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Board of Health


Meeting No. 29   Contact Candy Davidovits, Committee Administrator
Meeting Date Monday, March 22, 2010
  Phone 416-397-7767
Start Time 1:00 PM
  E-mail boh@toronto.ca
Location Committee Room 1, City Hall
  Chair   Councillor John Filion  

HL29.1

ACTION

Amended 

 

Ward: All 

Breastfeeding in Toronto: Promoting Supportive Environment

Committee Decision

The Board of Health:

 

1.          urged all Toronto birthing hospitals to achieve Baby-Friendly designation as soon as possible, giving priority to:

 

a.         developing a written policy that covers all Ten Steps to Successful Breastfeeding, including a mechanism to evaluate the policy;

 

b.         helping mothers initiate breastfeeding within a half hour of birth;

 

c.         ensuring that newborn infants are not given food or drink other than breast milk unless medically indicated; and

 

d.         refraining from the practice of providing infant formula to mothers at hospital discharge;

 

2.          requested the Medical Officer of Health to:

 

a.         work in collaboration with Toronto birthing hospitals to support their efforts to achieve Baby-Friendly designation and re-assess compliance with the Ten Steps to Successful Breastfeeding; providing a progress report to the Board of Health in two years;

 

b.         ensure that Toronto Public Health achieve Baby-Friendly designation and provide a progress report to the Board of Health in two years;

 

c.         continue to work with key stakeholders to promote exclusive breastfeeding to six months of age using population-wide and targeted strategies, paying particular attention to those women less likely to exclusively breastfeed to six months (i.e. younger women, recent immigrants, women with lower levels of income, women having a Caesarean birth);

 

d.         continue to work with key stakeholders to develop and implement strategies to engage public facilities (e.g. malls, restaurants, recreational facilities, parks, schools, colleges and universities and the workplace) in breastfeeding friendly initiatives, thereby increasing the number of breastfeeding friendly places and supporting a woman’s right to breastfeed in public;

 

e.         continue to work with key stakeholders to maintain high rates of breastfeeding intention and initiation, paying particular attention to those women who are less likely to plan to breastfeed or initiate breastfeeding (e.g. younger women, women with low levels of education and women with lower levels of family income);

 

f.          report annually to the Board of Health on birthing hospitals in Toronto which have achieved the “Baby-Friendly Designation”;

 

g.         report to the Board of Health in 2011 on the success of birthing hospitals in achieving the four priority recommendations; and

 

h.         advise Toronto BIA offices and the Toronto Association of Business Improvement Areas (TABIA) on the Breast Feeding Friendly Campaign and to ask for assistance in getting businesses to be breastfeeding friendly and post the sticker;

 

3.         requested the Medical Officer of Health to forward this report to the Ontario Minister of Health and Long-Term Care and the Better Outcomes Registry & Network (BORN) Ontario, acknowledging the Ministry's progress toward the development of an integrated perinatal data collection system and requesting that the Minister ensure that the Niday Perinatal database is collecting:

 

a.         accurate and complete infant feeding data to enable hospitals and community health services to monitor rates of initiation and any and exclusive breastfeeding; and

 

b.         key sociodemographic and sociocultural indicators to enable the identification of subpopulations at risk for low breastfeeding rates and adverse maternal/infant health outcomes;

 

4.         urged the Minister of Health and Long-Term Care to forbid birthing hospitals from accepting free donations of formula or other inducements in compliance with the WHO International Code of Marketing of Breastmilk Substitutes;

 

5.          congratulated the Toronto East General Hospital for meeting all the requirements supporting breastfeeding, and obtaining the Baby-Friendly Designation; and

 

6.         forwarded this report to the Ministry of Health Promotion, the Ministry of Health and Long-Term Care, the Ministry of Children and Youth Services, the Provincial Maternal Newborn Advisory Committee, the Ontario Public Health Association, the Ontario Breastfeeding Committee, the Child Health Integration Network of the Greater Toronto Area, the Local Health Integration Networks that are responsible for Toronto birthing hospitals and Toronto Best Start Network.

Decision Advice and Other Information

The following gave a presentation to the Board of Health on "Breastfeeding in Toronto, Promoting Supportive Environments":

 

-           Dr. David McKeown, Medical Officer of Health;

-           Lydia Ling, International Certified Lactation Consultant; and

-           So-Yan Seto, Acting Manager, Healthy Families, Toronto Public Health.

 

The Chair of the Board of Health and the Medical Officer of Health presented a scroll from the Quintessence Foundation to Lydia Ling and So-Yan Seto congratulating Toronto Public Health and the Chinese/Vietnamese Breastfeeding Network on having the largest number of participants at a Quintessence Breastfeeding Challenge 2009 event they organized in Toronto.

Origin
(March 4, 2010) Report from Medical Officer of Health
Summary

The Baby-Friendly Initiative (BFI) is an international program to improve breastfeeding outcomes for mothers and babies by improving the quality of their care.(1)   This initiative consists of a hospital and a community component and sets the standards that hospitals and community health services must achieve in order to obtain Baby-Friendly Designation. 

 

In 2007, the Board of Health directed the Medical Officer of Health to develop a breastfeeding report card.  To do so, Toronto Public Health (TPH) conducted a research study to determine rates of breastfeeding initiation, duration and exclusivity among first time mothers and to gain a better understanding of the factors which may influence these rates. 

 

The purpose of this Board of Health report is to provide a summary of the components and key findings of the research study described in the attached report, Breastfeeding in Toronto: Promoting Supportive Environments; and to contextualize the findings in relation to TPH’s mandate to protect, promote and support breastfeeding.

 

The research study found that almost all first-time Toronto mothers initiated breastfeeding and at six months postpartum almost three quarters of these mothers were still breastfeeding.  However, fewer than one in five mothers who initiated breastfeeding continued to exclusively breastfeed their babies to six months.  A number of factors including sociodemographic, sociocultural, birth-related, hospital policies and practices and community factors were found to be associated with any and/or exclusive breastfeeding at various points in time.

 

In response to these research findings, TPH will strive to achieve Baby-Friendly designation and continue to champion the Baby-Friendly Initiative with hospital and community partners.  Toronto Public Health will continue to work collaboratively with hospital and community partners to develop and implement an action plan focused on promoting breastfeeding and creating supportive environments to enable women to exclusively breastfeed to six months.

Background Information
HL29.1 - Breastfeeding in Toronto: Promoting Supportive Environments - Staff Report
(http://www.toronto.ca/legdocs/mmis/2010/hl/bgrd/backgroundfile-28171.pdf)

HL29.1 - Breastfeeding in Toronto - Promoting Supportive Environments - Attachment 1
(http://www.toronto.ca/legdocs/mmis/2010/hl/bgrd/backgroundfile-28423.pdf)

Motions
1 - Motion to Amend Item (Additional) moved by Fiona Nelson (Carried)

That the Board of Health urge the Minister of Health and Long-Term Care to forbid birthing hospitals from accepting free donations of formula or other inducements in compliance with the WHO International Code of Marketing of Breastmilk Substitutes.


2 - Motion to Amend Item (Additional) moved by Councillor Paula Fletcher (Carried)

That the Board of Health request that the Medical Officer of Health:

 

1.         report annually on birthing hospitals in Toronto which have achieved the “Baby Friendly Designation”;

 

2.         report to the Board of Health in 2011 on the success of birthing hospitals in achieving the four priority recommendations; and

 

3.         advise Toronto BIA offices and TABIA on the Breast Feeding Friendly Campaign and ask for assistance in getting businesses to be breastfeeding friendly and post the sticker.


3 - Motion to Amend Item (Additional) moved by Valerie Sterling (Carried)

That the Board of Health congratulate the Toronto East General Hospital for meeting all the requirements supporting breastfeeding, and obtaining the the Baby-Friendly Designation.


4 - Motion to Amend Item moved by Soo Wong (Carried)

That Recommendation 5. be amended to include "schools, colleges and univerisites" after the word "parks".


5 - Motion to Adopt Item as Amended moved by Councillor Paula Fletcher (Carried)

HL29.2

ACTION

Amended 

 

Ward: All 

The Provincial Early Learning Plan and Implications for Toronto Public Health

Committee Decision

 The Board of Health:

 

1.         wrote to the Premier of Ontario offering support for the Plan identified in the “With Our Best Future in Mind: Implementing Early Learning in Ontario” report, and calling on the Province to endorse the full plan and to ensure that:

 

a.         Boards of Health remain responsible for delivery of the Healthy Babies, Healthy Children (HBHC) program;

 

b.         Boards of Health receive sufficient and sustainable funding to support a full range of Reproductive Health and Child Health services in the Best Start Child & Family Centres (BSC&FC), including Healthy Babies, Healthy Children, Preschool Speech and Language, and Infant Hearing;

 

2.         requested the Medical Officer of Health to collaborate with Toronto Children’s Services (the Consolidated Municipal Service Manager) to seek opportunities to integrate appropriate early childhood public health program activities into child and family centres where feasible;

 

3.         requested the Province of Ontario to apply the provision of the Day Nurseries Act related to key public health priorities (e.g. provision of food and infection control) to the Early Learning and Childcare program;

 

4.         petitioned the provincial government to implement a monitoring and evaluation program to assess the health impact on children as they proceed through the program, as well as ensure that implementation of the program does not result in reduced childcare capacity in the City of Toronto;

 

5.         wrote to the Assistant Deputy Minister, Early Learning Division, Ontario Ministry of Education, to express support for the overall vision of the Early Learning Plan, including the establishment of Best Start Child and Family Centres, to identify potential implications for public health funding, service delivery, planning and accountability and to offer support in working with the Ministry to effectively address these implications; and

 

6.         sent this report to the Minister of Children and Youth Services, the Minister of Education, the Minister of Health and Long-Term Care, the Minister of Health Promotion, the General Manager of Toronto Children’s Services Division, the Ontario Public Health Association, the Association of Local Public Health Agencies (alpha), the Assistant Deputy Minister, Early Learning Division, Ministry of Education and the Toronto Best Start Network.

Origin
(March 4, 2010) Report from Medical Officer of Health
Summary

In June 2009, Dr Charles Pascal, the Special Advisor on Early Learning, presented his report “With Our Best Future in Mind:  Implementing Early Learning in Ontario”, to the Premier.  This report offers a bold vision for the transformation of early learning, extended child care, and family supports in Ontario.  Based on solid evidence and best practice, this vision for Ontario’s and Toronto’s young children and families offers significant potential for improving family access to service and optimizing developmental outcomes for children.

 

The Early Learning Plan proposed in the report includes a number of recommendations that have implications for public health funding, service, and accountability.  It is consistent with the goals of the Reproductive Health and Child Health requirements of the Ontario Public Health Standards and offers public health a new means of reaching out to pregnant women, young children and families.  Consequently it is recommended that the Board of Health support the overall vision of the Plan.

 

The provincial government has endorsed the full day learning and extended child care components of the Plan.  There is, however, less clarity about the Province’s commitment to the broader vision.

 

This report provides a general description of the implications of the Early Learning Report for public health services, and identifies those recommendations that the public health community and Toronto Public Health supports and those that may be of concern and/or require further clarity.  This report also describes provincial and local activities that ensure that public health is at the Early Years planning tables.

Background Information
HL29.2 - The Provincial Early Learning Plan and Implications for Toronto Public Health - Staff Report
(http://www.toronto.ca/legdocs/mmis/2010/hl/bgrd/backgroundfile-28172.pdf)

Motions
1 - Motion to Amend Item (Additional) moved by Fiona Nelson (Carried)

That the Board of Health:

 

1.         request the Province of Ontario to apply the provision of the Day Nurseries Act related to key public health priorities (eg. provision of food and infection control) to the Early Learning and Childcare program; and

 

2.         petition the provincial government to implement a monitoring and evaluation program to assess the health impact on children as they proceed through the program, as well as ensure that implementation of the program does not result in reduced childcare capacity in the City of Toronto.


2 - Motion to Amend Item (Additional) moved by Valerie Sterling (Carried)

 That the Board of Health write the Assistant Deputy Minister, Early Learning, offering support and identifying the implications for public health service planning, delivery and accountability of the broader vision – Best Start Child and Family Centres.


3 - Motion to Amend Item moved by Valerie Sterling (Carried)

Recommendation 6. be amended to include "the Ontario Public Health Association, Association of Local Public Health Agencies (alPHa), the Assistant Deputy Minister, Early Learning Division, Ministry of Education".


4 - Motion to Adopt Item as Amended (Carried)

HL29.3

Information

Received 

 

Ward: All 

Hot Weather Response Plan Update

Committee Decision

The Board of Health received Item HL29.3 for information.

Origin
(March 4, 2010) Report from Medical Officer of Health
Summary

This report provides an update on the City of Toronto Hot Weather Response Plan and the experience of summer 2009.

Background Information
HL29.3 - Hot Weather Response Plan Update - Staff Report
(http://www.toronto.ca/legdocs/mmis/2010/hl/bgrd/backgroundfile-28173.pdf)


HL29.4

Presentation

Received 

 

Ward: All 

Pandemic Influenza Preparedness Update

Committee Decision

The Board of Health received, for information, the verbal update on pandemic influenza preparedness.

Decision Advice and Other Information

Dr. Barbara Yaffe, Director and Associate Medical Officer of Health, gave a verbal update on pandemic influenza preparedness.

Summary

The Medical Officer of Health will give an update on pandemic influenza preparedness in Toronto.


HL29.5

Information

Received 

 

Ward: All 

Toronto Public Health Operating Budget Variance Report for the Twelve Months ended December 31, 2009

Committee Decision

The Board of Health received Item HL29.5 for information.

Origin
(March 4, 2010) Report from Medical Officer of Health
Summary

This report provides information to the Board of Health on the Toronto Public Health (TPH) Operating Budget Variance for the twelve months of operation ending on December 31, 2009.

 

At year-end, TPH gross expenditures were below budget by $7,021.0 thousand or 3.2 percent attributable to underspending of $732.1 thousand in Salaries and Benefits and $6,288.9 thousand in non-payroll. Revenue was underachieved by $6,289.5 thousand or 3.5 percent due to under-expenditures in provincial cost shared programs and fully funded programs, including the Children in Need of Dental Treatment (CINOT) Expansion.

Background Information
HL29.5 - Toronto Public Health Operating Budget Variance Report for the Twelve Months ended December 31, 2009 - Staff Report
(http://www.toronto.ca/legdocs/mmis/2010/hl/bgrd/backgroundfile-28174.pdf)

HL29.5 - Toronto Public Health Operating Variance Submission for the period ended December 31, 2009 - Attachment 1
(http://www.toronto.ca/legdocs/mmis/2010/hl/bgrd/backgroundfile-28175.pdf)


HL29.6

Information

Received 

 

Ward: All 

Toronto Public Health Capital Budget Variance for the Twelve Months ended December 31, 2009

Committee Decision

The Board of Health received Item HL29.6 for information.

Origin
(March 1, 2010) Report from Medical Officer of Health
Summary

This report provides an update to the Board of Health on the Toronto Public Health (TPH) Capital Budget variance for the twelve-month period ended December 31, 2009 (Appendix 1).

 

Toronto Public Health spent $3.934 million or 69.4 percent of the 2009 approved cash flow of $5.670 million as of December 31, 2009.  Two projects were completed in 2009.  The year-end under expenditure of $1.732 million will be carried forward to 2010.

Background Information
HL29.6 - Toronto Public Health Capital Budet Variance for the Twelve Months ended December 31, 2009 - Staff Report
(http://www.toronto.ca/legdocs/mmis/2010/hl/bgrd/backgroundfile-28176.pdf)

HL29.6 - Toronto Public Health 2009 Capital Budget Variance Report Preliminary for the Year Ended December 31, 2009 - Appendix 1
(http://www.toronto.ca/legdocs/mmis/2010/hl/bgrd/backgroundfile-28177.pdf)


HL29.7

Information

Received 

 

 

Local Health Committee Minutes

Committee Decision

The Board of Health received Item HL29.7 for information.

Summary

Local Health Committees submitting the following:

 

-           Minutes of the Etobicoke/York Local Health Committee meeting held on June 11, 2009.

 

-           Minutes of the Etobicoke/York Local Health Committee meeting held on October 15, 2009.

 

-           Minutes of the Etobicoke/York Local Health Committee meeting held on November 12, 2009.

 

-           Minutes of the Etobicoke/York Local Health Committee meeting held on January 14, 2010.

 

-           Minutes of the North York Local Health Committee meeting held on January 14, 2010. 

Background Information
HL29.7 - Etobicoke and York Local Health Committee Minutes - June 11, 2009
(http://www.toronto.ca/legdocs/mmis/2010/hl/bgrd/backgroundfile-27434.pdf)

HL29.7 - Etobicoke and York Local Health Committee Minutes - October 15, 2009
(http://www.toronto.ca/legdocs/mmis/2010/hl/bgrd/backgroundfile-27435.pdf)

HL29.7 - Etobicoke and York Local Health Committee Minutes - November 12, 2009
(http://www.toronto.ca/legdocs/mmis/2010/hl/bgrd/backgroundfile-27436.pdf)

HL29.7 - Etobicoke andYork Local Health Minutes - January 14, 2010
(http://www.toronto.ca/legdocs/mmis/2010/hl/bgrd/backgroundfile-27437.pdf)

HL29.7 - North York Local Health Committee Minutes - January 14, 2010
(http://www.toronto.ca/legdocs/mmis/2010/hl/bgrd/backgroundfile-27961.pdf)


HL29.8

ACTION

Amended 

 

Ward: All 

Special Diet Allowance Program

Committee Decision

The Board of Health:

 

1.         requested the Chair of the Board of Health to write to the Minister of Community and Social Services requesting the Minister to:

 

a.         continue the Special Diet Allowance Program as part of Ontario’s social assistance system; and

 

b.         implement the Ontario Human Rights Tribunal’s decision to provide adequate financial support to those eligible;

 

2.         requested the Ontario Minister of Finance to include the provisions for the Special Diet Allowance in the current budget; and

 

3.         forwarded the Board of Health recommendations on this matter to the Social Assistance Review Advisory Council.

 

Origin
(March 1, 2010) Letter from Cindy Wilkey, Income Security Advocacy Centre, submitted by Vaijayanthi Chari on behalf of the Scarborough Local Health Committee
Summary

Vaijayanthi Chari circulated a letter (March 1, 2010) from the Income Security Advocacy Centre which was considered at a recent meeting of the Scarborough Local Health Committee entitled "Special Diet Program Contravenes Human Rights: Province Considers Scrapping Program in Response".

Background Information
HL29.8 - Letter (March 1, 2010) from Cindy Wilkey, Income Security Advocacy Centre, submitted by Vaijayanthi Chari on behalf of the Scarborough Local Health Committee
(http://www.toronto.ca/legdocs/mmis/2010/hl/bgrd/backgroundfile-28585.pdf)

Motions
1 - Motion to Add New Business at Committee moved by Vaijayanthi Chari (Carried)

2 - Motion to Adopt Item moved by Vaijayanthi Chari (Carried)

That the Chair of the Board of Health write to the Minister of Community and Social Services:

 

1.         requesting the Minister to continue the Special Diet Allowance Program as part of Ontario’s social assistance system; and

 

2.         to implement the Human Rights Tribunal’s decision to provide adequate financial support to those eligible.

 

 


3 - Motion to Amend Item (Additional) moved by Valerie Sterling (Carried)

That the Board of Health:

 

1.         request the Minister of Finance to include the provisions for the Special Diet Allowance in the current budget; and

 

2.         forward the Board of Health recommendations to the Social Assistance Review Advisory Council. 

 


Procedural Motions
Motion to Adopt Minutes moved by Fiona Nelson (Carried)
Monday, March 22, 2010
Councillor John Filion, Chair, Board of Health
Meeting Sessions
Session Date Session Type Start Time End Time Public or Closed Session
2010-03-22 Afternoon 1:15 PM 2:35 PM Public
Attendance
Members were present for some or all of the time period indicated.
Date and Time Quorum Members
2010-03-22
1:15 PM - 2:35 PM
(Public Session)
Present Present: Bravo, Castro, Chari, Cho, Filion (Chair), Fletcher, Lee, Nelson, O'Brien, Perks, Sterling, Wong
Not Present: Davis