[{"text": "e", "start": 28.96, "end": 31.96}, {"text": "e e", "start": 58.92, "end": 62.96}, {"text": "Public Health subcommittee meeting January 13th soundcheck 2 sound check", "start": 92.24, "end": 98.92}, {"text": "two", "start": 118.84, "end": 121.84}, {"text": "e", "start": 148.84, "end": 151.84}, {"text": "e", "start": 178.84, "end": 181.84}, {"text": "e", "start": 208.76, "end": 211.76}, {"text": "e", "start": 238.72, "end": 241.72}, {"text": "e", "start": 268.72, "end": 271.72}, {"text": "e", "start": 298.639, "end": 301.639}, {"text": "e", "start": 328.639, "end": 331.639}, {"text": "e", "start": 358.639, "end": 361.639}, {"text": "e", "start": 388.56, "end": 391.56}, {"text": "e", "start": 418.52, "end": 421.52}, {"text": "e", "start": 448.52, "end": 451.52}, {"text": "e", "start": 478.44, "end": 481.44}, {"text": "e", "start": 508.44, "end": 511.44}, {"text": "e", "start": 538.44, "end": 541.44}, {"text": "e", "start": 568.36, "end": 571.36}, {"text": "e", "start": 598.32, "end": 601.32}, {"text": "e", "start": 628.32, "end": 631.32}, {"text": "e", "start": 658.24, "end": 661.24}, {"text": "e", "start": 688.24, "end": 691.24}, {"text": "e", "start": 718.24, "end": 721.24}, {"text": "e", "start": 748.16, "end": 751.16}, {"text": "e", "start": 778.12, "end": 781.12}, {"text": "e", "start": 808.12, "end": 811.12}, {"text": "e", "start": 838.04, "end": 841.04}, {"text": "e e", "start": 868.04, "end": 872.079}, {"text": "good morning and welcome to the public health subcommittee meeting for January 13 2025 we have Quorum present for today's", "start": 907.12, "end": 914.8}, {"text": "meeting so I'd like to call this meeting of the public health subcommittee to order a reminder to everyone that if you have an electronic device that makes", "start": 914.8, "end": 921.16}, {"text": "sounds U make it not make sounds please just not to interrupt yourself or others I'll move right into our agenda", "start": 921.16, "end": 928.36}, {"text": "and the first item is approving the agenda so can I have a move in a second or two approve the agenda as", "start": 928.36, "end": 934.24}, {"text": "presented move by member Dano seconded by councelor casar are there any amendments from", "start": 934.24, "end": 940.639}, {"text": "committee members to the agenda for today not seeing any uh we'll use show", "start": 940.639, "end": 946.639}, {"text": "of hands here since not everybody has access to the electronic voting system all those in favor of the agenda being", "start": 946.639, "end": 952.319}, {"text": "approved that's everybody so that carries thank you want to Declarations of Interest are", "start": 952.319, "end": 958.68}, {"text": "there Declarations of interest for today anyone have a disqualifying or non-disqualifying interest they want to", "start": 958.68, "end": 964.48}, {"text": "let us know about not seeing any we'll move on to item four which is the approval of the", "start": 964.48, "end": 970.8}, {"text": "minutes from our first meeting on December the 4th 2024 can I please have a move in second or two approve the", "start": 970.8, "end": 976}, {"text": "minutes of our December 4th meeting moved by member kby seconded by", "start": 976, "end": 981.639}, {"text": "member Lennox any discussion on the minutes from our last meeting any quibbles", "start": 981.639, "end": 989.279}, {"text": "okay not seeing any all those in favor of approving the minutes of our last meeting that is everyone so it's carried", "start": 989.72, "end": 995.24}, {"text": "thank you and we're right into delegations today and so today we'll have a virtual delegation that's", "start": 995.24, "end": 1001.959}, {"text": "pre-recorded just let you know how it's going to work in terms of people want to make comments or questions you can't question someone if they're not here and", "start": 1001.959, "end": 1008.199}, {"text": "so a pre-recorded video will not allow for questions it turns out but when we go to receive the presentation of the", "start": 1008.199, "end": 1013.92}, {"text": "video of the delegation we'll have a space there if anyone wants to make a comment or say anything at that time so", "start": 1013.92, "end": 1019.44}, {"text": "I'll look to you all then if you'd like to make a comment or enter in discussion about the delegation otherwise whenever clerks are", "start": 1019.44, "end": 1025.918}, {"text": "ready they can put it on the", "start": 1025.919, "end": 1028.639}, {"text": "screen water fluoridation effects on the immune compromised and unborn very young", "start": 1034.839, "end": 1040.64}, {"text": "I'm Monica and I'm an orthomolecular holistic health and cancer practitioner here in Hamilton next slide some", "start": 1040.64, "end": 1047.28}, {"text": "countries began water fluoridation in 1945 can Beed I'm not seeing any video but I was", "start": 1047.28, "end": 1054.76}, {"text": "hearing the delegate refer to next slide is it just Audio Only it's Audio Only and I think what the delegate was", "start": 1054.76, "end": 1060.799}, {"text": "intending is that you'd use the material that she provided which is included in the agenda as she speaks thanks I just", "start": 1060.799, "end": 1068.799}, {"text": "want to make sure we picked up on that visual cue carry on sorry thank", "start": 1068.799, "end": 1076}, {"text": "you water fluoridation effects on the IM new compromised and unborn very young", "start": 1076, "end": 1081.76}, {"text": "I'm Monica and I'm an orthomolecular holistic health and cancer practitioner here in Hamilton next slide some", "start": 1081.76, "end": 1088.44}, {"text": "countries began water fluoridation in 1945 saying that Dental cavities can be reduced by up to", "start": 1088.44, "end": 1094.2}, {"text": "25% this is the same era were LED in gasoline and paint asbest aluminum and", "start": 1094.2, "end": 1099.84}, {"text": "smoking were deemed safe for the public most countries in the world refuse to flate mostly because of health risks and", "start": 1099.84, "end": 1106.96}, {"text": "some use the precautionary principle because there is limited proof that it was necessary or safe for the public at", "start": 1106.96, "end": 1112.679}, {"text": "large but the late 1990s many countries stopped fluoridation or greatly reduce", "start": 1112.679, "end": 1118.08}, {"text": "the added amounts fluoride is not an essential nutrient most foods contain fluoride", "start": 1118.08, "end": 1124.559}, {"text": "Hamilton water and distribution website States fluide is already a naturally occurring material found in our", "start": 1124.559, "end": 1131.039}, {"text": "environment such as water rocks air plants soil most Foods next slide", "start": 1131.039, "end": 1137.64}, {"text": "currently only about 4 to 5.7% of the world population have artificially", "start": 1137.64, "end": 1142.72}, {"text": "floridated drinking water Australia Canada and us have the highest populations approximately 170 Canadian", "start": 1142.72, "end": 1150.84}, {"text": "communities florid dat and 76 of those are in Ontario the US is looking at stopping fluoridation altogether next", "start": 1150.84, "end": 1158.08}, {"text": "Slide the Hamilton water treatment website states that fluoride is added to the drinking water to promote dental", "start": 1158.08, "end": 1164.919}, {"text": "health and maintains levels of6 parts per million Lake Ontario is15 parts per million so", "start": 1164.919, "end": 1173.64}, {"text": "Hamilton's drinking water is four times the naturally occurring level of fluoride the fluoride added to the water", "start": 1173.64, "end": 1180.28}, {"text": "is an industrial byproduct and it is not the same as naturally occurring calcium fluoride found in foods and natural", "start": 1180.28, "end": 1187.24}, {"text": "water bodies cavity rates have declined just as rapidly in non fluoridated countries", "start": 1187.24, "end": 1194.4}, {"text": "because of better dental hygiene oral health education and restricting sugary Foods drinks fluoride is very corrosive", "start": 1194.4, "end": 1202.159}, {"text": "and reacts with Hamilton's lead pipes causing lead to leech into the water orthal phosphate is being used to reduce", "start": 1202.159, "end": 1208.44}, {"text": "the lead leeching but what doesn't stay in the pipes gets absorbed into our bodies material safety data sheets have", "start": 1208.44, "end": 1215.159}, {"text": "serious health warnings and also state that fluoride is corrosive to Metals concrete and glass do not discharge onto", "start": 1215.159, "end": 1223.24}, {"text": "ground into drains Lakes streams ponds or public Waters and 2014 the lanet", "start": 1223.24, "end": 1230.44}, {"text": "medical Journal classified fluoride arsenic lead and Mercury as neurotoxins", "start": 1230.44, "end": 1236.32}, {"text": "next slide over 80% of ontarians have one or more diseases or adverse health", "start": 1236.32, "end": 1242.6}, {"text": "conditions since 2021 Health disorders from all causes in all ages have", "start": 1242.6, "end": 1249.4}, {"text": "increased by 20% above the mean average The Unborn and very young the immune", "start": 1249.4, "end": 1255.36}, {"text": "compromised and the elderly are at a huge risk of excessive fluoride accumulation resulting in chronic health", "start": 1255.36, "end": 1262.159}, {"text": "issues that worsen over time and the creation of additional health and disease", "start": 1262.159, "end": 1268.12}, {"text": "conditions immune compromised people commonly have weakened and impaired liver and kidney functioning preventing", "start": 1268.12, "end": 1274.76}, {"text": "them from excreting fluoride efficiently and this leads to worsening of all disease symptoms and creates additional", "start": 1274.76, "end": 1281.039}, {"text": "Health complications as time goes on 70% of us children have dental fosis which", "start": 1281.039, "end": 1288.039}, {"text": "also means me their bones in pineal gland are compromised in conclusion Health Canada still stands by research", "start": 1288.039, "end": 1295.44}, {"text": "done in 1942 and states that the benefits of of preventing cavities outweigh any", "start": 1295.44, "end": 1301.559}, {"text": "potential health concerns September 20124 a US federal judge ruled that", "start": 1301.559, "end": 1307.2}, {"text": "water fluoridation poses an unreasonable risk of reduced IQ in", "start": 1307.2, "end": 1313.4}, {"text": "children and the US recently announced that they advise to stop fluoridating all public water in", "start": 1313.4, "end": 1319.679}, {"text": "2025 up toate scientific evidence shows that the risks of fluoridation outrank", "start": 1319.679, "end": 1326.12}, {"text": "the ideology of prevents less cavities I ask Hamilton Council to stop", "start": 1326.12, "end": 1333.4}, {"text": "or pause water fluoridation immediately citing the precautionary principle until", "start": 1333.4, "end": 1340.279}, {"text": "safety concerns using recent data have been addressed thank you", "start": 1340.279, "end": 1347.44}, {"text": "okay now that we're at the end of our delegation it's just a activity now receiving that delegation I'm a move in", "start": 1349.84, "end": 1355.32}, {"text": "second to receive the delegation move by councelor", "start": 1355.32, "end": 1361.12}, {"text": "hang second by councelor casar and so that means if there's any discussion debate questions also just in case", "start": 1361.12, "end": 1367.72}, {"text": "people would like to know uh senior director of water uh Nick Winters is in the room in case people had water", "start": 1367.72, "end": 1373.08}, {"text": "related questions they wanted to ask and know of course our Public Health staff's also here in case people had questions they want to ask about the delegation or", "start": 1373.08, "end": 1380.039}, {"text": "any comments people want to make I'll just speak for another few seconds to allow there to be space for anyone who", "start": 1380.039, "end": 1386.279}, {"text": "wanted to raise their hand and alas orac Tammy", "start": 1386.279, "end": 1391.88}, {"text": "please thank you chair um I think the big question is are these warranted or", "start": 1391.88, "end": 1398.44}, {"text": "is this uh delegation and the facts that she has um delegated to us is that are", "start": 1398.44, "end": 1406.2}, {"text": "they true through you chair to Dr Lou I think", "start": 1406.2, "end": 1411.32}, {"text": "because I think Dr Richardson did one of these yes I don't know that we can have Dr Lou respond to every single um thing", "start": 1411.32, "end": 1418.44}, {"text": "shared in the delegation but in general Dr L if you have a response that you can provide uh to the counselor uh through", "start": 1418.44, "end": 1425.64}, {"text": "the chair uh Brendan Lou associate medical officer of Health um so Community water foration uh continues to", "start": 1425.64, "end": 1431.4}, {"text": "be held as a as a safe costeffective uh very important Public Health measure in terms of reducing the", "start": 1431.4, "end": 1437.72}, {"text": "risk of dental decay in in Childs and adults it is continues to be held as a", "start": 1437.72, "end": 1443.08}, {"text": "crowning Public Health achievement by organizations worldwide including World Health Organization uh Dental associations um", "start": 1443.08, "end": 1450.84}, {"text": "both nationally and and internationally and provides uh uh Health oral health benefits uh that are Equitable across", "start": 1450.84, "end": 1457.76}, {"text": "socioeconomic groups particularly those who may have barriers to other forms of of preventive uh denti history um with", "start": 1457.76, "end": 1465.2}, {"text": "with any sort of um substance we're always considerate of what the the", "start": 1465.2, "end": 1470.84}, {"text": "health impacts of of that substance may be whether those are uh positive or protective effects or or well as well as", "start": 1470.84, "end": 1477.12}, {"text": "those that may have adverse uh effects and and that with any any substance there always are thresholds that we're", "start": 1477.12, "end": 1483.12}, {"text": "considered of that where um uh health risks are are a matter of concern that", "start": 1483.12, "end": 1488.52}, {"text": "we that we would be um wanting to avoid and so we uh are in U adher adherence", "start": 1488.52, "end": 1496.36}, {"text": "and alignment with uh the Canadian drinking water standards around um the uh levels of uh fluoride that are", "start": 1496.36, "end": 1503.919}, {"text": "provided in drinking water to prevent against uh adverse effects as described", "start": 1503.919, "end": 1509.76}, {"text": "in the best current best available research evidence um this is monitored on a regular basis and is is uh provided", "start": 1509.76, "end": 1516.32}, {"text": "in such a way to to maximize the uh health benefits particularly related to to dental decay which we know is a", "start": 1516.32, "end": 1523.2}, {"text": "significant Health risking concern particularly amongst those with um", "start": 1523.2, "end": 1528.32}, {"text": "barriers to care or who may be uh marginalized or or um at higher risk of", "start": 1528.32, "end": 1534.559}, {"text": "other uh negative Health impacts related to to health", "start": 1534.559, "end": 1539.559}, {"text": "inequities thanks councel h y just as a followup then um I appreciate that thank", "start": 1540.48, "end": 1546.52}, {"text": "you Dr Lou uh do we necessarily need to have the set standard of flid", "start": 1546.52, "end": 1554.88}, {"text": "fluidification or is this an opportunity for as to decrease it is that is that", "start": 1554.88, "end": 1561.159}, {"text": "even recommended or is that", "start": 1561.159, "end": 1565.159}, {"text": "possible uh to the counselor through the chair so um the the levels of fluide in", "start": 1566.279, "end": 1572.96}, {"text": "in drinking water are are monitored on a regular basis to maintain them at a level to uh be able to achieve the", "start": 1572.96, "end": 1579.399}, {"text": "health benefits that are are are reaped through um the provision of of fluoride", "start": 1579.399, "end": 1585.48}, {"text": "through through drinking water while being maintained well below a level where we would be concerned about uh", "start": 1585.48, "end": 1591.96}, {"text": "negative Health impacts related to fluoride such as as fosis uh as as has been uh described um the neurocognitive", "start": 1591.96, "end": 1600.76}, {"text": "effects related to to um fluoride have were also cited and uh there is um", "start": 1600.76, "end": 1608.2}, {"text": "certainly evidence for neurocognitive effects at a high level of toxicity around uh fluide but this is this is not", "start": 1608.2, "end": 1615.12}, {"text": "uh present or born out in the current best available research evidence at the level through which fluide is currently", "start": 1615.12, "end": 1620.44}, {"text": "provided in drinking water and and that's a uh part of the careful monitoring of the levels provided uh and", "start": 1620.44, "end": 1627.08}, {"text": "as with any substance maintaining that at a level that is protective to health and and and not detrimental in in the", "start": 1627.08, "end": 1632.279}, {"text": "way that we would be concerned at a toxic level okay last question then through you chair is uh to director", "start": 1632.279, "end": 1637.96}, {"text": "Winters the delegate talked about fluoride in the water pipes and how it has a negative uh or adverse effect on", "start": 1637.96, "end": 1644.679}, {"text": "the lead pipes that I know we do have a lot but um what is your um perhaps you", "start": 1644.679, "end": 1651.679}, {"text": "can answer that particular question on fluoride and the our system and how it might be corroding our", "start": 1651.679, "end": 1657.039}, {"text": "system certainly uh through the chair Nick winter director of the Hamilton Water Division uh to the counselor's", "start": 1657.039, "end": 1663.12}, {"text": "question um so fluoride the chemical itself is an oxidant a very strong", "start": 1663.12, "end": 1668.24}, {"text": "oxidant when it's concentrated but at the levels that it is injected into the city's treated drinking water for", "start": 1668.24, "end": 1675.279}, {"text": "protection of dental health uh there's no concerns about oxid oxidation of lead", "start": 1675.279, "end": 1681.039}, {"text": "pipes related to the amount of fluoride that we have in the water the delegate referenc the addition of orthop phosphat", "start": 1681.039, "end": 1688.12}, {"text": "to the city's drinking water as a protective measure against Metals leeching into that drinking water and", "start": 1688.12, "end": 1694.6}, {"text": "that's a protection from other factors hydrolysis um there's always some amount of metals that will interface with the", "start": 1694.6, "end": 1700.96}, {"text": "water and leech and so we're protecting against uh that type of interaction uh it's not related to any impacts from", "start": 1700.96, "end": 1707.559}, {"text": "fluoride thank you those are all my questions chair thanks councelor Wayne appreciate", "start": 1707.559, "end": 1712.88}, {"text": "those anyone else have a questions or comments yeah Vice chair", "start": 1712.88, "end": 1718.6}, {"text": "Johnson um I I I don't know if this is a comment or a question to Dr", "start": 1718.6, "end": 1725.32}, {"text": "Lou um a number of the sightings uh and references that were given in the in the", "start": 1725.32, "end": 1732.88}, {"text": "comprehensive presentation were uh American uh data um um and I was", "start": 1732.88, "end": 1739.559}, {"text": "wondering if you know when the judge made the ruling about that to protect", "start": 1739.559, "end": 1745.399}, {"text": "children how the American Academy of Pediatrics reacted um as a large um uh", "start": 1745.399, "end": 1752.84}, {"text": "Pediatric Health uh body um how they responded but that might give us some", "start": 1752.84, "end": 1758.679}, {"text": "insight as to you know a large uh you know broad section of Pediatricians", "start": 1758.679, "end": 1766.72}, {"text": "reacting to that uh to the member through the chair uh", "start": 1766.72, "end": 1772.2}, {"text": "I'm not uh specifically aware of of how the American Academy of Pediatrics has has responded to to this change I I I", "start": 1772.2, "end": 1779.12}, {"text": "can share that um a recent uh Health Canada expert panel having reviewed uh", "start": 1779.12, "end": 1784.519}, {"text": "most recent um scientific evidence has found that fosis is the most specific", "start": 1784.519, "end": 1790.88}, {"text": "outcome of concern when monitoring for uh levels of uh fluide toxicity within", "start": 1790.88, "end": 1796.039}, {"text": "the population uh and that there is not uh sufficient evidence to support a causal link of of fluids uh having a", "start": 1796.039, "end": 1804.6}, {"text": "negative impact on neurocognition below levels of 1.5 milligrams per liter uh and that is consistent with a recent", "start": 1804.6, "end": 1811.64}, {"text": "published report by the uh US National Institute of uh Health National toxic", "start": 1811.64, "end": 1817.12}, {"text": "toxicology program uh around that end point of a of a uh threshold far higher", "start": 1817.12, "end": 1823.159}, {"text": "than uh than the um uh the level that's maintained as a supplement through drinking water", "start": 1823.159, "end": 1829.96}, {"text": "and I think the response by both the American Academy and the Canadian Pediatrics uh Society was that it it is", "start": 1830.279, "end": 1838.72}, {"text": "a preventative health measure at a large like you like and just to highlight what you said that it reaches a larger", "start": 1838.72, "end": 1844.679}, {"text": "population that may not have access um in other ways to preventative Dental", "start": 1844.679, "end": 1852.32}, {"text": "Care thanks I don't see anybody else in my speaker list but I'll look around in case anyone wants to raise their hand", "start": 1853.88, "end": 1859.76}, {"text": "not seeing anyone okay we're at that little formal part where we receed the presentation all those in favor of", "start": 1859.76, "end": 1864.919}, {"text": "receiving the presentation anyone opposed can't see anyone opposed okay", "start": 1864.919, "end": 1871.84}, {"text": "that carries the presentation has been received for the record we're on to", "start": 1871.84, "end": 1877.2}, {"text": "7.1 which is items for information so we're just going to", "start": 1877.639, "end": 1882.88}, {"text": "receive individual parts of Correspondence here so can I have someone move in second that we receive the respond under", "start": 1882.88, "end": 1889.72}, {"text": "7.1 councel hang member Dano any discussion on", "start": 1889.72, "end": 1895.638}, {"text": "7.1 not seeing any all those in favor of receiving 7.1 that's everyone thank", "start": 1896.399, "end": 1903.399}, {"text": "you now we're on to 7.2 which is the second part of our Public Health subcommittee orientation and committee", "start": 1903.399, "end": 1910.96}, {"text": "members will have Dr Richardson come up to the podium to present there'll be an", "start": 1910.96, "end": 1916.32}, {"text": "overview of Public Health in Ontario as a first presentation and then a second presentation to introduction to programs", "start": 1916.32, "end": 1921.72}, {"text": "and services just want to say at the outset I'm whereare we have a new procedural bylaw and effect that says presentations can only be 10 minutes", "start": 1921.72, "end": 1927.36}, {"text": "long since these are considered also training of some kind we're going to let that go a little longer and in future", "start": 1927.36, "end": 1932.44}, {"text": "just to expect that if we see presentations from staff those will usually only be about 10 minutes long just everyone knows whenever you're", "start": 1932.44, "end": 1938.399}, {"text": "ready Dr Richardson take it away", "start": 1938.399, "end": 1942.44}, {"text": "for those following what's happening next at the end of this presentation we'll simply receive and make comments", "start": 1956.48, "end": 1962.279}, {"text": "on the report related to the presentation like we did our last meeting and then we have two motions to discuss before the end of today's", "start": 1962.279, "end": 1968.279}, {"text": "meeting for those who don't know there'll be also a little get together after this in room 192 um for folks who", "start": 1968.279, "end": 1975}, {"text": "want to get to meet members of the public health sub committee organized by uh Hamilton antire and Resource Center", "start": 1975, "end": 1981.799}, {"text": "so just letting everyone know", "start": 1981.799, "end": 1985.12}, {"text": "that let's try that now y that sounds like it's better okay good morning everybody and a bit of a snowy morning", "start": 1989.88, "end": 1996.159}, {"text": "hope everybody had a good weekend a good month since we saw you last a good holiday season indeed since we saw you", "start": 1996.159, "end": 2001.279}, {"text": "last um so as the chair has uh referenced this is the second in a", "start": 2001.279, "end": 2007.039}, {"text": "four-part series of orientation and we're mindful of the time and the changes that are going on and uh but we", "start": 2007.039, "end": 2013.2}, {"text": "do think that the these matters in terms of providing a fome education is important to go a little bit longer than", "start": 2013.2, "end": 2018.88}, {"text": "that current uh boundary today we have an overview of Public Health in Ontario and so we have Loretta Ryan who is the", "start": 2018.88, "end": 2025.799}, {"text": "executive director of The Association of local public health agencies of Ontario here as well as Monica Turner so Monica", "start": 2025.799, "end": 2032.24}, {"text": "is a longtime U Public Health uh person who's been more Public Health adjacent a", "start": 2032.24, "end": 2037.48}, {"text": "little but uh of late with Amo as well so she has worked both within the Ministry of Health but also with the", "start": 2037.48, "end": 2044}, {"text": "association of municipalities of Ontario and is now um working uh independently and supporting some of the work that", "start": 2044, "end": 2049.52}, {"text": "alfha is doing so they're going to go through that piece um the chair had talked about how getting to know the the", "start": 2049.52, "end": 2055.158}, {"text": "front row up there um is important to do and so that's a little bit about what the second part of this presentation is", "start": 2055.159, "end": 2060.638}, {"text": "about it's we have the directors who are here Kevin unfortunately is not he's uh taken ill this morning and so I'll do", "start": 2060.639, "end": 2067.32}, {"text": "his Pres presentation piece in his place uh uh but he's often uh the one that", "start": 2067.32, "end": 2072.56}, {"text": "individuals interact with the most because of the nature of the work within healthy environments um so we'll go through and", "start": 2072.56, "end": 2078.839}, {"text": "do that as the second part of the session just referencing again at some point there will also be some education", "start": 2078.839, "end": 2084.24}, {"text": "that's uh separate from this that clerks is arranging around conflicts of interest in that sort of", "start": 2084.24, "end": 2089.8}, {"text": "piece just a couple of updates before they begin one was just again to flag this piece about the more convenient", "start": 2089.8, "end": 2096.079}, {"text": "care act that was the piece of Corr respondence that you just received part of that um legislation did introduce the", "start": 2096.079, "end": 2103.64}, {"text": "uh the intention to move to a semi-autonomous Board of Health for Hamilton and so we are um awaiting to", "start": 2103.64, "end": 2110.88}, {"text": "see how that moves through the process it's been indicated it will go through the usual process so it's been referred now to committee after a second reading", "start": 2110.88, "end": 2118.56}, {"text": "and there are uh there is a public consultation process which is open until January the 31st um in terms of that", "start": 2118.56, "end": 2126.48}, {"text": "legislation um um the I'm just looking Matt because this one's not moving at", "start": 2126.48, "end": 2131.76}, {"text": "all sorry it's just interesting to see between these two uh two screens most", "start": 2131.76, "end": 2137.28}, {"text": "programs um as well from a funding perspective are um cost shared for", "start": 2137.28, "end": 2142.8}, {"text": "public health within Hamilton and so we just wanted to draw that to your attention because it comes up during this uh presentation that Monica and", "start": 2142.8, "end": 2149.319}, {"text": "Loretta are going to do our current funding ratio for Ontario public health standards programs is 6931 there's been", "start": 2149.319, "end": 2156.8}, {"text": "a long history around funding it is one of the issues that is currently being looked at as part of the renewal which", "start": 2156.8, "end": 2162.64}, {"text": "I'll get to in just a moment um the intention had been to restore to 2018 levels which were notionally a 7525", "start": 2162.64, "end": 2169.72}, {"text": "funding level but as you can see we're not there um some municipalities some boards of Health are down in almost the", "start": 2169.72, "end": 2175.88}, {"text": "50/50 uh ratio so we don't Fair badly um in comparison to them but the municipality itself provides substantial", "start": 2175.88, "end": 2183.48}, {"text": "dollars over and above the sort of cost share match that uh that uh would otherwise be there we do have a number", "start": 2183.48, "end": 2190}, {"text": "of programs as well that are 100% funded either from the municipality they've chosen to provide those over and above", "start": 2190, "end": 2195.04}, {"text": "the standards or we've attracted a federal program or a provincial program to operate here as well and so there's", "start": 2195.04, "end": 2201.72}, {"text": "examples of those on the screen and the strengthening Public Health strategy um the are there are", "start": 2201.72, "end": 2209.079}, {"text": "three legs to that strategy that have been rolling out over the last uh couple of years it feels like now um one is to", "start": 2209.079, "end": 2217.599}, {"text": "to uh clarify roles and responsibilities and so that is primarily looking at the", "start": 2217.599, "end": 2222.72}, {"text": "Ontario public health standards we had thought they would come up with new standards by the end of last year but as", "start": 2222.72, "end": 2227.76}, {"text": "they went through the consultation process and have been worked through at the provincial level we're now told to expect those in August of this year so", "start": 2227.76, "end": 2234.64}, {"text": "that'll be in time for us to renew our program plans according to those standards and then to have them fully in", "start": 2234.64, "end": 2240.8}, {"text": "place for January of next year there have also been voluntary mergers um", "start": 2240.8, "end": 2245.839}, {"text": "several of our health units and matarial were quite small and didn't have the size to have the expertise that is", "start": 2245.839, "end": 2253.16}, {"text": "needed to do the public health practice of today and so voluntary mergers were encouraged and indeed um in leg in uh", "start": 2253.16, "end": 2260.68}, {"text": "regulation changes that passed just before the holidays there has been a merger of nine Health units into four", "start": 2260.68, "end": 2267.8}, {"text": "new health units um going forward including some around us um and then", "start": 2267.8, "end": 2273.04}, {"text": "lastly is the funding piece which I've referenced has been another piece of the equation and so the province is doing a", "start": 2273.04, "end": 2279.56}, {"text": "review of the funding That Base funding methodology there's been a little bit of", "start": 2279.56, "end": 2284.8}, {"text": "movement on that that we've heard about we but we don't know notionally again that was supposed to be in place for 2026 the changes but we haven't really", "start": 2284.8, "end": 2292.04}, {"text": "heard a timeline in relation to those elements so just wanted to give you a", "start": 2292.04, "end": 2297.359}, {"text": "little bit of that background and now I'm just going to turn it over to Loretta and", "start": 2297.359, "end": 2302.52}, {"text": "Monica take it away thank you thank you so much", "start": 2302.52, "end": 2308.599}, {"text": "thank you Dr Richardson thank you to the chair and to the board members and the wonderful staff some of whom we had an", "start": 2308.599, "end": 2314.28}, {"text": "opportunity to meet this morning we're grateful to be here today I'm Loretta Ryan I'm the chief", "start": 2314.28, "end": 2320.8}, {"text": "executive officer at Alpha and I'm just going to set the stage and then I'm going to turn things over to Monica and", "start": 2320.8, "end": 2327.28}, {"text": "hope this advances yes so we're we don't have a lot of time today so we're going to go", "start": 2327.28, "end": 2333.2}, {"text": "rather quickly through some of the information we are happy to answer questions at the end you'll also see in", "start": 2333.2, "end": 2338.8}, {"text": "your package an orientation piece on Alpha and if you have any questions we're happy to answer those too so we're", "start": 2338.8, "end": 2345.8}, {"text": "talk about what is public health Public Health legislation in Ontario Ontario public health standards and the", "start": 2345.8, "end": 2352.4}, {"text": "accountability framework we'll also talk about your roles and responsibilities Board of Health", "start": 2352.4, "end": 2358.04}, {"text": "structures Ministry of Health a little bit more about public health funding Alpha leadership and services we'll just", "start": 2358.04, "end": 2364.48}, {"text": "we're just going to touch more on the the conference I was just asked also to talk about the Symposium so I'll give", "start": 2364.48, "end": 2370.28}, {"text": "you the highlights of that and again any questions and answers that you have and I will now without making much noise", "start": 2370.28, "end": 2377.599}, {"text": "pass this to Monica thank you uh appreciate being", "start": 2377.599, "end": 2384.119}, {"text": "here and thank you for that I will say I lived in Hamilton for seven years I went", "start": 2384.119, "end": 2389.44}, {"text": "to McMaster and I will also say that I started my public health political", "start": 2389.44, "end": 2395.8}, {"text": "career uh when I worked at the sex ed Center at Mac um in Hamilton Hall that", "start": 2395.8, "end": 2402.079}, {"text": "was way back when it probably still doesn't exist but I got involved in both", "start": 2402.079, "end": 2407.56}, {"text": "public health and and the sex Center Center and then I joined the MSU when they started to cut our funding does it", "start": 2407.56, "end": 2414.68}, {"text": "sound familiar but thank you so I'm going to talk about what is public health you know a fair bit about this", "start": 2414.68, "end": 2421.44}, {"text": "but what I'm going to try and do is pull it together with the Ontario public health standards and as well what what", "start": 2421.44, "end": 2427.52}, {"text": "as you as a committee need to be cognizant of so you know that public", "start": 2427.52, "end": 2432.76}, {"text": "health is the Art and Science of protecting and improving the health and well-being of people in the community", "start": 2432.76, "end": 2438.64}, {"text": "very much focus on social determinance of Health the province is now looking at", "start": 2438.64, "end": 2443.8}, {"text": "calling it The Social and structural determinance of Health that was in the", "start": 2443.8, "end": 2449.88}, {"text": "uh proposed revisions that came out in May we'll see if they make it through when we get them in August so they are", "start": 2449.88, "end": 2456.119}, {"text": "changing that up I do like the World Health Organization definition of Public", "start": 2456.119, "end": 2461.24}, {"text": "Health which says it refers to all organized measures to prevent disease", "start": 2461.24, "end": 2467.8}, {"text": "promote health and prolong life among the population as a whole its activities", "start": 2467.8, "end": 2473.359}, {"text": "aimed to provide conditions in which people can be healthy and focus on the entire population not on individual", "start": 2473.359, "end": 2481.04}, {"text": "patients or diseases and as you well know it's preventative and tries to", "start": 2481.04, "end": 2488.52}, {"text": "upstreet um and people really confuse that with the acute Health Care system", "start": 2488.52, "end": 2493.599}, {"text": "which is focused on individuals at the time that there are symptoms and there is disease Public Health tries to look", "start": 2493.599, "end": 2500.96}, {"text": "at it from a population base that may involve focusing on population uh", "start": 2500.96, "end": 2506.68}, {"text": "priority populations because it's hard to do entire communities and where can", "start": 2506.68, "end": 2512.64}, {"text": "you focus especially when resources are scarce and there is some overlap between", "start": 2512.64, "end": 2519.24}, {"text": "primary care and public health they do do similar interventions but for", "start": 2519.24, "end": 2524.44}, {"text": "different reasons in different Focus um and in particular Sexual Health um and", "start": 2524.44, "end": 2531.48}, {"text": "immunizations again they're done for different reasons but there is a good overlap and again Public Health always", "start": 2531.48, "end": 2537.92}, {"text": "works well with uh primary care and from an ethical perspective though people", "start": 2537.92, "end": 2544.48}, {"text": "don't understand that public health looks at popul ations and not in individuals from an ethical point of", "start": 2544.48, "end": 2550.44}, {"text": "view as well so I'll go to the next one so the public health system of in Canada", "start": 2550.44, "end": 2557.28}, {"text": "which many people do not understand because the province is the primary uh", "start": 2557.28, "end": 2563.76}, {"text": "has the primary responsibility for health um but the federal government", "start": 2563.76, "end": 2569.079}, {"text": "obviously has a role as well they have the public health agency of Canada they", "start": 2569.079, "end": 2574.16}, {"text": "have the First Nation Inuit Health branch in health Canada but they also", "start": 2574.16, "end": 2579.28}, {"text": "have the Canada Health act in which the whole um the principles that govern the", "start": 2579.28, "end": 2585.599}, {"text": "Canadian health insurance system reside and that is universality", "start": 2585.599, "end": 2591.599}, {"text": "portability accessibility within a public administration point of view so that sort of guides the principles but", "start": 2591.599, "end": 2598.839}, {"text": "it is the province that is responsible and I will not go into the BNA Act and the Constitution and all that good stuff", "start": 2598.839, "end": 2605.68}, {"text": "but it is the province I will say that the province spends well", "start": 2605.68, "end": 2610.92}, {"text": "last time we looked less than 3% of their health budget is on public health", "start": 2610.92, "end": 2616.4}, {"text": "um which again when you're looking at Upstream we want more so that you don't", "start": 2616.4, "end": 2621.559}, {"text": "have to deal with people in the acute care system but that's not the way it rolls uh in the uh in the uh Ministry so", "start": 2621.559, "end": 2630.52}, {"text": "in the Ministry of Health which Loretta will talk about more you have a chief uh medical officer of health and you also", "start": 2630.52, "end": 2637.76}, {"text": "have uh the public health Public Health Ontario which was created out of uh the", "start": 2637.76, "end": 2644.24}, {"text": "review of SARS and what we needed in in uh Ontario and I'll talk more about that", "start": 2644.24, "end": 2650.16}, {"text": "and as Dr Richardson said you have local public health agencies Health units and", "start": 2650.16, "end": 2655.88}, {"text": "we now have 29 um Health units down from 34 and that was effective January 1st I", "start": 2655.88, "end": 2663.64}, {"text": "will also say the ministry thought that those boards should have meetings on Jan January 1st it was and they gave us 3", "start": 2663.64, "end": 2669.68}, {"text": "weeks notice it was lots of fun um Public Health legislation and I always", "start": 2669.68, "end": 2674.76}, {"text": "joke this can keep you awake at night uh if you uh need to keep up there are some", "start": 2674.76, "end": 2680.44}, {"text": "sections I'll tell you that you should look at but the one you should really uh get to know and I'll go into some", "start": 2680.44, "end": 2686.8}, {"text": "details in the next slide is the health protection and promotion act it", "start": 2686.8, "end": 2692}, {"text": "essentially it's it's a good read it tells you what um public health does in", "start": 2692, "end": 2698.44}, {"text": "Ontario it also does get changed from time to time and I'll flag that to you but it's to provide for the organization", "start": 2698.44, "end": 2705.119}, {"text": "and delivery of public health programs and services very specifically I'll get to that prevention of uh the spread of", "start": 2705.119, "end": 2711.839}, {"text": "disease and health promotion and protection but the thing is a Board of Health is a local board under the", "start": 2711.839, "end": 2718.92}, {"text": "municipal act so you also have all the municipal aspects of legislation coming", "start": 2718.92, "end": 2725.04}, {"text": "into play as well that you need to be mindful of and you know as well as I do about meetings Clos meetings all that", "start": 2725.04, "end": 2732.04}, {"text": "interest the fact that uh the municipal world is completely transparent as", "start": 2732.04, "end": 2737.319}, {"text": "opposed to the provincial World which is completely opaque you're never invited to watch cabinet like you are even in in", "start": 2737.319, "end": 2743.96}, {"text": "a meeting like this um when I was at uh Amo I asked one of our policy interns to", "start": 2743.96, "end": 2750.72}, {"text": "count how many pieces of legislation affected Municipal governments it was", "start": 2750.72, "end": 2755.92}, {"text": "over 28 pieces of provincial legislation that bear on Municipal governments so", "start": 2755.92, "end": 2762.48}, {"text": "that gets us into a whole over conversation but that you need to be at least mindful of that environment and", "start": 2762.48, "end": 2768.4}, {"text": "then things such as Municipal Freedom of Information and PRI protection of privacy act mipa and for the retention", "start": 2768.4, "end": 2775.4}, {"text": "of Records you're dealing with uh personal health information so you've got the personal health information", "start": 2775.4, "end": 2781.24}, {"text": "privacy protection act P Hippa I will say that legislation is over 30 years old they're Terri ified to open it", "start": 2781.24, "end": 2788.48}, {"text": "because of all those things but it still talks about CD ROMs as a method by holding uh data and we know that", "start": 2788.48, "end": 2795.64}, {"text": "technology changes so we'll see if we ever get legislation changes for that so", "start": 2795.64, "end": 2800.76}, {"text": "just to say Boards of Health are accountable for meeting all legislative", "start": 2800.76, "end": 2806.839}, {"text": "requirements so getting to the uh Health protection promotion act or hppa as we", "start": 2806.839, "end": 2812.24}, {"text": "like to say it um it is very specific especially um section five sets out the", "start": 2812.24, "end": 2820.48}, {"text": "specific areas that must be provided by a Board of Health and this includes", "start": 2820.48, "end": 2826.119}, {"text": "Community sanitation and the prevention or elimination of health hazards", "start": 2826.119, "end": 2831.28}, {"text": "provision of Safe Drinking Water by small Drinking Water Systems control of infectious and reportable diseases", "start": 2831.28, "end": 2837.599}, {"text": "including providing immunization services to children and adults health", "start": 2837.599, "end": 2842.92}, {"text": "promotion Health protection and diseases and injury prevention um Family Health Collection and Analysis", "start": 2842.92, "end": 2850.359}, {"text": "of population data and then any other additional um programs and services as", "start": 2850.359, "end": 2856.88}, {"text": "prescribed by regulation regulations are again provincial so in section 7 it grants to", "start": 2856.88, "end": 2865.52}, {"text": "the minister the minister of Health the ability to publish Public Health standards for the provision of mandatory", "start": 2865.52, "end": 2872.119}, {"text": "programs and mandatory programs are what they were called in 1998", "start": 2872.119, "end": 2877.72}, {"text": "and they are very specific they're now the Ontario public health standards they're very specific about what public", "start": 2877.72, "end": 2884.52}, {"text": "health must provide to the populations um you've got uh a number of", "start": 2884.52, "end": 2890.839}, {"text": "other sections they're out there I won't read it I'm conscious of time but part", "start": 2890.839, "end": 2896.16}, {"text": "um six which is Health units and Boards of Health that's key for Boards of Health", "start": 2896.16, "end": 2903.52}, {"text": "that sets out again a lot of specifics for you it uh talks about the composition", "start": 2903.52, "end": 2909.16}, {"text": "operation and authority of boards of Health um it also gets into and I'll come to this later uh funding of", "start": 2909.16, "end": 2916.24}, {"text": "obligated municipalities a term that municipalities really dislikes but that's what's in the", "start": 2916.24, "end": 2922}, {"text": "legislation and then um part 61 was put", "start": 2922, "end": 2927.28}, {"text": "in in 2009 after uh SARS and such giving the chief medical officer of Health", "start": 2927.28, "end": 2934.2}, {"text": "specific powers that were needed during SS but were also then helpful during uh", "start": 2934.2, "end": 2939.88}, {"text": "covid and then lots of administration as well the Ontario public health standards", "start": 2939.88, "end": 2946.24}, {"text": "and a little bit of history as I said in 1998 there were the mandatory programs", "start": 2946.24, "end": 2952.28}, {"text": "this was done at the same time that uh Public Health was downloaded to", "start": 2952.28, "end": 2957.96}, {"text": "Municipal governments and when they downloaded it in legislation and I'll", "start": 2957.96, "end": 2963.359}, {"text": "get to some of those specifics they made very very very detailed uh what you", "start": 2963.359, "end": 2969.28}, {"text": "should do for public health in programs and Services I think even telling you how many Community meetings you had to", "start": 2969.28, "end": 2975.44}, {"text": "have in a particular subject and I'm seeing Dr Richardson nod so yes some of", "start": 2975.44, "end": 2981.599}, {"text": "the history so that was the that was the download in 98 in 2008 there were the", "start": 2981.599, "end": 2988.64}, {"text": "first Ontario public health standards and I will say it was my branch and I was the director that got to do it in", "start": 2988.64, "end": 2994.64}, {"text": "2008 and it was It was a joyful 2year uh adventure to do it uh we did rewrite it", "start": 2994.64, "end": 3002.119}, {"text": "we also made it much less specific and so that it could be specific to your particular populations but it's also", "start": 3002.119, "end": 3008.48}, {"text": "where the foundational standards came from we had never had that before but they were all elements of what was good", "start": 3008.48, "end": 3015.4}, {"text": "public health and so I always joke it sort of the the other program standards", "start": 3015.4, "end": 3020.839}, {"text": "rest on the foundational standards I used to use the little statue of Atlas holding up the gold the globe and such", "start": 3020.839, "end": 3028.44}, {"text": "as the uh metaphor for the foundational standards so I as Dr Richardson said", "start": 3028.44, "end": 3035.68}, {"text": "they're revising them again we'll see what they said they were fairly extensive reg uh revisions uh that came", "start": 3035.68, "end": 3042.72}, {"text": "out in May and we'll you'll get to see in August uh what they did with them but I will just move on to the", "start": 3042.72, "end": 3049.72}, {"text": "accountability framework because you as a committee really need to understand what the boards of Health are", "start": 3049.72, "end": 3056}, {"text": "responsible for as you're giving them advice we were so I've I've got two", "start": 3056, "end": 3061.559}, {"text": "slides on this so you've got four domains again fairly specific they're at", "start": 3061.559, "end": 3066.599}, {"text": "the front end of the sorry their midsection in the Ontario public health", "start": 3066.599, "end": 3071.839}, {"text": "standards you might want to give them a a review but we were expecting new draft", "start": 3071.839, "end": 3077.68}, {"text": "materials on accountability framework in this in Fall of 2024 that were to go", "start": 3077.68, "end": 3083.72}, {"text": "with the changes of the Ontario public health standards we haven't seen them but there were some things from the", "start": 3083.72, "end": 3090.24}, {"text": "accountability framework that were missing in the revision so we'll see if they're there um next slide please so", "start": 3090.24, "end": 3097.24}, {"text": "again I've laid out all the elements you have and uh the annual service plan and", "start": 3097.24, "end": 3104.96}, {"text": "budget submission and that's usually Due about March 31st and again these requirements they", "start": 3104.96, "end": 3112.559}, {"text": "will come to the committee they'll come to the board you're not responsible for doing them you are staff of course do", "start": 3112.559, "end": 3119.2}, {"text": "that work but you need to know what the boards need to review and such so the", "start": 3119.2, "end": 3127.119}, {"text": "annual service plan and budget submission very detailed it's 70 plus", "start": 3127.119, "end": 3133.88}, {"text": "pages of uh very detailed non-integrated uh framework um but it's where you get a", "start": 3133.88, "end": 3141.359}, {"text": "lot of the information but I will go my favorite line is the last one which", "start": 3141.359, "end": 3146.52}, {"text": "which is the boards of Health must comply with all legal and statutory requirements as if you had to be", "start": 3146.52, "end": 3151.92}, {"text": "reminded of that again because between the the legislation the hppa the Ontario", "start": 3151.92, "end": 3159}, {"text": "public health standards the accountability framework there's lots of ministry oversight of Board of Health", "start": 3159, "end": 3165.04}, {"text": "and health unit finances activities and performance in a lot of ways public health is under a microscope of the", "start": 3165.04, "end": 3172.52}, {"text": "ministry you are accountable or the boards of Health are very much accountable so I'll now stop and turn it", "start": 3172.52, "end": 3179.599}, {"text": "over to Loretta thank you Monica so a little bit more about your roles and", "start": 3179.599, "end": 3187.319}, {"text": "responsibilities the Board of Health in your governance role you're going to set the goals for your organization and", "start": 3187.319, "end": 3193.359}, {"text": "you're going to establish the systems and processes to support and Achieve these goals so very much a governance", "start": 3193.359, "end": 3200.16}, {"text": "role you do this by establishing general policies and procedures within the", "start": 3200.16, "end": 3205.64}, {"text": "operation of the the public health unit as Monica mentioned you have to uphold provincial", "start": 3205.64, "end": 3211.599}, {"text": "legislation uh the hppa and others you're accountable to the community for", "start": 3211.599, "end": 3217.2}, {"text": "ensuring the health needs are addressed by the appropriate programs and ensuring the health unit is well managed you", "start": 3217.2, "end": 3224.72}, {"text": "ensure program quality and Effectiveness and financial viability you hire your", "start": 3224.72, "end": 3229.76}, {"text": "medical officer of Health with the approval of the Ministry of Health you also assess the performance of the uh", "start": 3229.76, "end": 3238}, {"text": "medical officer of health and the associate medical officer of Health which you also hire and then you have to", "start": 3238, "end": 3243.96}, {"text": "assess your own performance it's a very important part of being a high performing board is to assess", "start": 3243.96, "end": 3251.318}, {"text": "yourself there are critical elements of this for an effective health unit", "start": 3251.4, "end": 3257}, {"text": "principles of governance and board accountabilities a statement of the board's obligations to act in the best", "start": 3257, "end": 3263.28}, {"text": "interests of the health unit the roles and respons responsibility of the board of directors the roles and", "start": 3263.28, "end": 3269.079}, {"text": "responsibilities of individual directors for example the chair would have specific", "start": 3269.079, "end": 3274.44}, {"text": "roles you need a clear differentiation between governance and management and", "start": 3274.44, "end": 3280.04}, {"text": "this is an area where some boards really struggle with so it's important to know what is governance and what is", "start": 3280.04, "end": 3285.799}, {"text": "operational Board needs to be focused on strategic leadership and direction it's a really really important role and the", "start": 3285.799, "end": 3293.599}, {"text": "board establishes policies makes decisions and monitors performance of the organization's business and as I", "start": 3293.599, "end": 3300.24}, {"text": "noted earlier its own Effectiveness many of you wear many hats", "start": 3300.24, "end": 3307.119}, {"text": "I once had a picture of one of my board members for Alpha and we put seven hats", "start": 3307.119, "end": 3312.2}, {"text": "on him and we stopped because we ran out of room but we knew that he had at least seven hats so juggling many hats can be", "start": 3312.2, "end": 3318.359}, {"text": "very challenging Monica's just going to make a note about a survey that she did well it wasn't so much a it wasn't so", "start": 3318.359, "end": 3325.119}, {"text": "much a survey but I interviewed three former uh Board of Health chairs and all", "start": 3325.119, "end": 3331.28}, {"text": "of whom worked for municipalities one was a mayor one was a regional chair and one was a CAO uh who happened to be", "start": 3331.28, "end": 3338.359}, {"text": "chair of a Board of Health and I said how do you manage the juggling of hats", "start": 3338.359, "end": 3343.52}, {"text": "because when you're at the board table the Board of Health table you have a fiduciary responsibility to the board", "start": 3343.52, "end": 3350.88}, {"text": "which also causes the tension from the municipal part of your brain as you as you're going going through it and they", "start": 3350.88, "end": 3357.72}, {"text": "all admitted that and they uh again uh can talk about this for much longer than", "start": 3357.72, "end": 3363.64}, {"text": "the chair would like me to so I'll keep it really short um but it's all about the fiduciary responsibility and that", "start": 3363.64, "end": 3370.88}, {"text": "tension between what the board need the Board of Health must do to set a budget", "start": 3370.88, "end": 3377.2}, {"text": "that meets all the requirements at the same time knowing that it's going to in go to the in your", "start": 3377.2, "end": 3384.48}, {"text": "case the municipality to uh affirm that budget or or modify it", "start": 3384.48, "end": 3390.319}, {"text": "or for other boards to take it to all the municipalities that have to pay there's some boards of Health that have", "start": 3390.319, "end": 3396.359}, {"text": "like over 30 municipalities that are under that board um one of the comments", "start": 3396.359, "end": 3403.44}, {"text": "that they made is that public health is not like any other Municipal department", "start": 3403.44, "end": 3409.4}, {"text": "and what they meant by non-emergency Department because public health is 247 364", "start": 3409.4, "end": 3416.64}, {"text": "5 days and that you also have it's not a zero sum budget in the sense that you", "start": 3416.64, "end": 3423.319}, {"text": "need to be able to prove to the ministry that you're meeting all your obligations that I've talked about so again it's a", "start": 3423.319, "end": 3430.2}, {"text": "balancing act but when you're at the board table you're wearing that hat when it goes to Municipal Council that's the", "start": 3430.2, "end": 3436.92}, {"text": "Hat you wear at that time I'll pass it back to Loretta thank you Monica so for you elected officials that", "start": 3436.92, "end": 3443.68}, {"text": "is indeed an additional challenge we also Al have citizen Representatives on boards these can be appointed by a", "start": 3443.68, "end": 3450.119}, {"text": "municipality and provintial appointees these are done through an order and Council there's a process for it the", "start": 3450.119, "end": 3457.119}, {"text": "bullet there with regards to current challenges it can take some time for", "start": 3457.119, "end": 3462.2}, {"text": "these appointments to be approved and it's a little bit surprising for boards sometimes it really can take a while for", "start": 3462.2, "end": 3468.44}, {"text": "these to be approved there are different types of", "start": 3468.44, "end": 3473.72}, {"text": "boards of Health I know we don't have a lot of time so we're just going to do the broad categories there's autonomous", "start": 3473.72, "end": 3479.2}, {"text": "they're separate from a municipality there's the term obligated again so you can have multiple obligated", "start": 3479.2, "end": 3485.079}, {"text": "municipalities on a board of health you may have provincial appointees you may have citizen", "start": 3485.079, "end": 3490.599}, {"text": "representatives and there are variations out there chadam Kent for example is one of them you can have semi-autonomous or", "start": 3490.599, "end": 3497.119}, {"text": "single tier so Municipal Council serves as the Board of Health and and staff within a municipal structure and", "start": 3497.119, "end": 3504.039}, {"text": "semi-autonomous occurs when Council appoints members to a separate board but retains Authority for budget and", "start": 3504.039, "end": 3509.64}, {"text": "Staffing approvals somebody new into public health it's a lot to Grapple with all these differences and of course", "start": 3509.64, "end": 3516.039}, {"text": "there's Regional and Regional Council is the Board of Health with no citizen reps or provincial appointees staff within", "start": 3516.039, "end": 3522.599}, {"text": "the administration of the regional government or who they rely", "start": 3522.599, "end": 3527.24}, {"text": "upon oh still me sorry still you I'd love to do the Ministry of Health so the", "start": 3528.4, "end": 3534.4}, {"text": "Ministry of Health one of the largest Ministries their org chart I think is at about 6 point now to fit it on one page", "start": 3534.4, "end": 3541.2}, {"text": "you need a magnifying glass uh the lead uh cabinet minister for all provincial matters is the Minister of health and", "start": 3541.2, "end": 3548.039}, {"text": "that includes Public Health has the hppa the authority to publish", "start": 3548.039, "end": 3553.76}, {"text": "Ops uh the standards make regulations make medical officer of", "start": 3553.76, "end": 3558.92}, {"text": "health and Associate medical off officer of Health appointments provincial funding and conduct public health unit", "start": 3558.92, "end": 3565.559}, {"text": "assessment the chief medical officer of health is currently Dr Kieran Moore he provides", "start": 3565.559, "end": 3571.599}, {"text": "Public Health advice within and Beyond provincial government and provides Public Health advice and direction to", "start": 3571.599, "end": 3577.319}, {"text": "Boards of Health medical officers of health and to the public the cmoh is appointed by the", "start": 3577.319, "end": 3584.119}, {"text": "Ontario legislature and this is important to know the CM is also an", "start": 3584.119, "end": 3589.2}, {"text": "assistant Deputy Minister within the Ministry of Health the CM has specific powers under", "start": 3589.2, "end": 3596.28}, {"text": "hppa if of the opinion there is a risk to health the public health division sits", "start": 3596.28, "end": 3602.039}, {"text": "within the Ministry of Health and this is a division that oversees manages and works with local public health units", "start": 3602.039, "end": 3608.92}, {"text": "five branches that report to an executive lead who then reports to the chief medical officer of Health I think", "start": 3608.92, "end": 3615.119}, {"text": "only the Ministry of Finance is larger but I'm not sure no I don't think so but anyways", "start": 3615.119, "end": 3621.4}, {"text": "okay um next slide is funding and again", "start": 3621.4, "end": 3626.52}, {"text": "could talk forever about this because it's always the focus funding always causes tension I will not talk forever", "start": 3626.52, "end": 3633.079}, {"text": "on this but just a brief history as I said uh in sort interrupt but if you", "start": 3633.079, "end": 3638.68}, {"text": "just move the microphone back to you sorry I usually can yeah it's okay just", "start": 3638.68, "end": 3643.72}, {"text": "share sorry yeah uh in 1998 the provincial government downloaded Public", "start": 3643.72, "end": 3649.559}, {"text": "Health to all to municipalities they also downloaded land ambulance but that's a separate topic but that meant", "start": 3649.559, "end": 3656.92}, {"text": "they changed the legislation the hppa says section 72 that", "start": 3656.92, "end": 3663.28}, {"text": "municipalities must pay for public health", "start": 3663.28, "end": 3669.24}, {"text": "100% that people sometimes forget so they downloaded it told municipalities", "start": 3669.24, "end": 3676.119}, {"text": "to pay 100% And I'm conscious of Dr cider if I get it wrong he'll tell me that I got it wrong um in", "start": 3676.119, "end": 3683.72}, {"text": "199 in 1999 it went to 5050 but again the province did it as a matter of", "start": 3683.72, "end": 3689.64}, {"text": "policy they did not they've never changed that legislation municipalities are 100% responsible for the funding of", "start": 3689.64, "end": 3697.039}, {"text": "Public Health and so then you after that situation you had SARS you had Walkerton", "start": 3697.039, "end": 3705.119}, {"text": "you unfortunately Public Health has a boom and bus situation so the provincial government at that time did something", "start": 3705.119, "end": 3712.319}, {"text": "called operation Health protection taking from all the queries what was the", "start": 3712.319, "end": 3717.92}, {"text": "best thing they could do this is when Public Health Ontario was set up and such but they said that by 20 2007 they", "start": 3717.92, "end": 3726.68}, {"text": "would go back to a nominal 7525 funding with the 25 being Municipal", "start": 3726.68, "end": 3733.079}, {"text": "governments to pay they also said at that time they would pay for any 100%", "start": 3733.079, "end": 3738.68}, {"text": "for any new programs they put in such as at the time West Nile and such like", "start": 3738.68, "end": 3744.64}, {"text": "that it got fuzzy after that then um as", "start": 3744.64, "end": 3751.039}, {"text": "Dr Richardson said they did say uh in the announcement and it's there in", "start": 3751.039, "end": 3757.52}, {"text": "August 23 that they would go back to the nominal 7525 we haven't quite got there", "start": 3757.52, "end": 3764.039}, {"text": "and she's quite right there are some Regional governments that pay over 50% of the cost of Public Health in fact I", "start": 3764.039, "end": 3771.16}, {"text": "believe Hamilton uh Dr Richardson gave you the averages I believe Hamilton pays", "start": 3771.16, "end": 3777.68}, {"text": "34% of the budget uh from the numbers given next slide please so this is the", "start": 3777.68, "end": 3784.2}, {"text": "one that I joked about if you want to if you want to you know wake up in the middle of the night read this and this", "start": 3784.2, "end": 3790.88}, {"text": "is the section 72 the obligated municipality shall pay and it says the expenses of of the", "start": 3790.88, "end": 3798.68}, {"text": "Board of Health and the performance of its function and duties under the hppa and other legislation again that's I set", "start": 3798.68, "end": 3806.24}, {"text": "out all the other legislation you must be mindful of but section 76 says the", "start": 3806.24, "end": 3812.76}, {"text": "minister may make grants for the purposes of this act uh in uh on such", "start": 3812.76, "end": 3819.96}, {"text": "conditions as he and she uh considers appropriate so what I'll leave you with", "start": 3819.96, "end": 3825.64}, {"text": "is municipalities must pay it's a matter of policy of the province Pace I'll turn", "start": 3825.64, "end": 3831.68}, {"text": "it back to Loretta on that side bring note I wanted", "start": 3831.68, "end": 3837.64}, {"text": "to respond to a question the chair asked earlier before we take general questions to let you know that yes we do have a", "start": 3837.64, "end": 3843.4}, {"text": "symposium coming up it's online it's February 12th to the 14th uh Dr Kieran", "start": 3843.4, "end": 3848.96}, {"text": "Moore and others including uh Sabine Ma and John paranak from strategy Corp and", "start": 3848.96, "end": 3854.76}, {"text": "if you have not had the pleasure of hearing an update from them if you want to know the latest at Queens Park they're absolutely fabulous in terms of", "start": 3854.76, "end": 3861.68}, {"text": "updating our membership we will have a merger update public keal onario will be", "start": 3861.68, "end": 3866.96}, {"text": "speaking and um we also have our strategic Plan update we've taken our strategic plan it's now one year", "start": 3866.96, "end": 3873.52}, {"text": "anniversary it is a guiding document for the association and we've done I think a lot of really great things using that", "start": 3873.52, "end": 3880}, {"text": "plan over the last year in the afternoon for the boards of health section we will also have an update from the association", "start": 3880, "end": 3886.839}, {"text": "of municipalities of Ontario better known as Amo with regards to the new homelessness report that was released", "start": 3886.839, "end": 3892.44}, {"text": "last week and that will be specifically for Board of Health members and we'll have a legal update from", "start": 3892.44, "end": 3898.119}, {"text": "Alpha's legal council so that's February 12th to the 14th registration Launches", "start": 3898.119, "end": 3903.2}, {"text": "on Wednesday registration is actually open now if you're really Keen but we'll be launching everything on Wednesday", "start": 3903.2, "end": 3909.52}, {"text": "you'll see both a newsletter and um an email telling you that you can now uh", "start": 3909.52, "end": 3915}, {"text": "sign up and to hold the date for June 18th to the 20th that's where we're", "start": 3915, "end": 3920.279}, {"text": "meeting in person in Toronto we'll be back at the Pantages Hotel it was a very successful conference conf last year and", "start": 3920.279, "end": 3927}, {"text": "we're currently planning that uh including a session with Mark forette a noted indigenous leader who was highly", "start": 3927, "end": 3934.2}, {"text": "rated last year and our members asked to have him come back and speak and with that happy to answer any", "start": 3934.2, "end": 3941.798}, {"text": "questions", "start": 3943.2, "end": 3946.2}, {"text": "oops sorry this is the end of this section I apologize I looked ahead and thought there were more slides in this", "start": 3948.839, "end": 3953.92}, {"text": "part um so we're at the end of this for Section so any questions I see first councelor way had her hand up and then", "start": 3953.92, "end": 3959.52}, {"text": "we'll go to others who may have questions thank you for your presentation um I want to refer back to", "start": 3959.52, "end": 3967}, {"text": "a slide 20 where you talk about the current funding model and challenges and there's a 1% growth funding over the", "start": 3967, "end": 3972.72}, {"text": "next three calendar years as of 2024 so that 1% is I know um previously", "start": 3972.72, "end": 3980.24}, {"text": "that that has been accounted for but how is this calculated", "start": 3980.24, "end": 3986.079}, {"text": "when each municipality grows at different rates because our municipality is growing a lot faster than other", "start": 3986.079, "end": 3992.76}, {"text": "municipalities so I just wonder um do you have any insight into how that", "start": 3992.76, "end": 3999.559}, {"text": "funding calculation is because 1% is just it feels like a static 1% number", "start": 3999.559, "end": 4005.44}, {"text": "across the board if if I may um through the chair to answer your question um", "start": 4005.44, "end": 4012.96}, {"text": "there's different levels to this so in many ways the Ministry of Health is", "start": 4012.96, "end": 4018.079}, {"text": "exceedingly proud of getting the 1% for multiple years because getting that out of Treasury board is amazing because", "start": 4018.079, "end": 4024.599}, {"text": "they do not like doing multiple year 1% is so below inflation and such um so it", "start": 4024.599, "end": 4033.72}, {"text": "does it it does not even meet the current programs and services you have even", "start": 4033.72, "end": 4041.2}, {"text": "though it's for three years then you also have the new standards that are coming for for 26 and you don't know if", "start": 4041.2, "end": 4047.68}, {"text": "it will fit that way um only those that are", "start": 4047.68, "end": 4052.799}, {"text": "merging would get additional over the 1% so the ministry", "start": 4052.799, "end": 4059.16}, {"text": "was mindful of all those issues and for the last 10 years it's been a nominal", "start": 4059.16, "end": 4067.359}, {"text": "7525 kind of but it's also been based on what the municip what the Board of", "start": 4067.359, "end": 4073.68}, {"text": "Health actually asked for and different Boards of Health asked for different amounts so you're absolutely right the", "start": 4073.68, "end": 4080.44}, {"text": "rate for different um different Health units was all the some asked for zero", "start": 4080.44, "end": 4087.799}, {"text": "some asked for you know over 10% uh it normally in in years uh this this", "start": 4087.799, "end": 4095.88}, {"text": "was there was lots of advocacy from Alpha and uh Public Health units and", "start": 4095.88, "end": 4102.798}, {"text": "medical officers of Health asking for more this is what cabinet in their wisdom decided", "start": 4102.799, "end": 4109.838}, {"text": "upon that is a very diplomatic answer thank you so much I try um thank you so as my follow-up", "start": 4109.839, "end": 4117.6}, {"text": "question then um through your work at emo what was what were some um perhaps", "start": 4117.6, "end": 4124.96}, {"text": "Insight that you might have on how we as a public health um committee could do", "start": 4124.96, "end": 4131.12}, {"text": "better advocacy at the different Ministry levels because it's it's not just Ministry of Health that we're", "start": 4131.12, "end": 4136.798}, {"text": "talking about right now because we're also seeing that there's a potentially a brand new ministry of mental illness", "start": 4136.799, "end": 4142.719}, {"text": "mental health and um those sort of challenges so so it seems as though it's", "start": 4142.719, "end": 4148.56}, {"text": "not all um centralized within Ministry of Health now it looks like there will", "start": 4148.56, "end": 4154.679}, {"text": "be other smaller Ministries inside of other Ministries", "start": 4154.679, "end": 4160.199}, {"text": "so that if I may um that's a very interesting question and again much", "start": 4160.199, "end": 4165.96}, {"text": "longer conversation the Ministry of Health is unlike any other Ministry and", "start": 4165.96, "end": 4172.48}, {"text": "it the right now uh mental health and addictions is a associate Ministry", "start": 4172.48, "end": 4178.6}, {"text": "underneath it and if you hear that Minister talk he was never given the money or the", "start": 4178.6, "end": 4184.92}, {"text": "staff support to do what he wanted to do so they may split it off but the", "start": 4184.92, "end": 4190.159}, {"text": "Ministry of Health is", "start": 4190.159, "end": 4194.92}, {"text": "not very good at working with others is I again I'm trying to be diplomatic they", "start": 4195.44, "end": 4202.64}, {"text": "they are so big and they live in a particular World um they are trying to", "start": 4202.64, "end": 4209.679}, {"text": "be better about working with other Ministries and such but from an advocacy point of view one they hate that word", "start": 4209.679, "end": 4216.159}, {"text": "advocacy I will tell you that I was not allowed to use it while I was in the ministry um and they The Province and", "start": 4216.159, "end": 4223.36}, {"text": "this is true of any be it Progressive conservatives conservatives liberals they all have very thin skin they do not", "start": 4223.36, "end": 4229.84}, {"text": "like to be criticized so one of the things I learned from at Amo was you thank them very much for what they've", "start": 4229.84, "end": 4235.44}, {"text": "done and encourage them to do better and how you can show them to do that and you", "start": 4235.44, "end": 4240.679}, {"text": "can have very candid conversations about outcomes at the same time and this gets", "start": 4240.679, "end": 4246}, {"text": "us into the whole discussion of Health funding and such hospitals and physician", "start": 4246, "end": 4252.719}, {"text": "organizations do have good way at the Ministry of Health and I know I'm being", "start": 4252.719, "end": 4259.44}, {"text": "recorded i' just like to add Alpha Works quite closely with the onar medical association and the association", "start": 4259.44, "end": 4265.719}, {"text": "municipalities of Ontario one of the pieces of advice that we've had from government relations uh experts to", "start": 4265.719, "end": 4273.12}, {"text": "appeal to both the hearts and Minds so with public health the return on investment it's very difficult to have a", "start": 4273.12, "end": 4279.76}, {"text": "healthy community and and sorry a healthy economy without a healthy Community they they go hand in hand so", "start": 4279.76, "end": 4287.12}, {"text": "one of the successful uh approaches that we've had is saying this investment in", "start": 4287.12, "end": 4292.28}, {"text": "public health this is what happens when you have this and it is a challenge because one um person once said it's", "start": 4292.28, "end": 4300.56}, {"text": "it's almost the value of nothing we didn't have that outbreak nobody got food poisoning here because Public", "start": 4300.56, "end": 4306.639}, {"text": "Health did its job but we know from the pandemic we have examples where we can", "start": 4306.639, "end": 4312.36}, {"text": "clearly show the economic impact when you don't have a healthy population so that's something that uh a lot of boards", "start": 4312.36, "end": 4319.28}, {"text": "are looking at how can you best position what your asks are and that's within how", "start": 4319.28, "end": 4324.76}, {"text": "are you supporting the community um that that you're serving so was a little bit of advice we were given thank you as", "start": 4324.76, "end": 4331.96}, {"text": "followup just um to uh Ed Ryan I'm glad you brought up the economic impact of", "start": 4331.96, "end": 4338.679}, {"text": "that um does I know Alpha is being a small and mighty organization but do you", "start": 4338.679, "end": 4344.639}, {"text": "have cap capacity or resources to help us with understanding the economic impact of Public Health um because I", "start": 4344.639, "end": 4351.199}, {"text": "think about our homelessness and our um homelessness", "start": 4351.199, "end": 4356.4}, {"text": "strategy our team works really hard at trying to identify what is the economic", "start": 4356.4, "end": 4362.159}, {"text": "cost of homelessness and I don't know if that's something that Alpha can help with and", "start": 4362.159, "end": 4368.719}, {"text": "so my question is more fundamental is that something that Alpha can do do you have a policy team that can help us with", "start": 4368.719, "end": 4375.6}, {"text": "just breaking down the numbers because as you have just said these Ministries are very economic driven and so they", "start": 4375.6, "end": 4383.56}, {"text": "don't they do listen with their hearts but they calculate with their calculators a lot more strongly than", "start": 4383.56, "end": 4390.96}, {"text": "they do so thank you so this is where working quite closely with Amo comes", "start": 4390.96, "end": 4397.04}, {"text": "into play we do have a resolution with regards to homelessness so supporting an organization such as Amo when they come", "start": 4397.04, "end": 4403.52}, {"text": "out with this type of report again presenting it at the upcoming Symposium these are all part of the", "start": 4403.52, "end": 4410}, {"text": "education and information that we do when we're supporting a partner uh the other thing that we've been doing and", "start": 4410, "end": 4415.08}, {"text": "it's been highly effective it will sound very simple but it's worked really well at meetings at Queens Park we have", "start": 4415.08, "end": 4421.04}, {"text": "infographics and I'm happy to to send in and share the link one of the most recent ones was on the value of Public", "start": 4421.04, "end": 4427.239}, {"text": "Health we'll be continuing with these Public Health matters infographics people are really busy at Queens Park as", "start": 4427.239, "end": 4434.159}, {"text": "you all are around on this table a big report is great for their staff they will go through it they will read it but", "start": 4434.159, "end": 4440.52}, {"text": "if we want to get the politicians attention we have found these infographics that have the stats similar", "start": 4440.52, "end": 4445.8}, {"text": "to what you're talking about graphically laid out easy to read we use that to um", "start": 4445.8, "end": 4452.4}, {"text": "start a meeting to engage a conversation they're not cure alls you know it's one page back back in front but they're", "start": 4452.4, "end": 4459.28}, {"text": "highly effective Communications tools so those are on the alpha website right on the homepage and look for more and if", "start": 4459.28, "end": 4465.84}, {"text": "you have ideas for ones that you'd like us to do we're always happy to hear from the membership a lot of what we do is is", "start": 4465.84, "end": 4472.679}, {"text": "a result of that feedback thank you thank you those are all my questions", "start": 4472.679, "end": 4478.159}, {"text": "chair thank you not okay uh member Kirkby and then U member", "start": 4478.159, "end": 4484.4}, {"text": "Chung okay hi thanks so much for your presentation um my question is I'm just curious about the changes the public", "start": 4485.12, "end": 4491.159}, {"text": "health standards and um the impact that might have locally on our public health approach here in Hamilton so I'm just", "start": 4491.159, "end": 4497.28}, {"text": "curious if you have any insights from what you know of the recommendations to date if there's any major changes or things that um might be good for us to", "start": 4497.28, "end": 4504.28}, {"text": "have some insight into now as even though not coming until August but just for this table to be aware", "start": 4504.28, "end": 4510.239}, {"text": "of to you through the chair I will say that we reviewed the revisions in May a", "start": 4510.239, "end": 4518.159}, {"text": "lot of things can happen between May and when they release them next August I will say that the changes were in my", "start": 4518.159, "end": 4526.239}, {"text": "mind subtle in the sense that they asked staff to do more things directly as", "start": 4526.239, "end": 4532.48}, {"text": "opposed to consult and advise it was in there doing the Partnerships which takes", "start": 4532.48, "end": 4537.8}, {"text": "more staff effort uh they also have um more extensive protocols uh especially", "start": 4537.8, "end": 4545.08}, {"text": "saying uh relationships with indigenous communities and organizations there is a more of a focus", "start": 4545.08, "end": 4553.84}, {"text": "um on on the doing and the Partnerships and following up with it they also", "start": 4553.84, "end": 4561.159}, {"text": "collapsed a few um uh standards so that there's", "start": 4561.159, "end": 4566.32}, {"text": "basically a comprehensive uh chronic disease that they put about six other", "start": 4566.32, "end": 4571.8}, {"text": "standards including school health in so I think that's going to be if they continue to do that that's going to be", "start": 4571.8, "end": 4578.96}, {"text": "very complex for public health units to to work through how they can do those", "start": 4578.96, "end": 4584.56}, {"text": "inter connections because I have discovered over the years Health units", "start": 4584.56, "end": 4589.76}, {"text": "often follow what the standards are and and use them as a guide for how they organize themselves so we'll see what", "start": 4589.76, "end": 4597.639}, {"text": "they say in August they have given from August to January for implementation but", "start": 4597.639, "end": 4603.48}, {"text": "combined with the 1% budget uh increase at this point it's I think challenging", "start": 4603.48, "end": 4610.36}, {"text": "and one of the issues will be where's your focus on priority populations cuz", "start": 4610.36, "end": 4615.84}, {"text": "you won't be able to do everything that's just an", "start": 4615.84, "end": 4621.32}, {"text": "observation thanks and on to member Chon yeah thank you for your presentation I just had a question in", "start": 4622.679, "end": 4628.679}, {"text": "terms of mergers so I know you guys presented a lot of mergers it seems like that's something the ministry is really", "start": 4628.679, "end": 4633.88}, {"text": "trying to incentivize in some ways um sounds like it's a phenomenon mostly for smaller boards and groups is is there a", "start": 4633.88, "end": 4641.04}, {"text": "phenomenon of that happening in bigger uh groups at all", "start": 4641.04, "end": 4646.56}, {"text": "um I will say yes one of the issues and it's been an issue for the ministry for", "start": 4646.76, "end": 4652.28}, {"text": "over 20 years to merge smaller um Health units um especially in Northern Ontario", "start": 4652.28, "end": 4659}, {"text": "Etc um they don't have the capacity say that Hamilton has and one of the things", "start": 4659, "end": 4665.12}, {"text": "that the ministry often does not say is that Regional and Regional Boards of", "start": 4665.12, "end": 4671.76}, {"text": "health health units and those that are within single tier cities like", "start": 4671.76, "end": 4676.84}, {"text": "yourselves are actually more efficient um and for the cost of them because you", "start": 4676.84, "end": 4682.48}, {"text": "don't have everything separate you're integrated within a municipal structure and so uh the marginal costs are much", "start": 4682.48, "end": 4690.4}, {"text": "less um but no the usually there's been a lot of Assessments over the years smaller", "start": 4690.4, "end": 4698.4}, {"text": "Health units just they may have one EP they don't have two they may not have an", "start": 4698.4, "end": 4703.52}, {"text": "associate medical officer of health so that theoh is 247 which just is exhausting the", "start": 4703.52, "end": 4712.76}, {"text": "smaller Health units they do the best they can but it has been the province", "start": 4712.76, "end": 4718.4}, {"text": "has always looked fewer is better um for multiple reasons and they did learn from", "start": 4718.4, "end": 4725.679}, {"text": "2019 when they tried to force uh the amalgamations to only 10 Health units in", "start": 4725.679, "end": 4731.679}, {"text": "the budget uh I don't know if people remember that that was quite an interesting day they said yep 10 Health", "start": 4731.679, "end": 4738.48}, {"text": "units and it didn't go well and municipalities really fought for their for for their health units um but they", "start": 4738.48, "end": 4745.96}, {"text": "are trying to get better capacity for surge capacity for just being able to", "start": 4745.96, "end": 4752.08}, {"text": "have a larger um pool of people to to do so it has been something it I could site", "start": 4752.08, "end": 4759.239}, {"text": "the 2006 capacity Review Committee which again actually talked about uh many of", "start": 4759.239, "end": 4766.04}, {"text": "the mergers that have now occurred okay not see any other speakers", "start": 4766.04, "end": 4772.84}, {"text": "on our list I'm just going to pass the chair to Vice chair Johnson for a moment just wanted to clarify if you could give", "start": 4772.84, "end": 4779.12}, {"text": "a little more information about where the alpha conference is located the hint on the internet seems to be it's on the", "start": 4779.12, "end": 4784.88}, {"text": "internet um because there's not a location provided but I thought I would give you a chance to do so because at some point today we'll have an", "start": 4784.88, "end": 4790.48}, {"text": "opportunity for people if they want to go to the alpha winter Symposium to declare um their and we can have a motion to that effect and we can send up", "start": 4790.48, "end": 4796.8}, {"text": "to two people to that Symposium so just ping everyone uh think about that in the", "start": 4796.8, "end": 4801.88}, {"text": "in the forgoing 30 minutes but yeah if you could tell us where it is located thank you sorry if I was unclear it's", "start": 4801.88, "end": 4807.679}, {"text": "online it's on a zoom webinar platform and we also have additional workshops at", "start": 4807.679, "end": 4813.48}, {"text": "no uh no extra cost that are included in your registration uh one of them is with", "start": 4813.48, "end": 4818.679}, {"text": "Tim Arnold from leaders uh for leaders for those of you who have been at previous Alpha events he is excellent at", "start": 4818.679, "end": 4825.679}, {"text": "getting boards to work effectively together highly rated by our members so we're bringing Tim back we also have a", "start": 4825.679, "end": 4832.239}, {"text": "workshop again at no additional charge with ezri Canada and that's looking at geographic information systems and", "start": 4832.239, "end": 4839.6}, {"text": "public health the simplest way to explain this it's sophisticated mapping where you layer so let's say you're", "start": 4839.6, "end": 4846.04}, {"text": "looking at uh flooding you could do layer on layer on layer with all the different factors in it's a very", "start": 4846.04, "end": 4852.32}, {"text": "powerful public health tool so that's a a little bit more technical so we'll have that as well you don't have to", "start": 4852.32, "end": 4858.28}, {"text": "attend everything so you've got a workshop on the afternoon of the 12th a workshop on the afternoon of the 13th", "start": 4858.28, "end": 4865.56}, {"text": "and then you have the Symposium the morning of the 14th and the boards of health section in the afternoon of the", "start": 4865.56, "end": 4871}, {"text": "14th while we encourage people to take advantage of all of that people have other things going on so sometimes", "start": 4871, "end": 4877.08}, {"text": "people will Bop in and out and lastly because it's virtual I won't be ruining anybody's Valentine's Day", "start": 4877.08, "end": 4883.36}, {"text": "dinner okay okay thank you for that information and everyone just keep in mind if you're interested in going we'll", "start": 4883.36, "end": 4888.84}, {"text": "get to that a bit later in the uh presentation yeah go ahead sorry sorry we we've kept the price as well in", "start": 4888.84, "end": 4895.32}, {"text": "recognition of the fact that everybody has very tight budgets we have not increased the fee for the Symposium for", "start": 4895.32, "end": 4901.6}, {"text": "at least two years now so we're trying to keep it as costeffective as possible and we we are adding workshops and more", "start": 4901.6, "end": 4908.08}, {"text": "workshops on to make it as high value as possible thanks very much just one moment here just going to", "start": 4908.08, "end": 4915.199}, {"text": "return to my road map to make sure I get the procedures right as they're changed so we've had the first presentation yeah", "start": 4915.199, "end": 4922.52}, {"text": "thank you and thank you very much uh Vice chair Johnson has returned the chair to me so taking it back thank", "start": 4922.52, "end": 4928.32}, {"text": "you um is no further discussion on the presentation we'll just go on to the next presentation thank you very much s", "start": 4928.32, "end": 4934.92}, {"text": "sorry you want to make you want to did you want to know about the elections you you mentioned um earlier would you like me to say something about that for the", "start": 4934.92, "end": 4941.12}, {"text": "boards of Health if you don't mind just saying that information is correspondence closer for the time distribut to everybody and they can it", "start": 4941.12, "end": 4946.92}, {"text": "come in the newslet okay thank you so much thank you very much all right we on to the second presentation now I believe", "start": 4946.92, "end": 4952.28}, {"text": "it's Dr Richardson is going to be delivering that presentation thank you chair I'm at least going to kick us off and then my", "start": 4952.28, "end": 4958.719}, {"text": "colleagues along the row are going to continue on Matt's just going to rather than have us all sort of traes down to", "start": 4958.719, "end": 4963.92}, {"text": "the front traes back and and trip over each other he's just going to present from there and we'll uh just wait one", "start": 4963.92, "end": 4970.639}, {"text": "second for him to get that up", "start": 4970.639, "end": 4974.679}, {"text": "we're just waiting for the presentation to load and we'll take questions at the end of this presentation as well before you receive both and then afterwards uh", "start": 4981.44, "end": 4987.48}, {"text": "the report and then after that if people are interested in going to the winter Symposium we'll entertain um that discussion as well at that", "start": 4987.48, "end": 4994.84}, {"text": "time there we go thank you Matt so we wanted just again to give you a couple", "start": 4997.719, "end": 5003.36}, {"text": "of of additional little pieces that um have uh come up through the the course of Alpha's um presentation but the main", "start": 5003.36, "end": 5010.88}, {"text": "point of this part of the presentation is just to go over those programs and services you heard a reference to the standards and just talk about how that", "start": 5010.88, "end": 5017.08}, {"text": "relates to how we're organized here in Hamilton um but just a a couple of things to note so Monica talked about", "start": 5017.08, "end": 5023.92}, {"text": "the annual service plan and budget and it uh coming back to this group and she", "start": 5023.92, "end": 5029.04}, {"text": "talked about how it is a large document in fact it can no longer be done in document format it is only an electronic", "start": 5029.04, "end": 5036}, {"text": "template um which the ministry provides to us they have not yet provided us this year's template usually we get that", "start": 5036, "end": 5042.44}, {"text": "towards the end of a of the previous year in order for us to populate and bring forward um and so we had planned", "start": 5042.44, "end": 5049.239}, {"text": "to bring the uh the aspb on February 24th to the next committee meeting and", "start": 5049.239, "end": 5054.56}, {"text": "we stay at that higher strategic level going through the the main purpose and and goals in the high level uh summary", "start": 5054.56, "end": 5060.88}, {"text": "of the budget however if we don't get the template soon we're going to have to delay that to a to a future meeting and", "start": 5060.88, "end": 5066.8}, {"text": "they'll delay its due date as well um as we go forward so it's somewhere February March you should expect to see it then", "start": 5066.8, "end": 5074.56}, {"text": "um the annual performance and accountability report so we do that each uh second quarter of the year so we", "start": 5074.56, "end": 5081.159}, {"text": "bring back a whole slew of um key performance indicators some of which are required by the ministry um of us some", "start": 5081.159, "end": 5088.199}, {"text": "of which we develop locally in response to the local priorities and we bring that forward along with an annual report", "start": 5088.199, "end": 5093.84}, {"text": "for the public public that we are obligated to uh to put out each year and", "start": 5093.84, "end": 5099.159}, {"text": "that will come usually in May or June I think this year we're planning for May and then an organizational risk", "start": 5099.159, "end": 5104.92}, {"text": "management plan and so this is not about sort of the risks to the Public's health or emergency situations this is about as", "start": 5104.92, "end": 5112}, {"text": "an organization um what are the key risks that we face whether they're you are", "start": 5112, "end": 5117.08}, {"text": "there challenges in recruiting Public Health nurses or Public Health Inspectors are there challenges in terms", "start": 5117.08, "end": 5122.56}, {"text": "of documentation standards you know they're really more the organizational elements of How It's run and so um staff", "start": 5122.56, "end": 5129.159}, {"text": "go through a uh an overview and develop all the risk within a framework that was provided by the auditor general for", "start": 5129.159, "end": 5135.679}, {"text": "Ontario and um we uh report on the highest level of risk here and we", "start": 5135.679, "end": 5141.159}, {"text": "presented an action plan to mitigate them and do a follow up on the previous years and how well that we've", "start": 5141.159, "end": 5147.28}, {"text": "done just a quick highlight on the next slide uh just again of the context that you heard and so just to contextualize", "start": 5147.28, "end": 5153.96}, {"text": "it here in Hamilton you know the the sort of challenges that we face around the broad mandate that we have Monica", "start": 5153.96, "end": 5159.88}, {"text": "talked about the breadth of the Ontario public health standards and how it's really challenging with the resources that we have I mean it's always the this", "start": 5159.88, "end": 5167.28}, {"text": "case that there is more to do than there are resources that are available we're always you know as a society having to", "start": 5167.28, "end": 5172.719}, {"text": "make choices around things and it's very much the case when it comes to the Ontario public health standards and so deciding which components of those", "start": 5172.719, "end": 5179.76}, {"text": "standards that are most key to do here in Hamilton is a lot of what our staff do as they go through the planning uh", "start": 5179.76, "end": 5186.32}, {"text": "process and that's why talking about priorities and why we were mentioning them in that first meeting about what they were in 24 you know how we're", "start": 5186.32, "end": 5193.52}, {"text": "working forward in terms of what will be the priorities coming forward for 2025 um we have had an increased Demand", "start": 5193.52, "end": 5200.88}, {"text": "on our services as well postco we know there's issues like mental health and um", "start": 5200.88, "end": 5206.08}, {"text": "the uh and substance use and their impacts in the community We There are various areas where they've been there's been a higher demand and so again", "start": 5206.08, "end": 5212.88}, {"text": "priorities are important and one of the things that's U that's key for us is increased Workforce flexibility so", "start": 5212.88, "end": 5219.28}, {"text": "Monica mentioned the boomed and bus boom and bust sort of um environment that Public Health Works in and the kinds of", "start": 5219.28, "end": 5224.76}, {"text": "programming that we do so whether that's you know not just pandemics which was of course a more extreme example but when", "start": 5224.76, "end": 5230.92}, {"text": "we're talking about outbreaks um that happen or particular cases of disease for example we've had increased number", "start": 5230.92, "end": 5236.8}, {"text": "of measles cases which we hadn't seen in years and they require you know sometimes up to 100 contacts to be", "start": 5236.8, "end": 5242.6}, {"text": "followed well we can't complete reorient our communicable disease control program because there's you know", "start": 5242.6, "end": 5248.44}, {"text": "another 64 communicable diseases they have to follow up on um and so we looked", "start": 5248.44, "end": 5254.679}, {"text": "at how can we introduce some flexibility in our Workforce so that they can help to meet those abs and flows that happen", "start": 5254.679, "end": 5261.239}, {"text": "over time so it's a a much more cost-effective way of doing it and it", "start": 5261.239, "end": 5266.48}, {"text": "increases has our our staff working to that broad scope and maintaining those competencies as they go forward so Jen", "start": 5266.48, "end": 5273.52}, {"text": "vicker man and our former director of Healthy Families have been and chief nursing officer have been key in moving this forward and we continue to do that", "start": 5273.52, "end": 5281.08}, {"text": "uh today this is also something that chief medical officer of Health in their um follow-up report from covid you know", "start": 5281.08, "end": 5287.639}, {"text": "it really pointed to being very important for health units to be responsive as we go forward so just wanted to point to those", "start": 5287.639, "end": 5294.92}, {"text": "and now I'll get to the organizational part Matt if you wouldn't mind the next org chart slide um this just lays out", "start": 5294.92, "end": 5301.639}, {"text": "the four divisions we have uh Within in public health services and the uh Office", "start": 5301.639, "end": 5307.159}, {"text": "of the chief of the medical officer of Health with myself Dr Lou and Dr Harvey", "start": 5307.159, "end": 5312.36}, {"text": "who is online today because he too is UN well um today so choosing to keep that", "start": 5312.36, "end": 5317.44}, {"text": "to himself rather than brisk it the for the rest of us but those four um divisions are communicable disease", "start": 5317.44, "end": 5323.44}, {"text": "control which is headed by Jordan Walker epidemiology and wellness who is which is headed by uh Julie petto healthy", "start": 5323.44, "end": 5330.52}, {"text": "environments which is headed by Kevin McDonald and Healthy Families which which is headed by Bonnie King who um is", "start": 5330.52, "end": 5337.32}, {"text": "helping us out um in the interim while we look to recruit a new Chief nursing officer and", "start": 5337.32, "end": 5343.719}, {"text": "director so each of the directors is just going to go through give you a broad high level highlight of the key", "start": 5343.719, "end": 5350.08}, {"text": "goals in their area and the work they do there is a narrative that we've included in as an example a story for those of us", "start": 5350.08, "end": 5357.04}, {"text": "we all relate better generally to stories rather than numbers and and bullets and so that is there as well we", "start": 5357.04, "end": 5363.44}, {"text": "won't go into those in details but just to hit a few highlights with within each of those areas so with that I'll turn it", "start": 5363.44, "end": 5370.04}, {"text": "over to Jordan and in case anybody's thinking they'll have to do Kevin's again I will do Kevin's piece so all", "start": 5370.04, "end": 5375.48}, {"text": "right thank you Elizabeth so Jordan Walker director for the communicable disease control division with Hamilton's", "start": 5375.48, "end": 5380.679}, {"text": "Public Health Services uh and so broadly the goals for the CDC division are to reduce the burden of communicable", "start": 5380.679, "end": 5386.88}, {"text": "infectious diseases of Public Health significance as well as reducing the burden of vaccine preventable diseases", "start": 5386.88, "end": 5392.96}, {"text": "through the promotion and administration of immunization and enforcement of the immunization of school pupils act as", "start": 5392.96, "end": 5399.6}, {"text": "well the division uh supports the management of inventory and distribution of all publicly funded uh vaccines to", "start": 5399.6, "end": 5405.719}, {"text": "Community Health Care Providers uh and finally um responsible for preparing for", "start": 5405.719, "end": 5411.159}, {"text": "responding to and recovering from uh emergencies with public health impacts", "start": 5411.159, "end": 5416.719}, {"text": "as you see on this slide our division is uh comprised of five program areas which", "start": 5416.719, "end": 5421.76}, {"text": "again as Elizabeth mentioned are described in Greater detail in the appendices to the report but at a high", "start": 5421.76, "end": 5427.199}, {"text": "level our five programs are the emergency response program which has a goal to uh ensure and support", "start": 5427.199, "end": 5433.04}, {"text": "organizational Readiness so that we're able to respond and recover as well as to mitigate risks uh from significant", "start": 5433.04, "end": 5439.28}, {"text": "threats to Public Health or disruptions to Public Health Services so not just uh threats to Public Health but threats to", "start": 5439.28, "end": 5445.96}, {"text": "our operations as well we have our infectious diseases program which has a goal to uh prevent and reduce the spread", "start": 5445.96, "end": 5453.08}, {"text": "of morbility morbidity uh and mortality uh of infectious diseases and this is achieved through such activities as", "start": 5453.08, "end": 5459.8}, {"text": "health promotion as well as case and contact management uh for diseases of Public Health significance something", "start": 5459.8, "end": 5465.639}, {"text": "that um certainly I think folks would be very familiar with following uh the covid pandemic um prior to that not not", "start": 5465.639, "end": 5472.199}, {"text": "as many folks I think were aware of the uh the sweet of diseases of Public Health significance and the amount of", "start": 5472.199, "end": 5477.4}, {"text": "case and contact followup that goes into uh every time one of those cases is identified in our community which Public", "start": 5477.4, "end": 5482.84}, {"text": "Health units undertake also within the division is the infection prevention and control and", "start": 5482.84, "end": 5488.76}, {"text": "outbreak Management program uh which also has a goal to control the spread of infectious diseases within our community", "start": 5488.76, "end": 5494.719}, {"text": "this is supported through activities such as the provision of outbreak management guidance to local institutions such as Long-Term Care", "start": 5494.719, "end": 5501.239}, {"text": "Homes retirement homes um congrate living settings uh as well as uh infection control inspections uh routine", "start": 5501.239, "end": 5508.56}, {"text": "infection control inspections as well as infection control complaint response uh in settings such as like licensed childcare settings and personal service", "start": 5508.56, "end": 5514.96}, {"text": "settings such as tattoo shops or aesthetic Services we have our community", "start": 5514.96, "end": 5520.679}, {"text": "vaccination and school clinics program uh which has a goal to reduce the burden of vaccine preventable disease through", "start": 5520.679, "end": 5526.159}, {"text": "supporting uh vaccine knowledge and confidence in our community as well as administration of some vaccines in", "start": 5526.159, "end": 5531.639}, {"text": "particular the grade seven vaccines in our schools um our respiratory uh", "start": 5531.639, "end": 5537.32}, {"text": "vaccine clinics which support covid and influenza uh throughout the respiratory season as well as ketchup clinics for", "start": 5537.32, "end": 5543.639}, {"text": "IND uals who are overdue on vaccination um primarily targeted to uh with those clinics being primarily targeted to", "start": 5543.639, "end": 5550.119}, {"text": "individuals who have barriers to accessing uh Healthcare or accessing those vaccines through other channels and lastly within the division", "start": 5550.119, "end": 5557.32}, {"text": "we have our uh Inventory management program uh which has a goal to ensure the effective management and", "start": 5557.32, "end": 5562.52}, {"text": "distribution of publicly funded vaccines so as to minimize wastage promote safety and ensure the uh efficacy of those", "start": 5562.52, "end": 5569.199}, {"text": "vaccines next slide please", "start": 5569.199, "end": 5573.719}, {"text": "and so as Elizabeth mentioned uh I'm not going to go through this story in great detail is uh both attached to the", "start": 5574.4, "end": 5579.6}, {"text": "presentation as well as to the appendices um but this is an example speaking to the public health response", "start": 5579.6, "end": 5584.719}, {"text": "to a theoretical case of measles I do want to highlight this is not a specific example of a a real world uh case but uh", "start": 5584.719, "end": 5591.239}, {"text": "it is a very typical response to uh measles and it does highlight the activities of the CDC division those", "start": 5591.239, "end": 5596.88}, {"text": "which we would undertake in response to reports of a disease of Public Health significance again so as to reduce that", "start": 5596.88, "end": 5602.239}, {"text": "burden of illness within the community uh within the example it speaks to the support and case followup that is", "start": 5602.239, "end": 5607.4}, {"text": "provided to families and individuals infected with a disease of Public Health significance it identifies the specific", "start": 5607.4, "end": 5613.28}, {"text": "uh or the the uh contact tracing efforts would be undertaken within the community to help mitigate further spread uh as", "start": 5613.28, "end": 5620}, {"text": "Elizabeth mentioned around the flexibility of resources within Public Health Services um and building that", "start": 5620, "end": 5625.639}, {"text": "flexible uh Workforce it does speak to the uh as as can often be the case with an infectious disease or within the CDC", "start": 5625.639, "end": 5631.92}, {"text": "division the need to rep prioritize resources both within the division or across programs within Public Health", "start": 5631.92, "end": 5637.239}, {"text": "Services to address time sensitive Community needs and operational pressures in the event of of cases or", "start": 5637.239, "end": 5643.08}, {"text": "outbreaks that require significant contact tracing or vaccination as certainly would be the case for amles uh", "start": 5643.08, "end": 5649.199}, {"text": "and lastly it speaks to um uh working collaboratively within the division to support access to timely vaccinations", "start": 5649.199, "end": 5655.56}, {"text": "for individuals identified as contacts um particularly for those again with barriers to accessing those vaccinations", "start": 5655.56, "end": 5661.119}, {"text": "through other healthc care providers next slide please and with that I believe I'll turn it over to Julie prto", "start": 5661.119, "end": 5668.04}, {"text": "good morning everyone uh Julie prto director of the epidemiology and wellness division um so I'm going to uh", "start": 5668.04, "end": 5674.4}, {"text": "follow a similar format uh as Jordan did just noting that of course there is uh further information in more details in", "start": 5674.4, "end": 5680.88}, {"text": "the appendices so the epidemiology uh and wellness division goals include focusing", "start": 5680.88, "end": 5686.84}, {"text": "on mental wellbeing substance use prevention harm reduction initiatives and Outreach and Addiction Services for", "start": 5686.84, "end": 5694.199}, {"text": "vulnerable populations providing data surveillance and population health information to ensure programs are", "start": 5694.199, "end": 5700.32}, {"text": "evidence-based and responsive to local needs and supporting business operations", "start": 5700.32, "end": 5705.6}, {"text": "and Service delivery in compliance with legislative privacy security and records and information management", "start": 5705.6, "end": 5712.88}, {"text": "requirements and so you'll see there uh on the left are the four teams or four", "start": 5712.88, "end": 5718.04}, {"text": "programs that are part of this division uh the first is the alcohol drugs and gambling services and the mental health", "start": 5718.04, "end": 5723.84}, {"text": "outreach program and its overarching goal is to to deliver integrated inclusive and accessible services to", "start": 5723.84, "end": 5730.679}, {"text": "individuals in Hamilton who are facing mental health addictions and homel homelessness challenges the data", "start": 5730.679, "end": 5737.48}, {"text": "management program ensures business operations and Service delivery comply with legislative privacy security and", "start": 5737.48, "end": 5744.239}, {"text": "records and information management requirements the epidemiology and evaluation program improved", "start": 5744.239, "end": 5751.08}, {"text": "understanding of population Health outcomes and and inequities in Hamilton and finally the mental well-being and", "start": 5751.08, "end": 5757.08}, {"text": "substance use program uh Works to reduce the burden uh and harms associated with substance use and promote Community", "start": 5757.08, "end": 5763.719}, {"text": "Mental Health and well-being and next slide please thank you", "start": 5763.719, "end": 5769.48}, {"text": "Matt uh so like Jordan indicated these are um fictional stories but really do", "start": 5769.48, "end": 5775.36}, {"text": "uh help you understand some of the work within this division so this is a story that provides an example of addressing", "start": 5775.36, "end": 5782.08}, {"text": "complex needs of UN housed individuals uh as noted AK first", "start": 5782.08, "end": 5787.119}, {"text": "contacted Public Health through a street Outreach worker so street street Outreach workers meet people where they", "start": 5787.119, "end": 5792.32}, {"text": "are at and help those who are experiencing homelessness mental health issues or substance abuse find support", "start": 5792.32, "end": 5798.4}, {"text": "and resources this story also demonstrates the importance of continuity of care which Fosters trusting relationships", "start": 5798.4, "end": 5805.159}, {"text": "between staff and clients over time this allows clients to share their story and seek support as needed clients are", "start": 5805.159, "end": 5812.119}, {"text": "empowered to actively participate in in prioritizing their issues and identify their most pressing", "start": 5812.119, "end": 5817.32}, {"text": "concerns this story also highlights the complexity of Need for some of our most vulnerable individuals in Hamilton and", "start": 5817.32, "end": 5823.76}, {"text": "the importance of addressing the social determinance of Health to allow individuals to be as healthy as", "start": 5823.76, "end": 5829.239}, {"text": "possible okay and I think I'm now turning so I have the pleasure of uh of", "start": 5829.239, "end": 5837}, {"text": "going over the healthy environments Division I did just want to note as well that in the packages that you have um", "start": 5837, "end": 5843.08}, {"text": "you have the presentation and but attached to the report you also have another version of this that has as well", "start": 5843.08, "end": 5850.92}, {"text": "the email addresses for contacts for people and these descriptions about the programs and services within them so um", "start": 5850.92, "end": 5857.28}, {"text": "just to to make sure you had those there those might be something to sort of keep on hand take you know set aside as as", "start": 5857.28, "end": 5862.36}, {"text": "something that might be helpful to you if you have questions that you want to relate to directors and staff in the future so Kevin's area healthy", "start": 5862.36, "end": 5869.639}, {"text": "environments division it um has four broad areas of programming so chronic", "start": 5869.639, "end": 5875.96}, {"text": "disease prevention um food and water safety and health hazards in Vector born diseases as well as tobacco control the", "start": 5875.96, "end": 5883.28}, {"text": "divisional goals are to reduce the burden of chronic diseases of Public Health importance and so again back to", "start": 5883.28, "end": 5888.88}, {"text": "that piece about prioritising needing to look at those that have the greatest burden um in our particular area but", "start": 5888.88, "end": 5895.32}, {"text": "also looking at those where there's something that a public health strategy can make a difference with so they have", "start": 5895.32, "end": 5900.88}, {"text": "to be evidence-based from that standpoint promoting the development of healthy built and natural environments", "start": 5900.88, "end": 5906.639}, {"text": "and mitigating the impacts of climate change on human health and so we often um talk here as well about air quality", "start": 5906.639, "end": 5913.159}, {"text": "and how it fits in with uh with both of those um in in that broader area and", "start": 5913.159, "end": 5918.679}, {"text": "then reducing human exposure to to health hazards and to Vector born diseases and I'm going to give you a", "start": 5918.679, "end": 5923.96}, {"text": "little bit more description of those programs in just a minute to really talk about the breadth of what some of these programs have to uh have to address and", "start": 5923.96, "end": 5931.119}, {"text": "preventing and reducing the the burden of foodborn illness as well as waterborne illness so again looking at", "start": 5931.119, "end": 5938.76}, {"text": "those um those program areas the chronic disease prevention program currently is looking at at four main areas of work so", "start": 5938.76, "end": 5946.88}, {"text": "one is around active transportation and so if you um change the slides if you would Matt um you'll see the story", "start": 5946.88, "end": 5953.88}, {"text": "speaks to um creating safe environments for kids in terms of of of uh getting to", "start": 5953.88, "end": 5959.4}, {"text": "school and how important active transportation is there and through health public policy and so a lot of the", "start": 5959.4, "end": 5965.32}, {"text": "work that is done within the chronic disease group is not done alone it is done in combination with others we had", "start": 5965.32, "end": 5970.719}, {"text": "Nick Winters here who was talking about fluoride um to talk about fluoride and and water issues but we also work with", "start": 5970.719, "end": 5977.119}, {"text": "our colleagues in planning our colleagues in transportation um around these issues to try and move forward", "start": 5977.119, "end": 5982.88}, {"text": "with a a coordinated approach across the city reducing sedentary behavior in", "start": 5982.88, "end": 5988.28}, {"text": "workplaces and schools is also a a big Focus area for the chronic disease program increasing accessibility and", "start": 5988.28, "end": 5995.159}, {"text": "availability of healthy foods is another area and increasing food literacy particularly in terms of newcomers and", "start": 5995.159, "end": 6002.04}, {"text": "working with newcomers uh to understand um the the uh the options that may be", "start": 6002.04, "end": 6007.679}, {"text": "available uh here and how they uh relate to to traditional foods and cooking they", "start": 6007.679, "end": 6013.199}, {"text": "may have been may have done under the food and water uh safety program it is a little bit more of the more", "start": 6013.199, "end": 6019.56}, {"text": "straightforward one in terms of the description kind of tells you what it is they do inspections of frood premises", "start": 6019.56, "end": 6025}, {"text": "festivals and special events they investigate food safety related complaints and so if there's a complaint", "start": 6025, "end": 6030.76}, {"text": "about a restaurant or an event they would be the ones that they would go to that those would go to and they do training and education of food handlers", "start": 6030.76, "end": 6037.44}, {"text": "and the public on safe food handling practices so for example we try to do something in the spring before the", "start": 6037.44, "end": 6042.8}, {"text": "barbecue season um uh starts out in order to prevent the the general um", "start": 6042.8, "end": 6049.48}, {"text": "increase in in related foodborn illness that we tend to see they're also focusing on preventing or", "start": 6049.48, "end": 6055.84}, {"text": "reducing the burden of waterborne illness we inspect small Drinking Water Systems we also work together with our", "start": 6055.84, "end": 6063.119}, {"text": "colleagues Nick winter and his colleagues on issues that may arise within the city's uh drinking water", "start": 6063.119, "end": 6068.84}, {"text": "system we inspect recreational water so everything from beaches to pools to um", "start": 6068.84, "end": 6075.48}, {"text": "hot tubs all of those and we complete annual mandatory uh inspections and", "start": 6075.48, "end": 6080.639}, {"text": "complaint based inspections on a frequency for each of those that is determined by The", "start": 6080.639, "end": 6085.679}, {"text": "Province um in the health hazards in Vector born disease program a very broad", "start": 6085.679, "end": 6090.719}, {"text": "uh number of issues fall there it makes it a bit challenging for that that group", "start": 6090.719, "end": 6095.76}, {"text": "uh because of the breadth of things that they need to address but they're looking to reduce exposure to environmental", "start": 6095.76, "end": 6101.199}, {"text": "health hazards and and mitigate risks related to those they do the work around air pollution and those exposures and", "start": 6101.199, "end": 6107.719}, {"text": "they also do the work around climate change um uh as it relates to environmental health and clim climate", "start": 6107.719, "end": 6114.04}, {"text": "change they are the group that does our work on Vector born diseases so this really started for us um with rabies", "start": 6114.04, "end": 6120.84}, {"text": "would have been the smallest um you know uh number of diseases we had originally which then expanded really to westn", "start": 6120.84, "end": 6127.44}, {"text": "virus um and then it's continued to expand as the number of vectors of significance um have increased so other", "start": 6127.44, "end": 6133.96}, {"text": "mosquitoes other diseases that are uh changing in terms of where they exist in", "start": 6133.96, "end": 6140.48}, {"text": "North America because of climate change and so this group um continues to do the", "start": 6140.48, "end": 6147.08}, {"text": "the monitoring and control related to West Nile they do the investigation of rabies cases or any bites that uh that", "start": 6147.08, "end": 6153.84}, {"text": "might occur with dogs in our community and they do surveillance for ticks for Lyme disease and other Vector born", "start": 6153.84, "end": 6160}, {"text": "diseases as they emerge our tobacco control program you know has been a long-standing program of", "start": 6160, "end": 6166.92}, {"text": "very important to our uh community and its well-being because of the impacts that tobacco has had on our population", "start": 6166.92, "end": 6174.08}, {"text": "they work to prevent the initiation of smoking and vaping through prevention campaigns cessation counseling and", "start": 6174.08, "end": 6179.76}, {"text": "supports training Health Providers um and Social Services providers they also", "start": 6179.76, "end": 6185.04}, {"text": "do the enforcement of both provincial and local bylaws as they relate to tobacco and um and vaping they inspect", "start": 6185.04, "end": 6192.84}, {"text": "hospitals and schools in terms of the application of the provincial legislation to those sorts of", "start": 6192.84, "end": 6198}, {"text": "Institutions and of course investigate uh complaints as well they also go to um", "start": 6198, "end": 6204.04}, {"text": "corner stores and anywhere that sells tobacco to do inspections to ensure that they're compliant uh with um uh issues", "start": 6204.04, "end": 6212.28}, {"text": "related to youth access and product display so um a lot of work continues to go on in tobacco is an important area of", "start": 6212.28, "end": 6218.48}, {"text": "practice there so I think Bonnie you're the one that's uh riing me thank you", "start": 6218.48, "end": 6224.08}, {"text": "good morning everyone I'm Bonnie King and I'm happy to be here as the interim director of The Healthy Families Division and our chief nursing officer", "start": 6224.08, "end": 6231.52}, {"text": "the overarching goal goal of the Healthy Families division is to support individuals and families across the city", "start": 6231.52, "end": 6237.92}, {"text": "to be able to achieve Optimal Health before and during pregnancy at Birth and", "start": 6237.92, "end": 6243.08}, {"text": "during the transition to Parenting and to support healthy growth and development through infancy the early", "start": 6243.08, "end": 6248.48}, {"text": "years throughout childhood and Adolescence and of course this includes focusing on Parental health and", "start": 6248.48, "end": 6253.96}, {"text": "well-being and family health and well-being our division also supports public health programs to meet the needs", "start": 6253.96, "end": 6260.119}, {"text": "of priority populations and to decrease in equity while enhancing Effectiveness", "start": 6260.119, "end": 6265.36}, {"text": "and impact of Public Health Services and the chief nursing officer role is to support the achievement of a", "start": 6265.36, "end": 6272.679}, {"text": "consistent high standard of nursing practice um as Elizabeth mentioned earlier to its fullest scope by ensuring", "start": 6272.679, "end": 6280.28}, {"text": "all nurses are practicing according to the relevant standards of practice um and there's three different standards um", "start": 6280.28, "end": 6287.08}, {"text": "terms of the Canadian Community Health nursing standards of practice our Public Health nursing discipline specific", "start": 6287.08, "end": 6292.52}, {"text": "competency and of course the College of nurses of Ontario as you see in the slide the", "start": 6292.52, "end": 6297.56}, {"text": "Healthy Families division is made up of six different programs each with its own specific goals and with a range of", "start": 6297.56, "end": 6303.96}, {"text": "strategies and services that are described in uh much more detail in appendex a um so Child and Adolescent is", "start": 6303.96, "end": 6311.159}, {"text": "the the first one listed and its goal is to improve the mental health of infants children youth and their families by", "start": 6311.159, "end": 6317.48}, {"text": "increasing access to Mental Health Services especially among priority populations our dental and vision", "start": 6317.48, "end": 6323.96}, {"text": "screening program has several goals first is really focusing on improving oral health among children through", "start": 6323.96, "end": 6330.08}, {"text": "Elementary School uh screening for students and providing access to the Healthy Smiles Ontario program uh as", "start": 6330.08, "end": 6336.76}, {"text": "well as ensuring the provision of uh vision screening in schools for students in senior kindergarten and linking with", "start": 6336.76, "end": 6342.76}, {"text": "supports and third to improve the oral health among adults and seniors in our community that are experiencing low", "start": 6342.76, "end": 6349.08}, {"text": "income and CH challenges in accessing uh insured services the goal of our healthy growth and", "start": 6349.08, "end": 6355.159}, {"text": "development program is to make sure all individuals who are pregnant and those with an infant or children under six and", "start": 6355.159, "end": 6361.119}, {"text": "their families are able to attain and sustain lifelong Optimal Health and developmental potential we do that", "start": 6361.119, "end": 6366.599}, {"text": "through a wide range of services listed in the appendix our health promotion program supports evidence in for", "start": 6366.599, "end": 6373.04}, {"text": "programming and effective service provision across our division and the planning and competency development", "start": 6373.04, "end": 6378.44}, {"text": "program provides high quality support to enhance organizational effectiveness efficiencies and impact of programs and", "start": 6378.44, "end": 6385.32}, {"text": "services and of course lastly our school program works to achieve Optimal Health of school aged Children and Youth", "start": 6385.32, "end": 6391.599}, {"text": "through strong Partnerships and collaboration with our school boards and schools across the city next", "start": 6391.599, "end": 6398.599}, {"text": "slide so this slide is an example of how our Healthy Families division can support families as their children grow", "start": 6398.599, "end": 6404.84}, {"text": "in this scenario a parent is easily able to initiate supports through our phone line and get connected with a range of", "start": 6404.84, "end": 6410.199}, {"text": "services in response to her needs and of course once your child's in school um", "start": 6410.199, "end": 6416}, {"text": "there's access to initiate supports for dental health concerns and later easy", "start": 6416, "end": 6421.159}, {"text": "access to brief Counseling Services through Child and Adolescent U Services", "start": 6421.159, "end": 6426.96}, {"text": "this scenario demonstrates our commitment to making it as easy as possible for individuals families and", "start": 6426.96, "end": 6432.719}, {"text": "service providers to connect with public health and Community Based programs and services by providing a variety of ways", "start": 6432.719, "end": 6440.239}, {"text": "and many opportunities to access information programs and services we work to ensure individuals and families", "start": 6440.239, "end": 6446.52}, {"text": "are able to get connected with the right supports at the right time whether it's through public health or through", "start": 6446.52, "end": 6451.96}, {"text": "community-based supports and services and we work to identify and understand and address barriers to healthy growth", "start": 6451.96, "end": 6458.119}, {"text": "and development in collaboration with individuals families and community service", "start": 6458.119, "end": 6464.04}, {"text": "providers just get that back on um so that concludes this uh this part of the", "start": 6471.84, "end": 6478.36}, {"text": "presentation happy to take any questions just a reminder in terms of where we're at we've now completed our second um", "start": 6478.36, "end": 6485.36}, {"text": "session and our have our our next piece which will be focused around the annual service plan and budget we are um going", "start": 6485.36, "end": 6493.599}, {"text": "to provide a little um bit of an overview of the Community Health stas Report that was received actually by the", "start": 6493.599, "end": 6499.239}, {"text": "public health committee uh back in November we're just deliberating in order to meet that timeline um or the", "start": 6499.239, "end": 6506.48}, {"text": "timelines that are set out we're thinking that it might be helpful to provide that in advance through a communication update and then um we'll", "start": 6506.48, "end": 6513.599}, {"text": "hit the highlights as we talk about the annual service plan and so everybody would have access to it um through that", "start": 6513.599, "end": 6520.04}, {"text": "route and could ask any questions when it comes um up as part of the annual service plan and of course that is going", "start": 6520.04, "end": 6526.88}, {"text": "to have the renewed priorities for 2025 and the action plans that have been developed as well as as some financial", "start": 6526.88, "end": 6533.159}, {"text": "information on the the last session we are just um working through exactly when to provide that um with the presenter", "start": 6533.159, "end": 6539.76}, {"text": "just needing some flexibility in that piece and so we'll see um uh exactly", "start": 6539.76, "end": 6545.36}, {"text": "when that piece ends up uh coming through you'll begin to see shortly you've had a lot of orientation Mee", "start": 6545.36, "end": 6551.56}, {"text": "materials these last two meetings you'll begin to see shortly a number of actual programmatic reports um which will um", "start": 6551.56, "end": 6558.56}, {"text": "get into the actual issues at play if you will as we start to go into February", "start": 6558.56, "end": 6563.88}, {"text": "so that's it for me chair any questions I'd be happy to have them and fill them", "start": 6563.88, "end": 6569.159}, {"text": "with the team okay I'll look around to see folks who want to ask questions member Joseph", "start": 6569.159, "end": 6575.56}, {"text": "you're first hello thank you uh", "start": 6575.56, "end": 6582.44}, {"text": "for those presentations I know um in reference to the", "start": 6582.44, "end": 6588.96}, {"text": "hppa um it outlines a number of mandatory programs and services and the first one", "start": 6588.96, "end": 6596.36}, {"text": "around Community sanitation and the maintenance of sanitary conditions I know I saw uh the part around", "start": 6596.36, "end": 6603.719}, {"text": "elimination of health hazards but I was wondering where the uh Community sanitation and the maintenance of", "start": 6603.719, "end": 6609.44}, {"text": "sanitary conditions obligations under the Board of Health reside in terms of the programming uh or if there is a gap", "start": 6609.44, "end": 6617}, {"text": "there in need of action of a body like this or um", "start": 6617, "end": 6623.84}, {"text": "this is a more than double bar question but and also if there's any uh", "start": 6623.84, "end": 6632.56}, {"text": "epidemiological requirements for operationalizing that um obligation", "start": 6632.56, "end": 6638.52}, {"text": "under the ACT through the chair so the the general", "start": 6638.52, "end": 6644.119}, {"text": "Provisions that are there in the hppa under Section Five um they reflect wording that was developed many many", "start": 6644.119, "end": 6650.679}, {"text": "years ago and so the the health protection promotion Act was redeveloped in from the public health act uh back in", "start": 6650.679, "end": 6657.84}, {"text": "1983 and so the programs and standards that are then published outline the specific responsibilities within each of", "start": 6657.84, "end": 6664.88}, {"text": "those areas that are expected by the provincial government for health units to do so most of that work Falls within", "start": 6664.88, "end": 6670.599}, {"text": "Environmental Health in terms of food premises water Wastewater um sort of", "start": 6670.599, "end": 6676.199}, {"text": "thoughts around those things and any other specific health hazards that arise for example during flooding we involved", "start": 6676.199, "end": 6681.96}, {"text": "very much along onside our colleagues around what are the issues that arise in a home or business that has been flooded", "start": 6681.96, "end": 6688.119}, {"text": "issues around mold issues around um about safety related to those and providing advice so it's not General", "start": 6688.119, "end": 6695.04}, {"text": "broad Community sanitation that uh generally uh rests with our colleagues", "start": 6695.04, "end": 6700.48}, {"text": "um over in public works but it is uh it's the specific areas that are outlined within the Ontario public", "start": 6700.48, "end": 6705.639}, {"text": "health standards that are in that environmental health um section", "start": 6705.639, "end": 6711.96}, {"text": "if I can just follow up yeah okay", "start": 6713.199, "end": 6719.119}, {"text": "um I understand the ways uh it's operationalized uh I believe we also", "start": 6719.119, "end": 6727.44}, {"text": "have an obligation under the ACT via the obligations for to collect and analyze", "start": 6727.44, "end": 6735.639}, {"text": "epidemiological data to assess local risks uh and", "start": 6735.639, "end": 6741.52}, {"text": "that may be a need we can take the particular example of those living", "start": 6741.52, "end": 6747.679}, {"text": "outside uh and conversations around Community sanitation um and the obligations of the", "start": 6747.679, "end": 6756.599}, {"text": "Board of Health outside of Public Works to both assess and uh maybe address any", "start": 6756.599, "end": 6765.04}, {"text": "needs that uh might be identified so my query was do those uh analytical", "start": 6765.04, "end": 6773.079}, {"text": "projects occur where uh and or is it just as you said top down kind of", "start": 6773.079, "end": 6779.88}, {"text": "outlined via the Ontario standards through the chair so you know", "start": 6779.88, "end": 6786.159}, {"text": "as I noted in terms of the areas of practice that are carried out it is uh limited to the areas that are outlined", "start": 6786.159, "end": 6792.52}, {"text": "in the standards that that we currently have again you know coming back to the issue of the evolution of practice and", "start": 6792.52, "end": 6799.8}, {"text": "you know what has happened to Public Health over time in terms of where that practice is expected and where we're directed to do the work and the issues", "start": 6799.8, "end": 6806.8}, {"text": "of resources um that's where the resources also flow with the the areas of practice", "start": 6806.8, "end": 6813.32}, {"text": "that are that are currently expected of us that's helpful thank", "start": 6813.32, "end": 6819.36}, {"text": "you next up is member", "start": 6819.88, "end": 6823.76}, {"text": "Dano thank you and through the chair thank you for the presentation uh a lot of helpful details uh I I have two", "start": 6825.32, "end": 6832.8}, {"text": "questions the first is around um the role of Public Health supporting access", "start": 6832.8, "end": 6838.56}, {"text": "to mental health supports and I'm thinking uh as opposed to the the mental health Street Outreach which is you know", "start": 6838.56, "end": 6845.36}, {"text": "a sort of a targeted Outreach to very vulnerable populations does public health have any role in helping provide", "start": 6845.36, "end": 6853.36}, {"text": "access uh or supporting access for say youth um noting that it is actually", "start": 6853.36, "end": 6859.56}, {"text": "quite challenging sometimes to get access to a social worker it's often not provided through Primary Care teams um", "start": 6859.56, "end": 6866.719}, {"text": "and and it's something that I hear about in the", "start": 6866.719, "end": 6870.88}, {"text": "community Through the chair so mental health is is one of the challenges that", "start": 6872.56, "end": 6877.719}, {"text": "we have um in terms of defining roles and then um there being gaps in systems", "start": 6877.719, "end": 6884.599}, {"text": "in terms of addressing it and and there's great awareness of those of those both the challenges and the gaps", "start": 6884.599, "end": 6891.119}, {"text": "that are there and so there's from a public health perspective our work is", "start": 6891.119, "end": 6897.199}, {"text": "generally upstream and so when you hear Bonnie talk about in Healthy Families the work that we're doing from a", "start": 6897.199, "end": 6902.92}, {"text": "prevention standpoint um in terms of kids uh kids early development around", "start": 6902.92, "end": 6908.599}, {"text": "you know adverse child events uh childhood events terms of the work that they're doing in schools to support um", "start": 6908.599, "end": 6915.079}, {"text": "you know healthy school environments uh you know bullying prevention different things that have been done over time", "start": 6915.079, "end": 6920.28}, {"text": "generally we're on that preventive end of the Spectrum the exception for us here in Hamilton is that um this Council", "start": 6920.28, "end": 6928.32}, {"text": "um does also provide alcohol drug and gambling Services um which are adult", "start": 6928.32, "end": 6933.76}, {"text": "focused uh generally and also Child and Adolescent Services which is a children's mental health program so", "start": 6933.76, "end": 6939.199}, {"text": "those aren't you know public health programs in the in the general term but they fall under Public Health here and", "start": 6939.199, "end": 6945.84}, {"text": "so um when it comes to accessing services our child and Child and", "start": 6945.84, "end": 6951.56}, {"text": "Adolescent program does work with other children's mental health providers to look at how can access be", "start": 6951.56, "end": 6959.119}, {"text": "expanded um they are have been doing more and more work in the community going out to places like libraries and", "start": 6959.119, "end": 6966.44}, {"text": "other locations so that they are there providing more and more dropin opportunities so that there is increased", "start": 6966.44, "end": 6972.04}, {"text": "availability of resources to get on short notice and they've been very successful with that work it's been very", "start": 6972.04, "end": 6977.199}, {"text": "good uh work that's been led by Lyn Foy the manager of that program um but", "start": 6977.199, "end": 6982.36}, {"text": "overall there Still Remains a significant challenge when it comes to the gaps at a community level the", "start": 6982.36, "end": 6987.92}, {"text": "children's mental health system is coordinated by lywood Charlton um Center and so they have that overall", "start": 6987.92, "end": 6994.239}, {"text": "responsibility for it um there's an awareness as well in terms of the transition point between children and", "start": 6994.239, "end": 7000.84}, {"text": "childhood and adulthood um and sort of looking at how can that be well coordinated and so the greater hamilt", "start": 7000.84, "end": 7006.28}, {"text": "and health network gets involved at that point but um you know it's an all of mental health you know could could use", "start": 7006.28, "end": 7012.92}, {"text": "uh you know continued investment of resources in looking at how can coordination and the um amount of", "start": 7012.92, "end": 7019.719}, {"text": "supports and resources treatment resources that are available be improved Bonnie just did you want to add", "start": 7019.719, "end": 7026.96}, {"text": "anything I think just emphasizing the the access issues um that we're really focusing on and having um child Anison", "start": 7026.96, "end": 7034.04}, {"text": "therapists um Elizabeth mentioned in communities but we're really trying to focus on areas that make it um super", "start": 7034.04, "end": 7040.04}, {"text": "easy for youth to just walk in and have a session with a therapist and sometimes", "start": 7040.04, "end": 7045.44}, {"text": "that's enough sometimes just having that single session and to establish a plan um is enough to kind of get them through", "start": 7045.44, "end": 7052}, {"text": "um and sometimes it's enough to get them through while they're waiting for services so I think that shift to really", "start": 7052, "end": 7057.079}, {"text": "community-based um you know quick access um is really helping but there's lots of", "start": 7057.079, "end": 7062.639}, {"text": "ongoing conversation across the sector about how we can continue to to provide more services um and in a more timely", "start": 7062.639, "end": 7069.32}, {"text": "way thank you for that um my other question", "start": 7069.32, "end": 7077.159}, {"text": "focuses in on the the specific focus on dealing", "start": 7077.159, "end": 7082.199}, {"text": "with tobacco use and sort of prevention and whatnot I was wondering if there's any role for public health uh you know", "start": 7082.199, "end": 7088.8}, {"text": "in terms of prevention enforcement around", "start": 7088.8, "end": 7092.638}, {"text": "cannabis so there is a role for public health around prevention related to", "start": 7094.639, "end": 7100.52}, {"text": "cannabis for that I'm going to turn it over to Julie and uh can go from", "start": 7100.52, "end": 7106.079}, {"text": "there uh thank you and through you chair so uh through the uh mental well-being and substance use program uh we do have", "start": 7106.079, "end": 7113.92}, {"text": "some ongoing work around uh promotion and prevention uh and so we're just beginning actually that work uh and", "start": 7113.92, "end": 7120.96}, {"text": "certainly can provide some more information uh in the coming months um but really looking at uh that", "start": 7120.96, "end": 7127.159}, {"text": "educational piece that knowledge translation uh and ensuring that there is an understanding around the risks", "start": 7127.159, "end": 7133.48}, {"text": "associated with cannabis use particularly uh for", "start": 7133.48, "end": 7138.639}, {"text": "youth thank you very much member dko and thanks to the staff for answering those questions I don't see anybody else on our list Oh councelor Hang welcome to", "start": 7140.44, "end": 7147.84}, {"text": "the list you're up next thank you um thank you for this presentation um as", "start": 7147.84, "end": 7154.599}, {"text": "this presentation is open to the public and transparent because of how the nature of our committee meetings are I", "start": 7154.599, "end": 7161.52}, {"text": "kind of wish there was a slide that showed the greater ecosystem of Public Health because um just as Dr Richardson", "start": 7161.52, "end": 7167.639}, {"text": "had mentioned the greater Health Hamilton Network um I almost wish that", "start": 7167.639, "end": 7173.119}, {"text": "the public could really understand how interconnected the entire system is and", "start": 7173.119, "end": 7178.88}, {"text": "how closely tied the public health Team connects in with other resources like", "start": 7178.88, "end": 7185.48}, {"text": "Jin like the hospital Network like some so I kind of wish that there was a slide", "start": 7185.48, "end": 7190.679}, {"text": "that kind of showed how interconnected and extensive because", "start": 7190.679, "end": 7196.599}, {"text": "that's also how we recruited the public health committee members to be on this", "start": 7196.599, "end": 7201.92}, {"text": "committee so I I think that there's a a narrative", "start": 7201.92, "end": 7207.199}, {"text": "piece that we missing here with how we are integrated into the community and I wonder through you chair if that could", "start": 7207.199, "end": 7213.84}, {"text": "be a Communications piece later on um so then that way again it's in public record it just goes to show how well", "start": 7213.84, "end": 7222.159}, {"text": "we're con collaborating with each other sure I guess staff can just take that away maybe in our future training", "start": 7222.159, "end": 7227.76}, {"text": "sessions could bring that in as a slide or two um or some other Public Communication I see nodding so they'll", "start": 7227.76, "end": 7234.52}, {"text": "be able to speak to that in the future session thanks councelor Hing anybody else who want to speak to the", "start": 7234.52, "end": 7240.04}, {"text": "presentation second part okay I'm not seeing anyone so at this point I need a mover and seconder", "start": 7240.04, "end": 7247.119}, {"text": "to put the report on the floor and the report is just about the presentation member Lennox and member", "start": 7247.119, "end": 7253.719}, {"text": "Dano this is that moment though we're going to take any enthusiasm for", "start": 7253.719, "end": 7259.119}, {"text": "attending the alpha winter Symposium from February 12th to 14th online if", "start": 7259.119, "end": 7264.76}, {"text": "anyone wants to go this is the moment we'd have to record that because we don't meet again until after the Symposium so this is this is", "start": 7264.76, "end": 7272.92}, {"text": "it okay uh Dr Joseph are you interested in attending", "start": 7274.199, "end": 7280.04}, {"text": "okay anyone else all right I'll also attend um just so we", "start": 7280.04, "end": 7285.639}, {"text": "have some representation from chair and vice chair in case there's something to report back formally so happy to also go", "start": 7285.639, "end": 7291}, {"text": "so we need someone to move that um preferably not myself or Dr Joseph councelor hang thank you very much we'll", "start": 7291, "end": 7296.639}, {"text": "move that and second to by coun tattis and the motion which clerks will just housekeep afterwards is that um there'll", "start": 7296.639, "end": 7303.04}, {"text": "be two people sent registration costs will be paid for by the city that kind", "start": 7303.04, "end": 7308.199}, {"text": "of thing we do this fairly routinely so we have some routine language just down in front at the moment so if everybody", "start": 7308.199, "end": 7313.8}, {"text": "understands the intention of what we're about to do move by counselor hang seconded by councelor tattis that we're going to send myself and Dr Joseph to", "start": 7313.8, "end": 7321.119}, {"text": "the alpha winter Symposium from February 12th to 14th all those in favor great and now we're going to", "start": 7321.119, "end": 7328.28}, {"text": "have and that's going to be an amendment to the report we're going to have a little piece on the report there I checked in with the LC and they checked", "start": 7328.28, "end": 7334.079}, {"text": "in with the deputy Clerk and that's how we're going to do this and so now we're going to I suppose approve the report as", "start": 7334.079, "end": 7339.28}, {"text": "amended but I'll look to the clerk in case I've made a mistake there", "start": 7339.28, "end": 7343.84}, {"text": "sorry through the chair it wouldn't be Amendment it would just be adding a clause okay great we all understand that", "start": 7345.84, "end": 7351.44}, {"text": "we're amending it by adding a clause that's part of the activity that we just approved wonderful so I need all those", "start": 7351.44, "end": 7357.28}, {"text": "in favor of receiving the presentation report is amended and the communication", "start": 7357.28, "end": 7363.32}, {"text": "item that's everybody it carries and so we're on to motions today so we have two motions 9.1 and 9.2 we'll start with 9.1", "start": 7363.32, "end": 7372.44}, {"text": "if member Joseph could introduce the motion and your secondary if you don't have a secondary I'm happy to happy to", "start": 7372.44, "end": 7377.639}, {"text": "second but otherwise floor is yours thank", "start": 7377.639, "end": 7384.159}, {"text": "you um I had raised this at our last uh", "start": 7384.159, "end": 7390.4}, {"text": "meeting um and I appreciated the the presentation uh and jam the orientation", "start": 7390.4, "end": 7396.76}, {"text": "session the first one around equity and um", "start": 7396.76, "end": 7402.88}, {"text": "we had the opportunity to discuss some of it and I shared my perspectives on on", "start": 7402.88, "end": 7408.199}, {"text": "how we got here um and very often you know when we", "start": 7408.199, "end": 7413.8}, {"text": "think about health policy in terms of Health Equity um and as we broadly we big we", "start": 7413.8, "end": 7423.159}, {"text": "have been learning about how to address disparities and equities uh by acknowledging that systems and", "start": 7423.159, "end": 7430.159}, {"text": "structures including governance structures are complicit with the reproduction of", "start": 7430.159, "end": 7436.96}, {"text": "inequities that Fidelity and integrity include uh the ways we are coherent in", "start": 7436.96, "end": 7446.199}, {"text": "in structure and form and discipline and policy and practice uh I think we've done a lot of that work I think this is", "start": 7446.199, "end": 7452.719}, {"text": "a seven-word amendment to terms of reference that had been created before", "start": 7452.719, "end": 7458.44}, {"text": "we've met uh I believe", "start": 7458.44, "end": 7463.599}, {"text": "that it does more to create a team that can do things together where everyone", "start": 7463.599, "end": 7470.36}, {"text": "can see themselves as equally valid uh", "start": 7470.36, "end": 7476.079}, {"text": "equally responsive as necessary that we're not all the same that we all bring our own unique experiences and strengths", "start": 7476.079, "end": 7483.48}, {"text": "and those come from different histories and the ways we reflect that in a structure in a document such as the", "start": 7483.48, "end": 7490.52}, {"text": "terms through governance allows for us to see each other as all possible leaders in", "start": 7490.52, "end": 7497.88}, {"text": "this uh in the practical sense you know we can operationalize how we do this as", "start": 7497.88, "end": 7505.04}, {"text": "we see fit I'm not asking for another vote here I'm asking for us to do the other piece of the work that sees the", "start": 7505.04, "end": 7511.84}, {"text": "change in the document itself such that the structure reflects the Fidelity to", "start": 7511.84, "end": 7517.48}, {"text": "and integrity of the equity principles that we profess to have and share", "start": 7517.48, "end": 7523.52}, {"text": "um so with that do I read it no", "start": 7523.52, "end": 7530.52}, {"text": "um I'm moving that we amend the the", "start": 7530.52, "end": 7536.44}, {"text": "the public health subc communties terms of reference such that we add these seven", "start": 7536.44, "end": 7542.76}, {"text": "words uh to the part around the chair of the public health subc commmittee shall", "start": 7542.76, "end": 7548.04}, {"text": "be a member of city council a community representative or an educational representative that", "start": 7548.04, "end": 7555.48}, {"text": "both are possible okay thank you very much any", "start": 7555.48, "end": 7560.52}, {"text": "speakers on this motion I've added myself to the list but I'll go last as the tradition", "start": 7560.52, "end": 7567.04}, {"text": "dictates member Danko uh thank you and and thank you to", "start": 7567.76, "end": 7572.88}, {"text": "the Mover for bringing this forward I just want to check in to see if there are any unintended consequences uh of a", "start": 7572.88, "end": 7581.159}, {"text": "change of this nature in particular I'm thinking about um the chair of the the committee or the the subcommittee is", "start": 7581.159, "end": 7588}, {"text": "often the spokesperson uh during covid I can tell you that when you're the spokesperson for an entity an", "start": 7588, "end": 7594.92}, {"text": "organization you do receive threats of lawsuits uh and so this these can be", "start": 7594.92, "end": 7600.559}, {"text": "sensitive matters would the community representative or the education representative have the same legal", "start": 7600.559, "end": 7607.88}, {"text": "coverage or support that a sitting counselor does uh noting that City councilors are employed uh through the", "start": 7607.88, "end": 7615.36}, {"text": "city of Hamilton and the rest of us are are here in voluntary capacity thank", "start": 7615.36, "end": 7620.599}, {"text": "you that's a fair legal question I'm not sure we have legal staff here to answer that question unfortunately I'm just", "start": 7620.599, "end": 7626.04}, {"text": "having a a brief Gander here gandering more seeing no one with a shaking head", "start": 7626.04, "end": 7633.119}, {"text": "in the affirmative um certainly something that could um be raised in time for Council depending on what", "start": 7633.119, "end": 7639.079}, {"text": "happens here anyways because Council would obviously rise is the Board of Health so perhaps that's a question that if you don't mind member Dano is sending", "start": 7639.079, "end": 7645.84}, {"text": "that question to the clerks and then they can appropriately find a legal person and if we can just remark on that Council whether it's a concern or not um", "start": 7645.84, "end": 7652.88}, {"text": "I don't know the answer to the question I'm not going to line on it so we'll leave it there um unless there's another question that you had", "start": 7652.88, "end": 7660.52}, {"text": "okay um before we go to second time speakers I'm just going to pass the chair to Vice chair Johnson just to oh", "start": 7660.52, "end": 7667.239}, {"text": "you want to ask something go ahead please so go ahead go before me please um just just to follow up um with what", "start": 7667.239, "end": 7673.639}, {"text": "member Danko said my question would be why would the protections be any different as a member", "start": 7673.639, "end": 7681.159}, {"text": "of the subcommittee in comparison to the chair because if I was to speak or make", "start": 7681.159, "end": 7686.76}, {"text": "comment publicly like I am right now I'm taking a similar risk I would imagine", "start": 7686.76, "end": 7692.159}, {"text": "that one has as the chair so that's what I are my protections the same would be", "start": 7692.159, "end": 7699.04}, {"text": "what I would want to also know in in addition to that and how does that change or not change if I'm the chair as", "start": 7699.04, "end": 7705.28}, {"text": "I don't in my mind I can't but not as a lawyer but I just wonder about that yeah", "start": 7705.28, "end": 7711.119}, {"text": "Fair we can add that Nuance to the questions we're going to ask our legal staff I mean obviously as a vice chair you would sometimes take over the chairs", "start": 7711.119, "end": 7716.199}, {"text": "you've done during this meeting so I'm assuming those legal protections would apply because you are a citizen but", "start": 7716.199, "end": 7721.44}, {"text": "don't want to make any kinds of assumptions about that because we don't have anyone in the legal team here to answer the question so I'm not going to", "start": 7721.44, "end": 7727.239}, {"text": "as a non- lawyer just the chair of this committee not going to willine on that any folks uh want to be added for a", "start": 7727.239, "end": 7733.8}, {"text": "first time speaker before I go looking down not seeing it all right I'll pass the chair over to you Vice", "start": 7733.8, "end": 7739.84}, {"text": "chair Johnson thank you so much be careful while you're there yeah um thank you very much for this motion I really", "start": 7739.84, "end": 7745.96}, {"text": "appreciate it and just wanted to briefly apologize I think it was my misunderstanding originally that thought we had to have the chair be a member of", "start": 7745.96, "end": 7752.52}, {"text": "council um because of the way procedural bylaw was written by Miss Reddit and so um we can have either a citizen the", "start": 7752.52, "end": 7759.159}, {"text": "educational representative or the um a member of council be the chair happy for that to be the case happy to be here uh", "start": 7759.159, "end": 7766}, {"text": "as long as people want me to be um the process works that might have to step down so if anybody really wants to be the chair of this committee after a", "start": 7766, "end": 7772}, {"text": "period of time whether they're feeling comfortable or whatever they want to do just kind of approach me about it because the way Council sets it up is if", "start": 7772, "end": 7778.119}, {"text": "you are a chair of a subcommittee you're the chair for the whole term it's the only time that election gets triggered", "start": 7778.119, "end": 7783.559}, {"text": "is if someone steps down so just being open about it right I don't have an overwhelming desire to chair this over", "start": 7783.559, "end": 7789.639}, {"text": "other people who may wish to do that work and want to share that if people want to do it and appreciate this idea that we don't want to wait until that", "start": 7789.639, "end": 7795.4}, {"text": "moment to then try and change the terms of reference because it would politicize those terms of reference so doing it now", "start": 7795.4, "end": 7800.8}, {"text": "in a deep political way just by saying hey we had ought to have this open open situation here makes everybody I think U", "start": 7800.8, "end": 7807.639}, {"text": "come to this from um a more Equitable perspective so just really appreciate the motion being brought and those are", "start": 7807.639, "end": 7813.44}, {"text": "my comments I'll take the chair back thank you and does anyone want to speak for a second time before we vote", "start": 7813.44, "end": 7821.88}, {"text": "I'm not seeing second time speakers so all those in favor of the motion anyone opposed and we'll get that", "start": 7821.88, "end": 7828.88}, {"text": "question answered before Council deliberates on it moving on to 9.2 and this is the feasibility of", "start": 7828.88, "end": 7835.76}, {"text": "implementing Wastewater surveillance this is a motion moved by member lenck seconded by me and please", "start": 7835.76, "end": 7842.599}, {"text": "uh introduce your motion and then we'll have discussion about it and you don't have to read the motion out loud and all the warehouses and things like that you", "start": 7842.599, "end": 7848.639}, {"text": "can just speak to it which way you want it's on the and everyone has a", "start": 7848.639, "end": 7853.88}, {"text": "copy perfect thank you chair um okay so yes so I'm going to", "start": 7853.88, "end": 7859.639}, {"text": "speak to the motion um where I'm asking uh for public health to look at the feasibility of implementing Wastewater", "start": 7859.639, "end": 7865.639}, {"text": "surveillance testing um I'm sure many are aware around this table but the concept of Wastewater surveillance has", "start": 7865.639, "end": 7871.92}, {"text": "been around for many many years and it was actually used as sort of one of the the main uh means of sort of addressing", "start": 7871.92, "end": 7878.599}, {"text": "sort of the polio eradication campaign in many many places across the globe so this is sort of um a process of", "start": 7878.599, "end": 7885.599}, {"text": "surveillance and technology that has existed for many times and is used for many purposes I think many of us became", "start": 7885.599, "end": 7892.44}, {"text": "perhaps more familiar with Wastewater surveillance through the Wastewater surveillance initiative that was launched in 2020 to address uh the", "start": 7892.44, "end": 7899.48}, {"text": "covid-19 pandemic and so through that program Wastewater surveillance was initiated um in many different places", "start": 7899.48, "end": 7906.559}, {"text": "across Ontario that was funded through the ministry of parks um as part of of that initiative there were researchers", "start": 7906.559, "end": 7912.96}, {"text": "at McMaster that were contracted by The Province to assist with this and so the necessary infrastructure is already in", "start": 7912.96, "end": 7918.96}, {"text": "place in sort of our Wastewater testing plants in Hamilton and the researchers at bmas continue to use these samples um", "start": 7918.96, "end": 7926.96}, {"text": "now solely for research purposes that previously were in place um for public health", "start": 7926.96, "end": 7932.36}, {"text": "purposes but due to the termination of the provincial funding in July 2024 the", "start": 7932.36, "end": 7937.52}, {"text": "infrastructure and capability is currently underused um the estimated cost of running this program just so everyone", "start": 7937.52, "end": 7943.52}, {"text": "knows is is annually fairly low so estimated at about $100,000 per year with modifications based on the number", "start": 7943.52, "end": 7950.239}, {"text": "of pathogens that you wish to test for and how frequently you're testing the sites and one of the benefits of the", "start": 7950.239, "end": 7956.639}, {"text": "Wastewater sampling is that it's a really really cost-effective tool for public health um concerns it can be", "start": 7956.639, "end": 7962.639}, {"text": "tailored um to identify specific pathogens of concern based on what a local community actually identifies as", "start": 7962.639, "end": 7969.239}, {"text": "their priorities so it can look at anything from respiratory viruses to sexually transmitted", "start": 7969.239, "end": 7974.96}, {"text": "infections for example just to give you idea of the broadness of the scope um and with the data sort of", "start": 7974.96, "end": 7981.92}, {"text": "rapidly available so usually available within 24 hours of testing Public Health decision makers can mount an informed", "start": 7981.92, "end": 7988.44}, {"text": "response and mobilize resources much more rapidly to address emerging emerging concerns than if you were using", "start": 7988.44, "end": 7993.96}, {"text": "medically attended case data which is currently our main stay and we can even use this data to sort of narrow in on", "start": 7993.96, "end": 8000.36}, {"text": "specific areas of of higher concern so during the co pandemic for example we", "start": 8000.36, "end": 8005.719}, {"text": "water testing targeted at specific highrisk sites like long-term care we're able to address outbreaks in specific", "start": 8005.719, "end": 8011.76}, {"text": "high-risk settings um in a way more effective again than case data but despite this kind of established value", "start": 8011.76, "end": 8018.159}, {"text": "of Wastewater surveillance and the existing technology most public health units are now still relying on heavily", "start": 8018.159, "end": 8024.079}, {"text": "heavily relying on medically attended case data and there's a number of issues with medically attended case data I think", "start": 8024.079, "end": 8030.559}, {"text": "most of us would be able to sort of generate them based on sort of our experience and what we know in the community but essentially to identify", "start": 8030.559, "end": 8038.719}, {"text": "kind of medical cases you need someone to actually present to Healthcare in some capacity so that means that mild", "start": 8038.719, "end": 8044.599}, {"text": "cases are most often missed because people don't present to any medical care this often allows disease to sort of", "start": 8044.599, "end": 8051.44}, {"text": "spread unseen and unchecked because we don't know that mild cases are occurring in the community we also know that cases", "start": 8051.44, "end": 8057.76}, {"text": "can only be diagnosed if they're considered So speaking as a healthcare wrer I'm only going to test for something if I'm actually considering it", "start": 8057.76, "end": 8063.96}, {"text": "on my differential diagnosis and so for novel pathogens things that we weren't maybe trained to see or have seen much", "start": 8063.96, "end": 8070.4}, {"text": "in practice those can be missed examples being things like moox which was not something that most practitioners in", "start": 8070.4, "end": 8077.239}, {"text": "Hamilton would probably have had to see very frequently but that we did see emerging in the last couple of years", "start": 8077.239, "end": 8082.88}, {"text": "that challenged clinicians um and also in order for something to be tested or diagnosed", "start": 8082.88, "end": 8088.76}, {"text": "someone first has to then seek medical care that requ require someone to have access to Medical Care and so we're likely going to see under diagnosis", "start": 8088.76, "end": 8095.4}, {"text": "among those who have barriers to accessing traditional Health Care Primary Care Etc and then when we look", "start": 8095.4, "end": 8101.84}, {"text": "at other reference measures like hospital and ICU Admissions and deaths those are all really time lagged", "start": 8101.84, "end": 8107.76}, {"text": "measures that often present only when things have sort of already started to to get more severe and things have been", "start": 8107.76, "end": 8113.8}, {"text": "circulating in the community for some time unnoticed and there was one just recent example of sort of the superiority of", "start": 8113.8, "end": 8120.639}, {"text": "waste water testing to clinically reported cases in Hamilton and that was in", "start": 8120.639, "end": 8126}, {"text": "2023 um Dr Brendan Lou sent out um an advisory uh to healthcare providers in", "start": 8126, "end": 8131.84}, {"text": "Hamilton letting them know that there were Wastewater signals of empo that were outpacing the clinically diagnosed", "start": 8131.84, "end": 8137.84}, {"text": "uh cases indicating that we were missing something in the community and we wouldn't have known that have we not had", "start": 8137.84, "end": 8142.92}, {"text": "that Wastewater surveillance data at that time um so you know I think there's a lot of evidence for moving away from", "start": 8142.92, "end": 8149.199}, {"text": "medically attended case data to sort of the more cost-efficient and effective um methods like Wastewater surveillance we", "start": 8149.199, "end": 8156}, {"text": "also know that you know this is a core tool for any pandemic preparedness in the future and I think it would be nice", "start": 8156, "end": 8161.719}, {"text": "to think that we learned something from the last few years in terms of how to be better prepared the next time around um", "start": 8161.719, "end": 8168.159}, {"text": "and as we're a public health subcommittee I feel like preparedness and prevention is a key tenant of our work and it would be wonderful to see", "start": 8168.159, "end": 8174.119}, {"text": "all of the tools at our disposal being appropriately used um there are public", "start": 8174.119, "end": 8179.36}, {"text": "health units in petero on and Ottawa who have recognized the value of these programs and have continued uh to fund", "start": 8179.36, "end": 8185.52}, {"text": "them after the provincial funding ended uh and so this motion uh really urges us", "start": 8185.52, "end": 8190.84}, {"text": "to sort of look at opportunities and feasibility of doing the same in Hamilton and I won't read the whole", "start": 8190.84, "end": 8197.08}, {"text": "motion but thank you thanks very much I'll add myself to the speakers let anybody else want to", "start": 8197.08, "end": 8202.478}, {"text": "speak to this before we get there councelor hang anyone else okay take away councelor thank you I'm highly", "start": 8202.479, "end": 8208.638}, {"text": "supportive of this motion just a question on what are we getting in the report", "start": 8208.639, "end": 8213.84}, {"text": "back because as it says it's the outlining of feasibility of implementing so the question and I don't think it's", "start": 8213.84, "end": 8220.478}, {"text": "going to Dr lenx I think it might go to staff because I want to understand", "start": 8220.479, "end": 8226.84}, {"text": "um what is the timeline for receiving this report um what are the expected", "start": 8226.84, "end": 8233.92}, {"text": "sort of outcomes that you would like to show us in this report um because they", "start": 8233.92, "end": 8241.359}, {"text": "think that just as Dr Lennox very eloquently um talked about there are so", "start": 8241.36, "end": 8247}, {"text": "many different things we can be testing for so what would be the operational efficiencies on what it we can't", "start": 8247, "end": 8253.76}, {"text": "obviously test for every single possible thing so what is the expectation for", "start": 8253.76, "end": 8259.598}, {"text": "something like this and then also um I do recall that do Lennox talked about", "start": 8259.599, "end": 8265.92}, {"text": "it's approximately 100,000 but I don't understand what that 100,000 paid for so", "start": 8265.92, "end": 8272.16}, {"text": "I don't like does that mean that we need to have a fullon another another lab", "start": 8272.16, "end": 8277.439}, {"text": "technician in Wastewater to be able to do this work because I know that putting on my other Council hat Wastewater is", "start": 8277.44, "end": 8284.92}, {"text": "going to be adding a lab technician to their FTE account so would something", "start": 8284.92, "end": 8290.2}, {"text": "like this require a second lab technician would it need a totally different lab setup would it like that's", "start": 8290.2, "end": 8296.84}, {"text": "what I'd like to understand in the feasibility of implementing I don't don't know what's involved in the report", "start": 8296.84, "end": 8303.478}, {"text": "thanks without o pining on any of the questions counceling act about the specifics that would be forthcoming in the report has anybody want to speak to", "start": 8303.479, "end": 8309.24}, {"text": "what they understand the motion to be asking for and if it addresses the questions councel hang had asked about uh to the councelor through the", "start": 8309.24, "end": 8316.76}, {"text": "chair um so I I think that a number of those elements as you described could", "start": 8316.76, "end": 8321.96}, {"text": "certainly have additional information um provided by by staff um", "start": 8321.96, "end": 8327.92}, {"text": "through uh the covid-19 pandemic where we had uh access to Wastewater", "start": 8327.92, "end": 8334.399}, {"text": "information that was testing that was not performed um inh house by public health staff that was data that was uh", "start": 8334.4, "end": 8341.08}, {"text": "uh tested at a an University Laboratory um we actually did Leverage the um University of Ottawa laboratory through", "start": 8341.08, "end": 8348.16}, {"text": "uh that process and and that was one of the um Labs that uh did perform much of", "start": 8348.16, "end": 8354.12}, {"text": "the Wastewater testing for many other locations uh across the province uh and", "start": 8354.12, "end": 8359.439}, {"text": "so the uh aspects such as the cost uh and those elements are are unknown to staff at", "start": 8359.44, "end": 8367.24}, {"text": "this point as we've never been in a position to to um put out a request for proposal or or or any of the types of uh", "start": 8367.24, "end": 8374.359}, {"text": "uh considerations around cost and and and resource intensivity of of that as as we were participating in in a larger", "start": 8374.36, "end": 8381}, {"text": "provincial program uh at that time um", "start": 8381, "end": 8386.16}, {"text": "so the feasibility would certainly include um uh perhaps some information", "start": 8386.16, "end": 8392.16}, {"text": "about um should should uh such a program be be implemented um details such as who", "start": 8392.16, "end": 8399.72}, {"text": "might be able to perform it what what the cost of it might be what what the process for um procurement for such a a", "start": 8399.72, "end": 8406.76}, {"text": "solution might be and and and those would be some of the things that I think that we would we would interpret within the wording of the motion okay thank you", "start": 8406.76, "end": 8413.96}, {"text": "so just as a point of clarification then when can we expect this report to come back because it is obviously not going", "start": 8413.96, "end": 8420.479}, {"text": "to come back before this budget so what is yeah Dr H's like no um yeah so it's", "start": 8420.479, "end": 8427.8}, {"text": "obviously not going to come back in the next couple of weeks so what is the expectation in terms of when we're going to see this type of report coming back", "start": 8427.8, "end": 8434}, {"text": "oh and I forgot to do this and Dr Lennox had already indicated beforehand and written it in um pen on the on the", "start": 8434, "end": 8439.88}, {"text": "motion Q2 2025 and I checked in with some staff who said they could probably get this back by the end of Q2 2025 if", "start": 8439.88, "end": 8447.04}, {"text": "staff want to change their mind now is the moment I see shaking of head so that seems like that'll be the timeline sorry", "start": 8447.04, "end": 8452.2}, {"text": "that not to make sure that was mentioned before thank you those are all my questions thanks anybody else have", "start": 8452.2, "end": 8457.96}, {"text": "questions before I hand the chair over to Vice chair Johnson not seeing", "start": 8457.96, "end": 8464.68}, {"text": "any pow um I really want to just thank Dr Lennox", "start": 8464.68, "end": 8469.72}, {"text": "for this so it's something I've been emailing about staff for a little while now and something I found really really valuable my learning about public health", "start": 8469.72, "end": 8476.08}, {"text": "and about Wastewater data and what it means and how it can help us to understand some of the these things", "start": 8476.08, "end": 8481.56}, {"text": "better um and just grateful for the leadership because frankly not a doctor and so struggled a lot with how do I", "start": 8481.56, "end": 8488.04}, {"text": "make the case how do I make sure I understand this and frankly this is one of the great things about this subcommittee from my perspective is that", "start": 8488.04, "end": 8494.12}, {"text": "we have experts here who can speak to the advocacy of doing things who can write about these things in intelligent", "start": 8494.12, "end": 8499.399}, {"text": "and thoughtful ways and he use their expertise to help us move these things forward so very supportive of this really look forward to seeing what the", "start": 8499.399, "end": 8505.28}, {"text": "feasibility looks like because I think um if we can afford to as a municipality it's only going to give us a Ben", "start": 8505.28, "end": 8510.68}, {"text": "official data that we can use to continue to make good Public Health decisions so thank you very", "start": 8510.68, "end": 8516.24}, {"text": "much on that note I'll take back the chair and I don't see further speakers on the list so at this point we will go", "start": 8516.319, "end": 8523.399}, {"text": "to the vote all those in favor of the motion wonderful that's everybody at", "start": 8523.399, "end": 8529.439}, {"text": "carries and now uh seeing as there's no further business for the public health subcommittee it is adjourned at 11:37", "start": 8529.439, "end": 8537.2}, {"text": "a.m. and the next meeting will be held on Monday February 24th at 9:30 in the morning those of the public or anybody", "start": 8537.2, "end": 8543.28}, {"text": "else who wants to join us in City Hall 192 which is down the stairs and then to the left is um we'll be going there", "start": 8543.28, "end": 8551.52}, {"text": "shortly just have a little public gathering so people can meet us otherwise everyone enjoy your day and", "start": 8551.52, "end": 8556.68}, {"text": "thanks for being here", "start": 8556.68, "end": 8560.279}]