Minutes - January 19, 2023 - Board of Health Meeting

Members Present: 

Matt Reid (Chair)
Mike Steele (Vice-Chair)
Selomon Menghsha
Aina DeViet
Tino Kasi
Skylar Franke
Michelle Smibert
Peter Cuddy
Mike McGuire

Others Present:

Stephanie Egelton, Executive Assistant to the Board of Health (recorder)
Emily Williams, Chief Executive Officer
Dr. Alexander Summers, Medical Officer of Health
Maureen MacCormick, Director, Healthy Living
Mary Lou Albanese, Director, Environmental Health and Infectious Disease
Jennifer Proulx, Acting Director, Healthy Start
Sarah Maaten, Acting Director, Office of the Medical Officer of Health
Christian Daboud, Manager, Health Equity and Indigenous Reconciliation
Tracey Gordon, Manager, Vaccine Preventable Disease
David Jansseune, Assistant Director, Finance
Dan Flaherty, Manager, Communications
Alex Tyml, Online Communications Coordinator
Parthiv Panchal, End User Support Analyst (exited at 7:26 p.m.)

Outgoing Secretary and Treasurer Emily Williams called the meeting to order at 7:01 p.m.

E. Williams welcomed everyone to the inaugural meeting of the Board of Health. E. Williams introduced and called upon Christian Daboud, Manager, Health Equity and Indigenous Reconciliation to open the meeting by acknowledging the Indigenous Peoples of this land and the First Nations within Middlesex and London.

Meeting Procedures

Election of 2023 Board of Health Executive and Other Procedures (Report No. 01-23)

Outgoing Secretary and Treasurer Williams introduced election and appointment procedures for the positions of Chair, Vice Chair, Secretary and Treasurer to the 2023 Board of Health.

E. Williams opened the floor to nominations for the position of Chair of the Board of Health for 2023.

It was moved by M. Steele, seconded by M. Smibert, that Matt Reid be nominated for Chair of the Board of Health for 2023.
Carried

Matt Reid accepted the nomination.

E. Williams invited further nominations. Hearing none, it was moved by M. Steele, seconded by M. Smibert, that Matt Reid be appointed as Chair of the Board of Health for 2023.
Carried

M. Reid took over as Chair presiding over the meeting, from Outgoing Secretary and Treasurer Williams.

Chair Reid opened the floor to nominations for the position of Vice-Chair of the Board of Health for 2023.

It was moved by M. Steele, seconded by S. Franke, that Mike Steele be nominated for Vice-Chair of the Board of Health for 2023.
Carried

Mike Steele accepted the nomination.

Chair Reid invited further nominations. Hearing none, it was moved by M. Steele, seconded by S. Franke, that Mike Steele be appointed as Vice-Chair of the Board of Health for 2023.
Carried

Chair Reid opened the floor to nominations for the position of Secretary of the Board of Health for 2023. It was noted that Emily Williams was the Secretary for 2022, and any member of the Board could be appointed as Secretary.

It was moved by M. Steele, seconded by A. DeViet, that Emily Williams be nominated for Secretary of the Board of Health for 2023.
Carried

Emily Williams accepted the nomination.

Chair Reid invited further nominations. Hearing none, it was moved by M. Steele, seconded by A. DeViet, that Emily Williams be appointed as Secretary of the Board of Health for 2023.
Carried

Chair Reid opened the floor to nominations for the position of Treasurer of the Board of Health for 2023.
It was noted that Emily Williams was the Treasurer for 2022, and any member of the Board could be appointed as Treasurer.

It was moved by A. DeViet, seconded by M. Steele, that Emily Williams be nominated for Treasurer of the Board of Health for 2023.
Carried

Emily Williams accepted the nomination.

Chair Reid invited further nominations. Hearing none, it was moved by A. DeViet, seconded by M. Steele, that Emily Williams be appointed as Treasurer of the Board of Health for 2023.
Carried

Chair Reid noted that there were proposed changes to times and dates for the Performance Appraisal Committee meetings, and the Board would need to approve the meeting dates as amended in Report No. 01-23.

It was moved by T. Kasi, seconded by P. Cuddy, that the meeting dates for 2023 be approved as amended.
Carried

Amendments to Board Committee Terms of Reference (Report No. 02-23)

Emily Williams, in the capacity of Chief Executive Officer introduced the report on amendments to terms of reference for board committees. It was noted there are proposed changes to the membership of the standing committees due to vacancies within provincially appointed members, along with the reporting calendar for the Performance Appraisal Committee. The amendments must be moved by the Board before Committee appointments can occur.

It was moved by M. Smibert, seconded by A. DeViet, that the Board of Health:
1) Approve the Terms of Reference for the Finance & Facilities Committee as amended in Appendix A;
2) Approve the Terms of Reference for the Governance Committee as amended in Appendix B; and,
3) Approve the Terms of Reference for the MOH and CEO Performance Appraisal Committee as amended in Appendix C.
Carried

Appointment of 2023 Board of Health Committees (Report No. 03-23)

Chair Reid noted that Board policy G-290 requires that the Board determine at the first meeting of each year whether it wishes to establish Standing Committees or have all matters dealt with directly by the Board.

Chair Reid reviewed the terms of reference for the Finance and Facilities Committee. It was noted that the Chair and Vice-Chair of the Board of Health sit on the Finance & Facilities Committee automatically. This fulfils the requirements for a City Representative and a Provincial Representative.

Chair Reid invited interest for members of the Finance and Facilities Committee for 2023.

Mike McGuire and Selomon Menghsha declared interest in being on the committee.

Chair Reid inquired if there was one more member interested in being on the Finance and Facilities Committee. No further interest was declared. Chair Reid noted that more membership could be explored as Committee meetings are held.

Chair Reid invited further interested members to be on the committee. Hearing none, it was moved by
T. Kasi, seconded by S. Franke, that Matt Reid, Mike Steele, Mike McGuire and Selomon Menghsha be appointed to the Finance & Facilities Committee for 2023.
Carried

Thus, the membership of Finance & Facilities Committee for 2023 consists as follows:
1) Matt Reid (Chair, City Appointee)
2) Mike Steele (Vice-Chair, Provincial Appointee)
3) Selomon Menghsha (Provincial Appointee)
4) Mike McGuire (County Appointee)

Chair Reid reviewed the terms of reference for the Governance Committee. It was noted that the Chair and Vice-Chair of the Board of Health sit on the Governance Committee automatically. This fulfils the requirements for a City Appointee and a Provincial Appointee.

Chair Reid invited interest for members of the Governance Committee for 2023.

Michelle Smibert, Aina DeViet, and Tino Kasi declared interest in being on the committee.

Chair Reid invited further interested members to be on the committee. Hearing none, it was moved by S. Franke, seconded by P. Cuddy, that Matt Reid, Mike Steele, Michelle Smibert, Aina DeViet and Tino Kasi be appointed to the Governance Committee for 2023.
Carried

Thus, the membership of the Governance Committee for 2023 consists as follows:
1) Matt Reid (Chair, City Appointee)
2) Mike Steele (Vice-Chair, Provincial Appointee)
3) Michelle Smibert (County Appointee)
4) Aina DeViet (County Appointee)
5) Tino Kasi (Provincial Appointee)

Chair Reid invited additional interest for the Performance Appraisal Committee. It was noted that automatically, all members of the Governance Committee are on this Committee. Any other interested Board Members are welcome to declare interest.

No further interest was declared for membership on the Performance Appraisal Committee.

It was moved by M. Smibert, seconded by S. Franke, that members of the Governance Committee consisting of Matt Reid, Mike Steele, Michelle Smibert, Aina DeViet and Tino Kasi be appointed to the Performance Appraisal Committee for 2023.
Carried

Disclosure of Conflict of Interest

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

Approval of Agenda

It was moved by S. Franke, seconded by P. Cuddy, that the AGENDA for the January 19, 2023 Board of Health meeting be approved.
Carried

Approval of Minutes

It was moved by T. Kasi, seconded by S. Franke, that the MINUTES of the December 15, 2022 Board of Health meeting be approved.
Carried

It was moved by A. DeViet, seconded by P. Cuddy, that the MINUTES of the November 10, 2022 Governance Committee meeting be received.
Carried

Reports and Agenda Items

2021 Annual Report and Attestation (Report No. 04-23)

Dr. Alexander Summers, Medical Officer of Health introduced the 2021 Annual Report and Attestation.

Dr. Summers noted that this was an update regarding one of the Health Unit’s critical reporting items to the Ministry of Health. Every year, the Health Unit is required to submit an Annual Service Plan, to describe to the Ministry how the Health Unit is going to deliver programs and services, by describing the work and providing associated financial information. Every quarter, the Health Unit submits a Standard Activity Report to the Ministry, outlining program activities and financial performance. At the end of the year, an Annual Report and Attestation is submitted for the Board of Health to attest that the activities outlined in the Ontario Public Health Standards have been achieved.

It was noted that annual service plans and annual reports have been deferred in recent years, along with some public health programming, due to the pandemic. As a result, there were components of the Ontario Public Health Standards that the Health Unit did not complete, noting that many public health units did also not complete all components. The Ministry of Health is aware of this and anticipated that all components would not have been completed.

Emily Williams, Chief Executive Officer noted that the financial component was not included with this report, as the Ministry of Health template has not been provided to public health units at this time. The information that would be in the report has been reviewed and approved by the Board of Health previously via the approved audited financial statements for the year 2021.

It was moved by P. Cuddy, seconded by M. Smibert, that the Board of Health approve the 2021 Annual Report and Attestation as noted in Report No. 04-23 re: “2021 Annual Report and Attestation.”
Carried

Compliance with the Immunization of Student Pupils Act in Middlesex-London (Report No. 05-23)

Mary Lou Albanese, Director, Environmental Health and Infectious Disease introduced the report on compliance with the Immunization of Student Pupils Act in the Middlesex-London region. Primary and secondary school students are required to be vaccinated for nine (9) different illnesses from junior kindergarten to grade 12 under the Immunization of Student Pupils Act. If guardians of students choose, an exemption can be provided to the Health Unit, noting that if this exemption is not received, a suspension from school may occur. Due to the pandemic, there has been a decrease in students able to get their vaccinations, impacting vaccination rates. To address this gap, the Vaccine Preventable Disease team sent notifications to families to provide information on catch up clinics, noting vaccinations that the pupil required and information on submitting exemptions. It was noted that the Health Unit’s first round of suspension occurred on January 18. M. Albanese introduced Tracey Gordon, Manager, Vaccine Preventable Disease to provide more information.

T. Gordon noted that the compliance process began in March 2022, with over 41,000 letters being sent to pupils in the region with overdue vaccinations, with a student catchment area of approximately 80,000. Throughout the summer, catch up clinics were held and there were opportunities for submission of records and exemptions. Screening of all students in all grades has not been completed in approximately ten (10) years. There are going to be 6 rounds of suspensions, with the first occurring January 18. Before suspensions began, the Health Unit provided support to guardians and healthcare providers by having staff available to answer questions and opening over 1400 vaccination appointments at various locations. As of January 19, 500 students were on the suspension list.

Board Member Skylar Franke inquired when the region would be able to be back to regular pupil vaccination rates. T. Gordon noted that June was the ideal time to get to the regular rate. M. Albanese noted that there are rounds of suspension dates each month until June, and dividing students into cohorts, it will be easier to provide support and stabilize vaccination rates. Dr. Alexander Summers, Medical Officer of Health, noted that there is a difference between compliance rates and vaccination coverage rates. Legislative compliance will support the Health Unit in determining vaccination coverage rates.

T. Gordon and Dr. Summers noted that the Health Unit is creating supportive ways to enforce legislation while supporting guardians and students. Higher risk schools and communities are receiving support to guide through the process. It was noted that data from other public health units on vaccination compliance in students was not available at this time.

Board Member Aina DeViet inquired if there would be a report to the Board in the summer regarding the follow-up to this work. Dr. Summers noted that this information can come as an update to the Board in the summer.

It was moved by S. Franke, seconded by A. DeViet, that the Board of Health receive Report No. 05-23 re: Compliance with the Immunization of Student Pupils Act in Middlesex-London for information.
Carried

Canada Life Benefits – Renewal Rates (Report No. 06-23)

Emily Williams, Chief Executive Officer introduced David Jansseune, Assistant Director, Finance to present the report on the Canada Life Benefits renewal. D. Jansseune noted that there is a 7.2% increase in premiums, which is an increase of approximately $116,000. The drivers for increases are life insurance and dental insurance – with a 16% increase in dental claims.

Vice Chair Mike Steele and Chair Reid inquired if the Health Unit has evaluated other potential insurance providers. E. Williams noted that the Health Unit uses AON Consultants to act as a broker for insurance providers for the Health Unit. The Health Unit is currently reviewing their relationship with AON and will determine if the Health Unit will do an open market search for insurance providers. D. Jansseune noted that the Health Unit has been with Canada Life since 2018, and rates are currently comparable to the negotiated rates from 2018.

It was moved by M. Steele, seconded by M. Smibert, that the Board of Health approve the renewal of the group insurance rates administered by Canada Life as described in Report No. 06-23 re: “Canada Life Benefits – Renewal Rates”.
Carried

Current Public Health Issues (Verbal)

Dr. Alexander Summers, Medical Officer of Health provided a verbal update on current public health issues within the region.

Dr. Summers’ update included the following:

• Overview of the Respiratory Season

- The impact of the respiratory season is generally waning. Specifically, the significant influenza wave from the fall is now over.
- Respiratory season has been impacting children and older populations.
- The region appears to have baseline immunity for COVID-19 and influenza.
- Respiratory season continues to concern healthcare organizations due to the potential strain on the system.
- Vaccination is cornerstone of response to the current respiratory season.

• Health and Homelessness

- In the City of London, the MLHU has been participating in the “Health and Homelessness” summits with various community partners. The MLHU has been engaged in this as at the leadership tables, acting as a health strategist and facilitator. Currently, there are no provincial initiatives for this work, and it is noted that the opioid epidemic is a critical dependency and is very evident in the region.

• There are discussions of an emergent RSV (Respiratory syncytial virus) vaccination.

It was moved by T. Kasi, seconded by P. Cuddy, that the Board of Health receive the verbal report re: Current Public Health Issues for information.
Carried

Medical Officer of Health Activity Report for November and December (Report No. 07-23)

Dr. Alexander Summers, Medical Officer of Health, presented the Medical Officer of Health activity report for November and December. There was no discussion on this report.

It was moved by M. Smibert, seconded by M. Steele, that the Board of Health receive Report No. 07-23 re: “Medical Officer of Health Activity Report for November and December” for information.
Carried

Chief Executive Officer Activity Report for December (Report No. 08-23)

Emily Williams, Chief Executive Officer, presented the Chief Executive Officer activity report for December. There was no discussion on this report.

It was moved by S. Franke, seconded by T. Kasi, that the Board of Health receive Report No. 08-23 re: “Chief Executive Officer Activity Report for December” for information.
Carried

Correspondence

It was moved by A. DeViet, seconded by T. Kasi, that the Board of Health receive item a) for information.
Carried

Other Business

The next meeting of the Middlesex-London Board of Health is a special meeting of the Board on Tuesday, January 24, 2023 at 6 p.m. The next regular meeting of the Board of Health is on Thursday, February 16, 2023 at 7 p.m.

Confidential

At 7:58 p.m., it was moved by M. Smibert, seconded by P. Cuddy, that the Board of Health will move in-camera to consider matters regarding labour relations or employee negotiations, an identifiable individual, including Board employees, litigation or potential litigation, including matters before administrative tribunals, affecting the municipality or local board and to approve previous confidential Board of Health minutes.
Carried

At 8:41 p.m., it was moved by T. Kasi, seconded by S. Franke, that the Board of Health return to public session from closed session.
Carried

Adjournment

At 8:42 p.m., it was moved by T. Kasi, seconded by S. Franke, that the meeting be adjourned.
Carried

Matt Reid
Chair

Emily Williams
Secretary