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Meeting of the Board of Health for the Porcupine Health Unit

Held on November 29, 2019, Timmins Office, Board Room

Present:

  • Sue Perras
  • Drago Stefanic            
  • Mickey Auger                      
  • Cleo Charlebois
  • Marc Dupuis
  • Sebastien Lessard
  • Kristin Murray
  • Denis Clement
  • George Pirie
  • Marc Ringuette
  • Rock Whissell

Staff:

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

Recorder:  Maria Cook


1. Call to Order

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

2. Approval of Agenda

MOVED BY: Mickey Auger
SECONDED BY: Drago Stefanic    

THAT the agenda for this meeting be approved.

Carried

3) Adoption of Minutes of Meeting

MOVED BY: Cleo Charlebois
SECONDED BY: Kristen Murray           

THAT the minutes of the meeting of the Board of Health for the Porcupine Health Unit held September 5, 2019 be approved.

Carried

4) Business Arising from Minutes

None.

5) Correspondence

Dr. Lianne Catton spoke to the following correspondence:

Southwestern Public Health

Re:  Expanding Alcohol Retail Outlets

  • Copy of letter, dated September 11th, to Minister Christine Elliot, requesting the Ontario government consider the impact of increasing the number of retail outlets on the health and safety of Ontarians before moving forward with more legislative changes.

Simcoe Muskoka District Health Unit

Re:  Vaping Display and Promotion 

  • Copy of letter, dated September 18th, to Minister Ginette Petitpas Taylor, and Minister Christine Elliott, requesting bans on the display and promotion of vapour products, in order to prevent further increase of vaping among youth and non-smokers.
  • Copy of letter, dated October 25th, to Minister Christine Elliot, requesting to ban flavoured e-cigarettes and recommending the further development of a renewed comprehensive tobacco control strategy towards the tobacco endgame goal of achieving a smoking rate of less than 5% by 2035.

Office of the County Warden

Re:  Provincial Plans for the Modernization of Public Health Service Delivery 

  • Copy of letter, dated September 18th, to Premier Doug Ford and Minister Christine Elliott, expressing their gratitude in listening and responding to feedback by municipalities to delay the in-year 2019-2020 funding changes to public health and social services.

Haliburton, Kawartha, Pine Ridge District Health Unit

Re:  Immunization for School Children – Seamless Immunization Registry 

  • Copy of letter, dated September 19th, to Minister Christine Elliott, supporting York Region’s Regional Council’s recommendations, endorsing the position of the Council of Ontario Medical Officers of Health in support of a seamless immunization registry whereby health care providers directly input immunization information at the time of vaccine administration.

Windsor-Essex County Health Unit

Re:  Consumption and Treatment Services Application

  • Copy of letter, dated September 27th, to Minister Christine Elliott, supporting the submission of a Consumption and Treatment Services Application for the City of Windsor, including the submission of an Exemption for Medical Purposes under the controlled Drugs and Substances Act for Activities at a Supervised Consumption Site Application required by Health Canada, and an additional comprehensive community consultation be conducted by the Windsor-Essex County Health Unit to determine a suitable and accessible location for a CTS in the City of Windsor.

Re:  Funding Cancelled for Leave the Pack Behind

  • Copy of letter, dated September 27th, to Minister Christine Elliott, supporting correspondence from Peterborough Public Health, expressing concern regarding the Provincial Government’s decision to cease funding for Leave the Pack Behind.

Re:  Public Mental Health – Parity of Esteem Position Statement

  • Copy of letter, dated September 27th, to Minister Christine Elliott, supporting Public Health Sudbury and Districts resolution #15-19, adopting the Public Mental Health – Parity of Esteem Position Statement. This Position Statement asserts that public health equally values mental and physical health.

Re:  Changes to Provincial Autism Supports

  • Copy of letter, dated September 27th, to Minister Todd Smith, Minister of Children, Community and Social Services, supporting correspondence from Peterborough Public Health regarding the planned changes to address long waiting lists and to expand Ontario’s five autism diagnostic hubs. Windsor-Essex also shares Peterborough Public Health’s concerns that through these changes, funding will be provided directly to families rather than towards a provision of evidence-based programs; and that amounts should be based on a child’s need and not their age.

Re:  Council of Ontario Medical Officers of Health (COMOH) – Alcohol Choice & Convenience

  • Copy of letter, dated September 27th, to Minister Rod Phillips, Minister of Finance, supporting a letter from Dr. Chris Mackie, COMOH Chair, opposing expanding alcohol retail sales in Ontario.                                     

Re:  Harms of Vaping and the Next Steps Regulation

  • Copy of letter, dated October 21st, to Minister Christine Elliott, calling for amendments to the Smoke-Free Ontario Act restricting the promotion and marketing of vaping products, the sale of flavoured vaping products and asking for all regulations and protections for tobacco such as the Automatic Prohibition (AP) process be applied to vaping retailers.

Re:  Restrictions on Display and Promotion of Vaping Products and the Ban of Flavoured E-Cigarettes

  • Copy of letter, dated October 22nd, to Minister Ginette Petitpas Taylor and Minister Christine Elliott, supporting correspondence from Simcoe Muskoka District Health Unit, calling for stringent eestrictions on the display and promotion of vaping products and to ban flavoured e-cigarettes to help prevent the further uptake of vaping and potential risk of smoking commencement by youth.

Re:  Removal of Regulation 268 of the Smoke-Free Ontario Act, 2017

  • Copy of letter, dated October 22nd, to Minister Christine Elliott, supporting correspondence from Kingston, Frontenac and Lennox & Addington Public Health, urging the Provincial Government to immediately remove Regulation 268 of the SFOA, 2017, prohibiting retailers from promoting vaping products and that the promotion and display of vape products be subject to the same prohibition as tobacco products.

Peterborough Public Health

Re:  Addressing the Opioid Emergency in Ontario – Recommendations from the Association of Municipalities of Ontario (AMO)

  • Copy of letter, dated October 1st, to Minister Christine Elliott, advising of their Board’s support and endorsement of AMO’s recommendations.

Kingston, Frontenac and Lennox & Addington Public Health

Re:  Vapour Products Display and Promotion

  • Copy of letter, dated October 11th, to Minister Christine Elliot, urging the Provincial Government to immediately remove Regulation 268 of the Smoke-Free Ontario Act, 2017, so that retailers will not be allowed to promote vaping products, and that the promotion and display of vape products are subject to the same prohibition as tobacco products.

Re:  Municipal Alcohol Policies and Municipal Policy Options to Mitigate Alcohol Harms

  • Copy of letter, dated October 18th, to Mayor Bryan Paterson and City Council, Kingston, ON, from their Board of Health, strongly advising municipalities to continue to prohibit alcohol consumption in public spaces and strengthen or develop municipal alcohol policies that balance the responsible provision and use of alcohol against the need to reduce alcohol-related risk and harm.

Public Health Sudbury and Districts

Re:  North East Public Health Transformation

  • Copy of letter, dated October 18th, to Jim Pine, Special Advisor, Public Health Modernization, congratulating him on his appointment and extending an invitation to meet with the leadership of the NE Boards of Health, to share with him, the work of the NE Transformation Initiative and engage further in developing a local public health system that best meets the public health needs for the people of the North East.

The Regional Municipality of Durham

Re:  Opioid Overdose Emergency

  • Copy of letter, dated October 24th, to Prime Minister Trudeau, requesting that the Government of Canada and Ontario recognize, acknowledge and declare a national health epidemic in respect to the opioid overdose emergency across Canada; that AMO’s recommendations with respect to Ontario’s opioid overdose emergency be endorsed; that the Government of Ontario be urged to continue funding the important work of public health units to help address the current opioid crisis; and that the Government of Canada and Ontario be advised that the opioid emergency is not limited to major urban centres and that federal and provincial representatives work directly with the prevention and addiction services, affordable social and supportive housing to address the crisis in our communities.

Timiskaming Health Unit        

Re:  Public Health Modernization – North East Public Health Transformation Initiative

  • Copy of motion, dated October 23rd, from the Board of Health for Timiskaming Health Unit, supporting the request of the Chairs of the five Boards of Health in the North East, namely that the Ministry of Health hold public health consultation sessions that are separate and distinct from the emergency health services consultation sessions, and are held in each North East Board of Health catchment area; and that the July 2019 submission to Deputy Helen Angus and Chief Medical Officer of Health Dr. David Williams, Transforming Public Health for the People of Northeastern Ontario, be shared with Mr. Jim Pine and ADM Blair; and that Mr. Pine be invited to meet with the leadership of the five North East Boards of Health, collectively, to share the work of the North East Public Health Transformation Initiative and engage further on developing a local public health system that best meets the public health needs of the people of the North East.

Grey Bruce Health Unit

Re:  Funding for Leave the Pack Behind

  • Copy of letter, dated October 31st, to Minister Christine Elliott, supporting correspondence from Peterborough Public Health, with respect to funding for Leave the Pack Behind.

Re:  National School Food Program

  • Copy of letter, dated October 31st, to Prime Minister Trudeau, supporting correspondence from Peterborough Public Health, with respect to moving forward with implementing a cost-shared national school food program.

Re:  Display and Promotion of Vaping Products

  • Copy of letter, dated October 31st, to Minister Christine Elliott, supporting correspondence from Simcoe Muskoka District Health Unit, regarding implementing restrictions on the display and promotion of vaping products.

Re:  Promotion and display of Vapour Products in Ontario

  • Copy of letter, dated October 31st, to Minister Christine Elliott, supporting correspondence from alPHa, regarding implementing restrictions of the display and promotion of vaping products.

Huron County Health Unit

Re:  Amendment to SFOA, 2017

Copy of letter, dated November 7th, to Minister Christine Elliott, recommending further investigation and regulations that would ban flavoured e-cigarettes, in addition to the significant amendment to the display and promotion regulation.

6) Medical Officer of Health Report

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

Ontario Health Team (OHT)

Dr. Catton is participating in the development of the next stage of the Ontario Health Team (OHT) application led by the Timmins and District Hospital (TADH) on behalf of the Porcupine Health Unit (PHU). We continue to support the development with data, the population health perspective and a health equity lens. The OHT is required to enhance integration of local health services around specific patient populations. At this time, it remains very patient care driven and as such, public health is supporting the team with upstream, population-based perspectives. Currently, the team is planning to concentrate on seniors at home, promoting healthy aging and preventing hospital admissions and Alternate Level of Care (ALC) patients. PHU initiatives such as “Stay on Your Feet” can further support this goal. There continues to be discussions between OHT’s in the region (Timmins includes MICs currently), such as Timiskaming, Chapleau, Kapuskasing and Hearst. The PHU has reached out to Kapuskasing and Hearst OHT’s to offer support as well.

Primary Care Network

Dr. Catton remains involved in the Timmins primary care network, initially started to address gaps in healthcare, to increase PHU capacity for upstream approaches. This has included ensuring primary care for unattached newborns at Timmins and District Hospital (TADH), and discussing tobacco cessation, dietitian services, sexual health clinics, as well as health services for the homeless at Living Space and supporting communities evacuated to Timmins.

Infection Prevention and Control Canada Northeastern Ontario (IPAC-NEO) Conference

Dr. Catton presented at the IPAC-NEO conference in September, organized from the group including PHU team members. Representatives from public health, hospitals, long-term care facilities and partners were present. The presentation on Tuberculosis (TB), the public health role, and the important social and historical context that necessitates a health equity approach was very well received. The group was encouraged to engage further within their institution to asses TB policies and increase awareness of the broader context of TB.

Timmins Physician Local Education Group (LEG)

Dr. Catton presented at the local Physician Education Day along with other physicians from across the Northeast. Over 50 physicians, medical students and residents and nurse practitioners attended. Topic of presentation was TB overview, the public health role, and important social and historical considerations within the local context.

Timmins and Area Drug Strategy (TADS) Committee

The TADS Steering Committee led by the PHU met last week to review the situational assessment. The group renewed their commitment to the development of a comprehensive strategy addressing prevention, harm reduction, treatment, enforcement and emergency management. This will include all substances, including alcohol use which remains quite high in the PHU region. The group agreed that an upstream focus is critical, and prevention of substance use, especially supporting children and youth will be important. There is a focus on continued outreach to other PHU communities to expand reach and local adaptation with local partners.

Timmins Opioid Early Warning and Response Task Force

The Timmins Opioid Early Warning and Response Task Force final plan was distributed to the TADS Steering Committee for review and feedback. The plan has been implemented successfully but unfortunately utilized too often during the past year. Local data from Emergency Management Services (EMS), Police services and emergency departments is reported weekly through a PHU online portal, as well as from other community partners through an opioid emergency response email. This enables timely assessment and response as needed in an attempt to reduce harms and deaths in our communities. Any concerns or alerts are shared in all PHU communities, and the responses have included informing pharmacies, hospitals, health care providers, social service sector and addiction services. In addition to the public awareness initiatives, enhanced outreach and ensuring increased access to naloxone, are key components of the response plan.

Population Health Status Report

After holding off on some staffing and other decisions due to the announced budget changes earlier this year, we looked for opportunities to advance important initiatives with the remaining 2019 budget. One of these opportunities was to increase our data collection and analysis to complete the PHU Population Health Status Report. This work is required as per the standards, and is important in guiding PHU strategies, informing public health priorities, and supporting the work of key community partners.

PHU 75th Anniversary

As the PHU celebrates its 75th Anniversary, open houses were held in each of the 9 offices. Dr. Catton thanked Board of Health members who took the time to join us to acknowledge our great PHU team. We welcomed community partners, municipal leaders, former staff and BOH members, to recognize the incredible work of the PHU, over the years. Dr. Catton was pleased to connect with PHU staff and partners in each branch office and is committed to spending more time in the communities going forward.

Community Safety and Well-Being Plan (CSWBP)

The PHU continues to be involved wit the development of CSWBP in several communities. Hornepayne was one of the first municipalities to engage the PHU and the nurse in Hornepayne has been very involved.

Dr. Catton has been asked to sit on the Advisory Committee for the City of Timmins CSWBP development. Population health perspective, a health equity lens and a comprehensive understanding of health and well-being of our communities are strengths the PHU brings to the tables. The PHU is committed to working with all of our communities on this important initiative.

PHU Staff Development

The ongoing support and development of all PHU team members continues to be a priority, especially during times of change and uncertainty. Dr. Catton continues to send regular staff emails with updates on Public Health Modernization, encouraging questions and feedback.

Indigenous cultural competency online training has been completed by almost all PHU staff and management. Ownership, Control, Access, and Possession (OCAP) training is being provided to program managers and coordinators to ensure appropriate considerations are understood and applied with any data collection, sharing and reporting practices of the PHU. This is another important component of the PHU Reconciliation Framework.

We have organized a Risk Communication session here at the PHU, for all program areas on December 4th. Dr. Ray Copes, Chief of Environmental and Occupational Health at Public Health Ontario (PHO), and two other team members are coming for an interactive session on risk communication. We have also invited staff from other Northeast health units to participate in-person or via webinar. This is an excellent opportunity for skill development of the PHU team and a good example of increasing capacity.

The PHU Annual All Staff Conference Day for team building and ongoing professional developed is planned for December 6th. All PHU branch offices close, staff travels to Timmins for an interactive conference. The Harm Reduction Services in Timmins remain open, and as always, emergency and on-call response is available. This year the theme is celebrating the 75th Anniversary of the PHU, and we have a guest speaker to engage the team on Change Management.

Public Health Modernization Consultation

At the recent Association of Local Public Health Agencies (alPHa) conference, Dr. Catton and BOH attendees were pleased to hear that the consultation is a ‘reset’. It was confirmed that while there are no predetermined outcomes, status quo is not an option as they look to strengthen the Public Health System. Hearing this from Mr. Jim Pine, Special Advisor, Public Health Modernization; Alison Blair, Executive Lead for Public Health Modernization; and Dr. David Williams, Chief Medical Officer of Health was very positive and welcome news.

The discussion paper: Public Health Modernization was shared and reviewed with all staff and presented to the BOH program committee, with plans for further engagement to develop the PHU response. This is expected to be the focus of in person consultation sessions occurring across the Province starting this week. Emergency Health Services (EHS) and Public Health (PH) consultation will occur at the same time as they involve municipalities, they will be separate consultations. We hope to have one in Timmins and have expressed that with the Ministry and Mr. Jim Pine, however no details have been confirmed for locations or dates for the PHU consultation.

This consultation is an important opportunity to explore opportunities to address the challenges in the discussion paper within the context of the PHU as the largest geographical health unit with large Francophone and Indigenous populations. Maintaining strong local connections and a voice for all unique PHU communities remains a priority.

7) Program Committee Report

a) Public Health Overview and Modernization

Mickey Auger thanked Dr. Catton for providing a Public Health Overview and Modernization presentation.

b) Risk Assessment Process and Management

Mickey Auger thanked Dr. Catton for providing an update/presentation regarding risk assessment process and management, noting that reportable risks were communicated to the Ministry, as required.

c) Letter of Support – Vaping Products

MOVED BY:  Marc Dupuis
SECONDED BY:  Kristin Murray

THAT the Board of Health for the Porcupine Health Unit directs that a letter be drafted, to support the regulatory amendment to the Smoke Free Ontario Act, 2017 (SFOA 2017), prohibiting the promotion of vapour products; and request for consideration of further restrictions to ban flavoured e-cigarettes.

Carried

8) Resource Committee Report

a) Staff Changes

MOVED BY:  Marc Ringuette
SECONDED BY:  George Pirie

THAT the report of staff changes be received for information.

Carried

b) Revenues and Expenditures – 9 months ended September 30, 2019

MOVED BY:  Rock Whissell
SECONDED BY:  George Pirie

THAT the report of revenues and expenditures for the Porcupine Health Unit for the nine months ended September 30, 2019 be approved.

Carried

c) 2020 Budget and Per Capita Rate

MOVED BY:  Denis Clement
SECONDED BY:  Marc Ringuette

THAT the Board of Health for the Porcupine Health Unit establish its net budget for the year 2020 at $15,872,870.  This budget covers both cost shared and 100% funded programs.    

Carried

MOVED BY:  George Pirie
SECONDED BY:  Drago Stefanic

WHEREAS, the Ministry of Health is shifting a greater portion of public health funding from the Province, to municipalities, in 2020; and

WHEREAS, they will limit the financial impact facing municipalities to a 10% increase in 2020, through the provision of mitigation funding;

NOW THEREFORE BE IT RESOLVED THAT, the Board of Health for the Porcupine Health Unit establish its per capita rate at $43.97, based on a population of 61,472 for the purposes of assessing its obligated municipalities for the year 2020.         

AND FURTHER THAT, 100% of the 2020 increase be subsidized through Health Unit reserve funds.

Carried

9) New Business

a) 2020 Schedule of Board Meeting Dates

MOVED BY:  Drago Stefanic
SECONDED BY:  Marc Ringuette

THAT the Board of Health for the Porcupine Health Unit approve the 2020 schedule of Board meeting dates, as circulated.

Carried

10) Receipt of Minutes for Information

a) Program Committee Meeting Minutes

MOVED BY:  Cleo Charlebois
SECONDED BY:  Kristin Murray

THAT the minutes of the Program Committee meeting held June 19, 2019 be received for information.

Carried

b) Resource Committee Meeting Minutes

MOVED BY:  Marc Ringuette
SECONDED BY:  George Pirie   

THAT the minutes of the Resource Committee meeting held June 19, 2019 be received for information.

Carried

c) Management Committee Meeting Minutes

MOVED BY:  Denis Clement
SECONDED BY:  Sebastien Lessard    

THAT the minutes of the Management Committee meetings held August 27 and September 16, 2019, be received for information.

Carried

11) Date of Next Meeting and Adjournment

MOVED BY:  Marc Ringuette
SECONDED BY:  Marc Dupuis        

THAT the next meeting of the Board of Health for the Porcupine Health Unit be held on January 23, 2020 at 5:00 pm and that this meeting adjourn.

Carried