January 24, 2019 - Board of Health Meeting Minutes

Members Present:

Ms. Trish Fulton (Chair)
Ms. Maureen Cassidy (Vice-Chair)
Mr. Ian Peer
Ms. Tino Kasi
Mr. Michael Clarke
Ms. Elizabeth Peloza
Mr. Matt Reid
Mr. John Brennan
Ms. Kelly Elliott

Regrets:
Ms. Aina DeViet, Mayor, Middlesex Centre

Others Present:

Dr. Christopher Mackie, Secretary-Treasurer
Ms. Elizabeth Milne, Executive Assistant to the Board of Health and Communications Coordinator (Recorder)
Dr. Alexander Summers, Associate Medical Officer of Health
Ms. Laura Di Cesare, Director, Healthy Organization
Ms. Mary Lou Albanese, Manager, Infectious Disease
Ms. Marilyn Atkin, Community Outreach and Harm Reduction
Ms. Shaya Dhinsa, Manager, Sexual Health
Mr. Dan Flaherty, Communications Manager
Ms. Lynn Guy, Executive Assistant to the Medical Officer of Health
Ms. Heather Lokko, Director, Healthy Start
Ms. Maureen Rowlands, Director, Healthy Living
Mr. Fatih Sekercioglu, Manager, Safe Water, Rabies and Vector-Borne Disease
Ms. Debbie Shugar, Manager, Reproductive Health, and Acting Manager, Screening Assessment and Intervention
Mr. Alex Tyml, Online Communications Coordinator
Mr. Stephen Turner, Director, Environmental Health and Infectious Disease
Ms. Nicole Gauthier, Manager, Privacy, Governance and Risk Management
Ms. Kendra Ramer, Manager, Strategic Projects
Ms. Rachelle Wood, Policy Advisor
Ms. Pam Hill, Addiction Services of Thames Valley

Dr. Mackie called the meeting to order at 7:01 p.m.

Dr. Mackie welcomed everyone to the inaugural meeting of the Board of Health and reviewed the meeting procedures, including an acknowledgement of the Indigenous Peoples of this land and the First Nations people within Middlesex and London, including the three First Nations communities within the area served by the Middlesex-London Health Unit.

Meeting Procedures

Election of 2019 Board of Health Executive and Other Procedures (Report No. 001-19)

Dr. Mackie opened the floor to nominations for the position of Chair of the Board of Health for 2019.

It was moved by Mr Peer, seconded by Mr. Clarke, that Ms. Trish Fulton be nominated for Chair of the Board of Health for 2019. Carried
Ms. Fulton accepted the nomination.

Dr. Mackie invited nominations three more times. Hearing none, it was moved by Mr. Peer, seconded by Mr. Clarke, that

1) Nominations for the position of Chair be closed; and
2) Ms. Trish Fulton be acclaimed as Chair of the Board of Health for 2019.
Carried

Ms. Fulton took over as Chair and welcomed members appointed by the County of Middlesex to the Board of Health: Ms. Kelly Elliott, Mr. John Brennan, and Ms. Aina DeViet.

Chair Fulton opened the floor to nominations for the position of Vice-Chair of the Board of Health for 2019.

It was moved by Mr. Reid, seconded by Mr. Peer, that Ms. Maureen Cassidy be nominated for Vice-Chair of the Board of Health for 2019.

Ms. Cassidy accepted the nomination.

Chair Fulton invited nominations three more times. Hearing none, it was moved by Mr. Reid, seconded by Mr. Peer, that
1) Nominations for the position of Vice-Chair be closed; and
2) Ms. Cassidy be acclaimed as Vice-Chair of the Board of Health for 2019.
Carried

Establishment of 2019 Standing Committees

It was moved by Ms. Cassidy, seconded by Mr. Peer, that the Board of Health establish and recognize the Governance Committee, the Finance & Facilities Committee, and the Relocation Advisory Committee. Carried

Chair Fulton reviewed the membership composition and terms of reference for the Finance & Facilities Committee (FFC).

Dr. Mackie clarified the membership composition for the Relocation Advisory Committee (RAC), an ad-hoc committee of the Board of Health, noting that the RAC’s Chair, Mr. Ian Peer, was appointed at the Committee’s first meeting and will serve until the Committee ceases to exist. For clarity, all additional RAC members, including the individual previously appointed (Mr. Michael Clarke), will be re-appointed to the Committee.

Chair Fulton invited nominations for members of the Relocation Advisory Committee for 2019, and reviewed the Committee’s terms of reference.

It was moved by Ms. Elliott, seconded by Mr. Reid, that Mr. John Brennan be nominated to the Relocation Advisory Committee for 2019.

Mr. Brennan accepted the nomination.

It was moved by Ms. Cassidy, seconded by Ms. Elliott, that Mr. Matt Reid be nominated to the Relocation Advisory Committee for 2019.

Mr. Reid accepted the nomination.

It was moved by Mr. Peer, seconded by Ms. Cassidy, that Mr. Michael Clarke be nominated to the Relocation Advisory Committee for 2019.

Mr. Clarke accepted the nomination.

Chair Fulton invited nominations three more times. Hearing none, it was moved that nominations be closed, and that Mr. Brennan, Mr. Reid, and Mr. Clarke, be appointed to the Relocation Advisory Committee for 2019. Carried

Therefore, the Relocation Advisory Committee for 2019 shall consist of the following Board of Health members:
1) Ms. Trish Fulton (Board Chair and Provincial Representative)
2) Mr. Ian Peer (Provincial Representative and RAC Chair)
3) Mr. Michael Clarke (Provincial Representative)
4) Mr. Matt Reid (City Representative)
5) Mr. John Brennan (County Representative)

Chair Fulton invited nominations for members of the Finance & Facilities Committee for 2019, and reviewed the Committee’s terms of reference.

It was moved by Mr. Brennan, seconded by Mr. Reid, that Ms. Kelly Elliott be nominated to the Finance & Facilities Committee for 2019.

Ms. Elliott accepted the nomination.

It was remarked that the Chair and Vice-Chair sit on the Finance & Facilities Committee automatically.

It was moved by Mr. Peer, seconded by Mr. Clarke, that Ms. Tino Kasi be nominated to the Finance & Facilities Committee for 2019.

Ms. Kasi accepted the nomination.

It was moved by Ms. Cassidy, seconded by Ms. Elliott, that Mr. Matt Reid be nominated to the Finance & Facilities Committee for 2019.

Mr. Reid accepted the nomination.

Chair Fulton invited nominations three more times. Hearing none, it was moved that nominations be closed and that Ms. Elliott, Ms. Kasi, and Mr. Reid be appointed to the Finance and Facilities Committee for 2019. Carried

Therefore, the Finance & Facilities Committee for 2019 shall consist of the following Board of Health members:
1) Ms. Trish Fulton, (Chair and Provincial Representative)
2) Ms. Maureen Cassidy (Vice-Chair and City Representative)
3) Ms. Tino Kasi (Provincial Representative)
4) Mr. Matt Reid (City Representative)
5) Ms. Kelly Elliott (County Representative)

Chair Fulton invited nominations for members of the Governance Committee for 2019, and reviewed the Committee’s terms of reference.

It was moved by Ms. Cassidy, seconded by Mr. Peer, that Ms. Elizabeth Peloza be nominated to the Governance Committee for 2019.

Ms. Peloza respectfully declined the nomination.

It was moved by Mr. Clarke, seconded by Ms Elliott, that Ms. Aina DeViet be nominated to the Governance Committee for 2019.

Ms. DeViet accepted the nomination.

It was moved by Ms. Cassidy, seconded by Ms. Kasi, that Mr. Ian Peer be nominated to the Governance Committee for 2019.

Mr. Peer accepted the nomination.

It was moved by Ms. Kasi, seconded by Mr. Peer, that Mr. Michael Clarke be nominated to the Governance Committee for 2019.

Mr. Clarke accepted the nomination.

After reviewing potential scheduling conflicts, Ms. Peloza indicated that she would reconsider her nomination to the Governance Committee and would agree to let her name stand should the Board of Health wish her to sit on the Committee.

Mr. Clarke withdrew his acceptance of nomination.

It was moved by Ms. Cassidy, seconded by Ms. Kasi, that Ms. Elizabeth Peloza be nominated to the Governance Committee for 2019.

Ms. Peloza accepted the nomination.

Chair Fulton invited nominations three more times. Hearing none, it was moved that nominations be closed, and that Ms. DeViet, Mr. Peer, and Ms. Peloza be appointed to the Governance Committee for 2019. Carried

Therefore, the Governance Committee for 2019 shall consist of the following Board of Health members:
1) Ms. Trish Fulton (Chair and Provincial Representative)
2) Ms. Maureen Cassidy (Vice-Chair and City Representative)
3) Mr. Ian Peer (Provincial Representative)
4) Ms. Elizabeth Peloza (City Representative)
5) Ms. Aina DeViet (County Representative)

Chair Fulton opened the floor to nominations for the position of Secretary-Treasurer of the Board of Health for 2019.

It was moved by Ms. Cassidy, seconded by Ms. Elliott, that Dr. Christopher Mackie be nominated for Secretary-Treasurer of the Board of Health for 2019. Carried

Dr. Mackie accepted the nomination.

Chair Fulton invited nominations three more times. Hearing no further discussion or nominations, it was moved by Ms. Cassidy, seconded by Ms. Elliott, that Dr. Mackie be elected as Secretary-Treasurer by acclaimed vote. Carried

Disclosures of Conflict(s) of Interest

Chair Fulton inquired if there were any disclosures of conflicts of interest. None were declared.

Approval of Agenda

It was moved by Mr. Peer, seconded by Mr. Clarke, that the AGENDA for the January 24, 2019 Board of Health meeting be approved. Carried

Approval of Minutes

It was moved by Ms. Cassidy, seconded by Mr. Clarke, that the MINUTES of the December 12, 2018 Relocation Advisory Committee meeting be received. Carried

It was moved by Ms. Elliott, seconded by Mr. Peer, that the MINUTES of the November 1, 2018 Finance & Facilities Committee meeting be received. Carried

Delegations and Information Reports

Ms. Albanese introduced and provided an overview of the Infectious Disease Program.

Active Tuberculosis in a Shelter (Report No. 004-19)

Ms. Albanese introduced and provided context for the report, including an update on a case of active Tuberculosis (TB) that has been living in the shelter system.

Discussion ensued on the following items:
• The immigration surveillance process for TB and the process for assessing these cases in shelters, including the type of testing that is currently being done.
• The different types of tests (BCG, TST, IGRA blood tests) and the Health Unit’s procedures for using each type.
• How long the screening program will be in place and when the end point will be determined.
• That the Health Unit has had a great partnership and worked very well with shelters to complete this screening.

It was moved by Ms. Cassidy, seconded by Ms. Elliott, that the Board of Health receive Report No. 004-19 re: “Active Tuberculosis in a Shelter” for information. Carried

Mr. Turner introduced Ms. Shaya Dhinsa, Manager, Sexual Health; Ms. Marilyn Atkin, Program Lead, Community Outreach and Harm Reduction; and Ms. Pam Hill, Addiction Services of Thames Valley.

Ms. Dhinsa and Ms. Atkin provided an update on the Sexual Health program.

Ms. Dhinsa also provided an overview of the Clinic and the Sexual Health Promotion Team, reviewing program achievements and clinic services.

Strategy to Address the HIV Outbreak and Related Issues in London: An Update (Report No. 005-19)

Ms. Atkin introduced this report, acknowledging and thanking community members and partners who have supported the Community Outreach and Harm Reduction team since its inception. Ms. Atkin’s presentation included an update on the HIV outbreak that has affected our jurisdiction since February 2016 (including an overview of HIV count rates, which have been declining) and a summary of strategies implemented to increase access to harm reduction supplies and improve treatment pathways for at-risk and HIV-positive clients.

Dr. Mackie and Ms. Atkin answered questions.

Discussion ensued on the following items:
• The HIV Leadership Strategy and its goal of increasing point-of-care HIV testing.
• Partners that the Health Unit has been working with to ensure point-of-care testing.
• The increasing rates of chlamydia and the associated risk factors.
• How Middlesex-London compares to other Ontario regions in regard to current HIV rates, which have declined since 2016 when an outbreak was declared.
• The Health Unit’s relationship with the Elgin-Middlesex Detention Centre (EMDC) and how the Outreach Team works with clients upon discharge from EMDC.
• Dr. Gayane Hovhannisyan’s role in addressing the HIV outbreak in 2016, and work that has been done with the provincial government to date, to assist in addressing HIV risk factors.
• That, even though the outbreak is over, important work remains to be done in regard to HIV testing, addressing risk factors, and increasing point-of-care testing.
• Which populations are to be targeted for testing and prevention, and what the next steps will entail.

It was moved by Ms. Peloza, seconded by Ms. Cassidy, that the Board of Health receive Report No. 005-19 re: “Strategy to Address the HIV Outbreak and Related Issues in London: An Update” for information. Carried

Ms. Lokko introduced Ms. Debbie Shugar, Manager, Reproductive Health, and Acting Manager, Screening Assessment and Intervention, and provided an update on the contract program manager who is supporting the early intervention programs as the program transitions to the Thames Valley Children’s Centre in 2019.

Ms. Shugar provided an update on the Screening Assessment and Intervention program.

Update on Transfer of Lead Agency Responsibilities for tykeTALK, Infant Hearing, and Blind/Low-Vision Early Intervention Programs (Report No. 006-19)

Ms. Shugar introduced and provided context for this report with regard to the transfer of lead agency responsibility.

It was moved by Mr. Peer, seconded by Ms. Kasi, that the Board of Health receive Report No. 006-19 re: “Update on Transfer of Lead Agency Responsibilities for tykeTALK, Infant Hearing, and Blind/Low-Vision Early Intervention Programs” for information.
Carried

Mr. Stephen Turner introduced Mr. Fatih Sekercioglu, Manager, Safe Water, Rabies and Vector-Borne Disease, and provided context on the Bill 66 submission.

Mr. Sekercioglu provided a program update on the Safe Water, Rabies and Vector-Borne Disease program, referencing Appendix C to Report No. 007-19 re: “Summary Information Report for January 2019.”

Discussion ensued on the Vector-Borne Disease program, including how the program monitors standing water in storm-water management ponds, and the number of touch points and the extensive work that the program carries out in the County of Middlesex, as identified by the Middlesex County Services Review.

Summary Information Report for January 2019 (Report No. 007-19)

It was moved by Mr. Clarke, seconded by Ms. Kasi, that the Board of Health receive Report No. 006-19 re: “Summary Information Report for January 2019” for information. Carried

Dr. Mackie highlighted the input on Bill 66 that the Health Unit submitted to the provincial government last Friday. This intervention was a success and resulted, per MLHU’s recommendation, in schedule 10 being withdrawn from the legislation, which might otherwise have put drinking water at risk of contamination. Dr. Mackie noted Dr. Sekercioglu’s expertise in this area.

Medical Officer of Health/Chief Executive Officer Activity Report for January (Report No. 008-19)

It was moved by Ms. Elliott, seconded by Mr. Reid, that the Board of Health receive Report No. 008-19 re: “Medical Officer of Health/Chief Executive Officer Activity Report for January” for information. Carried

It was moved by Mr. Peer, seconded by Mr. Clarke, that the MINUTES of the December 12, 2018 Board of Health meeting be approved. Carried

Chair Fulton reviewed the next meeting dates for the Board of Health and its standing committees.

Dr. Mackie noted a conflict for the February 21 Board of Health meeting and suggested some alternative dates for the meeting.

Ms. Fulton indicated that Ms. Milne would determine an alternative meeting date by circulating a poll to Board of Health members.

It was moved by Ms. Peloza, seconded by Mr. Peer, that the Board of Health approve the proposed meeting schedule for 2019, as amended. Carried

Recommendation Reports

Diversity and Inclusion Assessment (Report No. 002-19)

Dr. Mackie introduced the report. Ms. Lokko provided context.

Discussion ensued about the budget line being drawn upon to finance the diversity and inclusion work, and how much flexibility in regard to the budget is necessary here to allow the work to go forward.

It was moved by Mr. Peer, seconded by Ms. Kasi, that the Board of Health:
1) Receive Report No. 002-19 re: “Diversity and Inclusion Assessment” for information; and
2) Approve entering into a contract with Turner Consulting Group for the purpose of conducting MLHU’s Diversity and Inclusion Assessment.
Carried

Location Project Update (Report No. 003-19)

Dr. Mackie introduced the report and provided context, advising that the report recommends flexibility to give notice to landlords as timing of the build at Citi Plaza is clarified.

It was moved by Ms. Kasi, seconded by Mr. Clarke, that the Board of Health:
1) Receive Report No. 003-19 re: “Location Project Update”; and
2) Authorize the Medical Officer of Health to provide notice to the current landlords to terminate leases at 50 King Street and 201 Queens Avenue once the date of completion of the future landlord’s work is known.

Carried

Other Business

Chair Fulton reviewed the Confidentiality Attestation and Conflict of Interest Declaration, with corresponding policies, which each board member was to review and complete before leaving the meeting.

Chair Fulton reviewed the next meeting dates:
• Next Finance & Facilities Committee meeting: Thursday, February 7, and Thursday, February 14
• Next Board of Health meeting: to be determined by poll
• Next Governance Committee meeting: March 21, 2019

Correspondence

Chair Fulton reviewed the process for taking account of monthly correspondence.

Discussion ensued on item D, Results of the 2018 Nutritious Food Basket Survey for Wellington-Dufferin-Guelph Public Health, and how it relates to populations in the Middlesex-London region, food affordability, and the cost of following the new guide for vulnerable families (i.e., what food they should be eating versus whether they can afford the guide’s recommendations on a budget).

It was moved by Mr. Clarke, seconded by Ms. Elliott, that the Board of Health receive items a) through m). Carried

Chair Fulton reminded Board of Health members that all pink papers should be returned at the end of the meeting.

It was moved by Mr. Peer, seconded by Ms. Kasi, that the Board of Health approve the confidential minutes of the December 12, 2018 Board of Health meeting. Carried

Adjournment

At 8:57 p.m., it was moved by Ms. Elliott, seconded by Mr. Reid, that the meeting be adjourned. Carried

TRISH FULTON
Chair

CHRISTOPHER MACKIE
Secretary-Treasurer