Minutes To be Confirmed

This meeting of the Board of Health was conducted with members participating in person and remotely.

The Board of Health:

1. Requested the Medical Officer of Health to report to the Board of Health in the winter of 2023 with an update on the respiratory season in Toronto, including information on COVID-19 and Influenza.

2. Requested the Medical Officer of Health urgently explore all avenues toward re-issuing mask mandates, starting with schools, to reduce the spread of respiratory viruses and protect the capacity of pediatric health care services.

The Deputy Medical Officers of Health gave a presentation on Update on COVID-19 Response and Other Public Health Issues.

The Deputy Medical Officers of Health will give a presentation on Update on COVID-19 Response and Other Public Health Issues.

The Board of Health:

1. Requested the Medical Officer of Health to report to the next meeting of the Board of Health on changes to service standards resulting from the proposed 2023 Operating Budget.

2. Requested the Medical Officer of Health to provide an orientation and update to the Board of Health on the 2023 Budget submission and process at the earliest possible board meeting in 2023, including:

a. an update on Appendix A "2023 Service Levels" in the report (October 28, 2022) from the Medical Officer of Health;

b. additional details comparing the proposed 2023 Budget to planned and delivered budgets prior to 2022; and

c. additional information on the planned resumption of regular services, COVID-19 recovery initiatives, and other specific programs and services of interest to the Board, in consultation with the Acting Chair of the Board of Health.

3. Requested the Medical Officer of Health to advocate to Health Canada and the Ontario Ministry of Health for funding for the six 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 next meeting of the Board of Health on the progress made to secure funding:

a.  enhance resources for the Toronto Drug Strategy Secretariat;

b.  enhance programming for The Works;

c.  an expanded Outreach Overdose Team;

d.  expand Injectable Opioid Agonist Treatment (iOAT);

e.  enhance data and improve data sharing; and

f.  Mobile Consumption Services.

4. Requested the Medical Officer of Health to report to the next meeting of the Board of Health on what elements of the six Budget Proposals in Part 3 above are recommended to be funded immediately by the City of Toronto in 2023 while funding and reimbursement of costs from other levels of governments is sought.

5. Requested the Medical Officer of Health to continue to advocate to the Province of Ontario to:

a. confirm its commitment to provide provincial cost-sharing mitigation funding to public health units for the duration of the COVID-19 Response and for a minimum of two years after the end of the COVID-19 Response;

b. continue to provide funding for COVID-19 extraordinary costs for the duration of the COVID-19 Response; and

c. provide an opportunity to request funding for COVID-19 Recovery efforts.

Confidential Attachment 1 to the report (October 28, 2022) from the Medical Officer of Health is now public and can be accessed under Background Information.  (See Item HL1.4.)

The Board of Health:

1. Directed that the report (October 28, 2022) from the Medical Officer of Health be forwarded to the appropriate Committee for consideration as part of the 2023 Budget Process.

The Board of Health considered Items HL39.2 and HL39.3 together.

The Director, Finance and Administration gave a presentation on the Item.

The Board of Health recessed its public meeting in order to meet in closed session to consider the item as it pertain to personal matters about identifiable individuals, including municipal or local board employees, and labour relations or employee negotiations.

This report outlines the Toronto Public Health (TPH) 2023 Operating Budget Submission for consideration by the Board of Health. Toronto Public Health's 2023 Operating Budget Submission is $369,555.4 thousand gross, $159,304.3 thousand net and 2,309.9 positions.

This 2023 Operating Budget Submission is $1,226.3 thousand gross lower, $30,958.5 thousand net higher and 423.9 positions lower than the 2022 Approved Operating Budget as outlined in Table 1 in this report.

The 2023 Operating Budget Submission includes in-year changes, base changes, and a confidential program efficiency pending City Council approval as detailed in the recommendations included in this report.

At its meeting on July 25, 2022, the Board of Health - Budget Committee considered Item HU8.1, 2022 Toronto Public Health's 2022 and 2023 Operating and Capital Budgets.

The Board of Health recommends that:  

1. City Council approve a 2023 Recommended Capital Budget for Toronto Public Health with a total project cost of $15.277 million, including a 2023 cash flow of $5.062 million and future year commitments of $10.215 million.

2. City Council approve the 2023-2032 Capital Plan for Toronto Public Health totalling $16.189 million in project estimates, comprised of $0.449 million in 2024, $1.882 million in 2025, $2.509 million in 2026, $3.557 million in 2027, $3.026 million in 2028, $1.408 million in 2029, $1.127 million in 2030, $1.361 million in 2031 and $0.870 million in 2032.

The Board of Health:

1. Directed that the report (October 28, 2022) from the Medical Officer of Health be forwarded to the Budget Committee for consideration during the 2023 Budget process.

The Board of Health considered Items HL39.2 and HL39.3 together.

The Director, Finance and Administration gave a presentation on the Item.

This report provides an overview of Toronto Public Health's 2023 Capital Budget and 2024-2032 Plan Request.

Toronto Public Health is recommending a 2023-2032 Capital Budget and Plan of $31.466 million, including a 2023 Capital Budget of $5.062 million with future year commitments of $10.215 million and future year estimates of $16.189 million. The 10 Year Capital Budget and Plan Request will provide funding for sixteen projects.

The Board of Health recommends that:

1. City Council request the Civic Appointments Committee to make every effort to bring forward appointment recommendations for the Board of Health that reflect the full diversity and range of voices in our City, with particular attention to candidates from Black and Indigenous communities.

2. City Council request the City Manager to review options for designating certain seats on the Board of Health for the appointment of candidates from under-represented communities, with regard for City Council's commitments to reconciliation, equity and inclusion, and countering anti-Black racism.

3. City Council request the City Clerk to undertake enhanced outreach seeking applicants to the Board of Health from Black and Indigenous communities, in consultation with the Director, Indigenous Affairs Office, and the Manager, Confronting Anti-Black Racism Unit.

Dear colleagues,

Our institutions, including the Board of Health, should reflect the full diversity and range of voices in our City. We have to work hard to ensure that Toronto's Black, Indigenous, and equity-deserving communities have a seat at the table in everything we do.

The Board of Health has affirmed this perspective in the past and has an opportunity in this moment to emphasize the importance to City Council in the lead-up to new public appointments to the Board of Health for the 2022-2026 term. A commitment to reconciliation, equity, and justice must be a fundamental element of each step along the way in this process: from recruitment, through the Civic Appointments Committee, and finally to City Council.

Announcements

The Chair recognized Director Stephanie Donaldson who acknowledged that the Board of Health was meeting on the traditional territory of many nations including the Mississaugas of the Credit, the Anishnabeg, the Chippewa, the Haudenosaunee and the Wendat peoples and is now home to many diverse First Nations, Inuit and Métis peoples. Director Donaldson also acknowledged that Toronto is covered by Treaty 13 with the Mississaugas of the Credit.

The Chair acknowledged and thanked the Toronto Public Health staff and members of the Board of Health for their work.

The Medical Officer of Health acknowledged and thanked the Chair, and members of the Board of Health for their work, as well as all Chairs, Vice-Chairs and Members who served in the 2018 to 2022 term of Council.  The Medical Officer of Health also thanked staff for their efforts in carrying out the Board's directions.

Where the Directors of the Board of Health listed in the attendance for this meeting participated remotely, they were counted for quorum as permitted by Section 189(4.2) of the City of Toronto Act, 2006, and the Board's Procedures, as amended.