The Board of Health:

1.         received, for information, the presentation by the Co-Chairs, Public Health Champion Awards Selection Committee; and

2.         congratulated the recipients of the 2009 Public Health Champion Awards:

             -          Lillie Johnson, Canadian Sickle Cell Society, in the individual category; and

             -          Community Matters Toronto in the group/organization category; and

3.         directed that the documents submitted on behalf of the nominees remain confidential as they contain personal information about identifiable individuals, including City or local board employees.

Vaijayanthi Chari and Valerie Sterling, Co-Chairs of the Public Health Champion Awards Selection Committee, announced that the recipients of the 2009 Public Health Champion Awards will be:

-           Lillie Johnson, Canadian Sickle Cell Society, in the individual category; and

-           Community Matters Toronto in the group/organization category.

The Co-Chairs of the Public Health Champion Awards Selection Committee to announce the recipients of the 2009 Public Health Champion Awards.

The Board of Health:

1.         received, for information, the update on pandemic influenza preparedness; and

2.         referred the submission from Beric German and Anne Egger, Toronto Pandemic Homeless Working Group, together with the submissions from other speakers, to the General Manager, Shelter, Support and  Housing Administration, in consultation with the Medical Officer of Health, for consideration in any future reports and other appropriate action.

The Board of Health directed that:

1.          The CEOs of acute care hospitals, complex continuing care hospitals, long term care homes and nursing agencies be urged to provide  a comprehensive program to promote annual influenza immunization of health care workers (HCWs). 

2.         The Ontario Ministry of Health and Long-Term Care be requested to include annual institutional HCW influenza immunization rates as an indicator within the publicly reported Ontario Patient Safety Initiatives.

3.          The Medical Officer of Health be requested to report annually on influenza immunization coverage rates among HCWs in Toronto healthcare facilities for the next three years.

4.          The Ontario Minister of Health and Long-Term Care be urged to explore options to make annual influenza immunization mandatory for HCWs if coverage rates for healthcare institutions do not improve significantly over the next year.

5.         This report be forwarded to the Chief Medical Officer of Health for Ontario, the CEOs of all Toronto acute care and complex continuing care hospitals, and long term care homes, the CEOs of all Toronto-area Local Health Integration Networks (LHINs) and Regional Infection Control Networks (RICNs), the General Manager of City of Toronto Long-Term Care Homes and Services, the Chief and General Manager of Toronto Emergency Medical Services (EMS), Toronto Practitioners of Infection Control (TPIC), the Ontario Agency for Health Protection and Promotion (OAHPP), all Ontario Boards of Health, the Association of Local Public Health Agencies (alPHa), and the Ontario Public Health Association (OPHA).

The purpose of this report is to further advise the Board of Health about Ministry of Health Promotion (MHP) funding reductions to the 100% funded Smoke-Free Ontario Act (SFOA) enforcement program.

As reported under item HL24.2 of the June 16 Board of Health meeting, MHP notified Toronto Public Health (TPH) of reductions to the Youth Action Alliance program, the High School Grants program and enforcement of the SFOA across Ontario.  At the time of that report, MHP had not specified the amount of the reduction to the TPH enforcement program.

On August 25, 2009, MHP notified TPH that the enforcement funding allocation for the City of Toronto would be reduced by $99,561 based on the Ministry’s fiscal year (April 1, 2009 – March 31, 2010). This report will will outline the impact of this reduction on the TPH tobacco enforcement program.

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, 2009 (Appendix 1).

Toronto Public Health spent $1.021 million or 18 percent of the 2009 approved cash flow of $5.670 million as of June 30, 2009.

The year-end capital expenditure is projected to be $3.800 million or 67 percent of the approved cash flow.

The Board of Health recommended to the Budget Committee that:

1.         City Council increase the Toronto Public Health 2009 Operating Budget for one-time funding of $500.2 thousand gross and $0.0 net, that is provided by the Ministry of Health and Long-Term Care to cover the cost of implementation of the PECS Solution used to manage electronic record keeping at the planned pH1N1 mass immunization clinics.

2.         City Council confirm the authority of the Medical Officer of Health to execute the Protocol for Electronic Clinic System (PECS) License Agreement and the PECS Training and Service Agreement, between the Regional Municipality of Niagara and the City of Toronto, dated September 29, 2009.

The purpose of this report is to request a budget adjustment to Toronto Public Health’s (TPH) 2009 Operating Budget due to confirmation of 100 per cent funding from the Ontario Ministry of Health and Long-Term Care (MOHLTC), for implementation of the Protocol for Electronic Clinic System (PECS), an integral part of which is the software solution known as Clinic Event Management System (CEMS). This system and software was developed by the Niagara Region Public Health Unit and is being recommended and funded for the use of Ontario Public Health Units by the Ontario Ministry of Health and Long-Term Care for the purpose of managing the electronic record keeping associated with the mass immunization clinics that are being planned as part of the pandemic H1N1 (pH1N1) response.

This report also seeks City Council’s confirmation of the Medical Officer of Health’s authority to enter into a licence agreement and an agreement for training and support with the Regional Municipality of Niagara for the purpose of implementing the PECS Solution to support electronic record keeping at the pH1N1 mass immunization clinics.

The Board of Health Budget Sub-Committee on October 1, 2009, considered a report (October 1, 2009) from the Medical Officer of Health, addressed to the Board of Health, entitled “Budget Adjustment to the Toronto Public Health 2009 Approved Operating Budget and Confirmation of Authority to Sign Agreements”.

The Board of Health recommended to the Budget Committee that:

1.         City Council approve a 2010 Capital Budget with a total project cost of $5.227 million and a 2010 cash flow of $0.843 million and future year commitments of $4.384 million as detailed in Appendix 3, “Toronto Public Health’s 2010 Capital Budget”. The 2010 Capital Budget Submission consists of the following:

a.         new cash flow funding for:

i.          two new sub-projects and five changes in scope sub-projects with a 2010 total project cost of $5.227 million that requires cash flow of $0.843 million in 2010, and future year commitments of $0.995 million in 2011, $1.508 million in 2012, and $1.881 million in 2013; and

ii.          six previously approved sub-projects with a 2010 cash flow of $3.499 million and future year commitments of $2.858 million in 2010 and $1.892 million in 2012; and

b.         2009 approved cash flow for four previously approved sub-projects, with carry-forward funding from 2009 into 2010, totalling $1.870 million.

2.         City Council approve a 2011-2014 Capital Plan of $4.919 million with future years estimates of  $1.519 million in 2013; and $3.4 million in 2014 as outlined in Appendix 1 – Toronto Public Health 2010 Capital Budget and 2011-2019 Capital Plan.

3.         The net operating impacts of $0.248 million for 2011, $0.149 million for 2012, $0.084 million for 2013, $0.018 million for 2014, and $0.007 million for 2015 emanating from the approval of the 2010 Capital Budget as detailed in Appendix 2, “Toronto Public Health 2010-2019 Operating Budget Impact of Capital” be considered within the future years’ Toronto Public Health Operating Budget submissions.

4.         This report be considered by the Budget Committee during the 2010 budget process.

This report provides an overview of Toronto Public Health’s (TPH) 2010 Capital Budget,

and 2011-2019 Capital Plan Submission for approval.

TPH is submitting a 2010 – 2019 Capital Budget and Plan request of $35.395 million, including a 2010 Capital Budget of $4.342 million and future year commitments of $ 9.134 million and a 2011 – 2019 Capital Plan of $21.919 million. The Debt Affordability Target provided by the City for TPH is $4.342 million in 2010, $3.853 million in 2011 and, $3.400 million in each year from 2012 to 2019 for a total of $35.395 million.

The 10-Year Capital Budget and Plan request will provide funding for thirteen Information and Technology (IT) projects that support improvement of service delivery with the development and enhancement of systems while complying with provincial mandatory reporting system requirements. The associated operating impact of these thirteen IT projects at the end of ten years is $2.485 million gross and $0.793 million net for ten new positions and ongoing costs for service and maintenance.

The Board of Health Budget Sub-Committee on October 1, 2009, considered a report (September 29, 2009) from the Medical Officer of Health, addressed to the Board of Health, entitled “Toronto Public Health’s  2010 – 2019 Capital Budget and Plan Submission”.

The Board of Health recommends that:

1.         City Council appoint the physicians named in Confidential Attachment 1 as Associate Medical Officers of Health for the City of Toronto Health Unit.

2.         City Council transmit Recommendation 1 to the provincial Minister of Health and Long-Term Care for approval of the appointments in this recommendation.

3.         City Council repeal the by-laws appointing former Associate Medical Officers of Health outlined in Confidential Attachment 1.

4.         City Council grant authority to introduce the necessary Bill in Council to appoint the physicians named in Confidential Attachment 1 as Associate Medical Officers of Health, subject to the approval of the provincial Minister of Health and Long- Term Care.

5.         City Council grant authority to introduce the necessary Bill in Council to rescind the appointments of the Associate Medical Officers of Health named in Confidential Attachment 1.

At the Board of Health TB Sub-Committee meeting on September 17, 2009, Dr. Elizabeth Rea, Associate Medical Officer of Health, TB Prevention and Control, addressed the Sub-committee regarding OHIP coverage for new immigrants with Tuberculosis and advised that Tuberculosis continues to be a serious public health concern in Toronto and increasingly throughout the GTA, related largely to immigration patterns, and filed a draft letter.

The Board of Health:

 1.        disbanded the TB Sub-Committee as a Sub-Committee of the Board of Health.

2.         directed that the current members of the TB Sub-Committee continue to meet twice a year under the new name of the TB Coalition;

3.         directed that one (1) member of the Board of Health be appointed to the TB Coalition;

4.         appointed Fiona Nelson as the Board of Health representative to the TB Coalition.

The Board of Health TB Sub-Committee, on September 17, 2009, considered a verbal report from Marnie Kraguljac, Associate Director, TB Program, reviewing the accomplishments of the TB Program and the TB Sub-Committee to date, acknowledging the significant changes in the program for TB health and recommending that the Board of Health TB Sub-Committee discontinue its formal status as a Sub-Committee of the Board of Health.

•           Minutes of the North York Local Health Committee meeting held on April 21, 2009.

•           Minutes of the North York Local Health Committee meeting held on May 13, 2009.

•           Minutes of the North York Local Health Committee meeting held on June 9, 2009.

•           Minutes of the Scarborough Local Health Committee meeting held on May 11, 2009.

•           Minutes of the Scarborough Local Health Committee meeting held on June 8, 2009.