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May 15, 2014 - Minutes

Members Present

Ms. Denise Brown
Mr. Al Edmondson
Ms. Trish Fulton
Mr. Marcel Meyer (Chair)
Mr. Stephen Orser (Vice-Chair)
Mr. Ian Peer
Ms. Viola Poletes Montgomery
Ms. Nancy Poole
Mr. Mark Studenny
Ms. Sandy White

Regrets

Mr. David Bolton

Others Present

Dr. Christopher Mackie, Medical Officer of Health & CEO (Secretary-Treasurer)
Ms. Sherri Sanders, Executive Assistant to the Board of Health (Recorder)
Mr. Wally Adams, Director, Environmental Health and Chronic Disease Prevention Services
Ms. Diane Bewick, Director, Family Health Services & Chief Nursing Officer
Ms. Shaya Dhinsa, Manager, Sexual Health Services
Ms. Laura DiCesare, Director, Human Resources and Corporate Strategy (via teleconference)
Mr. Dan Flaherty, Manager, Communications
Mr. Jesse Helmer, London City Council Candidate
Ms. Alison Locker, Epidemiologist
Ms. Heather Lokko, Acting Director, Oral Health, Communicable Disease & Sexual Health Services
Mr. Ken Noseworthy, Nat’l Geog
Ms. Sarah Maaten, Epidemiologist
Mr. John Millson, Director, Finance and Operations
Mr. Alex Tyml, Online Communications Co-ordinator
City of London Police Services

Media Present

Mr. Craig Gilbert, London Community News
Ms. Elena Mayetuk, Londoner/Strathroy Age Dispatch

Mr. Marcel Meyer, Chair of the Board of Health, called the meeting to order at 7:00 p.m.

Disclosures Of Conflict(S) Of Interest

Chair Meyer inquired if there were any disclosures of conflict of interest to be declared. None were declared.

Approval Of Agenda

It was moved by Mr. Studenny, seconded by Ms. White that the AGENDA for the May 15, 2014 Board of Health meeting be approved.
Carried

Approval Of Minutes

It was moved by Ms. Poole, seconded by Ms. Peer that the public session MINUTES of the April 24, 2014 Board of Health meeting be approved.
Carried

Business Arising From The Minutes

None

Delegation And Recommendation Reports

1. Finance And Facilities Committee: March 26, 2014 Meeting (Report 031-14)

It was moved by Ms. Fulton, seconded by Mr. Edmondson that the Board of Health receive Report No. 020-14FFC re 2014 Q1 Budget Variance for information.
Carried

It was moved by Ms. Fulton, seconded by Mr. Peer that the Board of Health increase the Board of Health member compensation rate for a half day meeting to $144.16 retroactively to January 1st, 2014.
Carried

It was moved by Ms. Fulton, seconded by Mr. Studenny:

1) That the Board of Health no longer contribute or reduce its contributions to City of London’s Self Insurance Reserve Fund as the Board has not had any claims; and

2) That the Board of Health direct Health Unit staff to look for Insurance that provides better value than the current Policy.
Carried

Mr. Millson reported that in the past five years, the Health Unit claims have totaled less than $7,000, while contributions have been over $200,000.

It was moved by Ms. Fulton, seconded by Mr. Edmondson that Report 023-14FFC be received for information.
Carried

It was moved by Ms. Fulton, seconded by Mr. Peer that the Board of Health:

1) Endorse the Financial Signing Authority policy as appended to Report No. 024-14FFC re: Finance Policies Review: Report 1 of 3 and recommend that the Board of Health approve this policy with the above revision made; and

2) Receive for information the policies on Moving Expenses, Corporate Credit Cards and Petty Cash as appended to Report No. 024-14FFC re: Finance Policies Review: Report 1 of 3.

Carried

It was moved by Ms. Fulton, seconded by Mr. Studenny that Report No. 025-14FFC re Dental Clinic 2013 Financial Shortfall be received for information.
Carried

It was moved by Ms. Fulton, Mr. Studenny that Report 031-14, including the draft minutes of the May 1st Finance and Facilities Committee meeting, be received for information.
Carried

2. Verbal Report from Governance Committee Meeting: May 15, 2014 (Report No. 02-14GC)

It was moved by Mr. Studenny, seconded by Ms. White:

1) That the Board of Health receive Report No. 02-14GC re 2014 Board of Health Self-Assessment Results for information, and

2) That the Board of Health endorse the Governance Committee’s recommendation to develop a plan for continuous improvement of Board of Health effectiveness and engagement, including Board training and implementation of best practices for Board meeting processes, based on the findings of the survey and best practices.
Carried

It was moved by Mr. Studenny, seconded by Mr. Edmondson:

1) That the Board of Health approve the proposed strategic planning process as outlined in Appendix A of Report No. 03-14GC, and

2) That the Middlesex-London Health Unit Strategic Plan be developed to cover a 5 year timeframe, and

3) That the terms of reference for the Governance Committee (Attached as Appendix B to Report No. 03-14GC) be updated to include responsibility for stewarding the strategic planning process.
Carried

3. The Impact of Prescription and Non-Prescription Drug Use in Middlesex-London (Report 032-14)

Ms. Alison Locker, Epidemiologist, assisted Board members with their understanding of this report.

Dr. Mackie, Medical Officer of Health & CEO, introduced, Dr. John Craven who operates Clinic 528 in London.

Dr. Craven summarized a history of prescription drug misuse and treatment in London. He emphasized that 1 in 5 people have long-term pain, and often, the pain medication prescribed eventually is no longer effective and causes more pain from addiction. Dr. Craven stated that it is not the short-term use of the drugs, but it is the long-term complications that are the issue. Dr. Craven stated that more education is required to inform the public about the potency of commonly prescribed painkillers.

Ms. White declared a conflict of interest re her employer: Children’s Aid Society of London.

In response to a question about the position of the College of Physicians and Surgeons on the prescription of addictive painkilling drugs, Dr. Craven reported that several doctors no longer have the ability to prescribe opioids.

In response to a request for how London compares to other cities with teaching hospitals in regards to drug misuse, Ms. Locker responded that staff members will review the data sources to see if such information is available.

Ms. Locker reported that for the report entitled, The Impact of Prescription and Non-Prescription Drug Use in Middlesex-London, data sources used require that City of London and County of Middlesex data be analyzed together.

Dr. Mackie reported that next steps include:

  • Education of local physicians and nurse practioners about the abuse of opioid medications
  • Continued support for harm reduction programs
  • Application of the Four Pillar Approach

1. Harm reduction
2. Prevention
3. Treatment
4. Enforcement

Staff members were directed to follow up on the items discussed at the meeting, e.g., more dialogue with College of Physicians and Surgeons.

It was moved by Mr. Orser, seconded by Ms. White:

1) That Dr. Mackie be directed to work with Dr. Craven to challenge provincial party leaders to address the issue of opioid over-prescription, and

2) That the Board of Health direct staff to share the information provided in The Impact of Prescription and Non-Prescription Drug Use in Middlesex-London (Report 032-14) with Municipal partners.
Carried

4. Student Wellbeing and Learning: Foundations For A Healthy School Framework (Report 033-14)

It was moved by Ms. White, seconded by Ms. Poletes Montgomery:

1) That Report No. 033-14 re Student Wellbeing and Learning: Foundations for a Healthy School Framework be received for information; and

2) That Letters be sent from the Board of Health to the Honourable Deb Matthews, Minister of Health & Long-Term Care, and the Honourable Liz Sandals, Minister of Education, commending the Ministers on their collaborative efforts to ensure students’ wellbeing in schools.
Carried

Information Reports

5. Overdose Prevention in London and Middlesex County: Community Naloxone Program (Report 034-14)

Dr. Mackie assisted Board members with their understanding of this report. He explained that Naloxone is a drug that is an antidote for opioid drug overdose. Naloxone has few side effects and has no abuse potential. There would be no impact if given to someone who does not have an opioid overdose.

Ms. Shaya Dhinsa, Manager, Sexual Health Services, explained EMS uses Naloxone for some 911 calls. They have developed teaching materials for service providers who will be educating clients. Police in Middlesex-London currently do not have Naloxone, but police forces in some other jurisdictions do.

In response to a question about whether or not a client who has administered Naloxone to themselves would seek medical help for follow up. The teaching material recommends the client call 911 first, administer the first dose, wait 3-5 minutes and then follow up with a second dose if the first dose hasn’t started to work.

In response to a question about whether an antidote will encourage clients to increase doses of opioids, Ms. Dhinsa explained studies show there may be decrease in opioid use and an increase in self-esteem through peer leadership.

Concern was expressed about the legal liability of the Health Unit giving lay people access to Naloxone. Health Unit role is to teach how to use Naloxone safely and to learn the risks. Dr. Mackie explained that 41 people died last year from opioid overdose in Middlesex-London. The proven health risk is more important than the theoretical risk. Naloxone is being provided in the following Ontario areas currently: Toronto, Ottawa, Oxford County and Waterloo. The syringes provided are designed for safety and include the one-time use feature.

In response to a question about whether a Safe Injection Site would be necessary if Naloxone were provided, Dr. Mackie explained that three of the four services offered at Safe Injection Sites, e.g., safe equipment, education and connection with services, and treatment of overdose can be offered in community. The fourth service, immunity from prosecution, needs more discussion.

It was moved by Ms. Brown, seconded by Ms. Poole that the report be deferred until staff can obtain legal advice to ensure that there is no legal liability on the Health Unit or the Board of Health should anyone misuse Naloxone.
3 for, 6 opposed
Defeated

It was moved by Ms. White, seconded by Ms. Poletes Montgomery that Report No. 034-14 re Overdose Prevention in London and Middlesex County: Community Naloxone Program be received for information.
1 opposed, 8 for
Carried

6. Summary Information Report - May 2014 (Report 035-14)

It was moved by Ms. Brown, seconded by Mr. Peer that Report No. 035-14 re Summary Information Report -May 2014 be received for information.
Carried

7. Medical Officer of Health Activity Report – May Report (Report 036-14)

It was moved by Ms. White, seconded by Mr. Orser that Report No. 036-14 re Medical Officer of Health Activity Report – May be received for information.

At 9:05 p.m., it was moved by Mr. Peer, seconded by Mr. Studenny that the Board of Health take a five minute recess.

Confidential

At 9:10 p.m., it was moved by Mr. Orser, seconded by Mr. Edmondson that the Board of Health move in camera to discuss a matter concerning employee negotiations.
Carried

At 9:20 p.m. it was moved by Ms. White, seconded by Ms. Poletes Montgomery that the Board of Health return to public forum and report that a discussion was had concerning employee negotiations.
Carried

Other Business

Next Board of Health Meeting: Thursday, June 19, 2014 7:00 p.m.
Next Finance and Facilities Committee Meeting: Thursday June 12, 2014 9:00 a.m.

Correspondence

There were no questions about the correspondence.

Adjournment

At 9:25 p.m., it was moved by Mr. Peer, seconded Ms. White seconded that the meeting be adjourned.
Carried

Marcel Meyer
Chair

Christopher Mackie
Chair Secretary-Treasurer

 
Date of creation: June 11, 2014
Last modified on: June 11, 2014