Minutes - May 16, 2019 - Board of Health Meeting

Members Present:

Ms. Trish Fulton (Chair)
Ms. Aina DeViet
Mr. Ian Peer (via teleconference)
Mr. Matt Reid
Mr. John Brennan
Ms. Kelly Elliott
Mr. Michael Clarke

Regrets:

Ms. Elizabeth Peloza
Ms. Tino Kasi
Ms. Maureen Cassidy

Media:

Mr. Bryan Bicknell, CTV News

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
Mr. Jordan Banninga, Manager, Program Planning and Evaluation
Ms. Rhonda Brittan, Manager, Healthy Communities and Injury Prevention
Ms. Anita Cramp, Manager, Young Adult
Ms. Shaya Dhinsa, Manager, Sexual Health
Ms. Sheila Densham, Health Promoter
Mr. Dan Flaherty, Manager, Communications
Mr. Darrell Jutzi, Manager, Child Health
Ms. Donna Kosmack, Manager, Southwest Tobacco Control Area Network
Ms. Melissa McCann, Program Evaluator
Ms. Jennifer Proulx, Manager, Nurse-Family Partnership
Ms. Maureen Rowlands, Director, Healthy Living
Ms. Ruth Sanderson, Epidemiologist
Ms. Meena Shalu, Medical Student, Schulich School of Medicine & Dentistry
Ms. Linda Stobo, Manager, Chronic Disease Prevention and Tobacco Control
Mr. Alex Tyml, Online Communications Coordinator
Ms. Amanda Van Nynatten, Nursing Student, Nipissing University
Ms. Mariana Ionescu-Iorge, Nursing Student, Nipissing University

Chair Fulton called the meeting to order at 7:01 p.m.

Disclosures of Conflict(s) of Interest

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

Approval of Agenda

Chair Fulton mentioned the addition of walk-on Report No. 044-19 regarding the proposed regional public health entities, and noted where it would fall in the evening’s agenda.

It was moved by Ms. Elliott, seconded by Ms. De Viet, that the AGENDA for the May 16, 2019 Board of Health meeting be approved as amended. Carried

Minutes

It was moved by Ms. Elliott, seconded by Mr. Brennan, that the MINUTES of the April 18, 2019 Board of Health meeting be approved. Carried

It was moved by Ms. De Viet, seconded by Mr. Reid, that the draft MINUTES of the May 2, 2019 Finance & Facilities Committee meeting be received. Carried

Delegations and Reports

May 2, 2019 Finance & Facilities Committee Meeting Update (Report No. 036-19)

Mr. Reid provided an update from the May 2, 2019 FFC meeting, reviewing the following reports for the Board’s consideration:

Q1 Financial and Factual Certificate Update (Report No. 015-19FFC)

It was moved by Mr. Reid, seconded by Ms. Elliott, that the Board of Health approve Report No. 015-19FFC re: “Q1 Financial Update and Factual Certificate.” Carried

Mr. Reid advised that the Finance & Facilities Committee received Report No. 016-19FFC re: “Financial Controls Checklist” for information.

Q2 Physical Assets and Facilities Update (Report No. 017-19FFC)

It was moved by Mr. Reid, seconded by Ms. De Viet, that the Board of Health:
1) Receive Report No. 017-19FFC re: “Q2 Physical Assets and Facilities Update” for information; and
2) Direct staff to begin negotiations with Canba Investments Limited regarding the Strathroy Office at 51 Front Street.
Carried
Chair Fulton introduced five program updates for the evening.

Program Update: Population Health Assessment and Surveillance (PHAS)

Dr. Alex Summers, Associate Medical Officer of Health, introduced the PHAS Team and discussed the Team’s activities within the agency and some of the its program highlights for 2019, which include a population health assessment for the Community Health Status Resource.

Dr. Summers introduced Ms. Ruth Sanderson and provided the Community Health Status Resource Strategic Project update.

Community Health Status Resource Strategic Project Update (Report No. 037-19)

Discussion ensued on the following items:
• If this resource been through an evaluation process.
• How MLHU will know if its partners are using the resource.
• If any of the data is forwarded to the Ministry, and from which sources the data are retrieved.
• The proportion of primary versus secondary data sources.
• Why some of the data are so out-of-date.
• The difficulty of securing access to data to keep the resource up-to-date.

It was moved by Ms. Elliott, seconded by Mr. Reid, that the Board of Health receive Report No. 037-19 re: “Community Health Status Resource Strategic Project Update” for information. Carried

Program Update: Program Planning and Evaluation

Mr. Jordan Banninga, Manager, Program Planning and Evaluation, introduced the team and its role within the organization, namely to help programs and teams deliver better services to the community.

Mr. Banninga reviewed some of the programs within Program Planning and Evaluation, which include privacy and records, quality and transparency, research and knowledge exchange, and shared library services partnership.

Saving Lives. Changing Lives. Findings from the Temporary Overdose Prevention Site (TOPS) Evaluation (Report No. 038-19)

Mr. Banninga introduced and provided context for the report, including the purpose of evaluating the TOPS site. Mr. Banninga introduced Ms. Melissa McCann, who reviewed some of the report’s key evaluation findings and answered questions.

Discussion ensued on the following items:
• Recognizing the RHAC staff, who have worked to create a welcoming environment where everyone feels accepted.
• The number of lives that have been saved at the site to date.
• Testing equipment options available at TOPS to test for fentanyl in street drugs.
• The report’s client-focused perspective.
• The report’s methodology.
• What learning can be gleaned from the report and how it could be shared more widely with others who might benefit from it.
• The value of the lessons learned and how they could be shared more broadly.
• The Program Planning and Evaluation Team’s plans to author a peer-reviewed publication to share the report’s findings with the community, and that preliminary findings were shared by Ms. McCann at the Ontario Public Health Conference earlier this year.
• What London and Middlesex might look like in the absence of this service.
• The significant numbers of people who will continue to share injection gear and the length of time that people have identified as using injection drugs.
• The kinds of drugs being used at the site, as well as the proportion using stimulants versus opioids.

It was moved by Mr. Clarke, seconded by Ms. Elliott, that the Board of Health receive Report No. 038-19 re: “Saving Lives. Changing Lives. Findings from the Temporary Overdose Prevention Site (TOPS) Evaluation” for information. Carried

Program Update: Nurse-Family Partnership

Dr. Mackie introduced Ms. Jennifer Proulx, Manager, Nurse-Family Partnership (NFP). Ms. Proulx provided an update on the Nurse-Family Partnership Program, including the program’s eligibility criteria, its implementation in Canada, and an overview of the Canadian Nurse Family Partnership Education Pilot Project.

Completion of the Canadian Nurse-Family Partnership Education Project (Report No. 039-19)

Ms. Proulx introduced and provided context for the report, including a presentation of findings from the Pilot Project and some of the key lessons learned.

Discussion ensued on the following items:
• Where referrals to the program are coming from, and whether greater awareness about the program is required.
• That those who do not meet NFP criteria are then referred to the Healthy Babies Healthy Children program.
• Base budget funding for the program versus for the pilot.
• Whether NFP qualification is recognized and whether participating nurses get accredited. All nurses that go through this program become certified as Nurse-Family Partnership nurses.
• The self-referral process and how people self-referred to the program.

It was moved by Mr. Brennan, seconded by Ms. De Viet, that the Board of Health receive Report No. 039-19 re: “Completion of the Canadian Nurse-Family Partnership Education Project” for information. Carried

Program Update: Young Adult

Ms. Cramp provided an overview of the work of the Young Adult program within the Healthy Living Division. The program is comprised of three areas: situational supports; development and improvement of Healthy Schools; and curriculum supports to schools and school boards.

Discussion ensued on the following items:
• If nurses working in the schools have noticed increased interest in mental health topics and the mental wellbeing of students.
• How school nurses partner with student government in the schools.
• That French-speaking nurses provide the same services to French schools in Middlesex and London as they do to the TVDSB and LDCSB schools.

Program Update: Child Health

Mr. Jutzi provided an overview of the Child Health program within the Healthy Living Division. The program is comprised of the following areas: healthy schools; parenting; and curriculum supports to schools and school boards.

Discussion ensued on the Healthy Schools program and the proportion of schools serviced by MLHU that are located in the County.

Health Canada Seeking Feedback on Measures to Limit Youth Access and Appeal of Vaping Products (Report No. 040-19)

Ms. Stobo and Ms. Kosmack to provided context for this report.

Discussion ensued on the following items:
• The plain-packaging regulations, what theywill look like in practice, and the likelihood of these regulations reaching their final reading before the October federal election.
• That the letters attached to this report are very comprehensive and well researched in order to support the limiting of youth access to vaping products with convincing evidence.
• That staff will consider attaching an executive summary to the cover letters due to their length.
• That this letter is one component of a multi-component strategy.

It was moved by Ms. De Viet, seconded by Mr. Reid, that the Board of Health receive Report No. 040-19 re: “Health Canada Seeking Feedback on Measures to Limit Youth Access and Appeal of Vaping Products” for information. Carried

It was moved by Mr. Clarke, seconded by Ms. Elliott, that the Board of Health:
1) Submit a letter to the Tobacco Control Directorate of Health Canada, attached as Appendix A, expressing its support and recommendations for strengthened measures to limit youth access and appeal of vaping products; and
2) Endorse and submit a letter prepared by the Southwest Tobacco Control Area Network, attached as Appendix B, to the Tobacco Control Directorate of Health Canada on behalf of the eight public health units in southwestern Ontario.
Carried

It was moved by Mr. Clarke, seconded by Ms. De Viet, that the Middlesex-London Health Unit send a letter to the Tobacco Control Directorate of Health Canada to congratulate them on passing legislation for plain packaging of tobacco products. Carried

Harm Reduction Campaign (Report No. 041-19)

Ms. Shaya Dhinsa introduced and provided context for this report, including some of the key findings from the Harm Reduction Campaign.

Discussion ensued on the following items:
• Findings in the report that outline harm reduction strategies and supplies that the Health Unit may consider using in the future.
• Which harm reduction options are currently available on the market, and which are expected to be released in the future, in order to reduce the risk of infectious disease transmission.
• How these pending future harm reduction options will assist with treatment.

It was moved by Ms. Elliott, seconded by Mr. Brennan, that the Board of Health receive Report No. 041-19 re: “Harm Reduction Campaign” for information. Carried

Summary Information Report for May (Report No. 042-19)

It was moved by Mr. Reid, seconded by Mr. Brennan, that the Board of Health receive Report No. 042-19 re: “Summary Information Report for May” for information. Carried

Medical Officer of Health/CEO Activity Report for April (Report No. 043-19)

It was moved by Mr. Reid, seconded by Mr. Brennan, that the Board of Health receive Report No. 043-19 re: “Medical Officer of Health Activity Report for May” for information. Carried

Provincial Announcement of Regional Public Health Entities (Report No. 044-19)

Chair Fulton introduced the report and Dr. Mackie provided context, summarizing the changes to the public health landscape announced with the 2019 Ontario Budget. Dr. Mackie discussed the proposed boundary changes and the significant changes to the Health Unit’s funding for the coming years.

Discussion ensued on the following items:
• What the funding changes and cost-sharing with municipalities might look like going forward.
• Next steps from a budget perspective, and how MLHU will manage cost reductions in order to mitigate funding reductions.
• The one-time funding that the Ministry is offering for transitional support.
• The impact that funding reductions will have on municipal budgets for the remainder of 2019 and into 2020.
• The budgeting structure within the new regional public health entities.
• That MLHU will budget for the first three months of 2020, after which budgeting will be up to the new entity.
• That there will be a consultation process over the summer. Health units will have input into how the new structure will look.
• How the Board of Health might contribute to the consultations and what representation on a new regional Board of Health might look like.
• What proportion of 100%-funded programs is being reduced and how the Low-Income Seniors Dental Program will be funded.

It was moved by Mr. Reid, seconded by Mr. Clarke, that the Board of Health receive Report No. 044-19 re: “Provincial Appointment of Regional Public Health Entities” for information. Carried

Correspondence

It was moved by Mr. Reid, seconded by Ms. De Viet, that the Board of Health receive correspondence items a) through w). Carried

Dr. Mackie introduced and provided context for correspondence item x).

It was moved by Mr. Clarke, seconded by Mr. Brennan, that the Board of Health refer correspondence item x) to staff re: the Regional HIV/AIDS Connection Position Statement on Sex Work. Carried

Other Business

Chair Fulton provided a summary of the recent, April 29 Association of Local Public Health Agencies teleconference on the Ontario budget, in which she participated for the Ontario Board of Health Chairs. She added that there was no consensus or uniformity among boards of health regarding what a response to these changes should look like.

Chair Fulton reviewed the next meeting dates:
• Next Finance & Facilities Committee meeting: Thursday, June 6, 2019 @ 9:00 a.m.
• Next Board of Health meeting: Thursday, June 20 @ 7:00 p.m.
• Next Governance Committee meeting: Thursday, June 20, 2019 @ 6:00 p.m.
• Next Relocation Advisory Committee meeting: Wednesday June 26 @ 5:00 p.m.
• Special Board of Health meeting: Wednesday, June 26

Confidential

At 9:09 p.m., it was moved by Mr. Clarke, seconded by Mr. Reid that the Board of Health move in-camera to consider matters regarding identifiable individuals, information (e.g., a trade secret or scientific, technical, commercial, or financial) that belongs to the Middlesex-London Health Unit and has monetary value and to consider confidential minutes from the May 2, 2019 Finance & Facilities Committee meeting and the April 18, 2019 Board of Health meeting.
Carried

At 9:17 p.m., it was moved by Mr. Reid, seconded by Mr. Brennan, that the Board of Health rise and return to public session. Carried
At 9:17 p.m., the Board of Health returned to public session.

Adjournment

At 9:18 p.m., it was moved by Mr. Brennan, seconded by Mr. Reid, that the meeting be adjourned. Carried

TRISH FULTON
Chair

CHRISTOPHER MACKIE

Secretary-Treasurer