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November 15, 2012 - Minutes

Members Present

Ms. Viola Poletes Montgomery (Chair)
Mr. David Bolton
Ms. Denise Brown
Ms. Patricia Coderre 
Mr. Al Edmondson  
Mr. Marcel Meyer (Vice Chair) 
Mr. Stephen Orser
Ms. Nancy Poole 
Mr. Mark Studenny 

Regrets

None

Others Present

Mr. Wally Adams, Director, Environmental Health and Chronic Disease Prevention Services
Ms. Kathy Dowsett, Manager, Family Health Services
Mr. Dan Flaherty, Manager, Communications
Mr. Ross Graham, Manager, Special Projects
Ms. Kim Leacy, Registered Dietitian, Environmental Health
Ms. Andrea Lo, Medical Student          
Ms. Sarah Maaten, Epidemiologist, Environmental Health
Mr. John Millson, Director, Finance and Operations
Ms. Sherri Sanders, Executive Assistant to the Board of Health (Recorder)
Mr. Rick Shantz, Director, Information Technology
Ms. Linda Stobo, Manager, Chronic Disease Prevention
Ms. Nancy Summers, Manager, Family Health Services
Ms. Trudy Sweetzir, Communications Assistant
Ms. Louise Tyler, Director, Human Resources and Labour Relations Services
Dr. Bryna Warshawsky, Acting Medical Officer of Health & CEO and Director, Oral Health, Communicable Disease & Sexual Health Services

Media Outlets

Mr. Jonathan Sher, London Free Press
Ms. Viola Poletes Montgomery, Chair, Board of Health, called the meeting to order at 7:00 p.m.

Disclosures of Conflict(s) of Interest

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

Chair Poletes Montgomery explained that Board of Health members and staff were asked to wear purple on November 15 to show support for the Shine the Light AgainstWomen Abuse Campaign. This year is a tribute to Ms. Sonia El-Birani, a former Health Unit staff member who passed away in 2012. Ms. Poletes Montgomery noted that all decorations in the Board room and in Health Unit offices were purchased with staff members’ money and not with any Health Unit funds.

Approval of Agenda

It was moved by Mr. Bolton, seconded by Mr. Edmondson that the Agenda for the November 15, 2012, Board of Health meeting be approved. Carried

Approval of Minutes

It was moved by Mr. Orser, seconded by Ms. Brown that the minutes of the October 18, 2012, Board of Health meeting be approved.

Business Arising

Board member, Ms. Patricia Coderre, asked to discuss an item recorded in the October 18, 2012, minutes that stated the following:

“Further discussion ensued regarding the concept of the 75/25 cost-sharing arrangement. Councillor Denise Brown agreed to provide information that supports the 75/25 cost-sharing arrangement to Board of Health members.” 

Ms. Coderre stated that the above mentioned information had not been received to date.   Ms. Brown stated that she had found the information online in the alPHa Board of Health training manual. Ms. Brown reported that she has attempted to get documentation from the Minister of Health and Long-Term Care that states that the 75%/25% cost-sharing arrangement is a requirement.

In response to a question, Mr. John Millson, Director, Finance and Operations, confirmed that the 75%/25% cost-sharing arrangement is not legislated in the Health Protection and Promotion Act. Mr. Millson clarified that Section 76 of the Act deals with provincial funding and states that the Minister may make grants. The Ministry of Health and Long-Term Care is not required to provide any funding for public health.

Mr. Edmondson also confirmed that at the Association of Local Public Health Agencies (alPHa) Symposium in June 2012 (attended by himself and Board members, Ms. Pat Coderre and Mr. Stephen Orser, along with several staff members), Mr. Liam Scott, Solicitor for the Ministry of Health and Long-Term Care, provided information on the Ministry’s position on public health funding. The presentation indicated that the Ministry may make grants and that the 75/25 arrangement is merely a target that is not being achieved by many Boards of Health.

Ms. Nancy Poole asked Ms. Brown if she had received a letter from the Ministry of Health and Long-Term Care. Ms. Brown indicated twice that she had not received a letter.

Later in the meeting, Mr. Meyer presented a document (filed with the minutes) entitled, “Ontario Municipal Partnership Fund 2012 Allocation Notice County of Middlesex” which makes reference to the idea of 75% provincial funding of public health as follows:

The estimated municipal benefit of the province's 75% share of public health funding relative to its 50% share in 2004. Actual municipal savings may not correspond with the Allocation Notice due to budget approvals made by the local Boards of Health. Municipalities may provide additional funding beyond their obligated cost share. Any additional municipal funding is not included in the calculation of the public health figure.”

Reports

1) Report No. 131-12  re “Per Capita Funding Analysis and Improvements in Inspections Services”

Dr. Bryna WarshawskyActing Medical Officer of Health & CEO, assisted Board members with their understanding of this report. A copy of Dr. Warshawsky’s PowerPoint presentation is filed with the minutes. Dr. Warshawsky explained that based on per capita funding, the Health Unit has moved from 34th out of 37 Health Units in 2003 to approximately 23rd out of 36 Health Units (based on 2007 data) because of increased funding from the Province. She also explained that many variables may affect per capita funding, such as size of the health unit (smaller health units tend to have higher per capita funding), region (northern health units tend to have higher per capita funding due to transportation costs) and other programs for which only some health units receive funding (e.g., programs such as 100% funded Speech and Language programs which are provided for by the Middlesex-London Health Unit for additional health unit areas raise per capita figures in Middlesex-London relative to health units that don’t provide these services).

It was moved by Mr. Edmondson, seconded by Ms. Poole that Report No. 131-12 re “Per Capita Funding Analysis and Improvements in Inspection Services” be received for information. Carried

2) Report No. 132-12  re “2013 Cost-Shared Budget”

Dr. Warshawsky assisted Board members with their understanding of this report.  She explained that the $477,682 anticipated shortfall in 2013 will be handled by managed gapping of positions, decreased corporate training and professional development and reduced purchased services.  Dr. Warshawsky also cautioned that it is not certain that the Health Unit will receive a 2% increase from the province in 2013.

It was moved by Mr. Bolton, seconded by Mr. Studenny that the Board of Health:

1.   Approve the 2013 Cost-Shared Programs budget at the net amount of $23,213,670, noting that this is based on an estimated 2% provincial increase, and a 0% increase to both the City of London and the County of Middlesex, and further;

2.   Provide written notice to both the City of London and the County of Middlesex as set out for obligated municipalities in section 72(5) of the Health Protection and Promotion Act.

2 Opposed 6 For

Carried

3)  Report No. 133-12 re “Terms of Reference for a Review of Administrative Functions, Including Shared Services”

Dr. Warshawsky assisted Board members with their understanding of this report. Health Unit staff met with staff from the City of London and Middlesex County on October 29thto discuss the draft Terms of Reference.  Dr. Warshawsky indicated that discussions with the City and County have focused on the confidentiality aspects of the draft Terms of Reference and the scope of the review. Because the review may contain identifiable information about a position or individual, parts or all of the report may need to be dealt with in closed session. The Health Unit cannot tell another organization what it should consider confidential. However, it was agreed that the Health Unit will be the first body to receive the Consultants’ interim and final reports. Staff members will present in open session those sections of the report that they feel do not contain identifiable information about an individual, and will present those sections that they feel contain identifiable information in closed session, as permitted under the Municipal Act. It is hoped that the City and County will also treat as confidential the items that the Health Unit deems necessary to deal with in close session.

In response to a question about why information about positions might be considered confidential, Dr. Warshawsky explained that many positions have only one or two incumbents, and therefore, the discussion of a position could “identify an individual”.

Dr. Warshawsky presented the Organizational Chart for the Health Unit and explained the considerations regarding the scope of the review. She outlined the portions of the Health Unit that provide direct programs and services (Oral Health, Communicable Disease and Sexual Health Services; Environmental Health and Chronic Disease Prevention Services; and Family Health Services) and the areas of the Health Unit that are considered mainly administrative (Information Technology; Human Resources and Labour Relations; and Finance and Operations). She indicated that the Office of the Medical Officer of Health (Communications; Special Projects; Privacy and Occupational Health and Safety; Emergency Preparedness; and the Travel Clinic) is partly involved in providing programs and services (Communications; Emergency Planning and the Travel Clinic) and partly involved in risk management (Privacy and Occupational Health and Safety; Emergency Preparedness) Because they deliver program and services and/or are involved in risk management, she indicated that Health Unit staff are recommending that the Office of the Medical Officer of Health not be included in a review to assess the possibility of shared administrative services.  

Dr. Warshawsky explained that all operations of the Health Unit are open to review by the public. She explained that what is being requested is not an audit but rather a review of shared services. The Health Unit undergoes a full financial audit each year.

In response to a question about the line item which contains general expenses, Mr. Millson explained that the line item is primarily made up of general overhead costs, e.g., leases, heat, hydro, post-retirement benefits, photocopier rentals, etc. 

Various options were discussed including confining the review to Finance, Human Resources and Information Technologies (which includes Purchasing, Payroll and Facility Management); including a review for efficiencies of the Office of the Medical Officer of Health; and including the programs and services in the review. The Board of Health agreed to keep the language as written in the draft Terms of Reference which indicates that the review will be of “administrative functions, including but not limited to, Finance, Human Resources, Purchasing, Payroll, Facility Management and Information Technology”. It was further clarified by Ms. Coderre and agreed to by the Board of Health that the review would be confined to the areas of Finance and Operations, Human Resources and Labour Relations, Information Technology and the Office of the Medical Office of Health (excluding the Travel Clinic). Ms. Coderre outlined these areas on the organizational chart. It was discussed that the Board would have additional opportunities to consider the scope of what could be shared once the consultants` report is received.

There was also discussion that the Board of Health is requesting the review and should be directing the review.

It was moved by Mr. Bolton, seconded by Mr. Meyer:

1.  That the Terms of Reference in Appendix A of  Report No. 133-12 with the scope including but not limited to the areas of Finance, Human Resources, Purchasing, Payroll, Facility Management  and Information Technology be approved; and further,

2.  That the Consulting Firm of PricewaterhouseCoopers be asked to submit a written proposal, including a project plan and cost estimates for conducting the review, to the Board of Health for review and approval prior to the commencement of the project and that this language be incorporated into the Terms of Reference.

Carried 

4) Report No. 134-12  re “Healthy Babies Healthy Children: A Commitment to the Future”

Ms. Nancy Summers, Manager, Family Health Services, assisted Board members with their understanding of this report. Ms. Summers clarified that it is not one-time funding and that the position would not require administrative support.

It was moved by Mr. Edmondson, seconded by Ms. Brown that the Board of Health approve an increase of $100,000 to the base budget for enhancements to the Healthy Babies Healthy Children Program, it being noted that the increased resources are to fund a new 1.0 FTE Public Health Nurse position to support program delivery changes as described in this Report (Report No. 134-12).

1 Opposed 7 For

Carried

5)  Report No. 135-12  re “Nutritious Food Basket Costing Survey Results for 2012”

Mr. Wally Adams, Director, Environmental Health and Chronic Disease Prevention Services, introduced Ms. Linda Stobo, Manager, Chronic Disease Prevention and Tobacco Control Team, and Ms. Kim Leacy, Registered Dietitian to assist Board members with their understanding of this report.

In response to a question about whether the proposed $100 supplement would be deducted from existing Social Assistance payments, Ms. Leacy explained that this payment would be on top of the Social Assistance payments.

It was moved by Ms. Brown, seconded by Mr. Orser that the Board of Health:

1.     Send a letter to the Premier of Ontario, the Right Honourable Dalton McGuinty and candidates for the Liberal Leadership, with copies sent to local Members of Provincial Parliament,  to endorse Windsor-Essex County Board of Health’s recommendations to:

a.   Implement a monthly $100 Healthy Food Supplement for social assistance recipients in Ontario as recommended by alPHa, the Social Planning Network of Ontario  and the Stop Community Food Centre; and

b.   Partner with Ontario Collaborative Group on Healthy Eating and Physical Activity to support the implementation of the comprehensive, coordinated Ontario Food and Nutrition Strategy.

2.     Forward for information Report No. 135-12 re “Nutritious Food Basket Costing Survey Results for 2012” to the City of London, Middlesex County, and appropriate community agencies.

Carried

6)  Report No. 136-12 re “Progress on the 2012-2014 Strategic Directions”

Mr. Ross Graham, Manager, Special Projects, assisted Board members with their understanding of this report. Mr. Graham stated that this is the 3rd update about the Strategic Plan in 2012.  Mr. Graham presented each Board member with a paper copy of a brochure entitled, “2012-2014 Strategic Directions” that outlines the three-year strategic directions and the work of the Strategic Achievement Groups.

In response to a question about how the Health Unit can tell its stakeholders that it has met the indicators, Mr. Graham explained that each “Strategic Direction” has a Strategic Achievement Group who have developed an operational plan with specific outcomes to be achieved.  These groups will be reporting on their projected outcomes. Mr. Graham will be providing a full report to the Board of Health at an upcoming meeting.

It was moved by Mr. Meyer, seconded by Mr. Orser that the Board of Health approve distribution of the “Strategic Plan 2012-2014” as attached as Appendix A to Report No. 136-12 to community partners and all Ontario Boards of Health.

Carried

7)  Report No. 137-12 re “2012 Board of Health Self-Assessment Survey”

Mr. Wally Adams introduced Ms. Sarah Maaten who assisted Board members with their understanding of this report.

It was moved by Ms. Brown, seconded by Mr. Orser that the Board of Health proceed with the Board Self-Assessment in November 2012 as outlined Report No. 137-12 re “2012 Board of Health Self-Assessment Survey”.

Carried

8)  Report No. 138-12  re “Employee Group Insurance Contract”

Ms. Louise Tyler, Director, Human Resources and Labour Relations, assisted Board members with their understanding of this report.

It was moved by Ms. Brown, seconded by Mr. Bolton that the Board of Health award a contract to provide Employee Group Insurance Benefits to Great-West Life Insurance Company effective February 1, 2013.

Carried

9)  Report No. 139-12 re “Acting Medical Officer of Health Activity Report October 11 – November 8, 2012”

It was moved by Mr. Orser, seconded by Ms. Brown that Report No. 139-12 re “Acting Medical Officer of Health Activity Report – October 11 - November 8, 2012” be received for information.

Carried

Other Business

Chair Poletes Montgomery reminded Board members that Staff Day is Thursday, November 29th and to RSVP to Sherri Sanders, Executive Assistant to the Board of Health.

Next scheduled Board of Health Meeting – Thursday, December 13, 2012       6:00 p.m.

Correspondence

There were no questions re correspondence.

Adjournment

At 9:50 p.m., it was moved by Mr. Edmondson, seconded by Ms. Coderre that the meeting be adjourned.

Carried

VIOLA POLETES MONTGOMERY
Chair

BRYNA WARSHAWSKY
Secretary-Treasurer

 
Date of creation: November 15, 2012
Last modified on: March 5, 2013