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Reports

​Brant County Board of Health

Wednesday, April 24, 2019, 9:30a.m., Boardroom
Minutes

Present:

  • Mr. Greg Anderson, Chair
  • Ms. Helen Mulligan, Vice-Chair
  • Councillor John Bell
  • Councillor Robert Chambers
  • Mayor Kevin Davis
  • Ms. Janice Mills
  • Councillor John Sless
  • Councillor Brian Van Tilborg
  • Dr. M. Lock
  • Dr. J. Tober
  • Ms. L. Johnson (recorder)

Also Present:

  • Ms. Dee Perera, Director, Finance
  • Mr. Brent Richardson, Director, Human Resources
  • Ms. Andrea Riley, Manager, Substance Use and School Health
  • Ms. Rabia Tharani, Manager, Environmental Health and Infectious Diseases

1. Call to Order

Chair Anderson called the meeting to order at 9:38 a.m. Mayor Davis offered an apology for his inappropriate behaviour toward Dr. Lock and the Board as a whole at the March 20th Board meeting.

2. Conflict of Interest

Chair Anderson reminded Members to declare a conflict of interest, if one so arises, at the time the item is discussed.

3. In-Camera Meeting

Moved by: Ms. Mills
Seconded by: Ms. Mulligan
“That the meeting move to In-Camera at 9:40 a.m. regarding matters of personnel and potential liability.” Carried.

The regular Board of Health meeting resumed at 10:09 a.m.

At the In-Camera session, the following motion was passed:
”That the Board of Health direct Brant County Health Unit financial management to contact the City of Brantford and County of Brant financial staff regarding potential impacts on public health funding as a result of the 2019 Provincial Budget.”

4. Additions to Agenda

8.9 Provincial Appointee Re-Appointments (Dr. Tober)
8.10 Brant County Health Unit 2018 Annual Report (Dr. Tober)

5. Approval of Minutes

5.1 Brant County Board of Health Minutes, March 20, 2019

Moved by: Ms. Mills
Seconded by: Councillor Sless
“That the Brant County Board of Health Minutes, dated March 20, 2019, be approved as presented.” Carried.

6. Financial Report

6.1 Board of Health Finance and Audit Committee Report

Ms. Mills asked Ms. Perera to report. The Committee went through the amendments to the 2018 Audited Financial Statements, reviewed the 2019 Q1 Financial Statement and Accounts over $2000, and received an update on the boiler replacement. With the vacancy on the Finance and Audit Committee, the Board was asked for direction on filling the position. The Board appointed Councillor Sless to the Committee.

Moved by: Ms. Mills
Seconded by: Councillor Chambers
“That the Board of Health accept the report from the Finance and Audit Committee and appoint Councillor Sless to the Committee.” Carried.

6.2 2018 Audited Financial Statements

Ms. Perera presented the Revised 2018 Audited Financial Statement, as distributed at the meeting. After the March Board meeting, post-audit adjustments were discovered which impacted several pages of the Statements . They were reviewed line-by-line with the Finance and Audit Committee. The surplus changed to $367,288 and the amounts payable to the City of Brantford and County of Brant became $172,358 and $64,724, respectively.

Moved by: Ms. Mills
Seconded by: Ms. Mulligan
“That the Board of Health accept the Revised Audited Financial Statement for the calendar year ending December 31, 2018, including the general Program-Based Grant programs and specifically-funded programs listed herein:

Schedule 1 Brant County Health Unit Cost-Shared Programs
Schedule 2 Harm Reduction Program Enhancement
Schedule 3 Canada Prenatal Nutrition Program
Schedule 4 Healthy Babies, Healthy Children Program
Schedule 5 Healthy Smiles Ontario Program
Schedule 6 Infection Prevention and Control Nurse Initiative
Schedule 7 Infectious Disease Control Initiative (SARS)
Schedule 8 Small Drinking Water Systems Program
Schedule 9 Smoke-Free Ontario Programs
Schedule 10 Vector Borne Diseases Program
Schedule 11 9000 Nurses Initiative
Schedule 12 Electronic Cigarettes Act Program.” Carried.

6.3 Financial Statement ending March 31, 2019

Ms. Perera presented the Q1 Financial Statement ending March 31, 2019, as provided with the agenda.

Moved by: Councillor Van Tilborg
Seconded by: Ms. Mills
“That the Board of Health approve the Financial Statement ending March 31, 2019 as presented.” Carried.

6.4 2019 Provincial Budget

Dr. Tober presented the 2019 Provincial Budget report, dated April 24, 2019, as distributed with the agenda. The Province’s modernizing of public health units through regionalization and governance changes will have an impact, although details are minimal at this time. Funding for dental care for low-income seniors was a welcome announcement, although specifics regarding funds and client eligibility are not available yet. Recruitment for a Medical Officer of Health (MOH) will continue as public health units are legislated to have an MOH in place.

Ms. Perera left the meeting at 10:16 a.m.

7. Business Arising from Previous Minutes

7.1 Report from the Chair

Chair Anderson expressed concern about the Provincial Budget changes as all public health units await more information. Mayor Davis inquired about issuing a letter to the Province or releasing a public statement. The Board was hesitant about making statements based on unconfirmed information. A clearer understanding is anticipated by the next Board meeting.

Ms. Tharani joined the meeting at 10:19 a.m.

7.2 Report from the Medical Officer of Health

Dr. Lock presented the Medical Officer of Health Report, dated April 24, 2019, as provided with the agenda. Dr. Lock reported on a smaller wave of influenza A and very few influenza B cases. Measles outbreaks remain a concern in many countries. In response to a recent opioid event, the Health Unit issued a public alert, initiated mobile outreach by staff, dispensed Nalaxone kits at the Health Unit as well as directed people to other community partners who dispense kits, and conducted multiple media interviews. The report included recent statistics on opioid overdoses, hospital visits, deaths, and Naloxone distribution. Dr. Lock responded to questions: There are peaks in opioid overdoses and deaths particularly linked to fentanyl. More current statistics are becoming available all the time. Brantford is not significantly worse than other cities of comparable population; there is increased usage, deaths and surveillance. The number of locations dispensing Naloxone kits has increased and is getting a lot of media attention. Information on preventing the start of substance use is included in the reports in Items 8.3 and 8.4.

7.3 Report from the Executive Director

Dr. Tober presented the Chief Executive Officer Report, dated April 24, 2019, as distributed with the agenda. Dr. Tober’s report included the Auditor General Value for Money Audit on food safety, Ministry of Health and Long-Term Care program updates, and 2018 program reporting to the Ministry.

7.4 Food Safety Disclosure Report

Ms. Tharani presented the Food Disclosure By-law Report, dated April 24, 2019, as provided with the agenda. At a compliance inspection in December 2018, Admiral Submarine was cited with several infractions and convicted, resulting in a $465 ticket. At a re-inspection on February 7, 2019, Admiral Submarine was charged again which resulted in conviction and a ticket of $120. Ms. Tharani explained that Public Health Inspectors work with food premises owners on education as well as enforcement activities. Multiple tickets could lead to a summons and trial, and a larger fine. Fines are set by the Province. Closure of a food premises is based on more serious infractions. Ms. Tharani advised that the Health Unit is working to enhance the compliance information available about premises, both on the inspection cards posted on-site and on the Health Unit’s website, Food Safety page.

Ms. Tharani left the meeting at 10:44 a.m.

7.5 Medical Officer of Health Recruitment

Chair Anderson presented draft Terms of Reference for the Medical Officer of Health (MOH) Selection Committee, as provided to Members with the agenda. Members discussed various options for Selection Committee membership. On behalf of the full Board, the Selection Committee will conduct interviews and present a recommended candidate to the Board for approval to hire. Following Board approval, the appointment is requested of the Ministry of Health.

Moved by: Councillor Sless
Seconded by: Councillor Bell
“That the Brant County Board of Health approve the Terms of Reference for the Medical Officer of Health Selection Committee, and THAT four Members of the Board, being Chair Anderson, Vice-Chair Mulligan, Ms. Mills and Mayor Davis, be appointed to the Selection Committee.” Carried.

Ms. Riley joined the meeting at 10:53 a.m.

8. NEW BUSINESS

8.1 Human Resources Report

Mr. Richardson presented the Human Resources Report, dated April 24, 2019, as included with the agenda. The report provided 2018 statistics on employment numbers, succession management, recruitment, turnover, disability management and labour relations. Mr. Richardson responded to questions: There is no trend in retirement age for public health. The 9% turnover rate was at an acceptable level and fell below the provincial average.


8.2 School Health Program Report

Ms. Riley presented the School Health Program Report, dated April 24, 2019, as distributed with the agenda. Ms. Riley highlighted activities carried out by public health staff in elementary and secondary schools in Brant, including oral health screening, immunizations, and health promotion activities. Eight Public Health Nurses visited 60 schools weekly. There was a focus on mental health, with 31 schools participating in MindUP. Other activities included physical activity and healthy lifestyles, sexual health in secondary schools, and substance use awareness in secondary schools and senior grades in elementary schools. In relation to school health, Members noted the local Drugs Strategy, Zone planning meeting, don’t use/safe consumption messaging, and physical activity strategies.

8.3 Substance Use and the Smoke Free Ontario Act Program Report

Ms. Riley presented the Substance Use and Smoke Free Ontario Act (SFOA) Program Report, dated April 24, 2019, as distributed with the agenda. The report highlighted 2018 activities in substance use and tobacco prevention programming which focused on education and prevention/protection. There was an increase in the number of inspections under the SFOA. In response to questions, Ms. Riley advised that smoking complaints are typically received on the Tobacco Hotline (complaints under SFOA including cannabis) and are triaged to the appropriate responder: public health, City Housing, Parks and Recreation, etc. The Health Unit will be working with school boards toward more progressive SFOA enforcement including the student, parent, school, Tobacco Enforcement Officer and Public Health Nurse to introduce conversation about health and smoking cessation.

8.4 Harm Reduction Program Report

Ms. Riley presented the Harm Reduction Program Report, dated April 24, 2019, as distributed with the agenda. The report include activity and statistical information for 2018, and early 2019 data which is on par with last year. Much work has been put into surveillance on returned needles, with an increase to 57% seen. There were 3,454 Naloxone kits dispensed in 2018. Ms. Riley responded to questions: There is no way to tell whether returned needles were distributed through the Needle Exchange Program. It is difficult to know how many drug users are in the community. The Health Unit’s mandate is to make needles accessible and escalate outreach during an event. The saturation point for Naloxone kits may have been reached and the ongoing number of kits dispensed is expected to decrease. Naloxone has a one-year expiry time so most efficient use of the product must be considered. There is a significant cost savings to the health care system in preventing HIV and Hepatitis C cases through clean needle use. Efforts are underway to incorporate the municipal needle return bins into the count. Bins were disbursed in coordination with community partners to high-risk areas, and work continues with City staff to identify additional sites. There is active collaboration with the BIA and Grand River Conservation Authority, with plans to work with the County in the coming months.

Ms. Riley left the meeting at 11:47 a.m.

Moved by: Ms. Mills
Seconded by: Councillor Sless
“That the Board of Health accept Reports 8.1 and 8.4 as presented.” Carried.

8.5 Travel Health Clinic Report

Dr. Lock presented the Travel Health Clinic Report, dated April 24, 2019, as included with the package. Dr. Lock reported that clinic visits were slightly lower than previous years, as there were no student groups travelling abroad that accessed the clinic in 2018. Dr. Lock noted the benefit of catching up routine booster immunizations for clients attending the Travel Clinic.

Moved by: Councillor Bell
Seconded by: Ms. Mulligan
“That the Board of Health accept Report 8.5 as information.” Carried.

8.6 Chief Nursing Officer Assignment

Dr. Tober presented the Chief Nursing Officer (CNO) Report, dated April 24, 2019, as included with the agenda. As Ms. Christina Rajsic formerly held this assignment, a replacement designation is required.

Moved by: Councillor Sless
Seconded by: Councillor Bell
“That the Board of Health designate Janet Kwansah, Manager, Quality Assurance and Professional Practice, as the Chief Nursing Officer for the Brant County Health Unit.” Carried.

8.7 BCHU Strategic Plan Addendum: Performance Management System

Dr. Tober presented the Strategic Plan Addendum Report, dated April 24, 2019, as distributed with the agenda package. The Performance Management System formalizes the performance management system and continuous quality assurance process in place. Incorporating the Performance Management System document into the Strategic Plan responds to recommendations from the Ministry of Health Audit Team.

Moved by: Ms. Mills
Seconded by: Mayor Davis
“That the Board of Health approve the Brant County Health Unit Performance Management System document as an Addendum to the 2016-2026 Strategic Plan.” Carried.

8.8 alPHa Annual Conference—June 9-11, 2019

Dr. Tober advised of the call for resolutions for the Association of Local Public Health Agencies (alPHa) Annual Conference and General Meeting on June 9-11, 2019, as well as the call for nomination for a Central-West Board of Health Section representative.
8.9 Provincial Appointee Re-Appointment Dr. Tober reported that the Ministry of Health and Long-Term Care sent a letter thanking Ms. Ruby Toor for her service to the Brant County Board of Health and thereby not renewing Ms. Toor’s appointment. Chair Anderson read a letter of thank you from Ms. Toor for her time on the Board. It was noted that Chair Anderson’s provincial appointment will expire on October 1, 2019. Mr. Anderson has indicated his intent to apply for re-appointment. Members approved a letter of support to accompany the re-appointment submission.

Moved by: Ms. Mulligan
Seconded by: Mayor Davis
“That the Brant County Board of Health provide a letter of support for the provincial re-appointment of Mr. Greg Anderson to this Board.” Carried.

8.10 BCHU 2018 Annual Report

Dr. Tober presented the Brant County Health Unit 2018 Annual Report, as distributed at the meeting. The Annual Report contains operational, statistical, financial and event highlights for 2018, and is responsive to recommendations from the Ministry of Health Auditors. Upon Board approval, the Annual Report will be posted to the Health Unit’s website.

Moved by: Councillor Chambers
Seconded by: Councillor Van Tilborg
“That the Board of Health approve the Brant County Health Unit 2018 Annual Report as presented.” Carried.

9. Correspondence (Board members may request a copy of items that are not attached from Board of Health Secretary)

9.1 Correspondence received from Association of Local Public Health Agencies (alPHa), dated January 31, 2019 re alcohol choice and convenience and a provincial alcohol strategy.

9.2 Correspondence received from Ministry of Health and Long-Term Care, dated March 6, 2019, re health care system transformation.

9.3 Correspondence received from Simcoe Muskoka District Health Unit, dated March 20, 2019, re alPHa report: Improving and Maintaining the Health of the People: The Contribution of Public Health to Reducing Hallway Medicine.

9.4 Correspondence received from Windsor-Essex County Health Unit, dated March 5, 2019, re current opioid crisis. Mayor Davis noted three resolutions from boards of health to Premier Ford for increased funding for addiction services. Dr. Tober stated that the 2019 Provincial Budget announced addiction system funding. This funding would not flow to public health units, but rather to organizations such as St. Leonard’s Society and others. Implementation is anticipated for 2019; however, no details have been released.

9.5 Correspondence received from Windsor-Essex County Health Unit, dated March 5, 2019, re support for provincial oral health program low-income adults and seniors.

9.6 Correspondence received from Perth District Health Unit, dated March 20, 2019, re oral health program for low-income adults and seniors.

9.7 Correspondence received from City of Toronto, dated March 27, 2019, re Toronto Indigenous Overdose Strategy.

9.8 Correspondence received from Peterborough Public Health, dated April 3, 2019, re Bill 60 (An Act to amend the Ministry of Community and Social Services Act to establish the Social Assistance Research Commission).

9.9 Correspondence received from Peterborough Public Health, dated April 3, 2019, re Healthy Babies, Healthy Children program funding.

9.10 Correspondence received from Perth District Health Unit, dated April 2, 2019, re strengthening the Smoke-Free Ontario Act.

9.11 Correspondence received from Southwestern Public Health, dated April 3, 2019, re funding for the Child Visual Health and Vision Screening protocol.

9.12 Correspondence received from Sudbury and Districts Public Health, dated April 10, 2019, re Bill S-228, Child Health Protection Act.

9.13 Correspondence received from Middlesex-London Health Unit, dated April 16, 2019, re HIV case management.

9.14 Correspondence received from Kingston, Frontenac and Lennox & Addington Public Health, dated April 17, 2019, re Province’s plan to restructure Ontario’s public health system.

Moved by: Councillor Sless
Seconded by: Councillor Van Tilborg
“That the Board of Health receive the correspondence as listed.” Carried.

10. Questions/Announcements

10.1 Harm Reduction: Drugs Strategy and Safe Consumption Site

Mayor Davis distributed two draft resolutions for Members’ consideration at a future meeting. The first would direct staff to research and produce a report on aspects of establishing a safe consumption site in Brantford. The second would direct staff to provide a report on support, leadership and evaluation for the Brantford-Brant Community Drugs Strategy. Mayor Davis requested that both resolutions be considered at the next Board of Health meeting.

11. Future Agenda Items

12. Next Meeting Date

Wednesday, May 15, 2019, 9:30 am.

13. Adjournment

The meeting was adjourned at 11:58 a.m.