board of health for the peterborough county-city health ... · zoey wilton, peer leader . wes...

Board of Health for the Peterborough County-City Health Unit

AGENDA Board of Health Meeting

Wednesday, June 12, 2013 - 4:45 p.m. Lower Hall, Administration Building,

123 Paudash Street, Hiawatha First Nation

1. Welcome and Opening Prayer

2. Call to Order

2.1. New Member – Councillor Trisha Shearer, Hiawatha First Nation

3. Confirmation of the Agenda

4. Declaration of Pecuniary Interest

5. Delegations and Presentations 5.1. Presentation: A Day In The Life – Communications Secretary

Jane Naylor, Secretary

5.2. Presentation: Hiawatha Health Services Update Trudy Heffernan, Health and Social Services Manager

5.3. Presentation: Public Health - There’s An App For That

Miranda Doris, Peer Leader Zoey Wilton, Peer Leader Wes Sherman, Peer Leader

6. Confirmation of the Minutes of the Previous Meeting

6.1. May 8, 2013

7. Business Arising From the Minutes

8. Correspondence

9. New Business

9.1. Presentation: PCCHU Social Media Update Brittany Cadence, Communications Supervisor Kerri Tojcic, Computer Technician Analyst

9.2. Presentation: Emergency Preparedness

Donna Churipuy, Manager, Environmental Health Programs

9.3. Staff Report: Smoke-Free Multi-Unit Dwellings Update Donna Churipuy, Manager, Environmental Health Programs

9.4. 2012 Draft Audited Financial Statements

Brent Woodford, Director, Corporate Services Richard Steiginga, CA, Partner, Collins Barrow Chartered Accountants

9.5. alPHa Conference and Annual General Meeting Update

Dr. Rosana Pellizzari, Medical Officer of Health Jim Embrey, Board Member

9.6. Association of Municipalities of Ontario Conference, August 18-21

Dr. Rosana Pellizzari, Medical Officer of Health

9.7. Committee Report: Governance Chief Williams, Chair, Governance Committee

9.8. Committee Report: Property

Deputy Mayor Sharpe, Chair, Property Committee

9.9. 2013-17 PCCHU Strategic Plan Approval Dr. Rosana Pellizzari, Medical Officer of Health Larry Stinson, Director, Public Health Programs

10. In Camera to Discuss Confidential Personal and Property Matters

11. Date, Time, and Place of the Next Meeting

September 11, 2013, 4:45 p.m. General Committee Room, City Hall, 500 George St. N.

12. Adjournment

BOH Meeting – June 12, 2013 Item 6.1 - Page 1


MINUTES Wednesday, May 8, 2013

(Council Chambers, Administration Building, 22 Wiinookeedaa Rd., Curve Lake First Nation)

Present: Board Members: Councillor Henry Clarke Mr. Jim Embrey

Mayor John Fallis Councillor Lesley Parnell

Deputy Mayor Andy Sharpe Mayor Mary Smith Chief Phyllis Williams, Vice Chair

Regrets: Councillor Andrew Beamer

Councillor Trisha Shearer Mr. David Watton, Chair

Staff: Ms. Brittany Cadence, Supervisor, Communications Services Mrs. Janet Dawson, Health Promoter Mrs. Barbara Matwey, Administrative Assistant (Recorder) Dr. Rosana Pellizzari, Medical Officer of Health Mr. Larry Stinson, Director, Public Health Programs Mrs. Alida Tanna, Administrative Assistant Mr. Brent Woodford, Director, Corporate Services 1. Welcome and Opening Prayer

Chief Williams welcomed Board members, staff and visitors to Curve Lake First Nation and opened the meeting with a prayer.

2. Call to Order

In Mr. Watton’s absence, Chief Williams assumed the Chair called the meeting to order at 4:45 p.m.

2.1 New Member – Councillor Trisha Shearer, Hiawatha First Nation Chief Williams advised the Board that the new Board member from Hiawatha

First Nation was unable to attend the meeting due to a scheduling conflict.


Councillor Shearer will be in attendance at the next Board of Health meeting which will be held in Hiawatha.

2.2 Reappointment – Jim Embrey, Provincial Appointee

Chief Williams congratulated Mr. Embrey on his recent reappointment to the

Board of Health. His term has been extended to April 17, 2016.

3. Confirmation of the Agenda Moved by Seconded by Councillor Parnell Mayor Fallis That the agenda be approved as circulated.

- Carried (M-13-64)

4. Declaration of Pecuniary Interest There were no declarations of pecuniary interest.

5. Delegations and Presentations

5.1 Presentation: A Day in the Life – Access to Recreation/Physical Activity Program Presenter: Janet Dawson, Public Health Nurse

5.2 Presentation: Emerald Ash Borer – The Threat to the Urban Forest

Presenter: Wayne Jackson, Director of Utility Services & Deputy CAO, City of Peterborough

5.3 Presentation: TreeAzin® Systemic Insecticide and Emerald Ash Borer Management

Presenter: Joe Meating, B.Sc., M.Sc., President, BioForest Technologies Inc. 5.4 Delegation: Kasshabog Lake Dust and Noise Issues

Bev MacLeod, Resident Break for dinner at 6:10 p.m.

6. Approval of Minutes Moved by Seconded by Councillor Parnell Mayor Smith

That the minutes of the Board of Health meeting held on April 10, 2013 be approved as amended.

- Carried (M-13-65)


Moved by Seconded by Councillor Parnell Mayor Smith

That the minutes of the Board of Health meeting held on April 24, 2013 be approved as circulated. - Carried (M-13-66)

7. Business Arising From The Minutes Nil.

8. Correspondence

Moved by Seconded by Councillor Parnell Councillor Clarke

That the following documents be received for information and acted upon as deemed appropriate.

1. Letter dated April 17, 2013 from the Board Chair to Minsters Piruzza, Matthews and Sandals regarding student nutrition programs. 2. Letter dated April 17, 2013 from the Board Chair to Premier Wynne and Minister

Leal regarding student nutrition programs. 3. Letter dated April 17, 2013 from the Board Chair to Mr. Paul Godfrey, Ontario

Lottery and Gaming Corporation regarding support for problem gambling. 4. Letter dated April 17, 2013 from the Board Chair to Premier Wynne and Ministers

Sousa and Matthews regarding the public health impact of casino expansion. 5. Resolutions/Letters from other local public health agencies: Middlesex London - Artificial Tanning Niagara - Artificial Tanning North Bay Parry Sound - Healthy Kids Panel - Carried - (M-13-67) Moved by Seconded by Mayor Fallis Mr. Embrey

That the Board of Health for the Peterborough County-City Health Unit write a letter to the federal government to advocate for funding for school nutrition programs. - Carried - (M-13-68)

9. New Business 9.1 Staff Report: Emerald Ash Borer Dr. Rosana Pellizzari, Medical Officer of Health


Moved by Seconded by Councillor Clarke Councillor Parnell

That the Board of Health for the Peterborough County-City Health Unit:

receive the report for information;

express its support for the City of Peterborough’s Emerald Ash Borer program; and

forward a copy of the staff report to County, Township and First Nation Councils encouraging them to consider implementing a monitoring and control plan, supplemented by a public education campaign on the prevention of the Emerald Ash Borer.

- Carried - (M-13-69) 9.2 Staff Report: Mandatory Re-Inspection of On-Site Sewage Systems Atul Jain, Manager, Inspection Services

Moved by Seconded by

Deputy Mayor Sharpe Mayor Smith That the Board of Health for the Peterborough County-City Health Unit receive this report for information; and, direct staff to bring forward a draft County by-law for approval in Fall 2013, confirming the Health Unit as the Principal authority and proposing the Health Unit conduct the mandatory re-inspection of on-site sewage systems from January 1, 2014 to December 31, 2016. -Carried- (M-13-70)

9.3 Staff Report: Cuts to Discretionary Benefits – Update to the Board of Health Larry Stinson, Director, Public Health Programs Moved by Seconded by Mayor Fallis Councillor Clarke That the Board of Health for the Peterborough County-City Health Unit receive the staff report, Cuts to Discretionary Benefits: Update to the Board of Health, for information. - Carried - (M-13-71)

9.4 Q1 2013 Program Report Larry Stinson, Director, Public Health Programs Mr. Stinson provided an overview of the Health Unit’s activities during the last quarter of 2013. Moved by Seconded by Councillor Parnell Mayor Fallis

That the Board of Health for the Peterborough County-City Health Unit receive the Q1 2013 Program Report for information.

- Carried - (M-13-72)


9.5 Q1 2013 Financial Report Brent Woodford, Director, Corporate Services Mr. Woodford provided an overview of the Health Unit’s financial status for the first quarter of 2013. Moved by Seconded by Mr. Embrey Mayor Smith That the Board of Health for the Peterborough County-City Health Unit receive the report, Q1 2013 Financial Update, for information.

- Carried - (M-13-73)

9.6 2013- Budget Approval – Healthy Babies, Healthy Children Program Brent Woodford, Director, Corporate Services

Moved by Seconded by Councillor Clarke Councillor Parnell That the Board of Health for the Peterborough County-City Health Unit approve the 2013 budget for the Healthy Babies, Healthy Children program in the total amount of $828,413.

- Carried - (M-13-74)

9.7 2013-14 Budget Approval – Infant and Toddler Development Program Brent Woodford, Director, Corporate Services

Moved by Seconded by

Councillor Parnell Mayor Fallis That the Board of Health for the Peterborough County-City Health Unit approve

the 2013-14 budget for the Infant and Toddler Development Program (ITDP) in the total amount of $242,423.

- Carried - (M-13-75)

9.8 Reportable Diseases in Peterborough County-City 2012 Dr. Rosana Pellizzari, Medical Officer of Health Moved by Seconded by Mayor Fallis Mayor Smith

That the Board of Health for the Peterborough County-City Health Unit receive the report, Reportable Diseases in Peterborough County-City 2012, for information.

- Carried - (M-13-76) 9.9 alPHa Membership Renewal Dr. Rosana Pellizzari, Medical Officer of Health


Moved by Seconded by Mr. Embrey Councillor Clarke

That the Board of Health for the Peterborough County-City Health Unit approve the 2013-14 annual membership fee for the Association of Local Public Health Agencies (alPHa) in the amount of $6,855.36.

- Carried - (M-13-77)

9.10 Resolutions for the alPHa Annual General Meeting (June 3-4, 2013) Dr. Rosana Pellizzari, Medical Officer of Health

Moved by Seconded by Mayor Smith Deputy Mayor Sharpe

That the Board of Health for the Peterborough County-City Health Unit support the following resolutions to be voted on at the June 3, 2013 alPHa Annual General Meeting:

A13-2 - The Healthy Smiles Ontario Program and the Overall Inequity within the Oral Health Care System

A13-3 - Mandatory Baby-Friendly Designation for all Ontario Hospitals with Birthing Units

A13-4 - Gambling Expansion and Provincial Revenue Generation

A13-5 - Provincial Legislation to Prohibit the Use of Waterpipes in Enclosed Public Places and Enclosed Workplaces

- Carried - (M-13-78)

9.11 Strategic Plan Update Dr. Rosana Pellizzari, Medical Officer of Health Mr. Larry Stinson, Director, Public Health Programs Dr. Pellizzari and Mr. Stinson reviewed the draft strategic plan with Board members. The final report will be brought back for approval at the next Board of Health meeting in June.

10. In Camera to discuss Confidential Personal and Property Matters Moved by Seconded by Councillor Clarke Councillor Parnell

That the Board of Health go In Camera to discuss confidential Personal matters. - Carried - (M-13-79)

Moved by Seconded by Councillor Parnell Mayor Smith That the Board of Health rise from In Camera.

- Carried - (M-13-80)


Motions for Open Session

Moved by Seconded by Mayor Smith Mr. Embrey

That the Board of Health for the Peterborough County-City Health Unit direct staff to post the Non-Union Pay Equity Plan. -Carried - (M-13-81)

11. Date, Time, and Place of the Next Meetings

4:45 p.m., Wednesday, June 12, 2013; Council Chambers, Lower Hall, Administration Building, 123 Paudash Street, Hiawatha First Nation

12. Adjournment Moved by Seconded by Councillor Clarke Mayor Fallis That the meeting be adjourned.

- Carried - (M-13-82) The meeting adjourned at 8:07 p.m. _____________________________ __________________________ Chairperson Medical Officer of Health

To: All Members Board of Health

From: Dr. Rosana Pellizzari, Medical Officer of Health Subject: Correspondence Date: June 12, 2013

Recommendation: That the following documents be received for information and acted upon as deemed appropriate.

1. Letter dated May 7, 2013 from the Ontario Lottery and Gaming Corporation to the

Board Chair, in response to his initial letter dated April 17, 2013, regarding the provision of greater support to the prevention, treatment and research of problem gambling. REF. P. 3-4

2. Letter dated May 13, 2013 from Dr. Pellizzari to Curve Lake First Nation, Hiawatha First

Nation, County of Peterborough and Township Councils regarding the Emerald Ash Borer. Note: This correspondence was also provided to appropriate City of Peterborough staff. REF. P. 5

3. Letter dated May 28, 2013 from the Board Chair to Minister Flaherty regarding school nutrition programs. REF. P. 6-7

4. Letter dated May 28, 2013 from Minister Piruzza to the Board Chair, in response to his initial letter dated April 17, 2013, regarding school nutrition programs. REF. P. 8-9

5. Email received June 66, 2013 from the Association of Local Public Health Agencies (alPHa) regarding the disposition of the June 2013 alPHa Resolutions. REF. P. 10-22

6. Resolutions/Letters from other local public health agencies: Durham - Built Environment REF. P. 23-24 - Health Kids Strategy REF. P. 25 - Nicotine Replacement Therapy REF. P. 26

Porcupine - Built Environment REF. P. 27-28 - Oral Health REF. P. 29-30 Simcoe Muskoka - Menu Labelling REF. P. 31-32 Sudbury - Opportunity for All: The Path to Health Equity REF. P. 33-34 Toronto Public Health - Menu Labelling REF. P. 35-37

10 Hospital Drive, Peterborough, ON K9J 8M1 P: (705) 743-1000 or 1-877-743-0101 F: (705) 743-2897 www.pcchu.ca

May 13, 2013 ATTENTION: Council Members (Curve Lake First Nation, Hiawatha First Nation, County of

Peterborough, Townships) Dear Community Partner: The Emerald Ash Borer (EAB) is a highly destructive invasive beetle. It is a pest of ash trees which was confirmed to be present in Canada in the summer of 2002. It has killed a large number of ash trees in North America and poses a major economic and environmental threat to urban and forested areas across Canada and the United States. It has been found in several communities in both Durham region and Frontenac County and is expected to reach the Peterborough area in the near future. On May 8, 2013, the Board of Health (BOH) for the Peterborough County-City Health Unit (PCCHU) was presented with a staff report on Emerald Ash Borer. In addition, the City of Peterborough, along with a representative from BioForest Technologies Inc., presented on the City’s EAB prevention plan which the BOH endorsed during the meeting. Please find attached PCCHU’s staff report on EAB. It is essential that all partners including federal and provincial health departments, First Nations, provincial and municipal governments and industry continue to work together to protect Canada's valuable forest resources. To that end, I ask that you share this report with relevant partners within your organization and consider implementing a monitoring and control plan. In addition, I would encourage you to educate both staff and residents on the prevention of EAB, with emphasis on the importance of NOT moving firewood into the Peterborough area from endemic areas. Sincerely, Original signed by Rosana Pellizzari, MD, MSc, CCFP, FRCPC Medical Officer of Health, Peterborough County-City Health Unit /at Encl.

http://www.bioforest.ca/


May 28, 2013 The Honourable James M. Flaherty Minister of Finance Department of Finance Canada 140 O'Connor Street Ottawa, ON K1A 0G5 Dear Minister Flaherty: At its February 13, 2013 meeting, the Board of Health for the Peterborough County-City Health Unit reviewed the current status of the Student Nutrition Programs in local elementary and secondary schools. Subsequently, the Board of Health endorsed the enclosed report entitled “Student Nutrition Programs: Best Practices, Actions for Sustainability and Call to Action for Food For Kids Peterborough and County”. Student Nutrition Programs (SNP) including breakfast and snack programs supported by Food For Kids Peterborough and County with support from over 175 local community partners who donate food, funding, supplies, space and/or volunteer time were highlighted as an initiative with positive results and a direct impact on the health and learning capacity of children and youth. In the 2011-12 school year, over 1.8 million breakfasts and snacks were served to local students through breakfast programs. The Board of Health also endorsed the vision of Student Nutrition Programs (SNP), delivered in Peterborough County and City schools by Food For Kids Peterborough and County, that all students who would benefit can achieve the positive health, learning and behavioural outcomes that result from this key nutrition strategy and sound public policy. The Board of Health learned that despite a decade of evidence supporting the need for universal Student Nutrition Programs and local programs meeting international best practices, funding for local programs is at a critical point. Increasing student need, expanding programs, increasing food costs and decreased funding from foundations traditionally supporting SNPs, means that Food For Kids Peterborough and County programs are currently vulnerable. At its May 8, 2013 meeting, the Board of Health made the decision to write to you to outline the need for support from the Government of Canada for Student Nutrition Programs. A 2012 report from the City of Toronto1 outlined international funding models and highlighted that Canada remains the only G8 country not directly funding Student Nutrition Programs. We believe that governments at all levels have a role to play in protecting children’s health and improve their ability to learn and urge the federal government to provide both leadership and support for universal school nutrition programs.

Page 1 of 2


In closing, we look forward to working with you, as well as our active community partners to address the need for increased funding for Student Nutrition Programs. Given the threats Peterborough faces in its ability to sustain these programs, we would appreciate your immediate attention to this matter. Yours in health, Original signed by David Watton Chair, Board of Health Peterborough County-City Health Unit /at Encl. cc: Dean Del Mastro, MP Peterborough

Barry Devolin, MP Haliburton-Kawartha Lakes-Brock 1 Toronto Public Health: Nourishing Young Minds, June 2012

Page 2 of 2

June 2013 DISPOSITION OF RESOLUTIONS

alPHa Resolutions Session, 2013 Annual Conference Monday, June 3, 2013 Admiral Ballroom Radisson Admiral Toronto Harbourfront Hotel Toronto, Ontario

RESOLUTIONS CONSIDERED AT June 2013 alPHa Annual Conference

Resolution Number Title Sponsor Action from

Conference

A13-1 Banning the Sale and Distribution of All Tobacco Products in the Province by the Year 2030

Board of Health for the Haliburton, Kawartha, Pine Ridge District Health Unit

Referred to alPHa Board

A13-2 The Healthy Smiles Ontario Program and the Overall Inequity within the Oral Health Care System

Board of Health for the Haliburton, Kawartha, Pine Ridge District Health Unit

Carried as amended

A13-3 Baby-Friendly Designation for All Ontario Hospitals


Carried as amended

A13-4

Gambling Expansion and Provincial Revenue Generation

Toronto Public Health Carried as amended

A13-5

Provincial Legislation to Prohibit the Use of Waterpipes in Enclosed Public Places and Enclosed Workplaces

Simcoe Muskoka District Health Unit Carried

A13-6

Mandatory Physical Education for Ontario Secondary School Students

Haliburton, Kawartha, Pine Ridge District Health Unit

Carried as amended

alPHa RESOLUTION A13-1 TITLE: Banning the Sale and Distribution of All Tobacco Products in the Province by the Year

2030 SPONSOR: Board of Health for the Haliburton, Kawartha, Pine Ridge District Health Unit WHEREAS smoking, along with other forms of tobacco use, remains the leading cause of illness and

death in Ontario; and WHEREAS tobacco use is responsible for three times as many deaths as the combined total of

alcohol, drugs, suicide, homicide, injuries sustained from car crashes, and AIDS1; and WHEREAS scientific studies have concluded that cigarette smoking causes chronic lung disease,

coronary heart disease, stroke, cancer of the lungs, larynx, esophagus, mouth, and bladder, and contributes to cancer of the cervix, pancreas, and kidneys2; and

WHEREAS the use of cigars is known to cause lung, larynx, esophageal, and oral cancer3; and WHEREAS there is no safe level of exposure to second hand smoke and over the past three

decades, a substantial body of research has confirmed that exposure to tobacco smoke among children and adults causes a range of adverse health effects4; and

WHEREAS smoking during pregnancy not only affects the health of a mother, but also her unborn

and newborn baby5, including: a higher risk of miscarriage and complications during birth; having an infant with low birth weight;6 more prone to illnesses (e.g. asthma7 or sudden infant death syndrome8); and a higher chance of death at birth or shortly after;2 and

WHEREAS second-hand smoke exposure causes children to suffer from lower respiratory tract

infections, such as pneumonia and bronchitis, exacerbates childhood asthma, and increases the risk of acute, chronic, middle ear infection in children16; and

WHEREAS smokeless tobacco has over 3,000 chemicals including 28 known carcinogens, is not a

safe substitute for cigarettes and increases the risk of having a fatal heart attack, fatal stroke and certain cancers;9 and

WHEREAS the World Health Organization (WHO) estimates that by 2030, tobacco will account for

10 million deaths per year, making it the greatest cause of death worldwide;10 and WHEREAS more than 13,000 people die in Ontario from tobacco-related diseases every year,

making it the number one cause of death and disease in Ontario;11 and WHEREAS in 2002, in Ontario, the direct cost for health care related to tobacco was $1.6 billion

rising to the equivalent of $1.93 billion in 2009 when inflation and population growth are considered; 13, 7 and

WHEREAS the economic value of labour productivity lost to tobacco related illness was $4.4 billion

in 2002, with the 2009 equivalent calculated to be $5.8 billion;12 WHEREAS Ontario law acknowledges the harms of tobacco use by prohibiting the sale or furnishing

of cigarettes, tobacco products or smoking paraphernalia to minors; and WHEREAS Ontario law prohibits public school students from smoking or using tobacco products on

school property, including parking lots; and WHEREAS some Ontario jurisdictions prohibit smoking in playgrounds and recreational facilities; NOW THEREFORE BE IT RESOLVED that the Association of Local Public Health Agencies request the Ministry of Health and Long Term Care and its stakeholders to provide for the public health, safety, and welfare of all Ontario citizens by banning the sale and distribution of all tobacco products in Ontario by 2030, and by continuing to implement the recommendations made by the Smoke-Free Ontario – Scientific Advisory Committee as a means of achieving a tobacco-free Ontario; AND FURTHER that the Premier of Ontario, the Minister of Finance, the Chief Medical Officer of Health, the Ontario Public Health Association and Ontario Boards of Health be so advised. ACTION FROM CONFERENCE: Referred to alPHa Board of Directors References 1 Holowaty E, Cheong SC, Di Cori S, Garcia J, Luk R, Lyons C, Therialt ME. Tobacco or health in Ontario: Tobacco attributed cancers and deaths over the past 50 years... and the next 50. Toronto, ON: Cancer Care Ontario, 2002. Available at: http://www.cancercare.on.ca/common/pages/UserFile.aspx?fileId=14456 2 U.S. Department of Health and Human Services. The health consequences of smoking: A report of the Surgeon General. Atlanta, GA: U.S. Dept. of Health and Human Services, Centers for Disease Control and Prevention, Coordinating Center for Health Promotion, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, 2004. Available at: http://www.cdc.gov/tobacco/data_statistics/sgr/2004/index.htm 3 U.S. Dep’t of Health and Human Services, Centers for Disease Control and Prevention, Annual Smoking – Attributable Mortality, Years of Potential Life Lost, and Economic Costs – United States 1995-1999 (2002) MORBIDITY AND MORTALITY WEEKLY REPORT. Available at http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5114a2.htm 4 U.S. Department of Health and Human Services. The health consequences of involuntary exposure to tobacco smoke: A report of the Surgeon General. Atlanta, GA: U.S. Dept. of Health and Human Services, Centers for Disease Control and Prevention, Coordinating Center for Health Promotion, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, 2006. Available at: http://www.surgeongeneral.gov/library/secondhandsmoke/report/index.html 5 Health Canada. The Facts About Tobacco. Available at: http://www.hc-sc.gc.ca/hecssesc/tobacco/facts/health_facts/pre_postnatal.html 6 US Department of Health and Human Services. Reducing the Health Consequences of Smoking: 25 years of progress. A Report of the Surgeon General, Rockville, Maryland: U.S. Department of Health and Human Services, Public Health Service, Centers for Disease Control, Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, 1989. 7 U.S. Department of Health and Human Services. Reducing Tobacco Use: A Report of the Surgeon General. Atlanta, Georgia: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, 2000. 8 California Environmental Protection Agency. Health Effects of Exposure to Environmental Tobacco Smoke. Final Report. Sacramento: California Environmental Protection Agency, Office of Environmental Health Hazard Assessment, 1997. 9 Piano MR, Benowitz NL, FitzGerald GA, Corbridge S, Heath J, Hahn E, et al. Impact of smokeless tobacco products on cardiovascular disease. Implications for policy, prevention and treatment. Circulation 2010;122:1520-44.

http://www.cancercare.on.ca/common/pages/UserFile.aspx?fileId=14456%20

http://www.cdc.gov/tobacco/data_statistics/sgr/2004/index.htm

http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5114a2.htm

http://www.surgeongeneral.gov/library/secondhandsmoke/report/index.html

http://www.hc-sc.gc.ca/hecssesc/tobacco/facts/health_facts/pre_postnatal.html

10 U.S. Dep’t of Health and Human Services, Centers for Disease Control and Prevention, Reducing Tobacco Use: A Report of the Surgeon General, 437 (2001). 11 Rehm J, Baliunas D, Brochu S, Fischer B, Gnam W, Patra J, et al. The costs of substance abuse in Canada 2002: Highlights. Ottawa, Canada: Canadian Centre on Substance Abuse, 2006. Available at: http://www.ccsa.ca/2006%20CCSA%20Documents/ccsa-011332-2006.pdf 12 Based on 2002 data as reported, adjusted for 22.1% increase in median individual income and 8.1% population growth from 2002-09 (Ontario, all ages) during the same period (Statistics Canada, CANSIM Table 111-0008 and CANSIM, Estimates of population growth by province). 13 Smoke-Free Ontario – Scientific Advisory Committee. Evidence to Guide Action: Comprehensive Tobacco Control in Ontario. Toronto, ON: Ontario Agency for Health Protection and Promotion, 2010 16 Smoke-Free Ontario Act, as of May 31, 2006. Fact Sheet – costs of Tobacco Use and Tax Revenues. Ministry of Health Promotion. Accessed at http://www.mhp.gov.on.ca/en/smoke-free/factsheets/Tobacco_Revenue-120208.pdf March 2013

http://www.ccsa.ca/2006%20CCSA%20Documents/ccsa-011332-2006.pdf

http://www.mhp.gov.on.ca/en/smoke-free/factsheets/Tobacco_Revenue-120208.pdf

alPHa RESOLUTION A13-2

TITLE: The Healthy Smiles Ontario Program and the Overall Inequity within the Oral Health

Care System SPONSOR: Board of Health for the Haliburton, Kawartha, Pine Ridge District Health Unit WHEREAS OHIP pays to provide medical care to every part of the body except the mouth and one

in four Ontarians do not visit a dentist because of cost; and WHEREAS working adults and seniors on fixed incomes do not have a government program to

assist them with any dental care expenses; and WHEREAS there are four provincial dental programs for children aged 0-17 each with a different

set of eligibility criteria and fee guide, making access to them confusing to dental offices, administrators and families; and

WHEREAS children from families with partial insurance that cannot afford to pay the uninsured

portion of their dental treatment do not qualify for these programs; and WHEREAS Healthy Smiles Ontario, the preventive and early dental treatment program, is

underutilized provincially and locally; and WHEREAS there are different models of assisting in the delivery of provincially funded oral health

programs including Community Health Centres; and WHEREAS a number of recent provincial reports and initiatives have indicated the urgent need to

move forward to transform the current oral care health system; NOW THEREFORE BE IT RESOLVED that the Association of Local Public Health Agencies request the Government of Ontario to:

1. Increase the Healthy Smiles Ontario (HSO) income cut-off threshold, which is currently adjusted family net income of $20,000 or less;

2. Remove the ‘no dental insurance’ eligibility criterion from the HSO program; 3. Streamline children’s dental treatment programs to make them more efficient, effective and

equitable as recommended in Oral Health – More Than Just Cavities. A Report by Ontario’s Chief Medical Officer of Health, April 2012;

4. Extend provincial programs to include adults who need and cannot afford emergency dental care.

5. Continue to facilitate the partnerships between local health units and community health centres to assist with the delivery of provincially funded oral health programs;

6. Continue ongoing, stable and indexed 100% provincial funding of the HSO program beyond the sunset date originally announced (Fall 2013);

AND FURTHER that the Premier of Ontario, the Minister of Health and Long-Term Care, Chief Medical Officer of Health, the Association of Municipalities of Ontario and Ontario boards of health are so advised. ACTION FROM CONFERENCE: Resolution CARRIED AS AMENDED

alPHa RESOLUTION A13-3 TITLE: Baby-Friendly Designation for all Ontario Hospitals SPONSOR: Board of Health for the Peterborough County-City Health Unit WHEREAS breastfeeding supports optimal health and developmental outcomes in infants and

young children, as supported by research; and WHEREAS the Canadian Paediatric Society (CPS) recommends that breastfeeding should be

protected, promoted, and supported as breast milk is the ideal form of nutrition for all infants and young children; and

WHEREAS that World Health Organization’s Baby-Friendly Initiative (BFI) is an evidence-based

program to protect, promote, and support breastfeeding, as outlined in the Breastfeeding Committee for Canada’s BFI 10 Steps and Practice Outcome Indicators (2012); and

WHEREAS the Ministry of Health and Long-Term Care (MOHLTC) has identified BFI designation as a

requirement for Family Health programs for all Health Units in its Accountability Agreements; and

WHEREAS the provincial Healthy Kids Panel it its report titled No Time to Wait: The Healthy Kids

Strategy (2013) on reducing the incidence of childhood overweight and obesity, recommends that all hospitals with labour and delivery units and all paediatric hospitals to be designated Baby-Friendly; and

WHEREAS the CPS recommends that “provincial/territorial ministries of health should mandate the

development of a strategy for the implementation of the BFI in all health care facilities providing maternal/child health services, including hospitals, public health units, community health centres and physicians’ offices”; and

WHEREAS the Government of Canada has endorsed the WHO’s International Code on the

Marketing of Breastmilk Substitutes, (WHO Code) which protects breastfeeding by restricting the marketing of infant formula, in particular through the health care system; and

WHEREAS despite Canada’s adoption of the WHO Code the formula industry continues to violate

the WHO Code, and market formula through the health care system, specifically by providing free formula to hospitals;

NOW THEREFORE BE IT RESOLVED that the Association of Local Public Health Agencies urges the Minister of Health and Long Term Care to strongly encourage all Ontario hospitals to implement the BFI 10 Steps, and work to achieve Baby-Friendly designation;

AND FURTHER that the Premier of Ontario, Minister of Health and Long Term Care, Ontario Hospital Association, Ontario College of Family Physicians, College of Midwives of Ontario, Ontario LHINS, and Chief Medical Officer of Health are so advised. ACTION FROM CONFERENCE: Resolution CARRIED AS AMENDED

alPHa RESOLUTION A13-4 TITLE: Gambling Expansion and Provincial Revenue Generation SPONSOR: Toronto Public Health WHEREAS the Ontario government directed the Ontario Lottery and Gaming (OLG) Corporation in

2010 to modernize commercial and charitable gaming through a comprehensive strategic review; and

WHEREAS OLG's report: Modernizing Lottery and Gaming in Ontario: Strategic Business Review

(approved by the Ontario Ministry of Finance in March 2012) includes recommendations that will result in increased access to gambling in Ontario including through: increasing the 27 legal gambling sites to 29 sites, launching internet gaming, expanding lottery sales and allowing bingo halls to host electronic games; and

WHEREAS The Ontario 2012 budget includes provisions for gambling expansion to increase

provincial revenues; and WHEREAS gambling expansion has been identified as a significant public health issue in Ontario

and internationally due to its links to the prevalence of problem gambling and associated health and social impacts; and

WHEREAS an estimated 36 percent of Ontario gambling revenue Is derived from people with

moderate and severe gambling problems; and WHEREAS problem gambling has serious adverse health impacts on individuals, families and

communities; and WHEREAS the impacts of problem gambling are not evenly distributed in the community - males,

youth, older adults, Aboriginal peoples, individuals and families with low income are disproportionately affected; and

WHEREAS certain types of gambling, such as electronic gaming machines are the most addictive

forms of gambling; and WHEREAS increased availability and accessibility of gambling, including new casinos or slot

machines, is strongly associated with increases in the prevalence of problem gambling; and

WHEREAS a broad range of policies and strategies that focus on prevention are needed to

minimize the probability of problem gambling occurring and to reduce health and social impacts for problem gamblers and their families;

NOW THEREFORE BE IT RESOLVED that the Association of Local Public Health Agencies call for the Province of Ontario to refrain from expanding gambling availability as a way to generate additional revenues in Ontario; AND FURTHER that the Association of Local Public Health Agencies partner with health units and other stakeholders to strengthen and develop strategies that prevent or mitigate gambling-related harm in Ontario, promote awareness of treatment options, and protect vulnerable populations. ACTION FROM CONFERENCE: Resolution CARRIED AS AMENDED

alPHa RESOLUTION A13-5 TITLE: Provincial Legislation to Prohibit the Use of Waterpipes in Enclosed Public Places and

Enclosed Workplaces SPONSOR: Simcoe Muskoka District Health Unit WHEREAS the emerging use of waterpipes in enclosed public places and enclosed workplaces has

the potential to undermine the success of the Smoke-Free Ontario Act; and WHEREAS tobacco-free (“herbal”) waterpipe smoke has been demonstrated to have

concentrations of toxins comparable to tobacco waterpipe smoke1; and WHEREAS the environmental smoke from waterpipe use in indoor public places and workplaces

has been demonstrated to contain toxins at harmful concentrations2; and WHEREAS the alleged “herbal” preparations are poorly regulated and often contain tobacco even

when they are labelled tobacco free3; and WHEREAS the Tobacco Strategy Advisory Group report recommends an amendment of the Smoke-

Free Ontario Act, with “the addition of controls on the indoor use of waterpipes such as hookahs”;

NOW THEREFORE BE IT RESOLVED that the Association of Local Public Health Agencies (alPHa) advocate for provincial legislation to be enacted to prohibit the use of waterpipes (regardless of the substance being smoked) in all enclosed public places and enclosed workplaces. ACTION FROM CONFERENCE: Resolution CARRIED References 1 Shidadeh A; Salman R; Jaroud E; Saliba N; Sepetdijian E; Blank M; Does switching to a tobacco-free waterpipe reduce toxicant intake? A crossover study comparing CO, NO, PAH, volatile aldehydes, tar and nicotine yields. Food and Chemical Toxicology Journal Vol. 50, Issue 5, 2012. 2 The Ontario Tobacco Research Unit, OTRU Update, Waterpipe Smoking: A Growing Health Concern, January 31, 2011. 3 The Non-Smokers’ Rights Association, Hooked on Hookah: Issue Analysis and Policy Options for Waterpipe Smoking in Ontario, March 2011.

alPHa RESOLUTION A13-6

TITLE: Mandatory Physical Education for Ontario Secondary School Students SPONSOR: Haliburton, Kawartha, Pine Ridge District Health Unit WHEREAS physical inactivity may diminish academic performance, and is strongly associated with

chronic disease - the leading cause of death in Ontario; and WHEREAS Ontarians have high levels of physical inactivity as 49.2 % aged 12 and older report being

inactive during leisure time; and WHEREAS during adolescence, when youth establish lifelong habits, physical activity actually

declines; and WHEREAS only one physical education credit is required to graduate from Ontario secondary

schools, and enrollment in additional voluntary physical education classes is declining; and

WHEREAS participation in school-based physical education is effective in increasing physical

activity levels during the school years and into adulthood; NOW THEREFORE BE IT RESOLVED that alPHa urge the Government of Ontario to endorse the “Taking Action to Prevent Chronic Disease” report from Cancer Care Ontario and Public Health Ontario, and take immediate action towards implementation of the recommendation to require students to earn a physical education credit in every grade from 9 to 12 to achieve high school graduation; AND FURTHER that a collaborative approach be taken to development of the curriculum that includes the Ministry of Education, Ministry of Health and Long Term Care, Boards of Education, Secondary School staff, parents and students to ensure a positive experience for Ontario’s youth that will encourage healthy active living into adulthood. ACTION FROM CONFERENCE: Resolution CARRIED AS AMENDED

May 15, 2013 The Honourable Deb Matthews Minister – Minister’s Office Ministry of Health and Long-Term Care Hepburn Block 10th Floor 80 Grosvenor St Toronto, Ontario M7A 2C4 Dear Minister Matthews: Re: Menu labelling, Bill 59: Healthy Decisions for Healthy Eating Act, 2013 The Simcoe Muskoka District Health Unit strongly supports Bill 59: Healthy Decisions for Healthy Eating Act and urges you to take the necessary steps to ensure this bill becomes enacted. Canadians of all ages and income are eating out more than ever before1,2,3. Evidence indicates that eating meals away from home is associated with excessive intake of calories, sodium and fat among children and adults4,5. On average, Ontarians consume almost 2,900 mg sodium per day which is well above the recommended 1,500 mg per day6. High sodium intakes contribute to chronic diseases including hypertension, heart disease, stroke, and kidney failure. In addition, over one-quarter of Ontario youth aged 12 to 17, and over half of Ontario adults are overweight or obese7. It has been estimated that obesity costs Ontario billions of dollars every year. When considered against other non-communicable disease risk factors in Ontario, unhealthy diets have the most harmful potential impact on life expectancy for Ontarians after smoking8. Menu labelling informs people’s decision-making in complex food environments, supports information transparency and the community right to know, and makes nutrition information readily and consistently available at the point of sale when people eat out. Menu labelling can also lead to nutritionally beneficial product reformulations by restaurants. Requiring nutrition labeling on restaurant menus has also been recommended in several Canadian Federal and Provincial reports, including the recent Ontario Healthy Kids Panel report No Time to Wait: The Healthy Kids Strategy9. The Board of Health for the Simcoe Muskoka District Health Unit, at its meeting on November 21, 2012, approved a resolution urging the Minister of Health and Long-Term Care to develop strong and comprehensive legislation requiring large-scale foodservice establishments to provide nutrition information at point of purchase that will support Ontarians in making informed decisions regarding foods and beverages available in restaurants and other food premises. In addition, the Board of Health supported providing a copy of this letter to the Premier of Ontario, all local Members of Provincial Parliament (MPP), all Ontario Boards of Health and several provincial special interest groups and stakeholders communicating its support for developing this necessary legislation.

. . . 2

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Musk

oka

Dis

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2

On behalf of the Board of Health, I urge you to ensure the Ontario Government takes the necessary steps to enact Bill 59 Healthy Decisions for Healthy Eating Act, 2013 without delay in order to improve the health of Ontarians, support disease prevention and facilitate informed consumer choice. Sincerely, ORIGINAL SIGNED BY Barry Ward Chair, Board of Health c Premier of Ontario All local MPPs

France Gélinas, MPP Ontario Boards of Health Public Health Ontario Ontario Public Health Association Association of Local Public Health Agencies

Canadian Institute of Public Health Inspectors (CIPHI) (Phi Phan, President, [email protected]) Association of Supervisors of Public Health Inspectors in Ontario (ASPHIO) (President, Chris Munn, Bruce-Grey Health Unit) Ontario Society of Nutrition Professionals in Public Health (OSNPPH) (Co-Chairs, Shannon Edmonstone and Heather Thomas, [email protected]) Ontario Chronic Disease Prevention Management in Public Health (OCDPMPH) (Chairperson, Ellen Wodchis, [email protected])

1 CCFN (Canadian Council of Food and Nutrition). 2008. Tracking Nutrition Trends VII. Mississauga, ON:

Canadian Council of Food and Nutrition. 2 Garriguet Didier. 2007. Canadians' eating habits. Health Reports 18(2): 17-32.

3 Statistics Canada. 2006. Overview of Canadians’ Eating Habits. Ottawa: Statistics Canada.

4Fernando, Jeewani. 2010. Three Essays on Canadian Household Consumption of Food Away from

Home with Special Emphasis on Health and Nutrition. PhD Dissertation, University of Alberta. 5Guthrie, Joanne F., Biing-Hwan Lin, and Elizabeth Frazao. 2002. Role of food prepared away from home

in the American diet, 1977-78 versus 1994-96: Changes and consequences. Journal of Nutrition Education and Behavior 34(3): 140-150. 6Ontario Sodium Summit. 2012. Ontario Sodium Summit, Toronto, February 16-17, 2012: Summit

Proceedings. Report prepared by Intersol. Toronto: Ontario Sodium Summit, 7. 7Katzmarzyk Peter T. 2011. The economic costs associated with physical inactivity and obesity in Ontario,

The Health and Fitness Journal of Canada 4(4). http://www.healthandfitnessjournalofcanada.com/index.php/html/article/view/112, accessed March 22, 2013. 8 Manuel, Douglas G., Richard Perez, Carol Bennett, Laura Rosella, Monica Taljaard, Melody Roberts,

Ruth Sanderson, Meltem Tuna, Peter Tanuseputro, and Heather Manson. 2012. Seven More Years: The Impact of Smoking, Alcohol, Diet, Physical Activity and Stress on Health and Life Expectacy in Ontario: An ICES/PHO Report. Toronto: Institute for Clinical Evaluative Sciences and Public Health Ontario 9Healthy Kids Panel. No Time to Wait: The Healthy Kids Strategy. March 2013. Available at

http://www.health.gov.on.ca/en/public/programs/obesity/.

mailto:[email protected]



http://www.health.gov.on.ca/en/public/programs/obesity/

An Accredited Teaching Health Unit Centre agréé d’enseignement en santé

May 16, 2013 VIA EMAIL The Honourable Kathleen Wynne Premier of Ontario Room 281, Legislative Building Queen's Park Toronto ON M7A 1A1 Dear Premier: Re: Opportunity for All: The Path to Health Equity At its meeting on May 16, 2013, the Sudbury & District Board of Health carried the following resolution #25-13:

WHEREAS Opportunity for All: The Path to Health Equity, demonstrates inequities in health outcomes between least and most deprived areas across the City of Greater Sudbury; and WHEREAS health equity is possible and can be addressed through improvements to local social and economic environments; and WHEREAS the Sudbury & District Health Unit strives to champion and lead equitable opportunities for health as articulated in the 2013-2017 Strategic Plan and Health Equity Vision - 2020; THEREFORE BE IT RESOLVED THAT the Sudbury & District Board of Health accept the report, Opportunity for All: The Path to Health Equity and direct the Medical Officer of Health to continue organizational efforts to improve health equity; and FURTHER THAT the Medical Officer of Health be directed to ensure the continued collaboration with community partners to identify and implement appropriate strategies to improve health equity and monitor local progress; and FURTHER THAT the Medical Officer of Health report regularly to the Board of Health on key health equity actions and indicators for Sudbury and districts; and FURTHER THAT the Sudbury & District Board of Health send this report to the Premier of Ontario and strongly urge that government maintain its stated commitment to poverty reduction in Ontario as a public health measure; and

Letter Re: Opportunity for All: The Path to Health May 16, 2013 Page 2

FURTHER THAT a copy of this motion and report be forwarded to all Ontario Boards of Health, local Members of Provincial Parliament, Ontario’s Chief Medical Officer of Health, the Minister of Health and Long-Term Care, Public Health Ontario, the Association of Local Public Health Agencies, the Ontario Public Health Association, the Association of Municipalities of Ontario, the Ontario Municipal Social Services Association, and area municipalities.

The full report, Opportunity for All: The Path to Health Equity can be accessed online through the Sudbury & District Health Unit website, www.sdhu.com. It is the Board’s hope that this report will speak to our communities in Sudbury and districts and to public health stakeholders across the country as we continue to work together to build communities in which there is opportunity for all. Thank you for your attention to this important public health issue. Yours sincerely,

Penny Sutcliffe, MD, MHSc, FRCPC Medical Officer of Health and Chief Executive Officer URL address for the English report Opportunity for All: The Path to Health Equity: http://www.sdhu.com/uploads/content/listings/SIHReport_EN_FINAL_forweb.pdf

URL address for the French report Possibilités pour tous Le chemin vers l’équité en matière de santé : http://www.sdhu.com/uploads/content/listings/SIHReport_FR_FINAL_forweb.pdf

URL address for the English summary report Opportunity for All: The Path to Health Equity: http://www.sdhu.com/uploads/content/listings/SIH2pagerMay7.pdf

URL address for the French summary report Possibilités pour tous Le chemin vers l’équité en matière de santé : http://www.sdhu.com/uploads/content/listings/SIH2pagerFRMay10.pdf cc: Ontario Boards of Health Local Members of Provincial Parliament Chief Medical Officer of Health Minister of Health and Long-Term Care Public Health Ontario Association of Local Public Health Agencies Ontario Public Health Association Association of Municipalities of Ontario Ontario Municipal Social Services Association Sudbury & District Health Unit Constituent Municipalities

http://www.sdhu.com/

http://www.sdhu.com/uploads/content/listings/SIHReport_EN_FINAL_forweb.pdf

http://www.sdhu.com/uploads/content/listings/SIHReport_FR_FINAL_forweb.pdf

http://www.sdhu.com/uploads/content/listings/SIH2pagerMay7.pdf

http://www.sdhu.com/uploads/content/listings/SIH2pagerFRMay10.pdf

Staff Report

Smoke-Free Multi-Unit Dwellings: Update to the Board of Health Date:

June 12, 2013

To:

Board of Health

From:


Original approved by Original approved by

Rosana Pellizzari, M.D. Claire Townshend, Health Promoter

Recommendations That the Board of Health for the Peterborough County-City Health Unit receive the staff report, Smoke-Free Multi-Unit Dwellings: Update to the Board of Health, for information. Financial Implications and Impact There are no financial implications arising from this report. Decision History On October 13, 2010, the Board of Health received a staff report entitled, “Mitigating the health risks associated with second hand smoke in multi-unit dwellings (MUDs)” to provide scientific rationale for the creation of MUDs policies. At its April 10th, 2013 meeting, the Board of Health requested that staff prepare a report to provide an update on the status of MUDs.

Background

Tobacco use remains the leading cause of preventable illness and death in Ontario. There are more than 4000 chemicals found in second-hand-smoke (SHS), of which at least 250 are

BOH Meeting - June 12, 2013 Item 9.3 - Page 1

regulated toxins, and 69 are known carcinogens, or cancer causing agents.1 There is no safe level of exposure to SHS. Eliminating smoking in indoor spaces is the only way to fully protect nonsmokers from SHS exposure; cleaning the air and ventilating buildings cannot eliminate SHS.2 In adults, SHS exposure can cause serious cardiovascular and respiratory diseases including lung cancer and coronary heart disease; in children, it can cause Sudden Infant Death Syndrome (SIDS), asthma, ear infections, bronchitis and pneumonia.3,4 A staff report provided to the Board of Health in 2010 provides more background information on the health impact of SHS transfer within MUDs, refer to Appendix A. In Peterborough, MUDs has been a priority for tobacco control initiatives in the last year, resulting in new partnerships and increased awareness, but also new challenges, as will be highlighted in the following: Complaints: There is high demand for smoke-free housing in Peterborough. Our Tobacco Enforcement Officer received approximately 160 direct complaints in the past year from concerned tenants requesting support in eliminating unwanted SHS exposure infiltrating from neighbouring units into their own homes and from landlords interested in enacting policies. Many of the complaints both from tenants and landlords proceeded through the housing tribunal process. Not surprisingly, the majority of complaints come from tenants residing in units managed by the Peterborough Housing Corporation, as it is the largest social housing provider in Peterborough City and County. Tenant Survey: In 2012, a complaint was received from two tenants residing in a large privately owned apartment building with 112 units, with concerns about the level of SHS exposure. Our Tobacco Enforcement Officer, in collaboration with these tenants and with the permission of the landlord, implemented a survey to all residents in the building to access their level of support for a policy. The response rate was very high, with over 87% of tenants completing the survey. Interestingly, 58% of respondents indicated that someone in the household has health problems made worse by SHS exposure. In fact, almost half of respondents (47%) indicated an interest in having a partial smoking ban on a wing or floor, including inside private units and 45% were interested in a complete smoking ban for the entire building, including inside all private units. After administering the survey and reviewing the results, residents formed an ad hoc group to discuss next steps and plan, in a coordinated fashion, how to advocate for a smoke-free policy. Attempts to engage the landlord in this initiative is ongoing. SHS/MUDs Campaign: PCCHU implemented a small SHS/MUDs awareness campaign targeting two specific populations: residents and landlords affected by SHS exposure, and people who currently smoke in their homes. The goal of the campaign was to increase the awareness, knowledge and capacity amongst individuals to take action towards effecting change. The campaign was graphically designed to be similar to provincial resources and to test the potential reach of non-traditional communication vehicles. The campaign ran from December 2012 until April 31,


2013 and consisted of advertisements inside and outside of city transit buses and online (Kijiji) advertisements, which generated media coverage by local TV and newspapers. At the same time, in collaboration with the Halliburton, Kawartha, Pine Ridge District Health Unit, radio ads aired in January and February 2013. Peterborough Housing Providers: Positive advances have been made in the past year with respect to private landlords in Peterborough including a preliminary vote by the Peterborough Landlords Association to adopt a resolution proposed by PCCHU which include, in part, to champion the adoption of smoke-free policies among its members and work collaboratively with PCCHU to provide information and resources to its members and tenants on smoking, second-hand-smoke exposure and cessation supports. As well, dialogue has continued with Trent University to explore the possibility of any future residences be designated smoke-free. Unfortunately, there has been little progress with the social housing providers in the past year, despite exciting developments with this sector in other municipalities in Ontario. The Health Unit and Canadian Cancer Society met with the Board of Directors at Peterborough Housing Corporation (PHC) twice to encourage the implementation of smoke-free policies in existing buildings; the most recent being a presentation on June 20, 2012 by the Medical Officer of Health. From this, the PHC Board Chair sent a letter dated November 6, 2012 (refer to Appendix C) indicating that PHC has declared their newest building, Bradburn House with 18 units, as smoke-free. We acknowledge this positive step forward; however, it does not address the complaints received from, or protect the health of, tenants living in the existing 900+ units. As well, the letter indicated that PHC staff will be conducting a survey with tenants to identify the smoking trends amongst their tenants. Although the PCCHU has offered, PHC has not requested any assistance from the Health Unit in planning for or implementing smoke-free policies for existing buildings. Rationale Now that most Ontarians are protected under the Smoke-Free Ontario Act (SFOA) in public places and workplaces, demand for other smoke-free environments is on the rise, particularly in MUDs. Under the SFOA smoking is prohibited only in common areas and not inside individual units in shared housing. There is a growing need for smoke-free housing options as evident in a recent Ipsos Reid survey, where one-third of respondents indicated being regularly exposed to SHS in their homes and 80% would choose to live in a smoke-free building if given their preference.5

Building from the work done initially in Waterloo, approximately 70 community/social housing providers across Ontario have voluntarily implemented smoke-free polices. To list a few:

In June 2013, Northumberland County’s Social Services, affecting 11 buildings;

In April 2013, the Cochrane District Social Services Administration Board in Timmins & South Porcupine, affecting 395 units;


In fall of 2012, the United Counties of Leeds & Grenville implemented a smoke-free policy for their entire portfolio, affecting 667 units;

In July 2012, Barrie Municipal Non-Profit Housing Corporation passed a policy affecting 953 units; and

In April 1, 2010, Waterloo Region Housing, affecting 2,722 units.6

These examples illustrate that smoke-free policies in MUDs are and can be achievable, even when a large number of units are affected. Locally, we currently have 28 social housing providers, the largest being PHC with 1013 units. Only 15 have smoke-free policies as shown in Table 1. For a full list of municipalities and social housing providers implementing smoke-free policies in Ontario, refer to Appendix B. Table 1: Social Housing Providers with Smoke-Free Policies in Peterborough7

Name of Organization Name of Building Municipality # of

Smoke-Free Units

Policy Date (dd-mm-yyyy)

Youth Emergency Shelter Peterborough

Cameron House Peterborough

Brock Mission Peterborough

YWCA of Peterborough, Victoria and Haliburton

Crossroads Shelter Peterborough

St. Barnabas Housing Hillmar 31 Apartments Peterborough 43 01-10-2010

Otonabee Non‐Profit Housing Corp. Otonabee Non‐Profit Housing

Keene 21 01-10-2010

Kinsmen Garden Court of Peterborough

Kinsmen Garden Court Peterborough 66 01-10-2010


Centennial Crescent Peterborough 40 01-10-2010

Maryland Place Inc. Maryland Place Peterborough 23 01-04-2010

St. Giles Senior Citizens Residence St. Giles Senior Citizens Residence

Peterborough 48 01-04-2010

Millbrook Non‐Profit Housing Millbrook 39 01-04-2010

Homegrown Homes Entire Portfolio Peterborough 9 01‐01-2011

Peterborough Housing Corporation Bradburn House Peterborough 18 18‐01-2013

Although, there have been many positive advances in Peterborough’s private sector over the past year regarding MUDs; much more work needs to be done including implementation of comprehensive policies in both social housing and the private sector to protect tenants from the negative health effects of SHS exposure. Despite the increasing demand for, and well-known benefits of smoke-free housing, supply of smoke-free housing remains low due to housing providers and landlords being either unaware that no-smoking policies are legal, non-discriminatory and enforceable or unwilling to implement them.8 Recognizing that a regulatory ban isn’t at the forefront of the political agenda, we need to continue to work with our local housing providers and private landlords to foster and support voluntary adoptions of smoke-free policies.


Strategic Direction This report supports the strategic directions “Continue to Meet Our Mandate” by creating healthy public policies and the creation of supportive environments for Peterborough residents. It will also enhance our efforts to “Expand and Build New Strategic Partnerships” and “Build on Our Leadership Role” in comprehensive tobacco control. Contact: Claire Townshend, Health Promoter Tobacco Use Prevention Program (705) 743-1000, ext. 355 [email protected] Ingrid Cathcart, Health Promoter Tobacco Control Officer Tobacco Use Prevention Program (705) 743-1000, ext. 245 [email protected] Attachments: Appendix A – Mitigating the health risks associated with second hand smoke in multi-unit

dwellings (MUDS) – Staff Report 2010. Appendix B – Smoke-Free Housing Ontario: Ontario Community/Social Housing Providers with No-Smoking Policies, 2013. Appendix C – Letter from the Peterborough Housing Corporation, dated November 6, 2012. References: 1 Non-Smokers’ Rights Association. (2012). Exposure to Second-hand Smoke. Retrieved on May 9, 2013 from,

www.nsra-adnf.ca/cms/page1464.cfm 2 U.S. Department of Health and Human Services. (2006). The Health Consequences of Involuntary Exposure to

Tobacco Smoke: A Report of the Surgeon General. Atlanta: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, Coordinating Center for Health Promotion, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health. 3 World Health Organization. (2013). Fact Sheet: Tobacco. Retrieved on May 9, 2013 from,

www.who.int/mediacentre/factsheets/fs339/en/index.html 4 Non-Smokers’ Rights Association. (2012). Second-hand Smoke in Multi-Unit Dwellings. Retrieved on May 17, 2013

from, http://www.nsra-adnf.ca/cms/page1433.cfm 5 Smoke-Free Housing Coalition. (2010). 2010 Tenant Survey. Retrieved on May 9, 2013 from,

www.smokefreehousingon.ca/sfho/tenants-tenant-surveys.html 6 Smoke-Free Housing Ontario. (2013). Ontario Community/Social Housing Providers with No-Smoking Policies.

Retrieved May 9, 2013, from www.smokefreehousingon.ca/hsfo/file/files/Community_Housing_Jan_2013.pdf 7 Ibid.

8 Smoking and Health Action Foundation. (2012). Using Incentives to Stimulate the Supply of Smoke-Free Housing

Options. Retrieved on May 15, 2013 from, http://www.smokefreehousingon.ca/cms/file/files/tax__Incentives_Fact_Sheet-FINAL.pdf




http://www.nsra-adnf.ca/cms/page1464.cfm

http://www.surgeongeneral.gov/library/secondhandsmoke/report/

http://www.surgeongeneral.gov/library/secondhandsmoke/report/

http://www.who.int/mediacentre/factsheets/fs339/en/index.html

http://www.nsra-adnf.ca/cms/page1433.cfm

http://www.smokefreehousingon.ca/sfho/tenants-tenant-surveys.html

http://www.smokefreehousingon.ca/hsfo/file/files/Community_Housing_Jan_2013.pdf

http://www.smokefreehousingon.ca/cms/file/files/tax__Incentives_Fact_Sheet-FINAL.pdf

Staff Report Mitigating the health risks associated with second hand smoke in multi-unit dwellings (MUDS) Date:

October 13, 2010

To:

Board of Health

From:


Original approved by Original approved by _____________________________ ______________________________ Rosana Pellizzari, M.D. Donna Churipuy, Manager, Environmental Health

Purpose To provide scientific rationale for the creation of smoke-free multi-unit dwelling (MUDS) policies is discussed.

Decision History There is no decision history associated with this topic.

Financial Implications and Impact There are no financial implications arising from this report.

Recommendations It is recommended that the Board of Health receive this report for information.

APPENDIX A


Background The World Health Organization has identified the use of tobacco to be one of the leading causes of preventable disease and death in the world. Smoke-free environment policies have been proven to be an effective means of increasing smoker cessation rates, decreasing the number of new smokers and protecting against second hand smoke (SHS) exposure resulting in improved health outcomes. Currently the Smoke-Free Ontario Act and its amendments ban smoking in all enclosed public places and workplaces such as bars and restaurants, hospital entrances, casinos, the common areas of multi-unit dwellings, as well as in cars with children under 16. The Act also prohibits smoking in some outdoor locations such as school property, hospital entrances and the reserved seating area of outdoor theatres or stadiums. Although non-smokers are protected in many places outside their home there is no legislation that protects them in their home from smoke that enters from adjoining residences. A “multi-unit dwelling” includes: Multi-storey apartment buildings and condominiums; Houses partitioned into separate apartments (including boarding houses); Duplexes; Row houses; and Semi-detached houses.

Health Impacts of Second-Hand Smoke Transfer in Multi-Unit Dwellings National and International health bodies such as the World Health Organization and the US Office of the Surgeon General have concluded that there is no safe level of exposure to second-hand smoke. Second-hand smoke exposure is a serious problem for many Ontario residents living in multiple unit dwellings (MUDS) with the most sensitive populations being children, the elderly, and individuals with underlying medical conditions. Second-hand smoke is the diluted combination of air and side-stream and/or exhaled tobacco smoke that dissipates into the surrounding environment. Tobacco smoke contains over 4,000 chemicals and over fifty of these are identified as carcinogenic. Immediate reactions to being exposed to second-hand smoke can include: sore eyes and throat, increased blood pressure, nasal irritation, headaches, breathing difficulties (asthma or coughing), nausea and dizziness. Research shows a dose-dependent relationship where negative health impacts are more likely with prolonged periods of exposure and/or higher smoke concentrations. Exposure to second-hand smoke has been shown to have a causal relationship with many of the same diseases that affect smokers, most notably heart disease and lung cancer1. The 2006 US Surgeon General’s Report on the Health Consequences from Exposure to Tobacco Smoke concluded that research on the effects of SHS demonstrate a causal relationship with the


development of lung cancers (increased risk of 25%) and coronary heart diseases (increased risk of 10%) in non-smoking adults, and an increased risk for sudden infant death syndrome (SIDS), acute respiratory infections, ear infections, and asthma in children. Findings from the 2009 Canadian Expert Panel on Tobacco Smoke and Breast Cancer Risk confirm that long-term exposure to second-hand smoke has a causal relationship to breast cancer in younger, pre-menopausal women.2 Prevalence of Second-Hand Smoke Exposure in Multi-Unit Dwellings Remembering that SHS has over 4,000 identified chemicals, indoor measurement of exact levels of second hand smoke levels is very complex and any objective measurements are not only expensive to conduct but will miss components which contribute to toxicity. This complexity is explained by the American Society of Heating, Refrigerating and Air-Conditioning Engineers (ASHRAE) in their 2008 position paper. “The concentration of the various [second hand smoke] constituents in an indoor space depends on the number of smokers and their pattern of smoking, the volume of the space, the ventilation rate and the effectiveness of the air distribution, the rate of removal of [second hand smoke] from the indoor air by air cleaners, deposition of particles onto surfaces and surface adsorption and re-emission of gaseous components. Because [second hand smoke] is a complex mixture, measurement of single components are of varying specificity and none alone is considered to indicate the potential toxicity of [second hand smoke] at a particular concentration”. Second-hand smoke can enter shared or adjoined living units through cracks in walls or windows, doorways, shared plumbing, light fixtures, electrical outlets, shared ventilation systems, and from balcony and patio areas. It can drift internally from unit to unit or from the exterior of the building into the living areas e.g. balconies. In a 2006 Ontario survey, tenants who reported they had experienced second-hand smoke entering their unit said that it entered via the hallways (47%), through open windows (41%), shared ventilation (21%), air leaks from other units (18%), and kitchen or bathroom fans (13%). This was based on the tenant’s belief on where the transfer site occurs and not due to scientific testing. Second-hand smoke transfer from one unit to another is based on a variety of factors such as the amount of smoke concentration in the environment, the building’s ventilation system, the permeability of the unit’s structure, natural air flows, and climate conditions. Air leakage and transfer rates can vary greatly between units within the same apartment building. i

According to the Canadian and Mortgage Housing Corporation, most apartment buildings constructed since the mid-1960s have corridor ventilation systems that deliver outdoor air to the common corridors on each floor. This air flow enters apartment units around cracks along the door and is meant to ventilate the corridors, contain odours in apartments, and to provide air for in-suite ventilation devices (e.g. range hoods, bathroom fans). In its own investigation, CMHC found that corridor air ventilation systems do not improve air quality within individual


apartments because much of the “fresh” air delivered to the corridors escapes the building through the elevator shafts, garbage chute and stairwells3. Malfunctioning or ill-maintained systems as well as changing indoor-outdoor air temperatures (e.g. fall and winter) can create air pressure differences that lessen the efficacy of the corridor ventilation system causing stale corridor air and increasing the likelihood of odour transfer from hallway-to-unit. Two provincial public surveys have shed light on the prevalence of second-hand smoke transmission for people who live in multi-unit dwellings: 1. A 2006 survey commissioned by the Ontario Tobacco-Free Network (OTN) with Ipsos Reid

(n= 1832) found that 46% of respondents which included owners and renters had experienced second-hand smoke drift into their unit within the last six months4. A majority (64%) of all those surveyed indicated they would likely choose a smoke-free building if such a choice existed.

2. The Ontario Tobacco Research Unit published a cross-sectional analysis of the 2007-2008

Ontario Tobacco Survey of smokers and non-smokers (n= 3500) and found that residents in multi-unit dwellings were most likely to report second-hand smoke had entered their home from an outside source in the last six months5.

Mitigation of Health Risks The American Society of Heating, Refrigerating and Air-Conditioning Engineers (ASHRAE), considered the lead expert organization on the science and research of heating, refrigeration, and ventilation has released a position statement on the issue of second-hand smoke (which they refer to as ETS or Environmental Tobacco Smoke). In it their position paper ASHRAE recognize the convergence of more than 20 years of research on the health risks associated with second hand smoke and they feel that research findings are applicable across types of environments ie. The science holds up whether it is a restaurant or multi-unit dwelling. They also agree with other recognized authorities that no safe exposure level has ever been identified through the science. ASHRAE concludes that there are no engineering approaches, “…including current and advanced dilution ventilation or air cleaning technologies that have been demonstrated or should be relied upon to control health risks from ETS exposure in spaces where smoking occurs. Some engineering measures may reduce that exposure and the corresponding risk to some degree while also addressing to some extent the comfort issues of odour and some forms of irritation.”6 While residential ventilation systems and related air cleaning methods (e.g. air purifiers, air filters) can help to clear some of the components of tobacco smoke from indoor air, there is no known ventilation system that can remove all of the toxins found in second-hand smoke to effectively eliminate the negative health risks to harmless levels.


Comments

Given that prominent bodies such as ASHRAE, Health Canada, and the World Health Organization have concluded that second-hand smoke at any degree of exposure could pose harmful health risks it is not ethically sound to endorse ventilation systems or structural treatments as a solution to eliminating the transfer of second-hand smoke between units. Prohibiting smoking in multi-residential buildings is the only option to mitigate the health risks of second-hand smoke exposure.

Strategic Direction This Board of Health action supports the 2008-2012 Strategic Directions, Build on Our Leadership Role and Continue to Meet Our Mandate.

References 1 Ontario Campaign Against Tobacco web site: http://www.ocat.org/healtheffects/index.html Accessed on June 28, 2010. 2 Collishaw NE, Boyd NF, Cantor KP, Hammond SK, Johnson KC, Millar J, Miller AB, Miller M, Palmer JR, Salmon AG, Turcotte F. Canadian Expert Panel on Tobacco Smoke and Breast CancerRisk. Toronto, Canada: Ontario Tobacco Research Unit, OTRU Special Report Series, April 2009. 3 Canada Mortgage and Housing Corporation. http://www.cmhc-schl.gc.ca/en/co/reho/reho_002.cfm. Accessed on June 28, 2010. 4 Ontario Tobacco-Free Network. Highlights of Ipsos Reid research on drifting second-hand smoke in multi-unit dwellings. March 27, 2007. 5 Ontario Tobacco Research Unit. Reports of Tobacco Smoke Entering Ontario Homes. Ontario Tobacco Research Unit: March 2009. http://www.smokefreehousingon.ca/cms/file/OTRU_survey_mar2009.pdf 6 American Society of Heating, Refrigerating and Air-Conditioning Engineers (ASHRAE). Environmental Tobacco Smoke Position Document. (Atlanta: June 30, 2008.) http://www.ashrae.org/doclib/20090120_pos_ets.pdf

Contact: Jane Hoffmeyer Donna Churipuy Health Promoter, Tobacco Use Prevention Manager, Environmental Health (705) 743-1000, ext. 332 (705) 743-1000, ext. 218 [email protected] [email protected]


http://www.ocat.org/healtheffects/index.html

http://www.cmhc-schl.gc.ca/en/co/reho/reho_002.cfm

http://www.cmhc-schl.gc.ca/en/co/reho/reho_002.cfm

http://www.smokefreehousingon.ca/cms/file/OTRU_survey_mar2009.pdf

http://www.ashrae.org/doclib/20090120_pos_ets.pdf



Ontario Community/Social Housing Providers with No‐smoking Policies

Name of Organization

Name of Building City Phone # Units

# Smoke-Free Units

Policy Date

Ontario Finnish Resthome Association 2 buildings Sault Ste. Marie 705.945.9987 X206 253 229 31‐May‐131

Iroquois Falls Seniors Apartment Corp.

11 buildings Cochrane etc. 200 01‐Apr‐132

City of Timmins Non‐Profit Housing Corp.

2 buildings Timmins 93 01‐Apr‐133

Cochrane District Social Services Administration Board

various Timmins & South Porcupine

395 01‐Apr‐134

Peterborough Housing Corporation Bradburn House Peterborough 18 18 18‐Jan‐135

St. Joseph's Care Group Sister Leila Greco Apts. Thunder Bay 807.768.4400 132 132 02‐Jan‐136

Otonabee Municipal Non‐Profit Housing Corporation

Monaghan Court Keene 705.295.4900 19 19 01‐Jan‐137

United Counties of Leeds & Grenville entire portfolio various 800.770.2170 667 01‐Sep‐128

Gananoque Housing Inc. Stocking Hill Apts. Gananoque 613.382.7148 52 47 01‐Sep‐129

Barrie Municipal Non‐Profit Housing Corporation

entire portfolio Barrie 705.727.1101 X 226 953 668 01‐Jul‐1210

Ottawa Community Housing Corporation

245 Crichton St. Ottawa 613.731.7223 6 6 01‐Jun‐1211

MennoHomes Inc. Rockway Gardens Village Kitchener 519.578.5546 50 42 01‐Apr‐1212

Cambridge Kiwanis Non‐Profit Housing Corp.

Cambridge Kiwanis Village Cambridge 519.650.5437 258 47 01‐Apr‐1213

January 25, 2013 Page 1 of 5BOH Meeting - June 12, 2013 Item 9.3 - Page 11

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# Smoke-Free Units

Policy Date

Walden Municipal Non‐Profit Housing

Lively 705.692.4960 30 27 01‐Jan‐1214

Kirkland Lake Non‐Profit Housing Corp.

various Kirkland Lake 705.568.6688 85 01‐Jan‐1215

Hellenic Community of KW Suburbs Housing

Hellenic Place Kitchener 519.893.4778 91 81 31‐Oct‐1116

Municipality of Chatham‐Kent Social Housing Division

Riverview Terrace Chatham 519.756.4141 27 27 05‐Oct‐1117

Hesperus Fellowship Community 2 bldgs ‐ Hesperus Village I & II Thornhill 905.764.0840 X241 80 80 01‐Oct‐1118

Durham Regional Local Housing Corporation

Lakeview Harbourside Oshawa 1.800.372.1102 12 12 01‐Jul‐1119

Suomi Koti of Thunder Bay Inc. Suomi Koti Thunder Bay 807.474.9122 60 52 01‐Jul‐1120

Aldersgate Homes Inc. Aldersgate Village Belleville 613.962.1192 87 81 01‐Jun‐1121

Community Care Village Housing Lindsay 705.324.1600 70 70 01‐May‐1122

Royal Canadian Legion Zone K1 Veterans Homes Inc.

Zone K1 Veterans Building Haileybury 705.672.2557 25 25 13‐Apr‐1123

Bruce County Housing Corporation entire portfolio numerous 519.396.3450 633 154 01‐Apr‐1124

Cambridge Non‐Profit Housing Corporation

Fern Meadows Cambridge 519.622.5535 61 61 01‐Apr‐1125

Newo Holdings My Owen Place Waterloo 519.893.5040 49 49 01‐Mar‐1126

Homegrown Homes entire portfolio Peterborough 705.748.4534 9 01‐Jan‐1127

Richview Baptist Foundation Etobicoke 416.247.5316 323 309 01‐Jan‐1128

Belleville Emmanuel Residences Emmanuel Residences Belleville 613.969.8475 55 51 01‐Jan‐1129

Centretown Citizens Ottawa Corporation

Beaver Barracks Ottawa 613.234.4065 254 254 01‐Dec‐1030




# Smoke-Free Units

Policy Date

St. Barnabas Housing Hillmar Apartments Peterborough 705.743.1544 43 01‐Oct‐1031

Otonabee Non‐Profit Housing Corp. Otonabee Non‐Profit Housing Keene 705.295.4900 21 01‐Oct‐1032

Kinsmen Garden Court of Peterborough

Kinsmen Garden Court Peterborough 705.742.8366 66 01‐Oct‐1033


Centennial Crescent Peterborough 705.743.3526 40 01‐Oct‐1034

East Markham Non‐Profit Homes Tony Wong Place Markham 905.940.8909 120 120 01‐Jun‐1035

Region of Waterloo Community Housing Inc.

Kingscourt Place, Erb Court, Cushman Court

Kitchener‐ Waterloo 519.575.4801 X1215 132 01‐Apr‐1036


entire portfolio Kitchener‐Waterloo 519.575.4801 X1215 2723 273 01‐Apr‐1037

Simcoe County Housing Corporation 33 Brooks St. Barrie 705.725.7215 53 01‐Apr‐1038

Maryland Place Inc. Maryland Place Peterborough 705.743.8660 23 01‐Apr‐1039

St. Giles Senior Citizens Residence St. Giles Senior Citizens Residence Peterborough 705.743.8660 48 01‐Apr‐1040

Millbrook Non‐Profit Housing Millbrook 705.932.3066 39 01‐Apr‐1041

County of Wellington Housing Services

Fergusson Place Fergus 519.824.7822 x 4040 55 55 01‐Mar‐1042

Guelph Independent Living Willow Place Guelph 519.837.0800 83 01‐Mar‐1043


Sunnyside Supportive Housing and Seniors Wellness Centre

Kitchener 519.575.4801 X1215 30 30 02‐Feb‐1044

Rougebank Foundation Thomson Court Markham 905.294.9830 118 102 01‐Feb‐1045

Owen Sound Municipal Non‐profit Housing Corporation

Owen Sound 519.376.0573 26 26 01‐Jan‐1046

Christian Senior Citizens Home of Chatham

South Chatham Village Apartments Chatham 519.352.0053 67 01‐Jan‐1047




# Smoke-Free Units

Policy Date

Spruce Lodge Non‐Profit Housing Corporation

Woodland Towers Stratford 519.271.4090 X2236 198 194 01‐Jan‐1048

FAILA Non‐Profit Housing Corporation

FAILA Apartments Fenelon Falls 705.887.9604 50 47 01‐Sep‐0949

Haliburton Community Housing Corporation

Echo Hills & Parklane Haliburton 705.457.3973 or 9119 95 01‐Jun‐0950

St. Paul's United Church St. Paul's Place Thunder Bay 807.346.4282 30 01‐Feb‐0951

Artscape Non‐Profit Homes Inc. Artscape Wychwood Barns Toronto 416.392.1038 X39 26 26 20‐Nov‐0852

Collier Place Inc. Collier Place Seniors Residence Barrie 705.726.1517 156 11‐Nov‐0853

R. Paul Martin Construction Co. Ltd. West Side Stories Kingston 613.548.7136 118 118 01‐Jul‐0854

Ritz Lutheran Villa Ritz Lutheran Villa Mitchell 519.348.8612 X223 25 25 01‐Feb‐0855

Sudbury Finnish Rest Home Society, Inc.

Finlandia Village Sudbury 705.524.3137 175 8 01‐Jan‐0856

Huron County Highland Apartments South Brussels 519.887.9267 20 20 31‐Dec‐0657

Newtonbrook United Church and Taiwanese United Church Non‐Profit Homes Corporation

Lester B. Pearson Place Toronto 416.491.4346 53 53 01‐Jul‐0658

Ontario East Triangle Court Frankford59

Huron County Heartland Apartments Clinton60

Ukranian Catholic Church of Thunder Bay

Holy Cross Villa Thunder Bay 807.346.4282 3061

Marmora District Housing Commission

Marmora 613.472.539062

York River Heights Senior Citizens Bancroft 613.332.242063

Goodwill Industries Niagara St. Catharines 905.685.8777 25 2564




# Smoke-Free Units

Policy Date

Barrhaven Non‐Profit Housing Inc. Steepleview Crossing Ottawa 613.823.6230 7 765

Independence Centre and Network Haig Apartments Sudbury 705.673.0655 2066

R.J. Brooks Living Centre Bancroft 613.322.422867

County of Lambton ‐ Housing Services Dept.

Maxwell Park Place Sarnia 519.344.2062 X2041 57 5768

Mount Albert United Church Senior Citizens' Foundation

Royal Oak Court Manor Mount Albert 905.473.2567 82 3069

Lakehead Christian Senior Citizen Apts

Good Shepherd Village Thunder Bay 807.767.015170



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To: All Members Board of Health From: Chief Phyllis Williams, Chair, Governance Committee Subject: Committee Report: Governance Date: June 12, 2013 _____________________________________________________________________________ Recommendation: That the Board of Health for the Peterborough County-City Health Unit:

receive for information, meeting minutes of the Governance Committee for March 13, 2013, approved by the Committee on May 30, 2013; and,

approve the following documents referred by the Committee at the May 30, 2013 meeting: - 2-140 – By-Law Number 5, Powers and Term of Office of the Chairperson and Vice-

Chairperson of the Board of Health (revised) - 2-150 – By Law 6, Remuneration of Members (revised) - 2-153 – Procedure, Board Remuneration Review (new) - 2-251 – Procedure, Orientation for Board of Health Members (revised)

_____________________________________________________________________________ Please refer to the attached.



MINUTES Governance Committee Meeting

Wednesday, March 13, 2013 – 12:30 – 2:30 p.m. (Board Room - 10 Hospital Drive, Peterborough)

Present: Mr. Jim Embrey

Dr. Rosana Pellizzari Mayor Mary Smith Mrs. Alida Tanna, Recorder Mr. David Watton

Chief Phyllis Williams, Chair Mr. Brent Woodford 1. Call To Order

Chief Williams called the meeting to order at 12:35 p.m.

2. Confirmation of the Agenda Moved by Seconded by Mr. Watton Mayor Smith That the agenda be approved as circulated. Carried (M-13-11-GV)

3. Declaration of Pecuniary Interest None.

4. Delegations and Presentations None.

5. Confirmation of the Minutes of the Previous Meeting 5.1 February 1, 2013

Moved by Seconded by Mayor Smith Mr. Embrey That the minutes of February 1, 2013 be approved as written, and brought forward to the next Board of Health meeting.

Carried (M-13-12-GV)


6. Business Arising from the Minutes 6.1 Provincial Appointee Recruitment

Dr. Pellizzari advised the Committee that interviews were scheduled to take place with three applicants that day as selected by the sub-committee. The sub-committee, comprised of Mr. Embrey, Chief Williams and Dr. Pellizzari, were conducting the interviews and would apprise the Committee of any outcomes.

7. Correspondence None.

8. Program Reports None.

9. New Business 9.1 By-Laws, Policies and Procedures For Review (All)

The Committee reviewed and approved all documents provided for their consideration.

Moved by Seconded by Mr. Embrey Mr. Watton That the following documents be forwarded to the Board of Health at their next meeting for approval:

a. 2-120 – By-Law Number 3, Calling and Proceedings at Meetings (revised) b. 2-170 – By-Law Number 8, Building Code Act, Sewage Systems (revised) c. 2-185 – By-Law Number 10, Open and In Camera Meetings (revised) d. 2-300 – Policy, Medical Officer of Health (new) e. 2-342 – Policy, Medical Officer of Health, Selection (new) f. 2-343 – Procedure, Medical Officer of Health, Selection (new) g. 2-345 – Procedure, Medical Officer of Health, Absence (new) h. 2-816 – Policy, Hours of Work / Compensation Time (new)

Carried (M-13-13-GV)

9.2 2013-17 Strategic Plan Update (Watton)

Mr. Watton advised that the Strategic Planning Working Group had met on March 4th to review a conceptual draft of the plan received from Jonathan Bennett. They have scheduled their next meeting for March 26th in order to provide the Board with a draft on April 10th.


10. By-Laws None.

11. In Camera to Discuss Confidential Personal Matters Moved by Seconded by

Mr. Watton Mayor Smith That the Committee go In Camera to discuss confidential personal matters.

Carried (M–13-14-GV)

Moved by Seconded by Mayor Smith Mr. Embrey That the Committee rise from In Camera.

Carried (M–13–15–GV)

12. Date, Time and Place of Next Meeting The next meeting will be scheduled in May 2013, or at the call of the Chair.

13. Adjournment Moved by Seconded by Mayor Smith Chief Williams That the meeting be adjourned. Carried (M–13–16–GV)

The meeting adjourned at 2:40 p.m.

Chair Recorder

c: Mr. Jim Embrey Dr. Rosana Pellizzari Mayor Mary Smith Mr. David Watton Chief Phyllis Williams Mr. Brent Woodford


Organizational POLICY

Section: Board of Health Number: 2-140 Title:

By-Law Number 5 Powers, Duties and Term of Office of the Chairperson and Vice-Chairperson of the Board of Health

Approved by: Board of Health Original Approved by the Board of Health

On (YYYY-MM-DD): 1989-10-25

Signature:

Date (YYYY-MM-DD): Revision

Approved by: Board of Health

Housekeeping Revision On (YYYY-MM-DD): 2010-10-13

Approved by: Reviewed by: Board of Health Policies and

Procedures Committee

On (YYYY-MM-DD): On (YYYY-MM-DD): 2010-10-13

Reference: Health Protection and Promotion Act, R.S.O. 1990, c. H.7, Section 48 to and including Section 51, and R.R.O. 1990, Regional 559

NOTE: This is a CONTROLLED document for internal use only, any document appearing in a paper form should ALWAYS be checked against the online version prior to use.

By-Law Number 5 Powers, Duties and Term of Office of the

Chairperson and Vice-Chairperson of the Board of Health

1. In this By-law: 1.1. "Board" means the Board of Health for the Peterborough County-City Health Unit;

1.2. "Chairperson of the Board" means the Chairperson elected under the Act;

1.3. "Vice-Chairperson of the Board" means the Vice-Chairperson elected under the Act;

1.4. "Committee" means an assembly of two or more members appointed by the Board of Health;


1.5. "Council" means the municipal councils of the Corporations of the County of Peterborough and the City of Peterborough; and the Band Councils of Curve Lake First Nation and Hiawatha First Nation;

1.6. "Member" means a person who is appointed to the Board by a council or the Lieutenant Governor in Council or a person who is appointed to a committee by the Board.

2. The officers of the Board shall be: 2.1. the Chairperson of the Board; and

2.2. the Vice-Chairperson of the Board.

3. The Chairperson of the Board shall:

3.1. preside at all meetings of the Board;

3.2. represent the Board at public or official functions or designate the Vice-Chairperson or another

Board member to do so;

3.3. be ex-officio, a member of all committees to which he has not been appointed a member; and

3.4. perform such other duties as may be determined from time to time by the Board.

4. The Vice-Chairperson shall have all the powers and performs all the duties of the Chairperson of the Board in the absence or disability of the Chairperson of the Board together with such powers and duties, if any, as may be assigned from time to time by the Board.

5. The terms of all officers of the Board shall expire when their successors are elected and no later than immediately preceding the first meeting as set out in section 3 5 of By-law Number 3.

Historical Record Revisions: Board of Health, October 11, 2007 Board of Health, March 6, 2006 Board of Health, January 12, 2005 Board of Health, October 28, 1998 Review:


Organizational POLICY

Section: Board of Health Number: 2-150 Title: By-Law Number 6 Remuneration of Members


On (YYYY-MM-DD): 1989-10-11

Signature:


Approved by: Board of Health


Approved by: Reviewed by: Board of Health Policies and

Procedures Committee


Reference: 2-153 – Procedure, Board Remuneration Review


By-Law Number 6 Remuneration of Members

1. In this By-law: 1.1. "Board" means the Board of Health for the Peterborough County-City Health Unit;

1.2. "Council" means the municipal councils of the Corporations of the County of Peterborough and

the City of Peterborough, and Band cCouncils for Curve Lake First Nation and Hiawatha First Nation;

1.3. “Committee” means an assembly of two or more members appointed by the Board of Health”;

1.4. "Meeting" means an official gathering of members of the Board or its committees in one place to transact business; and


1.5. "Member" means a person who is appointed to the board by a council or the Lieutenant Governor in Council or a person who is appointed to a committee by the Board.

2. At its first meeting, the Board shall confirm which members shall be remunerated for attending meetings and shall determine the amount of the remuneration. The Board shall be provided with a recommendation from the Governance Committee on proposed adjustments or increases to support their decision.

3. The Board shall reimburse each member for all reasonable expenses incurred as a result of acting in his/her capacity as a member in accordance with the policies of the Board.

4. The Board shall reimburse each member for all reasonable expenses incurred by the attendance at conventions, conferences, seminars, etc. in accordance with the policies of the Board.

Historical Record Revisions: Board of Health, March 17, 2006 Review:


Organizational PROCEDURE

Section: Board of Health Number: 2-153 Title: Board Remuneration Review


On (YYYY-MM-DD):

Signature:


Approved by:

Housekeeping Revision On (YYYY-MM-DD):

Approved by: Reviewed by:

On (YYYY-MM-DD): On (YYYY-MM-DD):

Reference: 2-150 – By-Law Number 6, Remuneration of Members


Procedure 1. The Director of Corporate Services will prepare a report for the last meeting of the Governance

Committee held each calendar year showing the per cent increase given to staff for the year ending that December, and the increase in the Consumer Price Index (CPI) for the previous year.

2. The Governance Committee will review this data and examine the current Board remuneration rate.

3. The Governance Committee will provide a recommendation on remuneration to the Board at its first meeting of the following calendar year. The adjustment recommended will be based on the increase in the CPI or the increase given to staff, which ever is lower.


Organizational PROCEDURE

Section: Board of Health Number: 2-251 Title: Orientation for Board of Health Members


On (YYYY-MM-DD): 1984-09-01

Signature:


Approved by: Medical Officer of Health


Approved by: Reviewed by: Medical Officer of Health


Reference:


Objective

To provide new Board members with appropriate orientation to the Health Unit and its programs and services; and, to ensure that all returning members are provided with ongoing education to enhance their potential contribution and to the capacity of the Board as a whole.

To ensure that new board members receive adequate orientation to the Health Unit and its programs and services; and

Procedure

1. A letter will be sent welcoming the new Board member and advising of the date of the next Board meeting.

2. The new Board member will be invited to visit the Health Unit to meet with the Medical Officer of Health and the Directors, and to tour the building.


3. The Medical Officer of Health and Directors will describe the programs and services of the Health Unit and answer any questions of the new Board member.

4. The new Board member will be invited to attend the next Health Unit Orientation Day.

п. The new Board member will be provided with the following information: a copy of the Board of Health orientation manual and a copy of the most recent annual report.

Association of Local Public Health Agencies Board of Health Orientation Manual

History of the Peterborough County-City Health Unit (PCCHU)

History of Public Health Units of Ontario

PCCHU Strategic Plan

Current Organizational Chart

Most recent PCCHU Annual Report

Medical Officer of Health Job Description

Board of Health By-Laws, Policies and Procedures

Ontario Public Health Standards

Ontario Public Health Organizational Standards

Health Protection and Promotion Act and applicable Regulations

Municipal Conflict of Interest Act

Information on Related Organizations (e.g., Ministry of Health and Long-Term Care, Public Health Ontario, etc.)

Names and contact information of current Board of Health Members

This list may be supplemented with any reports/documents pertaining to major developments or issues of current interest to the Board.

р. The new Board member will be required to sign a Declaration of Confidentiality Form prior to attending their first Board of Health meeting. Returning Members will be required to sign the same form at the first regular Board of Health meeting of each calendar year.

7. Directors will prepare regular reports on the activities of their respective Divisions for the Medical Officer of Health who will present them at Board meetings.

с. Beyond the initial orientation program, the Board of Health will provide ongoing professional development to ensure that its members maintain or improve their skills, and that they continue to deepen their understanding of the Health Unit’s services, related community matters and governance.

т. Ongoing education may take place as part of a regular or special Board meeting, or in a separate educational session. Additional opportunities may include attendance with external organizations


at meetings, workshops and conferences.

10. Funds will be provided in the budget to allow Board members to attend conferences, workshops, or seminars related to community health.


To: All Members Board of Health From: Deputy Mayor Sharpe, Chair, Property Committee Subject: Committee Report: Property Date: June 12, 2013 _____________________________________________________________________________ Recommendation: That the Board of Health for the Peterborough County-City Health Unit receive for information, meeting minutes of the Property Committee for March 6, 2013, approved by the Committee on June 5, 2013. _____________________________________________________________________________ Please refer to the attached.



PROPERTY COMMITTEE MEETING MINUTES

March 6, 2013 – 5:00 p.m. to 6:30 p.m. City and County Rooms, 150 O’Carroll Avenue

Present: Councillor Henry Clarke Councillor Lesley Parnell Dr. Rosana Pellizzari Deputy Mayor Andy Sharpe

Mrs. Alida Tanna Mr. David Watton

Mr. Brent Woodford 1. Call To Order

Deputy Mayor Sharpe called the meeting to order at 5:00 p.m.

2. Declaration of Pecuniary Interest Nil.

3. Approval of the Agenda Moved by Seconded by

Councillor Clarke Councillor Parnell That the agenda be approved as circulated.

Carried (M–13–07–PR) 4. Approval of the Minutes

4.1 October 26, 2012

Moved by Seconded by Mr. Watton Councillor Clarke That the minutes of the Property Committee meeting held on October 26, 2012 be approved as circulated.

Carried (M–13–08–PR)

4.2 February 1, 2013

Alida Tanna noted a correction to the attendees for the minutes of February 1, 2013.


Moved by Seconded by Councillor Parnell Councillor Clarke That the minutes of the Property Committee meeting held on February 1, 2013 be approved as amended.


5. Business Arising from the Minutes Alida Tanna advised that the Municipal Act did apply to Board of Health Committees. An email sent via the Association of Local Public Health Agencies related to this was forwarded to the Board Chair for his information.

6. Correspondence Nil.

7. New Business

8. In Camera/Closed Session

Moved by Seconded by Mr. Watton Councillor Clarke

That the Committee go In Camera to discuss confidential property matters. Carried (M–13–10–PR)

Moved by Seconded by Councillor Parnell Mr. Watton That the Committee rise from In Camera.


9. Items to be referred to: 9.1 Board of Health

Minutes, October 26, 2012

Minutes, February 1, 2013

9.2 Other Nil.

10. Agenda Items for Next Meeting

No further items were identified.

11. Date, Time and Place of Next Meeting


To be determined.

12. Adjournment

Moved by Seconded by Councillor Parnell Councillor Clarke

That the meeting be adjourned. Carried (M–13–12–PR)

The meeting adjourned at 6:29 p.m.

c: BOH Property Committee Members Dr. Rosana Pellizzari Brent Woodford Chair Recorder
