Minutes - April 18, 2024 - Board of Health Meeting

Members Present: 

Matthew Newton-Reid (Chair)
Michael Steele (Vice-Chair)
Selomon Menghsha
Skylar Franke
Aina DeViet (exited at 7:09 p.m.)
Michelle Smibert
Peter Cuddy (entered at 7:06 p.m.)
Michael McGuire
Howard Shears
Emily Williams, Chief Executive Officer (ex-officio) (Secretary and Treasurer)
Dr. Alexander Summers, Medical Officer of Health (ex-officio)

Others Present:

Stephanie Egelton, Executive Assistant to the Board of Health (recorder)
Sarah Maaten, Director, Public Health Foundations
Jennifer Proulx, Director, Family and Community Health and Chief Nursing Officer
Dr. Joanne Kearon, Associate Medical Officer of Health
Mary Lou Albanese, Director, Environmental Health, Infectious Disease and Clinical Services
Cynthia Bos, Associate Director, Human Resources and Labour Relations
Lilka Young, Health and Safety Advisor
Ryan Fawcett, Manager, Privacy, Risk and Client Relations
David Jansseune, Associate Director, Finance and Operations/Chief Financial Officer
Angela Armstrong, Program Assistant, Communications
Morgan Lobzun, Communications Coordinator
Abha Solanki, End User Support Analyst, Information Technology
Andrew Powell, Manager, Safe Water, Tobacco Enforcement and Vector Borne Disease
Warren Dallin, Manager, Procurement and Operations
Jordan Banninga, Manager, Infectious Disease Control
Dr. Mark Cachia, Public Health and Preventative Medicine Resident

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.

At 7:01 p.m., it was noted that Ex-Officio Board Member and Secretary Emily Williams declared a conflict of interest to the Performance Appraisal Committee Verbal Report in her capacity as Chief Executive Officer due to the purposes of the meeting being about her performance appraisal for 2024. It was noted that due to the details of the meeting and per the Committee Chair, she remained present for the purposes of supporting the Executive Assistant in case there were general questions related to proposed changes within the Chief Executive Officer Performance Appraisal Document scoring categories. Further, it is noted that E. Williams as Secretary of the Board of Health opened the Committee meeting for the purposes of electing a 2024 Committee Chair and reviewing the Committee’s Terms of Reference.

At 7:02 p.m., Ex-Officio Board Member Alexander Summers declared a conflict of interest to the Performance Appraisal Committee Verbal Report in his capacity as Medical Officer of Health due to the purposes of the meeting being about his performance appraisal for 2024. It was noted that due to the details of the meeting and per the Committee Chair, he remained present for the purposes of supporting the Executive Assistant in case there were general questions related to proposed changes within the Medical Officer of Health Performance Appraisal Document scoring categories.

At 7:28 p.m., Board Member Michael (Mike) McGuire declared a conflict of interest relating to Report No. 27-24 due to a potential conflict of interest related to contractor employment with an organization who may have their small drinking water system inspected by the Middlesex-London Health Unit.

Approval of Agenda

It was moved by A. DeViet, seconded by M. Steele, that the AGENDA for the April 18, 2024 Board of Health meeting be approved.
Carried

Approval of Minutes

It was moved by M. Smibert, seconded by M. Steele, that the MINUTES of the March 21, 2024 Board of Health meeting be approved.
Carried

New Business

Performance Appraisal Committee Meeting Summary (Verbal Report)

It was reminded that Emily Williams, Chief Executive Officer and Dr. Alexander Summers, Medical Officer of Health declared a conflict of interest for this item.

Incoming Committee Chair Michelle Smibert provided an overview of reports heard by the Performance Appraisal Committee for the Board of Health’s consideration.

There were no questions or discussion.

It was moved by M. Smibert, seconded by M. Steele, that the Board of Health:
1) Receive Report No. 01-24PAC re: “2024 Medical Officer of Health and Chief Executive Officer Performance Appraisals Procedures” for information;
2) Approve the performance appraisal process, supporting documents, and timelines as amended in Appendix A; and
3) Direct staff to action the activities outlined in the MOH and CEO Performance Appraisals Checklist for 2024.
Carried

It was moved by M. Steele, seconded by H. Shears, that the Board of Health receive Report No. 02-24PAC re: “2024 Performance Appraisal Committee Terms of Reference” for information.
Carried

Governance Committee Meeting Summary (Verbal Report)

Incoming Committee Chair Michelle Smibert provided an overview of reports heard by the Governance Committee for the Board of Health’s consideration.

There were no questions or discussion.

It was moved by M. Steele, seconded by M. McGuire, that the Board of Health:
1) Receive Report No. 01-24GC re: “2024 Governance Committee Terms of Reference” for information; and
2) Receive Report No. 02-24GC re: “Governance Policy Review – April 2024” for information.
Carried

It was moved by M. Smibert., seconded by M. Steele, that the Board of Health approve the governance policies as amended in Appendix B (of Report No. 02-24GC).
Carried

2024 Annual Service Plan (Report No. 25-24)

Sarah Maaten, Director, Public Health Foundations and David Jansseune, Associate Director, Finance and Operations/Chief Financial Officer presented the 2024 Annual Service Plan for the Middlesex-London Health Unit. S. Maaten noted that the Annual Service Plan outlines work that the Health Unit will conduct in 2024.

S. Maaten explained that there are two (2) components to the Annual Service Plan: programs and interventions (intended outcomes) with a section on population health assessment for the community and the Board approved budget with the view of public health standards and programs (as opposed to division and department) as requested by the Ministry of Health. The Annual Service Plan outlines details on how public health standards are executed and reflects changes from the 2023 restructuring in how work will be conducted post restructuring.

D. Jansseune noted that the Annual Service Plan includes programs with shared funding between the Ministry of Health and municipalities (City of London and County of Middlesex), plus funding for the Ontario Seniors’ Dental Care Program. Appendix A of the report is a summary of the Board approved budget, with staffing amounts noted as full-time equivalents (FTE) and Appendix B of the report is the Annual Service Plan budget by program. D. Jansseune noted that the Board approved the budget at $38.6 million with 288 full-time equivalents and the Annual Service Plan budget by program is $33.4 million with a reconciliation of dollars and full-time equivalents. The Annual Service Plan is how the Ministry of Health creates the Health Unit’s Standard Activity Reporting (SAR), which is used for alignment in quarterly reporting.

There were no questions or discussion.

It was moved by M. Steele, seconded by M. Smibert, that the Board of Health:
1) Receive Report No. 25-24 re: “2024 Annual Service Plan” for information; and
2) Approve the 2024 Annual Service Plan for submission to the Ministry of Health.
Carried

2023 Occupational Health and Safety Report (Report No. 26-24)

Cynthia Bos, Associate Director, Human Resources and Labour Relations provided introduction to the 2023 Occupational Health and Safety Report. C. Bos introduced Lilka Young, Health and Safety Advisor and noted that L. Young and her colleague Dalia Salim, Human Resources Coordinator, Health and Safety are responsible for supporting the Occupational Health and Safety program at the Middlesex-London Health Unit.

L. Young presented the details of the 2023 report and included information on the Health Unit’s wellness program. Providing an annual report on occupational health and safety is a requirement under the Health Unit’s Occupational Health and Safety Policy and will be provided to staff following the presentation of this report.

L. Young provided the following key highlights from the 2023 Occupational Health and Safety Report:
• There has been continued improvements to and internal capacity building for occupational health, safety and wellness throughout the year
• 23% of employee incident reports were related to ergonomic reviews or musculoskeletal injuries
• 85 employee incident reports were submitted in 2023
• Incident reporting rate remains consistent to 2022 levels at 21% based on 390 employees
• Decrease (75%) in reports and claims to the Workplace Safety and Insurance Board (WSIB)
• Be Well’s launch of the online Cyno Platform supporting individual wellness and complimenting other MLHU wellness programming, with 35% engagement on Cyno by the end of the contract period (January to January)

Regarding injury and incident reporting at the Health Unit, 85 employee incident reports were received in 2023. 3.5% of these reports were employee needlesticks (3 employees) and 19% of reports were related to ergonomic reviews/consultations (16 employees). 29 non-employee incident reports were received in 2023.

The most reported incidents categories were:
• Ergonomics/ MSD Injuries (23% of employee incident reports)
• Workplace Violence (15% of employee incident reports)
• Struck with/caught by/ contact with (11% of employee incident reports)

L. Young noted that there was a 21% reporting rate for employee incident reports based on an employee count of 390.

L. Young provided a brief overview of incident reporting from 2019-2023. It was noted that there has been a decrease of workplace violence and rates are returning to pre-pandemic rates from 2019, which can be attributed to less COVID-related mandates and less clients attending Health Unit locations with concerns. The category of “slips, trips and falls” previously was in the top 3 of incidents and are now decreasing, and there has been an increase in near misses at 16%. L. Young noted that it is good to see these rates as it is displaying Health Unit staff’s action of reporting potential safety concerns before it becomes an injury. L. Young concluded that ergonomic incidents are slightly increasing from 2019, which can be attributed to returning to the Health Unit offices and working in that new environment.

Chair Matthew Newton-Reid noted that there has been an overall reduction of 75% in workplace incidents and inquired if this was because of the decrease in the overall workforce at the Health Unit. L. Young noted that in 2022, the Health Unit had twelve (12) Workplace Safety and Insurance Board (WSIB) reportable injuries, with 571 staff. L. Young added that there were eight (8) injuries reported but only three (3) had been approved. L. Young noted that she will provide the Board with the rate of Workplace Safety and Insurance Board (WSIB) reports. C. Bos added that Occupational Health and Safety paid attention to the reporting numbers and ensured that data provided was meaningful.

Board Members Howard Shears inquired how ergonomics concerns were being addressed at the Health Unit. L. Young explained that the Health Unit is proactive when addressing ergonomics matters brought forward by staff. L. Young explained that when a concern is brought forward, an ergonomic review is conducted to get a full picture of the situation – there could be a behaviour correction needed such as posture. Occupational Health and Safety reviews a checklist with the staff member and in certain situations an ergonomist’s support may be needed. Human Resources has a learning module for staff to complete on ergonomics within their learning portal as well.

Board Member Michelle Smibert provided positive feedback to Occupational Health and Safety, noting their great work and that the Health Unit is demonstrating a culture that embraces safety.

It was moved by S. Franke, seconded by S. Menghsha, that the Board of Health receive Report No. 26-24 re: “2023 Occupational Health and Safety Report” for information.
Carried

OAGO Performance Audit – Non-Municipal Water (Report No. 27-24)

Mary Lou Albanese, Director, Environmental Health, Infectious Disease and Clinical Services introduced Andrew Powell, Manager, Safe Water, Tobacco Enforcement and Vector-Borne Disease to present information on a request received from the Auditor General of Ontario regarding non-municipal water (small drinking water systems).

A. Powell explained to the Board of Health that on March 25, all public health units received a request from the Auditor General of Ontario for information to conduct an audit of non-municipal drinking water systems in Ontario. A. Powell noted that under Ontario Regulation 319 (under the Health Protection and Promotion Act) that there are requirements that must be followed by owners and operators such as minimum water testing for diseases and illnesses of public health concern (such as E. coli).

A. Powell noted that the Auditor General of Ontario requested documentation from the past five (5) years on:
• An inventory of all drinking water systems regulated under the Health Protection and Promotion Act and Safe Drinking Water Act
• Notifications of intent to stop water, provide water and permission to operate small drinking water systems
• Small drinking water system directives, contents and revisions made to them
• Adverse drinking water incident responses to system operators
• Compliance such as inspections, orders, and other activities related to safe drinking water (not limited to small drinking water systems)
• Public health inspector credentials, education and training

A. Powell added that in Middlesex-London, there are 127 small drinking water systems, and the Health Unit currently has 100% compliance of inspection rate timelines set by the Ministry of Health.

Chair Matthew Newton-Reid applauded the Health Unit for having 100% compliance rates and addressing all adverse water quality incidents (AWQI) within 24 hours.

Board Member Michael McGuire inquired if the Health Unit inspects water systems that service the County of Middlesex, such as within assisted living homes such as Middlesex Community Living.

A. Powell noted that this regulation does not include special care facilities (group homes) but those are covered under other inspection categories at the Health Unit. When group homes are inspected, the water quality is reviewed within these homes. A. Powell added that under Ontario Regulation 318 (under the Health Protection and Promotion Act), small drinking water systems that have uninhibited access (such as a restaurant washroom) are still inspected but covered under different categories of an inspection.

Board Member M. McGuire declared a conflict of interest relating to this report due to contractor employment with an organization who may have their small drinking water system inspected by the Health Unit. Board Member McGuire recused himself from further participation with this item.

Board Member Skylar Franke noted that she sits on the Lake Huron Primary Water Supply System Board and the Upper Thames River Conservation Authority and inquired how the Health Unit intersects with source water Boards and conservation authorities. A. Powell explained that a source water Board (such as Lake Huron) overseeing a large body of drinking water is regulated under Ontario Regulation 170 (under the Safe Drinking Water Act), which is inspected by the Ministry of the Environment, with the requirement that the Medical Officer of Health and Public Health Inspectors are advised when there is an adverse water quality event. For the relationship with the conservation authorities, the preventative action is stopping contamination within the ground before it reaches ground water. A. Powell added that he sits on the Lake Huron Primary Water Supply System Board as the Middlesex-London Health Unit representative.

Dr. Alexander Summers, Medical Officer of Health noted that the Walkerton Water Tragedy spearheaded the revolution on how drinking water is managed in Canada. Dr. Summers noted that there is a multi-barrier approach for safe drinking water in the community with regulatory bodies and multiple stakeholders ensuring the safety of drinking water, which is working well to ensure high quality and safe drinking water. There are overlapping protections to make sure there are no incidents like Walkerton ever again.

Chair Newton-Reid emphasized the Walkerton Tragedy and how it has created safety measures in place for the community. Chair Newton-Reid reflected on the topic of Truth and Reconciliation with Indigenous partners within the community and that their communities are continuing to face water quality concerns nearby to London. Chair Newton-Reid concluded that this needs to continue to be recognized and discussed.

Board Member S. Franke noted that in her involvement with the Lake Huron Primary Water Supply System Board, there is movement for having a pipeline of water from Lake Huron to Oneida Nation of the Thames. S. Franke added that funds have been allocated for the design work and the pipeline may take a few years but is a positive step. Chair Newton-Reid noted his support for this project.

It was moved by S. Franke, seconded by M. Smibert, that the Board of Health receive Report No. 27-24 re: “OAGO Performance Audit – Non-Municipal Water” for information.
Carried

Vector-Borne Disease Program: Contract Award (Report No. 28-24)

Emily Williams, Chief Executive Officer introduced Warren Dallin, Manager, Procurement and Operations and Andrew Powell, Manager, Safe Water, Tobacco Enforcement and Vector Borne Disease to present information on the Vector-Borne Disease Program contract award.

W. Dallin noted that in January 2024, a Request for Proposal (RFP) was issued to deliver select services for the Vector-Borne Disease program for the next three (3) years. The lowest-cost bid was an increase from prior contracts due to inflation. The program is delivered in two (2) parts. For Part A, the successful bidder was the Canadian Centre for Mosquito Management (CCMM) in the amount of $107,500 (exclusive of HST). For Part B, the successful bidder was GDG Canada Inc. in the amount of $22,748 (excluding HST). W. Dallin noted that Part A was budgeted at $100,000 for 2024, and due to this, there was negotiation to $107,500 for Part A. W. Dallin concluded that it is anticipated that the Q1 surplus will support the variance for the additional $7,500.

A. Powell provided information on the Vector-Borne Disease program for which this contract will support. Part A will be for roadside catch basins within the City of London and County of Middlesex. Larvicide will be dropped into catch basins in three (3) rounds during the summer months to lower the rates of mosquitos potentially carrying the West Nile Virus. Part B is for a contractor to test and identify any West Nile Virus in mosquitos by setting up traps overnight over 18 weeks.

Chair Matthew Newton-Reid inquired on the increase of the services for the Vector-Borne Disease Program. W. Dallin explained that initial quotes before negotiation were higher, which was driven mainly by labour rates. W. Dallin noted that the Health Unit provided the successful bidder with the services to be conducted and a price chart, which was negotiated. Dr. Alexander Summers, Medical Officer of Health added that the costs of services continue to rise and are consistent with other procured services within the Health Unit. Dr. Summers added that the Health Unit reviewed from a public health perspective if it was feasible to reduce the service in order to fit into budgetary constraints and it was determined to not be possible due to a risk to the community. Dr. Summers added that this action will inform the 2025 budget, and that this is the result of doing public health work well within the current financial constraints.

It was moved by M. Steele, seconded by S. Franke, that the Board of Health receive Report No. 28-24 re: “Vector-Borne Disease Program: Contract Award” for information.
Carried

The Evolving Food Safety Landscape (Report No. 29-24)

Mary Lou Albanese, Director, Environmental Health, Infectious Disease and Clinical Services introduced Jordan Banninga, Manager, Infectious Disease Control to present a report on the evolving food safety landscape on behalf of David Pavletic, Manager, Food Safety and Health Hazards.

J. Banninga provided an introduction on the Food Safety program at the Health Unit and reviewed emerging trends in the food safety landscape. The Food Safety and Health Hazards program provides the majority of support in food establishments, whereas Infectious Disease Control provides support (in the food safety context) to case and contact management of food borne illnesses and the delivery of the FoodNet program (funded by the Public Health Agency of Canada).

J. Banninga noted that the Board of Health previously heard a report in November 2022 regarding food safety emerging trends (Report No. 64-22) and explained the emerging trends in 2024. Special events have increased since the end of the COVID-19 pandemic, which are positive to bring the community together, but add some additional concerns with how food is being prepared. Public Health Inspectors attend special events to assess what vendors are doing, inspecting sites, and ensuring there is no risk to the public. J. Banninga reflected on a previous food borne illness outbreak in 2013 at the Canadian National Exhibition (CNE) related to the consumption of bacon jam. There are many new vendors at special events who need assistance and support to ensure they are being safe and successful. Some practices may not be established by new vendors such as safe food handling certifications, notice of intent, and pre-preparing food in a non-inspected kitchen environment. J. Banninga added that Public Health Inspectors are also providing inspection and education services with equity and inclusivity in mind, such as supporting newcomers with translating materials and culturally sensitive information for their event.

J. Banninga explained that another trend is manufactured products and home-based food businesses. Historically, manufactured food products have not been inspected by the local public health unit, but more food establishments are making take home goods for the public to consume. There are also jurisdictional grey areas with the introduction of shared kitchen and “ghost kitchens”, which are often seen on food delivery applications such as Uber Eats and Skip the Dishes. The Health Unit continues to inspect these types of shared kitchens to further learn more about this emerging trend. For home-based food businesses, the City of London currently does not have a municipal zoning by-law to permit home-based food businesses, but some lower tier municipalities in Middlesex County permit home-based food businesses.
Home-based food businesses sometimes cause logistics concerns as there are no specific hours of operation and they may not operate year-round.

J. Banninga explained information regarding the Health Unit’s FoodNet program, funded by the Public Health Agency of Canada. The Infectious Disease Control team operates the FoodNet program for Middlesex-London. The FoodNet program conducts surveillance of emerging food borne illness (human enteric) such as salmonella. This program is conducted through food sampling to retail stores to sample products that have been identified by the Public Health Agency of Canada with being a concern of potential food borne illness. The program also supports sampling of surface water and manure from local farms (noting that the Health Unit does not conduct routine sampling of local farm manure). J. Banninga noted that a success of the federal program is that all breaded chicken products (such as frozen chicken nuggets) in a grocery store are all cooked and frozen, significantly reducing the possibility of illness.

J. Banninga concluded that the next steps are to continue to monitor trends, ensure community awareness, and continue with learning and protocol development.

Chair Matthew Newton-Reid emphasized the need for permits and education, so that the Health Unit can keep the community safe. M. Albanese noted that with the increasing number of events post COVID-19 pandemic, the Health Unit has both on-call and a scheduled Saturday Public Health Inspector to support these events. M. Albanese added that with having a Saturday Public Health Inspector, the Health Unit can be more proactive and comprehensive in keeping the community safe after business hours.

It was moved by S. Franke, seconded by P. Cuddy, that the Board of Health receive Report No. 29-24 re: “The Evolving Food Safety Landscape” for information.
Carried

Current Public Health Issues (Verbal)

Dr. Summers provided a verbal update on current public health issues within the region.

Canadian Public Health Week

From April 8-12, it was the third annual Canadian Public Health Week. On April 8, the Middlesex-London Health Unit hosted a coffee break celebration and were joined by staff and representatives of the Board of Health, City of London and the County of Middlesex. During this week, behind the scenes work of public health was highlighted on social media and to further amplify how public health keeps the community safe.

Seniors’ Dental Update

The Government of Canada has released new information on the Canadian Dental Care Plan (CDCP). This program provides dental coverage for eligible Canadians with incomes below $90,000 and who do not have access to private dental insurance, and coverage starts on May 1, 2024 for eligible seniors. The plan may not cover the full cost of dental services. The Health Unit administers the Ontario Seniors Dental Care Plan (OSDCP) for Middlesex-London, with services at the Health Unit and not through private dentists. Clients who are eligible for both plans can choose through which program to access dental benefits; if they choose the Canadian Dental Care Program, dentists may bill for the remaining fee.

Podcast: In Conversation with Reta Ismail

Dr. Summers participated in Reta Ismail’s new podcast “In Conversation” during Canadian Public Health Week. During the podcast, Dr. Summers highlighted what public health does, the role of public health in the pandemic, emergent trends post pandemic and the overdose crisis.

MLHU in the News

The Health Unit was in the news this month regarding nicotine trends and risks, the April 8 Solar Eclipse, vaccination in the community, and toxic drug supply in the region.

Chair Matthew Newton-Reid thanked Vice-Chair Michael Steele for attending on behalf of the Board to provide greetings at the Health Unit’s Canadian Public Health Week celebration.

Vice-Chair Michael Steele noted that he was pleased to attend the Health Unit’s Canadian Public Health Week celebration to thank staff for their contributions to the community and for providing the Board of Health with important information to make decisions. Vice-Chair Steele added that the podcast “In Conversation” was well conducted and should be provided to future Board of Health members to learn about what public health does in the community.

It was moved by S. Franke, seconded by S. Menghsha, 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. 30-24)

Dr. Alexander Summers, Medical Officer of Health presented his activity report for March. Dr. Summers highlighted that with the approved changes to the Performance Appraisal Committee Terms of Reference and procedural documents, that the activity reports for the Medical Officer of Health and Chief Executive Officer would reflect the new categories at the next Board of Health meeting.

There were no questions or discussion.

It was moved by H. Shears, seconded by M. McGuire, that the Board of Health receive Report No. 30-24 re: “Medical Officer of Health Activity Report for March” for information.
Carried

Chief Executive Officer Activity Report for March (Report No. 31-24)

Emily Williams, Chief Executive Officer presented her activity report for March.

There were no questions or discussion.

It was moved by S. Franke, seconded by P. Cuddy, that the Board of Health receive Report No. 31-24 re: “Chief Executive Officer Activity Report for March” for information.
Carried

Correspondence

Dr. Alexander Summers, Medical Officer of Health highlighted Correspondence A - 2023 Chief Medical Officer of Health of Ontario Annual Report - Balancing Act: An All-of-Society Approach to Substance Use and Harms. Dr. Summers noted that the comprehensive overview of certain aspects of this report from the local context would be provided at an upcoming Board of Health meeting.

Board Member Skylar Franke inquired at how health care decisions are made between the government and the Chief Medical Officer of Health. Dr. Summers explained that the Chief Medical Officer of Health and Associate Deputy Minister provide expertise to the Provincial government, who then makes decisions on policy and funding. The Chief Medical Officer of Health would provide evidence informed recommendations that the government would consider.

Chair Matthew Newton-Reid noted that there are some recent public health issues (such as safe drug supply) that cannot be led by a local Medical Officer of Health and rely on the Chief Medical Officer of Health to support and mobilize with the government. Dr. Summers noted that at a future Board of Health meeting, the Community Drug and Alcohol Strategy will be highlighted in connection to the 2023 Annual Report (of the Chief Medical Officer of Health). Dr. Summers explained that public health leads population health surveillance at the local level and in supporting the community to address some of these issues. Dr. Summers concluded that there is no one solution or organization that can solve the crisis (opioid) the community is dealing with but are working with community partners and collaboration for the common good of Middlesex-London.

Board Member S. Franke inquired if she could send the 2023 Chief Medical Officer of Health Annual Report to City of London Council, and if it would be best to wait until the summary report comes to a future Board of Health meeting. Dr. Summers noted support in either direction.

It was moved by M. Steele, seconded by S. Franke, that the Board of Health receive items a) through e) for information:
a) 2023 Chief Medical Officer of Health of Ontario Annual Report - Balancing Act: An All-of-Society Approach to Substance Use and Harms
b) Association of Local Public Health Agencies re: 2024 Summary of the Ontario Budget
c) Middlesex-London Board of Health External Landscape for April
d) Association of Local Public Health Agencies re: 2023 Chief Medical Officer of Health of Ontario Annual Report
e) Haliburton, Kawartha, Pine Ridge District Public Health Unit re: National Framework for a School Food Program Act
Carried

Other Business

The next meeting of the Middlesex-London Board of Health is Thursday, May 16, 2024 at 7 p.m.

Closed Session

At 8:21 p.m., it was moved by P. Cuddy, seconded M. Smibert, that the Board of Health will move into a closed session to consider matters regarding personal matters about identifiable individuals, including municipal or local board employees; labour relations or employee negotiations; advice that is subject to solicitor-client privilege, including communications necessary for that purpose; and to approve previous closed session Board of Health minutes.
Carried

At 9:13 p.m., it was moved by P. Cuddy, seconded by M. Smibert, that the Board of Health return to public session from closed session.
Carried

Adjournment

At 9:13 p.m., it was moved by P. Cuddy, seconded by H. Shears, that the meeting be adjourned.
Carried

Matthew Newton-Reid
Chair

Emily Williams
Secretary