Decisions

The Board of Health:

1. Requested the Medical Officer of Health to report back to the Board with an update on Toronto Public Health’s Indigenous Health Strategy progress by Q1 2026.

2. Requested the Acting Medical Officer of Health to share this report with the City of Toronto Indigenous Affairs Office and Social Development, Finance and Administration Division to demonstrate how the work of the Indigenous Wellness Committee aligns with the City of Toronto Reconciliation Action Plan’s Strategic Action 13.

The Senior Policy and Strategic Issues Advisor, Indigenous Health and the Acting Medical Officer of Health gave a presentation on Indigenous Wellness Committee: Update.

In April 2023, the Medical Officer of Health provided an update to the Board of Health on developing a mental health and addictions strategy for the City of Toronto. At that time, the Board of Health recommended that the Medical Officer of Health co-develop a parallel strategy with Indigenous organizations and communities to ensure that approaches and actions support the unique needs of urban Indigenous people living in Toronto.

In response to this recommendation, Toronto Public Health staff co-hosted two Indigenous Wellness Roundtables with the Toronto Aboriginal Social Supports Council in October 2023, to determine next steps with Indigenous organizations. The main recommendation was to establish an Indigenous Wellness Committee, co-led by Toronto Public Health and Indigenous organizations.

This report provides a progress update on the work of the Indigenous Wellness Committee and includes recommendations to the Board of Health for continued communication about Toronto Public Health’s Indigenous Health Strategy.

The Board of Health:

1. Requested the Acting Medical Officer of Health to continue to collaborate with City divisions, public health agencies, academic institutions, and community researchers as appropriate, on initiatives to better understand environmental exposure risks in Toronto such as:

a. Exploring collaborative research opportunities to update information on the air pollution burden of illness, including cancer.

b. Continuing participation as a knowledge user in the Study of Winter Air Pollution in Toronto (SWAPIT) and other air quality studies to inform local policies and action.

c. Undertaking an assessment of the quality improvement options for optimizing the ChemTRAC program's operations and effectiveness.

2. Requested the Acting Medical Officer of Health to continue contributing to environmental carcinogen risk reduction through provision of public health technical expertise to the City of Toronto or other levels of government on relevant initiatives.

3. Requested the Acting Medical Officer of Health to continue amplifying messages about relevant environmental carcinogens through participation in initiatives of other agencies or City divisions to reduce public health risks of environmental cancers.

The Associate Medical Officer of Health gave a presentation on Environmental and Occupational-Related Cancer Prevention in Toronto: Public Health Actions.

Cancer-causing agents in the environment, or environmental carcinogens, contribute to some of the most common cancers in Ontario. Some carcinogens are in the environment from human activities (for example, pollution from cars or industry) while others are part of the natural environment (for example, radon and solar radiation). The severity and frequency of exposures to environmental cancer-causing agents are potentially modifiable. Some environmental exposures can be outside the control of individuals.

The burden of environmental cancers is felt across the city. As a public health unit, Toronto Public Health (TPH) has a role in environmental cancer prevention and in reducing exposures at the community level. Toronto Public Health contributes to community cancer prevention and exposure reduction by working with other levels of government and partners, and by taking action within local public health's scope and mandate. Toronto Public Health's prevention activities include increasing public awareness of primary cancer prevention, responding to public complaints, participating in research studies, enforcing existing laws, and advocating for laws to prevent exposures to environmental carcinogens.

Occupational cancers are related to workplace exposures. The hierarchy of hazard controls is a framework for actions to help protect worker health and safety in workplaces.  Many provincial laws exist to protect workers from occupational exposures to hazards.   

This report highlights Toronto Public Health's participation in existing strategies to prevent cancer. The report also identifies opportunities to enhance multi-level government efforts to reduce the burden of cancer from environmental and occupational carcinogens in Toronto.

The Board of Health:

1. Deferred consideration of this item to the next meeting of the Board of Health.

The Deputy Medical Officer of Health and Associate Medical Officer of Health gave a presentation on the Noise Action Plan Update.

Noise is raised by Toronto residents as an issue of concern. To address this concern, the City of Toronto has many initiatives guided by the 2019 Noise Action Plan and the updated City of Toronto Noise By-law. Toronto Public Health’s (TPH) mandate is determined by the Ontario Public Health Standards. Noise is not described as an environmental health hazard in the Ontario Public Health Standards. Toronto Public Health consults and provides advice to other City divisions in their work to mitigate the impacts of excessive noise. 

The 2019 Noise Action Plan contains recommended actions within the authority of each City division to reduce excessive noise in Toronto. Although the COVID-19 pandemic resulted in pauses to some City operations, Toronto Public Health and other City divisions have since made substantial progress in the Noise Action Plan. For example, Municipal Licensing and Standards completed the Noise By-law Review in 2024 in consultation with Toronto Public Health, other City divisions, and stakeholders. The review identified new efforts to mitigate noise in Toronto.  

This report, as requested by City Council through Item 2024.EC9.5, Implementation Review of the Noise By-law, provides an updated review of the health impacts of noise. The latest research continues to describe excessive noise exposure impacts on cardiovascular, cognitive, sleep, and mental health outcomes. These are smaller relative impacts than other environmental and social determinant of health factors on these outcomes. This means that while there is evidence to support links between excessive noise and adverse health impacts on individuals, the population-level impact of noise is limited relative to other factors that cause population morbidity and mortality.

The Board of Health:  

1. Received the report (March 18, 2025) from the Acting Medical Officer of Health for information.

This report provides an update on the Toronto Public Health 2025 Operating Budget considered by City Council on February 11, 2025.

City Council considered a 2025 Toronto Public Health Operating Budget of $288,575.6 thousand gross, $85,705.5 thousand net and 1,884 Full-Time Equivalent positions. The City approved Operating Budget reflects an increase of $2,677.5 thousand gross, $2,836.8 thousand net, and a reduction of twenty-four (24) positions compared with Board of Health recommendations. The City approved Operating Budget represents an increase of $3,145.4 thousand gross (1.1 percent increase) and $6,000.0 thousand net (7.5 percent) over the 2024 Approved Operating Budget.

The Board of Health:

1. Received the report (March 18, 2025) from the Acting Medical Officer of Health for information.

This report provides an update on the City approved Toronto Public Health 2025 Capital Budget and 2026-2034 Capital Plan. The City approved Toronto Public Health 2025 Capital Budget is $4,130 thousand for four (4) projects with future year commitments of $10,023 thousand, totaling $14,153 thousand. The City approved 2026-2034 Capital Plan has two (2) projects totaling $7,999 thousand in the Toronto Public Health 2026-2034 Capital Plan.

Key changes between the Board of Health recommended 2025 Capital Budget and 2026-2034 Capital Plan and the City approved 2025 Capital Budget and 2026-2034 Capital Plan are:

• Adding a new project, Homelessness and Addiction Recovery Treatment (HART) Hubs
• Postponing the Digital Strategy project  
• Carrying over cash flow from 2024

The Board of Health:

1. Received the report (March 18, 2025) from the Acting Medical Officer of Health for information.

This report provides an update to the Board of Health on the Toronto Public Health Operating Budget for the year ending on December 31, 2024.

The Board of Health:

1. Received the report (March 18, 2025) from the Acting Medical Officer of Health for information.

This report provides an update to the Board of Health on the Toronto Public Health Capital Budget Variance for the year ending on December 31, 2024.

The Board of Health:

1. Directed the Acting Medical Officer of Health to begin implementation of the interim Downtown HART Hub model, as set out in the update from the Medical Officer of Health and in accordance with the City of Toronto’s application to the Ministry of Health for HART Hub funding.

2. Directed the Acting Medical Officer of Health to report back once confirmation of Provincial funding is received with:

a. An update on the interim HART Hub model, including rollout of services, partnerships, and opportunities to enhance wrap-around case management supports;

b. Information on the permanent HART Hub model, including planned services, partnerships, and timelines for completion; and

c. Any agreements and authorities required to enable the Downtown HART Hub.

3. Directed the Acting Medical Officer of Health to develop a comprehensive client case management, aggregate reporting, and outreach coordination plan and report back by the June 3, 2025 Board of Health meeting.

4. Directed the Acting Medical Officer of Health to collaborate with City divisions to continue to support stakeholders in proximity to 277 Victoria Street including but not limited to Toronto Metropolitan University and the Downtown Yonge Business Improvement Area until September 30, 2025, including participating in the Yonge-Dundas Safety Network, and supporting their outreach teams with access to naloxone kits, and safe needle collection and disposal services, within the guidelines of the Ontario Naloxone Program and the Ontario Harm Reduction Distribution Program.

The Associate Medical Officer of Health gave a presentation on the Update on the City of Toronto’s Downtown Homelessness and Addiction Recovery Treatment (HART) Hub.

Last December, the Government of Ontario passed the Community Care and Recovery Act, requiring five Supervised Consumption Service (SCS) sites and Consumption and Treatment Services (CTS) sites in Toronto to close their doors no later than March 31, 2025.

Alongside these legislative changes, the provincial government also announced a new funding stream to support the creation of Homelessness and Addiction Recovery Treatment (HART) Hubs, including a total of $378 million to implement these hubs across Ontario.

The new Homelessness and Addiction Recovery Treatment (HART) Hub model will help address the needs of our most vulnerable communities, offering a comprehensive suite of supports, which can include, addiction care, primary care, supportive housing, employment support, and more.

As part of the Homelessness and Addiction Recovery Treatment (HART) Hub announcement, Supervised Consumption Service sites impacted by the new legislation were encouraged to apply for funding, with an aim to transition their services to the new model.

In response, Toronto Public Health (TPH) and partners across City divisions, healthcare, and community organizations submitted a Downtown Homelessness and Addiction Recovery Treatment (HART) Hub application to the Ministry of Health. The Ministry approved this application ‘in principle’ on January 2, 2025.

The City of Toronto’s Downtown Homelessness and Addiction Recovery Treatment (HART) Hub application outlines a range of proposed services that could be implemented pending suitable funding. These include 24/7 Intake, Medical Monitoring and Referrals. Supportive Housing Connection, Substance Use Treatment and Primary Care, Outpatient Medical Specialty Services, Assertive Community Therapy, Withdrawal Management Beds, and more.

Toronto Public Health has been working with partners to develop and implement plans for year one of the Hub, with some services initiating on April 1, and more becoming available throughout the year.

As we work to mitigate the impacts of the March 31 closures of Supervised Consumption Service sites and continue collaborating with our partners to establish our own Downtown Homelessness and Addiction Recovery Treatment (HART) Hub, I am requesting an update be provided to the Board of Health.

The Board of Health:

1. Re-opened Item HL13.7, titled "Hiring Process for the Next Medical Officer of Health".

2. Deleted Part 1 of its decision on Item HL13.7 and adopt the following:

Established a Medical Officer of Health Hiring Panel composed of the Chair, the Vice-Chair, and two citizen members of the Board of Health, and the Mayor.

3. Deleted Part 2 of its decision on HL13.7 and adopt the following:

Appointed the following to the Medical Officer of Health Hiring Panel:

Director Chris Moise

Director Alejandra Bravo

Director Stephanie Zhou

Director Abinaya Chandrabalan

Mayor Olivia Chow

I would like to provide you with an update on the hiring process for the Medical Officer of Health.

At our meeting on May 24, 2024, we struck a hiring panel to lead the hiring process. Phelps Group was selected to assist with the process and a search was carried out through the end of 2024. The hiring panel has now reconvened and has decided to restart the hiring process with an enhanced compensation package, which was approved by the Ministry, with the goal of reaching a broader pool of applicants.

As Deputy Mayor Amber Morley is no longer a member of the Board of Health, the hiring panel is now constituted by the following voting members:

• Councillor Chris Moise (Chair)
• Mayor Olivia Chow
• Councillor Alejandra Bravo
• Director Abinaya Chandrabalan
• Director Stephanie Zhou

Throughout the process, the hiring panel may engage with the Deputy City Manager, Community and Social Services, the City Manager’s office and the Ministry of Health in an advisory capacity.

The following timeline outlines the next steps in the hiring process:

• March - April: Candidate Outreach
• April 28 - May 2: Long List Definition
• May 5-9: First Round Interviews
• May 12-16: Second Round Interviews
• June 3: Medical Officer of Health Appointment at Board of Health
• June 25: Medical Officer of Health Appointment Approval at City Council
• June 27: Transmittal of Medical Officer of Health Appointment to the Minister

I will continue to provide updates at our Board of Health meetings as the hiring process unfolds.

The Board of Health:

1. Received the item for information.

The Associate Medical Officer of Health gave a presentation on the Update on the Legal Challenge of the Community Care and Recovery Act.

There have been recent developments on the Legal Challenge of the Community Care and Recovery Act, so I would like for us to receive an update from Toronto Public Health Staff.