Minutes Confirmed on July 8, 2024

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 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. Requested 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 Acting Director of Community Health & Well-being and Chief Nursing Officer and the Associate Medical Officer of Health gave a presentation on Healthy Aging 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.

The Board 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.

The Board of Health:

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

2. Authorized 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 the report (May 13, 2024) from the Medical Officer of Health.

3. Authorized the Medical Officer of Health to execute Grant Agreements with the applicants identified in Appendix 2 to the report (May 13, 2024) from the Medical Officer of Health.

4. Directed the Medical Officer of Health to work in collaboration with urban Indigenous community organizations to evaluate and reset the Toronto Urban Health Fund Indigenous funding stream using an Indigenous-led approach to redesign, in keeping with principles of Indigenous-self determination and the City of Toronto’s commitments to Truth and Reconciliation. 

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.

The Board 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.

The Board of Health:

 
1. Requested 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.

2. Requested 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.

3. Forwarded 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.

4. Requested the Province of Ontario and Ministry of Children, Community and Social Services to consult with public health units and municipalities on the design, delivery, and local governance of the National School Food Program in Ontario.

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 Board of Health:

1. Received the letter (May 10, 2024) from the City Clerk for information.

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 Board of Health:

1. Approved the Confidential Recommendation from the Board of Health - Performance Appraisal of the Medical Officer of Health Committee in Confidential Attachment 1 to the letter (May 21, 2024) from the Board of Health Performance Appraisal of the Medical Officer of Health Committee. 

2. Directed that Confidential Attachment 1 and Confidential Attachment 2 to the letter (May 21, 2024) 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.

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

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.

The Board of Health:

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

2. Appointed 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.

Announcements

The Chair 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. The Chair also acknowledged that Toronto is covered by Treaty 13 with the Mississaugas of the Credit.

The Chair further acknowledged that not all people came to these lands as migrants and settlers, and specifically acknowledged those who came here involuntarily, particularly those brought to these lands as a result of the Trans-Atlantic Slave Trade and Slavery. In support of the City of Toronto's ongoing efforts to confront anti-Black racism, the Chair paid tribute to those ancestors of African, Caribbean and Black origin and descent.

At 10:53 a.m. the Board of Health recessed its meeting until 11:04 a.m.

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.