The land of which we are gathered is here today's special territory for reinforce nations, signatory to the Robinson Treaty of 1850, and the broader health unit also includes private treaty three.
This is a home item, the Snobby, who have prepared for it since immemorial. I also, I also know as a history of countries in the Meat, he have had three of this area.
Okay, so what happens? I'm going to call it the sheet here in this sub people online
and some people want to so we know
Grat Arnold,
can't see her
Cindy's here, Casey's here. Jim Moffitt is commenting the board microphone is on mute
All is here,
Jim is here. Jim Moffitt is on
Yep, okay
I'm going to pick up
I don't necessarily
want to dismiss this here. Mark T. Barrett. I'm here.
Okay, thank you.
Christine Thompson is here. Todd Wheeler is here. I think that's it.
If you do need declarations with a conflict interest,
but Mr. McPherson is taken by just Thompson,
the gender be approved,
where the regular gender for the Board of Health
many meeting, we held a membership thing be approved.
Any opposed?
We're going to go that one again, that was something that we decided on before, it's just
too long in Colorado and individually, so we're just asking everybody opposed to the
resolution.
That way.
Okay, saying that.
Okay, we don't have an information session today.
Okay, move by Christine.
Second, when Mr. McPherson, the reminisce of the previous meeting,
I was done.
Fairfax, sorry, February 15.
With the regular report.
You approve?
Any opposed?
Question for today.
The decisions are the Board.
I think we're going
to need to 23, based on your request.
I'm going to review the resolution.
Maybe we'd better go ahead and speak with them.
I believe Mr.
I don't have a strategy to see the results.
Okay, so we should...
Okay, so what we're going to do then is we have a request for base money increase and we recommend a 5% increase and we're going to be spending amount to be approved and submitted to the Ministry of Health as far as the 2023 annual service budget.
Submission for a thundity district health unit and Mr. Dill has a presentation.
I do thank you. So through the chair.
I'm going to walk to a presentation here.
Okay, so this presentation is really just intended to give you a general overview of our annual service funding budget submission to the Ministry of Health for 2023.
Some of this will be a refresher from the orientation session in January.
I'll walk through the process and then we discuss the request that administration is currently recommending the included.
So our annual service plan and budget submissions, so this is quite an extensive document that's required to be submitted to the Ministry, no later than April 3rd, 2023 this year.
Usually it's due March 1st if it due to timing of the Ministry providing the templates they've given us a month's extension.
This document is one of the key elements of the accountability framework that it falls under the organizational requirements of the Ontario Public Health Standards.
So the purpose of this document is normally to describe the complete picture of programs and services being delivered by the Health Unit.
It demonstrates that programs and services align with the priorities of our communities and it demonstrates accountability for planning and use of the funding by a program.
So for the actual contents, this slide just gives you the sections and the components that we are that are required.
So we do have to do a community assessment, which includes local population health issues, priority populations.
Program plans including summary details on community needs and priorities, key partners,
stakeholders, programs and services that the Board of Health plans to deliver under each standard and public health interventions within each program.
And then of course the budget submission for each program is included in here.
We do have the opportunity to ask for one time funding request, and we provide information on the Board of Health Membership of Fortunatelyment of Costs in a Certification Section.
So our annual service funded budget submission for programming is directly linked to the budget that we present to the Board in November of every year.
But in addition to the base budget, there is also an opportunity to request additional funding from the Ministry.
So, when we're considering the request that we bring forward here, we always look at, as
administration, we look at the program pressures that we are currently facing, where we
feel additional funding with assist us in meeting the updated standards, while continuing
to fit within the guidelines provided by the Ministry.
So, to date, the Ministry has not given us guidance on based funding requests.
In the past, they provided specific instructions that we were allowed to ask for five requests.
Some years, it was made clear that there would be no base funding available, and other years
they've told us that we were going to get a 1%.
So we're still waiting for that.
We have, however, been told verbally, that the province does intend to reinvest the Ontario
Senior's dental care, previous capital allotments, into the operating budget.
So we do know that there will be potential for some increases in that area.
The funding direction that we've been given, again, the change to cost sharing arrangements
still remains in place, and they have guaranteed the mitigation funding for this year.
So I do always like to highlight that to you.
So for these funding, again, they haven't given us the guidance on the base funding increase.
In past years, we have put in specific increases, like we'll put in a request to a directly address
major increases. We've done programming requests for a street outreach
positions. The smoke free Ontario act legislation changes and some funding we had
asked for around the vision program. This year what we are recommending is putting
in a 5% base funding increase. Now that amount is consistent with the
increase to the municipal levy so there will not be an additional impact to the
municipalities at this point, we would be asking the province to match what the municipalities
have contributed as a percentage wise, so that would amount to $481,000, and that would
bring our total base budget, potentially, to $10,115,000 approximately.
I will note that, obviously, we're going to put this forward, we don't have any approval
from the Ministry for this, our budget that we presented to the board was without this request.
We have identified cost-saving measures, we have identified efficiencies to make up for that,
but if we were to get the 5% from the ministry, we would then bring information back to the board
on how we would use that money and how it would be applied in our budget.
The Ontario Seniors Dental Care Program, so this is the program that provides comprehensive dental care
to eligible low income seniors to help reduce unnecessary trips to the hospital,
Product chronic disease and increase quality of life for seniors, this is another 100%
provincially funded program, so any increase to this budget does not impact the municipal
levee. I already noted that we do know that they plan to re-embeve and have pulled dollars
into operating, so there is opportunity here, and I would note that our health unit in particular
is anticipating high demand for this program. We've also noted through discussions with other health
units and that the original operating budget we had wouldn't be sufficient just given the increased
rates from dentists along with some specialty services including denture provision.
So we are looking at the request in this one is actually for 494 or 500 and we can there's
a memo that's associated with that but it is really to support the dentists fees and avoid
putting people on weight less for that program.
Our one-time funding request, so this year, the Ministry has applied a limit of eight one-time funding requests, and they have provided specific categories.
So the categories that they provided that are listed on this screen, we have the COVID-19 extraordinary costs, our COVID-19 vaccine program.
They have a capital bucket that is up to a million dollar capital projects, and they have other requirements that must be completed before March 31,
of 2024 and it has to extend the life or improve the capital assets.
We've got the needle serene program, vaccine refrigerators, the PHI practice come and then there is one called extraordinary cost,
which is anything over and above our approved budget.
So a lot of what health units put in outside of the very specific defined ones fall under extraordinary cost.
We've used that for outbreaks, as an example in the past.
And then category for smoke free Ontario enforcement tablets,
we will not be asking for that, but I do list it on the slide for you.
So, and just to note that everything that we put in this one time funding request
are 100% funded by the Ministry.
And with the exception of COVID and COVID-19 vaccine programs,
These are all April 1st, 2023 to March 31st, 2024 programs that would be going on, so we do have time depending on when we get the approval to spend some of that money.
So I'll now go through each one of our requests and you will have a report associated with each of that.
And then once I'm done now, we can go back to the regular agenda, walk through each report, and we have a lot of members of management here and senior leadership to answer any questions you have.
So the first point I want to talk about is the roof and flashing repairs.
This is a report to, we're requesting that this be submitted to replace the shingles
and replace the flashing around the skylights.
The estimate of this time is $320,000.
So in 2022, we did a significant project for the Windows Insiding
and the contractors and subsequent we had architects and engineers here looking
at it to determine that this project should also be completed.
It's a significant capital project, but it is one that's deemed necessary to us from
a risk and financial perspective.
We have reported this to the previous board through the facility reports for several years,
noting that it would be that it wasn't upcoming need.
So with this report, we are also requesting this as a little bit different than the other reports
that we move to the tender process immediately, so this project is required to do to the nature
of work and the timing, it needs to be completed before winter. So we are asking the board
to approve that we go to tender. Once we received the tender back, we would then come back
to the board to discuss next steps on that. But it is administration's intention at this time
to carry forward with this project, depending on the results of the tender, in advance
of the ministry funding because we don't know when the ministry announcement will come for us.
So just slide the COVID-19 extraordinary and COVID vaccine budgets are once again a significant
portion of our annual request, provincial direction, along with the local situation, because
significantly changed the budgets that would be required.
The estimated amounts on this slide are what we know right now and are planning to be prepared
in the event that a surge occurs and we need to mobilize more staff.
But these are specifically extraordinary costs over and above the Board of Health's existing funding for January 1st to December 31st.
It's associated with monitoring detecting and containing COVID-19 and then on the vaccine side obviously delivering the vaccine program for the province.
We do know that these costs are an estimate and are subject to change. It does kind of assume steady state and no new major variants at this time.
Similar to the previous three years with the Ministry, if additional funding is required over and above this, it would be expected that the province would continue to provide 100% funding.
We cover this, and we follow the ministry directives in both of these areas for what the goal of the health unit is.
The next one will talk about is the needle insurance program, this one is a bit smaller, so the $25,000.
So this is 100% funding to augment the superior point harm reduction program ability to deliver this program.
Superior Appoints is generally experienced a steady yield distribution rate over time,
with an average of 869,000 needles distributed per year between 2019 and 2021.
It's also estimated that 80% of these needles are returned to the program through collection and disposal.
So, this money would help supplement that program and allow us to continue
We're running the program to the current need.
We also have a request for Indigenous engagement.
So this is funding to support the enhancement of our Indigenous Engagement activities within
the TBDHU Catchment Area.
So this enhanced funding is a further step in the commitment TBDHU has made to meaningful engagement
with Indigenous partners and advancing opportunities from crew of health outcomes of
Indigenous people in the TBDHU attachment area.
In the fall of 2019, we did an Indigenous engagement planner that worked to identify and expand
partnerships that TBHU has developed over the years with many Indigenous people, organizations
and communities.
And this funding would actually help us enhance those relationships at maybe a more senior level
and really strengthen the existing relationships that we have in a strategic way.
So it would be used to increase our capacity.
This funding is being submitted as a one-time request,
but we will also be completing advocacy with the Ministry
because this is an important area for TBDHU,
and we would like to see this move over to base funding.
But we will be asking the Ministry for one-time funding as well.
And then we are also putting in a request for vaccine forage.
So this is three purpose-built vaccine bridges to replace the current ones that we have actually these ones are located in this underbed office.
There have been several coaching incidents over the past few years that resulted in some issues with the bridges.
So we are going to request three new ones. District vaccine bridges were actually all replaced through this funding in the 2020 report.
We have a request for infectious disease, this last street outreach of just over, just under, so 815,000, so this proposal would really add staff to address the higher burden of infectious diseases, that disproportionately affect adverse populations.
So this is going to provide a much more comprehensive community-wide approach to addressing public health issues within that population.
While this is being submitted as a one-time request, administration has advocated and will continue to advocate that annual based funding is essential for this program based on the need in our area.
This was also addressed by Dr. Demil at last month's board meeting and the advocacy request that came through.
So this is the support of that as well.
And then finally, we have the PHI student practice
to come program.
So the Ministry has provided us this funding since 2012.
It helps health units to provide paid practice
and positions as part of a human resource
strategy to ensure the availability of certified public health
inspectors.
So we will be asking for that again.
So at this point, I think we'll go back to the full agenda
and walk through the resolutions.
And again, provide you the opportunity for discussion and questions about what we put forward.
Thank you.
Do you have any questions now before you move forward?
Thank you for that.
Practicality of some of that company.
With the longevity of some of these bridges and stuff like that,
is there a term that we have to replace you by standard or by what they can change.
So I'll actually pass that over to Diana Gallamon.
That was kind of, I would say approximately 10 issues.
Oh, okay, so I'll move it.
It's not like there's a government change in mind, so you're going to use it.
Oh, no, they're the same type of bridge.
They just, they just need updating.
For the question?
I don't know if you'll have the answers for this,
but just with respect to the indigenous engagement,
funding request, what are we currently,
like within the health unit right now,
What does that look like?
And are we partnering with all of the other indigenous communities
and with the resources that are already out there?
Because I do recognize this as a based funding request.
So I'm just wondering, where are we with that?
With this portfolio.
Thank you, sir.
Thank you, sir, the chair.
I think Dr. DeVille will start sharing with us that.
It's pretty clear, can we give this resolution, that comes along
in a separate resolution, don't part of it, can we deal with it as we...
Yeah, I was just asking questions on the presentation.
Yeah, but some of them are, that was individually on the ones for the presentation.
Yeah, I knew that, I was just, I thought this was a question period.
Shall I hold that until we get to that?
up to you guys, whatever you come through with is on the floor, so yeah, I thought we were still on the questions of the presentation
It's kind of misleading the questions at the bottom there.
I was going to say the same, I mean, I was like, but I'm going to ask them as we.
Okay.
I just, I realize how this was perhaps a little confusing.
This is what was originally a presentation
on the annual service plan in budget submission
and getting an overview of that submission
that we are currently preparing.
And I do recognize that there's a lot more information
that can be provided on each and every item,
but that's a good idea.
Okay, so we'll go with you over here,
so I'll move by Paul II and wait on,
I would recommend the five-year increase to the eventual phase funding amount of
the approved submitted to the Ministry.
This part of the 2023 annual service plan by this mission.
We're going to be at two notes.
Any opposed?
Yes.
That's a question.
Any questions?
I'll be just a high question.
Sorry, no.
I don't know.
I can do this one.
Yeah.
Specifically to this one.
Okay.
Do we think five percent is enough?
I mean, with inflation, I'm just concerned, are we aiming a little too low?
All your supplies, inflation to that, inflation to, you know what I mean?
We're projecting inflation this year to be substantially higher than that.
So, through the chair of the reason that we did go with 5% is because that didn't match what we asked the municipalities to contribute for this budget.
I would know, as I'm sure, would the rest of the public health staff, if we were to be able to get more money from the ministry,
we would find a way to use it effectively to address the issues with in our communities.
At this time, we thought that 5% was a reasonable request to the Ministry
that would still provide us great benefit and allow us to also advocate for some of the other
issues like the infectious disease treatment that we discussed. So I don't know if anybody also
to jump in feel free.
I'll just acknowledge, I do think we absolutely need more funding for the kind of pressures
that we experience here. And I think that Alpha has noted some of that, like, those that
Alpha has done some work around half her funding for health units. We do consider a lot of the stuff
that you mentioned when we bring the budget to the board in November. And certainly that we went through that
process in the board get a free not budget, which with, you know, recognizing we're trying
to find the right balance and of course it ended up with a 5% increase in this
value. So we're, you know, always trying to balance putting something reasonable forward
to the board, to the ministry while at the same time, advocating for more funding for
And just to comment on some of the history of it, when we looked up to the orientation but
where we were funded, compared to some of the other boards, we're down at the bottom.
And so we can't offer to the same extent services that other health units are offering.
And we are continuing trying to lobby to increase that funding.
So here's our opportunity, says we haven't been told no to anything.
Well that's us for something.
And we're asking for a consistent number to what we do with the municipalities.
If not, the budget that was set last fall is what we've got a little with, and this will be tent.
You're at the point where it's meeting tent.
So through the church's clarification then, if you go, I mean, I'll be kind of silly.
But if you were to go to ministry and say, eight percent, could they, would they just say,
you know, or would they say, we won't give you equal, we'll give you five.
Like is it an all or nothing?
Good question.
So, through the chair, they haven't provided us any guidance, but it doesn't mean that it's an all or nothing.
So, we've submitted things in the past and received a reduced number.
We have submitted one time request that they have moved over to base.
So, we don't know the actual direction yet, but it is not an all or nothing.
We could go in 5% and they can come back and say, across the board, everybody's getting 2%.
So, no, we don't know that, but it is not an all or nothing.
Okay. And then through the chair one more question, sorry. Do we know what the other health units
are we around the same number or higher or lower than them at this time?
Yes. So, through the chair, and then I'll pass over Dr. Damell may know from her side some more.
Every health unit is different. Every health unit has done different things over the years. Last year,
we were told a 1% based funding increase,
a lot of health units went in with 10% asks,
and ended up getting the 1%.
This year, I think a lot of health units are doing exactly
what we're doing here today discussing what their recommendations
are, and most from what I have heard from my colleagues across the
province, that they are trying to stay in line with their
municipal increase, because any increase above, the municipal
increase could also impact the municipal lab they going forward. So they're trying to keep them
the same. However, they will be advocating again as Dr. Dino noted through alpha through
everything additional opportunities for these funding. I just want to make sure that we're not
shorting ourselves at all. Thank you. Thank you. Thank you, Mr. Armstrong.
I think you're on mute there.
You're muted.
We lost you there for the second round to try and find you again.
Okay, thank you, through the chair, apologize for coming on late, but technical difficulties
down here.
But it comes to mind that since the COVID, the three year average percent increase was
6.7% according to some scales.
So I think we're sure to keep that in mind when we go forward to the government for funding.
Thank you.
Thank you for the questions.
All right.
We'll move on.
The opposed.
It's very.
Okay, move.
Mr. McPherson.
Second.
Mr. Malotrisky.
The.
I'll tell you a senior's dental.
Here program.
by the increase that we recommend to 140 or 494,500 increase to the 100th to the 100th.
Provisual dental care program, a monthly approved and submitted to the Ministry of Health
as far as the 2023 annual service plan and a budget submission for the fund readers to tell.
So the chair, we've not been operating for a year or a half, almost two years.
We feel we're getting close to what we understand the actual cost might be.
Yeah, through the chair, I think.
I think we are getting closer now.
So, for actually representatives, real full implementation of service delivery,
and we use that to help estimate the cost through this report.
Through the chair, I'll also I'd guarantee the program manager on the call.
Is there any specific questions about the grant?
Actually, I have a question too.
So what is our, I mean, I don't know how you measure the UC by the number of patients or, you know, how busy you are during the daily, what is the uptake on it as far as the number of people taking advantage of the service.
I'll let you alone.
Thank you.
Hi.
But we actually have about 450 people on our, um,
Okay, so we're right now, and we anticipate that we is very difficult to know the uptake on going. We do know that the costs are increasing as far as some of the dentures. We have a 2% increase from the dentures. In this particular year, we haven't functioned as a clinic at the health unit for a full year at this point in time that have used community dental providers.
So at this point in time, we know we have about 55 people without standing costs, like anticipated costs,
because we've made referrals to a dentist and an approximate cost of $2,000 per person.
So already before the end of the third quarter, we have an exceptional amount of money for dentures.
And that's about at this point, about $30,000 more than we expense last year in the first quarter of the year.
We also had no specialist costs last year, but more denture dentures than including at our clinic are referring to specialists like oral surgeons.
We had none of those last year, and we have up to 18 people waiting at this point in time, and the average cost of that has been for us about $3,000 when people are referred to an oral surgeon.
And we continue to have people coming into the program right now we may have about 15 people waiting to come into the actual program.
So we also anticipate we're still seeking other providers in district communities.
We lowered the amount for providers for district communities.
The share is doing many of the people on the program.
have already been on it, but if we get additional providers, we would need additional funding
for them, and dental provider costs are going up. We've stayed the same over two years paying
the same rates to people, but they have started to question and ask for additional, ask for
increases and what repaying we haven't done that in this particular year coming up. So last year,
We spent over $350,000 on community dental expenses, and we didn't have a clinic running.
So we anticipate we'll spend a significant more amount of money in this particular year,
just an external cost as well as some arm clinic that is now running.
Can I just have a fall off to that place, are these things, I mean, I know that you're dealing with professionals, so tendering doesn't really fit into their vocabulary, but do we have any type of policy to basically tenders to get the best rates for the dentures or the dentists or that sort of thing? Or is it just strictly, we set a fee for their services and that's it?
We're dependent on trying to seek people who wish to work with the senior's dental care program.
We tried to set separate rates.
We negotiate with them.
We only have one community denturist so far who has been willing to work with the program
because we pay them less money.
We pay them approximately 30% less than what they would actually get if they had someone going directly to them
or if they were willing to an insurance company.
So we have an agreement with them to accept less payment to work with our program and they've
agreed to do that.
So we do set rates.
There are no provincial rates through the program.
We have to negotiate to try to ensure services within our communities.
None of the specialist service providers like oral surgeons are willing to accept negotiation
with us, but we still have to ensure people get service through the program.
So at this point in time, we would be paying four rates when it was deemed necessary to send them.
We do have providers with our own clinic that do their best to try to serve them within our program at a more cost-effective way.
But when that's not possible, we need to send people out.
And we have a vulnerable population who are medically compromised in many ways.
And so we have to triage their needs appropriately and send them out to specialists when that is appropriate.
The reason I asked that is because I worked for years in the optical business, and we used to
have contracts with the city and the government provided contracts for examinations as
well as for eyeglasses, and they were set rates that people could pay over and above
they had the means, but this was the rate that we were giving, so that was the reason that I asked
It was only sort of a place, but I appreciate your answers, thank you.
Interesting.
Yes.
So through you, the chair.
A question, actually, about the provincial funding.
And obviously, this is a recognized program with the province.
But it seems like they haven't gotten to the next step yet, which is negotiating
you rate and access to, for this program, for the population of Ontario.
So I don't see an issue with this actual particular motion and request for funding, but I'd
like to ask, what are we doing to further get ourselves in a position where this is going
to be a very supported and enhanced program in Ontario?
Are you guys working with your colleagues across the province to leverage what you have to
offer and get access in some of these private dentist's office and denture's office.
We're going with the future of this because I can just see prices going up and up and up
and if we're not going to sort of set a proper program into place we could be looking at funding
increases year over year.
So the Ontario Association of Public Health Dentistry and that's where the public
The public dental providers come together to discuss challenges and issues and practices and that's discussed quite often at that level.
There's advocacy and feedback to the ministry on a regular basis through the leadership through the executive at that particular association.
And also through off other places as well, I think the government right now is concentrating
on that Canada, dental benefit at peace as well, but we have not yet, you know, there's been
very little communication from a dental perspective with the ministry over the past couple
of years.
Health units at this point in time are still in a position to have to negotiate and try
do what they can with providers and seek providers for our own clinics or within the community.
This is another publicly funded dental program.
We know healthy smiles Ontario is another one where community dental providers are paid potentially
55% of what they would normally be paid and that's been ongoing for many, many years.
and from a private practice perspective,
they're challenged with that and they're not very happy with that.
So additional programs where you're asking them
to accept less when they have over has become very difficult.
And it depends where you live, what the uptake is for people
wishing to work with you, Toronto seems to have more providers
who are willing to do collaboratively or at a lesser rate
or to seek staff dentists,
where in the north it's a little more challenging.
And we do meet in the north regularly
to look at some of those challenges
and try to make sure from a northern perspective
or looking at same rates or same strategies
so that there's fairness within our particular regions.
But it is a very challenging program
when we are required to set all the parameters
for the program and seek people to work with us
try to establish particularly and do at the mercy sometimes of the providers and whether they need
to really participate or work to give some of them want to do that type of work and are passionate
about that but others not so much. So kind of where we're at at this point in time and I don't
see anything in the very near future where anything is established to set particular rates and
I'm glad you're recording me.
Yeah, Carol, I may ask you a follow-up question just with respect to your response.
The Indigenous population in the north are at a significant disadvantage when it comes to dental care.
Is there a way to tap into more money for this population that you guys may be servicing through another opportunity fund or whatever it may be?
So, we, of course, we've also been sideline by COVID for some time, so we're ramping up when we're looking at all of our issues and our advocacy and our research and, you know, focused on particularly what's happening within our region.
There are other plans where benefits are covered from a dental perspective for indigenous people.
Of course there will be indigenous people that are not having access to those particular programs.
But we're trying to establish information as far as doing situational assessment for our particular district and what the needs are.
but we have found that there are avenues for some of our Indigenous population seniors to
access funds for service. Many children Indigenous they come through are help these files on
material program as well and we're very, very well aware of that through that particular program,
though. Excellent. Thank you. Do you wish? Yes. Through the chair, just a quick question about
those partnerships with some of the private dentists have some of the partnerships
that we also reached out to the schools because I can see the school system would be
not in the form of dentists but in our community I don't believe we have a dental school
but we do have a hygienist school so in that area of cleaning teeth and stuff like that as
well we might be able to tap in there because they do or they use do anyways have like an
and session for people to come and get their teeth cleaned and they usually apply to students
to get it done cheaper. So I just want to make sure that we really recognize whatever partnerships
we can in our community and they don't necessarily have to be those dentists.
No, we thank you. We had a partnership actually with St. Joe's,
the high-genus from there. For some time working collaboratively with them,
they actually don't have their dental program running at this point in time.
We do let people know about the college and the opportunity to attend their, I believe,
for cleaning for seniors, for others, it's sometimes $25.
That's something that they can access where the students are learning.
The cleaning is done by students and normally takes, it could take an hour and a half to two hours.
So we're happy because it's an opportunity for students to learn.
We do talk with the college regularly, what we have high-geness, and I don't think people are lacking the ability to access that service because you're able to access it from us.
And in district communities, we do engage them so that people do not have to travel unless necessary.
But for my dentist perspective, they don't have dental opportunity at the college.
So that's where the challenges lie that people can't go there to get dental from a dentist dental work done.
Yeah.
Thank you.
One quick follow up to that.
Very quick promise.
Do you know very much because I don't have a dental program?
Could there be an opportunity for them to do?
Like U of T has a dental program to do their residency to do something like that here to be able to.
Like do you know anything about that?
I'm just trying to expand that group that you're having an opportunity to partner with,
and we might not think of, for example, U of T, because I know with my program, we
radiation therapy, we go out past that community that we're actually being schooled in to do some
of our residency, and I'm just wondering if there's possibly an opportunity there.
It's possible. There are a lot of low-come opportunities in the North, where they do have
tend to just coming and going and we are set up with some of those dental providers as well
that almost on a yearly basis we're reading a contract because the dentist has left and there's
only one coming or that they're corporately owned dental offices, particularly throughout our
rural communities and locally we work with some of those schools, dental schools.
We haven't gotten to the point of talking with the local Thunder Bay dental association or
are looking within our clinic because we have just been establishing providers within our clinic
and learning to work together and setting up what days they can work and getting established.
We started in September and we just had a new dentist start.
An additional one start this month so we are kind of in our infancy of, you know, making sure
of our practices and looking at things appropriately for sure that does not preclude us being able
to collect one more looking at other opportunities to ensure that we have capacity. They would
have to be guided though where somebody's mentoring and supervising and we would have to have
people here on a full-time basis to be able to provide that opportunity to them.
Thank you. Thank you.
I was just wondering if I'm new person to the board, just wondering how a person applies or qualifies for the senior dental program.
It's a very low income eligibility criteria.
It is on the Ministry of the Ontario Ministry website, as far as seniors dental, the Ontario senior dental care program.
We normally, we have it on our website and we, during advertising, people contact us.
We do a lot of signing people up for the program.
A lot of seniors take advantage of them.
Connecting with us and having like Kathleen within our program spends an exorbitant amount of time helping people sign up for the program. Someone can call and she's on the phone for half an hour, helping them work through, signing up and establishing connection with the program.
All they have to, they fill out their application form and it's reviewed and they receive a card in the mail and they connect back with us and we help them navigate to access all the services that they need.
But we do that for them. We're actually looking at now a plan and places to how to connect with organizations that serve seniors, places seniors go to see if we can have them also assist seniors to be able to navigate and sign up for the program.
So we're at that point where we're reaching out and trying to get other service providers
to partner with us to help people sign up.
Also, promotional activities we're looking at doing this month, we're going to the 55
plus center.
We're going to go to the mall to try to help people sign up.
We're going to other organizations to be accessible and available for people to approach
to be able to access, but we do get many, many, many phone calls, where we help people register.
Unfortunately, it's all online.
Okay, thank you.
So, again, back to the resolution.
I'm going to read it again because it's been a while.
So, we recommend a 490-4500 increase to the 100% until you're seeing your
through and submit it to the Ministry of Health,
it's part of the 2020 Internal Service Plan,
but it's a mission for that health in it.
Any opposed?
Okay,
we got a bunch of these to go through,
so we'll move along to the next one here,
which is, thank you.
You'll be in the 2.2 second bay,
Paul,
with respect to the one-time final request
extraordinary cost.
There were three-spec to number,
to report number 12-2023, we recommend that the application for one-time 100% funding to
over $864,300 for a extraordinary cost associated with monitoring, detecting, and managed
COVID-19 in the Thunderreed District Health Unit, just to be approved for submission to the
Ministry of Health through the annual service plan by the submissions and the Director
purposes, and I as your Prime Minister, you have the right to complete any administration requirements
of the budget and a personal process required.
Questions?
Opposed?
Okay.
Next.
We'll by Ms. Brown, say Ms. McPherson, did a one-time funding request go with 19 vaccine program
extraordinary costs with respect to report number 13, that's when 23, we recommend that
application for one thing, 100% funding flow, totaling 1 million, 618,000 per share in
every cost associated with the hon.
The organizing, overseeing the full of 19 vaccine program.
And the thought of a district health, going to be approved for submission to the Ministry
Health.
Through the annual service plan, but dismissions process and the Director of Corporate Services
and Manager Finance be authorized to complete and any administration requirements
to the budget process as required questions?
Just a correction.
It's 1.6 million.
I think you said thousand.
Well, I know million.
I've read million.
That's right.
Good catch.
Any comments?
Any other questions?
Sorry.
Through the chair.
Are we still the vaccine clinics?
Are they still let the call see them?
Through the chair.
They are currently at the call of seeing them two days a week.
and we also do other clinics throughout the community community based clinics.
So are we looking like I don't know just because of this amount of money?
Are we looking at getting to a smaller space, rental space instead of the policy?
I don't know what they are charging us through the route or you sign to one year lease.
So I can speak, I can touch on that.
So through the chair.
The Coliseum has been very accommodating to us over the year with the rates.
We have now changed it so that we can be in and out within a day so that they don't.
We're not there for more than we need to be there.
So the other part is that we also rent space through the district community so that we can host our clinics there.
So, we will ramp up as needed.
This current plan here is a more full-sum spring and fall campaign,
which we would require the space for,
but I do think we've negotiated rates
and most of the community partners have been very, very accommodating to us.
Thank you.
Is there going to be an annual requirement for the coupons?
So, I'll pass that to them.
Well, why is everybody laughing at me?
I don't know the answer, that one.
I'm asking the accountant.
He's saying I'm not touching.
That's still to be determined, but it does look like the projections are potentially an annual fall booster for the general population,
who has potentially those at higher risk, having it per twice a year, but it's still
that's just an uncertainty of the program going forward given the uncertainties that I don't think.
Thank you.
Good questions.
Opposed?
Okay.
Move way.
Ms. Dawson, second by Mr. McPherson, rearing a one-time funding request for the
We recommend the application for one-time 100% funding for $120,000 dollars for repairs
that are building roof and polishing for the main office building to be approved for submission
to the Ministry of Health through the annual service planning budget submissions process.
And that the roof and polishing repairs be endorsed by the Board of Health and the Administration
be directed to receive a deterrence process without line.
And then the Director Corporate Services, and as we were fine as to be authorized to complete any administrative requirements of submission for submission as required.
Questions?
I have one, two, but here's.
To the chair.
Back to some history.
We, a number of years ago, put in a large capital request to the Ministry.
We've really never ever heard back.
And we have been working our way through all the different projects.
So, two-part question, do we know, do you know what is left now on that magic list, and the second part is, if they don't fund it, do we still have enough left and the cow will reserve, we have to cover this work so we can get it done this year.
So, through the chair, we'll also adjust this in the facilities report later in the meeting.
We do have a list of upcoming projects and upcoming needs from a capital perspective.
I would note that the original design and large submission that we made to the ministry.
We have made significant advancements on that over the last several years.
The guiding principles, I guess, around that larger renovation have been taken into account in all of the smaller renovations that we've done.
We have not heard back on whether that money is available.
But the ministry has given us a significant amount of capital funding over the last few years for the smaller projects we've done.
With what we see on our look ahead from the capital perspective, we do have the capital reserve of $2 million and we do feel at this time that that is sufficient for what we need, but of course we will always continue to ask the ministry to provide us the funding if available.
I can't really question if I made Mr. Drill, the value of the 320,000 is that a concrete
number is that an estimated number when you get that estimate or is it allowed to be
up in today's market as opposed to when you got it?
So through the chair, we actually received that number very similar to that last year while we were
doing the exterior of the building, we looked at potentially trying to do it at that time,
But the issue that the contractor identified was that the price would be elevated because it was a tight turnaround
There were less contractors available. So this actually this price is an estimate based on discussion with our engineers and architects of a reasonable process
Provided we put the tender out now and have enough time to plan and get enough contractors to be at on the project
Thank you very much for that.
Any other questions?
Opposed?
We will, again, motion.
You write the resolution.
Move by the Christine.
Second by Mr. Weiler.
The one-time funding request needed in syringe program.
With respect to report 14-2023 harm reduction.
We recommend the application for the one-time 100% funding for the $25,000.
for costs associated with delivering the needle syringe program to be approved for submission to the Ministry of Health through the annual service plan and the budget submission process and that the direct appropriate services and manager finance be authorized to complete the any administration and administration requirements of the budget budget submission process as required questions.
Right through the chair. I'm surprised this isn't in our base funding. Is this a like are we expecting
the harms prevention group to take this on after or?
So through the chair, I'll answer that and then I'll quickly pass it over to Kansas Belonjay who is the manager in this area to also comment
We do have an amount in our base budget related to this program. This
funding has been provided by the ministry because they suddenly need over and above the
base funding allocations that we have previously allocated. So that is why it's here.
But it is we do have a component in our base budget. This is just additional funding that the
ministry provided to us last year and we will again request this year.
Yeah, I'm just looking at Candice
if I missed anything there. No, there have been some increases in cost of needles as well as
cost of disposal. So this would also support. Thank you. Any further questions?
Okay, move late to our second by Cindy. We're getting a one-time funder request or indigenous
engagement that we're the respect to report number 15-2023. We recommend that the application
for one-time 100% the lending to a $3,000,000, $3,000 for the enhancement of indigenous engagement
activities within the Fundatory District Health, given it be a progress submission to the ministry,
help through the annual service plan and budget submission process in the direction of rapid
services and manager finance be authorized to complete an even administrative requirements
of the budget submission process as required. Questions?
Yeah, we'll just go back to my question through the chair previously. With respect to this program,
I'm recognizing it isn't a high need for base funding.
I'm just wondering if now's the time to have that conversation or do we just want to go
and try to access funding and look at further developing this as one of our core core needs.
And I question that because in other communities where
and other districts where health units have other higher population of ethnicities
in the Toronto area, specifically I'm thinking they may be looking at other ways to do engagement
with those populations. So I don't see any differently that they may be doing the same thing and I just want to recognize that what we can be doing we should be doing.
We actually do a lot of Indigenous engagement at different levels.
Like given the word that I do when this is a look at First Nations on the 30.
that was at the previous board would be more aware of,
but even at the program level,
we are working directly with many first nation communities
or first native partners.
And we certainly are looking more strategically
at how to move that forward and COVID the pandemic sort
of altered the kind of work that we're doing,
but we're certainly looking at it once again
more concretely going forward.
This actually is an item that I was going to bring back to the board for ongoing orientation
in terms of looking at what we're already doing, and I think it's because it's fairly
broad across the organization, what we do and where we want to go with this.
So I think that your question does actually sort of remind me that I should move ahead.
Okay.
Thank you.
And I think it was more exactly what you are.
because when I read this through Chairsory,
when I read this, I'm thinking this is another,
this is adding an employee.
When I read the breakdown of it,
and I'm going, so I've had the impression
that it was being broadly done
and maybe now it's going to be more focused
as an individual.
Is that kind of right?
Yeah, through the Chairs again,
there are,
You know, we've identified the need to have more, you know, at least another individual, very just focused on that, at the more of the senior level in our organization, which is what this ask is story.
Again, we're really wanting it based funded, but looking at sort of an indicted to do this liaison, for example, I mean, many other organizations would have sort of a position specific to that, and I think that would be beneficial for us here.
to be able to help and be more strategic and regional.
Okay.
If we're the questions,
Mayor, I'm sorry to post.
Thank you.
Okay.
We have a resolution with a specific person.
Second man is Thompson.
We're going to have one time funding requests for vaccine refrigerators
to respect to report number 11-2023.
We recommend that the application for one-time hundred percent
funding for the paid $80,000 or $3 purpose-bulf tax-saving
criteria is to be approved for submission to the Ministry of Health
to the end of service planning by the submission process and the
Director of Corporate Services Management Planets
to be authorized to complete any administration requirements
at the budget submission process.
Questions?
I can be dealt with this a little bit earlier on.
Any opposed?
Thank you.
Okay.
moved by the stompsing, second by Mr. Wheeler,
a resolution, recurring one-time
funding request for infectious disease and three-year-old reach funding.
There were, despite the report, number 16 to 2021, three infectious disease, three-year-old
reach.
We recommend the application for one-time 100% funding flow of 814,700 dollars for the cost
associated with identifying and addressing increased rates of disease as public health
significance in the infectious disease and street outreach programs and it's not to
be district health team to be approved for submission to the Ministry of Health through
the Anna Service Fund budget process emissions and to direct your corporate services
and monitor the finance, be authorized to complete any administration requirements
out if I did submission process required questions.
Through the chair, just again, this isn't in base funding, or it is because when I look
again at salaries and benefits, I'm looking at a substantial number of people, not
single individual, so are we growing that program? And this is how we're doing that,
if we're taking it out of the base funding?
So through the chair, I will note that we do have our infectious disease program in our
reach program key in our base budget. These are enhancements to further the work that's needed in those areas.
You've heard a question? What was it any?
Yes, good question. On that topic.
Did we ever receive anything back on your letter?
You wrote to anister?
Or is that normal?
Because being me, I'm not even sure if we send those kind of letters forward.
Do we ever get feedback?
So, through the chair, this is very much a work in progress, so I brought forward to the board last month, my concerns about what was happening, particularly here in Thunder Bay, fairly vulnerable, grave for rounded infectious diseases.
And we've worked with that work to define what the need would be, what are asked with the, in terms of what resources we need to be able to do this, which is reflected in that report.
perhaps that better answer through questions, and we are putting in this one time funding
but advocating it for base funding. I've also been separately connecting to the province
around us. I do have a meeting actually this afternoon, specifically related to this.
And I've also drafted that letter. It hasn't been sent off yet, pending us working through the details
and some communication from green. My part with the ministry to be able to position it properly,
So it's all kind of coming together,
and I do expect we would hear something back.
Often formally letter acknowledging, not necessarily saying that.
But I think it's more that gives me the leverage to how those conversations and I can often get more informal communication.
That's great.
Thank you.
And for the questions, we already did this one.
Yeah, sorry.
Sorry, it was a question.
I'm not a bullet.
Sorry.
That's okay.
I'm not a bullet.
Okay, we have a most hell of solution.
We'll go by Christine's second-limit, Mr. McPherson.
That a one-time primary question for a PhD.
Practical from.
And for the respect that we're going to be doing.
9, that's 2023, we recommend we have cases for 1,000, that's about 20,000 dollars,
with two public health inspectors students.
Students, finally, we approved for submission to the Ministry Health,
the annual service plan and budget submissions process.
In the director's corporate services and manager finance,
we have the rest to complete the implementation.
Requirements of the budget submission process as required.
questions.
I post,
on here, again, we'll be twisting, second by the grant, that we have a resolution
that we're going to help kids program funding extension, the Respect Report 70-2023 Finance.
We recommend that at one time funding from the public health agency at Canada for the program
title, Healthy Kids Home.
And Brock, it's helped on a new correct equity.
There's this program.
Currently, $1,150,600 and 78 dollars.
I've got the million.
There's a period of August 21 to May 2021,
to May 2024 be amended and approved for extensive
for the funding period until March 2025,
and approved additional funding for an $30,000
and $53 dollars for a total funding of $1,580,700,000, $31,000, and director of corporate
services and manager finance, we authorized to complete in a missed any administrative requirements
of the budget submission.
The process has required and questions.
Through the chair, can some of the information from this program be transferred from the city
to the district?
So through the chair, I'll pass that over to Joanna, who is the manager of the program.
Through the chair, thank you for that question. Part of the Healthy Kids Home Program runs a four week program in communities that can definitely be translated to the district throughout the pandemic.
We had to switch up programming from in person to a virtual program and it was shown to be just as effective when we delivered the programming virtually as in person.
So that is something that we're looking at how can we expand this program to the district in the future.
Thank you.
To the chair, the extra 430,000 being requested. It looks like the majority of that through salaries.
Would that be because of some contract negotiations or something that was am I reading it wrong?
So, through the chair, this is actually an remaining agreement for the 400 and very to extend to the program, beyond the current date, so this would be extending the contracts that are in place and all of the, I'm excited to go with that.
This program in particular does have a lot of incline donations from our partners as well, so there's a significant benefit to the extension of this program because we do have that as well.
Any further questions? What was the name?
Let's be close. Secondary.
It was ran with employee benefit.
The resolution that employee benefit can renew.
With respect to the report number of 15-2023,
we recommend that the renewal of the employee group kind of a family
with green shield Canada.
Health and control for the Association of the Public Health Agency's offer.
Employee Group Benefit Consortium Plan has presented for the policy term people first, 2023 to March 31, 2024.
The Director Corporate Service as a manager finance be authorized to complete any administrative requirements of the removal.
Questions?
So, sorry.
Through the chair, I just, when I was looking at the benefit plan that's noted here, I didn't see anything.
Like a lot of groups now when they're negotiating that if it's through GreenShield, they're looking at a mental health portion.
I didn't see anything in there for a police or mental health.
But is there something in that?
Through the chair, we do have significant plans in place here.
We do have an EFAP program that would deal specifically with that.
That is actually renewed separately outside of this.
And so that will also come to the Board when it comes up for renewal, but we do have what I would consider a fairly substantial plan in that area, and we also do a lot of work through our health promotion division in the community area of that, and we try to apply that internally as well.
Thank you.
Just a few minutes.
Thank you.
Any questions?
Follow the name?
Okay.
Move by Mr. McPherson.
Second way of the speak-off.
The resolution.
We are in the shared public library services program that we respect to report
2023.
Monitions.
Kind of do recommend the approval of $130,000, $700,000, $1,000, $1,000, $1,000, $1,000, $1,000, $1,000, $1,000, $1,000.
membership at the Fundabee District Health Unit for the period of April 1st, 2020, to be
the March 1st, 2020, for the Director for the Service as a Manager of Finance, be
authorized to complete any administrative requirements of the Fundabee process as required.
Questions?
You'd more than welcome that, questions?
I know.
No questions?
What was the money?
We got
through them.
So if you're in a communications information,
we need to get the resolution.
So these update, Mr. Dill.
Thank you, Mr. Dill.
I'll just give it a brief overview of this report for you.
So this is an annual report that's required by the Board of Health by law
regarding the inadequacy of our facilities.
So it provides detail around the main office and all of our district offices.
So this annual facility review links to our risk management program
and all recommendations for projects,
cap over requests, and general work we do throughout the year are really focused on areas that
are considered higher risk to the organization.
As I noted earlier, we've done some significant work and been successful in getting funding
from the Ministry for some minutes, pretty significant projects.
We replaced the building towers, so repairs made, and those were all reclated due to some
water dishes we were having.
We've replaced in the last few years the air handling units and the boilers.
We were, we were, we don't want to carry a single dental capital suite was another significant project we've done and then last year as you can see outside we just finished the windows and building on below project.
We do still have some projects to move forward on, one of them being the shingles and flashing that we discussed earlier.
We are looking at the tile flooring and what it would cost to replace that going forward because there are some potential health and safety issues that will be coming there.
We do have an elevator, we'll feed them this building at the other end that will require some improvements and then there's a generator system and some backups that are needed.
So again, we do have the capital reserve that will assist us with that, but we do always ask the Ministry for capital funding you're over here to try to get that.
within the report you'll notice that we do have four branch offices and in 2020 both the
Marathon Interest Bay offices did move to new facilities and at our current assessment of
space in the district does appear adequate at this time. So that's just a brief overview.
Have you had any questions and I have our manager out of your information systems and facilities on the line as well?
Do you have any questions here?
On to the chair.
A comment to hydro.
We have a nice reduction.
Yes, we can talk to about getting adoption.
Yes, this is it.
Yes, we do.
So through the chair, you can see we've done some significant work with our handling units, our
boilers.
So the building is becoming much more efficient as we do some of these projects.
We are hopeful that there will be another reduction next year.
Now that we have the new windows.
So we were quite pleased at the trend that that's going even light of increasing hydro reads.
What's the first to find why we did it since then?
Any questions?
In the report, there's a comment about generators in case there's an extended dollar failure.
I'm just asking, if there's an extended power failure, the generators, basically, would just have to support the fridges.
But everybody else would pretty much be sent home, right?
So through the chair, we have a generator system that supports the critical areas of the building.
And yes, we would evacuate the building and have people come home.
but there are critical components,
including our server room, our vaccine fridges,
that require that.
So we would also be looking at implementing a backup system
for our backup system.
Right there, there, there, there, there.
That's it, the backup system.
Thank you for your questions.
Good morning.
Moving on to the output when you're conference.
The report, regarding this symposium,
that is held for the citizenship center report.
And I saw, I attacked onto his base of the U.S.
He was a pretty sterile guy when it comes to doing that stuff.
Well, I found one of the best parts of the program was creating new board members that
I felt was some learning sessions.
I thought it was a pretty good orientation and learning session in the session.
And the afters did not take away from the afternoon session, but I found a learning session
really, really, really for bringing new board members on this field.
I don't know if anybody else who was on wants to add to the had or not, I mean, there was
a really new board, but if not, I mean, it was a good session, and I'm so glad I came to
that.
And I thank Mr. President for his remarks, and I'll take on that kind of thing.
You always tend to do things that a lot.
Kelly's nothing for us.
Okay.
Sure.
Oh, sorry.
Okay,
thank you.
It's a new word number on it.
I got a lot of good information out of it.
Which really worked well.
Thank you.
Thank you for attending that.
Thank you for the comment.
Okay.
I just have a couple of brief updates for you.
I'll provide certainly.
I wanted to let you know about some changes
in the senior leadership team here.
I'm a great speaker.
First of all, I am a gown lock over in the quarter.
It's officially down the director of health protection
and chief nurse check-off.
She has been acting in this role for the past year,
So, please, and I'm very pleased when she applied to take on this permanently in our recent recruitment process.
So, and Diana prior to taking on this role was actually the manager for infectious disease program and IPAC.
So, it's great to have her join us officially at the senior leadership table.
On the other side, though, I am sad to note that Mr. Lance still will be leaving after setting five years
with us as a director of corporate services.
And in fact, this is the last week in the last award
evening.
And I just want to acknowledge this significant contribution
to the pandemic to Kelvin at over the time he spent here.
I think all this experience, I'll perhaps get out of here,
helped him get his next position,
but I wish him all the best in the future.
And the recruitment process for his replacement
is currently in progress and I will certainly provide an update to the chair and to the board
when that is completed. The second item I wanted to mention and Mr. Smith started off the meeting
with the land acknowledgement today and that came up at the last meeting. Internally we are currently
updating our guidelines for land development for our staff and our programs and we will be
proposing, looking at the land acknowledgement for the Board of Health as well, so we will
be bringing something back for your consideration in terms of your land acknowledgement
for board meetings.
And the final update I wanted to provide, I believe I've already spoken to, which just
to follow up on the infectious disease and the advocacy that you endorsed at the last, at
We provide most of the answer to a question earlier on that funding, so I will continue to work with the chair regarding the letter and the board's communication to the ministry and we'll be updating with you with the outcomes of that.
That's my update, and I'd be happy to take it.
I would just like if I could, I would like to just piggyback on your comment.
Mr. Dill, in the five years it, I went on the board for years and the last, since last
is joined this group, it's been a very, very positive work and it's moved out that's moved
along very, very well and there's any any questions where you know, readily answered and this
appreciate everything you've done for us last, and we should know you had a lesson with your new
move.
Okay, next meeting. Let's say April the 19th on 2023. There is a word of
second meeting on the 19th. We do the 22nd year in finance, so the other year is
which is always really enjoyable.
Enjoyable. Hi.
These are the ways we might need to do your
drop dates, as far as the Board of Education evaluations.
And with that,
we'll buy a Christmas in a lot of boolean.
It's just a few hours for us to hear.
I'll refrain for a second.
Second advice on the word helping on held on March 15, 2023,
be adjourned at 25.
Thank you very much.
We went through a lot of stuff and everybody, I really appreciate the input, I appreciate the questions and appreciate patients with me some of your millions and thousands of stuff.
You know, any post?
We're good afternoon everybody.
Can you say it?
Good luck.
All right.
Thank you everybody.
Bye.
I'd like to Florida.