Providing Leadership in Public Health Management

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2 Carlton Street, Suite 1306 Toronto, Ontario M5B 1J3 Tel: (416) 595-0006 Fax: (416) 595-0030 E-mail: info@alphaweb.org alpha s members are the public health units in Ontario. alpha Sections: Boards of Health Section Council of Ontario Medical Officers of Health (COMOH) Affiliate Organizations: Association of Ontario Public Health Business Administrators Association of Public Health Epidemiologists in Ontario Association of Supervisors of Public Health Inspectors of Ontario Health Promotion Ontario Ontario Association of Public Health Dentistry Ontario Association of Public Health Nursing Leaders Ontario Society of Nutrition Professionals in Public Health Hon. Charles Sousa March 11 th 2016 Minister of Finance Hepburn Block 80 Grosvenor Street, 109 th Floor Toronto, ON M7A 2C4 Dear Minister Sousa, Re. Ontario Budget 2016 On behalf of member Medical Officers of Health, Boards of Health and Affiliate organizations of the Association of Local Public Health Agencies (alpha), I am writing today in response to elements of this year s Ontario Budget that are of particular interest to our members and the work that we do. We took note of your observation in the budget speech that Ontario s single greatest resource is its people. As the leaders of the public health system that is charged with keeping people healthy, we have a central role in protecting this resource. A healthy economy is not possible without healthy people, and we are pleased that the 2016 Budget contains some general language and some specific commitments that reflect an understanding of this truth. We are indeed pleased that the 2016 Budget continues the recent trend of including a section entitled Keeping Ontarians Healthy in the chapter that addresses health care more broadly. Although we would submit that this section would be equally at home under the infrastructure, environment or any number of the initiatives presented in the Making Everyday Life Easier chapters, we are always thankful to see it as a stated Government priority. As to the specifics, there are several items in this year s budget that are aligned with our interests, and to which our members will have important contributions to make: Menu Labelling: Our advocacy for this measure is well known and the Government of Ontario is to be congratulated for this important piece of legislation. We believe that consumers should be provided with the information that they need to make healthy choices, and we believe that retailers should bear some of the responsibility for providing it. We hope that your Government will now commit to the implementation of the other elements of the Healthy Kids Strategy that are aimed at reducing overweight and obesity and their associated health risks. ISPA amendments and Shingles Vaccine: We will commend the Ontario Government for any measures that increase vaccine uptake and coverage, subject to their licensure and application as recommended by the National Advisory Committee on Immunization. We look forward to providing our input to the amendments being considered to the Immunization of School Pupils Act that are aimed at limiting the acceptable grounds for exemptions, and we congratulate you for covering the Shingles vaccine for 65-70 yearolds as recommended by the Provincial Infectious Diseases Advisory Committee (PIDAC). www.alphaweb.org Providing Leadership in Public Health Management

Tobacco: alpha supports any effort to reduce the use and impact of tobacco industry products in Ontario. Pricing of such products has been clearly demonstrated as an effective tool to achieve this, and we thank you for the immediate $3 per carton increase and for ensuring future increases by tying them to the rate of inflation. The additional $5M commitment to smoking cessation services for priority populations is also welcome, and our members will certainly have some valuable expertise to lend to its effective implementation. Infrastructure: With what you have characterized as the largest investment in Ontario s history in priority public infrastructure projects such as roads, bridges, public transit, hospitals and schools, we see a magnificent opportunity for supporting the goal of keeping Ontarians healthy. As alluded to above, ensuring good health is about far more than the health care system. Community design and planning have enormous impacts on human health, and we strongly believe that this relationship must be a consideration. alpha believes that improving population health should be a stated objective of community and transportation system design, and supports the inclusion of health and health equitypromoting design criteria as a requirement for public funding. Basic Income: Having passed alpha Resolution A15-4 (Public Health Support for a Basic Income Guarantee) just last year, we were excited to see that the 2016 Budget includes a pledge to work with communities, researchers and other stakeholders to design and implement a Basic Income pilot project. The Resolution in question is attached to provide more information about our support for this initiative, and we are very much looking forward to participating in the process. Taken together, the above items are representative of the breadth of opportunities to give a central role to the health promotion and disease prevention activities that are the core business of Ontario s public health system. Many of these are requirements under The Ontario Public Health Standards (OPHS), and Ontario s Boards of Health are already delivering related programs and services. In other areas, they are engaged with community partners in policy, programming and advocacy that are aimed at keeping people well. We are aware of the ongoing difficulties presented by the current economy and of the related challenges to ensuring effective and appropriate public expenditures. To that end, we offer the above comments in an effort to assist you in meeting those challenges. We offer our congratulations on this year s budget, and we look forward to repeating them in the future as the value of Ontario s public health system and the importance of its goals and objectives are recognized and fully supported. Sincerely, Dr. Valerie Jaeger, President

Copy: Hon. Kathleen Wynne, Premier of Ontario Hon. Eric Hoskins, Minister of Health and Long-Term Care Hon. Dipika Damerla, Associate Minister of Health and Long-Term Care Dr. Bob Bell, Deputy Minister, Health and Long-Term Care Sharon Lee Smith, Associate Deputy Minister, Policy and Transformation Dr. David Williams, Chief Medical Officer of Health Roselle Martino, Assistant Deputy Minister, Population and Public Health Division. Encl.

alpha RESOLUTION A15-4 TITLE: SPONSOR: Public Health Support for a Basic Income Guarantee Simcoe Muskoka District Health Unit low income, and high income inequality, have well-established, strong relationships with a range of adverse health outcomes; and 1,745,900 Ontarians, or 13.9% of the population, live in low income according to the 2011 National Household Survey after-tax low-income measure; and income inequality continues to increase in Ontario and Canada; and current income security programs by provincial and federal governments have not proved sufficient to ensure adequate, secure income for all; and a basic income guarantee a cash transfer from government to citizens not tied to labour market participation - ensures everyone an income sufficient to meet basic needs and live with dignity, regardless of work status; and basic income resembles income guarantees currently provided in Canada for seniors and children, which have contributed to health improvements in those age groups; and there was an encouraging pilot project of basic income for working age adults conducted jointly by the Government of Manitoba and the Government of Canada in Dauphin, Manitoba in the 1970s, which demonstrated several improved health and educational outcomes; and a basic income guarantee can reduce poverty and income insecurity, and enable people to pursue educational, occupational, social and health opportunities relevant to them and their family; and the idea of a basic income guarantee has garnered expressions of support from the Canadian Medical Association and the Alberta Public Health Association as a means of improving health and food security for low income Canadians; and there is momentum growing across Canada from various sectors and political backgrounds for a basic income guarantee; NOW THEREFORE BE IT RESOLVED THAT the Association of Local Public Health Agencies (alpha) endorse the concept of a basic income guarantee; Continued

alpha RESOLUTION A15-4 continued AND FURTHER that alpha request that the federal Ministers of Employment and Social Development, Labour, and Health, as well as the Ontario Ministers Responsible for the Poverty Reduction Strategy, Seniors, Labour, Children and Youth Services, and Health and Long-Term Care, prioritize joint federal-provincial consideration and investigation into a basic income guarantee, as a policy option for reducing poverty and income insecurity and for providing opportunities for those in low income; AND FURTHER that the Prime Minister, the Premier of Ontario, the Chief Public Health Officer, the Chief Medical Officer of Health for Ontario, the Canadian Public Health Association, the Ontario Public Health Association, the Federation of Canadian Municipalities, and the Association of Municipalities of Ontario be so advised. ACTION FROM CONFERENCE: Resolution CARRIED AS AMENDED