Board of Health
The full agenda, as filed
All 6 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.
HL24.1amended
TO Supports: COVID-19 Equity Action Plan
In March 2020, the City of Toronto, in coordination with Toronto Public Health, Toronto Public Library and hundreds of community-based partners, launched an unprecedented emergency response to meet the needs of Torontonians who have been disproportionately impacted by the spread of COVID-19 and by the sudden, serious consequences of the first pandemic "lockdown". The City's Emergency Operations Centre and nearly every City division, agency and corporation has contributed to this massive effort to support Toronto's most vulnerable residents during a time of crisis. Many of the services, programs and systems mobilized for this effort - ranging from emergency food delivery to mental health supports to free 24/7 child care - are wholly new lines of operation and partnership for the City of Toronto and were designed, developed and then delivered into the community within mere days or weeks of the emergency declaration. These innovations have revealed the City's powerful creative and collaborative capacity. They have also demonstrated the value of maintaining and investing in a deep, interdependent relationship with a strong, activist community-based not-for-profit sector. The sector has continuously delivered front-line services and supports during the pandemic, championed the needs of highly vulnerable communities and held the City accountable to resolve emerging critical issues. Without the work of the community sector over the past 10 months, many Torontonians would be in a much more challenging situation than is currently faced. The guiding framework to organize this multi-dimensional emergency response was rolled out in March 2020, through Social Development, Finance and Administration Division, under the title: TO Supports: COVID-19 Equity Action Plan. TO Supports prioritizes ten action areas related to the social determinants of health and contains twenty-five separate actions to stop virus spread and deliver immediate emergency support to the neighbourhoods and populations that have been hardest hit by COVID-19. Since March, this Plan has been constantly evolving, adapting and intensifying in light of new information and data, new partnerships, new resurgence plans and new pandemic conditions. Attachment 1 to this report summarizes the City's implementation of TO Supports from March to November 2020. It includes key advice collected from community-based partners, current status indicators, and the City's work on the intergovernmental front to leverage the funding and legislative tools required to solve urgent problems facing equity-seeking groups during the pandemic. It also highlights plans for new, targeted and enhanced COVID-19 equity measures that were recently launched in conjunction with the announcement of Toronto's second pandemic "lockdown".
The Board of Health recommends that: 1. City Council approve TO Supports: COVID-19 Equity Action Plan and the 25 equity actions and targeted and enhanced equity measures that the City of Toronto, Toronto Public Health, and partners are taking to support Torontonians disproportionately impacted by COVID-19, as outlined in Attachment 1 to the report (November 30, 2020) from the Deputy City Manager, Community and Social Services. 2. City Council approve the inclusion of equity indicators in the Toronto Public Health COVID-19 Monitoring Dashboard in order to facilitate public reporting on the disproportionate impact of COVID-19 infection on certain population groups based on the social determinants of health such as income, racialization, and neighbourhood and to drive equity-focused policy and program actions. 3. City Council recognize that a comprehensive approach to reducing the disproportionate impact of COVID-19 on Indigenous, Black, and racialized Torontonians, including newcomers, must be central to the COVID-19 emergency response, to COVID-19 immunization planning, and to Toronto's recovery and rebuild efforts. 4. City Council request the Province of Ontario and the Government of Canada to establish dedicated not-for-profit sector stabilization and bridging funds to ensure the immediate and long-term resilience of the not-for-profit sector which is critical for inclusive economic and community recovery, including a $680 million Provincial fund, as advocated for by the Ontario Nonprofit Network, and a new $500-$700 million Federal Community Services COVID-19 Relief Fund, as advocated for by national human and community service federations. 5. City Council urge the Province of Ontario to immediately extend, for at least the next six months, eligibility for the Ontario Works Emergency Assistance benefit to include all working-age adults who have tested positive for COVID-19 or reside in a household where someone has tested positive and have been advised by an employer, medical practitioner, nurse practitioner, public health official, or other government official to self-isolate and who do not otherwise qualify for either Ontario Works or Federal benefits. 6. City Council request the Deputy City Manager, Community and Social Services, working with the Medical Officer of Health and Toronto's COVID-19 Incident Commander and in consultation with community stakeholders, to intensify, adapt, or revise TO Supports: COVID-19 Equity Action Plan as necessary to respond effectively to urgent COVID-19 health disparities as identified by the Medical Officer of Health on the basis of the Toronto Public Health COVID-19 Monitoring Dashboard equity indicators, COVID-19 data from Indigenous-led health organizations, or other COVID-19 evidence and information emerging from the community sector. 7. City Council request the Executive Director, Social Development, Finance and Administration, working with the Medical Officer of Health and the General Manager, Shelter, Support and Housing Administration, and community sector partners, to assess the level of need and optimal services to support families (e.g., adults with dependent children or other dependents) who need to self-isolate due to COVID-19 infection. 8. City Council forward the report (November 30, 2020) from the Deputy City Manager, Community and Social Services, to the Ontario Minister of Children, Community and Social Services, the Ontario Minister of Health, the Ontario Associate Minister of Mental Health and Addictions, the Ontario Minister of Long-Term Care, the Ontario Minister of Municipal Affairs and Housing, the Ontario Solicitor General, the Federal Deputy Prime Minister and Minister of Finance, the Federal Minister of Immigration, Refugees and Citizenship, and the Federal Minister of Health.
Staff recommendation as filed
The Deputy City Manager, Community and Social Services recommends that: 1. City Council and the Board of Health approve TO Supports: COVID-19 Equity Action Plan and the twenty-five equity actions and targeted and enhanced equity measures that the City of Toronto, Toronto Public Health, and partners are taking to support Torontonians disproportionately impacted by COVID-19, as outlined in Attachment 1 to this report. 2. City Council and the Board of Health approve the inclusion of equity indicators in the Toronto Public Health COVID-19 Monitoring Dashboard in order to facilitate public reporting on the disproportionate impact of COVID-19 infection on certain population groups based on the social determinants of health such as income, racialization, and neighbourhood and to drive equity-focused policy and program actions. 3. City Council and the Board of Health recognize that a comprehensive approach to reducing the disproportionate impact of COVID-19 on Indigenous, Black, and racialized Torontonians, including newcomers, must be central to the COVID-19 emergency response, to COVID-19 immunization planning, and to Toronto's recovery and rebuild efforts. 4. City Council request the Deputy City Manager, Community and Social Services, working with the Medical Officer of Health and Toronto's COVID-19 Incident Commander and in consultation with community stakeholders, to intensify, adapt, or revise the COVID-19 Equity Action Plan as necessary to respond effectively to urgent COVID-19 health disparities as identified by the Medical Officer of Health on the basis of the Toronto Public Health COVID-19 Monitoring Dashboard equity indicators, COVID-19 data from Indigenous-led health organizations, or other COVID-19 evidence and information emerging from the community sector. 5. City Council request the Executive Director, Social Development, Finance and Administration, working with the Medical Officer of Health and the General Manager, Shelter, Support and Housing Administration, and community sector partners, to assess the level of need and optimal services to support families (e.g., adults with dependent children or other dependents) who need to self-isolate due to COVID-19 infection. 6. City Council request the Province of Ontario and the Government of Canada to establish dedicated not-for-profit sector stabilization and bridging funds to ensure the immediate and long-term resilience of the not-for-profit sector which is critical for inclusive economic and community recovery, including a $680 million Provincial fund, as advocated for by the Ontario Nonprofit Network, and a new $500-$700 million Federal Community Services COVID-19 Relief Fund, as advocated for by national human and community service federations. 7. City Council urge the Province of Ontario to immediately extend, for at least the next six months, eligibility for the Ontario Works Emergency Assistance benefit to include all working age adults who have tested positive for COVID-19 or reside in a household where someone has tested positive and have been advised by an employer, medical practitioner, nurse practitioner, public health official, or other government official to self-isolate and who do not otherwise qualify for either Ontario Works or Federal benefits. 8. City Council forward TO Supports: COVID-19 Equity Action Plan to the Ontario Minister of Children, Community and Social Services, the Ontario Minister of Health, the Ontario Associate Minister of Mental Health and Addictions, the Ontario Minister of Long-Term Care, the Ontario Minister of Municipal Affairs and Housing, the Ontario Solicitor General, the Federal Deputy Prime Minister and Minister of Finance, the Federal Minister of Immigration, Refugees and Citizenship, and the Federal Minister of Health.
HL24.2amended
This report provides a status update of the COVID-19 pandemic locally, Toronto Public Health's (TPH) response work to date, and provincial and local public health measures. As well, it provides an update on the City of Toronto's COVID-19 Immunization Task Force (ITF) planning, results of a community survey on the effects of the pandemic as well as a report on the indirect impacts of the COVID-19 pandemic on mental health and well-being on Toronto's residents. On November 24, 2020, Toronto moved into the "Grey - Lockdown" level of the Province's Keeping Ontario Safe and Open Framework in response to the significant rate of COVID-19 spread. This change adds further restrictions in Toronto, including: gathering restrictions, restricting people from having non-essential visitors inside their homes, closing indoor and outdoor dining at restaurants and bars, closing all indoor gyms, closing hair salons, barber shops, nail salons and tattoo parlours, and closing all retail, including malls, except for curbside pick-up or delivery. Essential businesses such as supermarkets, grocery stores, convenience stores, hardware stores, beer and wine and liquor stores, pharmacies and safety supply stores can be open for in person shopping at 50 per cent capacity. Earlier in November, the City of Toronto formed the COVID-19 Immunization Task Force (ITF) as part of its pandemic response and recovery efforts. The ITF continues to work to ensure that the City is ready to play its role in helping Toronto residents get vaccinated in order to protect against COVID-19 infection. This work includes preparing for logistical considerations and partnering with community groups to build knowledge and support for the COVID-19 immunization plan. The Ministry of Health has indicated that it is working to establish an information system that can support the logistics of the COVID-19 immunization plan including registration, appointment booking, confirmation of vaccination and inventory management. The first shipments of the COVID-19 vaccine are expected to be delivered in the first quarter of 2021 and will likely be reserved for provincially identified, higher-risk populations, such as residents of long-term care homes and health care sector workers. It is expected that vaccines will become available for additional populations in the spring of 2021. TPH engaged Ipsos Reid to conduct public research to understand how residents of Toronto are managing the challenges of the COVID-19 pandemic. This COVID-19 Community Survey was administered online between October 20 and October 30, 2020. The survey includes feedback from 1,201 Toronto residents. Overall, a majority of Toronto residents agree that the city needs to take "whatever measures are necessary" to control the spread of COVID-19 and reduce the number of deaths (90 per cent agree). There is also widespread support (83 per cent) for a second lockdown, if the number of cases continues to rise. Initial survey results can be found in Attachment 1. The COVID-19 pandemic, as well as the public health measures put in place to prevent its spread, have been increasingly shown to impact mental health and well-being. To understand this further, TPH examined the impacts of the first wave of the COVID-19 pandemic and associated public health measures on the mental health and well-being of Toronto residents. As TPH used data from the first wave of the pandemic to inform this research, TPH is working to update this research with data since the resurgence of COVID-19, and will report back to the Board of Health with its findings.
The Board of Health recommends that: 1. City Council request the Provincial Government to provide resources and funding to support the community engagement plan being prepared by Toronto Public Health and Social Development, Finance and Administration to support community groups and other stakeholders to build knowledge and support for the COVID-19 immunization plan. 2. City Council request the Ontario Ministry of Health to provide resources and funding to adequately prepare for Toronto's COVID-19 immunization plan, including support for required technology, staffing, and logistics. 3. City Council request the Ontario Ministry of Health to ensure that the COVID-19 Vaccine Information System is created in consultation with Toronto Public Health and is a comprehensive and practical system that is simple to use.
Staff recommendation as filed
The Medical Officer of Health recommends that: 1. City Council and the Board of Health request the Ontario Ministry of Health to provide resources and funding to adequately prepare for Toronto's COVID-19 immunization plan, including support for required technology, staffing, and logistics. 2. City Council and the Board of Health request the Provincial Government to provide resources and funding to support the community engagement plan being prepared by Toronto Public Health and Social Development, Finance and Administration to support community groups and other stakeholders to build knowledge and support for the COVID-19 immunization plan. 3. City Council and the Board of Health request the Ontario Ministry of Health to ensure that the COVID-19 Vaccine Information System is created in consultation with Toronto Public Health and is a comprehensive and practical system that is simple to use. 4. The Board of Health request the Provincial Government to lead data collection on how people are managing the challenges of the COVID-19 pandemic and ensure representation from those disproportionately impacted by COVID-19, encompassing representative data at the public health unit level. 5. The Board of Health request the Medical Officer of Health to work with appropriate partners to identify relevant trends from the Toronto Public Health COVID-19 Community Survey Results in Attachment 1 and share these findings with stakeholders through community groups and Toronto's 13 COVID-19 Community Cluster tables. 6. The Board of Health direct that the Toronto Public Health COVID-19 Community Survey Results in Attachment 1 be forwarded to the Ontario Ministry of Health for information and consideration. 7. The Board of Health request the Medical Officer of Health to update Attachment 2, Indirect Impact of COVID-19 and Associated Public Health Measures on the Mental Health and Well-Being of Toronto Residents, with data and research from the remainder of 2020 and report to the Board of Health with the findings when the data analysis is complete.
HL24.3amended
Appointment of Associate Medical Officer of Health
This report recommends the appointment of an Associate Medical Officer of Health (AMOH) for the City of Toronto Health Unit and updates the status of AMOH appointment By-laws.
The Board of Health recommends that: 1. City Council appoint the physician in Confidential Attachment 1 to the report (November 30, 2020) from the Medical Officer of Health as an Associate Medical Officer of Health for the City of Toronto Health Unit. 2. City Council forward its decision to the Ontario Minister of Health for the approval of the Associate Medical Officer of Health appointment in Recommendation 1 above. 3. City Council authorize the introduction of the necessary Bill in City Council to appoint the physician in Confidential Attachment 1 to the report (November 30, 2020) from the Medical Officer of Health as an Associate Medical Officer of Health, subject to approval by the Ontario Minister of Health. 4. City Council authorize the public release of Confidential Attachment 1 to the report (November 30, 2020) from the Medical Officer of Health, once adopted by City Council. 5. City Council authorize the public release of Confidential Attachment 1 to the supplementary report (December 10, 2020) from the Medical Officer of Health, once City Council appoints the physician recommended for appointment as an Associate Medical Officer of Health for the City of Toronto Health Unit.
Staff recommendation as filed
The Medical Officer of Health recommends that: 1. City Council appoint the physician in Confidential Attachment 1 as an Associate Medical Officer of Health for the City of Toronto Health Unit. 2. City Council forward its decision to the Ontario Minister of Health for the approval of the Associate Medical Officer of Health appointment in Recommendation 1 above. 3. City Council authorize the introduction of the necessary Bill in City Council to appoint the physician in Confidential Attachment 1 as an Associate Medical Officer of Health, subject to approval by the Ontario Minister of Health. 4. City Council authorize the public release of Confidential Attachment 1, once adopted by City Council.
HL24.4adopted
2019 Performance Appraisal - Medical Officer of Health
At its meeting on November 24, 2020, the Board of Health - Performance Appraisal of the Medical Officer of Health Committee considered Item HP3.1, 2019 Performance Appraisal - Medical Officer of Health.
The Board of Health: 1. Approved the Confidential Recommendation from the Board of Health - Performance Appraisal of the Medical Officer of Health Committee in Confidential Attachment 1 to the letter (November 24, 2020) from the Board of Health - Performance Appraisal of the Medical Officer of Health Committee. 2. Directed that Confidential Attachment 1 to the letter (November 24, 2020) from the Board of Health - Performance Appraisal of the Medical Officer of Health Committee and Confidential Attachment 2 from the Medical Officer of Health remain confidential, as they relate to personal matters about an identifiable individual, including a municipal or local board employee.
Staff recommendation as filed
The Board of Health - Performance Appraisal of the Medical Officer of Health Committee recommends that: 1. The Board of Health approve the Confidential Recommendation from the Board of Health - Performance Appraisal of the Medical Officer of Health Committee. 2. The Board of Health direct that the Confidential Recommendation and Confidential Attachment 1 from the Medical Officer of Health remain confidential, as they relate to personal matters about an identifiable individual, including a municipal or local board employee.
HL24.5adopted
Proposed 2021 Schedule of Board of Health Meetings
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 November 25 and 26, 2020, City Council considered Item ST6.1 , 2021 Schedule of Meetings, and adopted the 2021 annual schedule of meetings for City Council and its Standing Committees. The schedule also included proposed 2021 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 .
The Board of Health: 1. Approved the following 2021 meeting dates: - Monday January 18 at 9:30 a.m. - Monday March 22 at 9:30 a.m. - Monday April 12 at 9:30 a.m. - Monday May 10 at 9:30 a.m. - Monday June 14 at 9:30 a.m. - Monday September 20 at 9:30 a.m. - Monday October 25 at 9:30 a.m. - Monday December 6 at 9:30 a.m.
Staff recommendation as filed
The Board Secretary, Board of Health, in consultation with the Chair, recommends that: 1. The Board of Health approve the following 2021 meeting dates: - Monday January 18 at 9:30 a.m. - Monday March 22 at 9:30 a.m. - Monday April 12 at 9:30 a.m. - Monday May 10 at 9:30 a.m. - Monday June 14 at 9:30 a.m. - Monday September 20 at 9:30 a.m. - Monday October 25 at 9:30 a.m. - Monday December 6 at 9:30 a.m.
HL24.6adopted
Student Nutrition Program Support for Remote Learning
The pandemic has resulted in many rapidly changing challenges to the Student Nutrition Program, which Toronto Public Health (TPH) and our school community partners have been working hard to mitigate since March 13 when the Province of Ontario closed schools across the province. Before the pandemic, thousands of vulnerable children and youth received a daily nutritious meal in school through the Student Nutrition Program. To support students during the rest of the spring term, funds were re-allocated to distribute grocery food gift cards to families in need with children who attend schools with nutrition programs. During the partial return to in-class learning this fall, TPH and school community partners have continued to work through a wide range of challenges. The Toronto Catholic District School Board (TCDSB) Student Achievement Board of Trustees, on December 3, 2020, approved a motion to "request the Province and Toronto Public Health to ensure that student nutrition funding is distributed with adequate flexibility to support students learning remotely, and to provide additional funding as required to continue in-school program delivery while expanding to support remote learners". Recommendation 1 below responds to the request for flexibility. Within the existing framework of agreements and funding, the Medical Officer of Health will provide a formal communication clarifying that municipal funds may be used to support students learning remotely. Our school community partners -- the Angel Foundation for Learning, the Toronto Foundation for Student Success, and the two English-language school boards -- will have the flexibility to tailor to local needs the use of existing municipal funds for student nutrition programming as the pandemic situation continues to evolve. Even with these changes, it is anticipated that there will continue to be challenges to ensuring that all students who would otherwise benefit from student nutrition programs are supported in the winter term, including increased food costs, requirements for safe program delivery, limited access to volunteer help, and ongoing changes to the number of students learning in-class, learning remotely, and temporarily isolating. That is why I am recommending the Board of Health support the call to the Province to cover the extraordinary pandemic-related costs faced by student nutrition programs supporting in-school and remote learning. The Province of Ontario has not increased its funding commitment for local student nutrition programs in Toronto since 2017. I am also recommending the Board of Health reiterate the request to the Government of Canada to provide core funding for a National School Food Program, which was a goal in the 2019 Federal Budget. Additionally, TPH staff have identified a modest amount of additional funding that is likely to be available to be allocated relatively quickly for the winter school term, from the reserves held for late applications and appeals to the Student Nutrition Program. City Council authority is required to reinvest these funds into enhancing existing local student nutrition programs. Finally, I am recommending the Board of Health request the Medical Officer of Health report back early in the new year with additional information on resource requirements to ensure that students who rely on the Student Nutrition Program continue to be supported whether they are learning in class or remotely. The necessary work is already underway with our school community partners. No child should have to learn on an empty stomach in Toronto. The Student Nutrition Program is even more critical this year, when so many families are facing immense hardship, for supporting the success of thousands of vulnerable children and youth.
The Board of Health recommends that: 1. City Council reiterate the request to the Government of Canada to provide core funding for a national school food program. 2. City Council request the Province of Ontario to make available sufficient funds to cover the extraordinary pandemic-related costs faced by student nutrition programs supporting in-school and remote learners, including increased food costs, requirements for safe program delivery, and limited access to volunteer help. 3. City Council authorize the Medical Officer of Health to reinvest any funds that remain unspent after assessing applications from the late applications and appeals period towards providing additional funding to existing municipally-supported student nutrition programs.
Staff recommendation as filed
Councillor Joe Cressy recommends that: 1. The Board of Health request the Medical Officer of Health to take appropriate action to enable the municipal student nutrition program funds to be used for the purchase of nutritious food for students who are learning remotely who otherwise would have accessed a student nutrition program. 2. City Council and the Board of Health request the Province of Ontario to make available sufficient funds to cover the extraordinary pandemic-related costs faced by student nutrition programs supporting in-school and remote learners, including increased food costs, requirements for safe program delivery, and limited access to volunteer help. 3. City Council and the Board of Health reiterate the request to the Government of Canada to provide core funding for a national school food program. 4. City Council authorize the Medical Officer of Health to reinvest any funds that remain unspent after assessing applications from the late applications and appeals period towards providing additional funding to existing municipally-supported student nutrition programs. 5. The Board of Health request the Medical Officer of Health to report to the January 18, 2021 meeting of the Board of Health with an update on additional resource needs and any other challenges facing municipally-supported student nutrition programs in Toronto.