Agenda

This meeting of the Board of Health will be conducted by electronic means and the proceedings of the Board of Health will be conducted publicly.

These measures are necessary to comply with public health guidelines and prevent the spread of COVID-19.

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 connecting to 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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Declarations of Interest under the Municipal Conflict of Interest Act

Confirmation of Minutes - June 14, 2021

Speakers/Presentations - The speakers list will be posted online at 12:30 p.m. on September 27, 2021

Communications/Reports

The Medical Officer of Health recommends that:  

1.  The Board of Health request the Medical Officer of Health to monitor the implementation of the Province of Ontario's vaccine certificate program and report back to the Board of Health in the first quarter of 2022 with an update on the program's impact in Toronto.

2.  The Board of Health request the Province of Ontario to require COVID-19 vaccination for students who are eligible based on their age/year of birth.

The City of Toronto (the City) is currently in the fourth wave of the COVID-19 pandemic. At the time of this report, we are observing an average of 153 daily COVID-19 cases over a 7-day period. As of September 9, 2021, 77.9 percent of individuals over the age of 12 have been fully vaccinated in Toronto. While the ongoing uptake of vaccination by Toronto residents is positive, analysis and modelling of the fourth wave demonstrates that ongoing vigilance is required to both promote increased vaccination and monitor progress towards reducing COVID-19 transmission.

This report provides an update on the response to the COVID-19 pandemic as of September 2021, and responds to Board of Health direction from March 2021 for the Medical Officer of Health to report on COVID-19 workplace vaccination policies. This report also responds to direction from the Board of Health in June 2021 to provide an update on Toronto Public Health (TPH) efforts to support the safe return to school. Finally, this report makes a recommendation for the Medical Officer of Health to monitor ongoing vaccine policy developments at the provincial level and request the Province of Ontario (the Province) to require school-age children who are eligible for the COVID-19 vaccine to be vaccinated.

There is no financial impact resulting from the adoption of the recommendations in this report.

The Medical Officer of Health recommends that:

1.  The Board of Health request the Medical Officer of Health to arrange an Indigenous cultural safety training session for the Board in 2022 to build the Board's capacity to respectfully advance Indigenous health and reconciliation through its public health policy mandate.

2.  The Board of Health request the Chair to call a Special Meeting of the Board of Health in 2022 for the training session referenced in Recommendation 1 above.

3.  The Board of Health request the Medical Officer of Health, in collaboration with Indigenous community partners and City of Toronto divisions, to continue the implementation of the Toronto Indigenous Health Strategy actions and operating principles using an approach that allows for transparency and accountability.

4.  The Board of Health request the Medical Officer of Health to review and advance the recommendations from the Toronto Indigenous Health Strategy Implementation Assessment, including:

a.  implementing an Indigenous Cultural Safety framework aimed at decolonizing Toronto Public Health's programs, services, policies and approach;

b.  engaging Toronto Public Health Senior Management Team in a facilitated discussion to further define and act on the Toronto Indigenous Health Strategy's Operating Principles;

c.  exploring mechanisms to ensure that Indigenous communities' perspectives are represented at the Board of Health;

d.  strengthening Toronto Public Health's relationships with Indigenous partners such as, the Toronto Aboriginal Support Services Council, the City of Toronto's Aboriginal Affairs Advisory Committee, and Indigenous community organizations;

e.  continuing to invest in staff development opportunities to strengthen cultural safety and Toronto Public Health's capacity to respectfully and effectively serve Indigenous Peoples in Toronto;

f.  reviewing Toronto Public Health's hiring practices and exploring opportunities to recruit and retain Indigenous employees; and

g.  reviewing and revising Toronto Public Health policies and practices to support Indigenous cultural safety.

Due to the ongoing impacts of colonization, Indigenous Peoples in Toronto continue to experience inequities within a number of health outcomes.

This report provides a progress update on Toronto Public Health's (TPH) implementation of the Toronto Indigenous Health Strategy (2016-2021). It also provides key recommendations for advancing the implementation of the strategy, specifically focused on enhancing cultural safety across TPH programs and services, strengthening partnerships with Indigenous communities, and advancing Indigenous health and reconciliation through a public health policy mandate.

The recommended next steps will better position TPH to work with Indigenous Peoples in Toronto to reduce health disparities and to support strong and vibrant Indigenous communities.

There is no financial impact resulting from the adoption of the recommendations in this report.

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, 2021.

As of June 30, 2021, TPH gross expenditure was overspent by $17.8 million gross and revenue was overachieved by $18.4 million, resulting in a net favourable variance of $0.6 million.

At year end, gross expenditure is expected to be overspent by $59.0 million gross and revenue will be overachieved by $58.8 million, resulting in net expenditure being over budget by $0.2 million.

As of June 30, 2021, Toronto Public Health's (TPH) gross expenditure is higher by $17.8 million gross (11.7 per cent) and revenue was higher than budgeted by $18.4 million (18.5 per cent), resulting in a net favourable variance of $0.6 million (1.2 per cent). The variance reflects the impact of the COVID-19 pandemic on TPH's budget from the suspension of cost-shared and City funded programs and services, as approximately 80 per cent of TPH resources have been redeployed to the COVID-19 response. These additional costs, incurred to increase resources to respond to the COVID-19 pandemic, and revenue shortfalls from user fees and other recoveries are to be funded by the Ministry of Health.

The Ministry of Health has indicated that extraordinary costs in response to the COVID-19 pandemic including eligible costs related to the operation of Mass Immunization Clinics that are over and above the 2021 provincial grant will be reimbursed.

At year end, gross expenditure is expected to be overspent by $59.0 million gross (17.0 per cent) and revenue will be overachieved by $58.8 million (26.6 per cent), resulting in a net expenditure of $0.2 million over budget.

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, 2021.

As of June 30, 2021, Toronto Public Health spent $1,089.5 thousand representing 21.7 per cent of the 2021 Approved Capital Budget of $5,032.0 thousand. 

Similar to last year, projects planned for 2021 continue to be affected by the impact of COVID-19 on the availability of resources within Toronto Public Health and its partners.

As of June 30, 2021, Toronto Public Health spent $1,089.5 thousand representing 21.7 per cent of the 2021 Approved Capital Budget of $5,032.0 thousand.

Director Kate Mulligan, the Board of Health's appointee to the Association of Local Public Health Agencies' (alPHa) Board of Directors and Board of Health Section, will provide a verbal update.

Councillor Joe Cressy recommends that:

1.  The Board of Health appoint Director Stephanie Donaldson to the Association of Local Public Health Agencies' (alPHa) Board of Directors and Board of Health Section for a term of office starting September 27, 2021 and ending December 31, 2021, and until a successor is appointed and authorize the reimbursement of expenses for attending alPHa's 2021 meetings and semi-annual meetings/conferences within the 2021 Approved Operating Budget for Toronto Public Health.

On behalf the Board, I would like to thank Director Kate Mulligan for her exceptional service and dedication as the Toronto Board of Health's representative on the alPHa Board of Directors and Board of Health Section.

I have spoken to Director Stephanie Donaldson and recommend that the Board appoint her to fill this vacant position.

Councillor Joe Cressy recommends that:

1.  The Board of Health request the Medical Officer of Health to review the local Health Impact Assessment, produced by the South Riverdale Community Health Centre and Save Jimmie Simpson regarding the Ontario Line in Riverside/Leslieville, once completed.

2.  The Board of Health request Metrolinx to extend the commenting period for the Draft Lakeshore East Joint Corridor Early Works Report beyond the October 24, 2021 deadline in order to allow the Medical Officer of Health to review the local Health Impact Assessment, produced by the South Riverdale Community Health Centre and Save Jimmie Simpson regarding the Ontario Line in Riverside/Leslieville, and provide proper comment.

I am introducing this item on behalf of Councillor Paula Fletcher.

At its meeting of August 2010, the Toronto Board of Health considered a report on Metrolinx' noise and vibration assessments for the Georgetown Rail Expansion and Air-Rail Link, now known the Union Pearson Express. The report, from the then Medical Officer of Health Dr. David McKeown, revealed several shortcomings in Metrolinx's work. For example, the report noted:

A review of the consultants' report identified several limitations in the noise and vibration assessments. In particular, noise impacts at City parks in the vicinity of the Georgetown Corridor were not evaluated and could be significant.

This report, over ten years old, underscores the historical issues that Metrolinx has had with building trust with local communities around issues like health impacts, noise, and vibration. With the proposed Ontario Line many residents in Toronto-Danforth are concerned that future Metrolinx assessments for the upcoming Ontario Line and GO Expansion could suffer from similar deficiencies.

When asked by community members, Metrolinx stated publicly that "it is not standard Metrolinx practice to conduct health impact assessments." So South Riverdale Community Health Centre (SRCHC) and Save Jimmie Simpson (SJS) have worked together to produce a Health Impact Assessment regarding the Ontario Line in Riverside/Leslieville. This HIA compares the proposed 1.5 kilometres of above-ground subway in this neighbourhood to a community-supported below ground option based partially on the approved TTC Relief Line proposal. It was conducted by a former Toronto Public Health specialist and is almost near completion.

Just this past week Metrolinx released their Early Works Report for the Joint Corridor and set a commenting deadline of October 24th. The documents are over a thousand pages and contain many technical studies that the community is keen to digest and respond to properly. This leaves little time to review the Metrolinx documents against the HIA.