Minutes - May 22, 2025 - Board of Health Meeting

Thursday, May 22, 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
Aina DeViet
Howard Shears
Skylar Franke (attended virtually)
Michael McGuire (attended virtually)
Peter Cuddy
Emily Williams, Chief Executive Officer (ex-officio) (Secretary and Treasurer)
Dr. Alexander Summers, Medical Officer of Health (ex-officio) (attended virtually)

Regrets:

Selomon Menghsha

Others Present:

Stephanie Egelton, Clerk 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
Omar Ozaldin, Director, Environmental Health, Infectious Diseases and Clinical Services
Kim Loupos, Public Health Dietitian, Municipal and Community Health
Promotion
Linda Stobo, Manager, Social Marketing and Health Systems Partnerships
Melissa Knowler, Public Health Nurse, Social Marketing and Health Systems
Partnerships
Darrell Jutzi, Manager, Municipal and Community Health Promotion
Tanya Verhaeghe, Health Promotion Specialist, Social Marketing and Health
Systems Partnerships
Dr. Amanda Perri, Epidemiologist, Population, Health, Assessment and
Surveillance
Parthiv Panchal, End User Support Analyst, Information Technology (exited at 8 p.m.)

Chair Michael Steele called the meeting to order at 7:06 p.m. The meeting was called to order past the advertised time due to technical issues.

Disclosure of Pecuniary Interest

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

Approval of Agenda

It was moved by M. Newton-Reid, seconded by A. DeViet, that the AGENDA for the May 22, 2025 Board of Health meeting be approved.
Carried

Approval of Minutes

It was moved by M. Smibert, seconded by P. Cuddy, that the MINUTES from the April 24, 2025 Board of Health meeting be approved.
Carried

New Business

Performance Appraisal Committee Meeting Update (Verbal Report)

Committee Chair Matthew Newton-Reid presented reports heard at the Performance Appraisal Committee meeting.

There were no questions or discussion.

It was moved by M. Newton-Reid, seconded by H. Shears, that the Board of Health:
1) Receive Report No. 01-25PAC re: “2025 Performance Appraisal Committee Terms of Reference” for information;
2) Approve the 2025 Performance Appraisal Committee Terms of Reference;
3) Receive Report No. 02-25PAC re: “2025 Medical Officer of Health and Chief Executive Officer Performance Appraisals Procedures” for information;
4) Approve the performance appraisal process, supporting documents, and timelines (Appendix A); and
5) Direct the Clerk on behalf of the Performance Appraisal Committee (through the Board of Health) to action the activities outlined in the MOH and CEO Performance Appraisals Checklist for 2025.
Carried

Quality and Governance Committee Meeting Update (Verbal Report)

Committee Chair Aina DeViet presented reports heard at the Quality and Governance Committee meeting.

There were no questions or discussion.

It was moved by A. DeViet, seconded by M. Smibert, that the Board of Health:
1) Receive Report No. 06-25QGC re: “Q1 2025 Organizational Performance Reporting” for information;
2) Receive Report No. 07-25QGC re: “2023-25 Provisional Plan 2025 Q1 Status Update” for information;
3) Receive Report No. 08-25QGC re: “Q1 2025 Risk Registry” for information;
4) Approve the Q1 Risk Register (Appendix A);
5) Receive Report No. 09-25QGC re: “Governance Policy Review for May 2025” for information;
6) Approve the governance policies as amended in Appendix B;
7) Receive Report No. 10-25QGC re: “Governance Policy Follow-Up – Investing and Donations” for information;
8) Approve Policy G-210 Investing as amended;
9) Approve Policy G-320 Donations;
10) Receive Report No. 11-25QGC re: “2025 Board of Health Member Self-Assessment” for information;
11) Approve the Board of Health Member Self-Assessment Tool as Appendix A; and
12) Direct the Clerk to initiate the Board of Health Member Self-Assessment for 2025.
Carried

Rethink Your Drinking Campaign – Southwest Polysubstance Working Group (Report No. 36-25)

Linda Stobo, Manager, Social Marketing and Health Systems Partnerships along with Melissa Knowler, Public Health Nurse presented information on the “Rethink Your Drinking” Campaign through the Southwest Polysubstance Working Group.

Rethink Your Drinking is an initiative established in 2011 with seven (7) public health units in Southwestern Ontario, part of the Southwest Polysubstance Working Group. With the release of the 2023 guidance on alcohol and health, the group reconvened and prioritized work to revamp the campaign. A collaborative group supports the mandate of harm reduction in the Ontario Public Health Standards, avoids duplication, and maintains a partnership with the Canadian Centre on Substance Use and Addition.

L. Stobo noted that there is no provincial website or campaign dedicated to alcohol and health, adding that the “Rethink your Thinking” website is run by the working group. The working group also have launched a social media campaign, with over 3.7 million impressions.

L. Stobo noted that next steps include further evaluation for a larger campaign across Ontario, a focused campaign on alcohol and cancer and using personal stories.

Vice-Chair Michelle Smibert applauded the working group for bringing awareness to this matter. M. Smibert noted that the campaign appeared to have a provincial or federal approach for awareness and advocacy, and inquired if public health has approached the provincial or federal government to support the campaign through amplified advocacy or funding. L. Stobo explained that there is no current commitment for broader health messaging from the province about alcohol. The working group is navigating relationships on their own with public health partners and the Canadian Centre on Substance Use and Addiction with the goal to see if these groups are using public health funding to campaign for harm reduction. M. Knowler noted that the Canadian Centre on Substance Use and Addiction has a campaign called “Drink Less, Live More” regarding the new guidance that the federal government released on alcohol, but there has not been a federal advocacy campaign on harm reduction related to alcohol. M. Knowler added that provincial priorities around alcohol have changed, but noting that both campaigns have brought awareness to the issue.

Board Member M. Newton-Reid noted that the provincial budget was released in the past week, and it is clear that the priorities are not the same as public health in regards to harm reduction related to alcohol use. M. Newton-Reid noted that alcohol sales have decreased in the province and there has been a social shift in society to consume alcohol less.

It was moved by P. Cuddy, seconded by A. DeViet, that the Board of Health receive Report No. 36-25 re: “Rethink Your Drinking Campaign – Southwest Polysubstance Working Group” for information.
Carried

Harvest Bucks: Supporting the Food System and Food Access Through Community and Partner Mobilization (Report No. 37-25)

Kim Loupos, Public Health Dietitian provided information on the Harvest Bucks program. Harvest Bucks began as a small pilot project in 2012, funded by London's Childhood Network. Since 2012, the program has greatly expanded to better support the Middlesex-London community. Harvest Bucks includes community program sponsorship for Harvest Bucks Vouchers, which are redeemable for eggs, fresh vegetables and fresh fruits. The program also supports London Good Food Boxes, which are distributed for free at community markets.

K. Loupos noted that for 2025, 85 community programs from 39 organizations are participating in the Harvest Bucks sponsorship or direct purchase programs. The Harvest Bucks Steering Committee guides the program and includes representation from a wide range of community partners to support and coordinate the program. Harvest Bucks Community Partners support the program through the delivery of organizational programming, such as Glen Cairn Community Resource Centre as the lead for the London Good Food Box program and Urban Roots as the lead for the community pop-up markets.

K. Loupos highlighted impacts and outcomes of the Harvest Bucks program. Since the program has been in service, there has been increased connection between organizations, community members and the community system. There has been an increase in availability and affordability of local produce and eggs, along with a decrease in food waste. In 2023, sponsorship for London Good Food Boxes and community pop up markets were added to give community programs flexibility to select options that work best for their community members. New businesses were added to the voucher program to provide more culturally diverse options for members in the community such as Berries Market, Superking, and United supermarkets. Middlesex County businesses and sponsored programs have also been added to accepting vouchers.

The London Food Bank has been a strong supporter of the Harvest Bucks program for many years. In 2023, the London Food Bank Board approved $250,000 annual base funding for the program as well as additional funding from 2024-2026.

K. Loupos noted that since the program has been in service, there have been various requests from organizations across Canada who are requesting information on the program and how to start Harvest Bucks in their own community.

Board Member M. Newton-Reid inquired how much financial support from the Health Unit is being provided for this program. E. Williams indicated that the program is funded through the food bank and that the Health Unit acts as a transfer payment agency. K. Loupos noted that while the food bank provides a large portion of funds, the Harvest Bucks program accepts private and community support. K. Loupos added that the Health Unit has not contributed to this program from their budget except for the physical “bucks” vouchers. Dr. Summers added that the Health Unit does not directly contribute financially, but with the employee resource of K. Loupos for the program.

It was moved by M. Newton-Reid, seconded by H. Shears, that the Board of Health receive Report No. 37-25 re: “Harvest Bucks: Supporting the Food System and Food Access Through Community and Partner Mobilization” for information.
Carried

The Built, Natural, and Social Environments Framework: Transportation Networks (Report No. 38-25)

Sarah Neil, Public Health Nurse and Laura Dueck, Public Health Nurse, both of the Municipal and Community Health Promotion team, presented the framework on the built, natural and social environment related to transportation networks. S. Neil noted that the Board of Health were first introduced to this framework in January, with the purpose of the framework to inform healthy public policy and support strategic planning activities and collaboration. Key aspects of the framework include: neighbourhood design, housing, food systems, green spaces and transportation networks.

Active transportation is a critical element of efficient, equitable, and diverse transportation networks. Active transportation includes movement by walking, cycling, using hybrid mobility aids such as scooters and e-bikes, and riding public transit. Creating and maintaining transportation networks that are safe, affordable, and accessible makes it easier for people of all ages and abilities to incorporate active transportation into daily life. Benefits include physical health, mental and social health improvements, environmental benefits and economic savings.

L. Dueck provided the Health Unit’s policy statement on active transportation, which is to prioritize active transportation when considering transportation networks. Further, recommendations included prioritizing active transportation, accessibility and safety, designing neighbourhoods that are complete and connected to daily needs and meaningful engagement with the community. The Health Unit will finalize an evidence report and municipal primer to share with municipalities and partners, and continue the development of framework priorities.

Board Member M. Newton-Reid inquired on the timing of this policy position being brought to the Board of Health at this time as opposed to a year ago. Dr. Summers indicated that this policy position was on the workplan before the discussion of the City of London’s Master Transportation Plan and discussions on bike lanes was brought to Council.

Board Member Skylar Franke noted that this report was timely, as the City of London Council recently had a discussion on bike lanes and growth boundaries. S. Franke noted that 1400 hectares of urban growth in the northwest and west of London expansion had been approved and inquired if there would opportunities for the Health Unit to provide input regarding active transportation as a policy voice. Dr. Summers explained that the goal is that evidence presented to the Board can inform how these communities are designed in a way to facilitate active transportation.

Vice-Chair Smibert noted that this report (and soon primer) is a good resource for municipalities. Vice-Chair Smibert added that Thames Centre is currently working on their Trails Master Plan, and this report has been provided to the consultant conducting this work.

Board Member Howard Shears noted his support for this work, as it is important to be involved early enough to ensure communities are retrofitted to have active transportation such as bike lanes and walking paths.

It was moved by P. Cuddy, seconded by M. Newton-Reid, that the Board of Health:
1) Receive Report No. 38-25 re: “The Built, Natural, and Social Environments Framework: Transportation Networks” and;
2) Approve the policy position and recommendations outlined in Appendix A.
Carried

Regional and Provincial Collaborative Structures: A Strategy for Effective Tobacco and Vapour Product Control (Report No. 39-25)

L. Stobo provided information on collaborative strategies for tobacco and vapour product control locally and provincially.

L. Stobo provided an introduction on the tobacco control structure. In 2006, Tobacco Control Area Networks (TCANs) were established with dedicated funding which was eliminated in 2019. In 2022, the Ontario Nicotine Dependence Structure (ONDS) was initiated.

Provincially, the structure connects public health units across Ontario through a joint Tobacco Control Area Network, working groups and advisory committees, project teams and a steering committee to support flexible collaboration. The structure also develops provincial resources for local use.

Regionally, the structure connects public health units across the southwest region and coordinates the planning, implementation, and evaluation of regional activities using steering committees and project teams. There was also an introduction in 2025 of a memorandum of understanding for a joint funding pool for regional tobacco control activities.

L. Stobo noted that the benefits of regional and provincial collaboration include extending the reach and impact of tobacco and vaping control initiatives, enhancing efficiency by sharing resources, aligning efforts across Boards of Health, and reducing duplication.

There were no questions or discussion.

It was moved by A. DeViet, seconded by H. Shears, that the Board of Health receive Report No. 39-25 re: “Regional and Provincial Collaborative Structures: A Strategy for Effective Tobacco and Vapour Product Control” for information.
Carried

Middlesex-London Population Health Needs and Priorities 2025 (Report No. 40-25)

Dr. Amanda Perri, Epidemiologist presented the Middlesex-London region’s population health needs and priorities for 2025. Dr. Perri noted that each year, the Health Unit prepares an Annual Service Plan (ASP) for the Ministry of Health, which highlights the current and emerging population health needs and priorities.

The Middlesex-London region has experienced significant demographic growth and transformation. Between 2016 and 2021, the population increased by 9.9%, exceeding the provincial growth rate of 5.8%.As of July 1, 2024, the region’s population is projected to reach 579,471. Projections suggest that the population of the Middlesex-London region will grow by approximately 16% over the next ten years, from 608,194 in 2025 to 703,152 in 2035.

The Middlesex-London region is becoming increasingly diverse, alongside population growth. In 2021, 4.1% of residents were recent immigrants, up from 2.6% in 2016. 24.7% of the population identified as racialized in 2021, a rise from 17% in 2016. This rapid demographic shift highlights the need to adapt public health programs and services to better support equity-deserving groups, particularly immigrants and racialized communities.

Dr. Perri summarized local data in areas of live births, homelessness, substance use, assaults, intimate partner violence, infectious diseases and immunization coverage.

Live births and birth/maternal services
Local births have remained similar to provincial data, with an increase in 2022. In 2024, the region recorded the highest number of live births in a decade, with 5,072 births, and the corresponding local rate was significantly higher than the provincial rate in 2022 and 2023. Since 2015, the percentage of infants in Middlesex-London requiring newcomer support has consistently been significantly higher than in Ontario, reaching about 10% in 2023. The increase in births, the impact of mental health concerns on families, and growing population of recent immigrants, signals growing local demand for maternal and child health services.

Homelessness
Homelessness in London has risen from just over 400 individuals in 2018 to 1,595 in December 2024. This sharp increase has significant health implications for affected individuals. The City of London has launched a collaborative response plan involving over 70 agencies, including the Health Unit. The plan aims to address both homelessness and its associated health impacts.

Substance Use
For the rate of emergency room visits for opioid poisonings, Middlesex-London since 2017 has had higher rates than the province and peer groups members. Further, between 2019-2022, Middlesex-London’s mortality rates have tripled and are higher than the province and peer group members.

Board Member M. Newton-Reid inquired which health units are in the local data peer group. Dr. Perri indicated that that there are seven (7) health units in the same peer group due to similar size and demographics such as Hamilton, Durham, Waterloo and Windsor. Dr. Perri added that the peer group data is collected by Public Health Ontario and is moving towards a regional approach (Southwestern Ontario) data collection.

Assaults
During the pandemic, emergency room visits due to assaults decreased significantly. Middlesex-London had significantly higher rates of assaults requiring an emergency room visit from 2015-2022.

Intimate Partner Violence
Middlesex-London had higher rates of intimate partner violence compared to the province and peer group in 2018 and 2021.

Board Member Aina DeViet inquired on the reason for the increased and decreased peaks for intimate partner violence data. Dr. Perri noted that this information is being reviewed more closely by IntelliHealth. Sarah Maaten, Director, Public Health Foundations explained that the ability to measure data during the pandemic was limited, and sometimes fluctuations in data are based on a smaller number, noting importance of when the data does not overlap. Overall, Middlesex-London is seeing a higher number of intimate partner violence incidents.

Infectious Diseases
In 2024, early detection efforts enabled timely response to significant infectious disease events, including chickenpox clusters among post-secondary students and a major Legionnaires’ disease outbreak. Between 2015 and 2025, reported infectious syphilis cases in Middlesex-London have more than quadrupled since 2015, with congenital syphilis reemerging as a public health concern. During the 2023-24 respiratory season, 183 respiratory outbreaks were confirmed in local institutions, which was more than double the pre-pandemic average of 76 outbreaks.

Immunization Coverage
In 2022, 41,000 students in Middlesex-London schools were overdue for at least one vaccine required under the Immunization of School Pupils Act (ISPA); this number decreased to 17,500 by the 2023-24 school year. Coverage levels have returned to or surpassed pre-pandemic levels.

Dr. Perri highlighted in conclusion that local demographic shifts have created challenges in meeting the diverse needs of the community. Rising birth rates, mental health concerns, and immigration trends highlight the need for expanded maternal and child health services. Rising rates of homelessness, substance use, and violence call for expanded, strategic public health responses. Ongoing infectious disease threats highlight the Health Unit’s vital role in prevention, case management, and outbreak response.

Board Member A. DeViet inquired if disease data rates compared geographically by rural and urban communities has been reviewed. Dr. Summers explained that when the data is available, the Health Unit organizes this data between rural and urban, income and sociodemographic as examples. Rural and urban data sets are assessed when available, mainly around chronic disease outcomes, which are slow to change. Dr. Summers noted that Middlesex County and the City of London data largely reflect each other, but is on the forefront of the Health Unit to review and understand each population. Dr. Perri noted that rural and urban data is displayed on the Health Unit’s Community Health Status Resource categories of healthy pregnancy and development, substance use and mental health.

Dr. Summers indicated that the goal is to have local data come to the Board annually and use this data to plan work as appropriate.

Board Member M. Newton-Reid noted that with population increases and needs within the community, it is more important to highlight that the Health Unit is not in a position to reduce the budget drastically or it will risk its ability to serve the community.

It was moved by P. Cuddy, seconded by M. Smibert, that the Board of Health receive Report No. 40-25 re: “Middlesex-London Population Health Needs and Priorities 2025” for information.
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.

Measles Update
Dr. Kearon provided an update on measles in Middlesex-London.

As of May 20, there have been 40 confirmed and 4 probable cases in Middlesex-London. 38 cases are linked to a multi-jurisdictional outbreak and there are 2 sporadic cases. The Health Unit has conducted 143 total measles investigations. Middlesex-London’s measles vaccination coverage remains high and overall risk level remains unchanged.

Dr. Kearon noted that per direction from the Office of the Chief Medical Officer of Health, public health units in southwestern Ontario are encouraging accelerated vaccination schedules for MMR (measles, mumps, rubella) vaccines:
• Infants (six to 11 months) – one does of MMR vaccine; two additional doses after 1 year of age
• Children (one to four years) – those with one dose of MMR vaccine to receive a second dose ASAP (minimum four weeks from first dose)
• Adults (18+) born on or after 1970 – second dose of MMR vaccine if only received one

The Health Unit is encouraging individuals to contact their primary care provider to receive the MMR vaccine. The overall risk in the Middlesex-London community remains low and the region is not in outbreak. Vaccination is the best protection against measles.

If you have been exposed to measles:
• If immunocompromised, infants • 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

School Board Collaboration on Enhancing Food Access
Dr. Summers provided an update on collaboration with school boards for enhancing food access for students. Nutrition plays an important role in supporting student well-being and learning, however, 1 in 4 households in Middlesex-London are impacted by food insecurity. School food programs cannot solve household food insecurity, but providing food at schools can help ease financial pressures on households.

Dr. Summers explained that the Ontario Student Nutrition Program (OSNP) has helped establish student nutrition programs across the province. Increased demand has outpaced available funding with rising food costs. Middlesex-London is poorly funded for student nutrition programs compared to the rest of the province, with less than 40% of schools in the region receive OSNP compared to other regions with roughly 90% of schools having OSNP. Current funding is used to support schools currently in the program, not to add additional schools to the program. Local school boards have identified food access and student food insecurity as urgent priorities.

Dr. Summers noted that with Southwestern Public Health Unit and Thames Valley District School Board, Middlesex-London (Health Unit) supported the development of a toolkit to help schools implement inclusive and accessible school food programs. The toolkit includes guidance on where and how to access funds for funding, food safety and best practices for implementing nutrition programs.

MLHU in the News
The Health Unit was in the news to comment on matters such as measles vaccination and the measles outbreak in Southwestern Ontario.

Board Member M. Newton-Reid inquired on the reason for less than 40% of Middlesex-London’s schools receive Ontario School Nutrition Program funding. Dr. Summers noted that when funding was distributed, other regions had more collective momentum in their school communities and no additional funding was given to onboarding new schools to the program in the community, only to stabilize existing schools within the program. Dr. Summers added that there have been no further opportunities to add schools to this program.

It was moved by A. DeViet, seconded by M. Newton-Reid, that the Board of Health receive the verbal report re: Current Public Health Issues for information.
Carried

Medical Officer of Health Activity Report for April (Report No. 41-25)

Dr. Summers presented his activity report for April.

There were no questions or discussion.

It was moved by P. Cuddy, seconded by S. Franke, that the Board of Health receive Report No. 41-25 re: “Medical Officer of Health Activity Report for April” for information.
Carried

Chief Executive Officer Activity Report for April (Report No. 42-25)

E. Williams presented her activity report for April.

There were no questions or discussion.

It was moved by M. Newton-Reid, seconded by H. Shears, that the Board of Health receive Report No. 42-25 re: “Chief Executive Officer Activity Report for April” for information.
Carried

Board of Health Chair and Vice-Chair Activity Report for March and April (Report No. 43-25)

Chair Steele and Vice-Chair Smibert presented their activity report for March and April.

There were no questions or discussion.

It was moved by M. McGuire, seconded by A. DeViet, that the Board of Health receive Report No. 43-25 re: “Board of Health Chair and Vice-Chair Activity Report for March and April” for information.
Carried

Correspondence

It was moved by M. Smibert, seconded by P. Cuddy, that the Board of Health receive items a) and b) for information:
a) County of Middlesex re: Joint Advocacy Support for Public Health Funding
b) Middlesex-London Board of Health External Landscape for May
Carried

Other Business

The next meeting of the Middlesex-London Board of Health is Thursday, July 24, 2025 at 7 p.m.

Closed Session

At 8:40 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:
• Personal matters about an identifiable individual, including municipal or local board employees;
• Labour relations or employee negotiations;
• 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 9:11 p.m., it was moved by S. Franke, seconded by P. Cuddy, that the Board of Health return to public session from closed session.
Carried

Adjournment

At 9:11 p.m., it was moved by M. Newton-Reid, seconded by H. Shears, that the meeting be adjourned.
Carried

MICHAEL STEELE 
Chair 

STEPHANIE EGELTON
Clerk

EMILY WILLIAMS
Secretary