BOARD OF HEALTH

AGENDA

MEETING No. 10

Date of Meeting: Monday, November 15, 1999 Enquiry: Trudy Perrin

Time: 1:00 p.m. Secretary

Location: Council Chamber 392-8027

City Hall clerk@city.toronto.

100 Queen Street West on.ca

DECLARATIONS OF INTEREST PURSUANT TO

THE MUNICIPAL CONFLICT OF INTEREST ACT.

CONFIRMATION OF MINUTES: October 18, 1999

DEPUTATIONS: List to be distributed at meeting.

1. INSPECTION OF RESTAURANTS

AND FOOD-HANDLING PREMISES

Councillor John Filion

(November 1999)

Submitting a motion recommending that the Medical Officer of Health, in consultation with appropriate City departments and organizations, such as the Ontario Restaurant Hotel and Motel Association and the Consumers Council of Canada, report to the Board of Health within six months on possible measures which can be taken to inform the public of the results of restaurant inspections in addition to repeat convictions and closures; and further that this report examine such possibilities as:

(a) a public rating system based on cleanliness and safe food-handling;

(b) making the results of inspections available to consumers via a phone line or web site; and

(c) the posting of notices on premises with repeat closures.

2. DENTAL MANAGEMENT STRUCTURE.

(DEFERRED FROM OCTOBER 18, 1999)

Medical Officer of Health and

Commissioner of Community and Neighbourhood Services

(September 29, 1999)

Responding to the directive from Council to examine methods of providing a harmonized program of municipally funded, non-mandatory dental treatment services for the City of Toronto in the year 2000; and recommending that:

(1) delivery of the municipally funded, non-mandatory dental treatment program be through a Amixed model@, which maximizes the City=s investment in the ten city-operated dental clinics and the preventive and school-based clinics, augmented, as required, through agreements with fee-for-service dental practitioners and non-profit organizations to provide coverage for residents in the former municipalities that did not offer these services;

(2) Public Health be responsible for determining client eligibility and for preauthorizing and predetermining the services to be rendered to individual clients under the municipally funded, non-mandatory dental treatment program;

(3) Public Health audit a proportion of cases served through fee-for-service to ensure that all needs were treated and the services claimed were provided;

(4) clients of the municipally funded, non-mandatory dental treatment program be provided with the option of obtaining dental and oral health services from any fee-for-service dental practitioner or organization that enters into an agreement with Public Health to provide services under the program;

(5) as only four of the former municipalities offered non-mandatory dental treatment and each program was different in terms of the target groups served and the coverage provided, the Medical Officer of Health take steps to implement appropriate information and operating systems and mechanisms across the whole City, which will:

(i) monitor the effectiveness of the program amalgamation;

(ii) maximize the efficiency and productivity from the use of scarce resources; and

(iii) accurately capture cost and other information that will reasonably identify cost per unit of services, and facilitate a meaningful comparison with other service delivery methods and models; and

(6) approval of the mixed model of service delivery recommended in this report be subject to Budget Committee consideration of service harmonization as part of the year 2000 budget review process.

3. REVIEW OF THE HARMONIZED

DENTAL PROGRAM.

(Report not yet available)

4. TORONTO ANIMAL SERVICES REVIEW.

(Report not yet available)

5. WILDLIFE STRATEGY FOR THE CITY OF TORONTO

AND RESPONSE TO RACCOON RABIES.

Medical Officer of Health

(November 5, 1999)

Presenting Toronto Public Health's Wildlife Strategy and the recommended response to the prevention and control of raccoon rabies, and recommending that, subject to final decisions of the Board of Health and City Council regarding the Animal Services Review, the Board of Health:

(1) endorse the Wildlife Strategy, with a principal focus on rabies prevention, as outlined in this report;

(2) recommend additional funding to the Public Health operating budget of:

(i) $60,000.00 for the year 2000 ($120,000.00 annualized) to implement the educational components of the Wildlife Strategy;

(ii) $30,000.00 one-time in 2000 to investigate the most effective ways of vaccinating raccoons and to conduct surveillance for the detection and prevention of rabies within Toronto's raccoon population;

(iii) $50,000.00 one-time in 2000 for research and development into appropriate policies and procedures to prevent human rabies that may result from Raccoon Rabies exposures; and

(iv) $6,000.00 annually for the purchase of traps to implement a point control program;

(5) endorse the establishment of:

(i) an active surveillance program for Raccoon Rabies within Toronto, focusing on high-risk areas and bordering green spaces, and that this report be initiated by the Medical Officer of Health at the appropriate time, in consultation with the Ontario Ministry of Natural Resources;

(ii) a raccoon rabies vaccination program within Toronto using the most effective methods available, and that this program be initiated by the Medical Officer of Health at the appropriate time, in consultation with the Ontario Ministry of Natural Resources; and

(iii) a Raccoon Rabies committee involving bordering health units, the Ministry of Health and the Ministry of Natural Resources, to ensure that Toronto Public Health is well informed about Raccoon Rabies in Ontario;

request the Ontario Minister of Health to add the City of Toronto to Table 1 of the Province of Ontario Regulation 567 (Rabies Immunization), thereby making the vaccination of dogs and cats mandatory across the entire City;

(4) request the Medical Officer of Health to report back to the Board of Health on the recommended polices and financial implications of a revised City response to potential rabies exposures once the necessary research is completed;

(5) refer this report to the Budget Advisory Committee for consideration during the 2000 operating budget process; and

(6) refer this report to the Animal Services Advisory Sub-Committee to hear public deputations and make recommendations back to the Board of Health for its January 2000 meeting.

7. ANIMAL SHELTERING SERVICES FOR WARDS 19-26 -

TORONTO HUMANE SOCIETY CONTRACT.

Medical Officer of Health

(November 5, 1999)

Respecting the extension of an interim arrangement for the provision of animal sheltering and related services for Wards 19 to 26, pending the results of the comprehensive review of options for the long term provisions of animal services in the City and recommending that:

(1) the Chief Administrative Officer and the Medical Officer of Health be authorized to extend the contract to June 30, 1999, between the Toronto Humane Society and the City of Toronto for the provision of animal sheltering and related services for Wards 19 and 26 for a total of $363,000.00 or $60,500.00 per month, upon the amended terms and conditions, in a form and content satisfactory to the City Solicitor; and

(2) the contract between the City and the Toronto Humane Society (the "TSH") be further amended to require the TSH to impound stray animals for a minimum period of five days.

3. PREVENTION AND CONTROL OF INFLUENZA

OUTBREAKS IN LONG-TERM CARE FACILITIES.

Medical Officer of Health

(October 25, 1999)

Recommending that:

(1) the Ministry of Health and Long-Term Care issue a protocol using existing legal or regulatory authority to mandate influenza immunization for health care workders in long-term care facilities for the 2000/2001 season, if vaccination rates of staff in Long-Term Care facilities are below 90 percent in any institution in the 1999/2000 season;

(2) the Long-Term Care Branch of the Ministry of Health develop a protocol for influenza control that addresses the prescribing, usage and funding of antiviral drugs during an influenza outbreak at a long-term care facility;

(3) the Ministry of Health and Long-Term Care designate specific funding to their Long-Term Care Division for an Infaction Control Practitioner in every Long-Term Care facilitiy;

(4) Toronto Public Health work with Long-Term Care facilities to develop a communication plan to ensure that their employees are aware of the Influenza Prevention and Surveillance Protocol for Ontario Long-Term Care facilities, relevant policies of the facility and their implications; and

(5) the Board of Health send a copy of this report to other Boards of Health in Ontario requesting that they adopt similar recommendations.

6. CANADA WIDE STANDARDS FOR

MERCURY IN POWER GENERATING SECTOR.

Medical Officer of Health

(November 4, 1999)

Providing information and recommendations on the Canada Wide Standard (CWS) being developed for mercury emissions from coal-fired generating stations; and recommending that:

(1) the Board of Health recommend that City Council write to the Federal Minister of the Environment to establish a Canada Wide Standard (CWS) for mercury that would effectively cap mercury emissions from Ontario's coal-fired generating stations at 45 kilograms by the year 2002;

(2) this report be forwarded to the Environmental Task Force and the Toronto Interdepartmental Environmental Committee for information; and

(3) this report be sent to all municipalities in the Province with a population of 50,000 people for information and endorsement.

4. HEALTH EFFECTS OF WIRELESS TELEPHONE

TRANSMISSION TOWERS.

Medical Officer of Health

(November 5, 1999)

Responding to a request from the Urban Environment and Development Committee for a review and report on a Prudent Avoidance Policy for the siting of wireless (cellular) telephone transmission towers, and recommending that:

(1) the Board of Health endorse the adoption of a Prudent Avoidance Policy in the siting of base cellular telephone antennas in the City of Toronto;

(2) the Board of Health forward this report to the Telecommunications Steering Committee for their information and any public consultation they deem appropriate;

(3) the Board of Health request the Telecommunications Steering Committee to incorporate a Prudent Avoidance Policy in a protocol for the siting of base cellular telephone antennas in the City of Toronto which includes the following:

(a) applicants who wish to install new antennas or modified antennas must demonstrate that radio frequency (RF) exposures in those areas namely used by people other than telecommunications workers (e.g., roof-top gardens, balconies, or grounds) will be at least 100 times lower than those currently recommended by Safety Code 6;

(b) in situtations where residents express concern over an existing base cellular telephone antenna, the owner and/or operator of the facility be requested to monitor levels of radio frequency (RF) fields around the antenna and provide this information to the affected community and the Telecommunications Steering Committee; and

(c) a mechanism for notifying residents of a proposed site for new telephone base antennas should be developed, which includes the advantages of using the proposed site, alternative sites considered, and the maximum expected exposure to RF due to installation in areas that the public or building occupants would normally use;

(4) City Council request the Federal Minister of Industry to ensure adherence to the City of Toronto's Prudent Avoidance Policy when granting approval for the siting of base cellular telephone antennas in the City of Toronto; and

(5) the Medical Officer of Health forward this report for information purposes to the Federal Minister of Health, all other Boards of Health in Ontario, and to the Toronto District School Board and the Toronto Catholic District School Board.

10. STANDARDS IN FOOD BANKS.

Medical Officer of Health

(October 25, 1999)

Respecting the adequacy of the standards of food donated to and distributed by food banks as requested by the Board of Health at its meeting on September 12, 1999; and recommending that the Board of Health receive this report for information.

11. POSTING WARNING SIGNS RELATING TO

ALCOHOL CONSUMPTION AND PREGNANCY.

Councillor John Adams, Midtown

(November 3, 1999)

Recommending that the Board of Health request the newly established Substance Abuse Sub-Committee to assess the impact, efficacy and cost of alcohol warning signs posted in restaurants and bars related to pregnancy as soon as the sub-committee convenes, and report back to the Board of Health in spring 2000.

ANY OTHER MATTERS