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.
HL3.1amended
Developing a Mental Health and Addictions Strategy for Toronto
The mandate of Toronto Public Health (TPH) is to improve the health of the population, reduce health inequities, and prepare for and respond to public health emergencies. In contrast to our health care delivery partners, such as hospitals and community-based health care agencies, public health achieves these objectives using a prevention focused approach, working at the population level. In this context, TPH works to promote mental health and respond to substance use issues across the population, which includes work to prevent and address the harms associated with substances. The COVID-19 pandemic has negatively impacted mental health and increased the need for services and interventions. An overall increase in the use of substances, such as alcohol and cannabis, has also been observed.1 Further, Toronto continues to be in the midst of a drug toxicity crisis, exacerbated by the continued impacts of the COVID-19 pandemic. In 2021, the Office of the Chief Coroner for Ontario confirmed there were 591 opioid toxicity deaths in Toronto. Drug toxicity deaths are preventable and due in large part to the unregulated drug supply, where unpredictable potency combined with unexpected and concerning substances significantly increase the risk of overdose. In June 2022, the Board of Health adopted a motion on the need for a mental health and addictions strategy for Toronto, and directed the Medical Officer of Health to update the Toronto Drug Strategy following extensive stakeholder engagement. This staff report provides an update on actions taken by Toronto Public Health to date, and makes recommendations on further steps to develop a Mental Health and Addictions Strategy. Shelter, Support and Housing Administration (SSHA) and Social Development, Finance and Administration (SDFA) staff were consulted in the development of this report.
The Board of Health: 1. Requested the Medical Officer of Health to continue to develop the comprehensive Mental Health and Addictions Strategy, which includes the refreshed Toronto Drug Strategy, with targeted actions to address mental health and substance use and present to the Board of Health in fall 2023. 2. Requested the Medical Officer of Health to include the impact of social isolation as a factor towards the development of the Mental Health and Addictions Strategy. 3. Requested the Medical Officer of Health to ensure that the Mental Health and Addictions Strategy for Toronto recognizes and differentiates between the unique challenges and approaches related to mental health compared to those of addictions. 4. Requested the Medical Officer of Health to undertake an Indigenous-specific and distinctions-based approach to ensure that the Mental Health and Addictions Strategy for Toronto be co-developed in true partnership with Indigenous organizations and communities to ensure that approaches and actions that support the unique needs of urban Indigenous people living in Toronto can be collectively activated. 5. Directed the Medical Officer of Health to continue to support the work of the Drug Strategy Implementation Panel while these new comprehensive strategies are developed. 6. Delegated to the Medical Officer of Health the authority to complete the annual declaration of compliance for the Service Accountability Agreement between Toronto Public Health and Ontario Health, the funder for the Methadone Works - Opioid Substitution Clinic within The Works program. 7. Requested the Medical Officer of Health, in consultation with the City Manager, to convene and chair a Mental Health and Addictions committee of relevant City Divisions and Toronto Public Health, focused on coordinating the City of Toronto's policies and programs related to mental health and substance use. 8. Reiterated its call requesting the Federal government to develop a national framework to permit the simple possession of all drugs for personal use. 9. Requested the Medical Officer of Health to continue working with Health Canada on the conditions that would allow for an exemption approval under Section 56(1) of the Controlled Drugs and Substances Act to decriminalize drug possession within the City of Toronto. 10. Reiterated its calls requesting the Federal and Provincial governments to immediately scale up prevention, harm reduction and treatment services for people who use drugs. 11. Endorsed the Toronto Youth Cabinet's Joint Statement on Addressing the Rising Mental Health Crisis Facing Children and Youth in Ontario, attached as the Attachment to Motion 1 by Councillor Chris Moise. 12. Requested the City Clerk provide a copy of the Board's decision to the Minister of Education.
Staff recommendation as filed
The Medical Officer of Health recommends that: 1. The Board of Health request the Medical Officer of Health to continue to develop the comprehensive Mental Health and Addictions Strategy, which includes the refreshed Toronto Drug Strategy, with targeted actions to address mental health and substance use and present to the Board of Health in fall 2023. 2. The Board of Health delegate to the Medical Officer of Health the authority to complete the annual declaration of compliance for the Service Accountability Agreement between Toronto Public Health and Ontario Health, the funder for the Methadone Works - Opioid Substitution Clinic within The Works program. 3. The Board of Health request the Medical Officer of Health, in consultation with the City Manager, to convene and chair a Mental Health and Addictions committee of relevant City Divisions and Toronto Public Health, focused on coordinating the City of Toronto's policies and programs related to mental health and substance use. 4. The Board of Health reiterate its call requesting the Federal government to develop a national framework to permit the simple possession of all drugs for personal use. 5. The Board of Health request the Medical Officer of Health to continue working with Health Canada on the conditions that would allow for an exemption approval under Section 56(1) of the Controlled Drugs and Substances Act to decriminalize drug possession within the City of Toronto. 6. The Board of Health reiterate its calls requesting the Federal and Provincial governments to immediately scale up prevention, harm reduction and treatment services for people who use drugs.
HL3.2received
Update on Toronto Public Health Immunization Operations - April 2023
The Deputy Medical Officer of Health will give a presentation on Update on Toronto Public Health Immunization Operations - April 2023.
The Board of Health: 1. Received the presentation (April 16, 2023) from the Deputy Medical Officer of Health for information.
HL3.3amended
Final Report from Black Scientists’ Task Force on Vaccine Equity
As invited by the Executive Director, Social Development, Finance and Administration Division, Dr. David Burt and Dr. Candice Todd, Co-Chairs of the Black Scientists' Task Force, will provide a presentation and final report on their recent work with Black communities on Vaccine Equity, that will include information on lessons learned from the pandemic and the early stages of recovery.
The Board of Health: 1. Directed the Medical Officer of Health to include community-led research on Black health in epidemiologic reports in order to ensure sustainable community engagement and socio-economic recovery. 2. Directed the Medical Officer of Health to explore, with other relevant partners, how wrap around community services that support Black mental health could be continued and report back as part of the Mental Health and Addiction Strategy to the Board of Health in fall 2023. 3. Directed the Medical Officer of Health to advocate for a dedicated stream on Black mental health at the proposed national mental health summit to help raise awareness, share best practices, and build a community of support for this important issue. 4. Requested the Medical Officer of Health to explore the establishment of a permanent "Black Health Secretariat Task Force" to address any ongoing challenges faced by the Black community in mental health and cancer and any other health related issues. 5. Requested Ontario Health and the Province of Ontario to collaborate and partner with Black communities as stewards in addressing health issues to ensure that interventions are culturally appropriate, community-driven, and sustainable over time. 6. Reiterated its request to the Province of Ontario to collect and share equity-based race data as it is crucial to understanding the pandemic's impact on Black communities, identifying areas of need, and creating targeted interventions and policies, as previously requested in items HL22.1, HL25.3, HL31.2 and HL36.1. 7. Requested Ontario Health and the Province of Ontario to address the long-term health outcomes of COVID-19 for Black Toronto communities, especially Long COVID-19, which is having lasting effects on physical and mental health and childhood development.
HL3.4adopted
Toronto Public Health 2023 Risk Management Report
This report provides the Board of Health with an update on the risk management reporting that is part of the Ontario Public Health Standards Accountability Framework. It outlines risks and challenges facing Toronto Public Health (TPH) in 2023, which include talent availability, uncertainty about the public health landscape, resource capacity to address evolving and emerging public health issues, and challenges securing public support and adherence to public health advice.
The Board of Health: 1. Received the report (March 29, 2023) 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.
HL3.5adopted
City Approved Toronto Public Health 2023 Operating Budget
This report provides an update on the City-approved Toronto Public Health (TPH) 2023 Operating Budget on February 15, 2023. On November 8, 2022, the Board of Health (BOH) recommended a TPH 2023 Operating Budget of $369,555.4 thousand gross and $159,304.3 thousand net that included one program efficiency. The City approved a final TPH 2023 Operating Budget of $368,966.8 thousand gross and $159,073.0 thousand net. The City-approved Budget provides a decrease of $1,815.0 thousand gross (0.5 per cent decrease) and an increase of $30,727.1 thousand net (23.9 per cent) over the 2022 Approved Operating Budget.
The Board of Health: 1. Received the report (March 29, 2023) 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.
HL3.6adopted
City Approved Toronto Public Health 2023 Capital Budget and 2024-2032 Capital Plan
This report provides an update on the City Approved Toronto Public Health (TPH) 2023 Capital Budget and 2024-2032 Capital Plan. The City Approved Toronto Public Health 2023 Capital Budget is $7.491 million for nine (9) projects with future year commitments of $10.216 million. In addition to the $10.216 million, there are another eleven (11) projects totalling $16.189 million in the TPH 2024-2032 Capital Plan. The change between the BOH Recommended 2023 Capital Budget and 2024-2032 Capital Plan and the City Approved 2023 Capital Budget and 2024-2032 Capital Plan is the cash flow carried forward funding from 2022.
The Board of Health: 1. Received the report (March 29, 2023) 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.
HL3.7adopted
Re-opening Item HL2.4, 2023 Board of Health Committees and Appointments, for Technical Amendments
At the February 21, 2023 Board of Health meeting, the Board considered item HL2.4, and in so doing, appointed directors to the following as recommended in the staff report recommendations 1 and 2: - Board of Health Budget Committee - Board of Health Performance Appraisal of the Medical Officer of Health Committee - Association of Local Public Health Agencies' (alPHa) Board of Directors and Board of Health Section. It has come to my attention that directives as set out in recommendations 2 and 3 in the report, were inadvertently omitted through the amendments made at the February 21, 2023 meeting. As such, I am requesting that Item HL2.4, 2023 Board of Health Committees and Appointments, be re-opened with respect to recommendations 2 and 3 in the report (February 6, 2023) from the Medical Officer of Health.
The Board of Health: 1. Re-opened Item HL2.4 entitled, "2023 Board of Health Committees and Appointments". 2. Amended the Board of Health's decision with respect to Item HL2.4 as follows: a. Amended Part 3 by adding "and pay expenses for attending alPHa's 2023 meetings and semi-annual meetings/conferences within Toronto Public Health's 2023 Approved Operating Budget" so that it now reads: 3. Appoint the following Board of Health director to the Association of Local Public Health Agencies' (alPHa) Board of Directors and Board of Health Section for a term of office ending on December 31, 2023, and until a successor is appointed, and pay expenses for attending alPHa's 2023 meetings and semi-annual meetings/conferences within Toronto Public Health's 2023 Approved Operating Budget : Director Anu Sriskandarajah b. Adopted the following recommendation from Item HL2.4 "Encourage all Board of Health directors to attend the Association of Local Public Health Agencies' (alPHa) Board of Health Section meetings and semi-annual meetings/conferences in Toronto and pay expenses for attending alPHa's 2023 meetings and conferences in Toronto within Toronto Public Health's 2023 Approved Operating Budget."
Staff recommendation as filed
Councillor Chris Moise recommends that the Board of Health: 1. Re-open HL2.4 entitled, "2023 Board of Health Committees and Appointments". 2. Amend the Board of Health's decision with respect to Item HL2.4 as follows: a. Amend Part 3 by adding "and pay expenses for attending alPHa's 2023 meetings and semi-annual meetings/conferences within Toronto Public Health's 2023 Approved Operating Budget" so that it now reads: 3. Appoint the following Board of Health director to the Association of Local Public Health Agencies' (alPHa) Board of Directors and Board of Health Section for a term of office ending on December 31, 2023, and until a successor is appointed, and pay expenses for attending alPHa's 2023 meetings and semi-annual meetings/conferences within Toronto Public Health's 2023 Approved Operating Budget : Director Anu Sriskandarajah b. Adopt the following recommendation from Item HL2.4 "Encourage all Board of Health directors to attend the Association of Local Public Health Agencies' (alPHa) Board of Health Section meetings and semi-annual meetings/conferences in Toronto and pay expenses for attending alPHa's 2023 meetings and conferences in Toronto within Toronto Public Health's 2023 Approved Operating Budget."
HL3.8received
In accordance with Section R. 53.(2) of By-law 2-2019, the Procedures By-law as amended by By-law 1-2020 and By-law 2-2020 of the Board of Health of the City of Toronto Health Unit, this letter serves as notice that the Board will consider amendments to the Procedures By-law at the next meeting of the Board of Health. The amendments are related to electronic participation at meetings and the time required to achieve quorum. City Council at its meeting on March 29, 30 and 31, 2023 considered Item EX3.7 Making Electronic Participation for Council and its Local Boards Permanent and, among other things, has authorized local boards to amend their rules of procedure with respect to these matters and to continue to meet electronically in accordance with previously adopted electronic participation rules until they can meet to consider procedural amendments.
The Board of Health: 1. Received the letter (April 6, 2023) from Councillor Chris Moise for information.