Board of Health
The full agenda, as filed
All 8 items in the clerk’s order. Each carries the city’s own words: the staff recommendation, what the body decided, and its status. Nothing below is written by us.
HL19.1adopted
One Year Extension of Electronic Meeting Rules
At its meeting of July 28 and 29, 2020, City Council adopted Item EX15.21, and in so doing has authorized its local boards to extend or adopt remote electronic meeting rules for a period of one year following the later of the termination of the Provincial emergency and the termination of the municipal emergency related to the issue of COVID-19.
The Board of Health: 1. Amended By-law 2-2019 and adopted the draft bill in Attachment 1 to the report (September 4, 2020) from the City Clerk to extend the remote electronic participation rules for a period ending one year following the termination of the COVID-19 emergency declaration under section 4 of the Emergency Management and Civil Protection Act.
Staff recommendation as filed
The City Clerk recommends that: 1. The Board of Health amend By-law 2-2019 and adopt the draft bill in Attachment 1 to extend the remote electronic participation rules for a period ending one year following the termination of the COVID-19 emergency declaration under section 4 of the Emergency Management and Civil Protection Act.
HL20.1amended
Response to COVID-19: Reopening and Preparation for a Potential Resurgence
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.
The Board of Health recommends that: 1. City Council request the City Manager to provide a presentation to the Board of Health in the fall of 2020 on the recommendations from the Toronto Office of Recovery and Rebuild. 2. City Council request the City Manager to work with the Federal and Provincial Governments to ensure the enforcement of existing quarantine rules for visitors to, and residents of, Toronto. 3. City Council request the Federal and Provincial Governments to strictly enforce travel restrictions with regard to COVID-19, including the mandatory 14-day quarantine for visitors and travel by "essential" workers. 4. City Council urge the Federal Government to implement a data system that will quickly transmit information about arriving international travellers to local authorities to support better compliance with the Quarantine Act. 5. City Council urge the Federal Government to expedite, in collaboration with the Province of Ontario and local public health units, the rapid implementation of new testing technologies, such as at-home and saliva-based tests, for the proactive surveillance of COVID-19. 6. City Council urge the Province of Ontario to take all necessary steps to improve the turnaround time for laboratory tests and achieve the timely reporting of positive results to individuals and local public health units. 7. City Council urge the Ontario Ministry of Health to increase testing capacity and develop an enhanced testing strategy aimed at suspected cases, contacts, and high-risk/high-need situations, including workplaces, schools, and neighbourhoods. 8. City Council urge the Ontario Ministry of Health to expedite, in collaboration with the Federal Government and local public health units, the rapid implementation of new testing technologies, such as at-home and saliva-based tests, for the proactive surveillance of COVID-19. 9. City Council urge the Ontario 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.
Staff recommendation as filed
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.
HL20.2amended
Toronto Public Health Guidance for Reopening Schools
The Medical Officer of Health will give a presentation on Toronto Public Health's Guidance for Reopening Schools.
The Board of Health: 1. Urged the Province of Ontario to provide school boards with the necessary resources and support to follow Toronto Public Health's recommendations on safely reopening schools during the COVID-19 pandemic, as outlined below and in the presentation (September 21, 2020) from the Medical Officer of Health: a. all classes (or cohort) sizes be limited to allow for two metre distancing; b. a saliva-based test be actively considered as a pilot project that can be scaled up, as needed; c. a protocol be developed to indicate when school reopenings should be adjusted to adaptive models (e.g., half day in school, half day online) and when schools should be moved fully online, with consideration for keeping the most vulnerable in schools regardless of community transmission; and d. active COVID-19 screening be implemented at all schools.
HL20.3adopted
Toronto Public Health Operating Budget Variance for the Six Months Ended June 2020
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.
The Board of Health: 1. Received the report (September 3, 2020) from the Medical Officer of Health for information.
Staff recommendation as filed
The Medical Officer of Health recommends that: 1. The Board of Health receive this report for information.
HL20.4adopted
Toronto Public Health Capital Budget Variance for the Six Months Ended June 30, 2020
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.
The Board of Health: 1. Received the report (September 3, 2020) from the Medical Officer of Health for information.
Staff recommendation as filed
The Medical Officer of Health recommends that: 1. The Board of Health receive this report for information.
HL20.5amended
2020 Ontario Seniors Dental Care Program - Capital Project
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 Board 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 $2.345 million gross, fully funded by the Ontario Ministry of Health, with cash flows of $2.781 million in 2020 and $0.711 million in 2021. 2. City Council authorize the Medical Officer of Health to enter into Capital Funding Agreements with the following dental clinics 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: a. Rexdale Community Health Centre, located at 8 Taber Road ($268,000); b. TAIBU Community Health Centre, located at 27 Tapscott Road, Unit #1 ($275,000); c. Toronto Public Health Dental Clinic, located at 2340 Dundas Street West ($320,800); d. Rexdale Community Health Centre, located at 222 Dixon Road, Suite 301 ($457,100); e. Black Creek Community Health Centre, located at 1 York Gate Boulevard, Suite 202 ($401,800); and f. Hong Fook (HF) Connecting Health Nurse Practitioner-Led Clinic, located at 3660 Midland Avenue, Suite 201 ($622,100).
Staff recommendation as filed
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.
HL20.6adopted
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.
The Board of Health: 1. Received the report (September 3, 2020) from the Medical Officer of Health for information.
Staff recommendation as filed
The Medical Officer of Health recommends that: 1. The Board of Health receive this report for information.
HL20.7adopted
Request for an Update on Status of the Opioid Poisoning Crisis in Toronto
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.
The Board of Health: 1. Requested the Medical Officer of Health to provide an update on the status of the opioid poisoning crisis in Toronto to the Board of Health at its meeting on October 19, 2020, 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.
Staff recommendation as filed
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.