Minutes - April 16, 2020 - Board of Health Meeting

Members Present:

(via teleconference)

Ms. Maureen Cassidy (Chair)
Ms. Aina DeViet (Vice-Chair) – arrived at 7:04 p.m.
Mr. John Brennan
Ms. Kelly Elliott – left at 6:50 p.m. due to technical difficulties
Ms. Tino Kasi
Ms. Arielle Kayabaga
Mr. Bob Parker
Mr. Ian Peer
Mr. Matt Reid

Others Present:

(via teleconference)

Dr. Christopher Mackie, Medical Officer of Health/CEO (Secretary Treasurer)
Ms. Lynn Guy, Executive Assistant to the Medical Officer of Health/CEO and Associate Medical Officer of Health (Recorder)
Dr. Alexander Summers, Associate Medical Officer of Health
Ms. Laura Di Cesare, Director, Healthy Organization
Ms. Heather Lokko, Director, Healthy Start
Ms. Maureen Rowlands, Director, Healthy Living
Mr. Stephen Turner, Director, Environmental Health and Infectious Disease
Dr. Michael Clarke, VP Modernization
Mr. Dan Flaherty, Manager, Communications
Ms. Elizabeth Milne, Executive Assistant to the Board of Health and Communications Coordinator
Ms. Laurie Rees, Public Health Nurse

Chair Cassidy called the meeting to order at 6:33 p.m.

Disclosure of Conflict of Interest

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

Approval of Agenda

It was moved by Mr. Peer, seconded by Ms. Kayabaga, that the AGENDA for the April 16, 2020 Board of Health meeting be approved.
Carried

Minutes

It was moved by Mr. Reid, seconded by Mr. Parker, that the MINUTES of the February 27, 2020 Board of Health meeting be approved.
Carried

It was moved by Ms. Kayabaga, seconded Mr. Reid, that the MINUTES of the March 26, 2020 Board of Health meeting be approved.
Carried

It was moved by Mr. Peer, seconded by Ms. Kasi, that the MINUTES of the February 27, 2020 Governance Committee meeting be received.
Carried

It was moved by Mr. Peer, seconded by Ms. Kasi, that the MINUTES of the March 5, 2020 Finance and Facilities Committee be received.
Carried

Reports And Agenda Items

Finance & Facilities Committee Meeting Update: March 4, 2020 (Report No. 015-20)

Ms. Cassidy provided this report forward noting that it is a recap of the 4 reports that FFC
It was moved by Ms. Kasi, seconded by Mr. Parker, that the Board of Health receive Report No. 015-20 for information.
Carried

Relocation & Advisory Committee (RAC) Meeting Update: Verbal

Mr. Peer noted that as of March 30 the move was completed and advised that there are still some outstanding deficiencies and change orders that will be addressed when business gets back to normal.

Dr. Mackie was asked by Mr. Reid to comment on the items that were left behind after the move as noted by the media.

Dr. Mackie started by saying that the 2 main objectives of this move were to establish the best facilities that meet the needs of the community and to ensure the move was as financially efficient as possible.

The move costs came in at approximately $500,000 less than expected due leaving some items being left behind, with permission of the landlord. The new office space is approximately 17,000 square feet smaller than the previous office spaces, which meant that not all of the furniture and equipment would fit or be needed in the new facility at Citi Plaza. This smaller footprint will mean that taxpayers will be paying about $200,000 less per year in lease costs which is approximately $6,000,000 over the 30-year lease.

Dr. Mackie advised that staff welcome the questions and debate and are more than happy to speak to the specifics.

Mr. Reid asked for Dr. Mackie to comment on two specific types of items left behind at 50 King St. and what the thought process for leaving these behind was. The first category was medical supplies such as syringes and scales and the second was IT equipment such as wireless microphones and computer screens.

Ms. Di Cesare was asked to comment and noted that at the time of the move, the Health Unit was able to make the move on time but on an expedited timeline due to constant threat by the contractors that they may need to stop work at any time due to being deemed non-essential workers. Also, at this time, staff were being redeployed to COVID-19 work so the staff who ended up packing the remaining things for the move were not familiar with the space and necessarily what did or didn’t need to be packed. Syringes that were left behind were in a cabinet that were missed, however they were expired and most likely dating back to 2007 and could not be used. They also did not have the mandatory safety features that are required now.

Ms. Di Cesare then discussed the remaining IT equipment, noting that a truck of obsolete equipment had been disposed of at an e-waste depot. She advised that the laptops and monitors that were left behind in the vault were missed by the people taking the other equipment to the e-waste depot as the door may have been closed in error. Ms. Di Cesare advised that the remaining laptops were in the vault area for approximately 10 years, were wiped clean and had no operating system on them. She also noted that many of them did not have working batteries.

Ms. Di Cesare noted that the monitors that were left behind were old enough that they were no longer compatible with the computers that are now being used.

Dr. Mackie advised that the IT Team took a visionary approach to updating computers during the relocation preparations, such that the vast majority of staff are able to work from home. This is evident now during COVID-19, as it has enabled staff to work remotely and not spread the virus at work as has happened in at least one other health units.

Ms. Di Cesare noted that during the move, the 5 member IT Team was not only moving all of the equipment to Citi Plaza, they were also developing a COVID-19 case and contact database that is currently being used by several other health units.

Ms. Kayabaga asked if staff were contacted by the County of Middlesex or by one of the three County representatives on the Board prior to the media being contacted about the contents that were left at 50 King St. Dr. Mackie noted that staff were not notified that the media was being notified, however there were previous conversations between Ms. Di Cesare and the county CAO in regard to what would be left behind. County staff noted that they would find partners within the county who could use some of the remaining furniture etc.

Ms. Di Cesare noted that she reached out to the County CAO to do a final walkthrough of 50 King St. but she did not receive a response.

Ms. Kayabaga noted her frustration and stated that the County’s communications approach was not appropriate. She asked that the Chair be in contact with the County to find other ways to deal with situations like this and not through the media. Time and resources were wasted and could have been dealt with differently and does not want to see this happen again. She noted that later in the meeting she would be happy to put forward a motion forward.

At this time, 6:50, Ms. Elliott was not able to continue to participate in the meeting due to internet difficulties. She did not return to the meeting.

Mr. Parker asked if there is any future plan or strategy to move out this equipment? Dr. Mackie advised that through negotiations with the county, the equipment is now with the County. He noted that the building is being demolished and what is remaining makes up a very small fraction of what would need to be removed. Ms. Di Cesare advised the Board that there were many donations of equipment and furniture made to non-profit organizations throughout the move timeline.

Mr. Peer asked if at any time during this process did the County offer to delay the move out date or assist in any way due to the pandemic? Dr. Mackie noted that there was nothing done related to COVID-19 but that previously a two-week extension was offered if needed.

At 7:04 p.m. Chair Cassidy asked if Ms. DeViet was logged into the meeting yet. Ms. DeViet had just joined with IT assistance. Chair Cassidy provided Ms. DeViet a brief summary of what she missed of the meeting so far.

It was decided that all 19 of the questions put forward by Ms. Elliott would be addressed. Chair Cassidy advised that she spoke to the new owner of 50 King St. Mr. Ali Soufan today, and that he would be disposing of and dismantling the furniture, partitions, cubicles and had also confirmed that with Health Unit Staff.

Questions put forward by Ms. Elliott:

1) Why were we not able to use the 3 smart boards left behind? Do we have new smart boards purchased?
Answer: Dr. Mackie advised that Mr. Bill Rayburn, CAO Middlesex County asked that they be left behind to use in area schools. They are not useable at Citi Plaza primarily due to their size.

2) Why were we not able to use the box of wireless microphone that were left behind?
Answer: Mr. Flaherty provided this update noting that the system is now obsolete and technically illegal to use as they broadcast on emergency frequencies.

3) Why were we not able to use the boxes of portable printers that were left behind?
Answer: Ms. Di Cesare reminded the Board that the Health Unit was moving towards a more paperless environment, moving electronic client records, reducing the number of photocopiers and printers. She noted that the smaller personal printers are not economical. There is no resale value for these printers and that some of them hadn’t been used in many years.

4) Why were we not able to use the livestreaming and conferencing equipment?
Answer: Mr. Flaherty advised that the cameras that were left in the boardroom are actually discontinued home security cameras that were adapted by the Communications Team to make work as streaming cameras, and provide a low-quality picture. He also noted that one is no longer functioning.

5) Why were we not able to find a use for the newer resin filing cabinets?
Answer: Ms. Di Cesare noted that due to the reduction of offices and stored materials at Citi Plaza there wasn’t a need for all of the cabinets. She also advised that all of the furniture in manager offices are their furniture from their previous office and that no new furniture was bought for those offices. All cabinets and storage that are currently at Citi Plaza are from 50 King St. and 201 Queens Ave. Ms. Di Cesare noted that there were efforts to sell this furniture.

6) There was no way to utilize any of the dozens of computer monitors that were left at all in the new office that are still relatively new and in good condition?
Answer: This was discussed earlier in the meeting.

7) There were dozens of easels, white board signs, etc that were left. We didn’t need these types of office supplies at all in the new office?
Answer: Most boards were not cleanable anymore and staff do not need these resources are no longer needed due to upgrades to technology.

8) Why were we not able to find a use for the dozens of filing cabinets and bookshelves in good condition? Were all new ones purchased for the new office?
Answer: This was discussed earlier in the meeting.

9) There was a significant amount of trade show/ display accessories left behind. Do we not need these?
Answer: Mr. Flaherty provided this update noting that many of the displays left behind were for programs that are no longer offered. He also noted that staff do not use the displays in the manner that once did as programs delivery has changed and they aren’t needed as often. Many displays were brought to Citi Plaza and will be redeployed with new panels. Some of the older displays have old branding on them, are very large and would be expensive to update.

10) Why was an expensive dark maple boardroom table left behind? Could it not be utilized in the new office?
Answer: Ms. Di Cesare noted that there was no room that was large enough to accommodate the large table.

11) Were new projectors for boardrooms purchased for the new office? Why could the newer ones from 50 King not be utilized?
Answer: Dr. Mackie noted that the AV Procurement Report that was previously presented to the Board highlighted the modern, updated equipment that would be purchased for a great price due to the competitive bid process. He also was happy to hear that the county would be able to utilize the older projectors.

12) There was a very new refrigerator and other kitchen appliances left behind. Did we purchase new kitchen appliances for the new office?
Answer: Ms. Di Cesare noted that one refrigerator was brought to Citi Plaza and is currently in the basement. She noted that there was an attempt to give away the other fridges but only one was donated.

13) There was significant amounts of office supplies, including boxes of paper never opened, file folders, hole punches, etc left. Could these office supplies not be utilized in the new space?
Answer: Ms. Di Cesare noted that there was a significant amount of office supplies due to the amalgamation of offices. Going forward there will be a centralized stationary ordering process to ensure there isn’t an overlap of supplies.

14) There was a box of medical equipment, including dozens of surgical scissors and tweezers and equipment to flush ears left behind. Could this not be used in the new space?
Answer: Syringes were discussed earlier in the meeting. Ms. Di Cesare noted that any medical equipment left behind should have been disposed of earlier as they are outdated. Some of this equipment also was missed during the packing of the office. The baby scales were deemed too old to use and too heavy for staff to carry to visits.

15) Expensive network racking was left behind – do we not need this sort of thing in the new space?
Answer: Ms. Di Cesare noted that there was lots of racking already at Citi Centre because it was a call-centre prior to the Health Unit moving in, therefore there wasn’t a need to move it all.

16) There are dozens and dozens of desks in excellent condition that were left behind and are far from being 20+ years old. Absolutely none of these could be used in the new space at all?
Answer: Some of this was previously discussed. Ms. Di Cesare noted that age and size of the furniture had to be taken into consideration. Early in this project the Health Unit applied to the Community Health Capital Program for funding. The specifications that they provided for office and cubicle size were smaller that what was being used at 50 King St. Also to consider was the ergonomic aspect and the costs associated with that benefit. Ms. Di Cesare noted that a 77% discount was received when buying the new cubicle furniture and therefore more economical to buy rather than move.Dr. Mackie noted that a crucial principle was to prioritize frontline staff, and ensuring appropriate equipment for staff was deemed essential to be able to work efficiently and in an ergonomically appropriate way.

17) Was any new waiting room furniture purchased for the new office, when the newer chairs and furniture left behind could have been used?
Answer: Ms. Di Cesare noted that several clinic spaces were amalgamated into one waiting room. No new chairs were purchased, however the cloth seat pans were replaced with vinyl so that they could be wiped down.

18) When frontline workers are saying that PPE is in dire need – why was much needed supplies left behind in piles destined for the garbage?
Answer: Ms. Di Cesare speculated that the noted “booties” that were left behind were most likely very old as it could not be determined as to what team used them. The kavi wipes that were left behind were either missed during the packing or were expired.

19) What assurance can be provided that all of the electronics, printers, cell phones, and back up tapes, were wiped of all confidential information from the MLHU and that there is no risk to any PEPIDA violations that have occurred?
Answer: The Board was assured that there is no personal health information left on any of these devices.

Chair Cassidy provided some personal comments. She noted that it would have been more appropriate for her, Dr. Mackie and Ms. Di Cesare to have received this information prior to it going to the media, as a courtesy at the least. Chair Cassidy advised that if she is approached by the media, she seeks the information first, before responding to the media. As seen at this meeting, all of the answers to the questions were answered. She also indicated that staff did and incredible job in an incredible trying circumstance.

Ms. Kayabaga agreed that this could have been handled differently.

Dr. Mackie noted that the County is an important partner, and this is an opportunity to build on the relationship. He asked if perhaps the Board Chair contact the Warden to share information back and forth. Keeping the lines of communication open is important.

Ms. Kasi inquired about addressing the public. Dr. Mackie noted that when this project is finalized and the pandemic work has abated, there will be an opportunity to draft a full Board of Health report that will highlight the 5-year process of the move project.

There was much discussion on how to work Ms. Kayabaga’s motion. The following was agreed to in principle and will be reworded as needed.

It was moved by Ms. Kayabaga, seconded by Ms. Kasi, that the Board of Health;

1) Direct the Chair of the Board of Health to write a letter to staff at the County of Middlesex to address the concerns and questions in regard to the items that were left behind at 50 King St.; and
2) To include an invitation for a meeting with the Warden to discuss the importance of the relationship with Middlesex County.
Carried

 It was moved by Mr. Peer, seconded by Mr. Brennan, that the Board of Health receive verbal RAC meeting update for information.
Carried

Further Adjustments to Health Unit Services During Pandemic (Report No. 016-20)

Dr. Mackie noted that Ms. Rowlands and Ms. Lokko drafted this report. It came about because of the need to redeploy most staff to work on COVID-19 issues.

It was moved by Mr. Peer, seconded by Mr. Parker, that the Board of Health receive Report No. 016-20 re: “Further Adjustments to Health Unit Services During Pandemic” for information.
Carried

Ontario Poverty Reduction Strategy Consultation (Report No. 017-20)

Ms. Rowlands provided the content for this report. She noted this important work really helps the most vulnerable in our community. This is a great example of collaborative work between MLHU staff, community partners and the government. She noted that in 2009 the Government of Ontario passed a bill towards reducing poverty and that every 5 years they do consultations. The Health Unit was happy to participate by submitting a report.

It was moved by Ms. Kasi, seconded by Mr. Reid, that the Board of Health receive Report No. 017-20 re: “Ontario Poverty Reduction Strategy Consultation” for information.
Carried

Public Health Inspector Enforcement Actions and Inspection Activities Q4 and 2019 Summary (Report No. 018-20)

Mr. Turner was present to speak to this report. He noted that this report represents approximately 6,000 inspections throughout the city and county. He noted that in general, compliance has been good. Mr. Turner answered that year over year statistics are fairly consistent.

It was moved by Mr. Reid, seconded by Mr. Peer, that the Board of Health receive Report No. 018-20 re: “Public Health Inspector Enforcement Actions and Inspection Activities – Q4 and 2019 Summary” for information.
Carried

Association of Local Public Health Agencies (alPHa) Resolution: Regulatory Measures to Address the Harms, the Availability and Youth Appeal of Vapour Products (Report No. 021-20)

Ms. Rowlands spoke to this report and highlighted the importance of the resolution as noted in the report. She noted that since the writing of this report, the government of Ontario has proposed further regulations but due to COVID-19 they will be delayed.

It was moved by Ms. DeViet, seconded by Mr. Parker, that the Board of Health:

1. Receive Report No. 021-20, “Regulatory Measures to Address the Harms, the Availability and Youth Appeal of Electronic Cigarettes and Vapour Products”;
2. Endorse the Statement of Sponsor Commitment and the Association of Local Public Health Agencies Resolution submission, “Reducing the Harms, the Availability and Youth Appeal of Electronic Cigarettes and Vaping Products through Regulation” attached as Appendix A; and,
3. Direct staff to submit the resolution (Appendix A) to the Association of Local Public Health Agencies (alPHa) for consideration at the Annual General Meeting in June.

Carried

Medical Officer of Health/CEO Activity Report for March (Report No. 019-20)
Medical Officer of Health/CEO Activity Report for April (Report No. 020-20)

Dr. Mackie noted that it has been an epic couple of months with full calendars.

It was moved by Mr. Peer, seconded by Mr. Reid, that the Board of Health receive Report No. 019-20 re: “Medical Officer of Health/CEO Activity Report for March” and Report No. 020-20 re: “Medical Officer of Health/CEO Activity Report for April” for information.
Carried

Verbal Update – COVID-19

Dr. Summers provided this verbal update. He reiterated that the majority of Health Unit staff have been redeployed to COVID-19 work. As of today at noon there have been 258 positive cases and 90% of those are in the City of London. There are currently 14 outbreaks in Long Term Care (LTC) and retirement homes.

Testing capacity has improved since last reported and is primarily happening at the 2 Assessment Centres but also at hospitals and in-site LTC homes. The Health Unit is working with LIHC to ensure people experiencing homelessness are able to get tested and with the help of LM EMS in-site testing in group homes. Liaison team is ensuring EMDC has the testing if needed.

Due to expanded testing, the case count will go up but this is a good thing so that cases can be identified.

Dr. Summers highlighted some new initiatives noting that MLHU is the first health unit in the province to enlist medical students to help with case and contact management. Three medical students from Western have matched to the Public Health Residency Program and these three were instrumental in training and utilizing 60 medical students to work remotely.

A new case and contact management tool was developed by the MLHU IT Team and is being used by 10 other health units.

Dr. Summers said that some people are suggesting that we are peaking but that cannot be confirmed at this time. Physical distancing is helping.

Daily press briefings with the Mayor continue and today Middlesex County Warden participated.
Not remotely through this yet.

Mr. Peer noted that there is a great deal of information out there and it is being delivered in a good way. He’s concerned about the pushback in areas outside of Middlesex and London and how that could affect residents here. Is there a plan to deal with this? Dr. Mackie provided some input noting that keeping up the physical distancing and other measures will continue to help. There has been a lot of compliance in the county and the city.

Ms. DeViet appreciates the daily updates that Dr. Summers provides and asked if testing in Seniors homes is occurring continuously. Dr. Summers noted that steps are in place before testing occurs. All homes are closed to everyone except workers, all congregate activities are cancelled, no new admissions unless self-isolated for 14 days, all staff are masking. If a resident is tested, the roommate and any staff who work with that patient will get tested. If the test comes back positive, the testing is expanded.

Dr. Summers noted that test results are being received within 24 to 48 hours.

Chair Cassidy asked about morbidity and mortality being related to age. Does that mean that younger people less likely to catch the virus? Dr. Summers said that what is clear is that age most predictive of the severity your symptoms will be.

Chair Cassidy noted the great work that the Health Unit is doing during.

It was moved by Mr. Parker, seconded by Ms. Cassidy, that the Board of Health receive the COVID-19 verbal update for information.
Carried

Correspondence

Chair Cassidy inquired if there were any questions, hearing none she asked for a mover and seconder.

It was moved by Mr. Peer, seconded by Ms. Kasi, that the Board of Health receive items a) through s.
Carried

Confidential

At 8:30 p.m., it was moved by Mr. Peer, seconded by Mr. Reid, that the Board of Health move in-camera to consider matters regarding a trade secret or financial information, supplied in confidence to the local board, which if disclosed, could reasonably be expected to prejudice significantly the competitive position or interfere significantly with contractual or other negotiations of a person, group of persons or organization, and a trade secret or financial information that belongs to the municipality or local board and has monetary value.
Carried

At 8:45 p.m., the Board of Health returned to public session.

At this time, it was acknowledged that the Relocation and Advisory Committee would be disbanded as discussed during the RAC update that Mr. Peer provided at the beginning of the meeting.

Adjournment

At 8:55 p.m., it was moved by Mr. Brennan, seconded by Ms. Kasi, that the meeting be adjourned.
Carried

Maureen Cassidy
Chair

Christopher Mackie
Secretary-Treasurer