Agenda

At this time, civic buildings are closed to the public and meetings of the Board of Health are being conducted by electronic means.  Members of the Board and senior staff may choose to participate in person or electronically. Other staff and the public will continue to participate in meetings remotely. These measures are necessary to comply with public health guidelines and prevent the spread of COVID-19. Meetings of the Board continue to be conducted publicly and will be streamed live on meeting day at youtube.com/TorontoCityCouncilLive.

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 during the COVID-19 Emergency

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 connecting to 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 member 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 www.toronto.ca/council. Visit the website for access to all agendas, reports, decisions, and minutes of City Council and its Committees and Boards. Items with original signatures are kept on file with the City Clerk's Office and are available for viewing.

Declarations of Interest under the Municipal Conflict of Interest Act

Confirmation of Minutes - July 2, 2020

Speakers/Presentations - The speakers list will be posted online at 8:30 a.m. on September 21, 2020

Communications/Reports

The Medical Officer of Health recommends that:

1.  The Board of Health request the Medical Officer of Health work with the Executive Director of Social Development, Finance and Administration, the Executive Director of the Housing Secretariat and the General Manager of Toronto Employment and Social Services to explore how to implement strategies such as those identified in this report, to address the social determinants of health for the City of Toronto's most vulnerable populations who have been adversely affected by the COVID-19 pandemic.

 
2.  The Board of Health urge the Ministry of Long-Term Care to fund on-site, dedicated infection prevention and control expertise at each long-term care facility and invest in training for existing practitioners to contribute to system-wide improvements related to infection prevention and control.

 
3.  The Board of Health urge the Federal Government to implement a data system that will quickly transmit information about arriving international travellers to local enforcement authorities to support better compliance with the Quarantine Act.

Since January 2020, Toronto Public Health (TPH) and City of Toronto partners have been responding to the COVID-19 pandemic. The number of new COVID-19 cases identified each day had shown a downward trend, but we have now started to observe an increase in the number of cases reported each day.

As the City continues to reopen more businesses and services as part of Stage 3 of the Provincial Recovery Framework, Toronto Public Health will continue working with the Province of Ontario to carefully monitor COVID-19 activity in the community and in institutional and congregate settings. Toronto Public Health staff are prepared to respond quickly when additional cases are observed.

This report is intended to provide an update on COVID-19 response activities, describe scenarios and planning for future events, including a potential resurgence, and provide recommendations to strengthen the response to the COVID-19 pandemic as we move towards fall 2020.

There are no financial impacts resulting from the adoption of the recommendations in this report.

The Medical Officer of Health will give a presentation on Toronto Public Health's Guidance for Reopening Schools.

The 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 Budget Variance for the six months ended on June 30, 2020.

As of June 30, 2020, in comparison to the 2020 Operating Budget approved by Council, TPH's net expenditure is lower than budget by $98.5 thousand net (0.3 percent).

As of December 31, 2020, TPH is projecting that the Operating Budget will be over budget by $5,075.7 thousand net (7.2 percent) which is expected to be fully recovered from the Province.

As of June 30, 2020, Toronto Public Health (TPH) gross expenditure is lower than budget by $6,928.6 thousand gross (6.0 percent), revenue was lower than budgeted by $6,830.1 thousand (7.8 percent), resulting in a net favourable variance of $98.5 thousand (0.3 percent). The favourable variance takes into consideration the extraordinary expenses incurred as resources have been redirected to support TPH's response to the COVID-19 pandemic.

As of December 31, 2020, TPH is projecting that expenditures will be more than budget by $3,272.9 thousand gross (1.2 percent) and revenue will be lower than budgeted by $1,802.8 thousand (0.9 percent), resulting in a net unfavourable variance of $5,075.7 thousand (7.2 percent). The unfavourable variance of $5,075.7 thousands is mainly due to additional costs incurred to increase resources engaged in TPH's response to the COVID-19 pandemic and a decrease in revenue from user fees and other recoveries.

The Ministry of Health has indicated that extraordinary costs in response to the COVID-19 pandemic that are over and above the Provincial grant will be fully funded by the Province. Revenue projections will be adjusted to reflect any additional funding received from other levels as part of future period reports.

The 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 Capital Budget Variance for the six months ended on June 30, 2020.

As of June 30, 2020, Toronto Public Health spent $1.101 million representing 26.3 percent of the 2020 Approved Capital Budget of $4.193 million.  

The majority of planned 2020 capital projects have been deferred as resources have been deployed to support Toronto Public Health's COVID-19 response.

As of June 30, 2020, Toronto Public Health spent $1.101 million representing 26.3 percent of the 2020 Approved Capital Budget of $4.193 million.  

The Chief Financial Officer and Treasurer has been provided the financial impacts associated with this program for review as part of the 2020 budget process.

The Medical Officer of Health recommends that:  

1. City Council increase the Toronto Public Health 2020 Capital Budget for the Ontario Seniors Dental Care Program Capital Project by the amount contained in Confidential Attachment 1.

2. City Council authorize the Medical Officer of Health to enter into the Capital Funding Agreements with the dental clinics contained in Confidential Attachment 1 for the receipt and expenditure of funding on such terms and conditions that are satisfactory to the Medical Officer of Health and in a form approved by the City Solicitor.

3. City Council authorize the public release of Confidential Attachment 1 following the Province of Ontario's public release of the funding allocation.

On November 20, 2019 the Government of Ontario launched the Ontario Seniors Dental Care Program (OSDCP). Through this 100 percent Ministry of Health funded program, local public health departments are to ensure the provision of dental treatment to low-income seniors. In Toronto, the OSDCP treatment services are provided to eligible seniors through dental clinics located in Toronto Public Health sites, Community Health Centres and Aboriginal Health Access Centres.

On August 31, 2020, the Province of Ontario announced new, one-time capital funding of $25 million to expand access to the Ontario Seniors Dental Care Program. The funding will be used to support infrastructure projects across the province, including building new dental clinics and renovating existing facilities. The Province has indicated that a portion of this funding will be allocated to dental clinics in Toronto.

This report recommends increasing Toronto Public Health's 2020 Capital Budget to accept the new provincial funding to expand the Ontario Seniors Dental Care Program in Toronto.

The Ministry of Health has approved additional one-time funding for capital purchases in support of the Ontario Seniors Dental Care Program. The amount of the funding and the proposed increase to Toronto Public Health's 2020 Capital budget is contained in Confidential Attachment 1.

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 receive this report for information.

The Baby-Friendly Initiative (BFI) is an internationally-recognized designation that was started in 1991 by the World Health Organization and the United Nations Children's Fund (UNICEF) to encourage practices that protect, promote, and support breastfeeding. In 2013 and 2018, Toronto Public Health was granted BFI designation by the Breastfeeding Committee for Canada. Designation can be obtained every five years by successfully completing a rigourous, multifaceted process.

In addition, since 2019 Toronto Public Health has implemented the Registered Nurses' Association of Ontario's Breastfeeding Best Practice Guidelines (BPGs) entitled: Breastfeeding - Promoting and Supporting the Initiation, Exclusivity, and Continuation of Breastfeeding for Newborns, Infants, and Young Children (2018). The BPGs offer 16 evidence-based breastfeeding education and promotion recommendations that incorporate all BFI principles.

The 2008 Ontario Public Health Standards made BFI designation a performance indicator for public health units. However, this indicator was removed in the Standards' 2018 update. Obtaining BFI designation was initially beneficial to develop practices to support breastfeeding. Given that obtaining BFI designation is a recurring resource-intensive endeavour, and now that strong practices have been established, Toronto Public Health will maintain its BFI designation until 2023 and, thereafter, continue to implement the BPGs' recommendations.

There are no financial implications resulting from the adoption of the recommendation in this report.

Councillor Joe Cressy and Councillor Gord Perks recommend that:

1. The Board of Health request that the Medical Officer of Health provide an update on the status of the opioid poisoning crisis in Toronto for the October 19, 2020 Board of Health meeting, focusing on Toronto Public Health's current response, and further actions needed by all levels of government to support the response to this public health crisis.

People who use drugs continue to face a high risk of overdose and death due to the increasingly toxic, unregulated drug supply in our city. This opioid poisoning crisis is further exacerbated by the reduction of harm reduction service capacity due to COVID-19. Suspected opioid overdose calls to the Toronto Paramedics Service have been higher in February, March and April 2020. Paramedics also responded to a high number of suspected opioid overdose-related deaths in April and May; 25 in each month. In July, paramedics responded to 27 suspected opioid overdose-related deaths; the largest monthly number seen since the City began monitoring this information in September 2017, and higher than the number of COVID-19 deaths during this month.