September 19, 2013 - Minutes

Members Present

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

Regrets

Ms. Denise Brown

Others Present

Mr. Wally Adams, Director, Environmental Health and Chronic Disease Prevention Services
Ms. Marylou Albanese, Manager, Healthy Communities and Injury Prevention Team
Ms. Diane Bewick, Director, Family Health Services
Ms. Liana Bontempo, Nutritious Food Basket Volunteer
Ms. Rhonda Brittan, Public Health Nurse
Ms. Ling Chen, Medical Student
Ms. Nancy Del Maestro, Coordinator, Best Start for Babies Program
Ms. Kathy Dowsett, Manager, Family Health Services
Mr. Dan Flaherty, Manager, Communications
Ms. Krista Kolodziejzyk, Nutritious Food Basket Volunteer
Ms. Kim Leacy, Registered Dietitian
Mr. Brian Lester, Executive Director, Regional HIV/AIDS Connection (RHAC)
Ms. Laura MacDonald, Nutritious Food Basket Volunteer
Dr. Christopher Mackie, Medical Officer of Health & CEO
Mr. John Millson, Director, Finance and Operations
Ms. Sherri Sanders, Executive Assistant to the Board of Health (Recorder)
Ms. Linda Stobo, Manager, Chronic Disease Prevention and Tobacco Control Team
Ms. Louise Tyler, Director, Human Resources and Labour Relations Services
Mr. Alex Tyml, Online Communications Coordinator
Dr. Bryna Warshawsky, Associate Medical Officer of Health and Director, Oral Health, Communicable Disease & Sexual Health Services

Media Outlets

None

Board of Health Chair, Mr. Marcel Meyer, 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 at this time.

Approval of Agenda

It was moved by Mr. Orser, seconded by Mr. Edmondson that the AGENDA for the September 19, 2013 Board of Health meeting be approved. Carried

Approval of Minutes

It was moved by Mr. Peer, seconded by Mr. Bolton that the MINUTES for the June 20, 2013 Board of Health meeting be approved. Carried

It was moved by Ms. Poole, seconded by Ms. Poletes Montgomery that the Confidential Minutes for the June 20, 2013 Board of Health meeting be approved. Carried

Reports with External Delegations

1) Harm Reduction Strategies (Report No. 092-13)

Chair Meyer introduced Dr. Bryna Warshawsky, Associate Medical Officer of Health and Director, Oral Health, Communicable Disease & Sexual Health Services, to present this report. Dr. Warshawsky reported that research shows that Harm Reduction Strategies do not increase the use of injection drugs, and that the reason for programs, such as needle exchange programs, is to prevent the spread of HIV/AIDS and Hepatitis C. Dr. Warshawsky introduced Mr. Brian Lester, Executive Director, Regional HIV/AIDS Connection (RHAC).

Mr. Lester explained that if Bill C-65, an Act to amend the Controlled Drugs and Substances Act, is passed by the Federal Government, it is important to advocate that the Bill does not put additional barriers in place for setting up supervised injection sites. There is currently only one supervised injection site in Canada, i.e., Insite in Vancouver. In response to a question about the impact that Insite has on its community, Dr. Mackie reported that the site actually reduces the number of needles discarded in the community.

Mr. Lester explained the Counterpoint Needle and Syringe Program in the City of London in partnership with the Health Unit. The Ministry of Health and Long-Term provides the Health Unit with 100% funding to cover the cost of needles and their disposal. The Finance and Facilities Committee will review the funding contract between the Health Unit and the Regional HIV/AIDS Connection at a future meeting in order to make a recommendation to the Board of Health.

Discussion ensued about the disposal of the needles. Mr. Lester explained that the program follows the best practices which indicate that making the return of used needles mandatory before new ones can be dispensed would actually increase the prevalence of infection in the community.

Dr. Warshawsky reported that she is working on a report to present at a future Board meeting about drug use in Middlesex-London. She explained that it is difficult to quantify the number of injection drug users in the community, because not all users utilize the program and some do pick up packages for others.

In response to a question about why the Health Unit does not distribute syringes with retractable needles, Dr. Warshawsky explained that the distribution of such syringes has been tried in other communities. However, the syringes are much more expensive, and uptake is lower, so the program was not as effective.

In response to a question about why the needle exchange program is not offered in Middlesex County, Dr. Warshawsky reported that Health Unit staff members will investigate the use of the Strathroy office and/or a mobile clinic that travels to various sites within the County.

In response to a question about whether needle disposal boxes could be put into neighbourhoods by an order of the Medical Officer of Health, Dr. Mackie indicated that the range of options for dealing with need waste would be explored in an upcoming report to the Board of Health.

It was moved by Mr. Orser, seconded by Ms. Poole that Health Unit staff conduct an environmental scan of injection drug use in Middlesex-London, including the burden of illness to the community, services offered in other communities, best practices for needle waste, and the role of the Local Health Integration Network and bring a report back to the Board of Health. Carried

It was moved by Ms. White, seconded by Ms. Poletes Montgomery that Report No. 092-13 re Harm Reduction Strategies, be received for information. Carried

At 8:15 p.m., it was moved by Ms. White, seconded by Ms. Poletes Montgomery that the Board of Health take a five minute recess. Carried

At 8:20 p.m. it was moved by Ms. Fulton, seconded by Mr. Studenny that the meeting be called back to order. Carried

Committee Reports

2) Finance and Facilities Committee (FFC) Report, August Meeting (Report No. 093-13)

3) Finance and Facilities Committee (FFC) Report, September Meeting (Report No. 094-13)

Ms. Trish Fulton, Chair of the Finance and Facilities Committee (FFC), introduced Reports No. 093-13 and 094-13 re the August and September Finance and Facilities Committee meetings.

Dr. Mackie led the Board through the slide presentation that he prepared for the September 5 FFC meeting about the proposed budget planning process and the compressed timeline for 2014. He reported that at the November 1 Board of Health Retreat, the Board will discuss a high-level vision for the Health Unit and the criteria, proposed by Health Unit staff, for the budget planning process.

Business Arising from the August 1 FFC meeting

It was moved by Mr. Edmondson, seconded by Ms. White that the Terms of Reference for the Finance and Facilities Committee be approved. Carried

It was moved by Mr. Peer, seconded by Mr. Studenny that the Board of Health endorse the Board Chair to sign the 2013 service agreement for the Healthy Babies Healthy Children program as attached as Appendix A to Report No. 003-13. Carried

It was moved by Mr. Orser, seconded by Mr. Bolton that the minutes of the August 1Finance and Facilities Committee be received. Carried

Business Arising from the September 5 FFC meeting

It was moved by Ms. White, seconded by Mr. Orser that the Board of Health authorize the Board Chair to sign the Amending Agreement attached as Appendix C to Report No. 004-13C. Carried
It was moved by Ms. Fulton, seconded by Mr. Edmondson that the Board of Health approve expenditures in the amount of $90,000 to cover the implementation of technology as recommended by PricewaterhouseCoopers and the additional resources of the Executive Assistant to the Board of Health to support to the FFC, as identified in Table 1 of Appendix B of Report No. 005-13C, it being noted that the funding would come from anticipated 2013 surplus. Carried

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

1. That the 2014 planning parameters include the reallocation of resources based on maximizing the value of services across the four principles of the Ontario Public Health Standards (Need, Impact, Capacity, and Partnerships/Collaboration),and further
2. That the 2014 planning parameters include 0% increase in municipal funding, and
3. That the approved parameters be communicated to the City of London and the County of Middlesex.

Carried

It was moved by Ms. Fulton, seconded by Ms. White that the Board of Health approve the audited Consolidated Financial Statements for the Middlesex-London Health Unit, March 31st, 2013 as appended to Report No. 009-13C. Carried

It was moved by Ms. Fulton, seconded by Mr. Edmondson that the Board of Health receive Report No. 094-13, including the draft Minutes of the September 5 Finance and Facilities Committee. Carried

4) Progress on the PwC Recommendations (Report No. 095-13)

Dr. Mackie assisted Board members with their understanding of this report. He highlighted the recommendations made by PricewaterhouseCoopers (PwC) that Health Unit staff members have prioritized to implement at this time. Dr. Mackie reported that approximately $106,000 of the $135,000 contract with PwC has been spent.

It was moved by Ms. Poletes Montgomery, seconded by Mr. Studenny that Report No. 095-13 be received for information. Carried

5) In Motion Community Challenge (Report No. 096-13)

Chair Meyer introduced Ms. Marylou Albanese, Manager, Healthy Communities and Injury Prevention Team, to assist Members with their understanding of this report.

It was moved by Ms. Poletes Montgomery, seconded by Mr. Bolton that Report No. 096-13 In Motion™ Community Challenge be received for information. Carried

It was moved by Ms. Poletes Montgomery, seconded by Ms. Poole that the Board of Health members challenge the Health Unit’s Senior Leadership Team in the In Motion™ Community Challenge. Carried

More information about the Challenge will be provided to Board members via email.

Action Reports

6) Child and Youth Network (CYN) Agreement (Report No. 097-13)

Ms. White declared a potential conflict of interest with this report and abstained from voting.

It was moved by Mr. Bolton, seconded by Mr. Edmondson that the Board of Health endorse the Family Centred Service System (FCSS) as attached as Appendix B to Report No.097-13 re Child & Youth Network: System Participation Memorandum of Understanding. Carried

7) Smart Start for Babies Three Year Funding Renewal Application (Report No. 098-13)

It was moved by Ms. Poletes Montgomery that the Middlesex-London Board of Health endorse the application form for the “Smart Start for Babies: Three Year Funding Renewal”. Carried

8) 2013 Nutritious Food Basket Survey Results for 2013 and Implications for Government Public Policy (Report No. 099-13)

It was moved by Ms. Poletes Montgomery, seconded by Mr. Edmondson that the Board of Health:

1. Recommend through the Ontario Poverty Reduction Strategy consultation process that the provincial government:

a. Increase social assistance rates to a level that reflects the rising cost of nutritious food and housing.
b. Implement the immediate introduction of a $100 monthly food supplement to the basic needs allowance for all adults receiving social assistance.
c. Continue the Special Diet Allowance program, with any review or revisions developed in collaboration with Registered Dietitians.
d. Sign a housing agreement with the federal government that will commit funds for cost-sharing the five year extension of the federal Investment in Affordable Housing Program.

2. Endorse the Chair writing a letter summarizing these recommendations and asking support from the City of London, Middlesex County, social service agencies and local Members of Provincial Parliament. Carried

It was moved by Ms. Poletes Montgomery, seconded by Ms. Poole that Mr. Al Edmondson, as Chair of the Board of Health (BOH) section of the Association of Local Public Health Agencies (alPHa) and the BOH Representative, South West Region, take the issue to the Alpha Board of Directors meeting on September 27, 2013. Carried

Information Reports

9) 2013 Mid-Year Performance on Accountability Agreement Indicators (Report No.103-13)

10) Locally Driven Collaborative Project: Food Skills (Report No. 100-13)

11) 2012-2013 Influenza Season in Middlesex-London– Final Report (Report No. 101-13)

12) Influenza Immunization Program 2013-2014 (Report No.104-13)

13) New Resource Lending System (Report No. 102-13)

14) Health Unit Recommendations about Electronic Cigarettes (E-Cigarettes) (Report 105-13)

Ms. Linda Stobo, Manger, Chronic Disease Prevention and Tobacco Control Team, explained that E-cigarettes are not tobacco based; however, many of them do still provide nicotine. Ms. Stobo explained that there are potential health risks of using this product and that no long-term safety studies have been completed.

15) Healthy Communities Partnership Update (Report No. 106-13)

Ms. Albanese reported that she will be making a formal presentation about the Healthy Communities Partnership at the October 8, 2013, meeting of Middlesex County. She also distributed copies of the document, Linking Health and the Built Environment in Rural Settings: Evidence and Recommendations for Planning Healthy Communities in Middlesex County, to each Board member. The report was developed by the Healthy Communities Partnership Middlesex-London and written by the Human Environments Analysis Laboratory at Western University in collaboration with the Health Unit. The purpose of this paper is to increase knowledge of the relationship between health and the built environment in rural contexts, while providing a local application to Middlesex County.

It was moved by Mr. Orser, seconded by Ms. Fulton that Items No. 9 through 15 be received for information. Carried

16) Medical Officer of Health Activity Report - September (Report No.107-13)

Dr. Mackie proposed that the Board of Health meet in July or August in 2014 to help mitigate a lengthy September agenda.

He also reported that a location has been set for the November 1, 2013 Board of Health Retreat –The Middlesex-Centre Wellness and Recreation Centre.

It was moved by Ms. Poletes Montgomery, seconded by Mr. Orser that Report No. 107-13 re Medical Officer of Health Activity Report – September be received for information. Carried

Correspondence

There were no questions about the correspondence.

Other Business

Next scheduled Board of Health Meeting: Thursday, October 17, 2013 at 7:00 p.m.

Flu shots will be available before the October Board Meeting at 50 King Street.

Adjournment

At 9:50 p.m., it was moved by Mr. Bolton, seconded by Mr. Studenny that the meeting be adjourned. Carried

MARCEL MEYER
Chair

CHRISTOPHER MACKIE
Chair Secretary-Treasurer