/IS:1><121\ Town of Bracebridge ~ BRACEBRIDGE Council Correspondence The Heart of Muskoka

TO: Mayor G. Smith and Members of Town Council S. Rettie, Chief Administrative Officer

COPY: Management Team Media

FROM: L. McDonald, Director of Corporate Services/Clerk

DATE: November 17, 2020

CIRCULATION:

Item # Description SECTION “A” – STAFF INFORMATION MEMOS: A1 Nil. SECTION “B” – GENERAL CORRESPONDENCE: Communication from the Simcoe Muskoka District Health Unit, regarding the 2019-2020 B1 Annual Community Report. Communication from Mia Brown, Program Manager, Substance Use and Injury Prevention B2 Program, Simcoe Muskoka District Health Unit, dated November 2020 regarding Simcoe Muskoka Opioid Strategy. Resolution from Matt MacDonald, Director of Corporate Services/City Clerk, City of Belleville, B3 dated November 10, 2020 regarding Proposing Changes to the Municipal Elections Act – Extension of Nomination Period. Resolution from Tanya Daniels, City Clerk, City of Brantford, dated November 12, 2020 B4 regarding Bill 218 – Ranked Ballots for Municipal Elections.

Page 1. ANNUAL COMMUNITY REPORT

Medical officer of health + Board Chair message

As reported in the 2018-2019 Annual Report, the Board of Health and the What is less visible is our preventive work that sets the stage for good Medical Officer of Health were challenged, like all health units, with the health in the long term, the work that is done in our immunization and province’s plans to transform the public health system. dental programs, and our family health teams. That work has been on hold While we were unclear what the announcement was going to mean for our due to the pandemic, and we now have thousands of children who have future, we began to prepare for the possibility of significant change by both missed their Grade 7 vaccinations, hundreds of low-income families who reviewing our mandate and operations while mounting a vigorous response have been unable to access our dental clinics, and many more families who highlighting the importance of public health. We could not have foreseen have not received the in-home health unit and breastfeeding support to that in just a year the world would be consumed by a pandemic that has help their children get a healthy start in life. New programs, like in-school disrupted our societies and economies – indeed our entire way of life. vision screening, are still on hold. Sexual health clinics, tobacco cessation workshops, infection prevention and control inspections, prenatal classes, Public health plays a critical and necessary role in the health and well-being and inspections of restaurants and other food service providers are a few of our communities and that has never been more obvious than now. Since of the other health unit programs and services that will need to resume as the activation of our Incident Management System on January 24, 2020, we our economy and our businesses continue to reopen, while we balance the have worked full out in an effort to control the spread of COVID-19 in our demands of our COVID-19 response. region. At peak community transmission of COVID-19 in April, the health unit had paused most routine programming and had redeployed about 180 staff Our federal, provincial and municipal governments have done a to the Infectious Diseases and Health Connection programs. More than 50 commendable job responding to the pandemic, as has public health with its other staff remained in their department and program, but devoted 100% support of that response. We have averted thousands of cases and deaths in of their time to COVID-19 work. As we write this message, the pandemic Simcoe Muskoka, through flattening of the curve, provincial policy, and case continues and most of the health unit’s employees continue to work on and contact management, and have avoided overwhelming our health care COVID-19, including shifts and weekends for those in the Infectious Diseases, system. Our partners in health, in local government, and in our communities COVID-19 and Health Connection programs. have also responded admirably. While the pandemic had dominated our work for most of 2020, it’s important The pandemic is something we are going to live with for some time and the to acknowledge that responding to threats to the health of our communities next months and beyond are going to be among the most challenging the is at the core of what public health does. In 2019 our health unit investigated people of our communities may ever experience. We will continue to offer two Legionella outbreaks, vaccinated hundreds of residents of Muskoka and the leadership and support that our communities expect, while working to Barrie in response to a Hepatitis A outbreak and exposure, and worked with ensure that the excellent public health programs and services so important our partners in Muskoka to ensure those affected by severe flooding had the to the health of our residents are resumed as soon as we are able. information they needed for safe water and food. 2019 health unit financials

Provincial Grant 77.5% 77.4% Cost Shared Mandatory & Related Programs

6.4% Healthy Smiles

Municipal Levy 21% 6.3% Healthy Babies Healthy Children EXPENDITURES REVENUE 5.3% 100% Funded Programs & Initiatives $38,930,147 $38,696,759 3.4% Smoke-Free Ontario

Other 1.5% 0.7% other

0.5% Ontario Seniors Dental Program 2019 year in numbers clinical services Environmental Health Community and Family department department Health Department ~ Personal service Client visits Food premises Recreational water Number of expectant Expectant parents setting and child to sexual health inspections facility inspections parents who registered in-person care inspections clinics 7,916 1,097 registered for online prenatal classes 1,307 3,580 prenatal classes 1,061 933

~ Rabies exposure Tick Total number of Families who investigations submissions Children Community and parent/caregiver visits received Triple P - screened for institution outbreak: 1,719 380 to Breastfeeding Place Positive Parenting tooth decay Hep A investigation 1,882 Program support 23,305 946 from SMDHU 428

Number of Smoke- Number of large- Free Ontario Act scale incidents/ ~ inspections for emergencies Number of public Home visits Immunizations smoking and vaping or public health health nurses by public health Vaccines given administered including retail community-wide supporting school nurses and/or at schools compliance and test outbreaks requiring health and well- family home shopping with youth IMS activation being with number visitors 22,256 869 79 of schools adult pediatric 4,127 3,592 5 30

Program Foundations and Finance + Human Resources DepartmentS

~ ( smdhu.org ~ HealthSTATS \_)

Number of times Health Visits to Number of times Visits to the Number of our Facebook posts Connection SMDHU website health unit mentioned Simcoe Muskoka staff as of were seen inquiries (homepage) in local news HealthSTATS website Dec 31, 2019 1,346,741 89,321 88,004 604 100,867 304

For more information about our programs and services: T. 705.721.7520 | TF. 1.877.721.7520 | www.simcoemuskokahealth.org ISSUE 2: NOV 2020

PILLAR AND PARTNERSHIP HIGHLIGHTS

The past eight months have been very challenging to us all as COVID-19 has had far reaching impacts on our communities and the work of SMOS. Despite these challenges, SMOS members have continued to move key work plan activities forward, as highlighted below.

EMERGENCY HARM REDUCTION MANAGEMENT TREATMENT

The Needle Exchange Program and The Simcoe Muskoka Opioid Overdose The use of Suboxone in local emergency provision of Naloxone training and Outbreak Response Plan continues to departments was initiated, along with distribution, including advocacy and be used as a framework by regional the continued provision of education to capacity building with local hospitals stakeholders to prevent, mitigate, primary care providers on the treatment for the distribution of Naloxone through prepare for, respond to, and recover emergency departments, continues of Opioid Use Disorder. Local physician from emergencies related to opioid across our region. leads have recently been designated to overdose outbreaks. The Emergency assist in moving both of these activities Selection of site options for a Management Pillar maintains the Plan forward. supervised consumption site (SCS) and other resources on the in Barrie was completed by the SCS www.preventod.ca website. Selection Advisory Committee in October. Community consultations on those sites has now begun. ----1 STATISTICS CANADA PROJECT COVID-19

In September 2019, Statistics Canada Has the COVID-19 pandemic and the community-based public health prevention agreed to fund the SMOS Statistics measures put in place to help control the pandemic negatively affected the health and Canada Data Project. This project will well-being of the general population including the sub-population of those who use bring together anonymized data from substances? a variety of sources on individuals who This was the question posed as part of a situational assessment conducted by the Simcoe have experienced overdose events and Muskoka District Health Unit between April and July, 2020. The assessment’s final fatalities in Simcoe Muskoka. It will report, Mitigating Harms of COVID-19 Public Health Measures references a rapid review provide an analysis of the heath, justice recently completed by Public Health Ontario on the Substance Use-Related Harms and and social and economic circumstances Risk Factors during Periods of Disruption. Together the two reports help to answer the of confirmed illicit drug overdose deaths question and to inform mitigation strategies to reduce the unintended negative effects of in the Simcoe Muskoka area, as well as the COVID-19 public health measures for people who use substances. a provincial picture. Unfortunately, based on the findings, some of the unintended negative impacts of the pandemic and pandemic response on the substance using population include: The project is aiming to achieve the • an increase in substance use in response to stress following outcomes: • a risk of using substances alone due to physical distancing measures • a disruption in the ways that people access their substances • Establishment of a framework • poor quality of substances available for ongoing data sharing and • decreased availability to some treatment and harm reduction services in the community collaboration between agencies on • a reluctance to attend the emergency department in the early stages of the pandemic opioids and other issues of broad interest. Local data corroborates these findings. There were 44 confirmed and probable opioid- related deaths in Simcoe Muskoka in the first five months of 2020, which was 50% • Identification of non-random higher than the comparable average for the previous three years. The City of Barrie characteristics of those most at risk has been disproportionally impacted by this recent increase, with 19 (or 43%) of these of opioid overdose, and increasing deaths, despite accounting for 25% of the Simcoe Muskoka population. Data from understanding of the roots of the the Barrie Police Service also shows a dramatic increase in suspected drug overdose crisis and primary risk factors. deaths attended by police in the first half of 2020 when compared with previous years • Development of evidence based (approximately twice as many deaths as expected). This increase appears to have started prior to the start of the pandemic in March 2020, which is different from the pattern measures intended to reduce observed across Ontario, where the number of opioid deaths have increased since the overdoses and deaths, and start of the pandemic. augmenting existing mitigation activities at the local, regional, Preliminary data for opioid poisoning emergency department (ED) visits in Simcoe provincial and national level. Muskoka suggest that visits over the first four months of 2020 were lower than previous years; whereas, deaths were higher. Opioid poisoning ED visits in May and July were • Development of policies and similar to previous years but June was substantially lower. This pattern of lower opioid programs addressing the root poisoning ED visits and higher deaths was also observed with the overall provincial data causes of the opioid overdose crisis. for the first half of 2020.

This is the first project of its kind in A Harm Reduction Task Group was formed in May 2020 with several health and social Ontario. The intention is that this data service providers. The purpose of the task group was to identify and address potential will be shared with agencies who wish to gaps in service for the drug using population in Barrie during COVID-19. The group met contribute their own local data sources three times between May and June 2020 which resulted in the creation of mitigation plans to replicate this project in their own areas for the service gaps and collaborative partnerships formed to address the ongoing needs elsewhere in the province. of this sub-population in Barrie.

----2 DATA & EVALUATION

While delayed due to COVID-19, the 2019 SMOS Scorecard and Dashboards have now been completed. This spreadsheet highlights interim outcomes achieved for the second year of the three-year SMOS strategy. The actions initiated and/or completed in 2019 by the SMOS pillars (as reflected in the dashboards) are intended to either directly or indirectly effect positive change in opioid-related use, emergency room visits and deaths, as measured by specific indicators (the scorecard). Highlights include: • There was a substantial spike in opioid-related deaths in Simcoe Muskoka in 2017. The total number and rate of opioid deaths in our area between 2017 and 2019 remained higher than provincial comparators. However, these numbers have not shown a statistically significant increase over the past three calendar years and appear to have stabilized during that time period, though at a very disconcertingly high rate. Of note, these years pre-date the COVID-19 pandemic and any effects that the pandemic has had on opioid-related deaths is not reflected in the current scorecard. • The indicators for opioid-related emergency room visits were stable in 2019 compared with 2018, though again at a much higher rate than 2017 and prior. Of note, the emergency room visit rate for opioids in Simcoe Muskoka is higher than the provincial rate. The indicator for wait times for addictions treatment trended upward in 2019. However, supports for treating opioid addiction and mitigating opioid use risk have improved, as the number of primary care prescribers of opioid agonist therapy continues to increase and Simcoe Muskoka has registered new participants in the Ontario Naloxone Program.

PREVENTION ENFORCEMENT

We continue to promote the Brain Story Certification program, Opioid-related investigations are on-going, with one element which provides an understanding of the science about how the focused on holding drug traffickers responsible by way of experiences we have in the earliest years of our lives change our criminal charges. brain architecture in lasting ways. Since March 2018, 468 people from various backgrounds in Simcoe Muskoka have participated Good Samaritan Drug Overdose Act training and awareness in the program, including health care workers, justice, education, sessions continue to be offered. The purpose of the Act is to social work and child care workers, and others. The course encourage people to call 911 and stay with the victim until consists of 19 learning modules and is completed at the participant’s own pace. emergency medical assistance arrives, without fear of arrest. In March 2020, the Prevention Pillar met with the Georgian The Enforcement Pillar is leading the SMOS/Stats Canada Data College Centre for Changemaking and Social Innovation to Project. This collaborative project was formed to bring together develop an experiential workshop based on the Alberta Family data on individuals who have experienced overdose events and Wellness Initiative’s (AFWI) The Brain Game. This hands-on fatalities. The data generated by the project will help to identify the learning opportunity is highly engaging and will serve as the primary risks and characteristics of those individuals most at risk impetus for agencies across our region to learn more about the AFWI and the Brain Story Certification program. For more of opioid use or overdose. Read more about this project on information visit: www.albertafamilywellness.org page 2.

The Simcoe Muskoka Opioid Strategy (SMOS) is a multi-sector General inquires can be directed to: comprehensive strategy aimed at reducing opioid harms in Simcoe and Mia Brown, [email protected] Muskoka. For more information on SMOS visit www.preventod.ca Program Manager, Substance Use and Injury Prevention Program Simcoe Muskoka District Health Unit ----3 CORPORATE SERVICES DEPARTMENT 169 FRONT STREET TELEPHONE 613-968-6481 ~itp of Jiellebille BELLEVILLE, ONTARIO FAX 613-967-3206 K8N 2Y8

November 10, 2020

The Honourable Doug Ford Delivered by e-mail Premier's Office, Room 281 [email protected] Legislative Building, Queen's Park , ON M7A 1A1

Dear Premier Ford:

RE: Bill 218 - Proposing Changes to the Municipal Elections Act - Extension of Nomination Period New B_usiness 10. Belleville City Council Meeting, November 9. 2020

This is to advise you that at the Council Meeting of November 9, 2020, the following resolution was approved.

"WHEREAS municipalities in Ontario are responsible for conducting fair and democratic elections of local representatives; and

WHEREAS the Government of Ontario, with Bill 218, Supporting Ontario's Recovery and Municipal Elections Act, 2020 is proposing changes to the Municipal Elections Act, 1996; to extend nomination day from the end of July to the second Friday in September; and

WHEREAS municipal elections are governed by the Municipal Elections Act which was amended in 2016 to include shorter nomination periods; and

WHEREAS the operation, finance and regulatory compliance of elections is fully undertaken by municipalities themselves; and

. .12 10. New Business Page 2 Belleville City Council Meeting November 9, 2020

WHEREAS local governments are best poised to understand the representational needs and challenges of the body politic they represent, and when looking at alternative voting methods to ensure voters have options in an effort to increase voter participation and are able to vote safely, it becomes more difficult to implement these alternatives with the proposed shorter period between Nomination day and the October 24, 2022 Election day;

NOW THEREFORE BE IT RESOLVED THAT the Corporation of the City of Belleville send a letter to the Premier, the Minister of Municipal Affairs and Housing and Minister of the Attorney General urging that the Government of Ontario respect Ontario municipalities' ability to apply sound representative principles in their execution of elections; and,

THAT the Corporation of the City of Belleville Council recommends that the Government of Ontario supports the freedom of municipalities to run democratic elections within the existing framework the Act currently offers without amendment; and THAT this resolution be circulated to all Ontario Municipalities, AMO and AMCTO."

Thank you for your attention to this matter.

Yours truly,

Matt MacDonald Director of Corporate Services/City Clerk

MMacD/nh Pc: AMO Todd Smith. MPP Prince Edward-Hastings Daryl Kramp. MPP Hastings - Lennox & Addington Minister of Municipal Affairs and Housing Minister of the Attorney General Councillor Kelly, City of Belleville Councillor Thompson, City of Belleville Ontario Municipalities B

November 12, 2020

MPP Will Bouma 96 Nelson Street, Suite 101 Brantford, ON N3T 2X1

Sent via email: [email protected]

Dear MPP Bouma:

Please be advised that Brantford City Council at its Special meeting held November 10, 2020 passed the following resolution:

Bill 218 - Ranked Ballots for Municipal Elections

WHEREAS Bill 218 – “Supporting Ontario's Recovery and Municipal Elections Act, 2020” removes the option for municipalities to choose the ranked ballot system for an election; and

WHEREAS in 2016 the Ontario Provincial Government gave municipalities the tools to use Ranked Balloting in Municipal elections commencing in 2018, which was deployed in the City of London thereby becoming the first Municipality in Canada to make the switch, while Cambridge and Kingston both passed referendums in favour of reform and Burlington, Barrie, Guelph, Meaford and others are now exploring a change as well; and

WHEREAS the change of election method process does not impact the Provincial election models but greatly impacts a Municipalities execution options; and

WHEREAS the only explanation given for this is that we should not be ‘experimenting’ with the electoral process during a pandemic mindful that ranked ballot voting is not an experiment but widely used throughout the world and should be a local option that Municipalities can look to utilize in the next election which is just under two years away

WHEREAS Bill 218 also moves up the Municipal nomination date from the end of July to mid September for no apparent reason thereby reinforcing the power of incumbency and potentially discouraging broader participation in municipal elections; and

WHEREAS these changes are being proposed without any consultation with AMO, Municipalities or the public;

CITY CLERK’S OFFICE City Hall, 100 Wellington Square, Brantford, ON N3T 2M2 P.O Box 818, Brantford, ON N3T 5R7 Phone: (519) 759-4150 Fax: (519) 759-7840 www.brantford.ca

2

NOW THEREFORE BE IT RESOLVED:

A. THAT the City Clerk BE DIRECTED to submit the following comments on behalf of the Council of the City of Brantford to the Province of Ontario with respect to the proposed changes to the Municipal Elections Act, 1996: i. Council does not support the proposed changes to the Municipal Elections Act, 1996, specifically related to the removal of the option for a municipality to hold a ranked ballot election; ii. Council does support the principle that each Municipality should be able to choose whether or not to use first-past-the-post or a ranked ballot election; and iii. Council encourages the Provincial government to meaningfully consult with Municipalities on municipal issues before introducing legislative changes of this magnitude; and

B. THAT the City Clerk BE DIRECTED to forward a copy of this resolution to MPP Will Bouma, Premier Doug Ford, and the list of other Municipalities and include a request to delay the decision until such a time that the Association of Municipalities of Ontario, Large Urban Mayor’s Caucus of Ontario, the Federation of Canadian Municipalities and comments from Municipalities have been collected and submitted to the Province.

I trust this information is of assistance.

Yours truly,

Tanya Daniels City Clerk [email protected]

cc: Hon. D. Ford, Premier of Ontario The Association of Municipalities of Ontario; The Federation of Canadian Municipalities; Large Urban Mayor’s Caucus of Ontario; All Ontario Municipalities