Board of Health
The full agenda, as filed
All 7 items in the clerk’s order. Each carries the city’s own words: the staff recommendation, what the body decided, and its status. Nothing below is written by us.
HL12.1adopted
The ChemTRAC program aims to increase public awareness of chemicals in the environment and reduce pollution from industrial and commercial sources by annually reporting to the public on the manufacture, use, or release of chemicals by local industries. It is administered by Toronto Public Health (TPH) and is guided by the Environmental Reporting and Disclosure By-law, which requires certain facilities to report each year if they use or release any of 25 priority substances above identified thresholds. The information reported to ChemTRAC is then publically released. The information for 2018 is currently available online through the program's interactive map and in the 2019 annual report. ChemTRAC, with its lower reporting thresholds and focus on local industries, complements the National Pollutant Release Inventory which captures information from facilities with large emissions. Regulating local industrial and commercial releases of contaminants that can affect human health and the environment is the responsibility of the Ontario Ministry of the Environment, Conservation and Parks and falls outside the scope of the ChemTRAC program. This report provides an update on the ChemTRAC program and responds to City Council's June 2019 request for a review of industrial operations in Ward 5 (York South-Weston) to determine compliance with the reporting requirements of the ChemTRAC program. For 2018, 26 facilities in Ward 5 reported amounts above the thresholds. As part of annual data quality control procedures, staff initiated audits of randomly selected facilities from the ward, including facilities that reported to ChemTRAC and facilities that did not report to ChemTRAC. Of 16 completed audits, a majority (88 percent) of audited facilities were in compliance with the By-law. Those who require assistance to be in compliance, including one identified in the audit this year, receive support from ChemTRAC to submit an accurate report.
The Board of Health: 1. Received the report (November 19, 2019) from the Medical Officer of Health for information.
Staff recommendation as filed
The Medical Officer of Health recommends that: 1. The Board of Health receive this report for information.
HL12.2adopted
Ontario Public Health Standards Risk Management Reporting for 2019
This report provides the Board of Health with an update on the risk management reporting that is part of the Ontario Public Health Accountability Framework requirements as of January 2018. Public health units are required to annually submit a Risk Management Report to the Ministry of Health. Toronto Public Health (TPH) developed an Enterprise Risk Management Framework to standardize the management (identification, assessment, prioritization, and evaluation) of risks. This framework increases TPH's likelihood of achieving its objectives, improves the identification of opportunities and threats, and supports effective and efficient resource allocation. TPH will continue to identify and mitigate its risks and report on risk management to the Board of Health and the Ministry of Health in the third quarter of 2020.
The Board of Health: 1. Received the report (November 22, 2019) from the Medical Officer of Health for information.
Staff recommendation as filed
The Medical Officer of Health recommends that: 1. The Board of Health receive this report for information.
HL12.3amended
Update on Aerosolized Liquid Products (Vapour Products)
This report responds to a request from the Board of Health for a report on the health impacts of vapour products and potential actions for federal and provincial levels of government. Vapour products, which may include nicotine, function through the aerosolization of liquids to produce a vapour that can be inhaled. In this report, vapour products will be referred to as aerosolized products or aerosolized liquid products. While aerosolized products, also known as e-cigarettes, are considered by some health authorities to be less harmful than combustible tobacco cigarettes, Health Canada and other health authorities have concluded that the long-term health effects from the use of aerosolized products are not yet fully known. Using aerosolized liquid products can expose the user to nicotine, an addictive substance which is associated with negative impacts on adolescent brain development, and to other chemicals that are harmful to health. Use of aerosolized liquid products has also been shown to lead to subsequent tobacco smoking among youth and young adults. This is particularly concerning as aerosolized liquid products have the potential to undermine public health gains achieved through more than a decade of coordinated, comprehensive, evidence-based commercial tobacco control work. Aerosolized liquid products, including newer brands that contain higher concentrations of nicotine, have become widely available in convenience stores, gas stations, and other retail outlets throughout Toronto. National surveys show there has been an increase in the use of aerosolized liquid products amongst youth. The recent increase and widespread availability of popular new brands in most convenience stores in Toronto, coupled with their pervasive advertising campaigns and unlimited promotion at retail outlets, may have played a role in the increasing use of these products amongst youth. Additionally, there are a wide variety of flavours available at retail outlets, including candy and dessert flavours. Flavours were cited in a national survey as one of the main reasons youth initiated aerosolized liquid product use. In light of current evidence, Toronto Public Health (TPH) recommends the federal government take action to prohibit aerosolized liquid product advertising and promotion where minors have access, prohibit the sale of flavours (except tobacco flavour) in retail stores accessible to minors, and set a limit on available nicotine concentrations in aerosolized liquid products. TPH also commends the province for their recent action to prohibit the in-store promotion of aerosolized liquid products and recommends the province take further action to prohibit the sale of all flavours (except tobacco) at retail stores accessible to minors. Finally, TPH recommends a report back to the Board of Health on amendments to the existing City of Toronto By-laws that prohibit smoking to also prohibit the use of aerosolized liquid products.
The Board of Health: 1. Requested the Government of Ontario to amend the Smoke-Free Ontario Act, 2017, such that provisions on aerosolized liquid products (vapour products) align more closely with those for tobacco products by adding a prohibition on the sale of any flavoured aerosolized liquid products (vapour products), with the exception of tobacco flavour, in stores accessible to minors. 2. Urged the Government of Ontario to: a. adopt Bill 151, the Smoke-Free Ontario Amendment Act (Vaping is not for Kids), 2019, which would prohibit the promotion of vapour products, expand the prohibition of flavoured vapour products, and limit point-of-sale locations for vapour products; and b. apply the taxes that specifically apply to tobacco to aerosolized liquid products (vapour products), in line with the existing taxation framework for tobacco products. 3. Requested the Government of Canada and the Federal Minister of Health to take prompt action to implement restrictions on the advertising and promotion, flavours, and nicotine content of aerosolized liquid products (vapour products) by enacting regulations in the Tobacco and Vaping Products Act in these policy areas. 4. Directed the Medical Officer of Health, in consultation with Legal Services and relevant City divisions, including Municipal Licensing and Standards, Parks, Forestry and Recreation, and Corporate Real Estate Management, to report in the second quarter of 2020 on amendments to the existing City of Toronto By-laws that prohibit smoking to incorporate similar prohibitions on the use of aerosolized liquid products (vapour products). 5. Directed the Medical Officer of Health, in consultation with relevant staff, to report in the second quarter of 2020 on the feasibility of restricting or banning the sale, consumption, and trade of aerosolized liquid products (vapour products) in Toronto. 6. Directed that the report (November 20, 2019) from the Medical Officer of Health be forwarded to the Premier of Ontario, the Ontario Minister of Health, the Federal Minister of Health, Ontario's Chief Medical Officer of Health, the Association of Local Public Health Agencies, the Ontario Campaign for Action on Tobacco, the Council of Chief Medical Officers of Health, the Canadian Medical Association, the Heart and Stroke Foundation of Canada, the Canadian Cancer Society, the Canadian Lung Association, Physicians for a Smoke-Free Canada, and all Toronto school boards.
Staff recommendation as filed
The Medical Officer of Health recommends that: 1. The Board of Health request the Government of Ontario to amend the Smoke-Free Ontario Act, 2017, such that provisions on aerosolized liquid products (vapour products) align more closely with those for tobacco products by adding a prohibition on the sale of any flavoured aerosolized liquid products (vapour products), with the exception of tobacco flavour, in stores accessible to minors. 2. The Board of Health request the Government of Canada and the Federal Minister of Health to take prompt action to implement restrictions on the advertising and promotion, flavours, and nicotine content of aerosolized liquid products (vapour products) by enacting regulations in the Tobacco and Vaping Products Act in these policy areas. 3. The Board of Health direct the Medical Officer of Health, in consultation with Legal Services and relevant City divisions, including Municipal Licensing and Standards, Parks, Forestry and Recreation, and Corporate Real Estate Management, to report on amendments to the existing City of Toronto By-laws that prohibit smoking to incorporate similar prohibitions on the use of aerosolized liquid products (vapour products). 4. The Board of Health forward this report to the Premier of Ontario, the Ontario Minister of Health, the Federal Minister of Health, Ontario's Chief Medical Officer of Health, the Association of Local Public Health Agencies, the Ontario Campaign for Action on Tobacco, the Council of Chief Medical Officers of Health, the Canadian Medical Association, the Heart and Stroke Foundation of Canada, the Canadian Cancer Society, the Canadian Lung Association, Physicians for a Smoke-Free Canada, and all Toronto school boards.
HL12.4amended
Toronto Public Health Organizational Review
This report responds to the request from the Board of Health to report on the status of the Toronto Public Health (TPH) organizational review. While TPH has experienced many changes, much growth, and evolving priorities, as a whole, TPH has not been reviewed in its entirety since its creation through the City's amalgamation in 1998. It is within this context that, in 2017, City Council directed the Medical Officer of Health to review TPH's organizational design.
The Board of Health: 1. Established a Toronto Public Health Organizational Review Committee with the mandate to consider and make recommendations to the Board of Health on: a. ongoing organizational changes in Toronto Public Health, as directed by City Council in Item 2017.EX22.2 headed "2017 Capital and Operating Budgets"; and b. the impact of the Government of Ontario's changes to public health in Ontario, as they pertain to the organizational structure of Toronto Public Health. 2. Appointed Directors Joe Cressy (as Chair), Kate Mulligan, and Gord Perks to the Committee for a term of office ending December 31, 2020, and until successors are appointed. 3. Directed the Committee to meet at the call of the Chair.
Staff recommendation as filed
The Medical Officer of Health recommends that: 1. The Board of Health receive this report for information.
HL12.5amended
Audit Committee Item AU4.9 - Auditor General's Office 2020 Work Plan
City Council, on October 29 and 30, 2019, adopted Item AU4.9 and has again requested the Board of Health to invite the Auditor General to complete a risk assessment of operations in order to inform potential audit projects on future Work Plans; and further directed the Auditor General to report to the Audit Committee on the Board's response to this request.
The Board of Health: 1. Requested the Medical Officer of Health to report to the Board of Health in the first quarter of 2020 with details on current audits that have been conducted of Toronto Public Health, including details on promoting and ensuring accountability.
HL12.6amended
Ministry of Health Discussion Paper on Changes to Public Health in Ontario
On November 18th, the Ministry of Health launched consultations on changes to the Public Health system in Ontario. Through the release of a Discussion Paper entitled, "Discussion Paper: Public Health Modernization", the Provincial Government defined key challenges for public health from their perspective: insufficient capacity, misalignment of health, social and other services, duplication of effort, and inconsistent priority setting and included questions for discussion for each topic. Feedback on this discussion paper is being sought on an individual basis by way of survey responses, with a submission deadline of February 10, 2020. The Ministry of Health has also indicated its intention to meet with stakeholders as part of their consultations. In order for the Board to be able to participate fully in this discussion, it would be helpful to receive an update on what we know with respect to the entire consultation process, as well as information for consideration with respect to the discussion paper.
The Board of Health: 1. Requested the Ontario Ministry of Health and the Special Advisor to the Ontario Minister of Health on the future of Public Health and Emergency Health Services to consult directly with the Toronto Board of Health and Toronto Public Health as part of the consultations on changes to public health in Ontario. 2. Requested the Medical Officer of Health to report to the Board of Health at its meeting on January 13, 2020 with an update on the consultations by the Ontario Ministry of Health with respect to changes to public health in Ontario and with information and feedback for consideration with respect to the "Discussion Paper: Public Health Modernization".
Staff recommendation as filed
Councillor Joe Cressy recommends that: 1. The Board of Health request the Medical Officer of Health report to the January 13, 2020 meeting of the Board of Health with an update on consultations by the Ministry of Health with respect to changes to Public Health in Ontario, and with information and feedback for consideration with respect to the Public Health Modernization discussion paper.
HL12.7adopted
After the November 12, 2019 Board of Health meeting, TAIBU Community Health Centre and its partners raised the possibility of providing training for Board of Health members pertaining to Anti-Black Racism, Understanding Equity from Africentric Values and Principles, and Embedding Equity and Anti-Black Racism in Governance and Leadership. Given the Board of Health's consideration of various health matters in the community and the City of Toronto's focus on confronting Anti-Black Racism (Item HL24.7) it would be valuable to take advantage of this training to build Board capacity to provide equitable space for racialized and marginalized representation. TAIBU Community Health Centre and its partners have advised that the training is three hours in duration and consists of a presentation, discussion, self-reflection, and group activities. Due to funding constraints, the training should occur by the end of January 2020.
The Board of Health: 1. Requested the Medical Officer of Health to arrange a three-hour training session for the Board in January 2020 from the TAIBU Community Health Centre and its partners on Anti-Black Racism, Understanding Equity from Africentric Values and Principles, and Embedding Equity and Anti-Black Racism in Governance and Leadership to build the Board's capacity to provide equitable space for racialized and marginalized representation. 2. Requested the Chair to call a Special Meeting of the Board of Health in January 2020 for the training session referenced in Part 1 above.
Staff recommendation as filed
Councillor Gord Perks recommends that: 1. The Board of Health request the Medical Officer of Health to arrange a three-hour training session for the Board in January 2020 from the TAIBU Community Health Centre and its partners on Anti-Black Racism, Understanding Equity from Africentric Values and Principles, and Embedding Equity and Anti-Black Racism in Governance and Leadership to build Board capacity to provide equitable space for racialized and marginalized representation. 2. The Board of Health request the Chair to call a Special Meeting of the Board of Health in January 2020 for the training session referenced in Recommendation 1.