Members of the Board and Staff: Please keep this agenda and the accompanying material until the City Council meeting dealing with these matters has ended.  The City Clerk’s Office will not provide additional copies.

Special Assistance for Members of the Public: City staff can arrange for special assistance with some advance notice.  If you need special assistance, please call 416‑397-7767, TTY 416-338-0889 or e-mail boh@toronto.ca.

Closed Meeting Requirements: If the Board of Health wants to meet in closed session (privately), a member of the Board must make a motion to do so and give the reason why the Board has to meet privately.  (City of Toronto Act, 2006)

Notice to people writing or making presentations to the Board of Health: The City of Toronto Act, 2006 and the City of Toronto Municipal Code authorize the City of Toronto to collect any personal information in your communication or presentation to City Council or its committees.

The City collects this information to enable it to make informed decisions on the relevant issue(s). If you are submitting letters, faxes, e-mails, presentations or other communications to the City, you should be aware that your name and the fact that you communicated with the City will become part of the public record and will appear on the City’s website. The City will also make your communication and any personal information in it – such as your postal address, telephone number or e-mail address – available to the public, unless you expressly request the City to remove it.

The City videotapes committee and community council meetings. If you make a presentation to a committee or community council, the City will be videotaping you and City staff may make the video tapes available to the public.

If you want to learn more about why and how the City collects your information, write to the City Clerk's Office, City Hall, 100 Queen Street West, Toronto ON M5H 2N2 or by calling 416-392-8032.

Declarations of Interest under the Municipal Conflict of Interest Act.

Confirmation of Minutes - February 16, 2010

Speakers/Presentations – A complete list will be distributed at the meeting.

Communications/Reports

The Medical Officer of Health recommends that:

1.         The Board of Health urge all Toronto birthing hospitals to achieve Baby-Friendly designation as soon as possible, giving priority to:

a.         developing a written policy that covers all Ten Steps to Successful Breastfeeding, including a mechanism to evaluate the policy;

b.         helping mothers initiate breastfeeding within a half hour of birth;

c.         ensuring that newborn infants are not given food or drink other than breast milk unless medically indicated; and

d.         refraining from the practice of providing infant formula to mothers at hospital discharge.

2.         The Medical Officer of Health work in collaboration with Toronto birthing hospitals to support their efforts to achieve Baby-Friendly designation and re-assess compliance with the Ten Steps to Successful Breastfeeding; providing a progress report to the Board of Health in two years.

3.         The Medical Officer of Health ensure that Toronto Public Health achieve Baby-Friendly designation and provide a progress report to the Board of Health in two years.

4.         The Medical Officer of Health continue to work with key stakeholders to promote exclusive breastfeeding to six months of age using population-wide and targeted strategies, paying particular attention to those women less likely to exclusively breastfeed to six months (i.e. younger women, recent immigrants, women with lower levels of income, women having a Caesarean birth).

5.         The Medical Officer of Health continue to work with key stakeholders to develop and implement strategies to engage public facilities (e.g. malls, restaurants, recreational facilities, parks and the workplace) in breastfeeding friendly initiatives, thereby increasing the number of breastfeeding friendly places and supporting a women’s right to breastfeed in public.

6.         The Medical Officer of Health continue to work with key stakeholders to maintain high rates of breastfeeding intention and initiation, paying particular attention to those women who are less likely to plan to breastfeed or initiate breastfeeding (e.g. younger women, women with low levels of education and women with lower levels of family income).

7.         The Medical Officer of Health forward this report to the Ontario Minister of Health and Long-Term Care and the Better Outcomes Registry & Network (BORN) Ontario, acknowledging the Ministry's progress toward the development of an integrated perinatal data collection system and requesting that the Minister ensure that the Niday Perinatal database is collecting:

a.         accurate and complete infant feeding data to enable hospitals and community health services to monitor rates of initiation and any and exclusive breastfeeding; and

b.         key sociodemographic and sociocultural indicators to enable the identification of subpopulations at risk for low breastfeeding rates and adverse maternal/infant health outcomes.

8.         This report be forwarded to the Ministry of Health Promotion, Ministry of Health and Long‑Term Care, Ministry of Children and Youth Services, Provincial Maternal Newborn Advisory Committee, Ontario Public Health Association, Ontario Breastfeeding Committee, Child Health Integration Network of the Greater Toronto Area, Local Health Integration Networks that are responsible for Toronto birthing hospitals and Toronto Best Start Network.

 The Medical Officer of Health recommends that:

1.         The Board of Health write to the Premier of Ontario offering support for the Plan identified in the “With Our Best Future in Mind: Implementing Early Learning in Ontario” report, and calling on the Province to endorse the full plan and to ensure that:

a.         Boards of Health remain responsible for delivery of the Healthy Babies, Healthy Children (HBHC) program;

b.         Boards of Health receive sufficient and sustainable funding to support a full range of Reproductive Health and Child Health services in the Best Start Child & Family Centres (BSC&FC), including Healthy Babies Healthy Children, Preschool Speech and Language, and Infant Hearing.

2.         The Medical Officer of Health collaborate with Toronto Children’s Services (the Consolidated Municipal Service Manager) to seek opportunities to integrate appropriate early childhood public health program activities into child and family centres where feasible.

3.         This report be sent to the Minister of Children and Youth Services, the Minister of Education, the Minister of Health and Long-Term Care, the Minister of Health Promotion, the General Manager of Toronto Children’s Services Division, and the Toronto Best Start Network.

In June 2009, Dr Charles Pascal, the Special Advisor on Early Learning, presented his report “With Our Best Future in Mind:  Implementing Early Learning in Ontario”, to the Premier.  This report offers a bold vision for the transformation of early learning, extended child care, and family supports in Ontario.  Based on solid evidence and best practice, this vision for Ontario’s and Toronto’s young children and families offers significant potential for improving family access to service and optimizing developmental outcomes for children.

The Early Learning Plan proposed in the report includes a number of recommendations that have implications for public health funding, service, and accountability.  It is consistent with the goals of the Reproductive Health and Child Health requirements of the Ontario Public Health Standards and offers public health a new means of reaching out to pregnant women, young children and families.  Consequently it is recommended that the Board of Health support the overall vision of the Plan.

The provincial government has endorsed the full day learning and extended child care components of the Plan.  There is, however, less clarity about the Province’s commitment to the broader vision.

This report provides a general description of the implications of the Early Learning Report for public health services, and identifies those recommendations that the public health community and Toronto Public Health supports and those that may be of concern and/or require further clarity.  This report also describes provincial and local activities that ensure that public health is at the Early Years planning tables.

See Table on page 1 of the staff report for detailed financial impact information. 

The Deputy City Manager and Chief Financial Officer has reviewed this report and agrees with the financial impact information.

The Deputy City Manager and Chief Financial Officer has reviewed this report and agrees with the financial impact information.

Local Health Committees submitting the following:

-           Minutes of the Etobicoke/York Local Health Committee meeting held on June 11, 2009.

-           Minutes of the Etobicoke/York Local Health Committee meeting held on October 15, 2009.

-           Minutes of the Etobicoke/York Local Health Committee meeting held on November 12, 2009.

-           Minutes of the Etobicoke/York Local Health Committee meeting held on January 14, 2010.

-           Minutes of the North York Local Health Committee meeting held on January 14, 2010.