Agenda

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

Directors of the Board and participating City Officials will be provided with the video conference details closer to the meeting date.

To provide comments or make a presentation to the Board of Health:

The public may submit written comments or register to speak to the Board on any item on the agenda.

Written comments may be submitted by writing to boh@toronto.ca.

To speak to the Board, please register by e-mail to boh@toronto.ca or by phone at 416-397-4592. Registered speakers will be provided with instructions on how to participate in the meeting.

Special Assistance for Members of the Public: City staff can arrange for special assistance with some advance notice. If you need special assistance, please call 416-397-4592, TTY 416-338-0889 or e-mail boh@toronto.ca.

Closed Meeting Requirements: If the Board of Health wants to meet in closed session (privately), a director of the Board must make a motion to do so and give the reason why the Board has to meet privately (City of Toronto Act, 2006).

Notice to People Writing or Making Presentations to the Board of Health: The City of Toronto Act, 2006 and the City of Toronto Municipal Code authorize the City of Toronto to collect any personal information in your communication or presentation to City Council or its Committees and Boards. The City collects this information to enable it to make informed decisions on the relevant issue(s). If you are submitting letters, faxes, e-mails, presentations or other communications to the City, you should be aware that your name and the fact that you communicated with the City will become part of the public record and will appear on the City's website. The City will also make your communication and any personal information in it - such as your postal address, telephone number or e-mail address - available to the public, unless you expressly request the City to remove it.

Many Committee, Board, and Advisory Body meetings are broadcast live over the internet for the public to view. If you speak at the meeting you will appear in the video broadcast. Video broadcasts are archived and continue to be publicly available.

If you want to learn more about why and how the City collects your information, write to the City Clerk's Office, City Hall, 100 Queen Street West, Toronto ON M5H 2N2 or call 416-397-4592.

toronto.ca/council

This agenda and any supplementary materials submitted to the City Clerk can be found online at toronto.ca/council. Visit the website for access to all agendas, reports, decisions, and minutes of City Council and its Committees and Boards.

Declarations of Interest under the Municipal Conflict of Interest Act

Confirmation of Minutes - October 23, 2023

Speakers/Presentations - The speakers list will be posted online at 8:30 a.m. on November 27, 2023

Communications/Reports

The Medical Officer of Health recommends that:

1. The Board of Health endorse Our Health, Our City: A Mental Health, Substance Use, Harm Reduction and Treatment Strategy for Toronto attached as Attachment 1 to this report.

2. The Board of Health direct the Medical Officer of Health to establish an implementation panel for Our Health, Our City: A Mental Health, Substance Use, Harm Reduction and Treatment Strategy for Toronto, and report back to the Board of Health in the first quarter of 2024 with recommendations on the panel terms of reference and membership selection criteria.

3. The Board of Health direct the Medical Officer of Health to provide dedicated staffing resources from Toronto Public Health to support the implementation of Our Health, Our City: A Mental Health, Substance Use, Harm Reduction and Treatment Strategy for Toronto, responsible for convening stakeholders, advocating with appropriate levels of government, and monitoring progress on implementation.

4. The Board of Health direct the Medical Officer of Health to report to the Board of Health with annual progress reports on the implementation of Our Health, Our City: A Mental Health, Substance Use, Harm Reduction and Treatment Strategy for Toronto.

5. The Board of Health request the Province of Ontario and Government of Canada to provide increased, ongoing and sustainable funding for shelter services, affordable housing and supportive housing, including supportive housing for people experiencing homelessness, complex mental health and/or substance use related challenges. 

6. The Board of Health request the Province of Ontario to fund low-barrier crisis stabilization spaces for people with mental health and/or substance use related issues that operate 24 hours per day, seven days per week across the city as part of a full continuum of evidence-based services, treatment and wrap around supports.

7. The Board of Health request the Medical Officer of Health to collaborate with first responders and hospitals to implement a coordination protocol that enhances the seamless transfer of individuals experiencing mental health and/or substance use crises to the most appropriate services.

8. The Board of Health endorse the expansion of the Toronto Community Crisis Service to be city-wide, as Toronto's fourth emergency service.

9. The Board of Health forward Our Health, Our City: A Mental Health, Substance Use, Harm Reduction and Treatment Strategy for Toronto attached as Attachment 1 to this report, to the following Federal Ministers: Minister of Mental Health and Addictions, Minister of Health, Minister of Employment, Workforce and Official Languages, Minister of Housing, Infrastructure and Communities, Minister for Women and Gender Equality and Youth, and Minister of Families, Children and Social Development.

10. The Board of Health forward Our Health, Our City: A Mental Health, Substance Use, Harm Reduction and Treatment Strategy for Toronto attached as Attachment 1 to this report, to the following Provincial Ministers for their information and consideration: Minister of Health, Minister of Children, Community and Social Services, Minister for Seniors and Accessibility, Minister of Municipal Affairs and Housing, Minister of Economic Development, Job Creation and Trade, Associate Minister of Mental Health and Addictions, Associate Minister of Housing, and Associate Minister of Women’s Social and Economic Opportunity.

With a diverse and growing population, the City of Toronto offers an extraordinary wealth of cultural, social, and economic opportunities, making it one of the most livable cities in the world. To keep Toronto vibrant and welcoming, individuals and communities in the city must have equitable access to opportunities to optimize their health and achieve their full potential.

In June 2022, the Board of Health requested the Medical Officer of Health to develop a Mental Health and Addictions Strategy for Toronto. At the same time, the Board of Health directed the Medical Officer of Health to engage with stakeholders throughout summer and fall 2022 to refresh the Toronto Drug Strategy. This staff report presents Our Health, Our City: A Mental Health, Substance Use, Harm Reduction and Treatment Strategy for Toronto.

The strategy was developed through extensive consultation over the last 18 months with many stakeholders and partners, including people with lived and living experience of mental health and/or substance use issues. The strategy presents a city-wide, comprehensive population-level approach with recommendations for all levels of government, City divisions, and community partners to help address mental health and substance use related issues across the lifespan. This report outlines the proposed vision, mission, guiding principles, strategic goals and recommended actions to guide the city for the next five years.

Multiple City divisions were consulted in the development of this strategy.

There are no financial impacts associated with this report.

Toronto Public Health will give a presentation on Enhancing Immunization Coverage for Toronto’s School-Aged Population.

The Medical Officer of Health recommends that:  

1. The Board of Health request the Medical Officer of Health:

a. Develop a dedicated surveillance framework for systematically and routinely monitoring climate change health impacts for Toronto;

b. Collaborate with Public Health Ontario, public health units and other partners to identify consistent climate change health indicators for use across the province; and

c. Use new and improved data and evidence to inform future priority actions for climate change and health for the City of Toronto.

2. The Board of Health request the Medical Officer of Health actively champion the application of a public health perspective to climate-related projects and decisions through collaborating with relevant City Divisions, including Environment and Climate and Social Development, Finance and Administration.

3. The Board of Health request the Medical Officer of Health engage with partners outside the City, including academic partners, the provincial and federal governments and community stakeholders, and contribute to action addressing emerging climate change and public health issues.

4. The Board of Health request the Medical Officer of Health report back on progress on the surveillance framework, collaboration efforts and climate change health indicators in the first quarter of 2025.

Climate change is not only an environmental problem – it is one of the most pressing health issues of the 21st century¹. In 2021, the United Nations Secretary-General called the International Panel on Climate Change report a “code red for humanity”. In Toronto, each of the last four decades has been increasingly warmer than any decade that preceded it since 1850². Toronto is susceptible to the impacts of national climate events as experienced by the 2023 Canadian wildfires that had smoke and particulate matter crossing municipal, provincial, and national boundaries. Residents are increasingly feeling these effects, with 89 percent of Torontonians believing climate change threatens their personal health and well-being³.

Direct and indirect health impacts of climate change include:

- Increased incidence of heat-related illness and premature death

- Increases in cardiovascular and respiratory illness from poor air quality

- Health effects from severe weather events such as injuries

- Increased incidence of water-borne diseases from contaminated water sources

- Food system impacts, including risks to food access and security, and increased food-borne illness

- Increases in vector-borne diseases from expanded vector habitats, and

- Worsening mental health.

Toronto Public Health (TPH) is an important partner in the City of Toronto’s (the "City") work on climate change by incorporating human health impacts into the City’s climate mitigation, adaptation, and resilience actions. Understanding current and future climate change health impacts for Toronto residents relies on timely monitoring of surveillance data. This information is required to identify and drive priority actions for the City. A surveillance framework can help the City better monitor and assess how resident health is affected by climate change, including any changes or developments of inequities. This evidence can inform actions taken by the City of Toronto and partners to promote climate change mitigation, adaptation, and resilience.

There is no financial impact associated with the adoption of the recommendations in this report.

City Council on October 11 and 12, 2023, referred Administrative Inquiry IA11.3 from Councillor James Pasternak, Ward 6, York Centre, regarding Cannabis Stores and Revenue Sharing and Answer IA11.3a from the City Manager to the Board of Health for consideration.

The Board Secretary, Board of Health, in consultation with the Chair, recommends that:

1.  The Board of Health approve the following 2024 meeting dates:

- Monday, January 15 at 9:30 a.m.

- Monday, February 12 at 9:30 a.m.

- Monday, March 25 at 9:30 a.m.

- Monday, April 29 at 9:30 a.m.

- Monday, May 27 at 9:30 a.m.

- Monday, July 8 at 9:30 a.m.

- Monday, September 9 at 9:30 a.m.

- Monday, October 21 at 9:30 a.m.

- Monday, November 18 at 9:30 a.m.

In accordance with Section 25 of the Board of Health Procedures By-law, regular meetings of the Board are determined by the Board and a schedule of those meetings shall be publicly available by the first meeting of the Board in each calendar year.

On October 11 and 12, 2023, City Council considered Item ST3.1, 2024 Schedule of Meetings, and approved the 2024 schedule of meetings for City Council and its Committees. The schedule also included proposed 2024 meeting dates for the Board of Health. The updated meeting schedule can be viewed on the City of Toronto's website at www.toronto.ca/council.