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.

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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.

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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 - April 29, 2024

Speakers/Presentations - The speakers list will be posted online at 8:30 a.m. on May 27, 2024

Communications/Reports

The Medical Officer of Health recommends that:  

1. The Board of Health request the Medical Officer of Health collaborate with community partners and relevant City divisions and agencies, including continuing Toronto Public Health's active participation on the Toronto Seniors Strategy, to identify and implement policies and other interventions to enhance the social, natural and built environments that promote and protect the health of a growing population of older adults.

2. The Board of Health request the Medical Officer of Health continue partnership and engagement with First Nations, Inuit and Métis (FNIM) communities, organizations and service providers to understand the impacts of colonization and the linked policies, systems and structures on systemic racism, discrimination, unmet care needs, service access barriers and inequities faced by aging FNIM communities in Toronto.

The number of older adults in Toronto is increasing. In 2021, the number of Torontonians who were 65 years and older was estimated to be 477,000. That number is estimated to rise by over 50 per cent by 2041, with people 75 years and older rising the most.

This demographic shift comes with anticipated population health impacts. Poorer health outcomes among low-income older adults, increased difficulty accessing health and social services, effects of social isolation and loneliness and health impacts related to changing environments are expected. However, the health of older adults can be positively affected by protective behaviours, such as increased physical activity and socialization.

To prepare for this change, Toronto Public Health is working closely with community partners and relevant City partners. This includes supporting the Toronto Seniors Strategy and identifying and implementing interventions to enhance the social, natural and built environments that promote and protect the health of a growing population of older adults.

First Nations, Inuit and Métis (FNIM) communities additionally face impacts of colonialism, systematic racism, discrimination, unmet care needs, service access barriers and inequities. Toronto Public Health will continue to partner and engage with FNIM communities, organizations and service providers to understand these impacts.

Toronto Public Health will continue to work through multisectoral collaborations to advance a city that is increasingly age-friendly, age-inclusive and age-equitable for its older adults.

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

The Medical Officer of Health recommends that:

1.  City Council authorize the Medical Officer of Health to award, execute and amend, on an ongoing basis, purchase of service agreements for food security initiatives with Working Women Community Centre, within the approved Toronto Public Health budget, in accordance with applicable program and funding guidelines, on such terms and conditions as are satisfactory to the Medical Officer of Health and in a form approved by the City Solicitor.

The purpose of this report is to provide information on the purchase of service contracts awarded and executed by the Medical Officer of Health for 2024, according to the delegation of authority by City Council.

This report also requests approval for the Medical Officer of Health to award, execute and amend, on an ongoing basis, purchase of services contracts with Working Women Community Centre to deliver food handler training and certification, food literacy, and employment skills development to low-income community participants, including newcomers and refugees.

This report has no financial impact beyond what has already been approved in the 2024 Operating Budget for Toronto Public Health. Attachment 1 outlines $7,437.7 thousand in service contracts awarded and executed by program to support delivery for 2024.

The Chief Financial Officer and Treasurer has reviewed the report and agrees with the financial impact information.

The Medical Officer of Health recommends that:

1. The Board of Health authorize the Medical Officer of Health to allocate $653.4 thousand in 2024 for seven (7) one-year projects.

2. The Board of Health authorize the Medical Officer of Health to allocate $1,867.7 thousand to seventeen (17) three-year projects to implement year two services in 2024 as recommended by the 2023 Toronto Urban Health Fund (TUHF) Review Panels and as outlined in Tables 2 and 3 and Appendix 2 to this report.

3. The Board of Health authorize the Medical Officer of Health to execute Grant Agreements with the applicants identified in Appendix 2 to this report.

The Toronto Urban Health Fund (TUHF) provides grants to community-based HIV prevention and substance use initiatives. Projects funded through the TUHF complement existing Toronto Public Health programs to provide effective services that focus on HIV, substance use and harm reduction programming to populations and groups that Toronto Public Health cannot access due to linguistic, cultural, and geographic barriers.

This report outlines the TUHF’s program criteria and priorities, application review process, and 2024 grant recommendations for Board of Health approval. The 2024 TUHF Review Panel recommend granting $653.4 thousand for seven (7) one-year projects and $1,867.7 thousand for seventeen (17) three-year projects that were approved in 2023. The grants total $2,521.1 thousand for the twenty-four (24) projects and are to be used between July 1, 2024 and June 30, 2025. The 2024 recommended projects focus on HIV prevention through sexual transmission, harm reduction, child and youth resiliency, and Indigenous health promotion.

This report recommends an allocation of $2,521.1 thousand for seven (7) one-year projects totaling $653.4 thousand and seventeen (17) three-year projects totaling $1,867.7 thousand from Toronto Public Health’s 2024 Operating Budget for projects outlined in Tables 2 and 3 and Appendix 2 to this report.

Funding of $2,521.1 thousand gross, $680.7 thousand net is available in Toronto Public Health's 2024 Approved Operating Budget and funding for 2025 will be included in the 2025 Operating Budget Submissions.

The TUHF is funded by the Ministry of Health and the City of Toronto.

Table 1: Estimated Financial Impacts ($ in thousands)

The Chief Financial Officer and Treasurer has reviewed this report and agrees with the information as presented in the Financial Impact Section.

The Medical Officer of Health recommends that:

1. City Council authorize the Medical Officer of Health to enter into agreements and other suitable arrangements, on behalf of the City of Toronto, for the transfer of funds to the Angel Foundation for Learning ($4,919.3 thousand) and the Toronto Foundation for Student Success ($14,214.9 thousand) for the purpose of administering the 2024 approved municipal funding (totalling $19,134.2 thousand) to eligible student nutrition programs across the City of Toronto on terms satisfactory to the Medical Officer of Health and in a form satisfactory to the City Solicitor.

2. The Board of Health request the Government of Canada to expand the National School Food Program to provide funding for a universal program which would provide nutritious meals for every school-aged child.

3. The Board of Health request the provincial Minister of Children, Community and Social Services to encourage the Government of Ontario to reach an agreement with the federal government as soon as possible so that the National School Food Program can be rolled out in the 2024-2025 school year.

4. The Board of Health forward this report to the federal Minister of Agriculture and Agri-Food, the federal Minister of Families, Children and Social Development, the federal Minister of Health, the federal Minister of Employment and Social Development Canada, the provincial Minister of Children, Community and Social Services, the provincial Minister of Health, the provincial Minister of Education, the Toronto District School Board, the Toronto Catholic District School Board, le Conseil scolaire Viamonde, le Conseil scolaire catholique MonAvenir, the Toronto Foundation for Student Success, the Angel Foundation for Learning, the Daily Bread Food Bank, and United Way Greater Toronto.

Student nutrition programs are meal and snack programs offered primarily in school settings. These programs help to ensure that children and youth, especially those at risk for poor nutritional intake, have access to safe and culturally appropriate nutritious food. Research continues to demonstrate that healthy school meals support student mental and physical health, and positively impact food choices. Participating students focus better, achieve academic success, develop greater nutrition knowledge and healthier eating habits. These positive impacts are shown to continue into adulthood resulting in long term positive health behaviours, such as reduced diet-related chronic disease.^1,2

Toronto's Student Nutrition Program has two streams: the Public Schools Stream, which includes public schools and some grandfathered independent schools and community sites, and the Independent Schools Stream. Student nutrition programs depend on funding from the City of Toronto (the City), the Government of Ontario, student and parent contributions, community and school board fundraising, and corporate donations. Additional funding and support from the federal and provincial governments is needed to meet student needs and ensure sustainable programs.

This report makes recommendations for the 2024 Student Nutrition Program service subsidy allocations, which includes an 8.5 per cent cost of food inflationary increase of $1,495.9 thousand from the approved 2023 budget. The proposed combined allocations to the Angel Foundation for Learning and the Toronto Foundation for Student Success are for the purpose of administering the 2024 approved municipal funding to eligible student nutrition programs across the City of Toronto and total $19,134.2 thousand which includes $280.1 thousand held in reserve for appeals and Fall applications. 

The 2024 Approved Operating Budget for Toronto Public Health includes funding of $19,164.3 thousand gross and net for municipally funded student nutrition programs, as follows:

- $18,844.7 thousand toward the cost of nutritious food for the Public Schools Stream which will reach 613 school communities across Toronto.

- $319.6 thousand toward the cost of nutritious food and capacity building for the Independent Schools Stream which will support seven eligible independent schools and assessment for eligibility of three independent schools in Toronto.

This report recommends an allocation of $19,134.2 thousand: $4,919.3 thousand to the Angel Foundation for Learning and $14,214.9 thousand to the Toronto Foundation for Student Success, which includes all funds held in reserve as outlined in Tables 1 and 2. The proposed combined allocations are for the purpose of administering the 2024 approved municipal funding to eligible student nutrition programs in Toronto.

There is no financial impact associated with this report beyond what has been approved in the 2024 Approved Operating Budget for Toronto Public Health.

The Chief Financial Officer and Treasurer has reviewed this report and agrees with the information as presented in the Financial Impact Section.

City Council, on April 17 and 18, 2024, adopted Item EX13.1 as amended and, in so doing, has requested the Board of Health and the Medical Officer of Health to review the report on governance models for student nutrition that was previously initiated by Toronto Public Health.

The Medical Officer of Health recommends that:  

1. The Board of Health direct that the confidential information contained in Confidential Attachment 1 remain confidential in its entirety, as it relates to personal matters about an identifiable individual, including a municipal or local board employee.

This report provides information respecting the 2023 performance appraisal for the Medical Officer of Health.

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

The Board of Health - Performance Appraisal of the Medical Officer of Health Committee recommends that:

1. The Board of Health approve the Confidential Recommendation from the Board of Health Performance Appraisal of the Medical Officer of Health Committee. 

2. The Board of Health direct that the Confidential Recommendation from the Board of Health
- Performance Appraisal of the Medical Officer of Health Committee and Confidential Attachment 1 to the report (May 7, 2024) from the Medical Officer of Health remain confidential in their entirety, as they relate to personal matters about an identifiable individual, including a municipal or local board employee.

At its meeting on May 21, 2024, the Board of Health - Performance Appraisal of the Medical Officer of Health Committee considered Item HP2.1, 2023 Performance Appraisal - Medical Officer of Health.

Councillor Chris Moise recommends that:

1. The Board of Health establish a Medical Officer of Health Hiring Committee composed of the Chair, the Vice-Chair, two citizen members, and one Councillor member.

2. The Board of Health appoint the following Board of Health directors to the Medical Officer of Health Hiring Committee:

- Director Chris Moise

- Director Alejandra Bravo

- Director Amber Morley

- Director Stephanie Zhou

- Director Abinaya Chandrabalan

On May 14, Dr. Eileen de Villa, Medical Officer of Health, announced her retirement effective at the end of this year. Her last day as Toronto’s Medical Officer of Health will be December 31, 2024.

The Board of Health will be responsible for recommending an appropriate successor to City Council. To ensure a smooth transition, the Board of Health should begin to seek candidates immediately.

I am recommending that the Board establish a Medical Officer of Health Hiring Committee composed of five members: the Chair, the Vice-Chair, two citizen members, and one Councillor member. The Committee may also wish to seek outside expertise from the City’s Chief People Officer and/or an external executive search firm.