Agenda

Consolidated



Board of Health


Meeting No. 7   Contact Candy Davidovits, Committee Administrator
Meeting Date Tuesday, September 13, 2011
  Phone 416-392-8032
Start Time 1:00 PM
  E-mail boh@toronto.ca
Location Committee Room 1, City Hall
  Chair   Councillor John Filion  


 

Board of Health

Councillor John Filion, Chair

Councillor Joe Mihevc, Vice-Chair

Councillor Raymond Cho

Councillor Sarah Doucette

Councillor Paula Fletcher

Councillor Gord Perks

Trustee Soo Wong

Alejandra Bravo

Eduardo Castro

Vaijayanthi Chari

Fiona Nelson

Valerie Sterling

 

Members of the Board and Staff:  Please keep this agenda and the accompanying material until the City Council meeting dealing with these matters has ended.

 

Special Assistance for Members of the Public:  City staff can arrange for special assistance with some advance notice.  If you need special assistance, please call 416‑397-7767, TTY 416-338-0889 or e-mail boh@toronto.ca.

 

Closed Meeting Requirements:  If the Board of Health wants to meet in closed session (privately), a member of the Board must make a motion to do so and give the reason why the Board has to meet privately.  (City of Toronto Act, 2006)

 

Notice to people writing or making presentations to the Board of Health:  The City of Toronto Act, 2006 and the City of Toronto Municipal Code authorize the City of Toronto to collect any personal information in your communication or presentation to City Council or its committees.  The City collects this information to enable it to make informed decisions on the relevant issue(s). If you are submitting letters, faxes, e-mails, presentations or other communications to the City, you should be aware that your name and the fact that you communicated with the City will become part of the public record and will appear on the City’s website. The City will also make your communication and any personal information in it - such as your postal address, telephone number or e-mail address - available to the public, unless you expressly request the City to remove it.

 

The City makes a video record of committee and community council meetings. If you make a presentation to a committee or community council, the City will be video-recording you and City staff may make the video record available to the public.

 

If you want to learn more about why and how the City collects your information, write to the City Clerk's Office, City Hall, 100 Queen Street West, Toronto ON M5H 2N2 or by calling 416-392-8032.


toronto.ca/council

This agenda and any supplementary materials submitted to the City Clerk can be found online at www.toronto.ca/council. Visit the website for access to all agendas, reports, decisions and minutes of City Council and its committees.

 

 

Declarations of Interest under the Municipal Conflict of Interest Act.

 

Confirmation of Minutes - July 26, 2011

 

Speakers/Presentations – A complete list will be distributed at the meeting. 

 

Communications/Reports   

HL7.1

Information 

 

 

Ward: All 

Tribute to Jack Layton, Public Health Champion
Summary

The Board of Health to pay tribute to Jack Layton, Public Health Champion.

Background Information
(September 13, 2011) A Tribute to Jack Layton, Public Health Champion, from Toronto Public Health
(http://www.toronto.ca/legdocs/mmis/2011/hl/bgrd/backgroundfile-40810.pdf)

(September 13, 2011) Poem submitted by Caroline Di Giovanni
(http://www.toronto.ca/legdocs/mmis/2011/hl/bgrd/backgroundfile-40811.pdf)


HL7.2

ACTION 

 

 

Ward: All 

Healthy Smiles Ontario Dental Program Implementation
Origin
(August 29, 2011) Report from the Medical Officer of Health
Recommendations

The Medical Officer of Health recommends that:

 

1.         The Board of Health urge the provincial government to improve service access and efficiency by consolidating provincially funded dental programs for low income children into one coherent, comprehensive basic dental prevention and treatment program with common services and eligibility requirements.

 

2.         The Board of Health ask the provincial government to allocate unspent funds from recent investments in dental services for low income families to implement a new primary dental care program for low income adults using the existing clinic infrastructure. A primary dental care program for adults should at a minimum provide treatment of pain, infection and trauma.

 

3.         The Board of Health approve the revised financial eligibility requirements for the municipally-funded dental program to reflect updated Statistics Canada Low Income Cut Off levels.

 

4.         The Medical Officer of Health review the capacity and utilization of all dental clinic sites operated by Toronto Public Health or in which it is a principal partner, to determine the optimal configuration of the City-funded dental infrastructure with respect to client access and service efficiency.

Summary

This report provides an update of the implementation of the 100% provincially funded Healthy Smiles Ontario (HSO) dental program for children and youth in Toronto.

 

Of the five dental clinics that were approved for construction, two are complete. Toronto Public Health (TPH) recently received approval for capital funding to complete the other clinics and to purchase the mobile dental van within the current fiscal year. It is expected that this project will be completed by December 31, 2011.

 

The objective of the HSO program is to improve the oral health of children and youth living in low income families by giving them improved access to preventive and maintenance dental care. Toronto Public Health supports the province's efforts to improve the oral health of children in low income families. However, due to the stringent financial eligibility requirement, the HSO dental program has been under-utilized.

 

The issue of access to dental care for low income adults 18-64 years old needs to be addressed. They are the most in need and the least served segment of Toronto's population. From an analysis of the provincial government commitment to spend $45 million annually to fund a dental program for low income families, there appears to be sufficient unspent funds and a growing infrastructure that could be used to offer primary dental care i.e. the relief of oral pain and infection, for adults. It is recommended that the Board Of Health (BOH) advocate to the province to streamline, consolidate and standardize provincially funded dental programs for children and youth, and use the combination of savings arising from these efficiencies, and the unspent funds from the expansion of the Children In Need Of Treatment (CINOT) and from the HSO dental programs to address the pressing dental core needs of low income adults. Access to primary dental care for low income adults will reduce their burden of illness, and contribute to improvement in health and wellbeing.

Financial Impact

There is no financial impact arising from this report.

Background Information
(August 29, 2011) Report from the Medical Officer of Health on Healthy Smiles Ontario Dental Program Implementation
(http://www.toronto.ca/legdocs/mmis/2011/hl/bgrd/backgroundfile-40419.pdf)


HL7.3

ACTION 

 

 

Ward: All 

Toronto Public Health 2012 Operating Budget Request
Confidential Attachment - Personal matters about an identifiable individual, including municipal or local board employees
Origin
(September 2, 2011) Report from the Medical Officer of Health
Recommendations

 The Medical Officer of Health recommends that:

 

1.         City Council approve the Toronto Public Health 2012 Operating Budget request of  $228,226.7 thousand gross / $41,137.4 thousand net as summarized in Table 1, “2012 Operating Budget Request”.

 

2.         City Council approve the list of base budget adjustments included in Table 5, “Overview of 2012 Operating Budget Request” of this report totalling an increase of $1,999.8 thousand gross and $818.5 thousand net.

 

3.         City Council approve 2012 Reduction Options of $8,242.6 thousand gross and $4,458.4 thousand net as outlined in Table 3, "2012 Requested Reduction Options Budget".

 

4.         The Board of Health forward this report to the City's Budget Committee for its consideration during the 2012 budget process.

Summary

This report outlines the Toronto Public Health (TPH) 2012 Operating Budget request for consideration by the Board of Health.

 

The Toronto Public Health 2012 Operating Budget Request totals $228,226.7 thousand gross / $41,137.4 thousand net.  This request is $6,242.8 thousand gross and $3,639.9 thousand net below the 2011 Operating Budget. The net decrease of $3,639.9 thousand over the 2011 Operating Budget is comprised of base budget increases for the negotiated collective agreement of $818.5 thousand net and reduction options of 10 percent or $4,458.4 thousand net.

Financial Impact

The Toronto Public Health 2012 Operating Budget request totals $228,226.7 thousand gross / $41,137.4 thousand net. This request is $6,242.8 thousand gross and $3,639.9 thousand net (8.1 percent) below the 2011 Operating Budget. The requested decrease is comprised of increases due to base changes of $1,999.8 thousand gross and $818.5 thousand net and decreases of $8,242.6 thousand gross and $4,458.4 thousand net for budget reduction options.

 

See table in the staff report for further financial impact information.

 

Toronto Public Health has reviewed its services and costs and where achievable absorbed expected inflation increases and reduced costs in the 2012 budget request.   Toronto Public Health has reviewed the 2012 Request with the Director of Financial Planning Division.  Corporate Financial Planning is recommending the Toronto Public Health 2012 Operating Budget Request except for the proposed reduction in corporate overhead charges of $790.0 thousand gross /$197.5 thousand net due to the City's current fiscal position. The provincial funding of this charge benefits the City by offsetting costs for other City programs.

 

The corporate overhead charge from the City is for general municipal services provided to Toronto Public Health.  This is a third annual planned reduction based on a review of this cost allocation by the City's Internal Audit Division.  The revised corporate charge was reviewed and validated by Corporate Accounting and the City's Internal Auditor in 2008 and a schedule was initiated in the 2009 operating budget cycle to allocate the full reduction required over five years. In 2011, Council did not reduce the requested amount of $650.0 thousand gross and $162.5 thousand net.  This necessitated an increase of $140.0 thousand gross and $35.0 thousand net increase in reduction as proposed in 2012.  There is no impact on public health service to the community from this reduction although the savings could be reallocated to delivering services.

Background Information
(September 2, 2011) Report from the Medical Officer of Health on Toronto Public Health 2012 Operating Budget Request
(http://www.toronto.ca/legdocs/mmis/2011/hl/bgrd/backgroundfile-40506.pdf)

(September 2, 2011) Attachment 1 - Toronto Public Health 2012 Operating Budget Request
(http://www.toronto.ca/legdocs/mmis/2011/hl/bgrd/backgroundfile-40507.pdf)

(September 2, 2011) Confidential Attachment 2 - Toronto Public Health 2012 Service Level/Standard Adjustment Options
(September 13, 2011) Presentation by the Medical Officer of Health on Toronto Public Health 2012 Operating Budget Request
(http://www.toronto.ca/legdocs/mmis/2011/hl/bgrd/backgroundfile-41220.pdf)


HL7.4

ACTION 

 

 

Ward: All 

Budget Adjustments to the Toronto Public Health 2011 Approved Operating Budget
Origin
(August 26, 2011) Report from the Medical Officer of Health
Recommendations

The Medical Officer of Health recommends that:

 

1.         The Toronto Public Health 2011 Approved Operating Budget be adjusted as follows:

 

a.         an increase of $220.8 thousand gross and $0.0 net to reflect confirmed 100 percent base funding from the Ministry of Health and Long-Term Care; and

 

b.         an increase of $1,175.0 thousand gross and $0.0 net to reflect the  one -time  100 percent  funding from the Provincial ministries.

 

2.         The Board of Health forward this report to the Budget Committee for consideration.

Summary

This report seeks approval for budget adjustments to the Toronto Public Health (TPH) 2011 Approved Operating Budget due to confirmation of funding from various Provincial ministries received after the submission of the 2011 Operating Budget request in January 2011.

Financial Impact

See table in the staff report for financial impact information.

 

The Deputy City Manager and Chief Financial Officer has reviewed this report and agrees with the financial impact information.

Background Information
(August 26, 2011) Report from the Medical Officer of Health on Budget Adjustments to the Toronto Public Health 2011 Approved Operating Budget
(http://www.toronto.ca/legdocs/mmis/2011/hl/bgrd/backgroundfile-40387.pdf)


HL7.5

Information 

 

 

Ward: All 

Toronto Public Health Capital Budget Variance Report for the Six Months Ended June 30, 2011
Origin
(August 24, 2011) Report from the Medical Officer of Health
Summary

This report provides an update to the Board of Health on the Toronto Public Health (TPH) Capital Budget variance for the six  month period ended June 30, 2011.

 

Toronto Public Health spent $1.497 million or 25.6 percent of the 2011 approved cash flow of $5.839 million as of June 30, 2011.

 

The year-end capital expenditure is projected to be $5.056 million or 86.6 percent of the final approved cash flow of $5.839 million.

Financial Impact

See table in the staff report for financial impact information.

 

The Deputy City Manager and Chief Financial Officer has reviewed this report and agrees with the financial impact information.

Background Information
(August 24, 2011) Report from the Medical Officer of Health on Toronto Public Health Capital Budget Variance Report for the Six Months Ended June 30, 2011
(http://www.toronto.ca/legdocs/mmis/2011/hl/bgrd/backgroundfile-40388.pdf)

(August 24, 2011) Appendix 1 - Toronto Public Health 2011 Capital Budget Variance Report for the Six Months Ended June 30, 2011
(http://www.toronto.ca/legdocs/mmis/2011/hl/bgrd/backgroundfile-40389.pdf)


HL7.6

Information 

 

 

Ward: All 

Toronto Public Health Operating Budget Variance Report for the Six Months Ended June 30, 2011
Origin
(August 24, 2011) Report from the Medical Officer of Health
Summary

This report provides an update to the Board of Health on the Toronto Public Health (TPH) Operating Budget Variance for the six months of operation ending on June 30, 2011.

 

Toronto Public Health’s operating budget was under spent by $794.2 thousand net or 3.6 percent for the six-month period ending on June 30, 2011.

 

Toronto Public Health gross expenditures were below budget by $5,970.1 thousand or 5.5 percent, attributable to the under spending of $4,760.0 thousand in Salaries and Benefits and $1,210.1 thousand in non payroll including utility costs. Revenue was underachieved by $5,175.9 thousand due to under-spending in provincial cost shared and fully funded programs.  At year end, Toronto Public Health expects to be under spent in gross expenditures by $7,800.0 thousand (3.3 percent) and below budget in revenue by $6,758.0 thousand (3.6 percent) resulting in $1,042.0 thousand (2.3 percent) net favourable variance.

Financial Impact

See table in the staff report for financial impact information.

 

The Deputy City Manager and Chief Financial Officer has reviewed this report and agrees with the financial impact information.

Background Information
(August 24, 2011) Report from the Medical Officer of Health on Toronto Public Health Operating Budget Variance Report for the Six Months Ended June 30, 2011
(http://www.toronto.ca/legdocs/mmis/2011/hl/bgrd/backgroundfile-40404.pdf)

(August 24, 2011) Attachment 1 (Schedule 1) - Toronto Public Health Operating Variance Submission for the Six Months Ended June 30, 2011
(http://www.toronto.ca/legdocs/mmis/2011/hl/bgrd/backgroundfile-40405.pdf)

(August 24, 2011) Attachment 1 (Schedule 2) - Toronto Public Health Operating Variance Submission for the Six Months Ended June 30, 2011
(http://www.toronto.ca/legdocs/mmis/2011/hl/bgrd/backgroundfile-40406.pdf)

(August 24, 2011) Attachment 1 (Schedule 3) - Toronto Public Health Operating Variance Submission for the Six Months Ended June 30, 2011
(http://www.toronto.ca/legdocs/mmis/2011/hl/bgrd/backgroundfile-40407.pdf)

(August 24, 2011) Attachment 1 (Schedule 4) - Toronto Public Health Operating Variance Submission for the Six Months Ended June 30, 2011
(http://www.toronto.ca/legdocs/mmis/2011/hl/bgrd/backgroundfile-40408.pdf)


HL7.7

ACTION 

 

 

Ward: All 

Legislative Amendments to Increase Awareness and Access to Public Pool and Public Spa Inspection Reports
Origin
(September 13, 2011) Member Motion from Councillor Filion, Chair, Board of Health
Recommendations

The Chair, Board of Health recommends that the Board of Health:

 

1.         request the Minister of Health and Long-Term Care to:

 

a.         establish set fines and short form wording for offences under O. Regulation 565 (Public Pools) and O. Regulation 428/05 (Public Spas) made under the authority of the Health Protection and Promotion Act.

 

b.         amend O. Regulation 565 ((Public Pools) and O. Regulation 428/05 (Public Spas) to require public pool and public spa operators to post, and keep posted, public pool and public spa inspection reports issued by a Medical Officer of Health, in a  clearly visible place, at or near the entrance to the facility.

 

c.         amend O. Regulation 565 (Public Pools) and O. Regulation 428/05 (Public Spas) to require standardized training for public pools and public spa operators with respect to water chemistry analyses and promoting health and safety and injury prevention.

 

2.         direct the Medical Office of Health to:

 

a.         enhance public awareness and access to pool and spa inspection reports by developing a web based public pool and public spa inspection disclosure system.  

 

B         report to the Board of Health in no later than six months on progress.

Summary

Public Health Inspectors conduct routine inspections of public swimming pools and public spas to ensure compliance with the public pool and public spa regulations made under the authority of the Health Protection and Promotion Act.  Toronto Public Health Inspectors have issued numerous closure orders and infraction notices on operators of public pools and public spas over the last two years.  These recommendations are intended to enhance existing enforcement options to enable public health inspectors to take more effective action in situations where there are repeated regulatory infractions at public pools and public spas.

Background Information
(September 13, 2011) Member Motion from the Chair, Board of Health, on Legislative Amendments to Increase Awareness and Access to Public Pool and Public Spa Inspection Reports
(http://www.toronto.ca/legdocs/mmis/2011/hl/bgrd/backgroundfile-40765.pdf)