Item - 2021.HL31.4

The Board of Health recommends to the Budget Committee that:

1.  City Council approve the Toronto Public Health 2022 Operating Budget Submission of $362,678.1 thousand gross, $128,753.0 thousand net and 2,736.7 positions, as summarized in Table 1, Overview of the Toronto Public Health 2022 Operating Budget Submission in the report (October 12, 2021) from the Medical Officer of Health, which includes the following incremental increases (and decreases, as outlined in Recommendations 1.e. and 1.k. below) from the Toronto Public Health 2021 Council Approved Operating Budget:

a.  an increase of $403.4 thousand gross and net for inflationary cost increases in the Student Nutrition Program;

b.  an increase of $922.0 thousand gross, $0 net and 9.0 positions to annualize the Overdose Prevention Site Program;

c.  an increase of $3,422.5 thousand gross and $0 net for the Toronto Voluntary Isolation Centre;

d.  an increase of $1,344.1 thousand gross, $0 net and 4.0 positions for a new Injectable Opioid Agonist Treatment program;

e.  an increase of $694.2 thousand gross and a decrease of $41.2 thousand net for additional funding from the Ministry of Children, Community and Social Services for inflation;

f.  an increase of $654.7 thousand gross and net and 128.0 positions for Toronto Public Health's COVID-19 response;

g.  an increase of $1,478.1 thousand gross, $0 net and 19.0 positions for the integration of the COVID-19 immunization into the Vaccine Preventable Diseases Program;

h.  an increase of $1,012.6 thousand gross, $0 net and 10.0 positions for COVID-19 recovery and rebuild;

i.  an increase of $826.1 thousand gross, $247.8 thousand net and 7.0 positions for a program enhancement for public health data and analytics;

j.  an increase of $3,345.9 thousand gross and net for 2022 salaries and benefits cost of living adjustments and inflation;

k.  an increase of $463.3 thousand gross, a decrease of $108.4 thousand net and an increase of 3.1 positions for 2022 administrative adjustments;

l.  an increase in revenue of $140.6 thousand resulting from the planned resumption of the Student Immunization Program;

m.  an increase of 102.0 positions for the Public Health Nurses for Schools Program;

n.  an increase of $959.1 thousand gross, $0 net and 10.0 positions for an enhancement to the Toronto Drug Strategy Secretariat;

o.  an increase of $202.2 thousand gross, $0 net and 2.0 positions for an enhancement to The Works Program;

p.  an increase of $762.6 thousand gross, $0 net and 12.0 positions to expand the Outreach Overdose Team;

q.  an increase of $538.4 thousand gross, $0 net and 5.0 positions to expand the Injectable Opioid Agonist Treatment Program;

r.  an increase of $378.4 thousand gross, $0 net and 4.0 positions to enhance data and improve data sharing in support of the Opioid Poisoning Crisis; and

s.  an increase of $526.3 thousand gross, $0 net and 9.0 positions for a new mobile supervised consumption services program.

The Board of Health:

1.  Requested the Medical Officer of Health to advocate to Health Canada and the Ontario Ministry of Health for funding for the six 2022 Budget Proposals below, as outlined in the presentation (October 5, 2021) from the Director, Finance and Administration, Toronto Public Health and the Medical Officer of Health, and to report to the December 6, 2021 meeting of the Board of Health on the progress made to secure funding:

1.  enhance resources for the Toronto Drug Strategy Secretariat;

2.  enhance programming for The Works;

3.  an expanded Outreach Overdose Team;

4.  expand Injectable Opioid Agonist Treatment (iOAT);

5.  enhance data and improve data sharing; and

6.  Mobile Consumption Services.

2.  Requested the Medical Officer of Health to report to the December 6, 2021 meeting of the Board of Health on what elements of the six 2022 Budget Proposals in Part 1 above, as outlined in the presentation (October 5, 2021) from the Director, Finance and Administration, Toronto Public Health and the Medical Officer of Health, are recommended to be funded immediately by the City of Toronto in 2022 while funding and reimbursement of costs from other levels of governments is sought.

3.  Directed that the report (October 12, 2021) from the Medical Officer of Health be forwarded to the Budget Committee for consideration during the 2022 Budget process.

4.  Directed that the report (October 12, 2021) from the Medical Officer of Health be forwarded to the Ministry of Health.

This report outlines the Toronto Public Health (TPH) 2022 Operating Budget Submission for consideration by the Board of Health. Toronto Public Health's 2022 Operating Budget Submission totals $362,678.1 thousand gross, $128,753.0 thousand net and 2,736.7 positions.

This submission is $17,933.9 thousand gross, $4,361.6 thousand net and 324.1 positions higher than the 2021 Operating Budget as approved by City Council on February 18, 2021 (referred to as "TPH 2021 Council Approved Operating Budget" for the purpose of this report).

The 2022 Operating Budget Submission includes in-year changes, base changes, and service enhancements pending City Council approval as detailed in the recommendations included in this report.

At its meeting on October 5, 2021, the Board of Health - Budget Committee considered Item HU7.1, 2022 Toronto Public Health Operating Budget Request - Additional Information for Discussion.