Minutes

Confirmed on
June 14, 2013



Board of Health


Meeting No. 21   Contact Dela Ting, Committee Administrator
Meeting Date Monday, April 29, 2013
  Phone 416-397-7769
Start Time 1:00 PM
  E-mail boh@toronto.ca
Location Committee Room 1, City Hall
  Chair   Councillor Joe Mihevc  

HL21.1

ACTION 

Adopted 

 

 

Introduction and Enactment of Bills - To Govern Proceedings of the Board of Health of the City of Toronto Health Unit

Board Decision

The Board of Health introduced and enacted the following:

 

1.         Bill No. 1 – To repeal By-law 1-1998; and

 

2.         Bill No. 2 – To Govern the Proceedings of the Board of Health for the City of Toronto Health Unit.

Summary

The Board of Health will introduce and enact:

 

Bill No.1 - To repeal By-law 1-1998

 

Bill No. 2 - To Govern the Proceedings of the Board of Health for the City of Toronto Health Unit.

Background Information
(April 15, 2013) Bills Index Board of Health April 29, 2013
(http://www.toronto.ca/legdocs/mmis/2013/hl/bgrd/backgroundfile-57599.pdf)

Motions
1 - Motion to Introduce and Pass General Bills moved by Kristle Calisto-Tavares (Carried)

That Bill Number 1 prepared for the meeting of the Board to be held April 29, 2013, be passed and hereby declared as a by-law.


2 - Motion to Introduce and Pass General Bills moved by Kristle Calisto-Tavares (Carried)
That Bill Number 2 prepared for the meeting of the Board to be held April 29, 2013, be passed and hereby declared as a by-law.

HL21.2

ACTION 

Amended 

 

Ward:All 

Menu Labelling - Making Key Nutrition Information Readily Available in Restaurants

Board Decision

The Board of Health:

 

1.         Urged the Ontario Premier and the Minister of Health and Long-Term Care to develop menu labelling legislation without further delay to support the public's right to know about nutrition content of restaurant foods. The provincial legislation should:

 

a.        Be directed to foodservice premises with ten or more outlets nationwide or at least $10 million in gross annual revenue;

b.        Require calories and sodium values to be listed on the menu and/or menu board for all standard menu items in the same font/font size as the price;

c.        Require that comprehensive nutrition information (i.e. calories plus 13 core nutrients) be made available to customers upon request at the point of purchase in the form of a pamphlet, brochure, or alternate format; and

d.       Require that contextual statements about daily recommended levels of calories and sodium be posted on the menu or menu board.

 

2.         Requested the Medical Officer of Health, in consultation with the City Solicitor and relevant stakeholders, to report to the Board of Health in the fall of 2013, if the provincial government has not proceeded with menu labelling legislation by September 1, 2013, on a proposed City by-law, that will require:

 

a.         Chain restaurants in Toronto with ten or more outlets nationwide or at least $10 million in gross annual revenues to post calories and sodium values on the menu or menu board for all standard menu items in the same font/font size as the price;

b.         Comprehensive nutrition information (i.e. calories plus 13 core nutrients) to be made available to customers upon request at the point of purchase in the form of a pamphlet, brochure, or alternate format; and

c.         Contextual statements about daily recommended levels of calories and sodium to be posted on the menu or menu board.

 

3.         Requested the Medical Officer of Health to report in the fall of 2013 on progress on the voluntary menu labelling pilot project with independent restaurants.

 

4.         Urged Boards of Health in the Greater Toronto Area and throughout Ontario to assist in expanding menu labelling legislation for chain restaurants and voluntary menu labelling initiatives for independent restaurants throughout the province of Ontario.

 

5.         Endorsed, in principle, the recommendations of No Time to Wait: The Healthy Kids Strategy, the 2012 report of the Ontario government's Healthy Kids Panel.

 

6.         Forwarded this report to Ontario's Chief Medical Officer of Health, the Ontario Minister of Health and Long-Term Care, the Ontario Public Health Association, Public Health Ontario, the Council of Ontario Medical Officers of Health, the Association of Local Public Health Agencies, the Ontario Medical Association, the Registered Nurses Association Ontario, the Ontario Stroke Network, Public Health Physicians of Canada, Dieticians of Canada, the Canadian Diabetes Association, the Childhood Obesity Foundation, the Centre for Science in the Public Interest Canada, and the Fitness Industry Council of Canada.

 

7.         Forwarded this report to leaders of official Ontario parties to gain their support for provincial menu labelling regulation.

 

8.         Requested that the report by the Medical Officer of Health on the voluntary pilot project for restaurants below the ten outlet/$10 million gross revenue threshold consider recognition for restaurants which voluntarily list calorie and sodium content on menus.

 

9.         Requested that should the Province not indicate a willingness to act on the recommendations from the Medical Officer of Health, that a draft by-law be prepared for consideration by the Board of Health and that prior to bringing it forward, that Toronto Public Health staff consult with the industry regarding details of implementation.

Decision Advice and Other Information

The Medical Officer of Health gave a presentation.

Origin
(April 15, 2013) Report from the Medical Officer of Health
Summary

As families consume more of their meals outside the home, more attention is being given to addressing the association between eating out, poor nutrition and corresponding health concerns, such as obesity and hypertension. Menu labelling, whereby nutrition information is provided on restaurant menus or menu boards, is a policy option that can improve the restaurant food environment by ensuring consumers are better able to make informed and healthier choices when eating out.

 

Menu labelling legislation is recommended by diverse experts and health organizations internationally and in Canada. Most recently, the Healthy Kids Panel, created to advise the province, has identified menu labelling as a strategy to prevent childhood obesity.  In 2008, New York City was the first jurisdiction to enact menu labelling legislation that requires large chain restaurants to post calorie levels on menus and/or menu boards. In 2010, the United States federal government passed a similar law.

 

Voluntary nutrition information disclosure programs in Canada have not fully achieved the goals of providing simple, readily available information by which the public can make informed choices when they eat out. There is growing pressure in Canada for governments to expand on the U.S. model and mandate calorie and sodium labelling on the menu for larger chain restaurants.

 

Toronto Public Health (TPH) undertook a comprehensive examination of the evidence on menu labelling as a policy approach to promoting food transparency and supportive food environments for people who eat out, and conducted Toronto-based research and consul-tations with key stakeholders to assess the readiness for menu labelling in Toronto restau-rants. The findings are captured in the attached technical report, What's on the Menu? Making Key Nutrition Information Readily Available in Restaurants.

 

This Board of Health report summarizes the following from the technical report: the evidence on the benefits and effectiveness of and consumer demand for menu labelling, the current policy context in Canada for menu labelling, and Toronto data on the readiness for menu labelling from resident and restaurant industry perspectives. 

 

There is clear evidence that consumers support having nutrition information when dining out. Furthermore, menu labelling makes nutrition information more visible and more likely to be understood and used by consumers. Menu labelling is used by consumers to make healthier menu choices and can prompt restaurants to create healthier menu options.

 

This report identifies important actions related to menu labelling that can enhance the ability of Toronto residents to make informed food choices in restaurants. The Board is urged to advocate for provincial menu labelling legislation for larger chain restaurants. If provincial action is not forthcoming, the Medical Officer of Health (MOH) recommends that the Board request the MOH to explore options for a possible municipal menu labelling by-law. In the interim, to help level the playing field, TPH will work with independently owned restaurants and smaller chains on a pilot project in 2013-14 to test the feasibility of these restaurants implementing and sustaining menu labelling. Toronto Public Health is also launching a communication campaign this spring to increase awareness among Toronto consumers of the nutrition content of restaurant foods. The MOH will report back to the Board later this year on progress on these actions.

Background Information
(April 15, 2013) Staff Report from the Medical Officer of Health Re: Menu Labelling - Making Key Nutrition Information Readily Available in Restaurants
(http://www.toronto.ca/legdocs/mmis/2013/hl/bgrd/backgroundfile-57581.pdf)

(April 15, 2013) Attachment 1: What's on the Menu? Making Key Nutrition Information Readily Available in Restaurants. 2013 Report prepared for Toronto Public Health
(http://www.toronto.ca/legdocs/mmis/2013/hl/bgrd/backgroundfile-57582.pdf)

(April 29, 2013) Presentation from the Medical Officer of Health - Menu Labelling - Making Key Nutrition Information Readily Available in Restaurants
(http://www.toronto.ca/legdocs/mmis/2013/hl/bgrd/backgroundfile-58082.pdf)

Communications
(April 29, 2013) Submission from Bill Jeffery, LLB, Naional Co-ordinator, Centre for Science in the Public Interest (CSPI) - On File with City Clerk (HL.New.HL21.2.1)
(April 29, 2013) Submission from Renee Gaudet, Representative Ontario Society of Nutrition Professionals - On File with City Clerk (HL.New.HL21.2.2)
(April 29, 2013) Submission from Stephanie Jones, MBA, Vice President, Ontario and Sustainability, Canadian Restaurant and Foodservices Association - On File With City Clerk (HL.Main.HL21.2.3)
(April 29, 2013) Submission from Nutrition Action Health Letter from Centre for Science in the Public Interest - On File With City Clerk (HL.New.HL21.2.4)
Speakers

Dr. Mary L'Abbe, PhD, Department of Nutritional Sciences, Faculty of Medicine, University of Toronto
Bill Jeffery, LLB, National Coordinator, Centre for Science in the Public Interest (CSPI)
Renee Gaudet, Representative, Ontario Society of Nutrition Professionals in Public Health (OSNPPH) (Submission Filed)
Rose Reisman, Digital Media and Communications Manager, Art of Living Well
Grace Valentini, Youth Health Action Network
Stephanie  Jones, VP Ontario and Sustainability, Canadian Restaurant and Foodservices Association (Submission Filed)
John  Nunziata and, Leslie A. Smejkal, ORHMA and Marko Gotowiec, Ont Restaurant Hotel & Motel Assoc (Toronto)
Vlad Chenenko, President, Meal Garden Inc.

Motions
1 - Motion to Amend Item (Additional) moved by Suman Roy (Lost)

That the Board of Health:

 

1.         strike a Menu Labelling Working Group for the purpose of considering options for a proposed menu labeling regulation to report back to the Board no later than the September 30, 2013 meeting

 

2.         refer item HL21.2 to the Menu Labelling Working Group.


2 - Motion to Amend Motion moved by Kristle Calisto-Tavares (Redundant)

That Part 1 of Suman Roy's motion be amended to add the words "of up to five board members" after the word "Group" so that this motion reads as follows:

 

That the Board of Health:

 

1.         strike a Menu Labelling Working Group of up to five board members for the purpose of considering options for a proposed menu labelling regulation, to report back to the Board no later than the September 30, 2013 meeting.


3 - Motion to Amend Item (Additional) moved by Councillor John Filion (Carried)

That:

 

1.         the report by the Medical Officer of Health on the voluntary pilot project for restaurants below the 10 outlet/$10 million gross revenue threshold consider recognition for restaurants which voluntarily list calorie and sodium content on menus.

 

2.         that should the Province not indicate a willingness to act on the recommendations from the Medical Officer of Health, that a draft by-law be prepared for consideration by the Board of Health and that prior to bringing it forward, that staff consult with the industry regarding details of implementation.


Vote (Amend Item (Additional))

Apr-29-2013

Result: Carried Majority Required - Part 2 of Motion 3 by Councillor Filion
Yes: 9 Raymond Cho, Sarah Doucette, John Filion, Pamela Gough, David Laws, Joe Mihevc (Chair), Gord Perks, Jennifer Sarjeant, Kristyn Wong-Tam 
No: 3 Kristle Calisto-Tavares, Suman Roy, Rumina Velshi 
Absent: 1 Abdul Fattah 

4 - Motion to Adopt Item as Amended moved by Councillor Sarah Doucette (Carried)

Vote (Adopt Item as Amended)

Apr-29-2013

Result: Carried Majority Required
Yes: 10 Raymond Cho, Sarah Doucette, John Filion, Pamela Gough, David Laws, Joe Mihevc (Chair), Gord Perks, Jennifer Sarjeant, Rumina Velshi, Kristyn Wong-Tam 
No: 2 Kristle Calisto-Tavares, Suman Roy 
Absent: 1 Abdul Fattah 

HL21.3

ACTION 

Adopted 

 

Ward:All 

Toronto Unvaccinated: The Impact of Vaccination on the City's Health

Board Decision

The Board of Health:

 

1.         Reaffirmed its request to the Ministry of Health and Long-Term Care to:

 

a.         Update the Immunization of School Pupils Act to be consistent with vaccines currently recommended in Ontario’s Publicly Funded Immunization Schedule (R.R.O. 1990, Ontario Regulation 645 in the Immunization of School Pupils Act).

b.         Strengthen the reporting of immunization information to public health by amending the Health Protection and Promotion Act to require mandatory reporting by health care providers to the Medical Officer of Health of the administration of an immunization to anyone below the age of 18 years.

c.         Ensure that Panorama, the electronic immunization system that will replace the Immunization Recording Immunization System (IRIS) to capture vaccine records for Ontario children, is designed to easily accept electronic information directly from health care provider electronic medical records for the efficient capture and sharing of immunizations records, and to act as an immunization registry for Ontario.

 

2.         Urged the Ministry of Health and Long-Term Care and Public Health Ontario to:

 

a.         Support both health care providers and parents by developing comprehensive and innovative communication tools to ensure access to accurate vaccine and disease risk-benefit information.

b.         Develop a comprehensive provincial vaccine safety communication strategy promoting plain language, evidence-informed advice to parents.

c.         Develop a provincial vaccine injury compensation program to compensate families in the rare circumstance a serious true vaccine injury occurs.

d.         Promote evidence-informed methods to improve immunization coverage to local public health agencies and health care providers.

 

3.         Forwarded the report (April 15, 2013) from the Medical Officer of Health to the Chief Medical Officer of Health and the Ontario Provincial Immunization Review Task Group and its sub-committees for consideration in the Task Group's final report.

 

4.         Forwarded the report (April 15, 2013) from the Medical Officer of Health to Public Health Ontario, the Provincial Infectious Diseases Advisory Committee on Immunization, the Association of Local Public Health Agencies, the Ontario Public Health Association, the Council of Medical Officers of Health of Ontario, the Public Health Agency of Canada and the Canadian Paediatric Society.

Decision Advice and Other Information

Dr. Barbara Yaffe, Associate Medical Officer of Health, Communicable Disease Control, Toronto Public Health Division, gave a presentation.

Origin
(April 15, 2013) Report from the Medical Officer of Health
Summary

The success of vaccination programs depend on public acceptance of vaccinations and the successful maintenance of high vaccination rates.  The first vaccines offered in North America were for contagious and life-threatening diseases like smallpox, polio and diphtheria.  These early childhood vaccination programs were successful despite public hesitancy because most parents had actually lived through disease epidemics and seen children suffer and die from these diseases.  Broad public acceptance of vaccinations over time has eliminated or significantly reduced most infectious diseases prevented by vaccines.  Now that vaccine preventable diseases are rarer, parents have become less fearful of them, and some are choosing to delay or refuse vaccination for their children . 

 

A technical report titled Toronto Unvaccinated: the Impact of Vaccination on the City's Health (Appendix 1) models the risk for infection, harm and death if more children in Toronto stopped getting routine childhood immunizations.  Three diseases polio, measles, and whooping cough (pertussis) were chosen to illustrate this risk. 

 

Even though wild polio has been eradicated in North America, it still circulates in a number of countries and can be re-introduced in Toronto through travel.  Measles is highly contagious and requires very high vaccination rates to stop the disease from spreading; if Toronto's vaccination rates drop by as little as 10%, outbreaks will occur, similar to what Europe is experiencing.  Whooping cough continues to circulate in Toronto, with severity and rates much lower compared to the pre-vaccine era; if whooping cough vaccination rates were to drop by just 25%, whooping cough cases could rise by 400% among children two years of age and younger, resulting in severe disease and death.  In summary, if children in Toronto are not vaccinated against previously common childhood diseases, Toronto will see a large increase in these diseases, with associated complications and deaths.  This report highlights key findings from the technical report, and current barriers to vaccination, including vaccine hesitancy, vaccine misinformation, and concerns about vaccine safety.  Suggested strategies to maintain and improve vaccination rates are offered with the aim of informing Ontario's Immunization System Review. 

Background Information
(April 15, 2013) Staff Report from the Medical Officer of Health Re: Toronto Unvaccinated: The Impact of Vaccination on the City's Health
(http://www.toronto.ca/legdocs/mmis/2013/hl/bgrd/backgroundfile-57578.pdf)

(April 15, 2013) Appendix 1: Toronto Unvaccinated: The Impact of Vaccination on the City's Health - Technical Report January 2013
(http://www.toronto.ca/legdocs/mmis/2013/hl/bgrd/backgroundfile-57638.pdf)

Speakers

Dr. Jay Keystone, University of Toronto
Dr. Bernice Krafchik
Dr. Cadigia Ali

Motions
Motion to Adopt Item moved by Councillor Sarah Doucette (Carried)

HL21.4

ACTION 

Adopted 

 

Ward:All 

Gambling Expansion in Toronto - Update

Board Recommendations

The Board of Health recommends that:

 

1.         If it consents to expansion of gambling in Toronto, City Council  make the implementation of the harm mitigation measures set out in the letter of April 10, 2013 from the Medical Officer of Health, addressed to the Executive Committee (Item EX30.1.73), a condition of its approval.

Decision Advice and Other Information

The Board of Health:

 

1.         Reiterated its recommendation to City Council that based on health evidence pointing to health risks associated with gambling, the Ontario Lottery and Gaming Corporation (OLG) not be invited to expand gambling in the City of Toronto.  (see HL18.1)

Origin
(April 18, 2013) Report from the Medical Officer of Health
Summary

The City Manager released a report, New Casino and Convention Development in Toronto, on April 8, 2013 for consideration by the Executive Committee at its meeting of April 15 and 16th, 2013.  The report included recommendations for options and conditions that City Council may consider should they decide to consent to a new or expanded casino in Toronto.  One recommended condition is that the Ontario Lottery and Gaming Corporation (OLG) and casino operator(s) "review and consider" the harm mitigation measures in the Medical Officer of Health's (MOH) report.

 

This report to the Board of Health (BOH) is to inform Board members that the MOH sent a letter to the Executive Committee based on the Board's position which noted that the establishment of a downtown casino and the expansion of gambling at Woodbine, both raise concerns of increased problem gambling and related adverse health impacts. Further, the MOH reaffirmed that, should City Council consent to host a new or expanded casino in Toronto, it is appropriate to make approval contingent on measures to mitigate harm. The MOH recommended therefore that the wording of a condition in the City Manager's report related to harm mitigation measures be strengthened such that the OLG and casino operator(s) be "required to work with the Toronto Medical Officer of Health to implement harm mitigation measures". Executive Committee did not adopt the MOH’s recommendation. The MOH recommends that the BOH endorse this recommendation.

Background Information
(April 18, 2013) Staff Report from the Medical Officer of Health Re: Gambling Expansion in Toronto - Update
(http://www.toronto.ca/legdocs/mmis/2013/hl/bgrd/backgroundfile-57699.pdf)

(April 10, 2013) Attachment 1: Letter from the Medical Officer of Health to Executive Committee, previously considered considered by Executive Committee as EX30.1.73
(http://www.toronto.ca/legdocs/mmis/2013/hl/bgrd/backgroundfile-57700.pdf)

Motions
Motion to Adopt Item moved by Councillor Joe Mihevc (Carried)

HL21.5

ACTION 

Amended 

 

Ward:All 

Medically Uninsured Residents in Toronto

Board Recommendations

The Board of Health recommends that:

 

1.         City Council request that the Ministry of Health and Long-Term Care in collaboration with the Local Health Integration Networks:

 

a.         Increase the dedicated provincial funding currently provided to community health centres for uninsured residents;

b.         Enable community health centres to use the dedicated provincial funding for uninsured residents for services beyond diagnostic and specialist care;

c.         Fund primary care at clinics that currently provide healthcare to uninsured residents, but do not receive dedicated provincial funding to provide this service;

d.         Fund essential healthcare services for uninsured children and youth;

e.         Establish a centralised hospital compassionate payment fund with clear eligibility requirements for urgent and major expenses including labour and delivery, newborn care, serious injury and urgent mental health needs; and

f.          Establish transparent and consistent practices for uninsured patient registration, patient accounting and cost recovery via a standardised non-insured fee schedule similar to OHIP rates, including the elimination of  hospital registration fees/outpatient fees/facility fees for uninsured residents, building on the system already piloted within the Toronto Central Local Health Integration Network.

 

2.         City Council request that the Ministry of Health and Long-Term Care in collaboration with the Local Health Integration Networks:

 

a.         Establish a centralised  information source to promote programs and services available to uninsured residents for both users and practitioners; and

b.         Establish healthcare facilities as safe environments where immigration status will not be reported to federal authorities.

 

3.         City Council reaffirm to the Federal Minister of Citizenship, Immigration and Multiculturalism its support to rescind the cuts to the Interim Federal Health Program.

 

4.         City Council request that Citizenship and Immigration Canada establish clear and operationally feasible guidelines for the administration of the Interim Federal Health Program.

 

5.         City Council request that Citizenship and Immigration Canada, the Ministry of Health and Long-Term Care and Local Health Integration Networks undertake initiatives to educate refugees, refugee claimants, community and settlement organisations and healthcare providers on the healthcare services covered by the Interim Federal Health Program.

 

6.         City Council reaffirm to the Minister of Health and Long-Term Care its support for the elimination of the three month wait period for OHIP coverage.

 

7.         City Council direct that a copy of the report (April 15, 2013) from the Medical Officer of Health be forwarded to Social Development, Finance and Administration to inform their work on improving access to City of Toronto programs and services for undocumented residents.

Decision Advice and Other Information

The Board of Health requested the Medical Officer of Health to work with community stakeholders and Local Health Integration Networks in Toronto to:

 

a.         devise communication strategies around where and what services are available to uninsured residents; and

 

b.         support advocacy strategies to the Provincial and Federal Governments.

 

The Medical Officer of Health gave a presentation.

Origin
(April 15, 2013) Report from the Medical Officer of Health
Summary

Ontario Health Insurance Plan (OHIP) funded healthcare services are available to the majority of people living in Ontario. However there are several resident populations that do not have access to publicly funded provincial healthcare, including people who have lost their identification, people in the three month OHIP wait period, temporary visa holders (e.g., students, visitors), some refugees and undocumented residents. The majority of uninsured residents are immigrants and within this group the most vulnerable are undocumented immigrants. Undocumented residents are not authorised to be in Canada. The vast majority of undocumented residents arrived in Canada through authorised channels, but their immigration status has changed over time.

 

This report describes groups that do not have access to OHIP funded healthcare and identifies their priority health needs, including obstetrical, newborn care and mental health. Children have unique and essential health needs that impact on their health in the short and long-term. Healthcare practitioners and agencies have developed a limited system to serve the uninsured population. At present, the demand for this care exceeds the capacity of the services available and few healthcare agencies receive dedicated funding to treat uninsured residents.  The current healthcare system does not provide adequate access to essential healthcare services for uninsured residents.

Background Information
(April 15, 2013) Staff Report from the Medical Officer of Health regarding Medically Uninsured Residents in Toronto
(http://www.toronto.ca/legdocs/mmis/2013/hl/bgrd/backgroundfile-57588.pdf)

(April 29, 2013) Presentation - Medically Uninsured Residents in Toronto
(http://www.toronto.ca/legdocs/mmis/2013/hl/bgrd/backgroundfile-57997.pdf)

Communications
(April 29, 2013) E-mail from Peter Clarke (HL.New.HL21.5.1)
Speakers

Michaela Hynie, Associate Director, York Institute for Health Research, Assoc. Professor, Psychology, York University
Dr. Paul Caulford, Medical Director/Assistant Professor, Community Volunteer Clinic
Denise Gastaldo, Associate Professor, University of Toronto
Jay MacGillivrary, Midwife, Director, Positive Pregnancy Programme, St. Michael's Hospital
Bob Gardner, Director of Policy, Wellesley Institute
Juana Berinstein, Director, Policy and Communications, Association of Ontario Midwives
Dr. Abeer Majeed, CCFP, Member, Physician/Organizer, Health for All
Russ Ford, Co Chair GT Community Health Centre Non-Insured, Working Group and Exec. Dir. LAMP C.H.C.
Axelle Janczur, Executive Director, Access Alliance Multiculture Health & Community Serv.
Bob Frankford, Right to Health Care Coalition

Motions
1 - Motion to Amend Item moved by Councillor Joe Mihevc (Carried)

That:

 

1          the Medical Officer of Health be requested to work with community stakeholders and Local Health Integration Networks in Toronto to:

 

a.          devise communication strategies around where and what services are available to uninsured residents; and

 

b.         support advocacy strategies to the Provincial and Federal Governments.

 

2.         the Board of Health recommend that City Council endorse the recommendations in this report.


2 - Motion to Adopt Item as Amended moved by Councillor Joe Mihevc (Carried)

HL21.6

Information 

Received 

 

Ward:All 

2012 Toronto Public Health Accountability Agreement Year End Indicator Performance

Board Decision

The Board of Health received the item for information.

Origin
(April 11, 2013) Report from the Medical Officer of Health
Summary

This report provides the Board of Health (BOH) with the results of Toronto Public Health (TPH) performance on the indicators for 2012 as set out in the Accountability Agreement (the Agreement) for 2011-2013 between the Ministry of Health and Long-Term Care (MOHLTC) and the BOH.

 

Background Information
(April 15, 2013) Staff Report from the Medical Officer of Health Re: 2012 Toronto Public Health Accountability Agreement Year End Indicator Performance
(http://www.toronto.ca/legdocs/mmis/2013/hl/bgrd/backgroundfile-57590.pdf)

(April 15, 2013) Attachment 1: Toronto Public Health 2012 Year End Indicator Performance
(http://www.toronto.ca/legdocs/mmis/2013/hl/bgrd/backgroundfile-57639.pdf)

Motions
Motion to Receive Item moved by Rumina  Velshi (Carried)
That the item be received for information.

HL21.7

Information 

Received 

 

Ward:All 

Ontario Public Health Sector Strategic Plan

Board Decision

The Board of Health received the item for information.

Origin
(April 29, 2013) Report from the Medical Officer of Health
Summary

On April 4, the Ministry of Health and Long-Term Care released Make No Little Plans:  Ontario's Public Health Sector Strategic Plan, a comprehensive strategic plan for Ontario's public health sector.  The plan is a result of collaborative efforts of the Public Health Leadership Council, headed by Ontario's Chief Medical Officer of Health, of which the Medical Officer of Health of Toronto is a member.  The plan was developed with consultation among key stakeholders both within and outside the health sector, including public health units throughout Ontario and representation from Boards of Health (including Toronto Board of Health).  The plan centres around five strategic goals, with eight collective areas of focus for the public health sector to tackle over the next three to five years.  Implementation plans will be developed by the Ministry of Health and Long-Term Care in consultation with public health sector stakeholders.

Background Information
(April 29, 2013) Staff Report from the Medical Officer of Health Re: Ontario Pulbic Health Sector Strategic Plan
(http://www.toronto.ca/legdocs/mmis/2013/hl/bgrd/backgroundfile-57635.pdf)

(April 29, 2013) Attachment: Make No Little Plans
(http://www.toronto.ca/legdocs/mmis/2013/hl/bgrd/backgroundfile-57698.pdf)

Motions
Motion to Receive Item moved by Councillor Raymond Cho (Carried)
That the item be received for information.

HL21.8

ACTION 

Adopted 

 

Ward:All 

Transportation Priorities and Investment for a Healthy Toronto - Update

Board Decision

The Board of Health:

 

1.         Urged the Premier of Ontario to consider the potential benefits to health and reduction of health inequities when selecting approaches to fund transportation infrastructure investments in the Greater Toronto and Hamilton Area.

 

2.         Forwarded the report (April 26, 2013) from the Medical Officer of Health to the:

 

(a)        Ontario Ministers of Finance, Transportation, Health and Long Term Care, and Community and Social Services, the President and Chief Executive Officer of Metrolinx, and the Chief Medical Officer of Health of Ontario;

 

(b)       City Manager, Chief Planner and Executive Director of City Planning, General Manager of Transportation Services, and the Chief Executive Officer of the Toronto Transit Commission;

 

(c)        Boards of Health of the City of Hamilton, and Regions of Durham, Halton, Peel, and York; and

 

(d)       Toronto Board of Trade, Association of Local Public Health Agencies, United Way, Canadian Urban Transit Association, Pembina Institute, CivicAction, Martin Prosperity Institute, Ontario College of Family Physicians, Ontario Public Health Association, Wellesley Institute, Evergreen and Ontario Medical Association.

Origin
(April 26, 2013) Report from the Medical Officer of Health
Summary

On March 25, 2013 the Board of Health adopted Transportation Priorities and Investment for a Healthy Toronto, which sets out population health and health equity criteria by which proposed revenue tools for new transit investments should be considered. At that time the Board of Health requested the City Manager to consider population health and health equity in evaluating proposed revenue tools and proposed new transit investments. On April 2, 2013, Metrolinx released its shortlist of revenue tools. On April 9, 2013 Toronto's City Manager released the results of public consultations on transit funding along with a shortlist of preferred revenue options (Metrolinx Transportation Growth Funding- Dedicated Revenues) for consideration by the Executive Committee on April 23.

 

The purpose of this report is to inform the Board of Health of the health and equity implications of funding tools being considered to support transportation expansion in the Greater Toronto and Hamilton Area (GTHA). The report presents the results of a screening-level, equity-based health impact assessment.  The assessment found that development charges, fuel taxes, high occupancy toll lanes, highway tolls or other road pricing, land value capture, parking levy, vehicle kilometres travelled fee and vehicle registration tax have the potential to support health by promoting active transportation (transit, walking and cycling), reducing exposure to air pollution and enhancing mobility.  The assessment also found that income taxes, while not directly tied to transportation behaviours or environmental improvements, are most supportive of health equity.

 

The impacts of any new costs for transportation expansion should be distributed as equitably as possible. Transportation policies can be healthy public policies if decision makers address the health and wellbeing of the whole population and work to mitigate any inequities. This report urges the Premier of Ontario to address health and equity impacts when selecting approaches to fund transportation investments in the GTHA.

Background Information
(April 26, 2013) Report from the Medical Officer of Health - Transportation Priorities and Investment for a Healthy Toronto - Update
(http://www.toronto.ca/legdocs/mmis/2013/hl/bgrd/backgroundfile-57693.pdf)

Communications
(April 29, 2013) E-mail from Peter Clarke (HL.New.HL21.8.1)
Motions
Motion to Adopt Item moved by Jennifer Sarjeant (Carried)

HL21.9

ACTION 

Adopted 

 

Ward:All 

Service Agreements Awarded and Executed by the Medical Officer of Health for 2013

Board Decision

The Board of Health forwards the report (April 15, 2013) from the Medical Officer of Health to the Executive Committee for its information.

Origin
(April 15, 2013) Report from the Medical Officer of Health
Summary

The purpose of this report is to provide information on the purchase of service contracts awarded and executed by the Medical Officer of Health for 2013, according to the delegation of authority by City Council.

Background Information
(April 15, 2013) Staff Report from the Medical Officer of Health Re: Service Agreements Awarded and Executed by the Medical Officer of Health for 2013
(http://www.toronto.ca/legdocs/mmis/2013/hl/bgrd/backgroundfile-57583.pdf)

Motions
Motion to Adopt Item moved by Kristle Calisto-Tavares (Carried)

HL21.10

Information 

Amended 

 

Ward:All 

Toronto Public Health Operating Budget Variance Report for the Three Months ended March 31, 2013

Board Decision

The Board of Health:

 

1.         Requested the Chair of the Board of Health and Medical Officer of Health to meet with the City Manager and Executive Director of Human Resources, to explore strategies that will address the recruitment and staffing process issues and seek approaches to fill the existing high volume of vacancies within reasonable time frames.

Origin
(April 15, 2013) Report from the Medical Officer of Health
Summary

This report provides an update to the Board of Health on Toronto Public Health’s (TPH) Operating Budget Variance for the three months ending on March 31, 2013.

 

Toronto Public Health’s operating budget was under spent by $320.2 thousand net or 3.1 percent for the three-month period ending on March 31, 2013.

 

TPH gross expenditures were below 2013 approved budget by $2,191.2 thousand or 4.4 percent, attributable to the under spending of $2,018.4 thousand in Salaries and Benefits and under spending of $172.8 thousand in non payroll including utility costs. Revenue was underachieved by $1,871.0 thousand or 4.7 percent mainly due to under spending across various provincially cost shared and fully funded programs. At year end, TPH expects to be under spent by $525.0 thousand net.

Background Information
(April 15, 2013) Staff Report from the Medical Officer of Health Re: Toronto Public Health Operating Budget Variance Report for the Three Months ended March 31, 2013
(http://www.toronto.ca/legdocs/mmis/2013/hl/bgrd/backgroundfile-57584.pdf)

(April 15, 2013) Appendix 1: Toronto Public Health Variance Report for the Period Ended March 31, 2013
(http://www.toronto.ca/legdocs/mmis/2013/hl/bgrd/backgroundfile-57585.pdf)

Motions
Motion to Amend Item moved by Councillor Joe Mihevc (Carried)

That the Chair of the Board of Health and Medical Officer of Health meet with the City Manager and Executive Director of Human Resources to explore strategies that will address the recruitment and staffing process issues and seek approaches to fill the existing high volume of vacancies within reasonable time frames. 

 


HL21.11

Information 

Received 

 

Ward:All 

Toronto Public Health Capital Budget Variance Report for the Three Months Ended March 31, 2013

Board Decision

The Board of Health received the item for information.

Origin
(April 15, 2013) 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 three months ended March 31, 2013.

 

TPH spent $1.293 million or 20.5 percent of the 2013 approved cash flow of $6.291 million as of March 31, 2013.

 

The year-end capital expenditure is projected to be $6.291 million or 100 percent spent.

Background Information
(April 15, 2013) Staff Report from the Medical Officer of Health Re: Toronto Public Health Capital Budget Variance Report for the Three Months Ended March 31, 2013
(http://www.toronto.ca/legdocs/mmis/2013/hl/bgrd/backgroundfile-57586.pdf)

(April 15, 2013) Appendix 1: Toronto Public Health 2013 Capital Budget Variance Report for the Period Ended March 31, 2013
(http://www.toronto.ca/legdocs/mmis/2013/hl/bgrd/backgroundfile-57587.pdf)

Motions
Motion to Receive Item moved by Councillor Raymond Cho (Carried)
That the item be received for information.

Procedural Motions
Motion to Adopt Minutes moved by Councillor Sarah Doucette (Carried)

That the minutes of the Board of Health meeting held on March 25, 2013, be confirmed.

Monday, April 29, 2013
Councillor Joe Mihevc, Chair, Board of Health
Meeting Sessions
Session Date Session Type Start Time End Time Public or Closed Session
2013-04-29 Afternoon 1:05 PM 6:25 PM Public
Attendance
Members were present for some or all of the time period indicated.
Date and Time Quorum Members
2013-04-29
01:05 PM - 06:25 PM
(Public Session)
Present Present: Kristle Calisto-Tavares, Raymond Cho, Sarah Doucette, John Filion, Pamela Gough, David Laws, Joe Mihevc (Chair), Gord Perks, Suman Roy, Jennifer Sarjeant, Rumina Velshi, Kristyn Wong-Tam
Not Present: Abdul Fattah