Minutes - February 20, 2025 - Board of Health Meeting

Thursday, February 20, 2025 at 7 p.m.
MLHU Board Room – CitiPlaza
110-355 Wellington Street
London, ON N6A 3N7

Members Present: 

Michael Steele (Chair)
Michelle Smibert (Vice-Chair)
Matthew Newton-Reid
Selomon Menghsha
Peter Cuddy
Aina DeViet
Howard Shears (attended virtually)
Skylar Franke
Michael McGuire (attended virtually)
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
Omar Ozaldin, Director, Environmental Health, Infectious Diseases and Clinical Services
Ryan Fawcett, Associate Director, Operations/Privacy Officer
Cynthia Bos, Associate Director, Human Resources and Labour Relations
Christian Daboud, Manager, Health Equity and Indigenous Reconciliation
Dr. Gani Braimoh, Co-Chair, Middlesex-London Anti-Black Racism Plan Advisory Committee
Darryl Ntow, Public Health Nurse
Parthiv Panchal, End User Support Analyst, Information Technology
Dr. Janice Mok, Medical Resident, Public Health and Preventative Medicine

Chair Michael Steele called the meeting to order at 7 p.m.

Dr. Alexander Summers, Medical Officer of Health introduced Omar Ozaldin, Director, Environmental Health, Infectious Diseases and Clinical Services.

Disclosure of Pecuniary Interest

Chair Steele inquired if there were any disclosures of pecuniary interest. None were declared.

Approval of Agenda

It was moved by M. Newton-Reid, seconded by M. Smibert, that the AGENDA for the February 20, 2025 Board of Health meeting be approved as amended.
Carried

Approval of Minutes

It was moved by M. Newton-Reid, seconded by A. DeViet, that:
a) the MINUTES for the October 17, 2024 Governance Committee meeting be approved; and
b) the MINUTES for the January 23, 2025 Board of Health meeting be approved.
Carried

New Business

Anti-Black Racism Plan Implementation Progress Report (Report No. 11-25)

Sarah Maaten, Director, Public Health Foundations introduced Dr. Gani Braimoh, Co-Chair, Anti-Black Racism Plan Advisory Committee and Christian Daboud, Manager, Health Equity and Indigenous Reconciliation to discuss work with the MLHU Anti-Black Racism Plan.

C. Daboud introduced the Anti-Black Racism Plan and provided updates on the work of the plan at the Health Unit. In 2020, racism was declared a public health crisis by the Board of Health after the murder of George Floyd. In response, the Health Unit engaged a consultancy firm for the development of the MLHU Anti-Black Racism Plan (ABRP).

The Anti-Black Racism Plan was developed through the engagement of the African, Caribbean and Black communities in London and Middlesex County. A total of 375 community members representing diverse ages, cultures and linguistic backgrounds contributed to the plan, ensuring it reflected the views and priorities of the community. 45 recommendations were provided and split into 7 groups, of which C. Daboud reviewed a few of them.

C. Daboud noted that building relationships and learning from the community is also critical to the Health Unit’s ability to assess the health of this population, to understand their health needs and aspirations and to prioritize the large amount of work required to reduce health inequities and reduce racism. A key mechanism for engagement and accountability is the Anti-Black Racism Plan Advisory Committee, which has been operating for three (3) years and is composed of members of the African, Caribbean, and Black communities of Middlesex County and London.

C. Daboud briefly reviewed the “Ways of Working” document that notes values to support anti-black racism work which is within the Anti-Black Racism Plan. This document guides the way that the Health Unit has undertaken this work such as creating lines (not circles), choosing critical connection over critical mass, moving at the speed of trust, deep listening, planning and designing with the community, centering lived experience, amplifying black joy, seeking people at the margins, and reckoning with the past to build the future. The Advisory Committee has also worked with other partners to hold community events and focus on black joy and black health through initiatives held by Type DiaBeat it and the WEAN Community Centre.

C. Daboud highlighted a series of recommendations that have been implemented and are being sustained at the Health Unit. The Health Equity and Indigenous Reconciliation team has developed and monitored the implementation of the Interpretation Policy to ensure clients from African, Caribbean and Black communities can access services in the languages of their preference to improve access and quality of care.
Physical and virtual spaces at the Health Unit are now more reflective of Black culture through the purchase and installation of art made by local Black artists. Social media messaging has been used for key cultural events such as Black History Month. Engagement activities have focused on educating ACB communities about Health Unit services.

Next steps include improving the Health Unit’s understanding of health issues affecting African, Caribbean and Black communities and adjusting services to better meet their needs, race-based data collection, and developing data governance mechanisms to disaggregate health-outcome data by race in 2025, and to have an Anti-Black Racism communication strategy.

C. Daboud re-introduced Dr. Braimoh and thanked Darryl Ntow, Public Health Nurse as a co-chair of the Anti-Black Racism Plan Advisory Group.

Dr. Braimoh reflected on his time as co-chair of the Advisory Committee and thanked the Board of Health for inviting him to attend this meeting. Dr. Braimoh noted that joining the Advisory Committee was an important and positive decision to look at equity within the community and public health, and to find ways to support the African, Caribbean and Black communities in Middlesex-London. Dr. Braimoh noted that it is important for everyone to take the step of removing injustice (racism), which the Advisory Committee and Board of Health are doing – everyone has experienced injustice in their lives. The Advisory Committee has many diverse individuals within the community, who are privileged to be able to provide recommendations to support this work and to be taken seriously.

Dr. Braimoh concluded by noting that we cannot erase the past, but we can influence the future through this work. Dr. Braimoh further invited the Board of Health to attend a future meeting of the Anti-Black Racism Advisory Committee.

Dr. Alexander Summers, Medical Officer of Health thanked Dr. Braimoh for his reflection and thanked him for the work that the Anti-Black Racism Advisory Committee does. Dr. Summers noted his gratitude to the Advisory Committee and committed to continuing to support this work, such as asking at every single team level what can we do differently to serve the African, Caribbean and Black Community.

Chair Steele requested that the Board of Health be notified of when the next Anti-Black Racism Advisory Committee will be held.

Board Member Skylar Franke inquired if there was an ability to collect race-based data to improve customer service in a situation of a service complaint to better serve the African, Caribbean and Black community. S. Maaten explained that the Health Unit is collecting demographic data in a pilot program to understand the differences in the health outcomes at the local population level. In 2025, the Health Unit is looking at a larger data governance strategy and how to responsibly and respectfully hold and use the data. R. Fawcett added that with future program planning this process will be incorporated into the Health Unit’s Client Relations process.

It was moved by P. Cuddy, seconded by S. Menghsha, that the Board of Health receive Report No. 11-25 re: “Anti-Black Racism Plan Implementation Progress Report” for information.
Carried

Amendments to the MLHU Anti-Black Racism Plan (Report No. 12-25)

C. Daboud highlighted proposed amendments to the Health Unit’s Anti-Black Racism Plan and noted that these recommendations are supported by the Anti-Black Racism Advisory Committee. 67% of the recommendations are implemented, in progress, or being sustained. Some recommendations require revision as they fall outside the scope of public health practice. Recommendations 18 and 33 were revised to align with public health practice, while recommendations 27 and 36 were removed as they fall outside public health’s scope.

The proposed amendments are:

Recommendation #18: Create an ACB paid position at MLHU that will focus on relationship-building, communication, and connection between the ACB community and MLHU.
• Proposed modification: MLHU will ensure that recruitment and talent management practices are equitable such that members of the African, Caribbean, and Black communities can be represented and perform at their full potential in the workforce at all levels. Furthermore, MLHU will ensure that the voice of people with lived experience of anti-Black racism guides public health practice from within and outside of the organization.

Recommendation #33: Seek out opportunities at community tables to advocate for increased Black representation and meaningful participation (including at decision-making tables), and call others to join in taking the initiative to challenge anti-Black racism and existing injustices.
• Proposed modification: The MLHU's Senior Leadership Team, in collaboration with the Anti-Black Racism Plan (ABRP) Advisory Committee and the Health Equity and Reconciliation Team will prioritize community tables to advocate for increased representation and meaningful participation from Black communities.

Recommendation #27: Promote the creation and ongoing maintenance of an ACB health and allied health care professional directory so that ACB community members can more easily access practitioners from the ACB community if they wish.
• Reason for Removal: This is outside the scope of public health mandate and practice.

Recommendation #36: Advocate with health system leaders for ACB “Connectors” that can support ACB community members with connection and navigation within and across the entire health care system.
• Reason for Removal: This is outside the scope of public health mandate and practice.

C. Daboud noted that the Health Unit acknowledges that recommendations 27 and 36 of the Anti-Black Racism Plan fall outside the jurisdiction of public health and cannot be directly facilitated. The Health Unit recognizes the importance of advocating whenever opportunities arise.

Dr. Summers noted that these recommendations were reviewed in depth with the Advisory Committee and the Health Unit and that these changes demonstrate how impactful these conversations are.

It was moved by M. Smibert, seconded by A. DeViet, that the Board of Health:
a) Receive Report No. 12-25 re: “Amendments to the MLHU Anti-Black Racism Plan” for information; and
b) Amend the Middlesex-London Health Unit’s Anti Black Racism Plan (ABRP) to include changes to recommendations 18, 27, 33, 36.
Carried

Quality and Governance Committee Meeting Update (Verbal Report)

2025 Quality and Governance Committee Chair, Aina DeViet presented the Committee’s first verbal report of 2025. There were no questions or discussion.

It was moved by A. DeViet, seconded by M. Newton-Reid, that the Board of Health:
a) Receive Report No. 01-25QGC re: “2025 Quality and Governance Committee Terms of Reference” for information;
b) Approve the 2025 Quality and Governance Committee Terms of Reference;
c) Receive Report No. 02-25QGC re: “2023-25 Provisional Plan 2024 Q4 Status Update” for information;
d) Receive Report No. 03-25QGC re: “Privacy Program – Information and Privacy Commissioner (IPC) Statistical Reports for 2024” for information;
e) Receive Report No. 04-25QGC re: “Q4 2024 Risk Registry” for information;
f) Approve the Q4 Risk Register (Appendix A); and
g) Receive Report No. 05-25QGC re: “Q4 2024 Organizational Performance Reporting” for information.
Carried

MLHU 2025 Continuity of Operations Plan (Report No. 13-25)

S. Maaten presented the 2025 Continuity of Operations Plan and noted that this is one of the Health Unit’s strategic initiatives.

The Continuity of Operations Plan uses an all-hazards approach for all types of emergencies to continue work at the Health Unit. The plan functions as a high level strategic document that ensures that the Health Unit can provide essential services during an emergency and identifies the most critical services that need to be prioritized to serve the community in an emergency. S. Maaten noted that this is a living document and will be adjusted as needed.

Board Member Aina DeViet inquired how these plans are integrated across the province and through local agencies. S. Maaten noted that the Strategic Advisor, Emergency Planning engages the informal network of emergency planning individuals and other foundational standards teams in health units to review consistency. Dr. Summers noted that integrating organizations in responses to emergencies is a key aspect of a lot of the foundational principles around emergency management and has been articulated in the Health Unit’s Emergency Response Plan.

Dr. Summers added that in January, the Health Unit held the inaugural meeting of the Middlesex-London Health System Emergency Management Table, which is a planning table that brings together the health system partners in the region to ensure clarity around roles and responsibilities. Further, the Health Unit liaises with municipalities including the emergency control groups at Middlesex County and the Emergency Operations Centre at the City of London.

Board Member Michelle Smibert inquired if there was a training component to the continuity of operations plan. S. Maaten noted that the training requirements are outlined in the Emergency Response Plan and there are requirements for engaging in training annually. S. Maaten added that staff have a really good sense of what would happen if there was an emergency for the Health Unit.

It was moved by S. Franke, seconded by M. McGuire, that the Board of Health receive Report No. 13-25 re: “MLHU 2025 Continuity of Operations Plan” for information.
Carried

2024 Public Sector Salary Disclosure for Middlesex-London Health Unit (Report No. 14-25)

Emily Williams, Chief Executive Officer presented the 2024 Public Sector Salary Disclosure for Middlesex-London Health Unit. The Public Sector Salary Disclosure Act, 1996 (the Act) requires organizations that receive public funding from the Province of Ontario to disclose annually the names, positions, salaries and total taxable benefits of employees paid $100,000 or more in a calendar year. This information is required to be uploaded into the provincial online portal by March 7 with public disclosures being made by March 31.

E. Williams noted that there are 36 individuals on this list for 2024 and added that the Board has received an amended appendix this evening, due to staff members needing to be added to the disclosure (an Epidemiologist and a Public Health Nurse).

Board Member Matthew Newton-Reid inquired when the Health Unit would potentially start seeing more Public Health Nurses on future salary disclosures. E. Williams noted that this may occur soon (potentially next year) pending negotiations, where the nurse is on the salary band, and the type of work that the nurse conducts. E. Williams noted that some nurses on the disclosure engaged in after hours on-call work regarding vaccine and that the top of the salary band is approximately $93,000.

It was moved by S. Menghsha, seconded by S. Franke, that the Board of Health receive Report No. 14-25 re: “2024 Public Sector Salary Disclosure for Middlesex-London Health Unit” for information.
Carried

Current Public Health Issues (Verbal Report)

Dr. Summers provided the Board of Health with an update on current public health issues.

Respiratory Season Update
Middlesex-London continues to be in a high-risk respiratory season. COVID-19 and influenza are circulating, with COVID trending downwards and influenza trending upwards. COVID’s peak in the region occurred earlier in the fall. Influenza is currently showing peaks, with a predicted peak in March and April. The RSV virus is also circulating and there are readily available vaccinations for RSV for pregnant persons, infants, and those over 65 years of age.

Measles Update
Neighbouring jurisdictions have seen significant measles outbreaks. In Middlesex-London, there are no measles cases but there have bene measles exposures. Middlesex-London’s measles vaccination rates are high, and the outbreaks are occurring with under-vaccinated populations. Vaccination hesitancy continues to be discussed.

Ministry of Finance Delegation
On January 29, Emily Williams and Dr. Alex Summers were invited to attend a private consultation meeting with the Parliamentary Assistant to the Minister of Finance, MPP Zee Hamid and Minister Rob Flack in St. Thomas (riding of Elgin-Middlesex-London). The consultation was for community partners to provide feedback on the 2025 Ontario Budget.

The Health Unit emphasized the following messages:
• Sustained and sufficient funding for public health units
• Equitable base funding for MLHU
• Suggestions to change the funding formula to include population growth impacts
• Increase in newcomers who are supported by public health, and that drives service costs (e.g., translation)

Provincial Election
On January 28, the Lieutenant Governor approved the Premier’s request to dissolve the legislature and there will be a provincial election on February 27. For the Health Unit, there is uncertainty around funding receipt, no passing of legislation that may impact public health and uncertainty around local political representatives.

MLHU in the News
The Health Unit was in the news regarding the measles exposures in the community, cold weather alerts and ongoing avian influenza activity.

Board Member M. Newton-Reid inquired on the threshold for a cold weather alert to be issued. Dr. Summers noted that the threshold is -15 degrees or -20 degrees with windchill.

Board Member Howard Shears noted that the United States seems to be moving away from promoting vaccination for COVID, influenza and measles. H. Shears inquired what contingency plans would the Health Unit have for uptick in disease. Dr. Summers noted that vaccination hesitancy is of concern (for uptick in diseases such as measles) as occurrences are happening closer. The work that the Health Unit continues to do with provincial partners is emphasizing that there is a need to continue to have capacity to investigate cases of infectious diseases, as well as emphasizing the need to make sure that as many people in our population are as vaccinated as possible. Dr. Summers noted that it is reassuring that locally, there are high rates of vaccination and locally, vaccines are readily available to provide to the community. Dr. Summers furthered highlighted the use of the Immunization of Student Pupils Act to vaccinate youth and to reach more people with vaccination.

It was moved by P. Cuddy, seconded by S. Franke, 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. 15-25)

Dr. Summers presented his activity report for January. There were no questions or discussion.

It was moved by P. Cuddy, seconded by M. Newton-Reid, that the Board of Health receive Report No. 15-25 re: “Medical Officer of Health Activity Report for January” for information.
Carried

Chief Executive Officer Activity Report for January (Report No. 16-25)

E. Williams presented her activity report for January. There were no questions or discussion.

It was moved by M. Smibert, seconded by H. Shears, that the Board of Health receive Report No. 16-25 re: “Chief Executive Officer Activity Report for January” for information.
Carried

Correspondence

It was moved by M. Newton-Reid, seconded by S. Franke, that the Board of Health receive items a) and b) for information:
a) Public Health Sudbury and Districts re: Response to Proposed Amendment of Section 22 of the Health Protection and Promotion Act
b) Middlesex-London Board of Health External Landscape for February
Carried

Other Business

The next meeting of the Middlesex-London Board of Health is Thursday, March 20, 2025 at 7 p.m.

Closed Session

At 8:04 p.m., it was moved by A. DeViet, seconded by P. Cuddy, that the Board of Health will move into a closed session to consider matters regarding:
• advice that is subject to solicitor-client privilege, including communications necessary for that purpose affecting the municipality or local board; and
• to approve previous closed session Board of Health minutes.
Carried

At 8:10 p.m., it was moved by M. Newton-Reid, seconded by S. Menghsha, that the Board of Health return to public session from closed session.
Carried

Adjournment

At 8:11 p.m., it was moved by S. Franke, seconded by A. DeViet, that the meeting be adjourned.
Carried

Michael Steele
Chair

Emily Williams
Secretary