Agenda

The Medical Officer of Health recommends that:

1.         The Board of Health urge the provincial government to improve service access and efficiency by consolidating provincially funded dental programs for low income children into one coherent, comprehensive basic dental prevention and treatment program with common services and eligibility requirements.

2.         The Board of Health ask the provincial government to allocate unspent funds from recent investments in dental services for low income families to implement a new primary dental care program for low income adults using the existing clinic infrastructure. A primary dental care program for adults should at a minimum provide treatment of pain, infection and trauma.

3.         The Board of Health approve the revised financial eligibility requirements for the municipally-funded dental program to reflect updated Statistics Canada Low Income Cut Off levels.

4.         The Medical Officer of Health review the capacity and utilization of all dental clinic sites operated by Toronto Public Health or in which it is a principal partner, to determine the optimal configuration of the City-funded dental infrastructure with respect to client access and service efficiency.

This report provides an update of the implementation of the 100% provincially funded Healthy Smiles Ontario (HSO) dental program for children and youth in Toronto.

Of the five dental clinics that were approved for construction, two are complete. Toronto Public Health (TPH) recently received approval for capital funding to complete the other clinics and to purchase the mobile dental van within the current fiscal year. It is expected that this project will be completed by December 31, 2011.

The objective of the HSO program is to improve the oral health of children and youth living in low income families by giving them improved access to preventive and maintenance dental care. Toronto Public Health supports the province's efforts to improve the oral health of children in low income families. However, due to the stringent financial eligibility requirement, the HSO dental program has been under-utilized.

The issue of access to dental care for low income adults 18-64 years old needs to be addressed. They are the most in need and the least served segment of Toronto's population. From an analysis of the provincial government commitment to spend $45 million annually to fund a dental program for low income families, there appears to be sufficient unspent funds and a growing infrastructure that could be used to offer primary dental care i.e. the relief of oral pain and infection, for adults. It is recommended that the Board Of Health (BOH) advocate to the province to streamline, consolidate and standardize provincially funded dental programs for children and youth, and use the combination of savings arising from these efficiencies, and the unspent funds from the expansion of the Children In Need Of Treatment (CINOT) and from the HSO dental programs to address the pressing dental core needs of low income adults. Access to primary dental care for low income adults will reduce their burden of illness, and contribute to improvement in health and wellbeing.

 The Medical Officer of Health recommends that:

1.         City Council approve the Toronto Public Health 2012 Operating Budget request of  $228,226.7 thousand gross / $41,137.4 thousand net as summarized in Table 1, “2012 Operating Budget Request”.

2.         City Council approve the list of base budget adjustments included in Table 5, “Overview of 2012 Operating Budget Request” of this report totalling an increase of $1,999.8 thousand gross and $818.5 thousand net.

3.         City Council approve 2012 Reduction Options of $8,242.6 thousand gross and $4,458.4 thousand net as outlined in Table 3, "2012 Requested Reduction Options Budget".

4.         The Board of Health forward this report to the City's Budget Committee for its consideration during the 2012 budget process.

This report outlines the Toronto Public Health (TPH) 2012 Operating Budget request for consideration by the Board of Health.

The Toronto Public Health 2012 Operating Budget Request totals $228,226.7 thousand gross / $41,137.4 thousand net.  This request is $6,242.8 thousand gross and $3,639.9 thousand net below the 2011 Operating Budget. The net decrease of $3,639.9 thousand over the 2011 Operating Budget is comprised of base budget increases for the negotiated collective agreement of $818.5 thousand net and reduction options of 10 percent or $4,458.4 thousand net.

The Medical Officer of Health recommends that:

1.         The Toronto Public Health 2011 Approved Operating Budget be adjusted as follows:

a.         an increase of $220.8 thousand gross and $0.0 net to reflect confirmed 100 percent base funding from the Ministry of Health and Long-Term Care; and

b.         an increase of $1,175.0 thousand gross and $0.0 net to reflect the  one -time  100 percent  funding from the Provincial ministries.

2.         The Board of Health forward this report to the Budget Committee for consideration.

This report seeks approval for budget adjustments to the Toronto Public Health (TPH) 2011 Approved Operating Budget due to confirmation of funding from various Provincial ministries received after the submission of the 2011 Operating Budget request in January 2011.

See table in the staff report for financial impact information.

The Deputy City Manager and Chief Financial Officer has reviewed this report and agrees with the financial impact information.

This report provides an update to the Board of Health on the Toronto Public Health (TPH) Capital Budget variance for the six  month period ended June 30, 2011.

Toronto Public Health spent $1.497 million or 25.6 percent of the 2011 approved cash flow of $5.839 million as of June 30, 2011.

The year-end capital expenditure is projected to be $5.056 million or 86.6 percent of the final approved cash flow of $5.839 million.

See table in the staff report for financial impact information.

The Deputy City Manager and Chief Financial Officer has reviewed this report and agrees with the financial impact information.

This report provides an update to the Board of Health on the Toronto Public Health (TPH) Operating Budget Variance for the six months of operation ending on June 30, 2011.

Toronto Public Health’s operating budget was under spent by $794.2 thousand net or 3.6 percent for the six-month period ending on June 30, 2011.

Toronto Public Health gross expenditures were below budget by $5,970.1 thousand or 5.5 percent, attributable to the under spending of $4,760.0 thousand in Salaries and Benefits and $1,210.1 thousand in non payroll including utility costs. Revenue was underachieved by $5,175.9 thousand due to under-spending in provincial cost shared and fully funded programs.  At year end, Toronto Public Health expects to be under spent in gross expenditures by $7,800.0 thousand (3.3 percent) and below budget in revenue by $6,758.0 thousand (3.6 percent) resulting in $1,042.0 thousand (2.3 percent) net favourable variance.

See table in the staff report for financial impact information.

The Deputy City Manager and Chief Financial Officer has reviewed this report and agrees with the financial impact information.