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Meeting of the Board of Health for the Porcupine Health Unit

Held on September 5, 2019, Timmins Office, Board Room

Present:

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

Staff:

  • Dr. Lianne Catton
  • Don West
  • Maria Cook
  • Lynn Leggett
  • 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: Denis Clement

Addition:  7) Program Committee Report
              c) Indigenous Cultural Competency Training
– Dr. Catton              

THAT the agenda for this meeting be approved, as amended.

Carried

3) Adoption of Minutes of Meeting

MOVED BY: Marc Ringuette
SECONDED BY: Mickey Auger             

THAT the minutes of the meeting of the Board of Health for the Porcupine Health Unit held June 19, 2019 be approved.

Carried

4) Business Arising from Minutes

None.

5) Correspondence

Dr. Lianne Catton spoke to the following correspondence:

City of Hamilton – Office of the Mayor

Re:  Public Health Services 

  • Copy of letter, dated June 14th, to Minister Christine Elliott, recommending that any restructuring or modernization of local Public Health take into account the following principles:

    • That it’s mandate to keep people and our communities healthy, prevent disease and reduce health inequities be maintained;
    • That its focus on the core functions of public health be continued;
    • That sufficient funding and human resources are ensured;
    • That the focus for public health services be maintained at the community level to best serve residents and lead strategic community partnerships with municipalities, school boards, health care organizations, community agencies and residents;
    • That there be local public health senior and medical leadership to provide advice on public health issues to municipal councils and participate in strategic community partnerships;
    • That local public health services be responsive and tailored to the health needs and priorities of each local community;
    • That representation of municipalities on any board of health be proportionate to both their population and to the size of the financial contribution of that municipality to the Regional Public Health Entity; and
    • That any transition be carried out with attention to good change management, and while ensuring ongoing service delivery.

Peterborough Public Health

Re:  Changes to Provincial Autism Supports 

  • Copy of letter, dated June 17th, to Minister Lisa MacLeod, supporting the Province’s plan to address the long waitlist, and to expand Ontario’s five autism diagnostic hubs, requesting that funding be provided towards the provision of evidence-based programs rather than directly to families, and that the amount should be based upon the child’s needs rather than their age.

Re:  Public Health Modernization 

  • Copy of letter, dated June 24th, to Councillor Carmen McGregor, alPHa Board President, thanking their Board for organizing and hosting the 2019 AGM, and as well, the adoption of their Board resolution, inquiring with regard to alPHa’s plan to implement the approved actions, and requesting to be copied/advised with regard to their follow-up, to the province, and that they provide a copy of their request of the Association of Municipalities of Ontario (AMO) and the City of Toronto, to establish a joint task force mandated to undertake establishing a set of principles that should guide any reorganization of public health in Ontario that include conducting public outreach to municipal, public health and other stakeholders to validate and strengthen the comprehensive set of principles to shape future reorganization; and meeting with provincial politicians and officials to provide a municipal and public health perspective on any proposed changes.

Re:  Support for Children Count Task Force Recommendations 

  • Copy of letter, dated June 25th, to Ministers Todd Smith, Stephen Lecce and Christine Elliott, supporting the recommendations of the Children Count Task Force, requesting that they consider implementing these recommendations, and advising that they welcome any opportunities to consult or engage in future actions that would support this work.

Re:  Funding Cancelled for Leave the Pack Behind 

  • Copy of letter, dated July 17th, to Minister Christine Elliott, expressing concern over their decision to cease funding for Leave the Pack Behind, noting that, working with Leave the Pack Behind staff at two of their post-secondary institutions has allowed them to engage hundreds of young adults and inspire dozens of quit attempts that otherwise would not have happened without partnerships and collaboration. They are urging the Ministry to reconsider the cancelation of this comprehensive and impactful program.

Haliburton, Kawartha, Pine Ridge District Health Unit

Re:  Health Promotion as a Core Function of Public Health 

  • Copy of letter, dated June 20th, to Minister Christine Elliott, endorsing recommendations made by Kingston, Frontenac, and Lennox & Addington Public Health, and supporting the mandate/function of health promotion and policy development as stated in the Ontario Public Health Standards: Requirements for Programs, Services and Accountability.

Regional Municipality of York

Re:  Position and Mandate for a Restructured York Region Public Health

  • Copy of letter, dated June 21st, to Sue Perras, PHU Board Chair, advising/sharing their Board’s position and mandate for a restructured York Region Board of Health together with their recommendations.

Association of Local Public Health Agencies (alPHa)

Re:  Update on Public Health Modernization

  • Copy of letters, dated June 21st and 28th, to Minister Christine Elliott, and copy of a letter dated July 12th to Dr. David Williams, with copies of resolutions, supporting a strong local public health system in Ontario that maintains a focus on the wellbeing of Ontario’s residents, increases efficiencies in service delivery, advances alignment with the health care system, enhances staff recruitment and retention, and improves public health promotion and protection.

Simcoe Muskoka District Health Unit

Re:  Public Health Modernization 

  • Copy of letter, dated June 27th, to Minister Christine Elliott, recommending the continued comprehensive mandate of public health as defined in the Ontario Public Health Standards (2018) and for gradual adjustments to the provincial-municipal cost-sharing of public health funding formula be phased in over 5 years, commencing in fiscal year 2021-22, and commending the decision of Premier Ford that provincial funding cuts for public health in the provincial budget will not go forward for the 2019 year, to allow for additional time for more comprehensive financial planning by health units and municipalities.

Windsor-Essex County Health Unit

Re:  Smoke-Free – Smoke/Vape Free Outdoor Spaces

  • Copy of letter, dated July 2nd, to Minister Christine Elliott advising of their Board’s resolution, encouraging municipalities to prohibit the smoking or vaping of any substance on all municipally owned outdoor sport and recreation properties, as well as parks, beaches, trails, playgrounds, at minimum, 9 m from entrances/exits of municipal buildings, transit shelters, and transit stops, and to update and adopt smoking by-laws to explicitly prohibit the use of cannabis in public spaces, including streets and sidewalks.

 Re: Immunization for School Children – Seamless Immunization Registry

  • Copy of letter, dated July 2nd, to Minister Christine Elliott, endorsing the position of the Council of Medical Officers of Health, in support of a seamless immunization registry whereby health care providers directly input immunization at the time of vaccine administration.

Leeds, Grenville & Lanark District Health Unit

Re:  Low Income Dental Program for Seniors

  • Copy of letter, dated July 4th, to Minister Christine Elliott, advising they are pleased with the provincial government’s decision to support a dental program for low income seniors and the decision to entrust local public health units with the responsibility to implement the program within each of their communities, noting that oral health has a major impact on overall health, with its link to chronic disease, and that this investment in dental care will also impact the Ministry’s priority to decrease hallway medicine.

Southwestern Public Health

Re:  Concerns about the future delivery of health promotion programs and services in Ontario by public health units

  • Copy of letter, dated July 8th, to Minister Christine Elliott, expressing concerns with regard to recent media reports regarding the Province’s position on the future delivery of health promotion related programs and services in Ontario, specifically that the MOHLTC will assume centralized lifestyle messages and that healthy public policy work is not where public health should invest its resources.

Township of Hornepayne

Re:  Letter of Support for Simcoe-Muskoka District Health Unit and Proposed Northeastern Boundaries 

  • Copy of letter, dated July 18th, to the Porcupine Health Unit, advising of their resolution in support of our Board’s letter, dated June 19th, to Minister Christine Elliott, supporting Simcoe-Muskoka District Health Unit’s proposal to remain intact and join with York Region Public Health to form a new regional Public Health entity on April 1st, 2020.

Re:  Northeast Public Health Transformation Initiative 

  • Copy of letter, dated July 19th, to the Porcupine Health Unit, advising of their resolution in support of our Board’s resolution #2019-44, dated June 19th, supporting the continued collaboration of the Boards of Health in Northeastern Ontario and ongoing MOHLTC support for this work.

Niagara Region – Office of the Regional Clerk

Re:  Resolution Respecting Proposed Provincial Restructuring of Local Public Health Agencies 

  • Copy of their resolution # PHD-C 06-2019, dated July 19th, to all Boards of Health, thanking the Premier and Minister of Health for responding to feedback by municipalities to delay funding changes to Public Health and other municipally operated health and social services, and that the Regional Chair be directed to write a letter to the MOHLTC and Minister of Municipal Affairs and Housing to request that any restructuring or modernization of local public health ensure adherence to the principles, as noted on page 3 of the resolution.

Kingston, Frontenac and Lennox & Addington Public Health (KFL&A)

Re: Key Principles for Restructuring Local Public Health in Ontario

  • Copy of letter, dated August 6th, to Minister Christine Elliott, advising of their Board’s resolution, regarding key principles and decision-making criteria that should be used to guide the restructuring process at the provincial level, and that KFL&A Public Health looks forward to the opportunity to directly work with the Ministry, on public health reorganization, in the promised consultation process.

6) Medical Officer of Health Report

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

Opioids

The Porcupine Health Unit (PHU) held an event recognizing International Overdose Prevention day on Friday, August 31st.  Timmins Mayor George Pirie read the proclamation, Dr. Catton spoke to highlight the tragedies seen with overdoses in our communities and the need to increase awareness, advocacy, and address the stigma to prevent such tragic outcomes.

Kristen Murray, Board of Heath (BOH) representative and City Councillor, Noella Rinaldo, City Councillor, Timmins Police Services (TPS), Timmins Fire Department (TFD), Emergency Medical Services (EMS), Living Space, Timmins Native Friendship Centre (TNFC, and other community partners involved in the Timmins and Area Drug Strategy (TADS) were present. Most importantly, families and friends who have lost a loved one to overdose also attended as sincere condolences were offered and the flags was lowered to half mast for a moment of silence. There is much work to be done and the PHU remains dedicated to the prevention of substance use and overdose.

While this day was for overdoses from all substances, the PHU continues to be dedicated to addressing the increasing opioid crisis in all our communities.

This requires a comprehensive population health approach with valued community partners, which includes prevention of substance use, promotion of mental wellness, community supports and policies, harm reduction and overdose prevention. Dr. Catton participated in an Association of Municipalities Ontario (AMO) Working Group looking at the Opioid Overdose Crises in Ontario and final paper with recommendations should be coming out any day.

The PHU has initiated the Timmins and Drug Strategy Steering Committee to develop a comprehensive drug strategy based on best practices and evidence, for the entire PHU area.

The Surveillance and Emergency Response Task Force has been very active this year, finalizing the plan. Just this week, the TPS confirmed lab results of carfentanil form drug seizure in July. Alerts were sent to social media outlets, commented with TPS on a media release, posers to partners. This is something we have suspected, and those using drugs have said for some time now. But laboratory confirmation is an important opportunity to increase the conversation to encourage parents to talk to kids about the risks, to educate the community on overdose prevention including increased access to naloxone.

NE Public Health Transformation Initiative

Most activities have been on hold over August while waiting for further direction from the Ministry. We expect to hear more about the consultation timelines and process regarding public health transformation, which has been postponed over the summer.

Resource Implications

We continue to address local needs, strategic plan priorities and accountability for the Ontario Public Health Standards to the Ministry. Earlier in the year several projects and positions were put on hold due to expected reduction in resources, with the changes announced in April. Dr. Catton met with program managers to explore opportunities to capitalize on budget available for the remainder of 2019, once the cost-sharing formula changes were delayed until 2020. This included thinking of innovative and alternative options such as short term and project specific positions.

PHU 75th Anniversary

PHU 75th anniversary celebrations are being planned. This will include open houses in each of our communities to welcome valued community partners; honour present and past employees, and their tremendous dedication to local connections in supporting healthy communities. This is an important opportunity to continue to promote public health and the Porcupine Health Unit across the district, as identified in our strategic plan.

Ontario Health Team (OHT)

The PHU continues to be involved in the next stages of the local OHT application process. We expect further direction regarding timelines this fall and expect to be looking at a December submission for the Timmins group. We will also be reaching out to other communities involved in the process. While we plan to maintain an upstream focus and role, public health offers invaluable expertise in collecting sharing and translating data as well as the population health perspective. Demonstrating the linkages with the work of public health and current government priorities of reducing hallway medicine, and  contributing to a more integrated health system overall during this time of health system transformation is another benefit of this work.

Primary Care Meetings

Dr. Catton has been meeting with primary care partners in to review opportunities to work towards shared goals and reduce duplication. With smaller communities and fewer partners at the table, the PHU contributes to addressing important gaps for our unique northern population. Balancing filling gaps and ensuring important upstream work is being done in terms of built environment, policy, and health equity is central to these ongoing relationships.

Infection Prevention and Control – North Eastern Ontario Conference (IPAC NEO)

Dr. Catton will be presenting at this year’s IPAC NEO Fall Conference in Timmins, on September 18th and 19th, with hospital, public health, long-term care partners from across the north east present. The topic will be Tuberculosis, to increase understanding of the public health approach to this extremely interesting public health disease, but also the tremendous social stigma and historical trauma, which can be often overlooked.

MD Continuing Medical Education (CME) Day

Dr. Catton will also participate and speak at the Timmins Local Education Group (LEG) CME day on Friday, October 4th, 2019, for local physicians and health care providers. Again, the topic will be tuberculosis, not only reviewing clinical diagnosis, testing and treatment; but also the important public health role involved. Again, the significant stigma, social implications, and historical trauma associated with tuberculosis for our local context will be discussed. 

Indigenous Engagement Specialist

The PHU has been planning for some time to have a position dedicated to further develop and implement the PHU Reconciliation Framework. We are pleased to have secured the funding to support this important role on an ongoing basis. This position will be an integral part of the Foundations Team, working as both a resource within the health unit, and with further developing meaningful relationships and an engagement strategy with Indigenous communities, partners and people. The Indigenous Engagement Specialist position will be posted and hopefully filled as soon as possible.

Indigenous Cultural Mindfulness Training

As part of the PHU Reconciliation Framework, almost all PHU staff have completed, or are in process of completing, a course on Indigenous Cultural Mindfulness - the San'yas Indigenous Cultural Safety Online Training Program. It is an excellent program and we are pleased to offer sessions for the BOH. The program takes approximately 8-10 hours, and once a session is confirmed there are 8 weeks to complete it. An information document was provided, and BOH members are encouraged to contact Dr. Catton should they wish to be registered, or if any questions. This is an important step to addressing the Truth and Reconciliation Commission of Canada Calls to Action; the PHU strategic plan priority 2; the Ontario Public Health Standards Relationship with Indigenous Communities Guideline (2018); and in developing meaningful and respectful relationships with Indigenous communities, partners, and people for improved health for all.

7) Program Committee Report

a) Strategic Plan Status Report January – June 2019 – Dr. Catton

Mickey Auger thanked Dr. Catton, for providing a status report, regarding the Porcupine Health Unit’s Strategic Plan, from January to June 2019.

b) Public Health Transformation Initiative Update – Dr. Catton

Mickey Auger thanked Dr. Catton for providing an update with regard to Public Health Transformation Initiative.

c) Indigenous Cultural Mindfulness Training – Dr. Catton

Mickey Auger thanked Dr. Catton for providing information regarding Indigenous Cultural Mindfulness Training.

8) Resource Committee Report

a) Public Health Funding Changes – D. West

Pat Britton thanked Don West for providing a presentation/update with regard to Public Health Funding changes.

b) Staff Changes

MOVED BY: Denis Clement
SECONDED BY: Marc Ringuette          

THAT the report of staff changes be received for information.

Carried

c) Revenues and Expenditures – 6 Months Ended June 30, 2019

MOVED BY: Rock Whissell
SECONDED BY: George Pirie

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

Carried

d) ONA Memorandum of Settlement

MOVED BY: Marc Ringuette
SECONDED BY: Rock Whissell

THAT the Board of Health for the Porcupine Health Unit approve the Memorandum of Settlement between the Porcupine Health Unit and the Ontario Nurses’ Association dated June 21, 2019, as circulated.

Carried

9) New Business

None.

10) Receipt of Minutes for Information

a) Program Committee Meeting Minutes

MOVED BY: Kristin Murray
SECONDED BY: Drago Stefanic          

THAT the minutes of the Program Committee meeting held May 23, 2019 be received for information.

Carried

b) Resource Committee Meeting

MOVED BY: George Pirie
SECONDED BY: Denis Clement

THAT the minutes of the Resource Committee meeting held May 23, 2019 be received for information.

Carried

c) Management Committee Meeting

MOVED BY: Drago Stefanic
SECONDED BY: Kristin Murray

THAT the minutes of the Management Committee meeting held May 15, 2019 be received for information.

Carried

11) Date of Next Meeting and Adjournment

MOVED BY: Pat Britton
SECONDED BY: Cleo Charlebois             

THAT the next meeting of the Board of Health for the Porcupine Health Unit be held on November 29, 2019 at 2:00 pm and that this meeting adjourn.

Carried