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Decision Document |
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Board of Health |
Meeting No. | 22 | Contact | Candy Davidovits, Committee Administrator | |
Meeting Date |
Monday, April 20, 2009 |
Phone | 416-392-8032 | |
Start Time |
1:00 PM |
boh@toronto.ca | ||
Location |
Committee Room 1, City Hall
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Chair | Councillor John Filion |
The Decision Document is for preliminary reference purposes only. Please refer to the Board of Health’s Report to City Council or to the Minutes for the official record.
How to Read the Decision Document: • Recommendations of the Board of Health to City Council appear after the item heading. • Other action taken by the Board on its own authority, which does not require Council’s approval, is listed in the decision document under the heading “Decision Advice and Other Information ”. • Declarations of Interest, if any, appear at the end of an item.
Minutes Confirmed – February 10, 2009 |
HL22.1 | ACTION |
Amended |
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Ward: All |
Food Safety and Foodborne Illness in Toronto |
Decision Advice and Other Information |
The Board of Health:
1. requested the Government of Ontario to implement the outstanding recommendations of the 2005 Report of the Meat Regulatory and Inspection Review (the Haines Report), including:
i. require all food premises to implement a provincially-developed food safety program based on a Hazard Analysis Critical Control Point approach;
ii. amend the Health Protection and Promotion Act to require that all food premise operators and at least one other person present in the food premise at all times of operation be a certified food handler;
iii. develop and implement a province-wide public health investigation, compliance and enforcement policy for all food premises; and
iv. develop and implement uniform consumer food safety education programs;
2. requested that the Ontario Ministry of Health and Long-Term Care explore the feasibility of making all health service data on gastrointestinal illness (the Integrated Public Health Information System; Telehealth Ontario; the Ontario Laboratory Information System; and the new Emergency Room Information System) available to local public health units and to the Ontario Agency for Health Protection and Promotion to enable early identification of potential clusters of foodborne illness;
3. requested the Ontario Agency for Health Protection and Promotion enhance laboratory capacity for rapid identification of agents of foodborne illness in Ontario;
4. requested that the Government of Ontario explore legislative and funding options to ensure food handlers are compensated for absences from work due to gastrointestinal illness;
5. requested that the Ministry of Health and Long-Term Care (MOHLTC) ensure that Boards of Health receive sufficient provincial funding to comply fully with the Food Safety Protocol of the Ontario Public Health Standards;
6. requested that the Government of Ontario and the Canadian Food Inspection Agency require full and timely disclosure of the food safety performance of all food premises they inspect, including premises inspected by local public health units;
7. requested that the Government of Ontario and the Government of Canada, with input from local public health units, review: the Foodborne Illness Outbreak Response Protocol to Guide a Multi-Jurisdictional Response (FIORP); the Ontario Foodborne Health Hazard and Illness Outbreak Investigations Memorandum of Agreement; and the Food Premises Plant Investigation: Multi-agency Roles document, to ensure that:
i. roles and responsibilities of responding agencies are clear and consistent in all protocols, including lead responsibility for public communications;
ii. regular training, including multi-agency simulation exercises, is provided for staff of all responding agencies; and
iii. a process is put in place for activating FIORP and striking an outbreak coordination committee of responding agencies whenever a significant multi-jurisdictional outbreak occurs;
8. requested the Canadian Food Inspection Agency to review its food recall and public notification policies and procedures to ensure that:
i. a food product is recalled and the public notified when epidemiologic evidence provides reasonable and probable grounds to conclude that cases of foodborne illness are linked to consumption of a food product; and
ii. public communications and recall verification procedures are thorough and effective in reducing exposure to a potentially hazardous food product;
9. requested the Medical Officer of Health to submit a report to the Board of Health outlining a more effective public education strategy to reach out to those communities that have been less fortunate in terms of getting useful information on healthy food and prevention of foodborne illness;
10. requested the Medical Officer of Health to report to the Board of Health on whether there are additional measures Toronto Public Health can take to permanently close food premises with an ongoing record of serious health violations; and
11. forwarded this report to the federal Ministers of Health and Agriculture andAgrifood; the Canadian Food Inspection Agency; the Public Health Agency of Canada (PHAC); SheilaWeatherill; the Ontario Ministers of Health and Long Term Care, Agriculture and Rural Affairs, and Natural Resources; the Ontario Agency for Health Protection and Promotion; the Association of Local Public Health Agencies; the Ontario Public Health Association; and all Boards of Health in Ontario.
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Summary |
This report provides a summary of the key findings and issues raised in two attached reports, Food Safety in Toronto and Foodborne Illness in Toronto.
Food is essential for health and for Toronto’s social, environmental, cultural and economic well-being. However, recent and recurring outbreaks of foodborne illness, both close to home and elsewhere, remind us that food can also be a source of illness and disease. Toronto Public Health (TPH) plays a critical role in contributing to the maintenance of food safety systems and in the surveillance, detection and investigation of foodborne illness.
Illness from food contaminated with micro-organisms is very common and legally reportable to public health, but most cases are not severe and go unreported, so that routine data greatly underestimate the full burden of illness. The Foodborne Illness in Toronto report presents an epidemiological overview of disease trends in Toronto and establishes a new estimate of the full burden of foodborne illness: 437 thousand cases per year, or one in every six residents; the report estimates the economic impact in health care costs and lost productivity to be in the range of $500 million annually.
To reduce the risk of foodborne illness, governments at all levels work together to regulate and monitor food safety at every stage in commercial food preparation from farm to table. The report Food Safety in Toronto describes the roles and functions of the responsible agencies and describes how these organizations work together when outbreaks of foodborne illness occur. The report also identifies weaknesses in current food safety systems and inter-agency cooperation and calls for improvements to be made by federal and provincial agencies.
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Background Information |
Food Safety and Foodborne Illness in Toronto - Staff Report (http://www.toronto.ca/legdocs/mmis/2009/hl/bgrd/backgroundfile-20464.pdf) Appendix A - Foodborne Illness in Toronto (http://www.toronto.ca/legdocs/mmis/2009/hl/bgrd/backgroundfile-20469.pdf) Appendix B - Food Safety in Toronto (http://www.toronto.ca/legdocs/mmis/2009/hl/bgrd/backgroundfile-20470.pdf) |
Communications |
(April 20, 2009) presentation from Dr. David McKeown, Medical Officer of Health (HL.New.HL22.1.1) |
HL22.2 | ACTION |
Adopted |
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Ward: All |
Diabetes Prevention Strategy - Update |
Decision Advice and Other Information |
The Board of Health recommended to the Budget Committee that:
1. The Toronto Public Health 2009 Approved Operating Budget be increased by $638,728 gross and $0.0 net, and five temporary positions, to reflect confirmed one-time funding from the Ministry of Health Promotion for the Diabetes Prevention Strategy for the period April – December 2009. |
Origin |
(April 1, 2009) Report from Medical Officer of Health |
Summary |
This report provides information on the implementation and funding of a new Diabetes Prevention Strategy for the community and the workplace in Toronto. A pilot project will be conducted between January 2009 and March 2010 and will be100% funded by the Ministry of Health Promotion (MHP). Toronto Public Health (TPH) has received funding from January 1, 2009 to March 31, 2009 of $186,065 which is included in TPH’s 2009 Approved Operating Budget. Funding has now been confirmed for April 2009 to March 2010 in the amount of $851,637.
Diabetes is a major public health challenge and is one of the fastest growing diseases in Canada and around the world. As of 2004, over two million Canadians are currently living with diabetes and that number is expected to reach three million by 2010. The Institute for Clinical Evaluative Studies (ICES) and St. Michael’s Hospital’s 2007 report Neighbourhood Environments and Resources for Healthy Living – A Focus on Diabetes in Toronto (known as the Diabetes Atlas) estimated the Toronto prevalence rate for diabetes was 7.6%, compared to 6.2% for the rest of Ontario. This was based on 1998/99 hospitalization and physician billing data.
This project will focus efforts on implementing diabetes prevention activities in two communities where adults are at high risk for diabetes and in six workplaces using a comprehensive workplace approach.
The purpose of this report is to inform the Board of Health that funding for the remaining 12 months of the project has been confirmed. The report seeks approval to adjust the Toronto Public Health 2009 Operating Budget to include the related funding and to increase the staff complement by five temporary positions. |
Background Information |
Diabetes Prevention Strategy - Update - Staff Report (http://www.toronto.ca/legdocs/mmis/2009/hl/bgrd/backgroundfile-20179.pdf) |
HL22.3 | ACTION |
Adopted |
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Ward: All |
2009 Public Health Champion Awards |
Decision Advice and Other Information |
The Board of Health:
1. directed that the Public Health Champion Awards Selection Committee continue to be comprised of three members of the Board of Health and one member from each of the four Local Health Committees;
2. reappointed the Co-Chairs and Board of Health members of the 2008 Public Health Champion Awards Selection Committee for 2009. Board of Health members are Councillor Gord Perks, Vaijayanthi Chari, and Wangari Muriuki. The committee co-chairs are Vaijayanthi Chari and Wangari Muriuki;
3. requested the Local Health Committees to appoint one member each to the 2009 Selection Committee;
4. requested the Selection Committee to convene in September 2009 and report its selections to the October Board of Health meeting; and
5. requested the Medical Officer of Health and the Public Health Champion Awards Selection Committee to implement the revisions outlined in this report to the nomination and promotion processes and timelines for 2009. |
Origin |
(March 31, 2009) Report from Medical Officer of Health |
Summary |
The Public Health Champion Awards were established as a legacy initiative commemorating the 125th anniversary of Toronto Public Health. They provide public recognition to individuals and organizations that have made an outstanding contribution to public health in Toronto. This report summarizes key findings from the evaluation of the 2008 Public Health Champion Awards and outlines the recommended changes to the nomination and selection process for the 2009 awards. |
Background Information |
2009 Public Health Champion Awards - Staff Report (http://www.toronto.ca/legdocs/mmis/2009/hl/bgrd/backgroundfile-20178.pdf) |
HL22.4 | ACTION |
Adopted |
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Ward: All |
Budget Adjustments to the Toronto Public Health 2009 Approved Operating Budget |
Decision Advice and Other Information |
The Board of Health recommended to the Budget Committee that:
1. City Council approve the following adjustments to Toronto Public Health’s 2009 Approved Operating Budget:
a. a reduction of $307.9 thousand gross and $0.0 net, and an increase of 4 temporary positions to reflect confirmed funding from various Provincial ministries and external sources (Attachment 1, Table1); and
b. an increase of $110.4 thousand gross and $0.0 net, to reflect unspent 2008 funds from Health Canada required in 2009 (Attachment 1, Table 2). |
Origin |
(March 31, 2009) Report from Medical Officer of Health |
Summary |
The purpose of this report is to request budget adjustments to Toronto Public Health’s (TPH) 2009 Approved Operating Budget due to the following:
a. Confirmation of funding from various Provincial ministries and external sources received after the submission of the 2009 Operating Budget request in September 2008; and
b. Unspent 2008 funds for 100% externally funded programs required in 2009. |
Background Information |
Budget Adjustments to the Toronto Public Health 2009 Approved Operating Budget - Staff Report (http://www.toronto.ca/legdocs/mmis/2009/hl/bgrd/backgroundfile-20176.pdf) |
HL22.5 | Information |
Received |
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Ward: All |
Toronto Public Health Operating Budget Variance for the Twelve Months ended December 31, 2008 |
Decision Advice and Other Information |
The Board of Health received, for information, the report (March 31, 2009) from the Medical Officer of Health. |
Origin |
(March 31, 2009) Report from 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 twelve months of operation ending on December 31, 2008.
At year-end, TPH gross expenditures were below budget by $4,693.4 thousand or 2.2 percent attributable to the underspending of $3,128.4 thousand in Salaries and Benefits and $1,565.0 thousand in non-payroll. Revenue was underachieved by $4,182.0 thousand or 2.5 percent due to under-expenditures in provincial cost shared programs, under- spending in capital projects, lower than planned food handler training registrations and Ontario Works Dental services recoveries.
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Background Information |
Toronto Public Health Operating Budget Variance for the Twelve Months ended December 31, 2008 - Staff Report (http://www.toronto.ca/legdocs/mmis/2009/hl/bgrd/backgroundfile-20174.pdf) Schedule 1 (http://www.toronto.ca/legdocs/mmis/2009/hl/bgrd/backgroundfile-20181.pdf) Schedule 2 (http://www.toronto.ca/legdocs/mmis/2009/hl/bgrd/backgroundfile-20182.pdf) Schedule 3 (http://www.toronto.ca/legdocs/mmis/2009/hl/bgrd/backgroundfile-20183.pdf) Schedule 4 (http://www.toronto.ca/legdocs/mmis/2009/hl/bgrd/backgroundfile-20184.pdf) |
HL22.6 | Information |
Received |
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Ward: All |
Update on City Council Approved Toronto Public Health 2009 Operating Budget |
Decision Advice and Other Information |
The Board of Health received, for information, the report (April 1, 2009) from the Medical Officer of Health. |
Origin |
(April 1, 2009) Report from Medical Officer of Health |
Summary |
This report provides the Board of Health (BOH) with an update on the Toronto Public Health (TPH) 2009 Operating Budget approved at the City Council meeting of March 31, 2009.
City Council approved a TPH 2009 Operating Budget of $217,992.9 thousand gross / $43,417.7 thousand net, including a base budget of $211,415.8 thousand gross / $43,465.5 thousand net and an adjustment of $6,577.1 thousand gross / -$47.8 thousand net relating to base budget reductions and service enhancements. This budget represents an increase of $7,379.0 thousand or 3.5 percent in gross / $515.4 thousand or 1.2 percent in net expenditures from the 2008 Operating Budget.
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Background Information |
Update on City Council Approved Toronto Public Health 2009 Operating Budget - Staff Report (http://www.toronto.ca/legdocs/mmis/2009/hl/bgrd/backgroundfile-20175.pdf) |
HL22.7 | Information |
Received |
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Ward: All |
Toronto Public Health Capital Budget Variance for the Twelve Months ended December 31, 2008 |
Decision Advice and Other Information |
The Board of Health received, for information, the report (March 31, 2009) from the Medical Officer of Health. |
Origin |
(March 31, 2009) Report from 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 twelve-month period ended December 31, 2008 (Appendix 1).
Toronto Public Health spent $3.191 million or 59.5 percent of the 2008 approved cash flow of $5.363 million as of December 31, 2008. The year-end under expenditure of $2.171 million will be carried forward to 2009.
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Background Information |
Toronto Public Health Capital Budget Variance for the Twelve Months ended December 31, 2008 - Staff Report (http://www.toronto.ca/legdocs/mmis/2009/hl/bgrd/backgroundfile-20173.pdf) Appendix 1 (http://www.toronto.ca/legdocs/mmis/2009/hl/bgrd/backgroundfile-20180.pdf) |
HL22.8 | Information |
Received |
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Ward: All |
Service Agreements Awarded and Executed by the Medical Officer of Health for 2009 |
Decision Advice and Other Information |
The Board of Health received, for information, the report (March 30, 2009) from the Medical Officer of Health. |
Origin |
(March 30, 2009) Report from 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 2009, according to the delegation of authority by City Council. |
Background Information |
Service Agreements Awarded and Executed by the Medical Officer of Health for 2009 - Staff Report (http://www.toronto.ca/legdocs/mmis/2009/hl/bgrd/backgroundfile-20177.pdf) |
HL22.9 | Information |
Received |
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Ward: All |
Pandemic Influenza Preparedness Update |
Decision Advice and Other Information |
The Board of Health received, for information, the report (April 1, 2009) from the Medical Officer of Health. |
Origin |
(April 1, 2009) Report from Medical Officer of Health |
Summary |
The report provides updated information on the epidemiology of influenza and outlines the progress Toronto Public Health (TPH) has made in its pandemic influenza preparedness activities since the last report to the Board of Health. |
Background Information |
Pandemic Influenza Preparedness Update - Staff Report (http://www.toronto.ca/legdocs/mmis/2009/hl/bgrd/backgroundfile-20186.pdf) |
HL22.10 | Information |
Received |
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Ward: All |
Local Health Committee Minutes |
Decision Advice and Other Information |
The Board of Health received, for information, the minutes of the Scarborough Local Health Committee meeting held on January 12, 2009. |
Summary |
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Background Information |
Scarborough Local Health Committee Minutes - January 12, 2009 (http://www.toronto.ca/legdocs/mmis/2009/hl/bgrd/backgroundfile-20187.pdf) |
HL22.11 | Information |
Received |
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Ward: All |
Establishment of a Toronto Water Lead Content Mitigation Rebate Program |
Decision Advice and Other Information |
The Board of Health received, for information, the letter (April 8, 2009) from the Public Works and Infrastructure Committee. |
Origin |
(April 8, 2009) Letter from Public Works and Infrastructure Committee |
Summary |
The Public Works and Infrastructure Committee, on April 8, 2009, considered the report (March 25, 2009) from the General Manager, Toronto Water, and the Medical Officer of Health entitled “Establishment of a Toronto Water Lead Content Mitigation Rebate Program”, and submitted a copy to the Board of Health for its information. |
Background Information |
Establishment of a Toronto Water Lead Content Mitigation Rebate Program - Letter (http://www.toronto.ca/legdocs/mmis/2009/hl/bgrd/backgroundfile-20441.pdf) Establishment of a Toronto Water Lead Content Mitigation Rebate Program-Staff Report (http://www.toronto.ca/legdocs/mmis/2009/hl/bgrd/backgroundfile-20445.pdf) Transmitted from City Council - Referral of Member Motion MM30.5 (http://www.toronto.ca/legdocs/mmis/2009/hl/bgrd/backgroundfile-20446.pdf) |
HL22.12 | ACTION |
Adopted |
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Ward: All |
Purchase Order Amendment to Sole Source Contract 47012030 with Loblaw Companies Limited for Food Certificates |
Decision Advice and Other Information |
The Board of Health:
A. recommended to the Government Management Committee that:
1. City Council grant authority to the Medical Officer of Health to extend and increase current sole source contract 47012030 with Loblaw Companies Limited, for the purchase of food certificates, under the same terms and conditions, for the period June 1, 2009 to May 31, 2011 by a total estimated amount of $850,000.00, revising the current contract value from $948,000.00 to $1,798,000.00, taxes not applicable; and
2. City Council authorize the Medical Officer of Health to award, amend and execute, on an ongoing basis, the purchase of goods agreement for the purchase of food certificates from Loblaw Companies Limited, Sobeys (Ontario Division) and Metro Ontario Inc. within the approved budget and in accordance with established terms and conditions; and
B. forwarded the report (April 15, 2009) from the Medical Officer of Health and the Acting Director, Purchasing and Materials Management, to the Government Management Committee for consideration at its May 12, 2009, meeting. |
Origin |
(April 15, 2009) Report from Medical Officer of Health and the Acting Director, Purchasing and Materials Management |
Summary |
This report requests authority to amend and extend the current sole source contract 47012030 to Loblaw Companies Limited for the purchase of food certificates for the period of June 1, 2009 to May 31, 2011 by an estimated amount of $850,000.00.
This report also requests City Council to delegate authority to the Medical Officer of Health to award, execute and amend on an ongoing basis the purchase of goods agreement for the purchase of food certificates from the three major grocery chains: Loblaw Companies Limited, Sobeys (Ontario Division) and Metro Ontario Inc. within the Toronto Public Health approved budget.
Food certificates are used to support the access of pregnant women, young families, children, and Tuberculosis (TB) clients to nutritional food and to promote healthy eating and provide food skills training which are critical components of a number of Toronto Public Health (TPH) programs. Food certificates are given to TPH clients in accordance with specific eligibility criteria and program policies and procedures. Acquiring food certificates from Loblaw along with certificates from other major grocery chains ensures that clients have a choice of grocery stores where certificates can be used.
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Background Information |
Purchase Order Amendment to Sole Source Contract 47012030 with Loblaw Companies Limited - Staff Report (http://www.toronto.ca/legdocs/mmis/2009/hl/bgrd/backgroundfile-20459.pdf) |
HL22.13 | ACTION |
Amended |
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Ward: All |
Health Impacts of Union-Pearson Rail Link |
Decision Advice and Other Information |
The Board of Health requested that the Medical Officer of Health conduct an independent assessment of the health impacts of the proposed Union-Pearson Rail line on the local air shed and report back to the Board of Health on his findings. |
Origin |
(February 27, 2009) Memo from Councillor Paula Fletcher |
Summary |
Letter (February 27, 2009) from Councillor Paula Fletcher requesting that the Medical Officer conduct an independent study of the health impacts of the proposed Union-Pearson Rail Line on the local air shed and report back to the Board of Health on his findings. |
Background Information |
Union-Pearson Rail Link - Letter (http://www.toronto.ca/legdocs/mmis/2009/hl/bgrd/backgroundfile-20502.pdf) |
Meeting Sessions |
Session Date | Session Type | Start Time | End Time | Public or Closed Session |
2009-04-20 | Afternoon | 1:05 PM | 2:20 PM | Public |
Attendance |
Date and Time | Quorum | Members |
2009-04-20 1:05 PM - 2:20 PM (Public Session) |
Present |
Present: Bravo, Chari, Cho, Davis, Filion, Fletcher, Lee, Muriuki, Nelson, Perks, Sterling, Wong Not Present: O'Brien |