Minutes - April 24, 2025 - Board of Health Meeting

Thursday, April 24, 2025 at 7 p.m.
MLHU Board Room – CitiPlaza
110-355 Wellington Street
London, ON N6A 3N7

Members Present: 

Michael Steele (Chair)
Michelle Smibert (Vice-Chair)
Matthew Newton-Reid
Selomon Menghsha
Aina DeViet
Howard Shears
Skylar Franke
Michael McGuire
Peter Cuddy (exited at 7:17 p.m.)
Emily Williams, Chief Executive Officer (ex-officio) (Secretary and Treasurer)
Dr. Alexander Summers, Medical Officer of Health (ex-officio)

Others Present:

Stephanie Egelton, Executive Assistant to the Board of Health (recorder)
Sarah Maaten, Director, Public Health Foundations
Dr. Joanne Kearon, Associate Medical Officer of Health
Jennifer Proulx, Director, Family and Community Health/Chief Nursing Officer
Ryan Fawcett, Associate Director, Operations/Privacy Officer
Cynthia Bos, Associate Director, Human Resources and Labour Relations
Mahesh Mallikarjunan, Health and Safety Advisor (exited at 7:10 p.m.)
Marc Resendes, Strategic Advisor, Emergency Management (exited at 7:37 p.m.)
Parthiv Panchal, End User Support Analyst, Information Technology (exited at 8 p.m.)

Chair Michael Steele called the meeting to order at 7 p.m.

Disclosure of Pecuniary Interest

Chair Steele inquired if there were any disclosures of pecuniary interest. None were declared.

Approval of Agenda

Chair Steele noted that Report No. 26-25 re: Rethink Your Drinking Campaign – Southwest Polysubstance Working Group was required to be deferred to a future Board of Health meeting.

It was moved by P. Cuddy, seconded by M. Smibert, that the Board of Health defer Report No. 26-25 re: Rethink Your Drinking Campaign – Southwest Polysubstance Working Group to a future Board of Health meeting.
Carried

It was moved by S. Franke, seconded by A. DeViet, that the AGENDA for the April 24, 2025 Board of Health meeting be approved as amended.
Carried

Approval of Minutes

It was moved by P. Cuddy, seconded by S. Franke, that the MINUTES from the March 20, 2025 Board of Health meeting be approved.
Carried

It was moved by P. Cuddy, seconded by H. Shears, that the MINUTES from the March 20, 2025 Finance and Facilities Committee meeting be received.
Carried

New Business

2024 Occupational Health and Safety Report (Report No. 25-25)

Cynthia Bos, Associate Director, Human Resources and Labour Relations, introduced Mahesh Mallikarjunan, Health and Safety Advisor to present the 2024 Occupational Health and Safety Report. C. Bos acknowledged former Health and Safety Advisor, Lilka Young, for her work on this report and updated the Board that Ms. Young has since moved to a new role with the Risk and Records Management team.

M. Mallikarjunan explained that the Occupational Health and Safety (OHS) team is made up of one (1) Health and Safety Advisor and one (1) Coordinator within the Human Resources team. The OHS team collaborates and participates with the Joint Occupational Health and Safety Committee (JOHSC) and leads Occupational Health and Safety activities. Key tasks of the OHS team include:
• Incident response and reporting;
• Hazard identification, assessment and control;
• Employee immunization tracking;
• Consultation on workplace safety;
• Facilitate OHS training and annual fit testing;
• Support the Joint Occupational Health and Safety Committee; and
• Policy review and development.

M. Mallikarjunan highlighted key trends for 2024:
• 36 worksite inspections across three (3) locations;
• 72 identified hazards;
• 38% of hazards were safety hazards;
• 22% employee incident reporting rate;
• 18.75% increase in reporting related to clients, visitors or contractors;
• 91% of incident reports did not require medical attention or result in lost time;
• 59% of employee reported incidents to WSIB were non-lost time claims;
• There were four (4) JOHSC meetings and one (1) education session;
• Common hazards identified included improper storage, issues with IT cord management and first aid kit supply replenishment; and
• Most employee reported incidents were ergonomics (40%), near miss events (25%) and workplace violence (10%).

Board Member Matthew Newton-Reid inquired on the context of the higher reports to the Workplace Safety and Insurance Board (WSIB) in previous years. M. Mallikarjunan that since 2021, all WSIB-related claims were from employees having COVID-19 exposures in the workplace or other matters relating to COVID-19 in the workplace.

It was moved by S. Menghsha, seconded by S. Franke, that the Board of Health receive Report No. 25-25 re: “2024 Occupational Health and Safety Report” for information.
Carried

Initiation of the Middlesex-London Health System Emergency Management Table (MLHSEMT) (Report No. 27-25)

Marc Resendes, Strategic Advisor, Emergency Management presented information on the initiation of the Middlesex-London Health System Emergency Management Table (MLHSEMT).

M. Resendes noted that the Health Unit’s Emergency Management program is guided by the Ontario Public Health Standards. Throughout 2024, consultations were held and the inaugural MLHSEMT was held in January.

M. Resendes noted that clear mechanisms to support coordination of emergency management was an opportunity for improvement for the Middlesex-London health system, particularly where there is clear connection to local emergency management governance tables (such as local emergency control groups). As a result, roles and responsibilities of health system partners have not always been clear during an emergency.

Within the Terms of Reference, it is noted that this table will address gaps felt during the COVID-19 pandemic in coordination and communication within the health system. The intention is to ensure coordination during emergencies, clarify roles and responsibilities, and formalize mechanisms for planning, problem-solving, and response across health system partners. The MLHSEMT will have a particular focus on planning and coordination.

M. Resendes noted that priorities for this table for 2025 and 2026 are to establish a Respiratory Illness Surge Sub-Committee and a Role Clarification Working Group. Work will begin to actively fill planning gaps and clarify emergency roles within the health sector and incorporate the table into the Health Unit’s Emergency Response Plan and local response plans as appropriate.

Dr. Summers noted that the Health Unit would be periodically mobilized in an operational context and noted that while the Health Unit would not be the lead in every emergency, it was important to bring all health system partners together as a public health agency.

Board Member M. Newton-Reid noted that capacity was low for some organizations in an emergency, and inquired how the health system would not be replicating or overburdening resources. Dr. Summers explained that a component of the table’s Terms of Reference is ensuring the table does not replicate work, adding that there would be very few emergencies that the Health Unit would lead.

Board Member Skylar Franke inquired about the membership of the table and if food security would be an emergency situation that the table would discuss. Dr. Summers noted that the membership included larger primary care associations, acute care and paramedics services. In regard to food security, the Health Unit has engaged with municipalities to discuss this matter, for example food security at reception centers, however, food security and impacts of climate change have not been discussed at the table at this time. S. Franke further noted her concern about food insecurity during uncertain economic times. Dr. Summers indicated that acute loss of food would be considered an emergency, but food insecurity more broadly is being discussed locally at other municipal groups.

It was moved by M. Newton-Reid, seconded by M. Smibert, that the Board of Health receive Report No. 27-25 re: “Initiation of the Middlesex-London Health System Emergency Management Table (MLHSEMT)” for information.
Carried

2025 Annual Service Plan (Report No. 28-25)

Dr. Summers, Medical Officer of Health and E. Williams, Chief Executive Officer, presented the 2025 Annual Service Plan to the Board of Health. Each year, the Ministry of Health requires local public health units to communicate their program plans and budgeted expenditures through the Annual Service Plan (ASP). The ASP includes a narrative component to describe the programs planned to be delivered in accordance with the Ontario Public Health Standards (OPHS) and related budget information. The Annual Service Plan was submitted on March 31 and is draft until the Board of Health approves it.

Dr. Summers noted that due to financial constraints, the Health Unit was unable to fulfill all aspects of the Ontario Public Health Standards. Dr. Summers added that it was critical for the Board of Health to be aware of this.

E. Williams advised that due to a change with the Annual Service Plan template, the budget summary tab was corrupted and further explained the variance. E. Williams explained that one of the columns had the Ministry of Health funding the Health Unit at 75% of the Board approved budget, which noted a variance. The variance is because of the Ministry (of Health) not funding 75% of the Health Unit’s budget and noting that municipalities are over-contributing. E. Williams noted that this was a new column in the Annual Service Plan document, which is positive to show transparency of the critical funding situation in the Health Unit. E. Williams noted that the variance is specifically related to costs associated with wage increase assumptions, increased demands for programs, and increased professional services, such as translation. E. Williams added that the Board of Health has already asked for increased funding from the municipalities and will also employ a gapping budget.

Board Member M. Newton-Reid inquired if the Province ever provided feedback or notification regarding information within the submitted Annual Service Plans. E. Williams stated that since her start at the Health Unit five years ago, no feedback has been provided from the Province on the contents within the Annual Service Plan.

Board Member S. Franke Skylar inquired if some of the program standards have been discontinued by the Health Unit or if the Health Unit is not able to meet these standards, such as Child Visual Health and vision screenings. Dr. Summers noted that these specifics programs were discontinued by the Health Unit but still remain in the program standards. Dr. Summers added that the Province (of Ontario) has acknowledged informally that public health units are not conducting this work. S. Franke inquired about other standards that are not being met by the Health Unit. Dr. Summers noted that Standards related to Chronic Disease Prevention and Wellness are not being fulsomely met.

S. Franke and Board Member A. DeViet indicated their concerns as a Board of Health member that the Health Unit was not meeting these standards due to financial constraint.

M. Newton-Reid noted that the advocacy that should be conducted to bring awareness should emphasize that this funding issue is a Province of Ontario issue and not a municipal issue, due to funding municipalities already overpaying their share.

It was moved by M. Smibert, seconded by H. Shears, that the Board of Health:
1) Receive Report No. 28-25 re: “2025 Annual Service Plan” for information; and
2) Approve the 2025 Annual Service Plan as submitted (Appendix A) to the Ministry of Health on March 31, 2025.
Carried

2026-2030 Strategic Plan Development (Report No. 29-25)

Sarah Maaten, Director, Public Health Foundations presented a report on the Health Unit’s 2026-2030 Strategic Plan Development.

S. Maaten noted that the Strategic Plan Development project began in January 2025 with the issue of a Request for Proposal to hire a consultant to lead the Health Unit through the development process. Quarry Consulting was selected as the consultant firm to lead the strategic plan development process. The goal is to have a new strategic plan approved by the Board of Health in December 2025, with implementation scheduled to begin in January 2026.

S. Maaten indicated that the Health Unit is in phase two of the project, where engagement is beginning. Engagement for this project is critical to the steering committee and the project team to hear voices of those who work at the Health Unit and engagement with the Health Unit.

Chair Steele noted that he is on the steering committee for the development of the Health Unit’s Strategic Plan and has been enjoying the process. Chair Steele also thanked Board Members for replying to the call for a Special Board of Health Meeting in May for the Board’s opportunity to engage in the development of the Strategic Plan.

It was moved by S. Franke, seconded by S. Menghsha, that the Board of Health receive Report No. 29-25 re: “2026-2030 Strategic Plan Development” for information.
Carried

2025 Budget Amendment (Report No. 30-25)

E. Williams, Chief Executive Officer, presented a 2025 budget amendment for the Board of Health’s consideration. E. Williams explained that the proposed amendment is an administrative amendment and not an increase or decrease in funds to the budget.

E. Williams noted that the Health Unit receives funding from the Ministry of Health for delivery of the Infection Prevention and Control Program (IPAC) within the region, which is a 100% funded program. For the 2024-2025 fiscal year, funding was approved for $228,900 in base funds, with an additional maximum of $228,900 in one-time funds, which was included in the 2024 budget as part of the Infectious Disease Control team. Based on new direction from the Ministry (of Health), a separate department was created and dedicated staff positions were allocated to the program in September 2024 and budgeted as a separate program for the 2025 budget. Further clarification confirmed that the IPAC program is to be contained in the fiscal year budget (known as MLHU2) due to the fiscal nature of the funds (April-March) and moved from the MLHU1 company.

There were no questions or discussion.

It was moved by M. Newton-Reid, seconded by A. DeViet, that the Board of Health:
1) Receive Report No. 30-25 re: “2025 Budget Amendment” for information; and
2) Approve an amendment to the 2025 Middlesex-London Board of Health Budget to move the Infection Prevention and Control (IPAC) department to MLHU2 in alignment with Ministry of Health direction.
Carried

MLHU2 Financial Statements 2024 (Report No. 31-25)

E. Williams, Chief Executive Officer presented the MLHU2 Financial Statements for 2024.

E. Williams reminded the Board of Health that MLHU2 includes programs that are funded from April 1, 2023 to March 31, 2024.

The four (4) programs included in the draft 2024 MLHU2 Financial Statements and within the MLHU2 company are:
• Healthy Babies, Healthy Children (funded by the Ministry of Children, Community and Social Services);
• Smart Start for Babies (funded by the Public Health Agency of Canada);
• FoodNet Canada (funded by the Public Health Agency of Canada); and
• Shared Library Services (funded by Public Health Ontario).

The MLHU2 programs represent approximately 7.2% or $2.9 million of the Middlesex London Health Unit’s total operating budget of $39.6 million.

E. Williams noted that all funding was utilized, except for a surplus from the Shared Library Services program. After investigation, it was determined that this surplus was from 2020, when the Health Unit’s Librarian at the time was redeployed to a different area of the organization during the COVID-19 pandemic. The Health Unit will discuss with Public Health Ontario the next steps for the surplus funds.

Board Member S. Franke inquired on the timeliness of the MLHU2 financial statements and audit. Chair Steele indicated that it was delayed given the timeframe of the year ending April 2024, and the statements were only just provided to the Health Unit for April 2025.

E. Williams indicated that the Health Unit was ready for the 2024 audit, and has met with KPMG’s lead auditors to review the plan. Feedback has also been provided to KPMG about the previous audit experience and was well received. E. Williams will be providing the lead auditors with an overview of the Health Unit’s funding as an orientation before they start the process.

It was moved by S. Franke, seconded by M. Newton-Reid, that the Board of Health:
1) Receive Report No. 31-25 re: “MLHU2 Financial Statements 2024” for information; and
2) Approve the 2024 MLHU2 Financial Statements.
Carried

Current Public Health Issues (Verbal Report)

Dr. Alexander Summers, Medical Officer of Health and Dr. Joanne Kearon, Associate Medical Officer of Health provided the Board of Health with an update on current public health issues.

Respiratory Season Update
Dr. Kearon indicated that the Middlesex-London region is no longer in a high-risk respiratory season for COVID-19, influenza and RSV, however, there has been an increase in other respiratory viruses. COVID-19 and influenza percent positivity has stayed on trend from the previous week. Rhinovirus/enterovirus and human metapneumovirus have increased in positivity slightly in the region.

Measles Update
Dr. Kearon noted that as of April 23, there are 19 confirmed cases of measles in Middlesex-London since January.

Of the 19 confirmed cases:
• 13 are linked to the multi-jurisdictional outbreak;
• 4 are sporadic;
• 1 is travel related; and
• 1 is to be determined.

Dr. Kearon emphasized that Middlesex-London’s measles vaccination coverage remains high, and that the region’s overall risk level remains low. Middlesex-London has a low rate of measles cases compared to surrounding jurisdictions and that vaccination (two doses) against measles is the best protection.

If you have been exposed to measles:
• If immunocompromised, infants under 1 year old, or pregnant and unvaccinated, and within 6 days of exposure, contact the Health Unit
• Monitor for signs and symptoms for 21 days
• If you require medical care, call ahead and alert them to the possibility of measles so they can take the appropriate precautions

New Messaging Notification System for Infectious Diseases
Dr. Kearon provided an update that the Health Unit is piloting using a messaging system to notify individuals exposed to infectious diseases (such as measles).

RAVE Mobile Safety is now being used to notify community members of potential infectious disease exposures. Individuals potentially exposed to an infectious disease (such as measles) will receive a telephone message (from the Middlesex-London Health Unit) with information about the exposure and appropriate next steps. Recipients are asked to listen to the complete message for individualized next steps. Dr. Kearon explained that RAVE is used by many governments, organizations, institutions, schools, and other public health units.

Auditor General’s Report: Safety of Non-Municipal Drinking Water
Dr. Summers provided an update on the Auditor General’s Report: Safety of Non-Municipal Drinking Water, released on March 31.

Highlights of the report included:
• Nearly 3 million Ontario residents (almost 20% of the population) use non-municipal drinking water
• Over 98% of samples tested over the past decade met Ontario Drinking Water Quality Standards
• 52% of 33 public health units with SWDS did not inspect all systems, with some backlogs of over 5 years
• Studies indicate that less than 1/3 of the 1.3 million Ontarians using private wells test their drinking water; of those tested, 35% of samples test positive for indicators of bacterial contamination

Dr. Summers indicated that the report was mainly in a rural context, with 20% of the population not using municipal drinking water systems. The Health Unit is required to support “the provision of safe drinking water by small drinking water systems” under the Health Protection and Promotion Act and directed by O. Reg. 319/08: Small Drinking Water Systems.

Public Health Inspectors are responsible for:
• Educating owners/operators of small drinking water systems;
• Conducting risk assessments of all small drinking water systems within the region and issuing directives outlining operational requirements;
• Monitoring sampling compliance and test results;
• Providing directions to correct adverse water quality; and
• Disclose results of risk assessments, risk levels, and adverse events for all small drinking water systems.

MLHU in the News
Dr. Summers noted that the Health Unit was in the news for measles, automated calls regarding infectious diseases, chicken pox (varicella) and the upcoming tick season.

Board Member Aina DeViet inquired how the Health Unit is made aware of new buildings being built in the region, for inspection of non-municipal drinking water systems. Dr. Summers indicated that within the City of London, this is flagged through the business licensing process, however, this is a gap within Middlesex County.

Board Member Selomon Menghsha inquired on the connectivity of private non-municipal drinking water systems. Dr. Summers explained that it depends on the source of the water, noting that private residences on wells would have more local water sources (as neighbours) if drilling was conducted. Dr. Summers indicated that underground water sources are going to be similar within relative geographic areas. The key difference is that while the water sources may be the same, it is the water treatment process that is checked to make sure it is working properly to ensure safe drinking water.

Chair Steele inquired if the automated contacts to those clients who have been exposed to infectious diseases are telephone calls or text messages. Dr. Kearon indicated that these were automated telephone calls (robocalls).

Board Member Howard Shears inquired on how often the Health Unit recommends that private wells be tested. Dr. Kearon noted that the recommendation is three (3) times per year. Dr. Summers added that testing is free and that individuals can drop off water samples to the Health Unit to be tested by Public Health Ontario.

It was moved by S. Menghsha, seconded by S. Franke, that the Board of Health receive the verbal report re: Current Public Health Issues for information.
Carried

Medical Officer of Health Activity Report for March (Report No. 33-25)

Dr. Summers presented his activity report for March.

There were no questions or discussion.

It was moved by M. McGuire, seconded by M. Smibert, that the Board of Health receive Report No. 33-25 re: “Medical Officer of Health Activity Report for March” for information.
Carried

Chief Executive Officer Activity Report for March (Report No. 34-25)

E. Williams presented her activity report for March.

There were no questions or discussion.

It was moved by M. McGuire, seconded by S. Menghsha, that the Board of Health receive Report No. 34-25 re: “Chief Executive Officer Activity Report for March” for information.
Carried

Correspondence

Board Member S. Franke inquired if local food insecurity rates (in relation to correspondence item b) were sent to local municipalities and stakeholders. Stephanie Egelton, Clerk, indicated that food insecurity rates had been sent to the County of Middlesex (including lower tier municipalities), the City of London, and all public health units in Ontario.

S. Franke requested that correspondence item b) from Windsor Essex County Health Unit re: Addressing Household Food Insecurity be endorsed instead of received.

It was moved by M. Newton-Reid, seconded by S. Franke, that the Board of Health receive items a), c), d), e) and f) for information:
a) Public Health Sudbury and Districts re: Support for a Provincial Immunization Registry
c) Windsor Essex County Health Unit re: Rabies Prevention in Windsor and Essex County
d) Windsor Essex County Health Unit re: Animal Bite Prevention Strategies in Windsor and Essex County
e) Windsor Essex County Health Unit re: Intimate Partner Gender Based Violence
f) Middlesex-London Board of Health External Landscape for April
Carried

It was moved by S. Franke, seconded by M. Newton-Reid, that the Board of Health endorse items b) and g):
b) Windsor Essex County Health Unit re: Addressing Household Food Insecurity
g) Public Heath Sudbury and Districts re: Endorsement of the Walport Report, and for continued focus on Public Health Emergency and Pandemic Preparedness

Carried

By-Laws

It was moved by M. Smibert, seconded by M. Newton-Reid, that the Board of Health approve the passing of G-B50 By-law No. 5 - Appointment of a Clerk for the Middlesex-London Board of Health through a first, second, and third reading.
Carried

It was moved by M. Newton-Reid, seconded by A. DeViet, that the Board of Health approve the passing of G-B60 By-law No. 6 - Appointment of a Deputy Clerk for the Middlesex-London Board of Health through a first, second, third reading.
Carried

Other Business

The next meeting of the Middlesex-London Board of Health is Thursday, May 22, 2025 at 7 p.m.

Closed Session

At 8:02 p.m., it was moved by M. Newton-Reid, seconded by M. Smibert, that the Board of Health will move into a closed session to consider matters regarding:
• Labour relations or employee negotiations;
• Information explicitly supplied in confidence to the municipality or local board by Canada, a province or territory or a Crown agency of any of them;
• A trade secret or scientific, technical, commercial, financial or labour relations information, supplied in confidence to the municipality or local board, which, if disclosed, could reasonably be expected to prejudice significantly the competitive position or interfere significantly with the contractual or other negotiations of a person, group of persons, or organization; and
• To approve previous closed session Board of Health minutes.
Carried

At 9:09 p.m., it was moved by A. DeViet, seconded by M. Newton-Reid, that the Board of Health return to public session from closed session.
Carried

Adjournment

At 9:10 p.m., it was moved by S. Franke, seconded by S. Menghsha, that the meeting be adjourned.
Carried

MICHAEL STEELE 
Chair 

STEPHANIE EGELTON
Clerk

EMILY WILLIAMS
Secretary