Minutes - July 24, 2025 - Board of Health Meeting

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

Members Present: 

Michael Steele (Chair)
Matthew Newton-Reid (attended virtually)
Aina DeViet
Howard Shears (attended virtually)
Skylar Franke – (entered at 7:13 p.m.)
Michael McGuire (attended virtually)
Selomon Menghsha (attended virtually)
Emily Williams, Chief Executive Officer (ex-officio) (Secretary and Treasurer)
Dr. Alexander Summers, Medical Officer of Health (ex-officio)

Regrets:

Peter Cuddy
Michelle Smibert (Vice-Chair)

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
Ryan Fawcett, Associate Director, Operations/Privacy Officer
Omar Ozaldin, Director, Environmental Health, Infectious Diseases and Clinical Services
Parthiv Panchal, End User Support Analyst, Information Technology
Warren Dallin, Manager, Procurement and Operations
Glen Pearson, Co-Executive Director, London Food Bank
Jane Roy, Co-Executive Director, London Food Bank
Kim Loupos, Public Health Dietitian
David Pavletic, Manager, Food Safety and Health Hazards

Chair Michael Steele called the meeting to order at 7:01 p.m.

Dr. Joanne Kearon, Associate Medical Officer of Health introduced Dr. Angela Ma, Public Health and Preventative Medicine Resident to the Board. Dr. Ma is doing her management rotation at the Middlesex-London Health Unit until September 15.

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 A. DeViet, seconded by S. Menghsha, that the AGENDA for the July 24, 2025 Board of Health meeting be approved.
Carried

Approval of Minutes

It was moved by M. Newton-Reid, seconded by M. McGuire, that the MINUTES from the May 15, 2025 Special Board of Health meeting be approved.
Carried

It was moved by M. Newton-Reid, seconded by M. McGuire, that the MINUTES from the May 22, 2025 Board of Health meeting be approved.
Carried

Consent Agenda

It was moved by M. Newton-Reid, seconded by A. DeViet, that the Board of Health receive Consent Agenda items 1.1 (a and b) and 1.2 (a, b, c, d) for information:
1.1 - Board of Health Committee Minutes
a) May 22, 2025 Performance Appraisal Committee
b) May 22, 2025 Quality and Governance Committee

1.2 - Information Reports
a) Medical Officer of Health Activity Report for May and June (Report No. 52-25)
b) Chief Executive Officer Activity Report for May and June (Report No. 53-25)
c) Board of Health Chair and Vice-Chair Activity Report for May and June (Report No. 54-25)
d) Middlesex-London Health Unit – Strategic Planning Update (Report No. 55-25)
Carried

External Communications and Correspondence

It was moved by S. Menghsha, seconded by M. Newton-Reid, that the Board of Health receive items a) through e) for information:
a) Middlesex-London Board of Health External Landscape for June and July
b) Briefing Notes – Amendments to the Health Protection and Promotion Act, 1990
c) Urban Public Health Network re: Incoming Chief Public Health Officer of Canada
d) Haliburton, Kawartha, Northumberland and Peterborough Public Health Unit re Preventing Intimate Partner and Gender-Based Violence
e) HIV Legal Network, the HIV & AIDS Legal Clinic Ontario re Prohibition of sterile needle and syringe distribution within HART Hubs
Carried

New Business

Delegation – London Food Bank

Dr. Alexander Summers, Medical Officer of Health, introduced Glen Pearson and Jane Roy, Co-Executive Directors of the London Food Bank, to provide information on the partnership with the Middlesex-London Health Unit and the current food insecurity situation in Middlesex-London.

G. Pearson thanked the Board of Health for being invited as a delegation and brought greetings on behalf of the London Food Bank Board of Directors. G. Pearson noted that in reviewing the Food Insecurity Report and associated municipal primer that the London Food Bank is in full support of its findings. Food banks today are vast and extensive because of challenges with rising costs and income. At this time, the London Food Bank assists 6000 families per month and 40 agencies (previously, there were only 15 agencies) with food and other resources. 35% of clients who come to the food bank are youth and 1/3 of people in Canada seeking the use of a food bank are youth. The London Food Bank currently helps 40,000 people each year in the City and is a charter member of Food Banks Canada. Food banks originally were supposed to be temporary, but the need for food banks will not be resolved until income disparities are resolved by government.

G. Pearson noted that in September, the London Food Bank Board will be presented with a difficult report. Some social agencies are nearing closing their food programs or have closed, and are coming to the Food Bank for help.

The London Food Bank connects with the Health Unit because they share a mutual recognition of the negative health impacts that can occur if there is hunger. For decades, the Health Unit and the London Food Bank have partnered by having a member of staff on the Board of Directors, the Harvest Bucks Program, support of the local Food Policy Council, and research for the annual nutritious food basket report. G. Pearson noted that the Food Bank has provided over $1 million in support for food programs in cooperation with the Health Unit.

Board Member Matthew Newton-Reid noted that in the future, the Board could provide a letter of support to the London Food Bank for their partnerships with the Health Unit. M. Newton-Reid further acknowledged the strain on families when school is out for the summer, and school meal programs ensure nutrition for their children.

Board Member Aina DeViet inquired how rural individuals have access to Food Banks, acknowledging that there are food banks in Ailsa Craig and Mt. Brydges. G. Pearson explained that several area food banks have positive relationships and strategize often. For example, when a larger donation comes in, the London Food Bank supports distribution to different food banks in the region.

Board Member Skylar Franke noted that within the Food Insecurity Report that many of the solutions are income related. S. Franke inquired if the London Food Bank had advocated to the government for support. G. Pearson noted that the London Food Bank has advocated with all levels of government, and agreed that food insecurity comes down to inadequate income, especially those on disability or Ontario Works.

Board Member Howard Shears noted that there is a new agency called “LionHearts” in London and wondering if they are beneficial to the Food Bank. G. Pearson noted that food banks have been through many lean times and they are always happy to have more groups supporting the food system. G. Pearson noted that the only concern with more groups involved is it can sometimes lack coordination. It is important for the Food Bank to be aware of those supporting the food system in order for public transparency and reporting.

It was moved by A. DeViet, seconded by S. Franke, that the Board of Health receive the verbal delegation from the London Food Bank for information.
Carried

Household Food Insecurity: A Primer for Municipalities (Report No. 48-25)

Dr. Summers introduced the Household Food Insecurity report and the primer for municipalities. Dr. Summers indicated that this report also emphasized that food insecurity in the community is related to income, and provided guidance around solutions and initiatives to address the matter. 1 in 10 households in Middlesex-London is experiencing food insecurity and Statistics Canada continue to highlight that income inequality in Canada is at rates not seen in decades. Solutions to help solve food insecurity are crucial to address long term health impacts of the community and the MLHU will continue discussing food insecurity with partners who will listen.

Dr. Summers highlighted the ongoing work of the Municipal and Community Health Promotion team and Kim Loupos, Public Health Dietitian who has been deeply involved in this work.

Board Member S. Franke thanked staff for their work on the municipal primer, and recognized that food insecurity is an income-based issue. S. Franke inquired if an amendment could be made to include the Middlesex-London Food Policy Council, local Members of Parliament and local Members of Provincial Parliament in the primer distribution.

It was moved by S. Franke, seconded by M. Newton-Reid, that the Board of Health:
1) Receive Report No. 48-25 re: “Household Food Insecurity: A Primer for Municipalities” for information; and
2) Direct the Clerk to send Report No. 48-25 (including Appendix A) to the City of London, Middlesex County, lower tier municipalities within the County of Middlesex, all Ontario Boards of Health, local Members of Parliament, local Members of Provincial Parliament and the Middlesex-London Food Policy Council.
Carried

S. Franke inquired on advocacy priorities for the health unit and what the follow-up will be. Dr. Summers noted that the Municipal and Community Health Promotion team was building a library of policy tools and templates to advance advocacy with local provincial, federal and municipal partners.

Finance and Facilities Committee Meeting Update (Verbal Report)

Finance and Facilities Committee Chair Selomon Menghsha reviewed reports that were discussed at the July 24 Finance and Facilities Committee meeting, which included organizational savings identified by Information Technology and Procurement and Operations.

There were no questions or discussion.

It was moved by S. Menghsha, seconded by S. Franke, that the Board of Health:
1) Receive Report No. 07-25FFC re: "Microsoft Non-Profit Status Achievement and Cost Savings" for information; and
2) Receive Report No. 08-25FFC re: “Procurement and Operations Savings – Q4 2024 and Q2 2025” for information.
Carried

Food Safety in MLHU: Current Landscape and Trends (Report No. 49-25)

David Pavletic, Manager, Food Safety and Health Hazards provided an update on the current landscape and trends of food safety in Middlesex-London.

D. Pavletic noted that the food safety landscape has changed a lot since 2019. Seasonal and special events have increased significantly, requiring increased service requests. This can range from suspected food borne illness reports to complaints of food safety practices. There are also consultative requests regarding legislation or when premises are preparing to open.

D. Pavletic noted that the biggest increase in food safety trends is rental kitchens of vendors who are preparing products for retail (online, markets, events and in some instances – grocery stores). There are a few rental kitchens who rent space to upwards of 50 – 75 small businesses. A few key notable regulatory exemptions have enabled businesses to prepare low-risk foods in environments which are not traditionally commercial in nature. D. Pavletic noted that the Health Unit has also seen an increase in the popularity of delivery services - online sales and home businesses which can operate with much less overhead than a traditional bricks and mortar establishment.

D. Pavletic also highlighted the challenges in the food safety landscape. The challenges associated with an increased volume of food premises is primarily one of limited resources. Complex logistics include difficulties in risk assessing and inspecting due to sporadic operational hours or locations where the food is being prepared in addition to maintaining an inventory of vendors who are transient. Rising public expectations can include requests for inspections by small businesses or requests from neighbouring local health units to provide comment on operators retailing products in their catchment area. An example of the evolving regulatory direction includes exemptions for low-risk food preparation made easy in non-commercial settings, which was implemented in 2020.

D. Pavletic noted that there are emerging businesses which require risk categorization work, many of which may be deemed high-risk, which then places strain on the team’s ability to complete the lower risk inspection work. The Food Safety and Health Hazards team is focused on establishing an inventory that is representative of the businesses that are operating in the community. The Health Unit has also conducted educational initiatives such as a social media campaign for event vendors to create community awareness of the regulatory requirements for operation. Work is being done with the London Training Centre to identify priority language requests to address equity needs.

S. Franke inquired about the process for a food premise to cease operating if there are violations. D. Pavletic noted that in order to close a food premise, a clear health hazard must be present and an order under the Health Protection and Promotion Act must be made. It is not uncommon to have infractions, but critical infractions need to be immediately addressed.

S. Franke noted she reviewed DineSafe, the website that displays inspection reports of inspection premises within Middlesex-London and noted there were food premises with infractions that are still open. D. Pavletic noted that education and assisted compliance approaches are taken for food premises as well. Dr. Joanne Kearon, Associate Medical Officer of Health, added that once a health hazard has been rectified, the Health Unit does not have legal grounds to keep the premises closed. Given the increasing demand, it has been increasingly more difficult to keep up with low-risk inspections.

S. Franke inquired if the Health Unit cannot inspect a premise and if there is a serious infraction, is the Board of Health liable. Dr. Summers noted that the Health Unit takes a risk-based approach when inspecting premises and all higher risk premises are inspected.

Board Member A. DeViet inquired how the Health Unit tracks the new premises and ventures to inspect. D. Pavletic noted that the Health Unit has a coordinator that works to connect with vendors, seeks notices of operation and provides education for special events for out of jurisdiction vendors.

Chair Steele inquired about what low risk food preparation is considered. D. Pavletic explained that low risk food preparation is shelf stable food like granola or baked goods that do not require climate control or refrigeration. These premises generally can be exempt from separate hand washing stations, which are usually required.

O. Ozaldin noted that the food processing and inspection field is becoming more complicated, especially now that there is a “gig economy” (transient and application focused such as Uber Eats) that is more prevalent within the community.

It was moved by S. Franke, seconded by M. Newton-Reid, that the Board of Health receive Report No. 49-25 re: “Food Safety in MLHU: Current Landscape and Trends” for information.
Carried

Public Health Response: Air Quality and Heat Response (Report No. 50-25)

O. Ozaldin presented the report on the Health Unit’s response to air quality and heat. O. Ozaldin noted that the report outlines how the Health Unit is responding to the growing public health threats associated with extreme heat and poor air quality, both of which are intensifying due to climate change. The report highlights internal procedures, communication strategies and collaboration with local municipalities and service agencies to protect the community’s vulnerable populations. The report also reflects alignment with provincial public health standards and outlines next steps, including enhancing alerting protocols and continuing policy advocacy to reduce health risks.

Board Member S. Franke noted that City of London Council will be receiving a report on a maximum heat by-law. S. Franke inquired what stronger public policy advocacy would be available to the Board on this matter. D. Pavletic noted that advocacy has been conducted around maximum heat by-laws.

S. Franke inquired if there was data on extreme heat or air quality related illnesses. O. Ozaldin noted that the Health Unit supports expansion of centers to protect those against temperature or air quality related concerns. The Health Unit currently monitors emergency room data during alerts for spikes in heat-related or respiratory illnesses, but this information is not published currently.

S. Franke noted that London will not make 2030 climate change targets and if public health would discuss this in the future. O. Ozaldin noted that failing to meet climate targets likely means more frequent and intense extreme weather events, greater pressure on healthcare systems from climate-related illness and increased disparities in health outcomes among vulnerable groups. O. Ozaldin noted that while public health does not control emissions targets, public health can prepare for impacts and advocate for health-informed policy at the local level.

S. Franke inquired about the key performance indicators related to this matter. O. Ozaldin noted that public health could consider indicators such as:
• Timeliness and reach of weather-related alerts
• Public engagement with messaging
• Syndromic data trends during alert periods
• Policy uptake (e.g., indoor temperature recommendations)

It was moved by S. Franke, seconded by M. Newton-Reid, that the Board of Health receive Report No. 50-25 re: “Public Health Response: Air Quality and Heat Response” for information.
Carried

2024 Annual Report and Attestation (Report No. 51-25)

Dr. Summers presented the 2024 Annual Report and Attestation for the Middlesex-London Health Unit. Dr. Summers reminded the Board of Health that all Boards of Health are required to complete the Annual Report and Attestation and highlight what work the Health Unit is conducting per the Ontario Public Health Standards with provincial funding. Dr. Summers indicated that the funding is insufficient for providing resources to fully meet the requirements of the Ontario Public Health Standards, as it was in 2023.

In particular, those resource implications and resource limitations are preventing the Health Unit from comprehensively delivering programs such as chronic disease prevention and well-being, healthy environments, healthy growth and development, school health, substance use and harm reduction and injury prevention. The Health Unit has prioritized to ensure the most acute and highest risk programs are being conducted.

Dr. Summers emphasized that the inability to reach the standards is not because of the skills of the staff and that is it from insufficient resources to conduct the work.

Emily Williams, Chief Executive Officer, noted that the allocation model is a translation of team and department resources into the program and standards reporting required by the Ministry.

E. Williams highlighted two aspects of the Annual Report from a financial perspective. On March 28, the Health Unit was informed of one-time COVID-19 funding with a deadline to spend this funding on March 31. The Health Unit categorized resources spent on COVID-19 matters during 2024, but not all funds were able to be used. E. Williams noted that the Ministry of Health advised on different occasions that there would be no more COVID-19 provided to public health units, and this funding was unexpected. E. Williams explained that in the Annual Service Plan and the Annual Report and Attestation, there is a new tab that notes provincial funding allocations tied to 75% of funding contribution. The Health Unit’s allocation in the report reflects the fact that the Ministry of Health is not meeting the 75% funding contribution.

Board Member Aina DeViet inquired where Middlesex-London is compared to other health units with service delivery. Dr. Summers explained that the Ministry of Health undertook an acknowledgment to review the Ontario Public Health Standards in 2023, with new standards being expected in August, which may recharacterize a shift for provincial contributions. In comparison, Simcoe-Muskoka has more resources for work regarding chronic disease prevention, school health and health protection resources. Further, comparators in southwestern Ontario include Windsor-Essex, who receive less resources. Dr. Summers concluded that the key takeaway is that there is an inequitable distribution of funding to public health units. E. Williams added that the Ministry is creating a database to collect information from Boards of Health to allow for comparison and aim for internal improvement.

Board Member S. Franke indicated concerns and frustration at inequitable funding for public health and thanked staff for their work.

Chair Steele noted that neighbours Southwestern Public Health receive significantly more funding and it is shown in school health services. If a student attending a Thames Valley District School Board elementary school lives in Oxford-Elgin, they have a public health nurse at their school. If the student lives in Middlesex-London, they do not have a public health nurse at their school. Chair Steele indicated that this has been shared with elected officials.

Chair Steele concluded that in previous year with different leadership, funds were returned back to the municipalities as there was a surplus and funding municipalities were not asked for increases until recent years. Chair Steele indicated that difficult conversations may occur with funding municipalities during the 2026 budget process.

It was moved by A. DeViet, seconded by S. Franke, that the Board of Health:
1) Receive Report No. 51-25 re: “2024 Annual Report and Attestation” for information; and
2) Approve the Middlesex-London Health Unit 2024 Annual Report and Attestation.
Carried

Current Public Health Issues (Verbal Report)

Dr. Kearon provided the Board of Health with an update on current public health issues.

Legionella Outbreak
Legionella is bacteria commonly found in natural and human-made water sources and is transmitted by inhaling droplets or mist in the air. The mild virus caused by legionella is Pontiac fever and the serious respiratory illness is Legionnaires’ disease. Risk factors for those who have been diagnosed with Legionnaires’ disease have generally been over the age of 40, a current or former smoker, have chronic lung conditions and other underlying health conditions.

Possible sources of legionella bacteria include:
• Humidifiers
• Water heaters
• Shower heads or sink taps
• Cooling towers (cooling systems for buildings)
• Home or industrial plumbing systems
• Hot tubs

Dr. Kearon explained that the Health Unit declared the Legionella outbreak on July 8, and there are currently 69 cases associated with the outbreak. 63 cases were hospitalized at some point during their exposure and there have been 2 deaths. Most cases have a home address within a 6 km radius, so the Health Unit is testing all cooling towers within 6 km of the “heat map” area of cases. A larger industrial outdoor system like a cooling tower is the most likely source of the bacteria (rather than something inside a building). As of July 21, there have been 12 locations that have tested positive for legionella bacteria, but the Health Unit is waiting on testing from Public Health Ontario to determine if the bacteria is dead or alive (causing illnesses). At this time, the source has not been confirmed.

The Health Unit has issued several media releases and has an outbreak page on its website to provide weekly updates to the public. Messaging to the public has noted that local businesses remain safe and open, prevention of legionella illnesses start with maintenance, anyone with symptoms post exposure should contact a health care provider, and mask use is not recommended by the Health Unit to prevent legionella illnesses.

Measles Update
As of July 23, there have been 57 confirmed and probable cases of measles in Middlesex-London. There have been no new cases between June 6 and July 14, with 10 new cases (9 in the same cluster) since July 14. Middlesex-London’s measles vaccination coverage remains high. Middlesex-London’s overall risk level remains unchanged and the region is not in outbreak.

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

The Health Unit has a listing on its website for possible exposures of measles and a measle self-assessment tool.

West Nile Virus
The Health Unit has detected its first West Nile Virus-positive mosquito trap for 2025 in Middlesex-London.

West Nile Virus is a mosquito-borne virus that can infect humans. Most people infected have no symptoms. Symptom onset can occur 2-15 days after bite and can include fever, headaches, body aches, mild rash and swollen lymph glands.

The Health Unit performs surveillance and sampling of mosquito larvae at 250 standing water sites located on public property. Larvicide treatment occurs on sites testing positive for a vector mosquito species.

The public can help prevent West Nile Virus by:
• Reducing standing water around home
• Avoiding being outdoors at dawn and dusk
• Wearing light-coloured long-sleeved shirts and pants
• Using insect repellant that contains DEET
• Installing or repairing tears in window and door screens to keep mosquitoes out of the home
• Clearing overgrowth and debris from shrubs around home

MLHU in the News
The Health Unit has been in the news for heat warnings, air quality statements, the Legionnaires’ disease outbreak and chlamydia cases.

Chair Steele noted that the Health Unit has been busy and has been seen in the media for different matters within the community.

Chair Steele noted that London Health Sciences Centre had released a statement that legionella was found in their cooling towers and inquired if the Health Unit was aware of this. Dr. Summers responded that the Health Unit had been in regular contact with LHSC on the matter.

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

By-Laws

Stephanie Egelton, Clerk, presented the proposed amendments to By-law No. 3 – Proceedings of the Board of Health.

S. Egelton noted that while the proposed amendments were minor, these amendments were still important for the Board of Health’s operations. These amendments include:
• More detailed instructions on when a Board Member declares pecuniary interest specifically around remaining in the meeting link or meeting room;
• Changes to the title of “Executive Assistant” to “Clerk” throughout the by-law; and
• Delegation of duties of Secretary to the Clerk when required

There were no questions or discussion.

It was moved by S. Franke, seconded by A. DeViet, that the Board of Health approve the amendments of G-B30 By-law No. 3 – Proceedings of the Board of Health through a first, second, and third reading.
Carried

Other Business

The next meeting of the Middlesex-London Board of Health is Thursday, September 18, 2025 at 7 p.m.

Chair Steele reminded the Board of Health to provide their availability to the Clerk regarding a Special Board of Health meeting to approve 2024 Financial Statements.

Closed Session

At 8:32 p.m., it was moved by A. DeViet, seconded by M. Newton-Reid, 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;
• a proposed or pending acquisition or disposition of land by the municipality or local board;
• advice that is subject to solicitor-client privilege, including communications necessary for that purpose;
• a position, plan, procedure, criteria or instruction to be applied to any negotiations carried on or to be carried on by or on behalf of the municipality or local board; and
• to approve previous closed session Board of Health minutes.
Carried

At 9:10 p.m., it was moved by S. Franke, seconded by A. DeViet, that the Board of Health return to public session from closed session.
Carried

Adjournment

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

MICHAEL STEELE 
Chair 

STEPHANIE EGELTON
Clerk

EMILY WILLIAMS
Secretary