Minutes - April 20, 2023 - Board of Health Meeting

Members Present: 

Matthew Newton-Reid (Chair)
Michael Steele (Vice-Chair)
Selomon Menghsha (arrived at 7:20 and attended virtually)
Skylar Franke
Michelle Smibert
Aina DeViet
Peter Cuddy
Tino Kasi
Emily Williams, Chief Executive Officer (ex-officio) (attended virtually)
Dr. Alexander Summers, Medical Officer of Health (ex-officio)

Regrets:

Michael McGuire

Others Present:

Stephanie Egelton, Executive Assistant to the Board of Health (recorder)
Sarah Maaten, Acting Director, Office of the Medical Officer of Health
Mary Lou Albanese, Director, Environmental Health and Infectious Disease
Dr. Joanne Kearon, Public Health Medical Resident
Jennifer Proulx, Acting Director, Healthy Start
David Jansseune, Assistant Director, Finance
Julie Goverde, Acting Manager, Community Health Promotion
Cynthia Bos, Manager, Human Resources
Dan Flaherty, Manager, Communications
Alex Tyml, Online Communications Coordinator Communications
Parthiv Panchal, End User Support Analyst, Information Technology

Chair Matthew Newton-Reid called the meeting to order at 7 p.m.

Disclosure of Conflict of Interest

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

Approval of Agenda

It was moved by S. Franke, seconded by A. DeViet, that the April 20, 2023 Board of Health meeting agenda be approved.
Carried

Approval of Minutes

It was moved by S. Franke, seconded by P. Cuddy, that the MINUTES of the March 16, 2023 Board of Health meeting be approved.
Carried
It was moved by M. Steele, seconded by M. Smibert, that the MINUTES of the March 16, 2023 Performance Appraisal Committee meeting be received.
Carried

New Business

Governance Committee Meeting Summary (Verbal)

The Governance Committee had their inaugural meeting, due to the previously cancelled meeting in February.

Chair of the Governance Committee, Michelle Smibert provided a verbal update from the April 20, 2023 meeting.

There was no discussion on this report.

It was moved by M. Smibert, seconded by S. Franke, that the Board of Health:
1) Receive Report No. 01-23GC re: “Governance Committee Reporting Calendar”;
2) To approve the 2023 Governance Committee Reporting Calendar (Appendix A);
3) Receive Report No. 02-23GC re: “Governance Policy Review” for information;
4) Approve the governance policies as amended, appended to this report (Appendix B).
5) Receive Report No. 03-23GC re: Quarterly Risk Register Update for information;
6) Receive Report No. 04-23, re: “2021-22 Provisional Plan Progress Update” for information; and
7) Receive Report No. 05-23 GC, re: “2022 Occupational Health and Safety Report” for information.
Carried

2023 Annual Service Plan and Budget Submission (Report No. 24-23)

Dr. Alexander Summers, Medical Officer of Health, presented the 2023 Annual Service Plan and Budget Submission report.

Dr. Summers noted that the Health Unit provides three (3) reports to the Ministry of Health to inform on activities, which all require endorsement from the Board of Health:
• Annual Service Plan – to outline program plans and budget
• Standard Activity Report (SAR) – provides quarterly financial forecasts and program activity
• Annual Report and Attestation – provides a year end report on program achievements and financial year-end actuals for each program

Dr. Summers further outlined the Ministry of Health reporting timelines for the Board of Health:
• 2023 Annual Service Plan – was due April 3
• 2021 Annual Report and Attestation – was due January 13
• 2022 Q4 Standard Activity Report (Financial Forecasts and Program Data) – was due January 31
• 2022 Annual Report and Attestation – due date to be determined
• 2023 Q2 Standard Activity Report (Financial Forecasts) – due at the end of July
• 2023 Q3 Standard Activity Report (Financial Forecasts and Risk Management) – due at the end of October
• 2023 Q4 Standard Activity Report (Financial Forecasts and Program Data) – due at the end of January 2024
• 2024 Annual Service Plan – due February 2024
Dr. Summers noted that the plan moving forward is to continue alignment of operational planning with strategic planning. Staff have outlined a map of the Ministry of Health reporting cycle until Q2 of 2025.

Dr. Summers further noted that the report in front of the Board for the 2023 Annual Service Plan includes program details and a budget submission for shared funded programs and Seniors Dental only (excludes all other 100% funded programs). The budget submission is identical to the Board approved budget, but the format has been changed from Division & Department to Health Standard & Programs. The Health Unit continues to fulfil a majority of the Ontario Public Health Standards, however the recovery from the pandemic and uncertainty of funding continue to make this challenging.

Board Member Skylar Franke inquired if the Harvest Bucks program was still being reflected in the Annual Service Plan. Dr. Summers confirmed that Harvest Bucks is still a program which the Health Unit supports. The Health Unit acts as a transfer payment agency for the Harvest Bucks program and is reflected as zero in the budget for this reason.

It was moved by M. Steele, seconded by P. Cuddy, that the Board of Health:
1) Receive Report No. 24-23, re: “2023 Annual Service Plan and Budget Submission” for information; and
2) Approve the 2023 Middlesex-London Health Unit Annual Service Plan for endorsement to the Ministry of Health.
Carried

Monitoring Food Affordability and Implications for Public Policy and Action (Report No. 25-23)

Dr. Summers introduced Julie Goverde, Acting Manager, Community Health Promotion to present the report on Monitoring Food Affordability and Implications for Public Policy and Action.

J. Goverde provided highlights and background on the report. It was noted reporting on food affordability was paused in 2020 and 2021 due to the COVID-19 pandemic. There is no comparable data for the 2022 report because dieticians creating the report changed the format to reflect new changes on how many people are grocery shopping. While the data isn’t comparable, it is still of value in determining food affordability. The new changes to the format of the report include both online and in person grocery shopping. It was noted that the estimated local monthly cost to feed a family of four was $1,084. In Ontario, according to the Consumer Price Index, the price of food purchased from stores in January 2023 was 10.1% higher than in January 2022, rising at an annual rate not seen since the early 1980s.

J. Goverde furthered noted that the grocery stores part of the study included twelve (12) grocers, with two (2) from the County of Middlesex and ten (10) from the City of London, and were split between premium and discount grocery stores. The study looked at whole food purchases, as opposed to prepared foods, and was based off Canada’s Food Guide. It was noted that these factors could be limiting to the data, as some individuals may not know how to prepare whole foods or the whole foods may not be culturally relevant to them. The data reflects that the most difficult situations for food affordability are for single individuals and parents on Ontario Works.

Board Member S. Franke noted that further in the agenda, there is correspondence from Public Health Sudbury and District, requesting the government to increase minimum wage in Ontario. S. Franke inquired if the Board could conduct similar advocacy to support those in the community who cannot afford food.

It was moved by S. Franke, seconded by M. Smibert, that the Board of Health direct the Board Chair to write a letter on behalf of the Board of Health to the Minister of Health, Minister of Children, Community and Social Services, and local Members of Provincial Parliament to advocate for increased social assistance payments in regard to the affordability of food.
Carried

S. Franke further inquired how the Board of Health can advocate further. J. Goverde noted that the Health Unit sends the report information to the Regional Living Wage Network, who use information to increase wages in their network. Dr. Summers added that in June, the Board Chair and Vice-Chair would be attending Board section meetings at the Association of Local Public Health Agencies’ Annual General meeting, where further advocacy work could be discussed.

It was moved by A. DeViet, seconded by P. Cuddy, that the Board of Health:
1) Receive Report No. 25-23, re: “Monitoring Food Affordability and Implications for Public Policy and Action” for information; and
2) Forward Report No. 25-23 re: “Monitoring Food Affordability and Implications for Public Policy and Action” to Ontario boards of health, the City of London, Middlesex County, and appropriate community agencies.
Carried

Middlesex-London Food Policy Council Update

Dr. Summers provided a follow-up to the Board of Health appointment to the Middlesex-London Food Policy Council. Dr. Summers noted that the Middlesex-London Food Policy Council’s Terms of Reference alluded to having representation from the Middlesex-London Board of Health, which could have been a Board Member or a staff member. The Board made the following motion at the February 16, 2023 meeting:

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.

Dr. Summers added that the Middlesex-London Food Policy Council sent a response letter, noting that the appointment of a senior staff member could not be accepted and that they were requesting a Board of Health Member, which has historically been the case. Dr. Summers and the Board’s position is that there is value of having a senior staff member appointed on the council to provide further insight on work the Health Unit is doing, and noting that there are senior staff from other organizations appointed to the council currently. Dr. Summers has suggested to the Chair of the Middlesex-London Food Policy Council to consider having a Health Unit senior staff member on their council and is currently awaiting feedback.

Currently, Board Member Michelle Smibert sits on the Middlesex-London Food Policy Council as a County of Middlesex representative. Previously, John Brennan (a former Board Member) filled this role as both the County representative and the Board of Health representative.

It was moved by S. Franke, seconded by M. Smibert, that the Board of Health receive the verbal update re: Middlesex-London Food Policy Council Appointment Update 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

Dr. Summers noted that the work involving the ongoing crisis of health and homelessness in the community continues. The solutions at hand focus on a new way of organizing the health and homelessness system, and how to be engaged in the governance of this system. The Health Unit does not work directly with clients seeking housing, but will continue to support community collaboration in modifying and reorienting the broader system to support individuals who are homeless and underhoused.

Warning Labels on Alcoholic Beverages

Dr. Summers noted that there is a correspondence item before the Board for proposed endorsement on supporting the amending of Bill S-254: An Act to amend the Food and Drugs Act. The federal government is reviewing the need for warning labels on alcoholic beverages. This technique has been effective for mitigating the impact of commercial tobacco.

Respiratory Season Update

Dr. Summers noted that COVID-19 infection rates are continuing to trend downwards, and influenza infection rates are remaining low but still present. The first wave of influenza this season was during November through December, and there will most likely be a second wave within the next month due to influenza B. In regard to COVID-19, there is a spring booster campaign for high-risk individuals underway. It is anticipated that in Fall 2023 there will be a general population booster campaign.

Board Member Michael Steele inquired if there has been any further reporting or research released on long-term impacts of those who have had COVID-19 infections. Dr. Summers explained that he is unaware of any new notable research, but noted that some individuals who had severe COVID-19 infections certainly have had significant post viral fatigue and associated symptoms. The burden on the overall population has not been quantified.

Chair Newton-Reid inquired if hospitalization rates for COVID-19 infection had decreased. Dr. Summers noted that the numbers were significantly lower. The severity of COVID-19 infections has dropped significantly as the severity outcome is less due to baseline immunity and collective immunity.

It was moved by M. Smibert, seconded by M. Steele, that the Board of Health receive the verbal report re: Current Public Health Issues for information.
Carried

Medical Officer of Health Activity Report for March (Report No. 26-23)

Dr. Summers presented the Medical Officer of Health activity report for March.

There was no discussion on this report.

It was moved by P. Cuddy, seconded by A. DeViet, that the Board of Health receive Report No. 26-23 re: “Medical Officer of Health Activity Report for March” for information.
Carried

Chief Executive Officer Activity Report for March (Report No. 27-23)

E. Williams presented the Chief Executive Officer activity report for March.

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. 27-23 re: “Chief Executive Officer Activity Report for March” for information.
Carried

Correspondence

It was moved by S. Franke, seconded by P. Cuddy, that the Board of Health endorse item a) re: Simcoe Muskoka District Health Unit re: Support for ‘Bill S-254 An Act to amend the Food and Drugs Act (warning label on alcoholic beverages)’ 
Carried

It was moved by M. Steele, seconded by S. Franke, that the Board of Health receive the following items for information:
b) April 2023 Middlesex-London Board of Health External Landscape
c) Public Health Sudbury & Districts re: Minimum Wage Increase
Carried

Board Member S. Franke inquired if the Health Unit pays employees a living wage. E. Williams confirmed that employees are paid a living wage.

S. Franke further inquired if the Health Unit is certified with the Ontario Living Wage Network. E. Williams confirmed that the Health Unit is not certified at this time.

It was moved by S. Franke, seconded by S. Menghsha, that the Board of Health direct staff to investigate seeking a living wage certification through the Ontario Living Wage Network for the Middlesex-London Health Unit.
Carried

Other Business

The next meeting of the Middlesex-London Board of Health is on Thursday, May 18, 2023 at 7 p.m.

Confidential

At 7:42 p.m., it was moved by A. DeViet, seconded by P. Cuddy, that the Board of Health will move in-camera to consider matters regarding labour relations or employee negotiations, personal matters about an identifiable individual, including Board employees, advice that is subject to solicitor-client privilege, including communications necessary for that purpose, 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 8:33 p.m., it was moved by M. Steele, seconded by P. Cuddy, that the Board of Health return to public session from closed session.
Carried

Adjournment

At 8:33 p.m., it was moved by M. Steele, seconded by P. Cuddy, that the Board of Health adjourn the meeting.
Carried

Matthew Newton-Reid
Chair

Emily Williams
Secretary