May 3, 1999
To:Board of Health
From:Dr. Sheela Basrur, Medical Officer of Health
Subject:1999 Operating Budget - Update
Purpose:
To inform the Board of Health of the 1999 operating budget approved by City Council, and to
advise the Board on the provisional estimates of provincial funding for public health programs
and services.
Source of Funds:
Not applicable.
Recommendations:
It is recommended that:
(1)the Board receive for information the 1999 operating budget approved by City Council.
(2)the Board request the Chief Administrative Officer to report the results of his upcoming
review of Public Health to City Council through the Board of Health, in addition to any
applicable standing committees; and
(3)the Board express its appreciation to the Minister of Health for her efforts to strengthen
public health through a return to cost shared funding for general programs and for increased
support for provincial priorities.
Background and Comments:
At its meeting on April 26-27, 1999 City Council adopted the Public Health Operating Budget
(an excerpt of the relevant recommendations considered by City Council are provided in
Attachment 1). The main financial highlights of the approved budget are:
(a)A gross budget of $111.821 million and a net budget of $53.559 million - this includes
projected provincial revenue totaling $76.3 million for Public Health and Ambulance
combined, of which the City estimates $41.2 million as revenue to Public Health;
(b)A $13.2 million increase in the municipally funded portion of the gross budget (from
$98.620 million to $111.820 million) for corporate charges;
(c)New funding as outlined in "Option B" to harmonize the TB Control, Needle Exchange
and Food Safety programs, totaling $1.054 million in 1999 and $2.661 million in 2000 and
beyond;
(d)A $100,000 fund for food access projects, to be disbursed at the sole discretion of the
Commissioner of Community & Neighbourhood Services to groups with one-time financial
needs;
(e)Additional funding of $800,000 to expand dental treatment services through existing
clinics, with no capital expansion, along with further review of the dental program
management structure and an additional further review of dental services delivery options
through a staff task force and a dental advisory committee comprised of various stakeholders;
and
(f)A comprehensive review of Public Health to be conducted by the CAO in consultation
with the Medical Officer of Health (MOH) - in order to fully comply with the requirements of
the Act, I recommend that the review be reported to Council through the Board of Health.
It should be noted that estimated provincial revenues for 50/50 cost-shared programs are
subject to confirmation by the Ministry of Health, a timeline for which is not yet known.
Provincial funding also covers the Public Health Research, Education and Development
(PHRED) Program, which will be cost-shared.
In addition, the Minister of Health has recently announced additional revenue which has not
been included in the operating budget, again subject to confirmation of specific funding
levels. These announcements include an additional $17 million provincially to augment the
Healthy Babies, Healthy Children program (for post-hospital discharge support) and an
additional $10 million provincially to strengthen the Ontario Tobacco Strategy (for prevention
and cessation). The allocation that will flow to Toronto is not yet known, but will likely be
calculated on a needs-adjusted, per capita basis.
Renewed provincial funding for Public Health is a much welcomed sign of support that
demonstrates a recognition of our essential role in the health system. It is recommended that
the Minister of Health be acknowledged for her role in strengthening the financial base for
public health programs and services.
Conclusions:
The 1999 Public Health Operating Budget has been approved by City Council, subject to
future technical amendments once provincial revenues are confirmed. A variety of further
work needs to be conducted by staff in time for the Year 2000 budget cycle, which will be the
subject of future reports to the Board at the appropriate time.
Contact Name:
Dr. Sheela Basrur
Medical Officer of Health
Tel:392-7402
Fax:392-0713
email:sbasrur@toronto.ca
Dr. Sheela V. Basrur
Medical Officer of Health
