July 19, 2018 - Board of Health - Meeting Minutes

Members Present:

Ms. Joanne Vanderheyden, Chair
Mr. Michael Clarke
Ms. Maureen Cassidy
Mr. Jesse Helmer
Mr. Trevor Hunter
Mr. Ian Peer
Mr. Marcel Meyer
Mr. Kurtis Smith

Regrets:
Ms. Trish Fulton
Ms. Tino Kasi

Others Present:

Dr. Christopher Mackie, Secretary-Treasurer
Dr. Alexander Summers, Associate Medical Officer of Health
Ms. Elizabeth Milne, Executive Assistant to the Board of Health and Communications (Recorder)
Ms. Marilyn Atkin, Program Lead, Community Outreach and Harm Reduction
Ms. Cynthia Bos, Human Resources Partner
Ms. Shaya Dhinsa, Manager, Sexual Health
Ms. Melanie Elms, Public Health Nurse
Mr. Brian Glasspoole, Manager, Finance
Ms. Donna Kosmack, South West Tobacco Control Area Network
Ms. Linda Stobo, Manager, Chronic Disease and Tobacco Control
Ms. Maureen Rowlands, Director, Healthy Living
Mr. Stephen Turner, Director, Environmental Health, and Infectious Diseases
Mr. Alex Tyml, Online Communications Coordinator

Media:
Ms. Megan Stacey, London Free Press
Mr. Joel Merritt, CTV News London

Chair Vanderheyden called the meeting to order at 7:00 p.m. and welcomed Dr. Summers, Associate Medical Officer of Health.

Disclosures of Conflict(s) of Interest

Chair Vanderheyden inquired if there were any disclosures of conflicts of interest to be declared. None were declared.

Approval of Agenda

It was moved by Mr. Clarke, seconded by Mr. Peer, that the AGENDA for the July 19, 2018 Board of Health meeting be approved.
Carried

Approval of Minutes

It was moved by Ms. Cassidy, seconded by Mr. Helmer, that the MINUTES of the June 21, 2018 Board of Health meeting be approved. Carried

Delegations and Committee Reports

Dr. Ken Lee, Addictions Services Thames Valley (ADSTV) re: Item #2: Nurse Practitioner Secondment Follow-up (Report No. 045-18)

Dr. Lee provided additional information to the Board of Health, including background on why ASTV requested support from MLHU through the secondment of a Nurse Practitioner to provide interim support to Rapid Access to Addiction Medicine (RAAM) clinics in London and Chippewa of the Thames First Nation.

Discussion ensued on the following items:
• Services provided by the RAAM clinic and the clinic’s interaction with medical schools, physicians, residents, and nurse practitioners.
• Treating with suboxone versus methodone, and the difference between patients who are administered these respective treatments.
• Whether or not decriminalization would make a difference in the RAAM clinic’s current treatment practice.
• Linking new practitioners with other community supports to provide wraparound services to those being treated, and the current referral process for the RAAM clinic.
• How many people are currently being seen at the clinic, and if there are plans to expand or extend services.

It was moved by Mr. Helmer, seconded by Ms. Cassidy, that the Board of Health receive Report No. 045-18 re: “Nurse Practitioner (NP) Secondment Follow-up” for information. Carried

Dr. Fatih Sekercioglu, Manager, Safe Water, Rabies, and Vector Borne Disease, Environmental Health and Infectious Diseases Division, re: Item #3: Small Non-Community Drinking Water Systems (Report No. 046-18)

Dr. Mackie introduced Dr. Sekercioglu and commended him for his work in completing his PhD while also working full-time as a manager at MLHU.

Dr. Sekercioglu gave a presentation and a summary of his dissertation to the Board of Health including background and history on Ontario’s small drinking-water systems, why this research was needed, what his research goals were, his key findings, and how his work will be applicable to MLHU’s efforts to safeguard rural small drinking-water systems in the Middlesex-London region.

Discussion ensued on the following items:
• Whether the training program developed through his dissertation is transferrable to other communities.
• How non-compliance is treated in areas that do not properly follow the regulations in place for small drinking-water systems.
• Whether Dr. Sekercioglu has had a chance to present his policy paper to the Ministry of Health and Long-Term Care.
• Whether or not there should be signage indicating when small drinking-water systems have last been inspected, or if they should be graded to advise the public before consuming.

It was moved by Mr. Hunter, seconded by Mr. Helmer, that the Board of Health receive Report No. 045-18 re: “Dr. Fatih Sekercioglu’s doctoral thesis: ‘Ontario’s Small, Non-Community Drinking Water Systems: How to Ensure Provision of Safe Drinking Water and Source Water Protection’” for information. Carried

Finance & Facilities Committee (FFC) Meeting – July 5, 2018 (Report No. 044-18)

Chair Vanderheyden introduced, provided context for, and summarized the following reports, which were considered at the July 5 FFC meeting:

Ministry of Children and Youth Services Program Funding (Report No. 029-18FFC)

It was moved by Ms. Cassidy, seconded by Mr. Helmer, that the Board of Health:
1. Receive Report No. 029-18FFC re: “Ministry of Children and Youth Services Program Funding”; and
2. Direct staff to receive this funding.
Carried

2019 PBMA Process, Criteria, and Weighting (Report No. 030-18FFC)

It was moved by Mr. Hunter, seconded by Mr. Clarke, that the Board of Health approve the 2019 PBMA criteria and weighting proposed in Appendix A to Report No. 030-18FFC. Carried

Allocation of Additional 2018 Funding from the Ministry of Health and Long-Term Care (Report No. 031-18FFC)

Dr. Mackie provided context for this report, including additional information provided to the Board regarding the third point on the recommendation: a request to approve the over-hiring of permanent staff in limited circumstances. This additional information summarized the current recruitment issues faced across the divisions to further support the request to the Board of Health. Dr. Mackie reviewed the current issues, the implications associated with gapping nursing positions, and how the over-hiring of staff in limited circumstances would assist in addressing these issues.

It was moved by Mr. Helmer, seconded by Mr. Peer, that the Board of Health:
1. Receive Report No. 031-18FFC re: “2018 Budget Funding Increases – Recommended Expenditures”;
2. Approve Appendix A; and
3. Approve the judicious over-hiring of permanent staff in limited circumstances.
Carried

The following reports were received by the Finance & Facilities Committee for information:

Chair Vanderheyden noted that the Finance & Facilities Committee reviewed the new policy G-205 Borrowing, which the Committee had revised and referred back to the Governance Committee.

It was moved by Ms. Cassidy, seconded by Mr. Helmer, that the Board of Health receive the MINUTES of the July 5, 2018 Finance & Facilities Committee meeting as amended. Carried

Recommendation Reports

Smoking Strategy Developments re: Smoke-Free Ontario Act, 2017 (Report No. 048-18)

Dr. Mackie introduced the report and provided context, recognizing that the new government’s intention is to improve the legislation and that the Health Unit wishes to work with them to help inform tobacco control policy.

It was moved by Mr. Clarke, seconded by Mr. Peer, that the Board of Health:
1. Receive Report No. 048-18 re: “Smoking Strategy Developments re: Smoke-Free Ontario Act, 2017” for information; and
2. Send a letter, attached as Appendix A, to the Ontario Government expressing MLHU’s ongoing commitment to address the burden of tobacco and nicotine addiction, and to encourage continued engagement of the public health community in current and future reviews of tobacco control policy and provincial tobacco strategy development.
Carried

Temporary Overdose Prevention Site Extension (Report No. 049-18)

Dr. Mackie introduced the report and provided context, outlining the current status and uptake of service at the Temporary Overdose Prevention Site (TOPS), the success of the program, and how the interventions provided by this service have saved lives since its inception. Dr. Mackie outlined the options for extending the service at TOPS, including both a federal and a provincial route.

Discussion ensued on the following items:
• Whether the TOPS would cease to operate once the permanent Supervised Consumption Facilities (SCFs) are approved and operating.
• That both the Regional HIV/AIDS Connection (RHAC) and MLHU are working with business owners and residents to address concerns about activities happening outside the TOPS facility, and that such activities outside or around the facility are not reflective of the success or conduct occurring inside the TOPS.
• Whether there is a need to extend the TOPS hours, and how this report addresses changes that may be made to the TOPS operations going forward.
• The contingency plan, if neither route for requesting an extension to TOPS services works out.

It was moved by Mr. Peer, seconded by Mr. Hunter, that the Board of Health:
1) Receive Report No. 049-18 re: “Temporary Overdose Prevention Site Extension” for information;
2) Request that the Ministry of Health and Long-Term Care (MOHLTC) extend approval of the Temporary Overdose Prevention Site for an additional six-month period;
3) Support an Interim Supervised Consumption Facility with federal exemption approval until the permanent site opens; and
4) Direct the Chair to write to the Ontario Minister of Health and Long-Term Care inviting the Minister for a tour of Ontario’s first Temporary Overdose Prevention Site.
Carried

Information Reports

Summary Information Report for July (Report No. 050-18)

It was moved by Mr. Helmer, seconded by Mr. Meyer, that the Board of Health receive Report No. 050-18 re: “Summary Information Report for July” for information. Carried

Medical Officer of Health/Chief Executive Officer Activity Report for July (Report No. 047-18)

It was moved by Ms. Cassidy, seconded by Mr. Helmer, that the Board of Health receive Report No. 047-18 re: “Medical Officer of Health/Chief Executive Officer Activity Report for July” for information. Carried

Correspondence

It was moved by Mr. Peer, seconded by Mr. Meyer, that the Board of Health receive correspondence items a) through j) and l) through o). Carried

It was moved by Mr. Peer, seconded by Mr. Meyer, that the Board of Health endorse item k). Carried

Chair Vanderheyden also made note of item n), and that this item would be referred to staff for purposes of developing a report to bring back to the Board of Health.

Other Business

It was moved by Ms. Cassidy, seconded by Mr. Hunter, that the Board of Health cancel its planned August 16, 2018 meeting. Carried

Chair Vanderheyden reviewed the next meeting dates of the Finance & Facilities Committee, the Board of Health, and the Governance Committee:

• Next Finance & Facilities Committee meeting: September 6, 2018 @ 9:00 a.m.
• Next Board of Health meeting: September 20, 2018 @ 7:00 p.m.
• Next Governance Committee meeting: September 20, 2018 @ 6:00 p.m.

Confidential

It was moved by Ms. Cassidy, seconded by Mr. Hunter, that the Board of Health approve the confidential minutes of the June 21, 2018 Board of Health meeting. Carried

Adjournment

At 7:57 p.m., it was moved by Mr. Meyer, seconded by Ms. Cassidy, that the meeting be adjourned. Carried

JOANNE VANDERHEYDEN
Chair

CHRISTOPHER MACKIE
Secretary-Treasurer