Toronto Public Health has engaged in an extensive consultation process with its staff and management as well as members of the Board of Health and Local Health Committees in order to develop a strategic plan for the next five years.  This plan, entitled “A Healthy City For All” builds on the organization’s history and charts its future direction.  It confirms the organization’s mission and foundational principles, and articulates priority directions and actions that will inform service and budget planning and provide the basis for monitoring organizational performance throughout the next five years.  Toronto Public Health’s Strategic Plan 2010-2014 is presented for adoption by the Board of Health.

Toronto Public Health (TPH) oversaw the Health Impact Assessment (HIA) component of the Mixed Waste Processing Study conducted by Golder Associates on behalf of Solid Waste Management Services (SWMS). This study was initiated to evaluate the options for managing Toronto’s mixed waste in order to help achieve the City’s Target 70 waste diversion objectives.  Potential impacts from various approaches to dealing with City of Toronto residential mixed waste were assessed using HIA screening and scoping approaches.  This report presents the findings of the HIA and the recommendations the Medical Officer of Health (MOH) has made for future action by SWMS.

The HIA was conducted in two phases. The first phase assessed various technology options and informed SWMS’s decision to move forward with Mechanical Biological Treatment with Anaerobic Digestion (MBT with AD) as the preferred technology for a residential mixed waste processing facility.  The only city-owned site that has sufficient area to accommodate the full processing and final curing operations is next to Green Lane Landfill in the Township of Southwold (near London, Ontario).

Once the preferred site and technology were identified, TPH held an HIA workshop with stakeholders from the community neighbouring the selected site. The participants at the workshop identified both negative and positive potential impacts from the proposed facility. Potential mitigation efforts were also discussed. 

The Medical Officer of Health has communicated his recommendations on ways to address stakeholder concerns during the design and operation of the proposed facility to the General Manager, SWMS. SWMS has indicated that they will implement these recommendations. The MOH will continue to work with SWMS and the Residual Waste Working Group to ensure health issues are considered during the next phases. The HIA process helped influence the selection of a mixed waste treatment technology option such that the one with the least environmental and health impact was chosen.

The Board of Health received Item HL32.3 for information.

This report provides an update on the implementation of the Environmental Reporting, Disclosure and Innovation Program. This program, now called ChemTRAC, is designed to protect public health and stimulate the greening of local facilities by tracking and reducing toxic chemicals found in Toronto’s environment. An important component of this program is the Environmental Reporting and Disclosure Bylaw (Municipal Code Chapter 423) which came into force January 1, 2010.

Toronto Public Health is coordinating the implementation of ChemTRAC, in partnership with Economic Development and Culture, the Toronto Environment Office and Toronto Water. The program activities in 2009 focused on informing facilities about the bylaw and developing resources to help them report their use of toxic chemicals.  This is an important step in order to ensure that facilities know how to comply with the bylaw and are aware of greening/pollution prevention resources. The education and outreach activities for facilities included a mailing to more than 6000 facilities that may need to report, a series of breakfast seminars held throughout the city, the development of a Guide to Reporting and release estimation calculators, along with creating and populating the program website (toronto.ca/chemtrac).

The development of an online reporting system to effectively and accurately collect the reported data was also started in 2009. This involved discussions with Environment Canada and Toronto Public Health Information Technology (IT) to plan and develop the necessary IT infrastructure.

These activities are the groundwork essential to continued program success and growth.

The Board of Health received Item HL32.4 for information.

The purpose of this report is to provide information on the environmental assessment requirements applicable to the Billy Bishop Toronto City Airport (“the Island Airport”).

Federal environmental assessment of a proposed project at the Island Airport is carried out by the Toronto Port Authority (TPA), usually on the basis of a screening environmental assessment. The TPA is responsible for identifying potential environmental effects, determining the significance of those effects, identifying feasible mitigation measures, and selecting an appropriate course of action. The environmental assessment of a proposed project may be referred to a review panel under certain circumstances.

TPA can conduct building, expansion and modification at the Island Airport without being subject to a Federal environmental assessment, so long as only excluded activities are undertaken. Any expansion at the Island Airport that goes beyond the nature or scope of these exclusions, such as the Tunnel currently proposed, requires an environmental assessment.

The Tripartite Agreement among the Federal government, the TPA and the City, also may limit the expansion of operations at the Island Airport.

This report outlines the review process, funding applications and recommendations of the Board of Health AIDS Prevention Community Investment Program Review Panel regarding allocations in 2010.

The 2010 approved operating budget for the AIDS Prevention Community Investment Program includes an allocation of $1,679,000. This report proposes funding allocations in the total amount of $1,574,960 for 41 projects in the City of Toronto and $104,040 to Schools Without Borders (SWB) for the AIDS Prevention Community Investment Program Global HIV/AIDS Initiative.  Funding is to be used between July 1, 2010 and June 30, 2011.

The Board of Health recommends that:

1.         City Council approve the allocation of $844,280 to 38 projects as recommended by the 2010 Drug Prevention Community Investment Program Review Panel in Appendix B and Appendix C of the revised report (June 10, 2010) from the Chair, Drug Prevention Community Investment Program Review Panel.

2.         City Council approve the listed applicants for multi-year assessment in Appendix D and E of the revised report (June 10, 2010) from the Chair, Drug Prevention Community Investment Program Review Panel.

3.         City Council grant authority to the Medical Officer of Health to execute Letters of Understanding on behalf of the City.

This report outlines the review process, funding applications and recommendations of the Board of Health Drug Prevention Community Investment Program Review Panel regarding allocations in 2010.

The 2010 Approved Operating Budget for the Drug Prevention Community Investment Program (DPCIP) includes an allocation of $844,280.  This report recommends the allocation of $844,280 to 38 projects.  Funding is to be used between July 1, 2010 and June 30, 2011.

This report is the second biannual update on mortality trends in the homeless population in the City of Toronto. Data has previously been collected from three sources regarding deaths among homeless people. Recent years of data indicate a downward trend in number of deaths.

As two of the three sources of data are no longer available, this will be the last report of this type on tracking homeless deaths.

The Board of Health received Item HL32.8 for information.

This report provides an update to the Board of Health on Toronto Public Health’s (TPH) Operating Budget Variance for the five months of operation ending on May 31, 2010.

Toronto Public Health’s operating budget was under spent by $389.8 thousand net or 2.5 percent for the five-month period ending on May 31, 2010.

Toronto Public Health gross expenditures were below budget by $248.0 thousand or 0.3 percent, attributable to the under spending of $247.5 thousand in Salaries and Benefits and $0.5 thousand in non payroll including utility costs. Revenue was overachieved by $141.8 thousand mainly due to higher than planned collection of user fees. At year-end, Toronto Public Health expects to be fully spent with no variance.

The Board of Health received Item HL32.9 for information.

The Ontario 2010 Budget announced the cancellation of the Special Diet Allowance (SDA) as a supplement to the basic social assistance allowance and its replacement with a nutritional supplement program. This report provides information on the potential impact of eliminating the SDA. It recommends criteria to be considered in developing the proposed nutritional supplement program for individuals who are beneficiaries of Ontario Works (OW) and the Ontario Disability Support Program (ODSP) and who have specific medical conditions, and it strongly supports advocacy efforts calling for increasing basic social assistance rates to provide people living in poverty with sufficient income for a healthy diet. 

The relationship between poverty, inadequate nutrition and poor health is clear and well-documented. Good nutrition can reduce the risk of chronic diseases, promote positive pregnancy outcomes and support healthy child growth and development. The SDA supports recipients’ overall health and their specific medical conditions and it enables access to healthier food choices. Creation of a new nutritional supplement program provides an opportunity to ensure that OW/ ODSP recipients with specific medical conditions are able to purchase the food they need to manage and improve their health. The importance of the role of diet in disease prevention and treatment must be recognized to ensure the proposed nutritional supplement program addresses these needs. Furthermore, as part of the design of any new program, the government must recognize that all Ontario residents require adequate income to purchase sufficient nutritious food to promote health and well being.

The Board of Health requested the Premier of Ontario and the Minister of Health Promotion to continue to fund 100 per cent of the expanded CINOT program for low-income children and youth 14 to 17 years of age in 2010 and future years.

The Ministry of Health Promotion (MHP) recently confirmed that the expansion of the CINOT dental program to include low-income children and youth 14 to 17 years of age will be cost shared with 75 per cent provincial funding in 2010.  In 2009, the expansion of CINOT was 100 per cent provincially funded.  In 2010, a source of funding is required for the City’s portion ($89,615) of the CINOT expansion.

The Medical Officer of Health (MOH) recommends that for 2010 only, the municipal share of funding for the CINOT expansion be reallocated from the 100 per cent municipally funded dental services budget.  This will result in some reduction of service for clients ineligible for provincial cost shared programs, but will maximize the use of provincial funding and consequently dental service levels.  Municipal funding for the CINOT expansion in 2011 will be requested through the 2011 Operating Budget process.

The MOH also recommends that the Board of Health (BOH) request that the Premier of Ontario and the Minster of Health Promotion continue 100 per cent funding of CINOT expansion since the provincial funds allocated for this purpose were significantly under-spent in 2009.   

Toronto Public Health (TPH) currently delivers four Ontario Early Years programs:  Healthy Babies Healthy Children (HBHC), Preschool Speech and Language (PSL), Infant Hearing (IHP) and Blind-Low Vision (BLV).  Each of these programs receives 100% funding from the Ministry of Children and Youth Services (MCYS).  Services within these programs are delivered in accordance with Ontario Public Health Standards, related Protocols, and/or provincial program requirements.

The Ministry of Children and Youth Services has advised Toronto Public Health that 2010 funding levels for each of these programs have been frozen at 2009 funding levels.  This means that funding has remained constant for the past four years, with no increase to respond to cost of service pressures or rising service demands.  While Toronto Public Health is endeavouring to maintain the highest level and quality of service possible within existing funding, service levels are gradually being eroded.  Toronto Public Health is no longer able to meet Ministry established service targets and opportunities to support the healthy growth and development of children are being missed.

The Board of Health referred Item HL32.13 to the Medical Officer of Health for his consideration.

Letter from Councillor Paula Fletcher requesting the Medical Officer of Health to investigate and report to the Board of Health, as soon as possible, on any recommendations for the Ministry of Environment regarding waters containing e.coli being discharged untreated into the Outer Harbour.

Fiona Nelson requested that the Board of Health consider an issue related to the Early Learning Program.