Board of Health
The full agenda, as filed
All 9 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.
HL4.1received
Gayle Bursey, Director, Healthy Public Policy, and Interim Director, Chronic Disease and Injury Prevention, Toronto Public Health, will give a presentation on Heat Relief Services Update.
The Board of Health received the item for information.
HL4.2amended
Ontario Government's Proposed Changes to the Provincial Health Care System
On February 26, 2019, the Deputy Premier and Minister of Health and Long-Term Care announced an Ontario strategy that includes legislative, operational, and policy changes to how the provincial health care system is currently managed and delivered. This report is in response to a City Council request on February 26, 2019 that the Medical Officer of Health report to the April 8, 2019 Board of Health meeting on the implications of the proposed policy and legislative changes to the provincial health care system, as recently announced by the Government of Ontario.
The Board of Health: 1. Directed that the report (March 25, 2019) from the Medical Officer of Health be forwarded to the Economic and Community Development Committee for information. 2. Called on the Provincial Government to continue full funding for all programs currently receiving provincial funding at Toronto Public Health, including funding received from the Local Health Integration Networks.
Staff recommendation as filed
The Medical Officer of Health recommends that: 1. The Board of Health receive this report for information.
HL4.3amended
Vaccine hesitancy is the reluctance or refusal to vaccinate despite the availability of vaccines. It is a growing concern internationally and has been identified as a top ten threat to global health by the World Health Organization. In Canada, an estimated 20 percent of parents are vaccine hesitant and are unsure about the safety and effectiveness of vaccines. Social media and the internet play a significant role in spreading misinformation about vaccines and have contributed greatly to vaccine hesitancy. Technology companies such as Pinterest, Facebook, Instagram, and Google have acknowledged the detrimental role that these platforms have played in spreading misinformation about vaccines, and have taken some action to address this issue. Clear and truthful messages supporting vaccines and the importance of immunization in protecting health are critical to combatting vaccine hesitancy. This report provides a number of recommended actions to help address this growing concern and the role the federal government, as well as international, national, and provincial organizations can play to support these efforts.
The Board of Health: 1. Requested Health Canada to explore avenues to reduce the spread and dissemination of misinformation and false claims about vaccines. 2. Requested the World Health Organization to consider global recommendations, similar to the World Health Organization Framework Convention on Tobacco Control, regulating direct and indirect advertising, promotion, and sponsorship by anti-vaccine groups and anti-vaccine messages in print, audio, video, and online advertisements. 3. Requested the following health professional organizations to educate their members on how to address vaccine hesitancy in their practices and promote vaccines: the Ontario Medical Association, the Canadian Medical Association, the Ontario Nurses' Association, the Registered Nurses' Association of Ontario, the Canadian Nurses Association, the Ontario Pharmacists Association, the Association of Ontario Midwives, the Ontario Chiropractic Association, and the Ontario Association of Naturopathic Doctors. 4. Directed that the report (March 28, 2019) from the Medical Officer of Health be forwarded to Health Canada, Innovation, Science and Economic Development Canada, the Public Health Agency of Canada, the Ministry of Health and Long-Term Care, Public Health Ontario, Ad Standards, the Canadian Association of Broadcasters, the Canadian Marketing Association, the Association of Canadian Advertisers, the Ontario Public Health Association, the Association of Local Public Health Agencies, the Council of Ontario Medical Officers of Health, the Ontario Medical Association, the Canadian Medical Association, the Ontario Nurses' Association, the Registered Nurses' Association of Ontario, the Canadian Nurses Association, the Ontario Pharmacists Association, the Association of Ontario Midwives, the Ontario Chiropractic Association, and the Ontario Association of Naturopathic Doctors. 5. Requested the Medical Officer of Health to report to the Board of Health at its meeting on September 23, 2019 with Toronto Public Health's strategy to address vaccine hesitancy which should include the following: a. Investigating the potential to restrict misleading advertising regarding vaccinations on City-owned land and infrastructure; b. Consulting with Health Canada regarding their ability to use additional regulations under their legislative authority to restrict misleading advertising regarding vaccinations; c. Additional actions to ensure that the public has the necessary information to make informed decisions about the importance of vaccinations for the health of all members of our community, including consideration of a public education campaign; and d. Assistance the Medical Officer of Health can provide to health care providers to ensure that they can support families in making informed vaccination decisions.
Staff recommendation as filed
The Medical Officer of Health recommends that: 1. The Board of Health request Health Canada to explore avenues to reduce the spread and dissemination of misinformation and false claims about vaccines. 2. The Board of Health request the World Health Organization to consider global recommendations, similar to the WHO Framework Convention on Tobacco Control, regulating direct and indirect advertising, promotion, and sponsorship by anti-vaccine groups and anti-vaccine messages in print, audio, video, and online advertisements. 3. The Board of Health request the following health professional organizations to educate their members on how to address vaccine hesitancy in their practices and promote vaccines: the Ontario Medical Association, the Canadian Medical Association, the Ontario Nurses' Association, the Registered Nurses' Association of Ontario, the Canadian Nurses Association, the Ontario Pharmacists Association, the Association of Ontario Midwives, the Ontario Chiropractic Association, and the Ontario Association of Naturopathic Doctors. 4. The Board of Health forward this report to Health Canada, Industry Canada, the Public Health Agency of Canada, the Ministry of Health and Long-Term Care, Public Health Ontario, Advertising Standards Canada, the Canadian Association of Broadcasters, the Canadian Marketing Association, the Association of Canadian Advertisers, Public Health Ontario, the Ontario Public Health Association, the Association of Local Public Health Agencies, the Council of Ontario Medical Officers of Health, the Ontario Medical Association, the Canadian Medical Association, the Ontario Nurses' Association, the Registered Nurses' Association of Ontario, the Canadian Nurses Association, the Ontario Pharmacists Association, the Association of Ontario Midwives, the Ontario Chiropractic Association, and the Ontario Association of Naturopathic Doctors.
HL4.4amended
Health Impacts of Alcohol Consumption Update
Alcohol consumption remains a leading risk factor for acute harms and chronic disease in Canada. Though the proportion of Ontario adults consuming alcohol has remained stable over the past two decades, the amount of alcohol consumed per person has increased significantly. In particular, average weekly consumption among women has increased by 90 percent between 1996 and 2017. Serious concerns related to this increase and to the social acceptance of alcohol consumption were raised by Canada's Chief Public Health Officer in the 2018 Report on the State of Public Health in Canada. An emerging issue is the increase in access to alcohol that started in 2014. Evidence has shown that increasing the availability of alcohol (for example, adding more access points, extending the hours of sale and service, or lowering purchase price) is associated with increased alcohol consumption and alcohol-related health and social harms. This report provides an update on the health impacts of alcohol consumption, describes recent changes to where and how alcohol is accessed, and presents evidence on mitigation measures. The evidence presented reaffirms previously adopted Board of Health recommendations for the Government of Ontario to proactively balance the provision of alcohol with the need to mitigate health and social harms.
The Board of Health: 1. In recognition of the strong and growing evidence that increasing access to alcohol is associated with health and social harms, reaffirmed its previous recommendations, including the development of a provincial alcohol strategy to mitigate alcohol-related harms in Ontario. 2. Directed that the report (March 25, 2019) from the Medical Officer of Health be forwarded to Ontario's Chief Medical Officer of Health, the Association of Local Public Health Agencies, the Council of Ontario Medical Officers of Health, the Centre for Addiction and Mental Health, the Ontario Public Health Association, the Alcohol and Gaming Commission of Ontario, the Ministry of Health and Long-Term Care, the Ministry of Finance, the Ministry of the Attorney General, the Ministry of the Solicitor General, the Ministry of Children, Community and Social Services, the Ontario Provincial Police, the Toronto Police Service, and the Canadian Automobile Association. 3. Requested the Medical Officer of Health to report to the Board of Health at its meeting on June 10, 2019 with recommendations for the hours of sale and the availability of retail sales of alcohol in the City of Toronto.
Staff recommendation as filed
The Medical Officer of Health recommends that: 1. The Board of Health, in recognition of the strong and growing evidence that increasing access to alcohol is associated with health and social harms, reaffirms its previous recommendations, including the development of a provincial alcohol strategy to mitigate alcohol-related harms in Ontario. 2. The Board of Health forward this report to Ontario's Chief Medical Officer of Health, the Association of Local Public Health Agencies, the Council of Ontario Medical Officers of Health, the Centre for Addiction and Mental Health, the Ontario Public Health Association, the Alcohol and Gaming Commission of Ontario, the Ministry of Health and Long-Term Care, the Ministry of Finance, the Ministry of the Attorney General, and the Ministry of Community Safety and Correctional Services.
HL4.5adopted
Disclosure of Infection Prevention and Control Inspections of Licensed Child Care Centres in Toronto
Toronto Public Health's (TPH) inspection staff conduct Infection Prevention and Control (IPAC) inspections at approximately 1,050 licensed child care centres annually under the Infection Prevention and Control Protocol, 2018 of the Ontario Public Health Standards. Effective July 1, 2018, the Ministry of Health and Long-Term Care added a new requirement through the Infection Prevention and Control Disclosure Protocol, 2018 that all IPAC inspections of licensed child care centres be made available online on the Board of Health's website. This staff report provides an overview of TPH's actions towards fulfilling this new requirement of the Ontario Public Health Standards.
The Board of Health received the report (March 20, 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.
HL4.6adopted
Appointments to the Toronto Food Policy Council
The Toronto Food Policy Council (TFPC) was created as a Subcommittee of the Board of Health (BOH) in 1991 to keep Toronto Public Health (TPH) and the BOH abreast of emerging policy issues, trends, challenges, and possibilities related to fostering an equitable, sustainable food system. This report provides an update on the membership for, and recommends appointments to, the TFPC.
The Board of Health: 1. Appointed the 14 individuals listed below to the Toronto Food Policy Council for a term of office ending December 31, 2021, and until successors are appointed: - Mimi Bizjak, Community Member - Ashna Bowry, Board of Health Appointee - Leslie Campbell, Community Member - Councillor Joe Cressy, Toronto City Councillor and Chair, Board of Health - David Crombie, Special Advisor - Sarah Elton, Community Member - Councillor Jennifer McKelvie, Toronto City Councillor - Bashir Munye, Community Member - Anita Prasad, Community Member - Susanna Redekop, Community Member - Robert Sleeper, Community Member - Emma Tamlin, Youth Member - Koa Thornhill, Community Member - Nathalie Vengal, Community Member
Staff recommendation as filed
The Medical Officer of Health recommends that: 1. The Board of Health appoint the 14 candidates listed in Confidential Attachment 1 to the Toronto Food Policy Council for a term of office ending December 31, 2021, and until successors are appointed. 2. The Board of Health authorize the public release of the names and biographies in Confidential Attachment 1, once Recommendation 1 of this report is adopted by the Board of Health.
HL4.7adopted
City Council Approved Toronto Public Health 2019 Operating Budget
This report provides the Board of Health (BOH) with an update on the Toronto Public Health (TPH) 2019 Operating Budget which was approved at the City Council meeting on March 7, 2019. In November 2018, the BOH recommended a 2019 Operating Budget of $257,012.0 thousand gross and $65,364.8 thousand net that included two reduction options and 10 proposals for new and enhanced services. Decisions made during the subsequent 2019 City Budget process are outlined in this report. City Council approved a TPH 2019 Budget Committee Recommended Operating Budget of $255,279.2 thousand gross and $64,498.8 thousand net. The Council Approved Budget provides an increase of $417.6 thousand gross (0.2 percent increase in gross expenditures) and $702.1 thousand net (1.1 percent increase in net expenditures) over the 2018 Approved Operating Budget.
The Board of Health received the report (March 20, 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.
HL4.8adopted
City Council Approved Toronto Public Health 2019-2028 Capital Budget and Plan
This report provides an update to the Board of Health on the Toronto Public Health 2019 Capital Budget and 2019-2028 Capital Plan, as approved by City Council on March 7, 2019.
The Board of Health received the report (March 21, 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.
HL4.9adopted
Provincial Funding Cuts to Supervised Consumption Services in Toronto
The overdose crisis is the defining health issue of our time. In both our city and our province, the number of people dying from opioid overdoses continues to rise. Recent data from the Coroner shows that in 2017, 308 people in Toronto died from opioid overdoses. This represents a 66 percent increase from 2016, and a 125 percent increase from 2015. Preliminary data from the Coroner for the first nine months of 2018 there were 193 deaths from opioids. This number is expected to rise as cause of death is determined in more cases. Just last month, the city saw 22 people die from suspected opioid overdose, with over 450 additional paramedic calls for suspected non-fatal opioid overdoses, the most since Toronto Public Health began reporting this data in August 2017. The situation remains urgent, and we need to do everything possible to save lives. Late last year, the provincial government introduced new regulations for supervised consumption services in Ontario, and announced a cap on the number of sites in the province of 21. Although there were concerns with the restrictive nature of the new Consumption and Treatment Service guidelines, the acknowledgement of the role of harm reduction services within the new framework was critical. At that time, the Board of Health formally requested that the Province maintain funding for all existing supervised injection and overdose prevention sites in the Toronto. On the afternoon of March 29, without prior notice, the Provincial Government announced only 15 of the 21 supervised injection and overdose prevention sites in Ontario had been approved for funding under the new regulations. The six sites not approved include three in Toronto, and three in London and Ottawa. Two overdose prevention sites in our city - Street Health at Dundas and Sherbourne and St. Stephen's Community House - were informed their funding would end abruptly two days later, along with their legal ability to operate. The third Toronto site not formally approved - Toronto Public Health's The Works - was informed they were still under review. Although emergency exemptions from the Federal Government were secured to ensure the continued legal operation of Street Health and St. Stephen's, both are currently operating using fundraising dollars alone. Without sustainable funding, it is possible these life-saving services could close. The evidence is clear - supervised consumption sites save lives. At Toronto Public Health's The Works alone, there have been over 40,000 client visits and 750 overdoses reversed since they opened in August 2017 - and, demand only continues to increase. With less access to supervised consumption services, we will see more fatal overdoses in our city. City Council has clearly articulated its support for evidence-based responses to the opioid overdose crisis, including harm reduction and supervised consumption services. In the midst of the most deadly public health crisis of our generation, we should be expanding life-saving services by opening new sites, not closing the ones we already have.
The Board of Health recommends that: 1. City Council request the Province of Ontario to reinstate funding for supervised consumption services at Street Health and St. Stephen's Community House and to maintain funding for Toronto Public Health's The Works.
Staff recommendation as filed
Councillor Joe Cressy recommends that: 1. City Council request the Province of Ontario to reinstate funding for supervised consumption services at Street Health and St. Stephen's Community House and to maintain funding for Toronto Public Health's The Works. 2. The Board of Health request the Medical Officer of Health to engage with the Federal Government on support for supervised consumption services in Toronto.