BOARD OF HEALTH

A G E N D A

Date of Meeting:Monday, January 25, 1999Enquiry:Trudy Perrin

100 Queen Street Westclerk@city.toronto.

Toronto City Hallon.ca

DECLARATIONS OF INTEREST PURSUANT TO THE MUNICIPAL CONFLICT OF INTEREST ACT

CONFIRMATION OF MINUTES OF MEETING HELD ON NOVEMBER 10, 1998

1.ELECTION OF CHAIR AND VICE-CHAIR

(A)Councillor Irene Jones

(January 13, 1999)

Expressing interest to continue her role as Chair or Vice-Chair on the Board of Health.

PRESENTATIONS

2.THE STATE OF THE CITY'S HEALTH: ACHIEVING PUBLIC HEALTH GOALS IN THE MILLENNIUM

Medical Officer of Health

(January 14, 1999)

Recommending that the Board of Health endorse this report and refer it to Community and Neighbourhood Services Committee, Budget Committee and City Council.

3.UPDATE ON INVESTING IN PUBLIC HEALTH

Medical Officer of Health

(January 15, 1999)

Recommending that this report be received for information.

4.MEETING PROVINCIAL STANDARDS ACROSS THE CITY FOR SELECTED PUBLIC HEALTH PROGRAMS AND SERVICES

Medical Officer of Health

(January 18, 1999)

Recommending that:

(1)the Board of Health select one of the following service level options for the Food Safety program and recommend the additional funding required within the 1999 budget approval process:

(a)Provision of an optimal service level for the City of Toronto, at an additional cost of $646,411 in 1999 (including a one-time cost of $61,000), and $1,756,234 in 2000 and subsequent years; or

(b)Provision of the minimum service level mandated by the Province, at an additional cost of $406,630 in 1999 (including a one-time cost of $39,900), and $1,100,189 in 2000 and subsequent years.

(2)the Board of Health select one of the following service options for tuberculosis (TB) control and recommend the additional funding required within the 1999 budget approval process:

(a)Provision of an optimal service level for the City of Toronto, at an additional cost of $726,159 in 1999 (including one-time costs of $100,000) and $1,878,478 in 2000 and subsequent years; or

(b)Provision of the minimum service level mandated by the Province, at an additional cost of $567,572 in 1999 (including one-time costs of $87,000) and $1,441,715 in 2000 and subsequent years.

(3)the Board of Health request Council through the Community & Neighbourhood Services Committee to advocate with the Board of Health and local hospitals for provincial funding to provide appropriate accommodation for people without housing who have active TB in order to reduce disease transmission and promote a stable environment which will assist them to regain their health.

(4)the Board of Health select one of the following service options for needle exchange for the purposes of HIV prevention and recommend the additional funding required within the 1999 budget approval process:

(a)Provision of an optimal service level for the City of Toronto, at an additional cost of $227,878 in 1999 (including one-time costs of $41,000 in 1999) and $560,634 in 2000 and subsequent years plus one-time capital costs of $82,000 in 2000; or

(b)Provision of the minimum service level mandated by the Province, at an additional cost of $180,565 in 1999 (including one-time costs of $41,000) and $418,696 in 2000 and subsequent years.

(5)the Board of Health recommend that Council urge the Ontario Ministry of Health and Health Canada to provide funding for methadone programs and services in Toronto that serve hard-to-reach and high-needs clients.

(6) the Board of Health recommend to Council that the City's Methadone Works pilot program be ended on March 31, 1999 unless ongoing external funding is obtained to continue the program beyond that date.

5.HARMONIZATION OF DENTAL & ORAL HEALTH SERVICES

Medical Officer of Health

(January 15, 1999)

Recommending that the Board of Health select one of the following options for harmonizing dental services in the City:

(1)That the Public Health dental treatment programs be harmonized to provide services to individuals who lack dental benefits and cannot afford to pay for dental care, including children of low-income families, ESL and other new immigrant adolescents, high risk mothers enrolled in another Public Health program, independent living seniors, and institutionalized seniors (with low income defined in accordance with the definition used by Statistics Canada.)

If this service level option is adopted, the following recommendations apply:

(a)That services be harmonized in the short term by extending the hours of some or all of the current clinic facilities to 8:00 a.m. - 7:00 p.m., at an additional annualized operating cost of $1.9 million for all sites in the former City of Toronto OR $900,000 for 4 sites as detailed in the report; and

(b)That the Board consider upgrading the current dental clinic facilities in Etobicoke to allow the clinic to operate with extended hours as described in (a), at an additional annualized operating cost of $200,000 plus one-time costs of $100,000 to upgrade the equipment and facility.

If Option (1) is not adopted, the following options should be considered:

(2)That the existing treatment budget of $3.6 million be reallocated across the entire City,

Or

(3)That the 100% municipally funded dental treatment programs be eliminated, for annualized savings of $3.6 million.

It is further recommended that:

(4)An internal work group of staff in Social Services and Public Health divisions be established to report on the implications providing basic dental benefits to adults participants of the Ontario Works Program who currently have access to emergency services only.

(5)The Board of Health advocate to the provincial and federal government that dental and oral health are primary health care issues and should be funded accordingly, especially for those groups who cannot access basic dental care due to the cost.

6.HARMONIZATION OF FOOD ACCESS GRANTS

Medical Officer of Health

(January 15, 1999)

Recommending that the Board of Health select one of the following service options for food access grants and request Municipal Grants Review Committee to recommend the additional funding required within the 1999 budget approval process:

(1)Establish an optimal service level for city-wide Food Access Grants at a new cost of $1,000,000 in operating grants, and $500,000 for capital grants targeted outside the former Toronto with $152,370 for grants administration, for an additional cost of $550,790 in 1999 and $1,652,370 in 2000 and subsequent years; or

(2)Establish a partnership funding model for city-wide Food Access Grants as in Option A with the City of Toronto contributing $750,000 and seeking additional funding of $750,000 from community foundations (if additional funds cannot be secured, the program would operate at a reduced level based on the municipal funding portion of $750,000 and any matching funds which could be secured), with at an additional cost of $300,790 in 1999, and $902,370 in 2000 and subsequent years; or

(3)Do not re-establish a Food Access Grants program.

COMMUNICATIONS

7.TORONTO TASK FORCE FOR THE FRAIL NON-RECEPTIVE OLDER ADULT

Medical Officer of Health

(January 15, 1999)

Recommending that:

(1)the Board of Health adopt the recommendations made in the report by the Toronto Task Force for the Frail Non-Receptive Older Adult;

(2)the report be forwarded to the Toronto District Health Council for their consideration;

(3)the Board strongly advocate that the Ministry of Health - Long Term Care Division move quickly to fund the implementation of a service model for frail non-receptive seniors as detailed in the report, accompanied by a strong evaluation component;

(4)Public Health continue to work with community agencies and advocate for improved services for this population; and

(5)Public Health develop a consistent approach to this target population across the City through the re-distribution of existing resources, pending the Ministry of Health's implementation of a service model for this population.

(A copy of the Report of the Toronto Task Force For Frail Non-Receptive (FNR) Older Adults titled "Serving Toronto's Frail Non-Receptive Older Adults" dated October 1998 is circulated to Members of the Board of Health and City Council only and is on file in the City Clerk's office.)

8.STATUS REPORT: REVIEW OF THE RECOMMENDATIONS OF THE REPORT OF THE TASK FORCE ON HEALTH AND WORK FOR THE CITY OF TORONTO

Medical Officer of Health

(January 15, 1999)

Recommending that:

(1)The Board of Health recognize the critical link between employment and population health by supporting in principle the Report of the Task Force on Health and Work and its recommendations;

(2)The Board of Health request City Council to receive the report and undertake a full review of and report on how the City of Toronto can implement key recommendations, in particular recommendation 17;

(3)The Board of Health request City Council to ensure that these recommendations be considered in human resources policies as well as planning processes under development in the City of Toronto;

(4)The Board of Health request that, in investigating the feasibility of a four-day work week, the City of Toronto begin by monitoring overtime currently worked in the City; and

(5)The Board of Health and City Council advocate to Human Resources Development Canada for the initiation and development of a voluntary collective benefits insurance fund for all Canadians in the non-standard and contingent workforce.

9.BY-LAW RESPECTING ANIMALS - REVISIONS

Medical Officer of Health

(January 15, 1999)

Recommending that the Board of Health receive this report for information.

(A)ANIMAL CONTROL: HARMONIZED BY-LAW

City Solicitor

(January 14, 1999)

Recommending that authority be granted to introduce the necessary Bill in Council in the form or substantially in the form of the by-law attached to this report.

(B)Wendy Korver, D.V.M., Bowmanville Veterinary Clinic

(December 1, 1998)

Forwarding comments

(C)Mrs. Betty Walker

(November 30, 1998)

Forwarding comments

(D)Michael Brassard

(December 2, 1998)

Forwarding comments

(E)Nancy Mueller, Chair, Community Standards Subcommittee of Crime S.C.O.P.E. Etobicoke Office

(December 1, 1998)

Forwarding comments

(F)Kristen Boychuk, North York

(undated)

Forwarding comments

(G)Dale Gienow, President, Speaking of Wildlife Inc., Baltimore, Ontario

(December 23, 1998)

Forwarding comments

(H)Christopher Pritchard, Chief Technician, Department of Otolaryngology, St. Michael's Hospital, Toronto and Tracey Yvonne Young, Logistics Assistant, Communications Department, St. Michael's Hospital, Toronto

(January 12, 1999)

Forwarding comments

10.CHILD NUTRITION PROGRAM

Medical Officer of Health

(January 13, 1999)

Recommending that this report be received for information.

11.REMUNERATION FOR MEMBERS OF THE BOARD OF HEALTH

Ronald T. Sapsford, Assistant Deputy Minister, Ministry of Health

(January 7, 1999)

Approving remuneration of $125 per diem for members of the Board of Health retroactive to January 1, 1998.

12.1997 AUDITOR'S REPORT AND STATEMENT OF REVENUE AND EXPENDITURE FOR THE BOARDS OF HEALTH FOR THE FORMER CITY OF TORONTO HEALTH UNIT AND FORMER BOROUGH OF EAST YORK HEALTH UNIT

Secretary, Board of Health Budget Subcommittee

(January 8, 1999)

Advising receipt of the foregoing report and forwarding same to the Board of Health for its information.

13.INCREASE IN MEMBERSHIP OF ANIMAL SERVICES ADVISORY SUBCOMMITTEE OF THE BOARD OF HEALTH

Councillor Irene Jones, Chair, Animal Services Advisory Subcommittee

(January 11, 1999)

Recommending:

(1)That the Board of Health expand membership of the Animal Services Advisory Subcommittee to include a representative from a recognized special interest group relating to birds within the City of Toronto, for the period ending November 30, 2000, and until their successors are appointed;

(2)that PIJAC (Pet Industry Joint Advisory Council of Council) be requested to confirm the name of their representative or name any other recognized organization from the pet trade industry within the City of Toronto, for the period ending November 30, 2000, and until their successors are appointed; and

(3)that the Toronto Cat Owners' Association again be requested to name their representative on this subcommittee.

14.BOARD OF HEALTH MEETING SCHEDULE TO JULY 1999

Committee Administrator, Board of Health

(January 18, 1999)

Forwarding meeting schedule to July 1999 for consideration.

IN-CAMERA ITEM

15.APPOINTMENT OF CITIZEN MEMBERS TO BOARD OF HEALTH

Administrator, Nominating Subcommittee of the Board of Health

(January 11, 1999)

Forwarding recommendations for the Board's consideration.