Item - 2020.HL24.1

During the review of the Order Paper on December 16, 2020, City Council adopted a procedural motion to remove this Item from the Board of Health and bring it forward to City Council for consideration.

The Board of Health recommends that:

1.  City Council approve TO Supports: COVID-19 Equity Action Plan and the 25 equity actions and targeted and enhanced equity measures that the City of Toronto, Toronto Public Health, and partners are taking to support Torontonians disproportionately impacted by COVID-19, as outlined in Attachment 1 to the report (November 30, 2020) from the Deputy City Manager, Community and Social Services.

2.  City Council approve the inclusion of equity indicators in the Toronto Public Health COVID-19 Monitoring Dashboard in order to facilitate public reporting on the disproportionate impact of COVID-19 infection on certain population groups based on the social determinants of health such as income, racialization, and neighbourhood and to drive equity-focused policy and program actions.

3.  City Council recognize that a comprehensive approach to reducing the disproportionate impact of COVID-19 on Indigenous, Black, and racialized Torontonians, including newcomers, must be central to the COVID-19 emergency response, to COVID-19 immunization planning, and to Toronto's recovery and rebuild efforts.

4.  City Council request the Province of Ontario and the Government of Canada to establish dedicated not-for-profit sector stabilization and bridging funds to ensure the immediate and long-term resilience of the not-for-profit sector which is critical for inclusive economic and community recovery, including a $680 million Provincial fund, as advocated for by the Ontario Nonprofit Network, and a new $500-$700 million Federal Community Services COVID-19 Relief Fund, as advocated for by national human and community service federations.

5.  City Council urge the Province of Ontario to immediately extend, for at least the next six months, eligibility for the Ontario Works Emergency Assistance benefit to include all working-age adults who have tested positive for COVID-19 or reside in a household where someone has tested positive and have been advised by an employer, medical practitioner, nurse practitioner, public health official, or other government official to self-isolate and who do not otherwise qualify for either Ontario Works or Federal benefits.

6.  City Council request the Deputy City Manager, Community and Social Services, working with the Medical Officer of Health and Toronto's COVID-19 Incident Commander and in consultation with community stakeholders, to intensify, adapt, or revise TO Supports: COVID-19 Equity Action Plan as necessary to respond effectively to urgent COVID-19 health disparities as identified by the Medical Officer of Health on the basis of the Toronto Public Health COVID-19 Monitoring Dashboard equity indicators, COVID-19 data from Indigenous-led health organizations, or other COVID-19 evidence and information emerging from the community sector.

7.  City Council request the Executive Director, Social Development, Finance and Administration, working with the Medical Officer of Health and the General Manager, Shelter, Support and Housing Administration, and community sector partners, to assess the level of need and optimal services to support families (e.g., adults with dependent children or other dependents) who need to self-isolate due to COVID-19 infection.

8.  City Council forward the report (November 30, 2020) from the Deputy City Manager, Community and Social Services, to the Ontario Minister of Children, Community and Social Services, the Ontario Minister of Health, the Ontario Associate Minister of Mental Health and Addictions, the Ontario Minister of Long-Term Care, the Ontario Minister of Municipal Affairs and Housing, the Ontario Solicitor General, the Federal Deputy Prime Minister and Minister of Finance, the Federal Minister of Immigration, Refugees and Citizenship, and the Federal Minister of Health.

The Board of Health:

1.  Approved TO Supports: COVID-19 Equity Action Plan and the 25 equity actions and targeted and enhanced equity measures that the City of Toronto, Toronto Public Health, and partners are taking to support Torontonians disproportionately impacted by COVID-19, as outlined in Attachment 1 to the report (November 30, 2020) from the Deputy City Manager, Community and Social Services.

2.  Approved the inclusion of equity indicators in the Toronto Public Health COVID-19 Monitoring Dashboard in order to facilitate public reporting on the disproportionate impact of COVID-19 infection on certain population groups based on the social determinants of health such as income, racialization, and neighbourhood and to drive equity-focused policy and program actions.

3.  Recognized that a comprehensive approach to reducing the disproportionate impact of COVID-19 on Indigenous, Black, and racialized Torontonians, including newcomers, must be central to the COVID-19 emergency response, to COVID-19 immunization planning, and to Toronto's recovery and rebuild efforts.

4.  Endorsed the newly-announced measures to reduce crowding on the Toronto Transit Commission's bus routes supporting essential workers and neighbourhoods disproportionately affected by COVID-19 and urged the Toronto Transit Commission to continue to take all possible steps to facilitate safe physical distancing on transit vehicles.

5.  Requested the Medical Officer of Health, in consultation with the Deputy City Manager, Community and Social Services, to report to the January 18, 2021 meeting of the Board of Health on the potential value of universal paid sick leave as a measure to enable employees to follow public health guidance to stay home from work and self-isolate when feeling unwell and to seek COVID-19 testing, including:

a.  providing an overview of current paid sick leave provisions and protections available to workers in Toronto, including for part-time and temporary workers, through the Federal and Provincial Governments;

b.  identifying existing barriers and areas for improvement that could help the public to follow public health guidance; and

c.  options for the Federal and Provincial Governments to enhance paid sick leave to enable employees to follow public health guidance to stay home from work and self-isolate when feeling unwell and to seek COVID-19 testing.

6.  Requested the Medical Officer of Health, in consultation with the Deputy City Manager, Community and Social Services, Toronto's COVID-19 Incident Commander, and community stakeholders, to monitor the implementation of TO Supports: COVID-19 Equity Action Plan, including the new targeted and enhanced equity measures described in the Plan, and to report to the Board of Health in the first quarter of 2021 with a focus on results achieved for equity-seeking groups, including the impacts of implementing Indigenous-led COVID-19 health equity measures, Black-led COVID-19 health equity measures, and measures to minimize COVID-19 impacts on Torontonians living with a disability.

7.  Requested the Medical Officer of Health, in consultation with the Deputy City Manager, Community and Social Services, the General Manager, Shelter, Support and Housing Administration, and community sector partners, to assess the level of need and optimal services to support families (e.g., adults with dependent children or other dependents) who need to self-isolate due to COVID-19 infection.

The Deputy City Manager, Community and Social Services, gave a presentation on TO Supports: COVID-19 Equity Action Plan.

In March 2020, the City of Toronto, in coordination with Toronto Public Health, Toronto Public Library and hundreds of community-based partners, launched an unprecedented emergency response to meet the needs of Torontonians who have been disproportionately impacted by the spread of COVID-19 and by the sudden, serious consequences of the first pandemic "lockdown". The City's Emergency Operations Centre and nearly every City division, agency and corporation has contributed to this massive effort to support Toronto's most vulnerable residents during a time of crisis.

Many of the services, programs and systems mobilized for this effort - ranging from emergency food delivery to mental health supports to free 24/7 child care - are wholly new lines of operation and partnership for the City of Toronto and were designed, developed and then delivered into the community within mere days or weeks of the emergency declaration. These innovations have revealed the City's powerful creative and collaborative capacity. They have also demonstrated the value of maintaining and investing in a deep, interdependent relationship with a strong, activist community-based not-for-profit sector. The sector has continuously delivered front-line services and supports during the pandemic, championed the needs of highly vulnerable communities and held the City accountable to resolve emerging critical issues. Without the work of the community sector over the past 10 months, many Torontonians would be in a much more challenging situation than is currently faced.

The guiding framework to organize this multi-dimensional emergency response was rolled out in March 2020, through Social Development, Finance and Administration Division, under the title: TO Supports: COVID-19 Equity Action Plan. TO Supports prioritizes ten action areas related to the social determinants of health and contains twenty-five separate actions to stop virus spread and deliver immediate emergency support to the neighbourhoods and populations that have been hardest hit by COVID-19. Since March, this Plan has been constantly evolving, adapting and intensifying in light of new information and data, new partnerships, new resurgence plans and new pandemic conditions.

Attachment 1 to this report summarizes the City's implementation of TO Supports from March to November 2020. It includes key advice collected from community-based partners, current status indicators, and the City's work on the intergovernmental front to leverage the funding and legislative tools required to solve urgent problems facing equity-seeking groups during the pandemic. It also highlights plans for new, targeted and enhanced COVID-19 equity measures that were recently launched in conjunction with the announcement of Toronto's second pandemic "lockdown".

To support Torontonians who have been hardest hit by COVID-19 and to stop the virus spread, the City is taking urgent action on multiple fronts, in strong collaboration with community partners. Our COVID-19 Equity Action Plan is called, "TO Supports".

Ongoing cooperation and commitment from other levels of government is required for the City to meet the needs of residents during the pandemic and implement many of the actions in "TO Supports".

This report summarizes, in Attachment 1, the status of current Council-adopted intergovernmental requests to advance Toronto's COVID-19 equity actions.