Item - 2020.HL23.3

The Board of Health recommends to the Budget Committee that:

1.  City Council approve the Toronto Public Health 2021 Operating Budget Request of $344,596.4 thousand gross, $127,383.9 thousand net, and 2,486.3 positions, as summarized in Table 1, Overview of the Toronto Public Health 2021 Operating Budget Submission, in the report (November 5, 2020) from the Medical Officer of Health, which includes the following:

a.  an increase from the Toronto Public Health 2020 Operating Budget of $3,897.0 thousand gross and $0 net for the annualization of the COVID-19 Volunteer Isolation Centre funded 100 percent by the Public Health Agency of Canada;

b.  an increase from the Toronto Public Health 2020 Operating Budget of $1,818.3 thousand gross and $0 net for the annualization of School Focussed Nursing COVID-19 service enhancements funded 100 percent by the Ontario Ministry of Health;

c.  an increase from the Toronto Public Health 2020 Operating Budget of $57,580.1 thousand gross, $57,580.1 thousand net, and 467 positions for Toronto Public Health's COVID-19 response;

d.  an increase from the Toronto Public Health 2020 Operating Budget of $1,349.8 thousand gross and net and a decrease of 1.6 positions related to increases in 2021 salaries and benefits for Cost of Living Adjustments (COLA) for union staff members;

e.  an increase from the Toronto Public Health 2020 Operating Budget of $409.8 thousand gross and net for inflationary cost increases in the Student Nutrition Program;

f.  a decrease from the Toronto Public Health 2020 Operating Budget of $199.5 thousand gross and $0 net for the annualization of the Infant Hearing program funded 100 percent by the Ontario Ministry of Children, Community and Social Services;

g.  a decrease from the Toronto Public Health 2020 Operating Budget of $652.1 thousand gross, an increase of $319.2 thousand net, and a reduction of 5 positions for 2021 Administrative Adjustments;

h.  a decrease from the Toronto Public Health 2020 Operating Budget of $165.0 thousand gross and $0 net for the Supervised Injection Service funded by the Ontario Ministry of Health in 2020 on a one-time basis; 

i.  an increase in revenue of $4,836.9 thousand from the Toronto Public Health 2020 Operating Budget to reflect the Ontario Ministry of Health's extended and increased one-time mitigation funding to December 31, 2021;

j.  a decrease in revenue from the Toronto Public Health 2020 Operating Budget of $1,461.0 thousand as a result of a reduction in the collection of user fees and other revenues due to COVID-19;

k.  a decrease in revenue from the Toronto Public Health 2020 Operating Budget of $136.6 thousand to reflect the Ontario Ministry of Health's grant capped at the forecast reported to the Ministry in the 2018 third-quarter financial report; and

l.  a new and enhanced service request of $135.1 thousand gross and net related to increased capacity for the Hassle Free Clinic.

2.  City Council request the Ontario Ministry of Health to provide funding to reimburse the City of Toronto for all extraordinary costs incurred by Toronto Public Health in 2021 for additional staffing and resources for Toronto Public Health's COVID-19 response.

The Board of Health:

1.  Directed the Medical Officer of Health to allocate and spend any funds necessary for Toronto Public Health's COVID-19 response and, in the event that such spending exceeds the Approved Toronto Public Health 2021 Operating Budget, to report with recommendations on seeking reimbursement from the Provincial Government.

2.  Directed that the report (November 5, 2020) from the Medical Officer of Health be forwarded to the Budget Committee for consideration during the 2021 Budget process.

3.  Directed that the report (November 5, 2020) from the Medical Officer of Health be forwarded to the Ontario Ministry of Health.

This report outlines the Toronto Public Health (TPH) 2021 Operating Budget Submission for consideration by the Board of Health. TPH's 2021 Operating Budget Submission totals $344,596.4 thousand gross, $127,383.9 thousand net, and 2,486.3 positions.

This submission is $64,173.5 thousand gross and $56,554.8 thousand net higher than the Restated 2020 Operating Budget. This submission also reflects an increase of 460.4 positions above the Restated 2020 Operating Budget. The increases to the 2021 Operating Budget Submission is predominately related to the additional staffing and resources for TPH's COVID-19 response to be funded by the Ministry of Health.

The 2021 Operating Budget Submission includes 2020 in-year changes, 2021 base changes, pending Council approval, and a 2021 service enhancement as detailed in the recommendations included in this report.