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Reports

Brant County Board of Health

Wednesday. February 20, 2019, 9:30 a.m., Boardroom
Minutes

Present:

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

Regrets:

  • Councillor John Bell
  • Councillor John Sless

Also Present:

  • Ms. Dee Perera, Director, Finance
  • Ms. Christina Rajsic, Director, Program Standards
  • Mr. Brent Richardson, Director, Human Resources
  • Mr. Glenn Roach, Acting Director, Finances
  • Ms. Andrea Riley, Manager, Substance Use and School Health

1. Call to Order

Chair Anderson called the meeting to order at 9:34 am.

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. Mulligan
Seconded by: Ms. Toor
“That the meeting move to In-Camera at 9:35 am regarding a personal matter about potential litigation.” Carried.
The regular Board of Health meeting resumed at 9:46 am.
There were no actions or motions resulting from the In-camera session.

4. Additions to Agenda

None.

5. Approval of Minutes

5.1 Brant County Board of Health Minutes, January 30, 2019

Moved by: Councillor Van Tilborg
Seconded by: Mayor Davis
“That the Brant County Board of Health Minutes, dated January 30, 2019, be approved as presented.” Carried.

6. Financial Report

6.1 Board of Health Finance and Audit Committee Report
Chair Anderson, Acting Chair for the Finance and Audit Committee, reported that a revised procurement policy and procedure was presented which clarifies a number of items and responds to recommendations made by the Ministry of Health auditors. A revised version was distributed at the Finance and Audit meeting noting corrections to the corporate credit card limit amount, and clarification of two signing officers as relevant. The revised Procurement policy and procedure was approved by the Finance and Audit Committee

Ms. Perera and Mr. Roach left the meeting at 9:50 am.

7. Business Arising from Previous Minutes

7.1 Report from the Chair

No report.

7.2 Report from the Medical Officer of Health

Dr. Lock presented the Medical Officer of Health’s Report, dated February 20, 2019, as distributed at the meeting. Dr. Lock reported that influenza across Canada continues to decline with little indication of a secondary peak that usually occurs. Brant’s case numbers are static. Most people impacted by this strain seem to be youth and children. Dr. Lock reported on measles that are surfacing nationally and internationally. Measles is a vaccine-preventable disease that can potentially result in death. The falling rates of vaccination against measles, and other associated diseases, is of significant public health concern.

Members inquired how the Health Unit could combat the anti-vaccine messages with pro-vaccine messages through social media. Most anti-vaccine information is based on false science and is difficult to counter once it is circulating. The issue is larger than Brant and requires a provincial or national approach for consistent messaging and wide-spread impact. The medical community tried various approaches on a small scale. While the Immunization of School Pupils Act requires mandatory vaccination for school pupils, parents may exempt their children from all or some immunizations. To do this, the parent must attend an education session and sign-off on their decision.

Members also inquired about ebola. Dr. Lock confirmed there is a vaccine against ebola. However, as cases appear in political war zones, eg, Democratic Republic of the Congo, there are many barriers to vaccination. There are many contacts to be traced for each patient, some residents do not believe in vaccinations, burial rights play a part, and there is a challenge getting medical staff into an infected area due to unsafe conditions. Many cases are in rural areas; however, if it moves to large urban areas, there is insufficient vaccine to immunize broadly if ebola becomes a world travel concern.

7.3 Report from the Executive Director

Dr. Tober presented the Executive Director’s Report, dated February 20, 2019, as included with the agenda. Dr. Tober’s report included the following: The Ontario Auditor General’s Value for Money Audit will target food safety; health units have been asked to complete a survey and several health units will be selected to participate in the audit. The fourth-quarter financial report for 2018 is due on March 1, and the program activities report will be due on April 26. Millards commenced their annual financial audit and are on-site from February 19-21. The Ministry has released 2017 year-end performance indicator results to health units for verification prior to finalizing the report. Dr. Tober presented the 2019 Annual Service Plan and Budget Submission to the Board. The Ministry has extended the due date until April 1 due to problems with the template.

Ms. Riley joined the meeting at 10:05 am.

7.4 Food Safety Disclosure Report

No report.

Ms. Riley joined the meeting at 10:10 am.

7.5 Board of Health Policies and Procedures Update

Dr. Tober presented the Board of Health Policies and Procedures Update, dated February 20, 2019, as included with the agenda. Dr. Tober advised that non-pecuniary conflict of interest was removed from the Board of Health Conflict of Interest policy and procedure.

Moved by: Ms. Mulligan
Seconded by: Ms. Mills
That the Brant County Board of Health approve the Board of Health—Conflict of Interest policy and procedure as presented”.” Carried.

Dr. Tober advised that a Whistleblower policy and procedure were developed in response to the Ministry auditors’ request that this be set out separately from the existing Anti-Harassment/Bullying policy. The Whistleblower policy outlines the complaint process under 3 categories: financial, Criminal Code and health & safety. This policy was shared with the Board as written complaints may be submitted to the Chair of the Board of Health if the activity is with respect to the Executive Director, Medical Officer of Health or a member of the Board of Health; and to the Vice-Chair of the Board of Health if the activity is with respect to the Chair of the Board of Health.

The Ministry of Health auditors also noted an absence of training plan for Board Members based on areas requiring improvement on the Board’s self-evaluations. They recommended the Board develop a training plan. The Board identified Financial Management and Risk Management as areas requiring improvement and requested that Dr. Tober make arrangements for that training in 2019.

Moved by: Ms. Mills
Seconded by: Councillor Chambers
“That the Board of Health accept Reports 7.1 through 7.5 as presented.” Carried.

Mr. Richardson left the meeting at 10:14 am.

8. New Business

8.1 Program Standards Overview—Part 2

Dr. Tober presented the Program Standards Overview—Part 2, dated February 20, 2019, as included with the agenda. Focusing on the Program Standards section of the Ontario Public Health Standards (OPHS), the report provided a high-level overview of the following two areas: Chronic Disease Prevention and Wellness, and Substance Use and Healthy Schools. It also served as an orientation to new Members. More detailed program reports will be presented individually throughout the year. Health Unit activities are directed by the OPHS and accompanying Ministry of Health Protocols and Guidelines. The Health Unit uses GIS mapping and other tools to determine areas of greatest need and target services there. The Health Unit also ensures the Brant Health Atlas is as current as statistics allow for the planning purposes of Health Unit staff and community partners.
Members inquired about concrete deliverables and metrics for Health Equity activities, local falls rates, and mental health promotion in rural areas. Dr. Tober assured Members that future program-specific reports will have detailed information about activities, rates and performance.

8.2 Harm Reduction Report

Ms. Riley presented the Harm Reduction Report, dated February 20, 2019, as distributed with the agenda. Much work has been done over the past few months between the Health Unit and municipal partners on role definition. There is lack of clarity about the mandate of the Drug Strategy, and the Brant County Health Unit’s (BCHU) mandate which is directed by the Province’s Ontario Public Health Standards. The report outlined community needle tracking, needle return rate surveillance, community disposal bins, community needle sweeps and safe needle pick-up and reporting. The percentage of needles turned in has declined over the past few years, which may be, in part, due to a limited tracking system with agency partners. The City tracks needle returns on their property. The plan is to have
one tracking system for a comprehensive picture on numbers, hot spots and a response strategy.

There are four needle drop bins in the community with more to be installed once location, management and monitoring are determined. Implementation is expected in April. Also starting in April, training will be available for volunteers who conduct regular or single-time needle sweeps targeted at areas where unsafe needle disposal is common. BCHU provides education on what citizens should do when they find used needles: how to pick them up
safely and dispose of them, or where to report the find. Education this year will focus on core area elementary and secondary schools, Parks and Recreation staff, Canada Post, neighbourhood associations and some business owners.

Members inquired about concerns regarding mobilizing volunteers, cost/direction to businesses with needle disposal boxes in their washrooms; access to mental health and addiction services; consistent messaging and coordinated approach to reduce duplication; and clarification on leads for distribution, retrieval and training; liabilities.

BCHU will be talking to the BIA Board in March to bring a proactive approach to businesses. Targeted training includes information on how/where people can access addition services and the current needle exchange partners already have links to treatment or provide treatment. The Drug Strategy and BCHU are both looking at covering gaps and education within their respective roles.

Mental health and addictions treatment fall under the Local Health Integration Network (LHIN). There are 5 local mental health/addictions service providers. The Health Unit is not a treatment provider but does promote other agencies’ services and locations.

Chair Anderson recognized the sense of urgency from City Councillors and the work being done by Health Unit staff, and requested that follow-up reports and discussions continue on harm reduction to track progress.

Ms. Riley left the meeting at 10:53 am.

Moved by: Councillor Van Tilborg
Seconded by: Mayor Davis
“That the Board of Health accept Reports 8.1 and 8.2 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 Simcoe Muskoka District Health Unit, dated February 6, 2019 re support of a provincial oral health program for seniors.

9.2 Correspondence received from Southwestern Public Health, dated January 10, 2019, re regulatory framework for cannabis storefronts.

9.3 Correspondence received from Durham Region, dated January 31, 2019, re cannabis use in public places.

Moved by: Ms. Mulligan
Seconded by: Ms. Mills
“That the Board of Health receive the correspondence as listed.” Carried.

10. Questions/Announcements

11. Future Agenda Items

12. Next Meeting Date

Wednesday, March 20, 2019, 9:30 am.
Finance and Audit Committee Meeting on Wednesday, March 20, 2019 at 8:45 am.

13. Adjournment

The meeting was adjourned at 10:55 am.