Toronto Public Health Service Level Review

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1 Toronto Public Health Service Level Review Dr. David McKeown, Medical Officer of Health Presentation to Executive Committee June 30, 2015

2 Health in Toronto 31,500 births annually 80,000 communicable diseases reported annually 17,000 food premises 86 long-term care homes 21 hospital sites 924 licensed day nurseries 3,469 personal services settings 808 schools - 2 -

3 Ontario Public Health Standards 147 Requirements: assessment and surveillance, health promotion and policy development, disease prevention, and health protection 26 Protocols

4 Toronto Public Health Program Map Toronto Public Health TPH reduces health inequalities and improves the health of the whole population Public Health Foundations Chronic Diseases & Injuries Family Health Infectious Diseases Environmental Health Emergency Preparedness Purpose: To ensure effective public health programs responding to the health needs of the population. Purpose: To reduce the burden of preventable chronic diseases and injuries of public health importance and reduce the frequency and severity of preventable injury and of substance misuse. Purpose: To enable individuals and families to achieve optimal preconception health, experience a healthy pregnancy, have the healthiest newborn(s) possible, and be prepared for parenthood and all children to attain and sustain optimal health and developmental potential. Purpose: To prevent or reduce the burden infectious diseases of public health importance. Purpose: To prevent and reduce the burden of illness from health hazards in the physical environment. Purpose: To ensure a consistent and effective response to public health emergencies and emergencies with public health impacts

5 Key Service Levels Chronic Diseases & Injuries 250, , , ,000 Projected Actuals Number (#) of Student Nutrition Toronto (SNT) participants 50, ,000 16,000 14,000 12,000 10,000 8,000 6,000 4,000 2,000 0 Approved Actual Number (#) inspections done for tobacco enforcements SFOA amendments will result in increased inspections Note: 2015 Actuals throughout the presentations are projections based on current year-to-date actuals - 5 -

6 Key Service Levels Family Health 90% 80% 70% 60% 50% 40% 30% 20% 10% Approved Actual Percentage (%) of newborns screened for Healthy Babies, Healthy Children (HBHC) program Variance in actuals due to new HBHC screen tool Insufficient staffing to support screening completion 0% 34,000 33,000 32,000 31,000 Number (#) of clients receiving dental treatment in all TPH clinics (including children, seniors, and adults) 30,000 29,000 28,000 27,000 26,000 Approved Actual 2012 to 2013 Variance is 3.69% Same % increase was used for 2015 projections Potential duplication in # of patients entered for 2014 due to change in system used - 6 -

7 Key Service Levels Infectious Diseases 90,000 85,000 80,000 75,000 Approved Actual Number (#) of notifications of infectious diseases received, assessed, and reviewed 70,000 65,000 88,000 86,000 84,000 82,000 80,000 78,000 Approved Actual Number of vaccinations provided for Hepatitis B, meningococcal and HPV provided to grade 7 & 8 76,

8 Key Service Levels Environmental Health 18,000 Number (#) of food premises inspected annually Approved Actual 15, , , ,000 Number (#) of mosquito catch basins treated with larvacide 380, , ,000 Approved Actual 320, ,

9 Service Challenges, Opportunities, and Strategies

10 Service Challenges, Opportunities and Strategies - Student Nutrition Program Challenges Opportunities Strategies Rising food costs Unmet demand in higher needs communities Efficiencies in food procurement & delivery Increase private & public fundraising Food procurement pilots Governance review

11 Service Challenges, Opportunities and Strategies - Family Health (Oral Health) Challenges Opportunities Strategies Dental wait List for approx seniors Access to dental care for low income adults & seniors Provincial integration of 6 dental programs for children Reinvesting City funds that become available after integration Advocating to the province for dental program for low income adults/seniors

12 Service Challenges, Opportunities and Strategies - Vaccine Preventable Diseases Challenges Opportunities Strategies New school vaccination requirements Implementing Panorama (immunization information system) Not compliant with provincial requirements for day nursery immunization Parental vaccine hesitancy Provincial immunization review recommendations Federal approval of 2-dose HPV vaccination schedule Provincial funding advocacy Phased implementation of day nursery immunization program Catch-up school clinics Enhanced vaccine information and promotion

13 Service Challenges, Opportunities and Strategies - Tobacco Enforcement Challenges Enforcement workload from enhanced provincial and municipal regulation Opportunities Program Based Grant & One-time Funding available from the Ministry of Health & Long-Term Care Strategies Hand-held field technology to increase service efficiency

14 Thank You Toronto Public Health Annual Report

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