unit uses these funds. Maureen MacCormick, Director, Healthy Living clarified that the CLIF funding was used to support education of cannabis retailers licensed under the Cannabis Act in the region.

P. Cuddy further inquired on the challenges in recruiting qualified nurses with School Focused Nurses Initiative funding. Dr. Alexander Summers, Medical Officer of Health, noted that these challenges were mainly to do with the temporary nature of these roles (due to the temporary nature of the funding) in a highly competitive job market for nurses.

Shared Funding – Variances
- Grants, user fees, and incomes are showing favourability of $1,127,000 due to Nurses Retention Incentive.
- Salaries and wages are showing favourability of $1,386,000 due to vacancies at the MLHU.
- Overtime hours are showing unfavourability of $128,000.
- Benefits are showing favourability of $749,000.
- General Expenses are showing favourability of $572,000 which includes:
o Professional Services at $186,000;
o Program Supplies at $257,000;
o Travel at $181,000;
o Equipment at $100,000;
o Transfer to reserves at $361,000 unfavourability (which includes the previous transfers to the Employment Costs and Technology & Infrastructure reserves);
o Other costs at $209,000.

Forecast
- Shared Funding Programs had forecasted a surplus of $2.3 million with an actual of $2.1 million. COVID-19 & School Focused Nursing Initiative forecasted expenditures at $22.1 million of actual at $21.1 million.
- This demonstrates highly accurate forecasting for the 2022 budget year.

Cashflow
- There is a potential for GIC investments to diversify cashflow and offset interest rate expenses.
- The bank balance as of December 31 was $4.2 million (positive).
- For borrowing, the fixed loan is at $3.05 million with $2.8 million owing and the variable loan is at $1.15 million with $1.035 million owing.
- In reserves, there is $287,000 in the Employment Cost Reserve and $250,000 in the Technology & Infrastructure Reserve.
- COVID-19 funding for Q4 was $3.4 million.
- Strathroy Capital (Seniors’ Dental) funding for Q4 was $939,000, with scheduled construction beginning soon.

Board Member Skylar Franke inquired if MLHU can pay off all loans ahead of time due to inflationary costs and interest rates. D. Jansseune noted that the fixed rate loan had a specific pay term, and the variable loan has an interest rate of prime plus one. It was noted that in next year’s budget, there is an accelerated loan payment plan proposed. MLHU cannot pay off the entire portion of the loan due to Ministry of Health direction to redirect surplus funds from operating to COVID-19 expenses.

D. Jansseune noted that MLHU is continuing with year-end closing with minimal entries, preparing for the annual audit in March and April, preparing financial statements and the Ministry of Health Annual Reconciliation Report. It was added that any changes to numbers would be reported to the Board of Health, through the Finance and Facilities Committee.

It was moved by S. Franke, seconded by P. Cuddy, that the Board of Health:
1) Approve the 2023 Finance and Facilities Committee Reporting Calendar to include the timing change of meetings to the second Thursday of the meeting month;
2) Approve the Finance and Facilities Committee Terms of Reference as amended; and
3) Receive Report No. 02-23FFC re: “2022 Q4 Financial Update, Financial Borrowing and Factual Certificate” for information.
Carried

Public Sector Salary Disclosure Act – 2022 Record of Employees’ Salaries and Benefits (Report No. 11-23)

E. Williams introduced the report regarding the Public Sector Salary Disclosure Act – 2022 Record of Employees’ Salaries and Benefits. E. Williams noted that the MLHU is required as a public sector organization per the Public Sector Salary Disclosure Act to disclose the names, positions and salaries (over $100,000) of employees within the organization. In 2021, there were 99 individuals on the legislative record and this number in 2022 had decreased to 58 due to the decrease in COVID-19 pandemic overtime.

There was no discussion on this report.

It was moved by M. Smibert, seconded by M. McGuire, that the Board of Health receive Report No. 11-23 re: “Public Sector Salary Disclosure Act – 2022 Record of Employees’ Salaries and Benefits” for information.
Carried

Annual Privacy Program Update (Report No. 15-23)

E. Williams provided the annual update on MLHU’s Privacy Program. E. Williams noted that annual reporting of access requests under the Municipal Freedom of Information and Protection Act (MFIPPA), the Personal Health Information and Protection Act (PHIPA) and privacy breaches to the Information and Privacy Commissioner of Ontario is mandatory. March 1 is the reporting deadline for privacy breaches and March 31 is the deadline for access requests. All MLHU staff have taken mandatory privacy training.

E. Williams noted that all access requests were completed in mandated time periods. There were 14 MFIPPA requests, 5 PHIPA requests and 10 privacy breaches (9 were disclosures without authority) and appropriate actions were taken. Privacy breaches included paper records being accessed without authority and emails misdirected.

S. Franke inquired the comparison of privacy breaches to previous years. E. Williams noted that in 2021, there were 6 privacy breaches, with 5 being information disclosed without authority.

It was moved by M. Smibert, seconded by S. Franke, that the Board of Health receive Report No. 15-23 re: “Annual Privacy Program Update” for information.
Carried

2021-22 Provisional Plan Progress Update (Report No. 16-23)

Dr. Alexander Summers, Medical Officer of Health, introduced Amanda Harvey, Acting Manager, Program Planning and Evaluation, to provide an update on the Provisional Plan.

A. Harvey reminded the Board that in 2021, the Board of Health approved extending the timelines for phase two and three of the Provisional Plan by a minimum of three months, which extended the work of the phases and carries the Provisional Plan into Q2 2023. MLHU has made progress on 7 projects within the Provisional Plan:
- Employment Systems Review
- Implementation of the Anti-Black Racism Plan
- Onboarding and Enhancement of the Electronic Client Record (ECR)
- Transition to SharePoint
- Implementation of the Joy in Work Framework
- Return to Office
- Sociodemographic and Race-based Data Collection in Electronic Systems

It was moved by S. Franke, seconded by P. Cuddy, that the Board of Health that the Board of Health receive Report No. 16-23, re: “2021-22 Provisional Plan Progress Update” for information.
Carried

Representation on the Middlesex-London Food Policy Council (Report No. 12-23)

M. MacCormick introduced Julie Goverde, Acting Manager, Community Health Promotion, to present the report on representation on the Middlesex-London Food Policy Council.

J. Goverde noted that the Middlesex-London Policy Food Policy Council is seeking a representative from the Board to sit on the council. Currently, there is an MLHU Dietician that sits on the council as a non-voting member. It is recommended that the Board of Health appoint a member representative to the Middlesex-London Food Policy Council as a voting member or direct the Medical Officer of Health to appoint a senior staff member to the Middlesex-London Food Policy Council as a voting member for a two (2) year term. The MLHU provides an important public health perspective for planning and decision-making and helps maintain the Middlesex-London Food Policy Council as a community organization anchored in health, with a commitment to food system sustainability.

Vice-Chair Steele inquired to the Board on the options at hand: appointing a member of the Board to sit on the Middlesex-London Food Policy Council or directing the Medical Officer of Health to appoint a senior staff member to the Middlesex-London Food Policy Council. The Board was in favour of directing the Medical Officer of Health to appoint a staff member to the Middlesex-London Food Policy Council.

It was moved by S. Franke, seconded by M. Smibert, that the Board of Health:
1) Direct the Medical Officer of Health to appoint a senior staff member to the Middlesex-London Food Policy Council as a voting member for a two (2) year term; and
2) Receive Report No. 12-23 re: Board of Health Representation on the Food Policy Council for information.
Carried

Current Public Health Issues (Verbal)

Dr. Alexander Summers, Medical Officer of Health, provided a verbal update on current public health issues within the region.

Health and Homelessness

There have been Health and Homelessness Summits last fall and in January and MLHU has been participating in these summits along with over 200 agencies locally. Significant trust has been built within the sector leading to the co-design of a new model being proposed to support 24/7 integrated hubs, with roll out to occur in 2023. There is an emphasis on creating places for people to go for wrap-around health services with an entry point to housing. Dr. Summers noted that the situation is not limited to the City of London but is also impacting the County of Middlesex.

Immunization of School Pupils Act

The Health Unit continues to proceed with enforcement of the Immunization of School Pupils Act. Suspensions have been proceeding and new learnings have been incorporated in each subsequent cohort. There are six cohorts from January to May, with the most recent suspension date on February 15, 2023. The MLHU continues to provide comprehensive support to keep students in school, including offering catch-up vaccines clinics.

COVID-19 and Influenza

COVID-19 and influenza are continuing to circulate in the community. Currently, the hospital system is not under threat. It is anticipated that additional COVID-19 boosters will be rolled out in spring to high-risk population, but the overall vaccination cadence for the general population is unclear at this time.

It was moved by S. Franke, seconded by P. Cuddy, that the Board of Health receive the verbal report re: “Current Public Health Issues” for information.
Carried

Medical Officer of Health Activity Report for January (Report No. 13-23)

Dr. Alexander Summers, Medical Officer of Health, presented the Medical Officer of Health activity report for January.

There was no discussion on this report.

It was moved by M. Smibert, seconded by S. Franke, that the Board of Health receive Report No. 13-23 re: “Medical Officer of Health Activity Report for January” for information.
Carried

Chief Executive Officer Activity Report for January (Report No. 14-23)

Emily Williams, Chief Executive Officer, presented the Chief Executive Officer activity report for January.

There was no discussion on this report.

It was moved by M. McGuire, seconded by S. Menghsha, that the Board of Health receive Report No. 14-23 re: “Chief Executive Officer Activity Report for January” for information.
Carried

Correspondence

It was moved by M. Smibert, seconded by S. Franke, that the Board of Health receive item a) for information.
Carried

Other Business

The next meeting of the Middlesex-London Board of Health is on Thursday, March 16, 2023 at 7 p.m.

Confidential

At 7:49 p.m., it was moved by P. Cuddy, seconded by S. Franke, that the Board of Health will move in-camera to consider matters regarding labour relations or employee negotiations, an identifiable individual, including Board employees, litigation or potential litigation, including matters before administrative tribunals, affecting the municipality or local board and to approve previous confidential Board of Health minutes.
Carried

At 8:03 p.m., it was moved by M. Smibert, seconded by P. Cuddy, that the Board of Health return to public session from closed session.
Carried

Adjournment

At 8:03 p.m., it was moved by S. Franke, seconded by P. Cuddy, that the meeting be adjourned.
Carried

Mike Steele
Vice-Chair

Emily Williams
Secretary