Minutes - November 16, 2023 - Board of Health Meeting

Members Present: 

Matthew Newton-Reid (Chair)
Michael Steele (Vice-Chair)
Selomon Menghsha
Skylar Franke
Michelle Smibert
Aina DeViet
Peter Cuddy
Michael McGuire
Howard Shears
Emily Williams, Chief Executive Officer (ex-officio)
Dr. Alexander Summers, Medical Officer of Health (ex-officio)

Regrets:

Tino Kasi

Others Present:

Stephanie Egelton, Executive Assistant to the Board of Health (recorder)
Sarah Maaten, Director, Public Health Foundations
Mary Lou Albanese, Director, Environmental Health and Infectious Disease
Jennifer Proulx, Acting Director, Healthy Start and Chief Nursing Officer
Dr. Joanne Kearon, Associate Medical Officer of Health
Cynthia Bos, Manager, Human Resources
Lindsay Croswell, Community Health Nursing Specialist
David Jansseune, Assistant Director, Finance
Rhonda Brittan, Manager, Healthy Beginnings Visiting and Group Programs
Jody Shepherd, Associate Manager, Healthy Families Home Visiting
Julie Goverde, Acting Manager, Community Health Promotion
Isabel Resendes, Manager, Healthy Families Home Visiting
Alison Locker, Manager, Population, Health, Assessment and Surveillance
Alex Tyml, Online Communications Coordinator, Communications
Abha Solanki, End User Support Analyst, Information Technology
Marc Resendes, Acting Manager, Strategy, Planning and Performance
Morgan Lobzun, Communications Coordinator
Emily Van Kesteren, Acting Manager, Communications

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 P. Cuddy, seconded by M. Steele, that the AGENDA of the November 16, 2023 Board of Health meeting be approved.
Carried

Approval of Minutes

It was moved by A. DeViet, seconded by M. Smibert, that the MINUTES of the October 19, 2023 Board of Health meeting be approved.
Carried

New Business

Governance Committee Summary from November 16 (Verbal)

Governance Committee Chair, Michelle Smibert provided a verbal update on items heard at the November 16, 2023 Governance Committee meeting.

It was moved by M. Smibert, seconded by P. Cuddy, that the Board of Health receive Report No. 12-23GC re: “2023 Board of Health Self-Assessment Results” for information.
Carried

It was moved by M. Smibert, seconded by M. Steele, that the Board of Health:
1) Receive Report No. 13-23GC re: “Governance Policy Review” for information; and
2) Approve the governance policies as amended.
Carried

It was moved by M. Smibert, seconded by P. Cuddy, that the Board of Health:
1) Receive Report No. 14-23GC re: “MLHU Q3 2023 Risk Register” for information; and
2) Approve the Q3 2023 Risk Register.
Carried

It was moved by M. Smibert, seconded by S. Franke, that the Board of Health receive Report No. 15-23GC, re: “2023-24 Provisional Plan Q3 Status Update” for information.
Carried

Monitoring Food Affordability and Implications for Public Policy and Action (2023) (Report No. 69-23)

Dr. Alexander Summers, Medical Officer of Health provided background information on the updated report (from April, Report No. 25-23) titled Monitoring Food Affordability and Implications for Public Policy and Action. This is a report noting the 2023 information on food affordability within the region, which has become an increasing challenge for many in the community. Dr. Summers added that monitoring food affordability is a part of a public health unit’s legislative responsibility. Dr. Summers thanked Kim Loupos, Public Health Dietitian for her work on this report and introduced Julie Goverde, Acting Manager, Community Health Promotion to present this report.

J. Goverde noted that the report which the Board received in April contained food affordability and cost of living data from 2022, and the report in front of the Board contained the recently received data for 2023. To monitor food affordability, public health Dietitians use a hybrid model of in-store and online data collection. In May 2023, the estimated local monthly cost to feed a family of four was $1,124, an increase from $1,084 in May 2022. Local monthly food and average rental costs are compared to a variety of household and income scenarios, including households receiving social assistance, minimum wage earners, and median incomes. The scenarios include food and rent only and are not inclusive of other needs such as utilities or personal care. Households with low incomes spend up to 47% of their after-tax income on food, whereas households with adequate incomes (based on a family of 4) only spend approximately 12% of their after-tax income. The scenarios highlight that incomes and social assistance rates have not kept pace with the increased cost of living. 1 in 6 families in Middlesex-London are considered food insecure, even though over half of these families have paid employment. Food insecurity continues to cause a wide range of physical and mental health challenges.

J. Goverde added that the infographic highlighting food affordability provided as Appendix B will be posted to the Health Unit website but noted it has not been updated since 2019. One of the informational items on the infographic (data provided by Canada Mortgage and Housing Corporation) that is no longer accurate is the rental pricing for the Middlesex-London community, as these prices have increased. In 2024, the Health Unit is going to continue to collect data and monitor the food system through additional upstream data work.

Dr. Summers emphasized that access to nutritious food continues to be a challenge for many in the region and across the province. The disparity between the cost of food and the monthly income required to provide food for a family is also of great concern. Dr. Summers added that this work is important surveillance work to highlight the concerns and health impact risks for the population.

Chair Newton-Reid noted that social assistance rates do not appeared to have increased in this time of inflation and inquired if the government had responded to the correspondence sent by the Board in April 2023. It was confirmed that no response was received.

It was moved by S. Menghsha, seconded by M. Steele, that the Board of Health:
1) Receive Report No. 69-23 re: “Monitoring Food Affordability and Implications for Public Policy and Action (2023)” for information; and
2) Forward Report No. 69-23 re: “Monitoring Food Affordability and Implications for Public Policy and Action (2023)” to Ontario Boards of Health, the City of London, Middlesex County, and appropriate community agencies.
Carried

MLHU Ontario Living Wage Network Certification (Report No. 70-23)

Cynthia Bos, Manager, Human Resources presented an informational report on the Health Unit’s Living Wage Network certification. It was noted that this report was in response to the following motion from the April 2023 Board of Health meeting:

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.

C. Bos noted that Human Resources was notified on October 16 that the Health Unit was being recertified as a living wage employer. There were adjustments made to the student “Test Shopper” role in order to ensure these individuals were meeting living wage standards – this was an increase from minimum wage and had a budget impact of only $600 annually. The Ontario Living Wage Network will be working with the Health Unit for an announcement of the recertification.

Board Member Skylar Franke thanked the Health Unit for recertifying as a living wage employer and would like more government agencies to strive to be a living wage employer.

It was moved by S. Franke, seconded by M. Smibert, that the Board of Health receive Report No. 70-23 re: “MLHU Ontario Living Wage Network Certification” for information.
Carried

2023 Q3 Financial Update and Factual Certificate (Report No. 71-23)

David Jansseune, Assistant Director, Finance presented the 2023 Q3 Financial Update and Factual Certificate for the quarter ending September 30. D. Jansseune reminded the Board that this set of financial information is not consolidated to keep the MLHU and MLHU2 budgeting companies separate.

January to September expenses were approximately $338,000 favourable, however, did not fully offset the gap due to not enough vacancies. The forecast indicates that the unfavourable expenses will be offset with the additional 1% prorated Ministry of Health funding, and the Health Unit pausing on the $100,000 transfer to the Funding Stabilization Reserve (which will be reviewed in December if there is a surplus). It was noted that expenses were very close to budget and approximately $150,000 unfavourable over twelve (12) months.

D. Jansseune commented on the funding information for the Health Unit’s 100% funded programs. There are four (4) in MLHU and four (4) in MLHU2. COVID-19 expenditures are at approximately $4.9 million, and the Health Unit has unfortunately not received any funding and are paying these expenses from the cash balance. The forecast for COVID-19 expenses is approximately $7 million to year end. D. Jansseune added that the Ontario Seniors’ Dental Care Program costs are at approximately $3.7 million, with an expected small surplus because of the Strathroy clinic not being operational until midway through the operating year.

Cashflow remains positive and the Health Unit has not utilized the line of credit yet this year. The balance is declining due to using cash to pay for COVID-19 expenses but is projected to still have a small positive balance in Q4.

Chair Newton-Reid inquired if the Health Unit would be receiving the estimated $7 million in COVID-19 funding. E. Williams noted that the Province of Ontario (Ministry of Health) have indicated that funding will be received this year (using Q3 results for funding amount decisions), however the timing is unknown.

It was moved by P. Cuddy, seconded by S. Franke, that the Board of Health receive Report No. 71-23 re: “2023 Q3 Financial Update and Factual Certificate” for information.
Carried

Nurse-Family Partnership Annual Report (Report No. 72-23)

Jennifer Proulx, Acting Director, Healthy Start and Chief Nursing Officer introduced Lindsay Croswell, Community Health Nursing Specialist to provide the Board of Health with the Nurse-Family Partnership Annual Report.

L. Croswell provided a brief introduction to the Nurse-Family Partnership (NFP) program. NFP is an evidence-based intensive two and a half year (2.5) home visiting program delivered by Public Health Nurses. The most effective outcomes were found to be in those pregnant or parenting for the first time who are experiencing multiple social and economic disadvantages. The program is grounded in theory and focuses on Nurses building a trusting, therapeutic relationship with their clients in order to effect behaviour change.

Research outcomes of this program included:
• Improved Pregnancy Outcomes (reduction in smoking and preterm births)
• Improved Maternal Life course (economic self-sufficiency, reduced mortality, academic achievement)
• Improvement in Child Health and Development (improved behavioural and cognitive development, significant reduction in use of substances in teen years)
• Improved parenting (reduction in government-verified reports of child abuse and neglect by 48%, 56% reduction in Emergency Department visits for injuries and ingestions)

The Nurse-Family Partnership is an internationally licensed program located currently in eight (8) countries and has been in Canada since 2008. In 2019, the Middlesex-London Health Unit became the single license holder for Ontario. As license holder, part of the Health Unit’s license agreement requires the submission of an annual report to the international team that includes program data indicators showing adherence to program fidelity, program outcomes, and client demographics.

Intake data for 2022 notes that:
• 364 clients participated in the program, ranging from 12-26 years old
• 3595 home visits were completed
• 50% reported an annual income of less than $25,000
• 40% reported tobacco or nicotine use
• 38% reported alcohol use
• 47% reported cannabis use
• 60% reported concerns with their mental health
• 59% reported current or recent experience with intimate partner violence

L. Croswell noted that the lifetime graduate rate in Ontario (for the program) is 44%. Attrition data breaks down the reasons clients left the program in 2022, including how many graduated. The program has seen several clients discharged earlier than the official graduation date because they have returned to school or the workforce and no longer have time for visits. While these discharges are part of the “addressable” attrition rate, these clients are leaving the program as a result of succeeding in identified program goals.

Attrition data for 2022 notes that:
• 84 participants graduated in 2022
• 72 discharges considered “unaddressable”
• 36 discharges considered “addressable”
• 4 that transferred to another NFP site

The Health Unit has been successful in beginning expansion in Ontario to four (4) additional health units who are partnering in implementation (of the program) and one (1) additional health unit beginning implementation in early 2024. Moving into the expansion phase of international replication was made possible because the British Columbia primary research findings were published in July of this year. The Health Unit has increased collaborative work with British Columbia over the last few years, especially in the delivery of virtual education for the Nurse-Family Partnership teams. Most recently, the Health Unit has collaborated on developing educator guidance for the curriculum which is vital to sustainability planning. Finally, the Health Unit has been able to grow data reporting capacity with each year and were able to add indicators for child protection involvement, depression and anxiety scores, longer-term breastfeeding, father/non-birthing parent involvement, and a breakdown of referral sources.

Dr. Summers thanked L. Croswell for her presentation and noted that the Nurse-Family Partnership goes hand in hand with other home visiting programs. Dr. Summers concluded that more data analysis will be completed to determine if more clients are able to access this program, as it prevents future negative health impacts across the lifespan.

Board Member Aina DeViet noted that this program was very innovative and has international presence. A. DeViet inquired if data is shared internationally to other countries that are part of the Nurse-Family Partnership (NFP). L. Croswell explained that within the structure of the NFP, there are multiple sub committees such as global clinical advisory, education, data collection, and research/analysis with many opportunities for sharing information and best practices. For example, there was recently a visit to London by an NFP international consultant from Scotland to share data and experience.

Board Member Howard Shears inquired how clients are referred to the NFP program at the Health Unit. L. Croswell explained that clients are screened in collaboration with the Healthy Babies, Healthy Children program and those that meet the NFP criteria are referred to the program.

It was moved by A. DeViet, seconded by S. Franke, that the Board of Health receive Report No. 72-23 re: “Nurse-Family Partnership Annual Report” for information.
Carried

Healthy Start Home Visiting (Report No. 73-23)

J. Proulx introduced Rhonda Brittan, Manager, Healthy Beginnings Visiting and Group Programs and Isabel Resendes, Manager, Healthy Families Home Visiting to provide an update on home visiting programs.

I. Resendes provided background information on home visiting at the Middlesex-London Heath Unit. Early childhood experiences can influence a child’s entire life trajectory. Adverse Childhood Experiences (ACEs) and chronic stressors such as poverty, abuse and neglect can have effects beyond the child and family.
Home visiting is a public health intervention and critical strategy within an upstream population health approach that aims to optimize newborn and child healthy growth and development and reduce health inequities. I. Resendes noted that the Health Unit’s Healthy Start division delivers two home visiting programs, which significantly support the achievement of requirements under the Ontario Public Health Standards (OPHS) Healthy Growth and Development Standard. These programs are Healthy Babies Healthy Children and the Nurse-Family Partnership.

The Healthy Babies Healthy Children is a mandatory provincial program funded by the Ministry of Children, Community and Social Services and provides screening, assessment, and support to families from the prenatal period through the early childhood period. From January 1, 2023, to September 30, 2023, the Healthy Families Home Visiting Team supported 322 eligible families in the program with 1947 completed home visits.

R. Brittan provided information on the Nurse-Family Partnership, noting that L. Croswell provided in depth information as well during this Board meeting. The Nurse-Family Partnership is a targeted and intensive home visiting program for young, first-time parents from early pregnancy (up to the end of 28 weeks gestation) until the child’s second birthday. Program goals include improving prenatal health outcomes, children’s subsequent health and development, and parents’ attainment of future goals. Nurse-Family Partnership Public Health Nurses have supported 43 families with 378 home visits from January 1 to September 30, 2023.

R. Brittan highlighted the community needs within these programs and added that some of these needs have also been highlighted in the previous board report at this meeting regarding food affordability. From 2016-2022, there has been a 7.6% increase in the number of infants born in Middlesex-London. In 2022, screening data showed Middlesex-London had the highest rates in the province of families identifying risk factors such as concerns about money, need for newcomer support, and lack of a primary care provider. 2022 Nurse-Family Partnership data showed a high prevalence of smoking/vaping, alcohol and cannabis use, 85% of clients reported concerns with mental health, and almost half reported exposure to intimate partner violence in the past 12 months.

Both the Healthy Babies Healthy Children and Nurse-Family Partnership programs will continue to deliver home visiting interventions to families with the highest need in order to achieve optimal child outcomes and continue data collection to assess program fidelity and impact.

Chair Newton-Reid inquired on how screening is conducted for the home visiting programs. I. Resendes explained that screening is conducted for approximately 70% of the babies born in the Middlesex-London region, and eligibility is determined when 2 or more risk factors are met. Generally, the program would be offered to clients if criteria is met and if they chose to be involved. Approximately 60% of screened clients have qualified for the home visiting programs.

Chair Newton-Reid further inquired if the Health Unit has had to turn away individuals from the program. I. Resendes noted that in 2020, there was a waitlist for home visiting programs, so teams needed to review screening data and target clients who needed support the most.

Dr. Summers noted that funding for the Healthy Babies Healthy Children program has had no increases to funding in 12 years. As a result, there is a scarcity of resources and only 70% of infants are screened. J. Proulx noted that there has been consideration of different ways of delivering programs (virtual) but there is evidence that demonstrates that home visiting achieves positive outcomes.

Board Member Howard Shears inquired on the fiscal sustainability of the home visiting programs. Dr. Summers noted that the Health Unit can only reflect on 25 years of the funding patterns provided by the Ministry of Children, Community and Social Services and noted that additional funds will be needed to continue current rates of programming. Emily Williams, Chief Executive Officer noted that over the summer, the Health Unit met with the Minister of Children, Community and Social Services as funding has been stagnant for 12 years and the actual funding needed to keep up with the demand for the program would be over $3 million. Chair Newton-Reid added that the meeting with the Minister was good and there was interest from the Minister regarding the program, as the Health Unit has not received increases and the people who need the program most are not able to access due to capacity. E. Williams noted that additional funding for Healthy Babies Healthy Children was submitted as a business case to the City of London’s Assessment Growth Fund due to growth in birth numbers in the region.

It was moved by P. Cuddy, seconded by H. Shears, that the Board of Health receive Report No. 73-23 re: “Healthy Start Home Visiting” for information.
Carried

Intimate Partner Violence (Report No. 74-23)

J. Proulx and Alison Locker, Manager, Population Health, Assessment and Surveillance presented a report on intimate partner violence (IPV) in Middlesex-London.

J. Proulx provided an overview on intimate partner violence (IPV), noting that IPV refers to a pattern of behaviours that are aimed at establishing control by one person over another, and perpetrated by someone who is, or was, involved in an intimate or dating relationship. Behaviours may include physical injury or violence, emotional or psychological abuse, sexual harassment or violence, economic abuse, progressive social isolation, stalking, deprivation, intimidation and threats. Intimate partner violence can happen in many forms of relationships, including within a marriage, common-law or dating relationship, regardless of the gender and sexual orientation of the partners at any time during a relationship, and even after it has ended. IPV can occur whether partners live together or are sexually intimate with one another.

IPV is associated with significant health consequences, including physical health symptoms, mental health symptoms, reproductive health symptoms, and death.

A. Locker provided statistics and data regarding IPV, starting with the evidence of the
burden of domestic IPV. Statistics Canada reported that between 2017 and 2021, the rate of police-reported IPV was higher for female victims compared to males, regardless of age category, ranging from 6.5 to 7.0 times greater among victims 12-24 years of age, to 3.3 times greater among victims 25-64 years of age, and 1.5 to 1.7 times higher among victims 65+ years of age. The highest rates were reported among female victims 12-24 years of age, at 773 to 805 victims per 100,000 females, which is a very high rate. For female victims 25-64 years of age, rates were also high, at 541 to 654 per 100,000 females. A. Locker noted that the data being presented are only cases of IPV that were reported to police, noting that many are not reported.
A. Locker provided the data for Middlesex-London regarding IPV, noting that since 2012, the number of emergency department visits due to domestic violence among Middlesex-London residents was relatively low, between 46 and 95, depending on the year. In the most recent five years of data, rates of emergency department visits were higher among females (20 to 33 per 100,000 females), and the local rate among females was three to ten times higher than the rate among males, depending on the year. Further, rates were highest among those 0-19 and 20-44 years of age, and rates overall are comparable to Ontario.

J. Proulx provided an overview of the interventions which the Health Unit is using to assist in preventing IPV. Primary preventions include home visiting programs such as Healthy Babies Healthy Children and Nurse-Family Partnership. Secondary prevention includes case finding and selective screening, and appropriate response to disclosures of IPV in client facing services. A tertiary prevention intervention is work being conducted in the Intervention for Health Enhancement and Living (iHEAL) which is a research health promotion program being funded by Western University and the Public Health Agency of Canada that supports women who are in the process of leaving an abusive partner.

It was moved by S. Franke, seconded by M. Smibert, that the Board of Health receive Report No. 74-23 re: “Intimate Partner Violence” for information.
Carried

Current Public Health Issues (Verbal)

This report was presented by Dr. Summers who provided a verbal update on current public health issues in the region.

Respiratory Season
COVID-19 infection rates are high but flatlining in the region, and public health is continuing to highlight the importance of vaccination. Dr. Summers thanked the community for continuing to support vaccination efforts.

The Western Fair mass vaccination clinic continues to vaccinate many people. The uptake is not as large as during the initial vaccination campaign, but still making an impact. The Western Fair vaccination clinic will be closing in December, as it was funded through COVID-19 funding and this clinic is not part of the Health Unit’s operational plan for 2024. Fortunately, the Health Unit is working with other partners such as pharmacies and physicians. The Health Unit continues to support long term care homes and hospitals to protect the most vulnerable. The Influenza virus is circulating in the community but has not peaked yet. Typical patterns with Influenza include a wave later in the winter.

2024 Budget Impacts on Public Health Partners
With lack of funding for public health, some of the surrounding health units are making changes to their operations in order to be financially sustainable. An example is a recent announcement from Huron-Perth Public Health, with this health unit having to lay off 10% of their workforce.

MLHU in the News
There continues to be news regarding the Health Unit. Currently, vaccination has been in the news and questions regarding the uptake of both the COVID-19 and Influenza vaccinations. There will be more data available later in the year.

Health and Homelessness
The homelessness crisis continues in the community. The Health Unit is part of the Health and Homelessness work with the City of London and other partners, with the role of providing strategic guidance on health impacts for those without shelter or stable housing.

Board Member S. Franke inquired if there are vaccination clinics outside of the Western Fair.
Dr. Summers noted that for non-COVID or Influenza vaccines, in-school vaccination is provided for grade 7 students. There are also mobile clinics, and clinics at Health Unit offices in Strathroy and CitiPlaza. Public health is trying to fill the gap for those without access to primary care and meet people where they are at.

S. Franke followed up to inquire if there has been a cost analysis of public health delivering vaccines vs. other agencies such as pharmacies. Dr. Summers noted that there has been no formal evaluation regarding a cost analysis on vaccine delivery, but noted that the Province of Ontario is planning to evaluate in the coming year.

Board Member A. DeViet noted that there are residents in rural Ontario who are experiencing accessibility issues with receiving a vaccine, as there is limited availability in pharmacies within the County. Dr. Summers noted that public health provides primary care, long term care and hospitals with vaccines – not pharmacies. Public health does not have a line of sight on vaccine delivery to pharmacies, as this is managed by the Province. There are considerations of partnering with organizations such as the Middlesex County Library Services to provide vaccination to residents who cannot access a vaccine at a pharmacy or if they cannot get to an urban centre.

Chair Newton-Reid noted that it appeared that the approval of the new COVID-19 vaccine was approved later than it should have been, and in the midst of influenza season. Chair Newton-Reid inquired if Dr. Summers could comment on the timing, noting that this is not the local public health units’ fault. Dr. Summers noted that there is now more understanding on the seasonality trends of illnesses – respiratory season begins generally in October. COVID-19 does not seem to have a specific season, and this is still being studied. There is complexity to analyzing strains of the virus in order to make an effective vaccine, and it is generally preferred to try and deliver the COVID-19 and Influenza vaccines in the same timeframe. If COVID-19 continues to appear earlier in the season as more data is collected, the vaccine will need to be available earlier.

It was moved by M. McGuire, 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 October (Report No. 75-23)

Dr. Summers presented his activity report for October. There was no discussion on this report.

It was moved by P. Cuddy, seconded by M. Smibert, that the Board of Health receive Report No. 75-23 re: “Medical Officer of Health Activity Report for October” for information.
Carried

Chief Executive Officer Activity Report for October (Report No. 76-23)

Emily Williams, Chief Executive Officer presented her activity report for October. There was no discussion on this report.

It was moved by S. Menghsha, seconded by S. Franke, that the Board of Health receive Report No. 76-23 re: “Chief Executive Officer Activity Report for October” for information.
Carried

Correspondence

It was moved by M. McGuire, seconded by S. Franke, that the Board of Health receive the following items for information:
a) Public Health Sudbury & Districts re: Calls for expansion of outdoor air quality monitoring stations and the Air Quality Health Index across Northern Ontario
b) Niagara Region Public Health re: Bill 103 Smoke-Free Ontario Amendment Act (Vaping is not for Kids), 2023
c) Middlesex-London Board of Health External Landscape for November 2023
Carried

It was moved by M. Smibert, seconded by M. McGuire, that the Board of Health endorse the following items:
d) Public Health Sudbury & Districts re: Public Health Strengthening and Chronic Disease Prevention
e) Public Health Sudbury & Districts re: Support for a Funded Healthy School Food Program in Budget 2024 (Federal)
Carried

Other Business

The next meeting of the Middlesex-London Board of Health is on Thursday, December 14 at 7 p.m.

Closed Session

At 8:11 p.m., it was moved by P. Cuddy, seconded by S. Franke, that the Board of Health will move into a closed session to consider matters regarding labour relations or employee negotiations, personal matters about 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 9:16 p.m., it was moved by S. Menghsha, seconded by S. Franke, that the Board of Health return to public session from closed session.
Carried

Adjournment

At 9:16 p.m., it was moved by M. Steele, seconded by H. Shears, that the meeting be adjourned.
Carried

Matthew Newton-Reid
Chair

Emily Williams
Secretary