BRANT COUNTY BOARD OF HEALTH REGULAR AGENDA Wednesday, March 17, 2021, 9:30 a.m, Zoom (Classroom 420/421)
1. CALL TO ORDER Chair John Bell
2. CONFLICT OF INTEREST
3. ADDITIONS TO AGENDA / Motion to APPROVE OF AGENDA
4. APPROVAL OF MINUTES 4.1 Motion to approve Brant County Board of Health Minutes of February 17 and March 5, 2021 * All
5. FINANCIAL REPORT No report.
6. BUSINESS ARISING FROM PREVIOUS MINUTES 6.1 Report from the Chair Chair John Bell 6.2 Report from the Medical Officer of Health * Dr. Elizabeth Urbantke 6.3 Report from the Chief Executive Officer * Dr. Jo Ann Tober 6.4 Food Safety Disclosure Report No report 6.5 COVID-19 Reports 6.5.1 COVID-19 Case Management Report * Dr. Elizabeth Urbantke 6.6.2 COVID-19 Immunization Report * Dr. Jo Ann Tober 6.6 Harm Reduction Program * Mr. Gerry Moniz
Motion to accept reports as presented.
7. NEW BUSINESS 7.1 Human Resources Report * Mr. Brent Richardson 7.2 Healthy Growth and Development Program Report * Ms. Joan Millsap
Motion to accept reports as presented.
8. CORRESPONDENCE (Board members may request a copy of items that are not attached from Board of Health Secretary) 8.1 Correspondence from Peterborough Public Health, dated February 12, 2021, re Food Literacy for Students Act. 8.2 Correspondence from Chatham-Kent Public Health, dated February 16, 2021, re paid sick leave during COVID. 8.3 Correspondence from Peterborough Public Health, dated February 16 2021, re paid sick leave. 8.4 Correspondence from Association of Local Public Health Agencies, dated February 19, 2021, re keeping Ontario safe and open. 8.5 Correspondence from Windsor-Essex County Health Unit, dated February 22, 2021, re mandatory paid sick leave for Ontario workers. 8.6 Correspondence from Simcoe Muskoka District Health Unit, dated March 1, 2021, re provincial employment standards reform for provision of paid sick days. 8.7 Correspondence from Peterborough Public Health, dated March 3, 2021, re lack of provincial representation on the board of health. 8.8 Correspondence from Peterborough Public Health, dated March 5, 2021, re student nutrition programs.
Motion to receive the correspondence.
Brant County Board of Health Agenda Page 2 of 2 March 17, 2021
9. INCAMERA
10. QUESTIONS / ANNOUNCEMENTS
11. FUTURE AGENDA ITEMS
12. NEXT MEETING DATE Wednesday, April 21, 2021, at 9:30 a.m.
13. ADJOURNMENT Chair
* Attachments **Attachments for Board of Health members only to be distributed at the meeting
BRANT COUNTY BOARD OF HEALTH REPORT #: 6.2 DATE: March 17, 2021
FROM: Dr. Elizabeth Urbantke Acting Medical Officer of Health
RE: Medical Officer of Health’s Report
Focus has been on COVID-19 response and vaccination campaign which will be covered in separate reports.
Opioid data and response will be covered in separate report.
BRANT COUNTY BOARD OF HEALTH REPORT #: 6.3 DATE: March 17, 2021
FROM: Dr. Jo Ann Tober, Chief Executive Officer
RE: Chief Executive Officer Report
Activities continue to be focused on the roll out of the local COVID-19 vaccine immunization campaign, COVID case and contact management, and Harm Reduction activities.
Details are provided in separate reports on these topics.
Current statistics on topics will be presented during the specific reports at the Board of Health meeting.
BRANT COUNTY BOARD OF HEALTH REPORT #: 6.5.1 DATE: March 17, 2021
FROM: Dr. Elizabeth Urbantke, Acting Medical Officer of Health
RE: COVID-19 Case Management Report
Up-to-date metrics will be reported at the meeting.
Variants of Concern Viruses, like COVID-19, constantly change through mutation. These changes, also known as variants, are expected to occur over time. Sometimes new variants emerge and disappear. Other times, new variants emerge and persist. This is a natural phenomenon for all viruses, including the virus that causes COVID- 19.
A variant of concern is a mutation for which there is evidence that it will impact public health and clinical practice affecting one or more of: transmissibility (spread), virulence (severity of disease), vaccine effectiveness or diagnostic testing.
VOCs identified globally and in Ontario include: - B.1.1.7 variant first identified the UK - B1351 variant first identified in South Africa - P1 variant first identified in Brazil
As of February 3, 2021, all COVID-19 PCR-positive specimens with Ct value ≤35 in Ontario are screened for the N501Y mutation.
BRANT COUNTY BOARD OF HEALTH REPORT #: 6.5.2 DATE: March 17, 2021
FROM: Dr. Jo Ann Tober, Chief Executive Officer
RE: COVID-19 Immunization Report
The local immunization campaign continues to follow the Ministry of Health Three Phase Framework for vaccine administration in Ontario. The province is currently in Phase 1 of the plan which focuses on high-risk populations and includes the immunization of those in congregate settings for seniors, health care workers, adults in First Nations, Metis and Inuit populations, adult chronic home care recipients and adults over 80 years of age. This phase is expected to continue to the end of March.
Locally, the administration of both first and second doses of vaccine have been completed for residents, staff and essential caregivers of long term care and retirements homes. Immunizations have been offered to all health care workers in the highest risk, very high risk and high risk categories and are now being offered to those in moderate risk categories. Immunizations began for those over 80 years of age on March 4 and will continue until this cohort is complete in approximately mid-March. Recipients of chronic home care are currently being invited to book into vaccine clinics and Indigenous adults have been invited to attend any immunization clinics.
Planning has continued for the roll out of vaccine to other groups identified in the Provincial Framework for vaccine distribution. A local Vaccine Sequencing Task Force continues to meet to discuss the sequencing of local groups and community organizations. The sequencing of the Phase 2 populations is currently under discussion. Groups continue to be contacted and provided with information on the vaccine in preparation for when vaccination of these groups can begin.
During a tactical briefing on March 5, 2021, Dirk Huyer, Coordinator of the Provincial COVID Outbreak Response, released details of Phase 2 of the vaccine roll out. This document outlined the next groups to receive vaccine which include adults 60 to 79 in 5-year increments, high-risk congregate settings (shelters, community living) individuals with high-risk chronic conditions and their caregivers, those who cannot work from home and at-risk populations. Phase 2 is expected to last from April to July 2021. Phase 3 includes adults 59 years of age and younger and is expected to begin in July 2021.
Information continues to evolve and be updated on the transportation of the first two vaccines approved for use in Canada, Pfizer and Moderna. These vaccines are stored in a frozen state at -70 degrees and -20 degrees respectively. They require special storage and handling and are to be moved under strict conditions to ensure that the vaccine is not subject to vibration and rendered ineffective. Transportation of the Moderna vaccine has been updated to allow the transport of the vaccine in single dose syringes under careful handling conditions. This will facilitate the immunization of individuals who have moved into a long-term care home or retirement home since it will allow the transport of a small number of doses for use in multiple locations.
Two additional COVID vaccines have been approved for use in Canada. The AstraZeneca vaccine was approved for use on February 26, and the Johnson and Johnson vaccine was approved on March 5. Both of these recently approved vaccines are stored at refrigerator temperatures allowing for easier storage and transportation. The Johnson and Johnson vaccine has a one dose regime rendering it easier for administration for hard to reach or mobile populations where administration of a second dose may be difficult.
Brant County Board of Health # 6.5.2 March 17, 2021 COVID-19 Immunization Report Page 2
Some AstraZeneca Vaccine will be arriving in Ontario in March and the administration of these doses to individuals between the ages of 60 and 64 is being piloted by pharmacies and primary care providers in a small number of communities beginning on March 12. Three Hundred and twenty-five pharmacies in three regions: Toronto, Kingston, and Windsor-Essex will be administering the bulk of the available AstraZeneca supply through booked appointments using the pharmacy booking system. In addition, a small number of primary care providers will be administering AstraZeneca in offices in Toronto, Peel Region, Hamilton, Guelph, Peterborough and Simcoe-Muskoka. Future supplies of AstraZeneca are expected to then be rolled out to a broader group of pharmacies and primary care providers in Ontario when the vaccine supply allows. Availability of the Johnson and Johnson vaccine is currently unknown.
On March 8, 2021, a memo was received from Dr. Williams, Chief Medical Officer of Health directing that the interval between the first and second doses of all currently approved COVID vaccines is to be extended to up to 4 months effective March 10. This lengthened interval between doses will facilitate the administration of more first doses of vaccine with a target of all adults in Ontario receiving their first dose of vaccine by the end of June.
Vaccinations continue to occur through both mass immunization clinics and mobile teams throughout the community. Vaccine supply has remained limited but is expected to increase in late March and into April. Immunization clinics in the community will continue to run at the capacity of vaccine supply. BRANT COUNTY BOARD OF HEALTH REPORT #: 6.6 DATE: March 17, 2021
FROM: Gerry Moniz, Manager, Chronic Disease Prevention and Injury Prevention (CDIP)
RE: Harm Reduction Report
Overview of activities to date
Brantford-Brant Community Drugs Strategy (Drugs Strategy) 1. The Drug Strategy Coordinator position has been established. Meetings with the Drugs Strategy partners (working groups, coordinating committee, service providers etc.) are underway to discuss the progress to date and directions for moving forward. The coordinator will also work with the partners to develop a Drugs Strategy action plan for 2021 in line with the four pillars approach (prevention, treatment, enforcement, and harm reduction). 2. A Drugs Strategy Evaluation Framework has been developed and is attached for reference. The purpose of the evaluation is to examine the development and evolution of the Drugs Strategy over time, and assess it accomplishments and outcomes. Learnings from the evaluation are intended to inform adjustments in the strategy during being implemented as well as future priorities and interventions.
Harm Reduction Program 3. BCHU continues to carry out a number of harm reduction activities as per the public health mandate including the following: o monitoring and responding to calls for needle pick up o education and resource distribution (such as sharps containers—both large and pocket-sized) to people who use substances, businesses, residents/property owners, and the public o naloxone distribution and training (via zoom) to community partners. o needle distribution, collections of and reporting on used needles o community needle sweeps; the team is reaching out to the community for volunteers to work in partnership to conduct sweeps o anti-stigma public awareness messaging. 4. BCHU continues to work with City staff to determine the exact locations for installation of four needle disposal bins in the community. 5. A needle return incentive pilot project has been designed and is attached. BCHU is working with the Needle Syringe Program partners to finalize the pilot details and provide training to staff. The pilot anticipated start date is March 29.
Opioid surveillance 6. In February, there were a total of 21 opioid related incidents in Brant, including 14 overdoses and 7 deaths. Two public safety alerts regarding a spike in fatal cases were issued last month by the Brantford Police and Drug Strategy Partners. Fentanyl continues to be the drug most likely responsible for both overdoses and deaths.
Brant County Board of Health # 6.6 Page 2 Harm Reduction Report March 17, 2021
Brantford-Brant Community Drugs Strategy Evaluation Learning Framework
Program Description The Brantford-Brant Community Drugs Strategy (hereafter referred to as the Drugs Strategy) launched in 2017, serving as a roadmap for addressing substance use and addiction within the Brant/Brantford communities. The Drugs Strategy has been informed by research and community-level evidence, offering insight into four pillars of practice: prevention/education, harm reduction, treatment/recovery, and enforcement/justice. A high-level logic model is presented in Appendix A to depict the theory of change for the Drugs Strategy, which will be employed in the evaluation.
Evaluation Purpose and Audience The Brant County Health Unit (BCHU) is proposing to evaluate the Drugs Strategy to learn about its development, evolution and accomplishments from past and forthcoming experiences. The learning derived from the evaluation is intended to support the work of BCHU, other Drugs Strategy partners, and key decision-makers in leading and guiding the implementation of the Drugs Strategy.
The following evaluation questions are based around the innovations arising from the Drugs Strategy, the partnerships, and its outcomes.
1. How is the Drugs Strategy adapting to the complex, emergent, and dynamic conditions within Brant/Brantford? a. What innovations are emerging? What innovations are being sustained? b. What resources are necessary to ensure sustainability of the Drugs Strategy efforts? c. How are the Drugs Strategy initiatives interacting with the current context? d. How should the Drugs Strategy adapt in response to the evolving environment? 2. Given where we are now, what are the next steps? a. What has been accomplished thus far? What remains outstanding to address? What are the community priorities going forward? b. What are the strengths of the Drugs Strategy implementation? Where are the opportunities to improve the Drugs Strategy implementation? 3. How have the partnerships contributed to the implementation of the Drugs Strategy? a. What is working well? What is helping to enhance the partnerships? b. What is not working well? What is hindering success of the partnerships? c. How can the partnerships be improved to offer sustainable support to the Drugs Strategy? d. Are there gaps in partnerships at the different levels of the Drugs Strategy implementation? 4. What difference is the Drugs Strategy making in Brant/Brantford? a. What are the emerging outcomes? What are the unexpected outcomes? b. How are the needs of the Brant/Brantford community being met? Whose lives are changing? In what ways, and to what extent? 5. What is the social return on investment of the Drugs Strategy? a. What are the costs for the Drugs Strategy implementation? b. How has the Drugs Strategy contributed to the outcomes?
Brant County Board of Health # 6.6 Page 3 Harm Reduction Report March 17, 2021
Evaluation Approach The evaluation will employ two approaches: developmental evaluation and contribution analysis. Developmental evaluation has been chosen as an approach to this evaluation due to the evolving nature of the Drugs Strategy. Developmental evaluation focuses on reflection and learning about the Drugs Strategy implementation, while encouraging adaptation and innovation to complex and dynamic situations. Contribution analysis will be used to describe the story of change within Brant/Brantford through the efforts of the Drugs Strategy. Contribution analysis examines the theory of change and tests assumptions associated with the implementation of the Drugs Strategy.
Evaluation Methods and Design The evaluation will employ a mixed methods approach, and will be informed iteratively by subsequent evaluation learning activities (e.g., facilitated discussions).
Evaluation Matrix Evaluation Questions Indicators Data Sources Timeline
1. How is the Drugs Strategy adapting to the complex, emergent, and dynamic conditions within Brant/Brantford?
List/map of interventions and Intervention and observed outcomes outcome mapping 1a. What innovations Ongoing are emerging? What Intervention reach and engagement Intervention-specific innovations are being data evaluations sustained? Feedback from Drugs Strategy Ongoing; Facilitated discussions committees and working groups quarterly
Feedback from Drugs Strategy Facilitated discussions 1b. What resources are committees and working groups necessary to ensure Intervention-specific Ongoing; sustainability of the Recommendations for critical inputs evaluations quarterly Drugs Strategy efforts? to ensure feasibility, sustainability, and/or expansion of interventions Systems mapping
Assessment of Drugs Strategy Facilitated discussions function with Drugs Strategy
1c. How are the Drugs committees and working groups Environmental Strategy initiatives Ongoing; analysis (ACTION interacting with the Identified contextual factors quarterly tool) current context?
Risks and assumptions associated Force field analysis with and unique to the logic model
Feedback from Drugs Strategy Facilitated discussions 1d. How should the committees and working groups Drugs Strategy adapt in Environmental Ongoing; response to the Recommendations for adaptation to analysis (ACTION quarterly evolving environment? the structure, organization, and tool) function of the Drugs Strategy Brant County Board of Health # 6.6 Page 4 Harm Reduction Report March 17, 2021
Evaluation Questions Indicators Data Sources Timeline
Soft systems methodology
2. Given where we are now, what are the next steps?
2a. What has been List of accomplishments and accomplished thus far? Intervention and recommendations achieved What remains outcome mapping Spring 2021 outstanding to address? and Winter Stage of community readiness What are the Community readiness 2022 community priorities tool Identified community priorities going forward?
2b. What are the strengths of the Drugs Feedback from partners on the Strategy strengths Partnership survey Spring 2021 implementation? Where and Winter are the opportunities to Recommendations for improving Partner interviews 2022 improve the Drugs Drugs Strategy implementation Strategy implementation?
3. How have the partnerships contributed to the implementation of the Drugs Strategy?
Feedback from partners regarding 3a. What is working aspects that work well for them Partnership survey Spring 2021 well? What is helping and Winter to enhance the Feedback from partners with Partner interviews 2022 partnerships? identified facilitators and strengths of partnerships
Feedback from partners regarding 3b. What is not working aspects not working for them Partnership survey Spring 2021 well? What is hindering and Winter success of the Feedback from partners with Partner interviews 2022 partnerships? identified barriers and weaknesses of partnerships
Feedback on sustainability of 3c. How can the partnerships and recommendations to Partnership survey partnerships be enhance partnerships Spring 2021 improved to offer Partner interview and Winter sustainable support to Revised Terms of Reference for 2022 the Drugs Strategy? Drugs Strategy committees and Coalition checklist working groups Brant County Board of Health # 6.6 Page 5 Harm Reduction Report March 17, 2021
Evaluation Questions Indicators Data Sources Timeline
Partnership network Partnership map of connections mapping 3d. Are there gaps in partnerships at the Spring 2021 Identified partners not at the table Partnership survey different levels of the and Winter (missing connections) Drugs Strategy 2022 Partner interview implementation? Relationships across stakeholders Stakeholder analysis
4. What difference is the Drugs Strategy making in Brant/Brantford?
Measured short-term, intermediate, and unintended outcomes identified Population data 4a. What are the in logic model (and any changes) emerging outcomes? Stakeholder and Quarterly What are the Revised logic model (nested) intervention-specific unexpected outcomes? surveys Community profile
Most significant change stories from Most significant Winter / vulnerable populations, people who change technique Spring 2022 use substances, and residents
Intervention engagement data 4b. How are the needs Intervention-specific of the Brant/Brantford Ongoing Changes in knowledge, attitudes, evaluations community being met? practices among intended audiences Whose lives are changing? In what Connections between people and ways, and to what organizations extent? Spring 2021 Identified structural barriers within Systems mapping and Winter the system 2022
Change in systems level connections
5. What is the social return on investment of the Drugs Strategy?
Costs associated with each intervention based on outputs and Cost-benefit/cost- outcomes (e.g., $XX for every effectiveness analysis 5a. What are the costs individual attending sessions; $XX Winter / for the Drugs Strategy saved for every individual referred to Social return on Spring 2022 implementation? opioid substitution therapy) investment
calculations Cost-benefit comparisons for repeated interventions Brant County Board of Health # 6.6 Page 6 Harm Reduction Report March 17, 2021
Evaluation Questions Indicators Data Sources Timeline
Intervention and List of interventions and outcomes outcome mapping 5b. How has the Drugs
Strategy contributed to Ongoing Stakeholder characterization of Stakeholder and the outcomes? contribution intervention- specific survey
Brant County Board of Health # 6.6 Page 7 Harm Reduction Report March 17, 2021
Appendix A: High-level Logic Model for the Brantford-Brant Community Drugs Strategy
Brant County Board of Health # 6.6 Page 8 Harm Reduction Report March 17, 2021
Needle Return Incentive Pilot Project Proposal
March 8, 2021 Brant County Health Unit
Background
A review of over 3000 publications from the past 20 years conducted by the Brant County Health Unit (BCHU) found no peer-reviewed articles or agency reports examining monetary and other incentives to improve needle return or proper disposal of used needles. In one study, Needle Syringe Program (NSP) clients suggested incentives as a strategy to encourage the return of used needles (Spaulding & Canady, 2020); otherwise, incentives have not been studied in published research. One public health unit in Ontario (North Bay Parry Sound District Health Unit; NBPSDHU) and several grassroots efforts in British Columbia have attempted to provide monetary incentives of some kind for individuals who return needles. However, the effects of these initiatives have not been formally evaluated.
Goal
BCHU is proposing to implement a Needle Return Incentive (NRI) pilot project to examine whether and to what extent offering a monetary incentive to people who use intravenous drugs will increase the return of used needles to the NSP. The NRI Initiative is modelled on the NBPSDHU approach, offering a $5 gift card for every 100 needles returned. The pilot will be implemented over a 3-month period. The end goal is to reduce the number of improperly discarded used needles within public spaces and private property in Brant and Brantford. This pilot project acts as a proof-of-concept considering the lack of published evidence for monetary incentives to address the return of used needles.
Project Description
Key activities: Incentive – People who use intravenous drugs are asked to return needles in exchange for $5 gift card for every 100 used needles returned, to a maximum of $20 per person per day. Needles are to be returned in a sharps container or hard plastic container. Education – At the time of a transaction at the NSP, clients will be provided with education around proper needle disposal. They will be offered personal sharps containers as well as a postcard which lists disposal locations in the community. Marketing – a communication campaign will be implemented to promote the NRI and raise awareness about safe needle disposal. Messages and materials will be informed by needle disposal awareness campaigns implemented in other Canadian jurisdictions, such as “Don’t be a Prick” (Nova Scotia) and “Make it your gig to return your rig” (British Columbia). The campaign will involve posters and postcards distributed at the NSP sites and in venues across the city to remind people, including NSP clients and non-clients, to properly dispose of used needles.
Pilot duration: 3-month, with a possibility of extension pending the progress with reducing the number of improperly discarded needles in the community.
Indicator of Success: Reduced number of used needles reported in community spaces (both public spaces and private property) over a 3-month period.
Concerns: People might return fewer than 100 needles at a time or dispose of garbage in containers along with some needles. NSP and BCHU staff cannot police the return of needles and must trust clients. Costs might over-run due to popularity of incentive.
Staff and agencies involved in the pilot: BCHU - Gerry Moniz – BCHU, Manager, Chronic Diseases Prevention and Injury Prevention - Tin Vo – BCHU, Drug Strategy Coordinator - Harm Reduction (HR) team - Population Health Assessment (PHA) team - Communications team NSP agencies - St. Leonard's Community Services - Grand River Clinic - Colborne Street Clinic
Project Plan Activities Timelines Deliverables Responsible person/agency Explore with NSP partners the NRI pilot details March 1-12 Meetings with NSP G. Moniz (process, safety, agreement etc.) partners Finalized project plan Draft and sign NRI agreement with NSP partners March 8-19 Signed NRI agreement Finance (as an addendum to the NSP MOU) Develop tool (gift card tracking sheet, client March 8-12 Surveys and interview T. Vo survey, staff survey, and staff interview guide) guide PHA Purchase gift cards March 8-19 Gift cards Finance Train NSP staff and BCHU staff March 15-19 Training sessions T. Vo Develop and print campaign materials March 8-25 Poster, postcard, stickers Communications Launch NRI, distribute gift cards and campaign March 29 Media release Communications materials HR NSP agencies Track distribution of gift cards and returned March 29 – June Gift card distribution PHA needles 30 Needle returns NSP agencies Check-in with NSP sites weekly regarding needle On-going; weekly Feedback HR returns and gift card distribution Conduct interviews with NSP staff and BCHU April 26-30 Interviews, data analysis PHA staff NSP agencies Progress report at 1-month May 3-7 Progress report G. Moniz, T. Vo, PHA
Implement NSP and BCHU staff surveys, and June 21-30 Data collected PHA client surveys NSP agencies Final report at 3-month July 1-9 Final report G. Moniz, T. Vo, PHA
Budget Activity Budget Gift cards (est. 1200 visitors x $5 over 3 months) $6000 Printing costs (e.g., posters, postcards, stickers) $1500 Sharps containers (est. 1200 visitors X $10) $12,000 Total: $19,500
Evaluation An evaluation will be conducted to assess the impact of the pilot project. The table below summarizes the evaluation questions, respective indicators, data sources and timeline.
Evaluation Question Indicator Data Source Timeline How is the NRI Initiative Challenges and successes (focused on risks Interviews with BCHU and 1-month working? What is working well and assumptions) NSP staff check-in and not working well? Client feedback NSP client survey To what extent has the incentive # of gift cards distributed Gift card tracking sheet 3-month contributed to a reduction in the # needles reported per month during pilot Community Used Needle review number of needles reported in compared to 2020 monthly data prior to Reporting Tool (REDCap) community settings? NRI Initiative What outcomes have been Client and staff feedback related to intended BCHU and NSP staff survey 3-month observed over the pilot period? and unintended outcomes NSP client survey review
Appendix 1. Project Logic Model
The NRI Initiative is presented in a logic model diagram (Figure 1) to provide an overview of how the Initiative intends on achieving its outcomes, as well as some risks and assumptions that might influence the success of the Initiative.
Figure 1: Needle Return Incentive Initiative Logic Model
BRANT COUNTY BOARD OF HEALTH REPORT #: 7.1 DATE: March 17, 2021
FROM: Brent Richardson, Director, Human Resources
RE: 2020 Human Resources Year in Review Report
STAFF DEMOGRAPHICS
Brant County Health Unit employs a broad range of professionals including Public Health Nurses, Public Health Inspectors, Dieticians, Registered Practical Nurses, Planners, Epidemiologist, etc.
Staffing
Casual 6
Part-Time 15
Full-Time Part-Time Full-Time 96 Casual
2020 Number of Employees: 117 2019 Number of Employees: 123 Unionized employees: 94 Non-Unionized employees: 23 Full time: 96 Part time: 15 Casual: 6
Succession Management
The number of staff eligible to retire today (over 55 yrs.) has been steadily dropping over the course of the last couple of years due to retirements. In 2020 the trend continued with an additional seven staff electing to retire.
As a result, this has further reduced our risk associated with the high number of staff that could leave all at once leaving a gap in knowledge and experience. We have been actively working on a robust succession management plan to build skills and capacity in our team to fill the vacancies, knowledge, skills and abilities when these retirees move on to the next chapter of their lives.
Board of Health Report # 7.1 Page 2 Human Resources Report March 17, 2021
We currently have 19 staff that based on their age can retire. It should be noted that age is the minimum requirement. There are a number of factors including years of service etc. that could also have an impact on their decision to retire.
Team leads – As part of the Succession Management plan we introduced team leads to assist the management team and to build leadership capacity among the teams. This has proven to be a valuable resource not only for the staff that are being further supported by these leads but also the management team who are able to communicate more effectively with their staff via their lead. This was highlighted during our COVID 19 response when staff where working remotely and the information and guidance changed so rapidly. The assistance of the leads was extremely helpful.
RECRUITMENT In 2020, we experienced an increase in recruitment by 6.45%. The Health Unit saw an increase in the number of applicants and number of interviews by 103.7% and 35.29% respectively. The Health Unit was able to reduce the number of days to hire by 47.48% in 2020. Some of the most notable recruitments from 2020 were the increase in the internal supervisory and lead opportunities as part of our succession management plan.
Recruitment Competitions 60
40
20
0 Front Line Supervisory/Lead Management
2018 2019 2020
2020 Recruitment Statistics: Change from 2019 to 2020 Number of competitions: 33 Increase in number of competitions: 6.45% Number of applicants for all positions: 2642 Decrease in days to hire from 2019 to 2020: 47.48% Average Number of days to hire: 22 Increase in number of applicants by 103.7% Number of interviews: 115 Increase in number of interviews by 35.29%
Board of Health Report # 7.1 Page 3 Human Resources Report March 17, 2021
Recruitment Stats (2018 - 2020)
3000
2500
2000
1500
1000
500
0 Number of Number of Average Number of Number of Competitions Applicants for All Days to Hire Interviews Positions
2018 2019 2020
TURNOVER In 2020, Brant County Health Unit saw turnover for various reasons including retirement, contracts ending, and resignations to pursue other career opportunities. Turnover rate for 2020: 15.8% (18 employees) • 39% Retirements (7 employees) • 39% Resignations (7 employees - all pursuing new opportunities) • 22% Contract Ending (4 employees)
Turnover rate for 2019: 17%
DISABILITY MANAGEMENT Sick leave benefits are available to staff via their respective collective agreements and for management via the Human Resources Policy. We have tried to focus on reporting and managing these leaves more closely due to the nature of the cost associated with the benefit. We had seen a slight increase in the incidental sick leave benefits utilization over 2018 and 2019 which we believe is a result of better reporting in the time management system (ADP). In 2020, our incidental sick leave benefit utilization went down, likely due to the pandemic and the public health measures put in place to keep people healthy. We are working in partnership with our ONA bargaining units to have a consistent and collaborative process. We are managing the Short term and Long term claims more closely and we are starting to see benefits.
Board of Health Report # 7.1 Page 4 Human Resources Report March 17, 2021
Leave Trends (2018 - 2020)
19 20 18 16 14 12 9 10 8 8 4.76 6 4.6 3 4 3 3 4 2.5 2 1 2 2 1 2 0 0 0 Average Disability Long-Term Maternity Educational ESA Leaves Number of Related Disability Leaves Leaves Casual Sick Leaves Days per Emloyee
2018 2019 2020
Casual Sick Days Total 2020: 277 (Casual Sick Days Total 2019: 585.78) Average Number of Casual Sick Days per Employee: 2.5 Disability Related Leaves: 9 Long-Term Disability: 1 Maternity Leaves: 3 Educational Leaves: 0 ESA Leaves (Infectious Diseases Emergency Leave): 1
LABOUR RELATIONS Number of grievances: ONA Allied (General): 2 ONA Nursing: 5
The overarching theme of grievances from 2020 is related to the COVID-19 Pandemic. The Health Unit had four grievances (two from each bargaining unit 2 group and 2 policy) related to compensation for the Easter Stat Holiday and one policy grievance from the Nursing group in relation to Pandemic pay. All four of the grievances related to the Easter Stat Holiday have been resolved. The Pandemic pay nursing grievance was withdrawn.
The other Nursing grievances were related to discipline that was issued as a result of internal complaints of interpersonal conduct. The investigations had findings of inappropriate conduct which led to discipline being issued and a subsequent grievance from ONA. The grievances have now been resolved.
BRANT COUNTY BOARD OF HEALTH REPORT #: 7.2 DATE: March 17, 2021
FROM: Joan Millsap, Manager, Healthy Growth & Development
RE: Healthy Growth and Development Program
Overview
The goal of the Healthy Growth and Development (HG&D) Program is to achieve optimal health and development for families from preconception, through to pregnancy and parenting newborns, children, and youth. During the COVID-19 response in 2020, the program focused efforts on ensuring parents of newborns, parents with concerns, and community partners received the information they needed to help meet these goals.
Healthy Babies Healthy Children (HBHC) The majority of the work was done as part of the HBHC program. This is funded by the Ministry of Children, Community and Social Services with the vision that every child identified with risk will have access to services that support healthy child development and effective parenting. The components of the program are universal screening in the postpartum period with targeted screening in the prenatal and early childhood periods; in-depth family assessments in clients’ homes; and blended home visiting with Public Health Nurses (PHNs) and Family Home Visitors (FHVs). The program is voluntary and families are supported by the PHNs to identify and work towards meeting personal family goals.
In 2020: Universal screening of postpartum women continued. The Brant County Health Unit (BCHU) received postpartum HBHC Screens for 96% of all births (1254 women). Sixty to sixty-nine percent of these women were successfully contacted and provided with information and support for newborn care, infant feeding, and community resources. These rates are comparable to 2019 rates. In addition, 93 HBHC screens were completed for prenatal and families with young children. Generally, these clients refer themselves, or are referred by Brant Family and Children Services or their healthcare provider. The rate of contact with these women was approximately 10% lower than previous years. With staff redeployment to COVID, the subsequent components of in-depth family assessments and ongoing home visiting were reduced. Client interactions were done by phone or virtually. Within the overall HBHC program 1,389 families had 5,916 interactions with PHNs or FHVs.
Healthy Pregnancies The Health Unit’s in-class prenatal classes were held twice monthly before being suspended in mid- March. Staff were quickly able to strengthen the focus on encouraging expectant parents to utilize the on- line prenatal education program for their learning needs. Usage of this program has steadily grown in recent years: 105 attended in 2018; 237 in 2019 after a communication campaign to promote its use; and 338 attended in 2020.
The Canada Prenatal Nutrition Program (CPNP) is a weekly drop-in program for young expectant women and their supports. In collaboration with EarlyONs and Margot’s Place, the participants attend brief prenatal and postnatal education sessions, share a meal, and learn about community services. Before being suspended in mid-March, nine weekly drop-in sessions were held with an average of eighteen young moms and their support persons attending. The program re-started in July as a private Facebook
Board of Health Report # 7.2 Page 2 Healthy Growth & Development March 17, 2021 page with weekly live chats. The advantage of this on-line approach is that videos, quizzes, discussions, and other postings can be saved and women can watch them when it is convenient for them. In order to increase the support for vulnerable expectant women and new mothers, BCHU opened up eligibility for the program to all ages.
Healthy Growth and Development Promotion A primary focus of the healthy pregnancies and healthy growth and development promotion programs in recent years has been strengthening BCHU’s relationships with community partners in order to identify and refer vulnerable families to necessary services quickly and appropriately. In March, the PHNs suspended their daily attendance to the Brant Community Healthcare System postpartum floor and special care nursery, weekly attendance at Paediatric rounds, and monthly visits to obstetrician offices. However, staff were able to continue collaboration on a more informal basis due to established relationships with these partners. PHNs attended their virtual team meetings and collaborated to update the “Your Newborn Guide” and “Passport for Growth” resources that all new parents receive at the hospital. This resource is also mailed to parents who deliver out of town and is available at family doctors’ offices.
The Health Unit is committed to increasing postpartum women’s access to resources and services in the community, and to increase families’ awareness of the factors associated with healthy growth and development. To facilitate this, BCHU maintained PHN staffing on the Family Line throughout 2020. In addition to actively reaching out to parents referred by the hospital or community partners, the Health Unit responded to 238 enquires to Family Line. A major component of this service is breastfeeding support for new mothers. Home visits to mothers were suspended in March; however, staff continued to provide guidance by phone, with referrals to a community partner if needed.
The HG&D program has always worked very closely with community partners in the Early Years sector and in 2020 this work became even more important. With the contraction of HBHC services, BCHU relies on partners to identify and support families who may need either slight or more intensive support. These relationships were maintained by attending network and community coordination virtual meetings.
There is concern that in both the Health Unit’s HG&D work and in meetings with community partners, staff are anecdotally seeing an increase in parents experiencing mental health challenges. This is combined with a more limited ability to support them. Initial discussions are underway for focusing on perinatal mental health support as the community re-opens.
Positive Parenting “Positive parenting promotes healthy attachment between the parent and child, as well as child management strategies to promote positive behaviours in children” (Healthy Growth and Development Guideline 2018). For the past several years, the Health Unit and community partners have aimed to increase parents’ knowledge of positive parenting techniques by offering the TripleP program to families. Before March, 12 sessions with 67 attendees were held. While in-person classes were suspended, Health Unit staff continued to respond to parent queries (28 in 2020,) directed them to the Ontario Triple P site for virtual classes, and offered an on-line individual Triple P program. Uptake for this has been very low. The year gave the Health Unit an opportunity to refine the HG&D information on the BCHU website. Parenting and growth and development information was all updated and expanded, with more appealing video content added.