Board of Health
The full agenda, as filed
All 7 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.
HL3.1amended
Toronto Indigenous Overdose Strategy
The opioid poisoning crisis continues unabated in Toronto and in communities across the country. Indigenous individuals and communities have experienced profound grief and loss from this crisis. While there is limited data available, we know that many Indigenous People in Toronto have overdosed and some have died as a result of the toxic illicit drug supply. New prevention, harm reduction, and treatment initiatives have been implemented in recent years, but not on the scale or with the urgency required. For Indigenous communities in Toronto, the lack of culturally-safe services that reflect the diversity of Indigenous values and traditions are contributing to this crisis. The need for a separate Indigenous-led process to develop an overdose prevention and response strategy for Indigenous People in Toronto was recommended in the Toronto Overdose Action Plan (TOAP). This staff report provides an overview of the recently-developed Toronto Indigenous Overdose Strategy (TIOS), which is intended as a companion document to the TOAP. Development of the TIOS was led by an Indigenous facilitator, in collaboration with an Advisory Committee comprised of Indigenous service providers and community members and Toronto Public Health (TPH) staff. Indigenous service providers and non-Indigenous service providers that work with Indigenous People who use substances were consulted as part of this initiative. However, this report is deeply rooted in the perspectives and advice received from a diverse range of Indigenous People who use/have used substances and who were the main stakeholders consulted for this Strategy. The directions in the TIOS align well with those of the TOAP. The TIOS directs recommendations to all levels of government and community service providers in the areas of prevention, harm reduction, and treatment. The recommendations are grounded in an Indigenous world view that seeks to reconnect Indigenous People to their culture and traditions as part of improving health and well-being holistically. Overall, people said they want Indigenous services delivered by Indigenous service providers, in particular, Indigenous peer workers with lived experience of substance use. TPH is strongly committed to supporting implementation of the recommended actions in TIOS, and will undertake the actions directed to TPH. TPH will dedicate an Indigenous staff resource to assist in supporting the implementation of TIOS in collaboration with Indigenous service providers and community members, including Indigenous People who use/have used substances, and City divisions.
The Board of Health: 1. Endorsed the Toronto Indigenous Overdose Strategy, as outlined in Attachment 1 to the report (February 6, 2019) from the Medical Officer of Health. 2. Again urged the Government of Canada and the Province of Ontario to fund and support the development of Indigenous-led overdose prevention and response action plans at the federal and provincial levels. 3. Urged the federal and provincial governments to align 2019/2020 (and beyond) funding calls with practical and immediate overdose responses, in particular, access to funding supports for Indigenous agencies to create, strengthen, and enhance culturally-safe outreach, mobile, and peer support services to Indigenous Peoples who use substances. 4. Urged the federal and provincial governments to contribute funding to Toronto Public Health's Toronto Urban Health Fund Indigenous Stream, which is under development, to support Indigenous agencies. 5. Urged the federal and provincial governments to contribute funding to Toronto Public Health's Toronto Urban Health Fund to enhance support to Indigenous-specific programs and services in mainstream organizations to expand their outreach and harm reduction capacity. 6. Urged the Ministry of Health and Long-Term Care to dedicate funding for 24/7 Indigenous-led Consumption and Treatment Services in Toronto, as part of the new Consumption and Treatment Services Program. 7. Urged the Ministry of Health and Long-Term Care to ensure the availability of culturally-safe medical care to Indigenous Peoples who use substances now and into the future. Health care providers should explore opportunities to support the use of traditional medicines and approaches to healing, including facilitating access to Ceremony, Healing Circles, Elders, and/or Healers, for their Indigenous clients. 8. Urged the Ministry of Health and Long-Term Care to require all provincially-funded health care providers that provide medical services to Indigenous Peoples in Toronto to demonstrate accountability through formal mandates and strategic plans for their investments and outcomes related to culturally-safe care for Indigenous Peoples, including ongoing Indigenous cultural-safety training and education for non-Indigenous health care providers. 9. Urged the Ministry of Health and Long-Term Care to increase and target funding to support the development and operationalization of culturally-safe, appropriate, and on-demand abstinence-based treatment spaces for Indigenous Peoples. 10. Directed that the Toronto Indigenous Overdose Strategy, as outlined in Attachment 1 to the report (February 6, 2019) from the Medical Officer of Health, be forwarded to the Ministry of Health and Long-Term Care, the Toronto Indigenous Health Advisory Circle, the City's Aboriginal Affairs Committee, the City's Indigenous Affairs Office, the City's Shelter, Support and Housing Administration Division, the Toronto Aboriginal Support Services Council, and all local public health units in Ontario. 11. Directed the Medical Officer of Health to provide a one-year progress report on the implementation of the Toronto Indigenous Overdose Strategy to the Board of Health and the Toronto Indigenous Health Advisory Circle in 2020. 12. Requested that Michelle Sault, Principal Consultant, Minokaw Consulting, make a presentation on the Toronto Indigenous Overdose Strategy at a future Board of Health meeting in 2019.
Staff recommendation as filed
The Medical Officer of Health recommends that: 1. The Board of Health endorse the Toronto Indigenous Overdose Strategy, as outlined in Attachment 1. 2. The Board of Health again urge the Government of Canada and the Province of Ontario to fund and support the development of Indigenous-led overdose prevention and response action plans at the federal and provincial levels. 3. The Board of Health urge the federal and provincial governments to align 2019/2020 (and beyond) funding calls with practical and immediate overdose responses, in particular, access to funding supports for Indigenous agencies to create, strengthen, and enhance culturally-safe outreach, mobile, and peer support services to Indigenous Peoples who use substances. 4. The Board of Health urge the federal and provincial governments to contribute funding to Toronto Public Health's Toronto Urban Health Fund Indigenous Stream, which is under development, to support Indigenous agencies. 5. The Board of Health urge the federal and provincial governments to contribute funding to Toronto Public Health's Toronto Urban Health Fund to enhance support to Indigenous-specific programs and services in mainstream organizations to expand their outreach and harm reduction capacity. 6. The Board of Health urge the Ministry of Health and Long-Term Care to dedicate funding for 24/7 Indigenous-led Consumption and Treatment Services in Toronto, as part of the new Consumption and Treatment Services Program. 7. The Board of Health urge the Ministry of Health and Long-Term Care to ensure the availability of culturally-safe medical care to Indigenous Peoples who use substances now and into the future. Health care providers should explore opportunities to support the use of traditional medicines and approaches to healing, including facilitating access to Ceremony, Healing Circles, Elders, and/or Healers for their Indigenous clients. 8. The Board of Health urge the Ministry of Health and Long-Term Care to require all provincially-funded health care providers that provide medical services to Indigenous Peoples in Toronto to demonstrate accountability through formal mandates and strategic plans for their investments and outcomes related to culturally-safe care for Indigenous Peoples, including ongoing Indigenous cultural safety training and education for non-Indigenous health care providers. 9. The Board of Health urge the Ministry of Health and Long-Term Care to increase and target funding to support the development and operationalization of culturally-safe, appropriate, and on-demand abstinence-based treatment spaces for Indigenous Peoples. 10. The Board of Health forward the Toronto Indigenous Overdose Strategy to the Ministry of Health and Long-Term Care, the Toronto Indigenous Health Advisory Circle, the City's Aboriginal Affairs Committee, the City's Indigenous Affairs Office, the City's Shelter, Support and Housing Administration Division, the Toronto Aboriginal Support Services Council, and all local public health units in Ontario. 11. The Board of Health direct the Medical Officer of Health to provide a one-year progress report on the implementation of the Toronto Indigenous Overdose Strategy to the Board of Health and the Toronto Indigenous Health Advisory Circle in 2020.
HL3.2adopted
Expanding Opioid Substitution Treatment with Managed Opioid Programs
The opioid poisoning crisis continues unabated in Toronto in large part due to the illicit drug supply, which has become increasingly toxic with fentanyls and other potent drugs. There is a critical need to expand treatment options to include managed opioid programs. This strategy is part of the response to the overdose crisis in British Columbia and Alberta, and is urgently needed in Toronto and elsewhere in Ontario. Methadone and Suboxone are the most commonly offered opioid substitution treatments. These need to be expanded to include managed opioid programs which provide patients with oral or injectable hydromorphone or diacetylmorphine (pharmaceutical heroin) under medical supervision. Managed opioid programs are evidence-based programs that have been shown to increase retention in treatment, reduce the use of street drugs, and decrease crime. The Province of Ontario recently announced a $102 million funding agreement with the federal government for drug treatment. In the context of the current opioid poisoning crisis, the Ministry of Health and Long-Term Care should target some of this funding to rapidly scale up the implementation of managed opioid programs in Toronto and elsewhere in Ontario to help save lives and improve health outcomes for people who use drugs.
The Board of Health: 1. Urged the Ministry of Health and Long-Term Care to: a. Immediately target operational and capital funding to support rapid scaled up implementation of managed opioid programs (including low barrier models) in Toronto and elsewhere in Ontario, given the urgency of the opioid poisoning crisis; b. Take immediate action to ensure the required concentrations of managed opioid medications (i.e., 50 milligrams/milliliters and 100 milligrams/milliliters hydromorphone) are accessible to treat people with opioid use disorder in Ontario and, further, take the necessary steps to add these medications at the appropriate concentrations to the Ontario Drug Benefit Formulary for the treatment of opioid use disorder; c. Seek authority from Health Canada to import diacetylmorphine (pharmaceutical heroin) for use as a managed opioid program medication in Ontario; d. Work with Health Canada and other necessary federal bodies to address barriers to procuring, storing, and transporting diacetylmorphine (pharmaceutical heroin) and/or mitigate their effects to facilitate the use of this managed opioid program medication; and e. Ensure that managed opioid medications are universally accessible to all Ontarians who could benefit from these kinds of programs, and that cost is not a barrier.
Staff recommendation as filed
The Medical Officer of Health recommends that: 1. The Board of Health urge the Ministry of Health and Long-Term Care to: a. Immediately target operational and capital funding to support rapid scaled up implementation of managed opioid programs (including low barrier models) in Toronto and elsewhere in Ontario, given the urgency of the opioid poisoning crisis; b. Take immediate action to ensure the required concentrations of managed opioid medications (i.e., 50 milligrams/milliliters and 100 milligrams/milliliters hydromorphone) are accessible to treat people with opioid use disorder in Ontario. And further, to take the necessary steps to add these medications at the appropriate concentrations to the Ontario Drug Benefit Formulary for the treatment of opioid use disorder; c. Seek authority from Health Canada to import diacetylmorphine (pharmaceutical heroin) for use as a managed opioid program medication in Ontario; d. Work with Health Canada and other necessary federal bodies to address barriers to procuring, storing, and transporting diacetylmorphine (pharmaceutical heroin) and/or mitigate their effects to facilitate the use of this managed opioid program medication; and e. Ensure that managed opioid medications are universally accessible to all Ontarians who could benefit from these kinds of programs, and that cost is not a barrier.
HL3.3amended
Addition of Edibles and Other Products to Federal Cannabis Legislation
On October 17, 2018, the Cannabis Act, 2017 came into force, legalizing the use of cannabis for non-medical purposes. This federal legislation regulates cannabis cultivation, production, packaging, labelling, and promotion of dried and fresh cannabis, cannabis oil and seeds, and cannabis accessories. The Government of Canada has committed to amending the Cannabis Act by October 17, 2019 to include additional cannabis products. In preparation, Health Canada is conducting consultations on proposed amendments to the existing Cannabis Regulations to regulate edible cannabis, cannabis extracts, and topicals. Toronto Public Health supports a public health approach to the legalization and regulation of cannabis products. Cannabis is a psychoactive substance with potential harms to health. Drug-impaired driving, early initiation of cannabis use, and frequent use are among the main public health concerns related to cannabis. The Board of Health has supported a range of actions directed at the federal and provincial governments to protect health and reduce harms from cannabis use. This report provides comments based on a review of the proposed amendments to the federal Cannabis Regulations. The proposed amendments include the production and sale of cannabis vaping products, edibles, and other products, such as skin products prepared with cannabis as an ingredient. The recommendations in this report provide regulatory actions the federal government can take to prevent youth exposure to cannabis products that encourage initiation of use, reduce accidental ingestion of cannabis products, reduce consumption of high-potency cannabis products, and highlight the need to collect information on the public health impact of cannabis legalization.
The Board of Health: 1. Urged the Government of Canada to: a. Enhance existing and develop new tools for monitoring, data collection, and reporting to better understand cannabis consumption rates and the full range of potential health impacts (negative and positive) of all cannabis products, including information on unintended consequences of the introduction of non-traditional methods of cannabis consumption; b. Prioritize research, in collaboration with public health and other subject matter experts, to establish low-risk consumption limits for cannabis; c. Focus public education efforts on establishing youth-protective, healthy practices related to the consumption of cannabis products, as they represent new forms of consumption for many people; d. Prohibit edible cannabis products that are particularly appealing to children due to colour or shape (i.e., gummy bears, lollipops, etc.); e. Prohibit youth-friendly flavours of cannabis vaping products, such as desserts, candy, or soft drinks; f. Require edible cannabis products in a single package/container to reflect traditional consumption portions of similar products without cannabis; g. Prohibit the marketing, promotion, and display of vaping devices that may be used to consume cannabis in places where youth have access, regardless of whether or not the product or advertising medium represents an association with cannabis; h. Establish a maximum limit for total available Delta-9-tetrahydrocannabinol amounts in one-time use (i.e., disposable) vaping devices and require cannabis vape cartridges and vaping devices to include a mechanism to limit the maximum quantity/dosage of Delta-9-tetrahydrocannabinol inhaled in a single "puff" or inhale; i. Require cannabis product labelling to include: A. Dosing information for vape cartridges, vape devices, and edible cannabis products; B. Warnings on cannabis vape cartridges that the product has high Delta-9-tetrahydrocannabinol content; and C. Health warning messages, including avoiding co-consumption of edible cannabis with alcohol and/or highly-caffeinated drinks. j. Prohibit cannabis topical products that mimic food or drink, including the appearance of the immediate packaging or container to resemble food packaging; and k. Prohibit the marketing and promotion of cannabis use in movies, video games, and other media accessible to youth. 2. Directed that its decision and the report (February 12, 2019) from the Medical Officer of Health be forwarded to all Toronto school boards and Toronto-based Members of Parliament and Members of Provincial Parliament.
Staff recommendation as filed
The Medical Officer of Health recommends that: 1. The Board of Health urge the Government of Canada to: a. Enhance existing and develop new tools for monitoring, data collection, and reporting to better understand cannabis consumption rates and the full range of potential health impacts (negative and positive) of all cannabis products, including information on unintended consequences of the introduction of non-traditional methods of cannabis consumption; b. Prioritize research, in collaboration with public health and other subject matter experts, to establish low-risk consumption limits for cannabis; c. Focus public education efforts on establishing youth-protective, healthy practices related to the consumption of cannabis products, as they represent new forms of consumption for many people; d. Prohibit edible cannabis products that are particularly appealing to children due to colour or shape (e.g., gummy bear, lollipop); e. Prohibit youth-friendly flavours of cannabis vaping products, such as desserts, candy, or soft drinks; f. Require edible cannabis products in a single package/container to reflect traditional consumption portions of similar products without cannabis; g. Prohibit the marketing, promotion, and display of vaping devices that may be used to consume cannabis in places where youth have access, regardless of whether or not the product or advertising medium represents an association with cannabis; h. Establish a maximum limit for total available Delta-9-tetrahydrocannabinol amounts in one-time use (i.e., disposable) vaping devices and require cannabis vape cartridges and vaping devices to include a mechanism to limit the maximum quantity/dosage of Delta-9-tetrahydrocannabinol inhaled in a single "puff" or inhale; i. Require cannabis product labelling to include: A. Dosing information for vape cartridges, vape devices, and edible cannabis products; B. Warnings on cannabis vape cartridges that the product has high Delta-9-tetrahydrocannabinol content; and C. Health warning messages, including avoiding co-consumption of edible cannabis with alcohol and/or highly-caffeinated drinks. j. Prohibit cannabis topical products that mimic food or drink, including the appearance of the immediate packaging or container to resemble food packaging; and k. Prohibit marketing and promotion of cannabis use in movies, video games, and other media accessible to youth.
HL3.4amended
2019 Board of Health Committees and Appointments
This report provides the Board of Health with an overview of its current formal and informal committees. The Board of Health is asked to appoint new members to the Budget and Performance Appraisal of the Medical Officer of Health Committees, approve the 2019 recommended appointments to the Toronto Urban Health Fund Review Panel and revised Terms of Reference, and appoint a Board of Health Councillor member as Chairperson of the Toronto Drug Strategy Implementation Panel and approve the recommended membership and updated Terms of Reference In addition to the above appointments, the Board of Health is also requested to appoint a public member of the Board of Health to the Association of Local Public Health Agencies' Board of Directors and Board of Health Section.
The Board of Health: 1. Appointed the Board of Health members listed below to the following Committees for a term of office ending December 31, 2019, and until successors are appointed: a. Board of Health Budget Committee: - Ashna Bowry - Councillor Joe Cressy - Trustee Stephanie Donaldson - Angela Jonsson - Councillor Gord Perks - Soo Wong b. Board of Health Performance Appraisal of the Medical Officer of Health Committee: - Councillor Joe Cressy - Councillor Cynthia Lai - Peter Wong - Councillor Kristyn Wong-Tam 2. Appointed Kate Mulligan to the 2019 Association of Local Public Health Agencies' Board of Directors and Board of Health Section and agreed to pay her expenses incurred when participating in, and attending, the Association of Local Public Health Agencies' 2019 meetings and semi-annual meetings/conferences, within the approved 2019 budget, for a term of office ending December 31, 2019, and until a successor is appointed. 3. Encouraged all Board of Health members to attend the Association of Local Public Health Agencies' Board of Health Section meetings and semi-annual meetings/conferences held in Toronto in 2019 and agreed to pay expenses associated with this participation, within the approved 2019 budget. 4. Approved the revised Terms of Reference for the Toronto Urban Health Fund Review Panel, as outlined in Attachment 1 to the report (February 11, 2019) from the Medical Officer of Health, and appointed Councillor Kristyn Wong-Tam as the Board of Health member on the 2019 Toronto Urban Health Fund Review Panel for a term of office ending December 31, 2019, and until a successor is appointed. 5. Appointed the individuals listed below from the following communities and/or areas of expertise to the 2019 Toronto Urban Health Fund Review Panel for a term of office ending December 31, 2019, and until successors are appointed: a. Indigenous Member: - Allen Woodhouse (also appointed as an HIV Expert) b. HIV Experts: - Zahra Bolouk - Ciro Bisignano - Guy Mian - Andrea Westbrook - Allen Woodhouse (also appointed as an Indigenous Member) c. Harm Reduction Experts: - Chaudhry Ahmed - Beth Collison - Marc-Andre Hermanstyne - Mary Elizabeth Lindsey - Stephanie Moulton d. Child and Youth Resiliency Experts: - Sahar Golshan - Julia Gonsalves - Jordana Rovet - Danielle Sutherland - Dorene Weston 6. Appointed the individuals listed below from the following communities and/or areas of expertise as alternates for the 2019 Toronto Urban Health Fund Review Panel, with such appointments effective only in the event a vacancy for the specific community and/or area of expertise occurs prior to the first meeting of the 2019 Toronto Urban Health Fund Review Panel, for a term of office ending December 31, 2019, and until successors are appointed: - Dakarayi Chigugudhli, Alternate HIV Expert - Lindsey Jennings, Alternate Harm Reduction Expert - Enrique Robert, Alternate Child and Youth Resiliency Expert 7. Approved the revised Terms of Reference for the Toronto Drug Strategy Implementation Panel, as outlined in Attachment 2 to the report (February 11, 2019) from the Medical Officer of Health, and appointed Councillor Gord Perks as Chair of the Toronto Drug Strategy Implementation Panel for a term of office ending December 31, 2022, and until a successor is appointed. 8. Appointed the individuals listed below to the Toronto Drug Strategy Implementation Panel for a term of office ending December 31, 2022, and until successors are appointed: - Kaitlyn Adams-Lewis, Youth Coordinator, Toronto Indigenous Health Advisory Circle, Youth Council - Zahra Bolouk, Representative, Research Group on Drug Use - Joanne Brown, Executive Director, Parent Action on Drugs - JF Crépault, Senior Policy Analyst, The Centre for Addiction and Mental Health - Frank Crichlow, Representative, Toronto Drug Users Union - Rose D'Alimonte, Manager, Social Work, Toronto District School Board - Madam Justice Mary Hogan, Ontario Court of Justice, Toronto Region - Jann Houston, Director, Strategic Support, Toronto Public Health, City of Toronto - Amber Kellen, Director, John Howard Society of Toronto - Andrea Kusters, Representative, Grief Recovery After Substance Passing (GRASP) - Peter Leslie, Representative, Toronto Harm Reduction Alliance - Dennis Long, Executive Director, Breakaway Addiction Services - Debra Neil, Representative, Knowledge and Power of Women (KAPOW) - Rachel Robinson, Representative, Knowledge and Power of Women (KAPOW) - Michael Nurse, Representative, Black Coalition for AIDS Prevention - Steph Pinch, Youth Representative/Co-ordinator, TRIP! Project - Lori Kufner, Youth Representative/Co-ordinator, TRIP! Project - Cindy Raycroft, Representative, COUNTERfit Women's Harm Reduction Program, South Riverdale Community Health Centre - Gord Tanner, Director, Shelter, Support and Housing Administration Division, City of Toronto - Steve Teekens, Representative, Toronto Indigenous Health Advisory Circle - Steven Watts, Staff Inspector, Drug Squad, Toronto Police Service
Staff recommendation as filed
The Medical Officer of Health recommends that: 1. The Board of Health review the current membership of its Budget and Performance Appraisal of the Medical Officer of Health Committees and appoint Board of Health members for a term ending December 31, 2019, and until successors are appointed. 2. The Board of Health appoint a public member of the Board of Health to the Association of Local Public Health Agencies' Board of Directors and Board of Health Section and pay expenses incurred by the Board of Health appointed representative when participating in the 2019 meetings and when attending the Association of Local Public Health Agencies' semi-annual meetings/conferences within the approved 2019 budget. 3. The Board of Health encourage all Board of Health members to attend the Association of Local Public Health Agencies' Board of Health Section meetings and semi-annual meetings/conferences held in Toronto in 2019 and pay expenses associated with participation within the approved 2019 budget. 4. The Board of Health approve the revised Terms of Reference for the Toronto Urban Health Fund, as outlined in Attachment 1, and appoint a Board of Health member (Councillor or public) to the 2019 Toronto Urban Health Fund Review Panel for a term ending December 31, 2019, and until a successor is appointed. 5. The Board of Health appoint the candidates listed in Confidential Attachment 1 to the 2019 Toronto Urban Health Fund Review Panel for a term ending December 31, 2019, and until successors are appointed. The recommended candidates are from the following communities and/or areas of expertise: a. Indigenous candidate; b. HIV expert candidates; c. Harm reduction expert candidates; and d. Child and youth resiliency expert candidates. 6. The Board of Health appoint the individuals listed in Confidential Attachment 1 to the 2019 Toronto Urban Health Fund Review Panel as an alternate HIV expert member, an alternate harm reduction expert member, and an alternate child and youth resiliency expert member and that such appointments be effective only in the event a vacancy occurs prior to the first meeting of the Toronto Urban Health Fund Review Panel. 7. The Board of Health appoint a Board of Health Councillor member as Chair of the Toronto Drug Strategy Implementation Panel. 8. The Board of Health approve the revised Terms of Reference for the Toronto Drug Strategy Implementation Panel, as outlined in Attachment 2. 9. The Board of Health appoint the candidates listed in Confidential Attachment 2 to the Toronto Drug Strategy Implementation Panel for a term ending December 31, 2022. 10. The Board of Health authorize the public release of the names and biographies in Confidential Attachments 1 and 2, once Recommendations 5, 6, and 9 of this report are adopted by the Board of Health.
HL3.5amended
In January 2019, City Council adopted a report from the Medical Officer of Health that proposed a strategy for heat relief services in order to put the City in a stronger position to protect residents from extreme heat. At this meeting, additional motions were adopted that aim to strengthen the hot weather response through enhanced signage of cool spaces and consideration for creating shade structures, cool rooms in apartment buildings, and voluntary contact lists of vulnerable tenants in apartments. This report provides an update on the work accomplished to implement heat relief strategies for the summer of 2019 and how additional strategies will be incorporated into the work plan. To coordinate the implementation of heat relief strategies, City Council requested the Deputy City Manager, Corporate Services, to develop a Heat Relief Work Group with representation from nine City Divisions to more effectively coordinate initiatives which have been shown to be successful for addressing extreme heat. These initiatives include the development of a strategic communications plan, enhancements to web-based information, expansion of the Heat Relief Network, introduction of shade structures, and piloting a neighbour-checking program. As weather patterns continue to change and periods of hot weather increase in both duration and intensity, the City's response to hot weather must also evolve. Given that Toronto can expect to experience more days of extreme heat, the Heat Relief Work Group has determined that, for the long term, vulnerable populations will be best protected through a seasonal response to hot weather where support is provided through pre-existing services that they already access.
The Board of Health recommends that: 1. City Council request the Executive Director, Municipal Licensing and Standards, in consultation with the Medical Officer of Health, as part of their Heat in Apartments Working Group to identify strategies to address indoor temperatures in apartment buildings, to explore the feasibility of the following: a. Options for window protection in apartment buildings that balance child safety with the ability to permit air circulation for heat relief and consider potential modifications to the City of Toronto Municipal Code Chapter 629, Property Standards; b. Reviewing, removing, or changing the dates (September 15 and June 1) in the City of Toronto Municipal Code Chapter 497, Heating, as other jurisdictions have done in response to changing weather patterns; and c. Reporting to the Heat in Apartments Working Group on the status of Recommendations 1.a. and 1.b. by September 2019. 2. City Council request the Executive Director, Municipal Licensing and Standards, in consultation with the Medical Officer of Health and the Chief Communications Officer, Strategic Communications, to develop a strategy to continue to significantly increase effective communications to landlords and the public to provide clarity that landlords should use reasonable flexibility regarding the activation of heating systems in apartment units between September 15 and June 1, where the unit is a minimum of 21 degrees Celsius without heating, starting in the spring of 2019, and for the Medical Officer of Health to report back to the Board of Health at its meeting on April 8, 2019 on the communications strategy. 3. City Council request the Chief Planner and Executive Director, City Planning, to work with the Medical Officer of Health to identify opportunities in the City's planning processes, such as the development application approval process, to require air conditioning, common cool rooms, and/or shade structures in redeveloped or newly-developed buildings and policy options to include ways to mitigate the effect of building improvements on rent, such as grant-based retrofit incentives. 4. City Council request the Board of Directors, Toronto Community Housing Corporation, to direct the President and Chief Executive Officer, Toronto Community Housing Corporation, to follow the City of Toronto's direction on flexibility with heating systems at the time directed in shoulder seasons (September 15 to June 1) and to implement cooling options, including air conditioning, common cool rooms, and/or shade structures within the Toronto Community Housing Corporation's buildings that can be implemented on an ongoing basis as part of the state of good repair and in new buildings.
Staff recommendation as filed
The Medical Officer of Health recommends that: 1. City Council request the Executive Director, Municipal Licensing and Standards, in collaboration with the Medical Officer of Health, as part of their Heat in Apartments Working Group to identify strategies to address indoor temperatures in apartment buildings, to explore the feasibility of the following: a. Options for window protection in apartment buildings that balance child safety with the ability to permit air circulation for heat relief and consider potential modifications to Municipal Code Chapter 629, Property Standards; and b. Strategies to continue to increase communication to landlords to provide clarity that landlords do not need to turn the heat on between September 15 and June 1 where the unit is a minimum of 21 degrees Celsius without heating.
HL3.6adopted
The Board of Health will introduce and enact: Bill 1 - To Repeal By-law 2-2016 Governing the Proceedings of the Board of Health for the City of Toronto Health Unit. Bill 2 - To Govern the Proceedings of the Board of Health for the City of Toronto Health Unit.
The Board of Health introduced and enacted the following: 1. Bill 1 - To Repeal By-law 2-2016 Governing the Proceedings of the Board of Health for the City of Toronto Health Unit; and 2. Bill 2 - To Govern the Proceedings of the Board of Health for the City of Toronto Health Unit.
HL3.7adopted
Need for More Affordable, Supportive, and Harm Reduction Housing
At its meeting in January 2019, the Toronto Drug Strategy Implementation Panel discussed the intersection of homelessness and the lack of affordable and supportive housing options on the current opioid overdose crisis. Access to safe, affordable, and appropriate housing is critical to preventing the harms associated with substance use. Individuals who have lost their housing and become homeless are at an increased risk for overdose and other health harms. Stable and affordable housing is critical to stabilizing their lives and improving their health and well-being. However, finding and maintaining housing can be difficult for people who use drugs because of the discrimination they often face in the housing market. We need a range of housing options that respond to the diverse needs of people in our community, including people who use drugs. This includes more affordable housing, but also supportive housing and harm reduction housing. Housing was one of the key strategies recommended in the Toronto Overdose Action Plan, which the Board of Health endorsed in March 2017. While the City of Toronto is working to increase the affordable housing stock in Toronto, including through the "Housing Now" Initiative approved by City Council on January 30, 2019, more action is needed. The City is developing a new 10-year housing plan and including a public health perspective is critical to informing this planning process.
The Board of Health: 1. Requested the Medical Officer of Health to articulate the critical role of supportive and harm reduction housing as part of the development of the City of Toronto's new 10-year affordable housing plan.
Staff recommendation as filed
Councillor Joe Cressy recommends that: 1. The Medical Officer of Health articulate the critical role of supportive and harm reduction housing as part of the development of the City of Toronto's new 10-year affordable housing plan.