Minutes - September 19, 2019 - Board of Health Meeting

Members Present:

Ms. Trish Fulton (Chair)

Ms. Maureen Cassidy (Vice-Chair)
Ms. Aina DeViet
Mr. Ian Peer
Mr. John Brennan
Ms. Kelly Elliott
Mr. Michael Clarke
Ms. Elizabeth Peloza
Ms. Tino Kasi

Regrets: Mr. Matt Reid

Others Present:

Dr. Christopher Mackie, Secretary-Treasurer
Ms. Lynn Guy, Executive Assistant to the Medical Officer of Health (Recorder)
Dr. Alexander Summers, Associate Medical Officer of Health
Mr. Stephen Turner, Director, Environmental Health & Infectious Diseases
Ms. Heather Lokko, Director, Healthy Start
Ms. Maureen Rowlands, Director, Healthy Living
Mr. Joe Belancic, Manager, Procurement and Operations
Ms. Rhonda Brittan, Manager, Healthy Communities & Injury Prevention
Mr. Brian Glasspoole, Manager, Finance
Ms. Linda Stobo, Manager, Chronic Disease Prevention and Tobacco Control
Mr. Alex Tyml, Online Communications Coordinator
Mr. Dan Flaherty, Manager, Communications
Mr. David Pavletic, Manager Food Safety
Mr. Andrew Powell, Acting Manager, Safe Water, Rabies and VBD
Ms. Mary Lou Albanese, Manager Infectious Disease
Mr. Jeff Cameron, Manager IT
Chair Fulton called the meeting to order at 7:00 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

It was moved by Ms. Elliott, seconded by Ms. Peloza that the amended AGENDA for the September 19, 2019 Board of Health meeting be approved. Carried

Minutes

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

It was moved by Mr. Peer, seconded by Ms. Elliott, that the MINUTES of the June 20, 2019 Governance Committee meeting be received. Carried

It was moved by Ms. Deviet, seconded by Ms. Peloza, that the draft MINUTES of the September 5, 2019 Finance & Facilities Committee meeting be received. Carried

Delegations and Reports

September 5, 2019 Finance & Facilities Committee Meeting Update (Report No. 051-19)

Ms. Cassidy provided an update from the September 5, 2019 FFC meeting and reviewed the following reports for the Board’s consideration:

Draft Financial Statements – March 31, 2019 (Report No. 028-19)

It was moved by Ms. Cassidy, seconded by Mr. Peer, that the Board of Health approve the audited Consolidated Financial Statements for the Middlesex-London Health Unit, March 31, 2019 as appended to Report No. 028-19FFC. Carried

Q2 Financial Update and Factual Certificate (Report No. 029-19FFC)

It was moved by Ms. Cassidy, seconded by Ms. Elliott, that the Board of Health:
1) Receive Report No. 029-19FFC re “Q2 Financial Update and Factual Certificate” for information; and
2) Approve the allocation of variance funds, above those required to offset the agency gapping budget, to relocation-related expenses to a maximum of $1 million in 2019.
Carried

2019 Budget – MOHLTC Approved Grants (Report No. 030-19FFC)

It was moved by Ms. Cassidy, seconded by Ms. DeViet, that the Board of Health:
1) Receive Report No. 030-19 FFC re: “2019 Budget – MOHLTC-Approved Grants” for information; and
2) Approve removing the deficit mitigation step with respect to recruitment as outlined in the April Board of Health Report 031-19 re: “Impact of 2019 Provincial Budget.”
Carried

Governance Update - September 19, 2019

Ms. DeViet provided a verbal update from tonight’s Governance Committee meeting and noted that the Committee had seven policies to review.

It was moved by Ms. DeViet, seconded by Ms. Peloza, that the Board of Health approve the governance policies appended to Report 014-19GC. Carried

Public Health Inspector (PHI) Program Review (Report No. 052-19)

Mr. Stephen Turner, Director, Environmental Health and Infectious Diseases Division, introduced the three managers whose staff are mentioned in this report: Mr. David Pavletic, Manager, Food Safety and Healthy Environments; Ms. Mary Lou Albanese, Manager, Infectious Diseases; and Mr. Andrew Powell, Acting Manager, Safe Water, Rabies and Vector Borne Diseases. All three were present to provide further information if required.

Mr. Turner noted that by implementing a program review, the Health Unit was able to pinpoint opportunities for improving efficiency and effectiveness throughout the three teams.

While the work of the PHI is often reactive, Ms. Albanese noted that a monthly surveillance meeting has been instituted to examine statistics and thus better assess what is happening in the community. This new measure allows PHI staff to plan accordingly.

Discussion turned to the ongoing professional development for PHIs. All Inspectors are certified in Public Health Inspection (CPHI); however, only 50% are certified members of the Canadian Institute of Public Health Inspectors (CIPHI). It was noted that until two years ago it was not mandatory for Inspectors to have CIPHI designation. Mr. Turner advised that steps are being taken to ensure that all PHIs will receive this designation through in-house training and education.

It is anticipated that with the upcoming health unit amalgamations, the findings from this review will be helpful in identifying alignment opportunities. Mr. Turner noted that the hybrid model for public health inspection that MLHU uses is a common approach that is also used by some other health units.

It was moved by Mr. Peer, seconded by Mr. Clarke, that the Board of Health receive Report No. 052-19 re: “Public Health Inspector Program Review” for information. Carried

Public Health Inspector Enforcement Actions – Q2 2019 (Report No. 053-19)

Mr. Turner noted that this report is the second to be brought to the Board of Health since the quarterly reporting process was implemented, and asked Board members to advise him should they wish to see any changes to how data is being presented to them, or should they have suggestions on how the reporting might be improved. Chair Fulton suggested that an annual aggregation report might be beneficial.

It was moved by Ms. DeViet, seconded by Ms. Cassidy, that the Board of Health receive Report No. 053-19: re: “Public Health Inspector Enforcement Actions” for information. Carried

Unified Communications – Contract Award and Implementation (Report No. 054-19)

There was discussion in regard to which costs are considered annualized costs and which are capital costs.
Mr. Belancic added that with this new contract, headsets will be needed as most desk phones will be eliminated. Staff will have the option of answering calls either on their cell phones or via computer.

It was moved by Mr. Peer, seconded by Ms. Kasi, that the Board of Health:
1) Receive Report No. 054-19 re: “Unified Communications – Contract Award and Implementation” for information;
2) Approve a contractual agreement with Telecom Metric for the provision of a phone system; and
3) Approve additional costs related to the implementation of a Unified Communication System.
Carried

Summary Information Report for September (Report No. 055-19)

Ms. Rhonda Brittan provided additional information for this summary report. She noted that cannabis health products (CHP) are not just for medical use, but for recreational use as well.

Board members expressed frustration at the use of the term “health” products in relation to this consultation.

Ms. Brittan assured Board members that, as noted in the response from the Ontario Public Health Collaboration on Cannabis, they will focus on minimizing public health risks as they relate to the potential sale of CHP. This will include recommending alignment with the Cannabis Act in regard to providing cannabis to minors, packaging, and Health Canada regulations as they pertain to cannabis and cannabis-related products; prohibiting products that require inhalation; and ensuring that clear guidelines are in place for enforcement responsibilities.

Ms. Brittan noted that this consultation was developed specifically to gauge interest on the part of the public and industry. At this time, it is not known what the composition of these products will be.

Discussion ensued on the following items:
• The need for more evidence before sales of CHP become legal, as it is still very early in the process
• The legal age for purchasing CHP being 18 years

It was moved by Ms. DeViet, seconded by Ms. Elliott, that the Board of Health receive Report No. 055-19 re: “Summary Information Report for September” for information. Carried

Medical Officer of Health/CEO Activity Report for September (Report No. 057-19)

It was moved by Ms. Cassidy, seconded by Ms. Elliott, that the Board of Health receive Report No. 057-19 re: “Medical Officer of Health Activity Report for September” for information. Carried

Verbal Update – Vaping

Dr. Mackie provided this update. He advised the Board of Health that on September 18, the Health Unit was notified of a case of respiratory illness related to vaping. A teenager became seriously ill and was admitted to hospital and placed on life support. This person is now at home recovering.

The case was reported by a London doctor under the Canada Consumer Product Safety Act.

Dr. Mackie asked Mr. Dan Flaherty, Manager, Communications, to estimate the value and impact of the media that the Health Unit received since its media announcement about this case. Mr. Flaherty estimated that the value would be in excess of a million dollars. This would include all media outlets, social media, television, radio, print material, and wire services. For broadcast television coverage alone, he estimated approximately $425,000.

The messages reach extended beyond Canadian borders and, as of today, has been picked up in the United States, Asia, New Zealand, and Australia. Mr. Flaherty advised that determining the messages full reach can be difficult due to so much sharing taking place on social media, but this is his best estimate.

It was noted that both Dr. Mackie and Ms. Linda Stobo have participated in many media interviews over the last thirty hours and that it was remarkable how many requests were received.
Dr. Mackie thanked Chair Fulton for attending the media announcement. He noted that staff at the Health Unit are happy to be part of something such as this that helps to improve the lives of its residents.

On the same day as the announcement, Ontario Health Minister Christine Elliott issued an order that public hospitals in the province must provide statistical, non-identifying information about vaping-related illness to the Chief Medical Officer of Health (CMOH) for Ontario.

Discussion ensued on the following items:
• Whether the hundreds of cases in the United States can be directly linked to vaping and, if not, whether there are people who could use this to their advantage.
• Whether it matters which product you are inhaling. Dr. Mackie advised that the issue might not be the additive or the brand you are using, and that it could be that sufferers have a predisposition to the product. This is not clear yet.
• Staff are not releasing which brand this case was using, as it is not helpful at this time.
• The implications of hospitals reporting directly to the CMOH and not to local medical officers of health.

Chair Fulton added that she was struck by the questions being posed in regard to the announcement and impressed by the responses provided by both Dr. Mackie and Ms. Stobo. She noted further that the message that came through from them is that “we do not know,” so be cautious, because vaping has the potential to cause serious health problems.

It was moved by Mr. Clarke, seconded by Mr. Brennan, that the Board of Health receive the verbal update re: “Vaping” for information. Carried

Verbal Update – Legionella

Dr. Summers noted that Health Unit staff are currently investigating an outbreak of legionellosis in the City of London. He provided a brief description of the bacteria – where, how, and why it grows – noting that legionella is very common in the environment.

Generally, the Health Unit sees approximately 6 cases per year. So far in 2019, there have been 15 local cases. A new case was reported today.

Dr. Summers advised the Board that this is an unusual event. In recent days, Health Unit staff have begun investigating a highly clustered area in south-central London, where 6 cases have been reported in two weeks.

Health-care providers have been notified via a newsletter and urged to consider Legionnaires’ disease if the noted symptoms are presented.

Dr. Summers noted that community partners and the Province have been involved in this investigation.

It was moved by Ms. Cassidy, seconded by Ms. DeViet, that the Board of Health receive Dr. Summers’s verbal update re: “Legionella” for information. Carried

Verbal Update – Indigenous Learning Series Through Pillar Non-Profit

Ms. Heather Lokko, Director, Healthy Start Division, introduced Mr. Joe Antone, Manager, Health Equity and Indigenous Reconciliation. Mr. Antone noted that he and other Indigenous people from neighbouring First Nations groups have been working with Pillar Non-Profit to develop relevant training. It would be a great opportunity for the Board to attend a two-day training session and to bring forward the Health Unit’s Reconciliation Plan. Mr. Antone outlined what the two days would entail. Day one would see attendees travel to a First Nations location, while day two would most likely be held at Pillar Non-Profit.

Mr. Antone will send the three dates on which the training will be offered to Ms. Guy and/or Ms. Elizabeth Milne, who will forward them to Board members. There will be spots for four to five members to participate. It is recommended that attendance be spread across the three date options. Mr. Clarke asked to be registered.

It was moved by Ms. Peloza, seconded by Mr. Clarke, that the Board of Health receive this verbal update re: “Indigenous Learning Series” for information. Carried

Correspondence

It was moved by Ms. Cassidy, seconded by Ms. Elliott, that the Board of Health receive correspondence items a) through ee).
Carried

Other Business

• Chair Fulton announced that Board member Mr. Matt Reid has been nominated for the Pillar Non-Profit Network Community Innovation Awards in the “Community Leadership” category. She asked Board Members to get in touch should they wish to attend the awards ceremony along with Health Unit staff.
• Chair Fulton advised Board members interested in attending the alPHa Fall Symposium to contact Ms. Elizabeth Milne.
• Mr. Clarke enquired about a rumour that there will be a delay in flu-vaccine delivery this year. Dr. Summers responded that there will be a slight delay, but it is anticipated that the Health Unit will have received most stock for distribution by the end of October.

It was moved by Ms. DeViet, seconded by Ms. Elliott, that the Board of Health approve the draft 2020 Board of Health meeting schedule. Carried
• Next Finance & Facilities Committee meeting: Thursday, October 3 @ 9:00 a.m.
• Next Board of Health meeting: Thursday, October 17 @ 7:00 p.m.
• Next Governance Committee meeting: Thursday, November 21 @ 6:00 p.m.

Confidential

At 8:14 p.m., it was moved by Ms. Elliott, seconded by Ms. Peloza, that the Board of Health move in camera to consider matters regarding identifiable individuals and to consider confidential minutes from the July 18, 2019 Board of Health meeting.
Carried

Board Members did not return to public session, but concluded the confidential meeting and moved into a restricted confidential session.

TRISH FULTON
Chair

CHRISTOPHER MACKIE

Secretary-Treasurer