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Meeting of the Board of Health for the Porcupine Health Unit

Held on June 19, 2019, Timmins Office, Board Room

Present:

  • Sue Perras
  • Mickey Auger
  • Cleo Charlebois
  • Sebastien Lessard
  • Kristin Murray
  • Pat Britton
  • Denis Clement
  • George Pirie
  • Marc Ringuette
  • Rock Whissell

Staff:

  • Dr. Lianne Catton
  • Don West
  • Maria Cook
  • Lynn Leggett
  • Joëlle Aubin
  • Anna Gauthier
  • Sue Lajoie
  • Chantal Riopel

Recorder:  Maria Cook


1. Call to Order

Sue Perras, Chair, 5:00 p.m.

2. Approval of Agenda

MOVED BY: Cleo Charlebois
SECONDED BY: Kristin Murray                              

Addition: 

9)  NEW BUSINESS

a)  North East Public Health Board Chairs Meeting

THAT the agenda for this meeting be approved as amended.

Carried

3. Adoption of Minutes of Meeting

MOVED BY: Mickey Auger
SECONDED BY: Denis Clement

THAT the minutes of the meeting of the Board of Health for the Porcupine Health Unit held May 23, 2019 be approved.

Carried

4. Business Arising from Minutes

None.

5. Correspondence

Dr. Lianne Catton spoke to the following correspondence:

The Regional Municipality of Peel - Office of the Regional Chair

Re:  Public Health Vision Screening in Peel Schools

  • Copy of letter, dated May 8th, to Minister Christine Elliott advising of their Regional Council’s resolution, requesting that the Ontario Public Health Standards Child Visual Health and Vision Screening Protocol be partially implemented by promoting the availability of a free annual comprehensive eye exam by an optometrist to parents and caregivers of young children; and that changes to the Child Visual Health and Vision Screening Protocol, that reflect the scientific evidence and build on OHIP-funded comprehensive eye exams.

Re: Modernization of Ontario Public Health Units in the 2019 Ontario Budget

  • Copy of letter, dated May 21st, to Minister Christine Elliott, advising of their Regional Council’s resolution # 2019-416, requesting:

    • That the Province maintain the mandate and core functions of local public health, as described in the Ontario Public Health Standards (OPHS), 2018;
    • That the Province ensure that public health remains responsive to local community needs and is enabled to work collaboratively with local municipalities and community organizations;
    • That the Province achieve and maintain the 75% provincial and 25% municipal funding formula for Peel Public Health, ensuring sufficient funding levels to meet community needs;
    • That financial implications for municipalities be mitigated, prevented, and that the Province fully fund any costs associated with Peel Public Health’s transition to a regional public health entity;
    • That the Province consult with municipalities and public health agencies on the modernization of Ontario public health units; and
    • That the resolution from Mayors and Regional Chairs of Ontario (MARCO) regarding public health cuts, be endorsed.

 Windsor-Essex County Health Unit

 Re:  Smoke-Free Multi-Unit Dwellings 

  • Copy of letter, dated May 21st, to Prime Minister Trudeau, advising of their Board’s resolution, endorsing the following actions and policies to reduce the exposure of second-hand smoke in multi-unit housing:
  • Encourage all landlords and property owners of multi-unit housing to voluntarily adopt no-smoking policies in their rental units or properties and explicitly include cannabis smoke and vaping of any substance in the definition of smoking;
  • All future private sector rental properties and buildings developed in Ontario should be vape and smoke-free from the onset;
  • Encourage public/social housing providers to voluntarily adopt no-smoking and/or vaping policies in their units and/or properties;
  • All future public/social housing developments in Ontario should be smoke and vape-free from the onset; and
  • Encourage the Ontario Ministry of Housing to develop government policy and programs to facilitate the provision of smoke-free housing.

Re: Urgent provincial action needed to address the potential health and social harms from the ongoing modernization of alcohol retail sales in Ontario 

  • Copy of letters, dated May 21st from Windsor-Essex County Health Unit Board of Health, to Minister Christine Elliott, supporting Simcoe Muskoka District Health Unit’s request to develop a comprehensive provincial alcohol strategy to mitigate harms and monitor the health impacts of the increasing access and availability to alcohol in Ontario.

North Bay Parry Sound District Health Unit

Re:  Letter of Support for Simcoe Muskoka District Health Unit – Proposed Boundaries

  • Copy of letter, dated May 23rd, to Minister Christine Elliott, supporting Simcoe Muskoka District Health Unit’s Board of Health recommending that the full territory of the Simcoe Muskoka District Health Unit remain intact and join with York Region Public Health to form a new regional public health entity on April 1, 2020.

Kingston, Frontenac and Lennox & Addington (KFLA) Public Health

Re:  Health Promotion as a Core Function of Public Health

  • Copy of letter, dated May 23rd, to Minister Christine Elliott, advising of their Board’s resolution, urging the government of Ontario to maintain the current health promotion mandate of local public health; and to consult with Medical Officer’s of Health, across Ontario, should they consider any changes to the health promotion mandate and/or functions of local public health units or future public health entities.

Re: Endorsement of the Children Count Task Force Recommendations

  • Copy of letter, dated June 4th, to Premier Doug Ford, endorsing the Children Count Task Force Recommendations.

Re: Announcement re: Reversing Retroactive Funding Cuts to Municipal Funding

  • Copy of letter, dated June 4th, to Premier Doug Ford, advising KFL&A Public Health looks forward to the opportunity to work collaboratively with the Province of Ontario, ensuring the core public health functions will be preserved and leveraged to help reorient the health system, creating efficiencies in health care through protection from disease and promotion of health, to reduce hallway medicine and keep the people of Ontario healthy.

Brant County Health Unit

Re:  2019 Ontario Budget

  • Copy of letter, dated May 27th, to Premier Doug Ford and Minister Christine Elliott, expressing their concerns regarding the implications of the 2019 budget noting that the proposed reduction in funding for public health services represents a significant strain of the ability to continue to deliver on its mandate and requesting that, before the new directions for public health units are fully implemented, that any changes to the funding ratio be done in consultation with municipalities rather than unilaterally by the Province and deferred to the municipal 2020 funding year; and that the following be considered when the development of the new regional public health entities and regional governance structure occurs to maintain a strong public health presence and impact in their community:
    • No loss of service to our community - All current programs and services under the Foundational and Program Standards continue to be funded by the Regional Public Health Entity to provide services in Brant.
    • Meaningful input into program planning -The needs of Brantford and Brant County are considered in the planning of programs and services for our community.
    • Integrity of the Health Unit - The Health Unit continues to function as a unit and services continue to be provided locally.
    • Appropriate municipal role in governance - The public expects that their municipal tax dollars are overseen by municipal politicians, For the municipal investment, representatives of the obligated municipalities will continue in this oversight role.
    • Effective administrative support -All administrative services provided by the Regional Public Health Entity will be at the same level or better than currently exists in the Health Unit Ontario.

Peterborough Public Health

Re: Public Health Modernization: Getting it Right!

  • Copy of resolution, received via email on May 28th, which the Board of Health for Peterborough Public Health have summitted to alPHa to bring forward to the June 10th Annual General Meeting, calling upon the Ontario government to delay the implementation of any organizational and financial changes to local public health until April 1, 2021 with a commitment to engage in meaningful consultation over the next 18 months; and that any changes in the cost-shared formula be phased in over 5 years commencing in fiscal 2021-22; and that in any consultations with the province, that alPHa propose a joint task force made up of both political representatives and staff be established with the Association of Municipalities of Ontario (AMO) and the City of Toronto to undertake the following activities:
    • Establish a set of principles to guide the reorganization of public health in Ontario that include:
      • Assurance that the enhancement of health promotion and disease prevention is the primary priority of any changes undertaken;
      • Undertaking the consolidation of health units around a community of interests which include distinguishing between rural and urban challenges, and the meaningful participation of First Nations;
      • Taking into account the ability of municipalities to pay, considerations for the broad range of proposed changes in funding arrangements between the province and municipalities;
      • Developing a governance structure that provides accountability to local3 councils required to fund local public health agencies; and
  • Conduct public outreach to municipal, public health and other stakeholders to validate both the principles and the resulting plans for future re-organization; and
  • Ensure that the municipal and public health perspectives on any proposed changes, including the outcomes of consultation, are incorporated.

Timiskaming Health Unit

Re: Northeastern Regional Public Health Regional Boundaries

  • Copy of letter, dated June 4th, to Minister Christine Elliott, supporting motion passed by Sudbury and Districts Health Unit, endorsing Simcoe Muskoka District Health Unit’s Board of Health’s position, that the organization of their public health services remains intact as they transition to the new regional public health entity.

Re: North East Public Health Collaboration Project

  • Copy of letter, dated June 6th, to Minister Christine Elliott and Dr. David Williams, Chief MOH, advising their Board is committed to the continued collaboration of the Boards of Health in Northeastern Ontario, and looks forward to ongoing MOHLTC support for this work; and further that their Board, having engaged in this work since 2017, anticipates sharing with the MOHLTC its experiences so that other regions may benefit and further anticipates providing, to the Ministry, its expert advise on public health functions and structures for the North East.

Grey Bruce Health Unit

Re:  Modernization of Alcohol Sales in Ontario

  • Copy of letters, dated June 4th, to Minister Christine Elliott, supporting correspondence form Simcoe Muskoka District Health Unit with respect to the need for a comprehensive provincial alcohol strategy.

Re:  Minimizing harms associate with the announced expansion of the sale of beverage alcohol in Ontario

  • Copy of letter, dated June 4th, to Premier Doug Ford, supporting correspondence from KFL&A Public Health, urging the provincial government to ensure a plan to address safe and responsible sale and consumption of alcohol in Ontario.

Re: Endorsement of the Children Count Task Force Recommendations

  • Copy of letter, dated June 4th, to Premier Doug Ford, supporting correspondence from KFL&A Public Health endorsing the Children Count Task Force Recommendations.

Township of Hornepayne

Re:  Porcupine Health Unit – Board Support

  • Copy of letter, dated June 5th, to Minister Christine Elliott, advising of their Resolution No. 2019-265, urging the Ministry of Health & Long-Term Care and the Province of Ontario to allow for extensive engagement with the field and local public health expertise to ensure that the core functions and strengths of the public health system are maintained with significant consideration for the maintenance of a strong local public health presence and representation.

6. Medical Officer of Health Report

Dr. Catton, Medical Officer of Health, provided an update/report with regard to the following:

Opioids

The Opioid Surveillance and Early Response Task Force met to reassess the local data collection system and response plans. At this time there has been an ongoing state of “yellow”, Enhanced Surveillance stage. Partners involved include the Timmins Police Service (TPS), Emergency Medical Services (EMS), Timmins and District Hospital (TADH), Ontario Provincial Police (OPP), Nishnawbe-Aski Police Service (NAPS), and the Timmins Fire Department (TFD). The next steps will include media to increase the profile of the Timmins and Area Drug Strategy (TADS) work, and the local context of the opioid crisis for our communities.

There continues to be high rates of opioid related EMS calls and emergency department visits, and the PHU and partners remain vigilant for any surges.  Posters illustrating signs of overdose, prevention, treatment, and availability of naloxone have been posted on Porcupine Health Unit (PHU) doors in French and English. The response to any surge has included notification of community partners, hospitals, pharmacies, and school boards.  Social media posts are frequently shared and a joint release with TPS occurred around one tragic surge of opioid events.

Lyme Disease

While the PHU has positively identified the presence of black legged ticks capable of carrying the bacterium Borrelia Burgdorferi, the PHU region remains a low risk. As such the PHU continues with passive surveillance, whereby ticks found on humans are sent to the public health lab, to determine the type of tick and if it carried the bacterium. Ticks found on animals can be brought to a veterinary clinic for testing.

While the PHU area remains a relatively low risk, ticks capable of causing Lyme Disease are present in the region, and increasing awareness is key. This was new in the past few years, and is expected to increase with climate change. Increasing promotion of the prevention of tick bites, along with identification of ticks and safe removal continues. There is also regular communication with health care providers regarding the risk of Lyme disease, and sharing of evidence-based testing and treating guidelines.

Northeast Public Health Transformation Initiative (NEPHTI)

The five health units of the NE continue discussions to determine opportunities going forward as a larger regional entity. The PHU continues to ensure strong local connections with municipalities, and community partners are maintained with consideration for our unique and diverse needs as a region. Several management team members have been involved in collaboration Leadership and Work Teams exploring opportunities to create a strong and nimble public health entity with consideration for the unique and diverse needs across the northeast.

Dr. Catton continues to email staff with regular updates as well as providing documents on the PHU intranet site for staff to review. Staff has also received regular presentations at monthly grand rounds, similar to the BOH and the entire management team continues to support and engage with PHU employees throughout these uncertain times. The Steering Committee, consisting of the five MOH’s are meeting in Sudbury to review potential governance and leadership models as well as recommendations from the Leadership Teams next week, which includes Programs, Foundations and Corporate Services. At this time, Ministry feedback has been very positive and supportive with respect to this work.

Ontario Health Team

The PHU was involved in the assessment application for an Ontario Health Team which as led by the Timmins and District Hospital (TADH) and included several health and social service sector partners across the region. There were over 150 self-assessments submitted across Ontario for review. The review and approval process has been extended into July. The teams approved will be notified of the next steps to submit an application by the fall. The PHU was able to support the process with local data and a health equity lens to help delineate priorities.

Internal PHU Reorganization

The PHU has undergone a significant reorganization, to create efficiencies, increase capacity and improve consistency across PHU teams. The Foundations team was created to improve accountability for the Foundations Standard. The team is working with all program areas for program planning, health equity, effective public health practice, population health surveillance, and communications. The Chronic Disease and Injury Prevention team have expanded to include Healthy Growth and Development, the Northern Fruit and Vegetable Program (NFVP) as well the Canada Prenatal Nutrition Program (CPNP) and is now the Health and Well-Being team. Having comprehensive health promotion across the life span being addressed by one team will increase efficiencies.

Movement of staff within the Timmins offices was required to facilitate the establishment of the new teams. This also included exploring efficiencies for reception at the Timcor office and bringing the Infectious Disease and Environmental Health teams together to share a space. The reorganization and moves have gone extremely well, and the management team continues to work to support staff with these transitions.

Indigenous Cultural Awareness of all PHU Staff

Almost all PHU staff have completed online cultural competency training, offered by the Ontario Indigenous Cultural Safety Program. In the fall, spots will be offered to BOH members for this valuable awareness building opportunity. This is an important step in addressing the need for cultural awareness in PHU work, in line with the Truth and Reconciliation Commission of Canada (TRC) Calls to Action. The PHU continues to work towards meaningful engagement with Indigenous partners, community members, and First Nations communities.

Porcupine Lake

Dr. Catton and the Manager of Environmental Health continue to be active members of the City of Timmins Porcupine Watershed Liaison Committee, with the Ministry of the Environment, Conservation and Parks (MECP), Canadian Environmental Law Association (CELA) and Friends of Porcupine River Watershed. The Environmental health team undertook an extensive review of historical sampling and procedures for Porcupine Lake, as well as Ministry protocols. This included a review with Public Health Ontario (PHO) and other public health units. An enhanced beach sampling plan has been developed for 2019 to inform ongoing management of Porcupine Lake as well as safe use for residents over the summer. Messaging for all waterways is on the PHU website and will be shared at all beaches, to raise awareness regarding the multiple factors affecting beach water quality, such as recent rainfall.

7. Program Committee Report

a) Public Health Transformation

MOVED BY: Kristin Murray
SECONDED BY: Sebastien Lessard

WHEREAS since November 2017, the boards of health in Northeastern Ontario, namely the Boards for Algoma Public Health, Public Health Sudbury & Districts, Porcupine Health Unit, North Bay Parry Sound District Health Unit, and Timiskaming Health Unit, have proactively and strategically engaged in the Northeast Public Health Collaboration Project to identify opportunities for collaboration and potential shared services; and

WHEREAS the Northeast Public Health Collaboration Project work to date has been supported by two one-time funding grants from the Ministry of Health and Long-Term Care (MOHLTC); and

WHEREAS subsequent to the proposed transformation of public health announced in the April 11, 2019 provincial budget, the work of the Collaboration has been accelerated and reoriented as the Northeast Public Health Transformation Initiative with the vision of a healthy northeastern Ontario enabled by a coordinated, efficient, effective, and collaborative public health entity; and

WHEREAS the Board understands there will be opportunities for consultation with the MOHLTC on the regional implementation of public health transformation;

THEREFORE, be it resolved that the Board of Health for the Porcupine Health Unit supports the continued collaboration of the boards of health in Northeastern Ontario and looks forward to ongoing MOHLTC support for this work;

AND FURTHER that the Board, having engaged in this work since 2017, anticipates sharing with the MOHLTC its experiences so that other regions may benefit and further anticipates providing to the Ministry its expert advice on public health functions and structures for the North East;

AND FURTHER that this motion be shared with the Premier of Ontario, the Minister of Health and Long-Term Care, the Chief Medical Officer of Health, the Association of Local Public Health Agencies, all Ontario Boards of Health and Porcupine Health Unit member municipalities.                

Carried

8. Resource Committee Report

a) Staff Changes

MOVED BY: Rock Whissell
SECONDED BY: George Pirie              

THAT the report of staff changes be received for information.

Carried

9. New Business

Northeast Public Health Board Chairs Meeting

Sue Perras provided an update with regard to the Northeast Public Health Board Chairs meeting which took place on May 23rd.

10. Receipt of Minutes for Information

Resource Committee Meeting

MOVED BY: Denis Clement
SECONDED BY: Marc Ringuette

THAT the minutes of the Resource Committee meeting held April 25, 2019 be received for information.

Carried

11. Date of Next Meeting and Adjournment

MOVED BY: Kristin Murray
SECONDED BY: Mickey Auger               

THAT the next meeting of the Board of Health for the Porcupine Health Unit be held on September 5, 2019 at 5:00 pm and that this meeting adjourn.

Carried