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.

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Declarations of Interest under the Municipal Conflict of Interest Act

Confirmation of Minutes - July 7, 2025

Speakers/Presentations - The speakers list will be posted online at 8:30 a.m. on September 15, 2025

Communications/Reports

The Acting Medical Officer of Health recommends that:  

1. The Board of Health request the Mayor to propose a 2026 Operating Budget for Toronto Public Health of $316,267.7 thousand gross, $112,527.5 thousand net, and 1,847.5 positions, as summarized in Table 1, Overview of the TPH 2026 Operating Budget Submission, which includes the following incremental changes from the TPH 2025 Operating Budget:

    a. an increase of $6,439.2 thousand gross and $6,439.2 thousand net for inflationary costs and salaries and benefits

    b. a decrease of $885.2 thousand gross and an increase of $701.4 thousand net, and 1 position for 2026 administrative and technical adjustments

    c. an estimated increase of $1,538.4 thousand gross, $0 net for operating costs related to Downtown Homeless Addiction Recovery Treatment (HART) Hub

    d. an increase in revenue of $1,535.5 thousand to accept additional funds from the provincial government to support the delivery of Ontario Public Health Standards programs and services

    e. a decrease of $6,274.8 thousand gross, $1,000.0 thousand net resulting from the removal of prior year one-time expenses and related funding

    f. a decrease of $1,061.0 thousand gross, $1,061.0 thousand net, along with 6.0 positions to meet efficiency targets

   g. an increase of $15,019.7 thousand gross, $15,019.7 thousand net, and 3 positions for Phase 3 and Phase 4 expansion of the Student Nutrition Program, projected growth in student participation, and enhancements to the Food Safety program to support the expansion.

2. The Board of Health directs that this report be forwarded to the City of Toronto Budget Committee for consideration during the 2026 Budget process.

This report outlines the Toronto Public Health (TPH) 2026 Operating Budget Submission for consideration by the Board of Health. Toronto Public Health's 2026 Operating Budget Submission is $316,267.7 thousand gross, $112,527.5 thousand net and 1,847.5 positions.

Toronto Public Health is intending to achieve the City's affordability target, apart from requests to increase its operating budget to strengthen and expand the Student Nutrition Program.  

This 2026 Operating Budget Submission is higher than the 2025 Operating Budget by $14,776.3 thousand gross, $18,563.9 thousand net with 2.0 less positions. The increase in Toronto Public Health's year-over-year budget is predominately attributed to costs to strengthen and expand the City's Student Nutrition Program, and inflationary and cost of living adjustment (COLA) increases for staff.

Additional information on the change between the 2026 Operating Budget Submission and the 2025 Operating Budget is available in Table 1 in this report.

The 2026 Operating Budget Submission includes in-year changes, and base changes as detailed in the recommendations in this report.

Toronto Public Health's (TPH) 2026 Operating Budget Submission totals $316,287.4 thousand gross, $112,527.5 thousand net and 1,847.5 positions. This submission is $14,776.3 thousand gross and $18,563.9 thousand net higher, and 2.0 positions less than the 2025 Operating Budget for TPH.

The 2025 Operating Budget includes an estimate increase of $3,592.2 thousand gross and $0 net to develop and operate a Downtown HART Hub.

TPH received an affordability target for 2026. Excluding the new and enhanced funding requests for the Student Nutrition Program of $15,019.7 thousand gross and net, and 3.0 permanent positions, which includes funding for Phase 3 and 4 (155 additional school communities) of the Universal School Food Program, TPH has achieved its target.

The Chief Financial Officer and Treasurer has been advised of the financial impacts associated with this report to be considered along with other priorities as part of the annual budget process.

The Board of Health - Budget Committee recommends that:

1. The Board of Health request the Province of Ontario to increase funding for Toronto Public Health to cover an annual cost of living increase equivalent to the annual average Ontario Consumer Price Index.

At its meeting on July 7, 2025, the Board of Health - Budget Committee considered item HU4.1 and made recommendations to the Board of Health.

The Acting Medical Officer of Health recommends that:  

1. The Board of Health request the Mayor to propose a 2026 Capital Budget to City Council for Toronto Public Health with total cash flows and future year commitments of $16.084 million, including a 2026 cash flow of $12.650 million, 2027 commitment of $2.122 million and 2028 commitment of $1.312 million.

2. The Board of Heath request the Mayor to propose a 2027-2035 Capital Plan to City Council for Toronto Public Health with total project estimates of $16.854 million, comprised of $2.796 million in 2027, $4.122 million in 2028, $4.805 million in 2029, $3.139 million in 2030, $0.984 million in 2031 and $1.008 million in 2032.

3. The Board of Health direct that this report be forwarded to the Budget Committee for consideration during the 2026 Budget process.

This report provides an overview of Toronto Public Health's 2026 Capital Budget and 2027-2035 Plan Request.

Toronto Public Health is recommending a 2026 Capital Budget of $16.084 million, including 2026 Budget of $12.650 million and future year commitments of $3.434 million. Toronto Public Health is also recommending a 2027-2035 Capital Plan of $16.854 million for future year estimates. The proposed 2026-2035 Capital Budget and Plan will provide funding for nine (9) projects:

1) Electronic Medical Record

2) Inspection Management Implementation

3) Mobile Dental Van

4) Downtown Homelessness, Addiction Recovery and Treatment (HART) Hub

5) Student Nutrition Program-- Universal Morning Meal Program

6) Socio-Demographic Data Collection and Reporting

7) e-Consent Portal

8) Inspection Management Program

9) Workload Management and Scheduling

Toronto Public Health is recommending a 2026 Capital Budget of $16.084 million with 2026 Budget of $12.650 million and future year commitments of $3.434 million, and a 2027-2035 Capital Plan of $16.854 million for future year estimates. These capital projects are detailed in Appendix 1 of this report.

The Chief Financial Officer and Treasurer has been advised of the financial impacts associated with the recommended 2026-2035 Capital Budget and Plan of Toronto Public Health to be considered along with other priorities as part of the annual Budget process.

The Board of Health - Budget Committee recommends that:

1. The Board of Health request the Province of Ontario to increase funding for Toronto Public Health to cover an annual cost of living increase equivalent to the annual average Ontario Consumer Price Index.

At its meeting on July 7, 2025, the Board of Health - Budget Committee considered item HU4.1 and made recommendations to the Board of Health.

The Acting Medical Officer of Health recommends that:  

1. The Board of Health receive this report for information.

This report provides an update to the Board of Health on the Toronto Public Health (TPH) Operating Variance for the six months ended on June 30, 2025.

As of June 30, 2025, Toronto Public Health's gross expenditure was underspent by $19.3 million and revenue was underachieved by $13.6 million, resulting in a favourable net variance of $5.7 million.

At year end, Toronto Public Health's gross expenditure is projected to be underspent by $28.3 million, while revenue is expected to be underachieved by $13.7 million. As a result, net expenditure will be under budget by $14.5 million.

Toronto Public Health will request a budget adjustment to increase its 2025 Operating budget by $8.3 million gross and net to reflect the transfer of 2025 cost-of-living allowance that is allocated to Toronto Public Health from Non-Program through City of Toronto's Q2 variance report process.

When adjusted for the 2025 cost-of-living allowance budget, Toronto Public Health's net year-to-date variance was favorable by $5.7 million or 19.2 percent. Net year-end variance is projected to be favorable by $14.5 million or 15.5 percent. These variances are mainly due to underspending in mandatory cost-shared programs from reinitiation of paused programs, primarily within Community Health and Wellbeing (CHW) including Chronic Disease and Injury Prevention.

There are no financial impacts associated with adoption of this report.

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

The Acting Medical Officer of Health recommends that:  

1. The Board of Health receive this report for information.

This report provides an update to the Board of Health on the Toronto Public Health (TPH) Capital Variance for the six months that ended on June 30, 2025.  

As of June 30, 2025, Toronto Public Health spent $0.865 million representing 11.7 percent of the 2025 Approved Capital Budget of $7.415 million.

At year end, Toronto Public Health's capital expenditures are expected to be $6.847 million representing 92.3 per cent of the 2025 Approved Capital Budget of $7.415 million.

Toronto Public Health spent $0.865 million or 11.7 percent of the 2025 Approved Capital Budget as of June 30, 2025, and projects year-end expenditures to be at $6.848 million or 92.3 percent of the 2025 Approved Capital Budget of $7.415 million.

There are no financial impacts associated with adoption of this report.

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

The Acting Medical Officer of Health recommends that:  

1. The Board of Health request the Medical Officer of Health to explore options for uses of artificial intelligence tools at Toronto Public Health, that is in accordance with City policies, legislative requirements and industry best practices, and report back to the Board of Health in the first quarter of 2027 with an update on this work.

In July 2025, the City of Toronto took its first steps to embrace and adopt artificial intelligence (AI) by releasing the Guidance for the Responsible Use of Generative Artificial Intelligence (Generative AI Guidance) to City staff. In response to the Board of Health's June 2025 request to review the guidelines, TPH has reviewed and confirmed that the Generative Artificial Intelligence Guidance is aligned with best practices from the Association of Local Public Health Agencies (alPHa), Province of Ontario, and the Government of Canada.

The City has adopted and enabled Microsoft (MS) Chat, the first generative artificial intelligence tool officially endorsed for City-wide use.  Toronto Public Health staff are engaged in training on City policies, legislative requirements (e.g. PHIPA) and industry best practices including specific privacy and personal health information policies and legislation.

This report also explores the broader opportunities for the use of artificial intelligence at Toronto Public Health while maintaining high standards of privacy, security, and ethics. With proper risk mitigation, artificial intelligence tools could help Toronto Public Health optimize resources and better meet its mandate.

In addition to issuing the Generative Artificial Intelligence Guidance, the City of Toronto has a governance framework in place that considers privacy, security, and ethics. The framework guides adoption of artificial intelligence tools in accordance with City policies, legislative requirements and industry best practices.

Toronto Public Health is investigating three pilot projects that use artificial intelligence tools, outside of Microsoft Chat, that could support the work of Toronto Public Health. Toronto Public Health will form an internal artificial intelligence working group in fall 2025 and work closely with Technology Services Division (TSD) and the Chief Information Security Officer (CISO) to continue to address risk while advancing innovative opportunities for service delivery. Technology Services Division and Chief Information Security Officer were consulted in the preparation of this report.  

There are no financial impacts associated with the adoption of the recommendation in this report.

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

1.  The Board of Health approve the following 2026 meeting dates:

Monday, January 5, 2026 at 9:30 a.m.

Monday, February 23, 2026 at 9:30 a.m.

Monday, March 30, 2026 at 9:30 a.m.

Monday, May 4, 2026 at 9:30 a.m.

Monday, June 1, 2026 at 9:30 a.m.

Monday, July 13, 2026 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 July 23 and 24, 2025, City Council considered Item CC32.3, 2026 Schedule of Meetings, and approved the 2026 schedule of meetings for City Council and its Committees. The schedule also included proposed 2026 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.