June 30, 1999
To:Board of Health and Community Services Committee
From:Dr. Sheela V. Basrur, Medical Officer of Health
Subject:Expansion of Public Health Dental Program and New Management Structure for Dental Services
Purpose:
This report is to update the Board of Health and the Community Services Committee on the expansion of the Public Health
dental program and the new management structure for dental services.
Source of Funds:
Funds to the amount of $800,000 for the expansion of the Public Health dental program have been approved in the 1999
Budget.
Recommendation:
It is recommended that the Board of Health and the Community Services Committee receive this report for information.
Background:
On April 26, 1999, Toronto City Council approved the addition of $800,000 to Public Health's budget for the purpose of
expanding the dental program for children and seniors across the new city. It was also requested that the Commissioner of
Community and Neighbourhood Services report on whether, with this expansion, a pilot program for dental services to be
proposed by the Ontario Dental Association (ODA) can be included. In addition, the Commissioner of Community and
Neighbourhood Services and the Medical Officer of Health were requested to report on the new management structure for
dental services. This report is in response to these requests.
Comments:
Once additional funds to expand the dental program were approved, eligibility requirements to access the dental program
were standardized, to enable more equitable access across the City. The requirements are as follows:
(i)All clients must reside within the City of Toronto;
(ii)Children up to Grade 8, who are not eligible for the Children in Need of Treatment (CINOT) or Ontario Works
(O.W.) dental programs, who have an oral health need and whose families declare financial hardship;
(iii)English as a Second Language (E.S.L.) adolescents not eligible for the OW dental program, who have an oral health
need and whose families declare financial hardship; and
(iv)Seniors 65 years and older whose annual income is below $16,750 (single person), $25,500 (couples). Seniors are
required to pay half of the laboratory bill for the provision or repair of dentures.
This system of financial control regarding eligibility of clients is under review by the City Auditor, whose
recommendations will be reported separately at a later date.
Staff are in the process of recruiting additional dental teams to respond to increased demand for services. Two dental
clinics in schools in the former City of North York will remain open during the summer months to provide both preventive
and treatment services, and once staff have been recruited, the hours of the dental clinic at the Etobicoke Civic Centre will
be extended. In addition, most existing clinics in the former City of Toronto will have their hours extended by mid July
1999. The costs for all these expanded clinics will be covered within the $800,000 budget.
After the first meeting of the Dental Services Task Force on May 31, 1999, the Commissioner of Community and
Neighbourhood Services and public health staff met with representatives from the Ontario Dental Association (ODA) to
outline a process for developing a proposal for a pilot dental program to be managed by the ODA.
The ODA were aware that the pilot project would not be implemented before September 1999, and that staff would be
required to review the expanded program and report back on its successes and failures prior to year-end. This would only
give three months for an evaluation of the project. After these discussions, the Commissioner received correspondence
dated June 16, 1999 from the ODA, advising that they would not be submitting a proposal for the pilot project. Please see
Appendix 1 for a copy of the ODA letter and the Commissioner's response.
The Commissioner of Community and Neighbourhood Services and the Medical Officer of Health were also requested to
report within three months to the Community Services Committee on the new management structure for dental services.
The services of the Berkeley Consulting Group were retained through the Amalgamation Office to do a review and analysis
of the management requirements of the dental program. The consultants are currently in the process of conducting their
research. It is important, however, that the recommendations of the Dental Services Task Force and its stakeholder
advisory committee, be taken into account by the consultants. The Dental Services Task Force, chaired by the
Commissioner of Community Services, has been requested to develop options for the delivery of public health dental
services. It is therefore recommended that the report from the Berkeley Consulting Group be delayed to enable inclusion of
the issues arising from recommendations of the Dental Task Force which is anticipated to conclude its deliberations by July
30,1999.
Conclusions:
Staff are in the process of expanding the dental program as approved by Toronto City Council. The ODA has written to
advise the Commissioner of Community and Neighbourhood Services that they will not be submitting a proposal for a pilot
project for 1999. It is recommended that review of the new management structure for dental service incorporate the
findings of the Dental Services Task Force.
Contact Name:
Dr. Hazel Stewart
Director, West Region
Toronto Public Health
277 Victoria Street, 5th Floor
Tel. 416-392-0442 ext. 87027
Fax. 416-392-0713
Dr. Sheela V. BasrurShirley Hoy
Medical Officer of HealthCommissioner,
Community & Neighbourhood Services
