Minutes Confirmed on March 22, 2021

This meeting of the Board of Health was held by electronic means and the proceedings of the Board of Health were conducted publicly.

These measures were necessary to comply with physical distancing requirements and as civic buildings were closed to the public.

The Board of Health:

1.  Elected Director Joe Cressy as Chair of the Board of Health for a term of office starting January 18, 2021 and ending December 31, 2021, and until a successor is appointed.

There was one nomination. The Board Secretary declared Director Joe Cressy the Chair of the Board of Health.

Election of the Chair of the Board of Health under Part H, Section 22, of the Board of Health Procedures By-law for a term of office starting January 18, 2021 and ending December 31, 2021, and until a successor is appointed.

The Board of Health:

1.  Elected Director Kristyn Wong-Tam as Vice Chair of the Board of Health for a term of office starting January 18, 2021 and ending December 31, 2021, and until a successor is appointed.

There was one nomination. The Chair declared Director Kristyn Wong-Tam the Vice Chair of the Board of Health.

Election of the Vice Chair of the Board of Health under Part H, Section 22, of the Board of Health Procedures By-law for a term of office starting January 18, 2021 and ending December 31, 2021, and until a successor is appointed.

The Board of Health recommends that:

1.  City Council request the Federal Government to provide funding to the City of Toronto to support the City of Toronto's COVID-19 Immunization Task Force's plan for a broad-based community engagement, education, and mobilization campaign to raise awareness and build support for the COVID-19 vaccine.

2.  City Council urge the Government of Ontario to take immediate action to address the rising rate of new COVID-19 cases, hospitalizations, and patients in intensive care units, including the following:

a.  provide additional supports to essential frontline workers, including paid sick leave, targeted support for temporary workers, and enhanced proactive workplace inspections;

b.  continue efforts to expand test, trace, and isolate systems;

c.  provide additional financial relief to ensure that affected businesses and workers are fully supported through the lockdown period;

d.  continue to carefully monitor the Provincial circumstances and other evidence in order to adjust public health measures accordingly; and

e.  proactively plan to reopen schools and other sectors safely.

3.  City Council request the Government of Ontario to:

a.  require employers in Ontario to provide no less than five paid sick days annually to workers, after three months of employment, through amendments to the Employment Standards Act, 2000 or through a different mechanism;

b.  provide necessary funding, fiscal relief, and/or supports to employers so that all workers in Ontario have access to no less than 10 paid sick days annually in the event of a declared infectious disease emergency such as the COVID-19 pandemic; and

c.  ensure all workers in Ontario have access to protected and paid emergency leave so that care can be provided to children, parents, or other family members who may become ill.

4.  City Council request the Ontario Ministry of Labour, Training and Skills Development to provide resources and funding to support workplaces that hire temporary workers to appropriately train staff in the use of Personal Protective Equipment and infection prevention and control measures.

The Board of Health:

1.  Requested the Federal Government to provide funding to the City of Toronto to support the City of Toronto's COVID-19 Immunization Task Force's plan for a broad-based community engagement, education, and mobilization campaign to raise awareness and build support for the COVID-19 vaccine.

2.  Urged the Government of Ontario to take immediate action to address the rising rate of new COVID-19 cases, hospitalizations, and patients in intensive care units, including the following:

a.  provide additional supports to essential frontline workers, including paid sick leave, targeted support for temporary workers, and enhanced proactive workplace inspections;

b.  continue efforts to expand test, trace, and isolate systems;

c.  provide additional financial relief to ensure that affected businesses and workers are fully supported through the lockdown period;

d.  continue to carefully monitor the Provincial circumstances and other evidence in order to adjust public health measures accordingly; and

e.  proactively plan to reopen schools and other sectors safely.

3.  Requested the Government of Ontario to collect and share disaggregated data based on race, income, occupation, neighbourhood, and housing status as part of the Provincial COVID-19 immunization data system.

4.  Requested the Government of Ontario to:

a.  require employers in Ontario to provide no less than five paid sick days annually to workers, after three months of employment, through amendments to the Employment Standards Act, 2000 or through a different mechanism;

b.  provide necessary funding, fiscal relief, and/or supports to employers so that all workers in Ontario have access to no less than 10 paid sick days annually in the event of a declared infectious disease emergency such as the COVID-19 pandemic; and

c.  ensure all workers in Ontario have access to protected and paid emergency leave so that care can be provided to children, parents, or other family members who may become ill.

5.  Called on the Government of Ontario to recognize supportive housing as a public health measure to protect vulnerable and marginalized residents who are experiencing homelessness and provide $48 million in annual ongoing operating funding to create and maintain 2,000 new permanent supportive housing opportunities by mid-2022, with $12.24 million per year required immediately (and ongoing annually) to operationalize 510 supportive housing units and an additional $14.11 million per year starting in September 2021 (and ongoing annually) to operationalize an additional 588 supportive housing units in Toronto in 2021, as requested by Toronto City Council in December 2020 (Item 2020.PH19.11, Emergency Housing Action).

6.  Requested the Ontario Ministry of Health to publicly provide a detailed breakdown of the proposed phased vaccine prioritization framework, including a specific breakdown of the individuals and groups who will be prioritized in Phase 2 of the Ontario COVID-19 Vaccine Distribution Implementation Plan.

7.  Requested the Ontario Ministry of Labour, Training and Skills Development to require employers to ensure that existing and future sick leave provisions, including protections against repercussions by employers when workers access sick leave and follow public health guidelines, are clearly communicated to workers and management in multiple languages.

8.  Requested the Ontario Ministry of Labour, Training and Skills Development to provide resources and funding to support workplaces that hire temporary workers to appropriately train staff in the use of Personal Protective Equipment and infection prevention and control measures.

9.  Requested the Medical Officer of Health, in consultation with the Fire Chief and General Manager, Emergency Management, and Toronto's COVID-19 Incident Commander, and the Executive Director, Social Development, Finance and Administration, to report to the March 22, 2021 meeting of the Board of Health with detailed breakdowns of immunization plans for all priority populations and vulnerable groups, such as people experiencing homelessness, people living in congregate settings, and essential frontline workers, by the Government of Ontario, the City of Toronto, and Toronto Public Health, including overcoming vaccine hesitancy.

10.  Requested the Medical Officer of Health to report in 2021 on the status and trends in workplace COVID-19 outbreak data and any new Provincial safety measures for essential workplaces and essential workers.

11.  Requested the Medical Officer of Health to publicly post, on a weekly basis, the names of workplaces with COVID-19 outbreaks, as closely aligned with other summary reports as possible, in a manner that maintains and protects individual privacy and that is based on the Provincial outbreak definition of two or more cases over a 14-day period.

12.  Requested the Medical Officer of Health to engage Toronto's COVID-19 Community Cluster tables and other relevant stakeholders on the development of Toronto Public Health's equity indicators and include these indicators in the Toronto Public Health COVID-19 Monitoring Dashboard in February 2021.

13.  Requested the Medical Officer of Health to explore any opportunity to directly collect disaggregated data as part of Toronto Public Health's COVID-19 immunization campaign.

14.  Requested the Medical Officer of Health to consider and implement any additional measures or restrictions necessary to halt the spread of COVID-19, in partnership with Ontario's Public Health Units and the Government of Ontario or under their own powers under the Health Protection and Promotion Act.

15.  Directed that the report (January 5, 2021) from the Medical Officer of Health be forwarded for information to the Federal Government, the Federation of Canadian Municipalities, and the Association of Municipalities of Ontario, with a request that they review and consider Part 4 above.

The Medical Officer of Health, the Fire Chief and General Manager, Emergency Management, and Toronto's COVID-19 Incident Commander, and the Director, Community Resources, Social Development, Finance and Administration, gave a presentation on Response to COVID-19: Update Presentation to the Board of Health.

This report provides an update on the COVID-19 pandemic locally and the City of Toronto's COVID-19 Immunization Task Force's (ITF) planning. It also outlines Toronto Public Health's (TPH) response to COVID-19 outbreaks in workplaces, provides an update on the launch of TPH equity indicators on the TPH COVID-19 Monitoring Dashboard, outlines supports intended to facilitate self-isolation for families due to COVID-19 infection in a household, and provides information on the importance of paid sick leave provisions, particularly for essential workers, in mitigating the spread of COVID-19.

On December 21, 2020, the Provincial Government announced that Ontario would be moving into the "Grey - Lockdown" level of the Province's Keeping Ontario Safe and Open Framework as of December 26, 2020. Toronto has been in the "Grey - Lockdown" level since November 24, 2020 and will remain at this level until at least January 23, 2021. These restrictions remain in place in response to the continuing significant rate of COVID-19 spread in Toronto.

The COVID-19 ITF continues to plan for the roll-out of the vaccine to all Toronto residents in order to protect everyone against COVID-19 infection and end the pandemic. As of the end of 2020, over 50,000 doses have been received in Toronto and these are being administered to residents, essential care providers and staff of long-term care homes and retirement homes. In early 2021, it is expected that another 50,000 doses of the Pfizer/BioNTech and Moderna COVID-19 vaccines will be available for administration in Toronto.

On September 21, 2020, the Board of Health (BOH) requested TPH to publicly share details of workplace outbreaks while respecting privacy requirements. TPH has developed a process to share anonymized outbreak information related to community and workplace settings on its website. These details are expected to become publicly available early in 2021.

On October 19, 2020, the BOH requested TPH to expand the TPH COVID-19 Monitoring Dashboard to include equity indicators. In consultation with key equity-seeking stakeholders, TPH will be expanding the TPH COVID-19 Monitoring Dashboard in February 2021 to include three equity indicators on income, ethno-racial group and neighbourhoods. These indicators will provide insight into how well the response to the pandemic is contributing to a reduction in COVID-19 related socio-demographic inequities and will support TPH decision-making.

During the pandemic, it has become increasingly evident that paid sick leave provisions are essential to protect the health of individual workers, their workplaces, and the broader community. This report recommends that the Government of Ontario require employers in the province to provide no less than five paid sick days annually and provide necessary funding, fiscal relief and/or supports to employers so that all workers in Ontario have access to no less than 10 paid sick days annually during a declared infectious disease emergency such as the COVID-19 pandemic.

The Board of Health:

1.  Appointed the following Board of Health directors to the Board of Health - Budget Committee for a term of office starting January 18, 2021 and ending December 31, 2021, and until successors are appointed:

Director Joe Cressy

Director Stephanie Donaldson

Director Mike Layton

Director Ida Li Preti

Director Gord Perks

2.  Appointed the following Board of Health directors to the Board of Health - Performance Appraisal of the Medical Officer of Health Committee for a term of office starting January 18, 2021 and ending December 31, 2021, and until successors are appointed:

Director Joe Cressy

Director Kate Mulligan

Director Kristyn Wong-Tam

3.  Appointed Director Kate Mulligan to the Association of Local Public Health Agencies (alPHa) Board of Directors and Board of Health Section for a term of office starting January 18, 2021 and ending December 31, 2021, and until a successor is appointed and agreed to pay expenses for attending alPHa's 2021 meetings and semi-annual meetings/conferences within Toronto Public Health's 2021 Approved Operating Budget.

4.  Encouraged 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 agreed to pay expenses for attending alPHa's 2021 meetings and conferences in Toronto within Toronto Public Health's 2021 Approved Operating Budget.

This report outlines two Committees of the Board of Health, along with an external Board, that require reappointment for 2021.

Appointments to the following Committees and external Board are needed: the Board of Health - Budget Committee, the Board of Health - Performance Appraisal of the Medical Officer of Health Committee, and the Association of Local Public Health Agencies' (alPHa) Board of Directors and Board of Health Section.

The Board of Health recommends that:

1.  City Council request the Government of Ontario to provide adequate funding to the Angel Foundation for Learning and the Toronto Foundation for Student Success to fully stabilize student nutrition program support for remote learners for the school period of January to June 2021.

 
2.  City Council direct that the report (January 5, 2021) from the Medical Officer of Health be forwarded to the Toronto District School Board, the Toronto Catholic District School Board, the Angel Foundation for Learning, the Toronto Foundation for Student Success, the Ontario Ministry of Education, the Ontario Ministry of Health, and the Federal Minister of Families, Children and Social Development.

The Board of Health:

1.  Requested the Government of Ontario to provide adequate funding to the Angel Foundation for Learning and the Toronto Foundation for Student Success to fully stabilize student nutrition program support for remote learners for the school period of January to June 2021.

 
2.  Requested the Medical Officer of Health to report in March 2021 on the status of additional emergency pandemic funding for student nutrition programs from the Government of Ontario.

When the 2020 Operating Budget was approved in February 2020, it was not foreseeable how COVID-19 would impact the ability of student nutrition programs to provide nutrition support to Toronto's vulnerable children and youth. The 2020 budget has been fully allocated to student nutrition programs, yet these programs are facing increased operational challenges as they deal with higher food costs, fewer volunteers, and appeals to support both in-school and remote learners who otherwise would have accessed a student nutrition program.

This report responds to a motion from the December 14, 2020 Board of Health meeting requesting the Medical Officer of Health to report at its January 18, 2021 meeting with an update on additional resource needs and any other challenges facing municipally-supported student nutrition programs in Toronto. Two scenarios were examined to provide an estimation of additional resources. Also, anticipating that COVID-19 may necessitate that a remote learning model continues for the 2021/22 school year, estimates capture the balance of the 2020/21 school year and the first part of the 2021/22 school year.

Student nutrition programs contribute to the health and wellbeing of students through nutritious food choices and have been demonstrated to improve learning outcomes among children. Toronto Public Health continues to monitor the evolving COVID-19 situation with schools and works with student nutrition programs, school boards, and their foundations to ensure the safe operation of student nutrition programs.

The Board of Health recommends that:

1.  City Council authorize the Medical Officer of Health to award, execute, and amend, on an ongoing basis, a purchase of service contract for the Ontario Seniors Dental Care Program with Rexdale Community Health Centre and the Centre for Addiction and Mental Health, in a form approved by the City Solicitor.

On November 20, 2019, the Government of Ontario launched the Ontario Seniors Dental Care Program, a 100 percent Ministry of Health funded program for low-income seniors in Ontario. Through this program, Toronto Public Health provides dental treatment to eligible seniors at clinics located in Toronto Public Health sites, Community Health Centres (CHC) and Aboriginal Health Access Centres (AHAC).

The purpose of this report is to request approval for the Medical Officer of Health to award, execute and amend, on an ongoing basis, a purchase of service contract with Rexdale CHC and the Centre for Addiction and Mental Health (CAMH) to further support the service delivery and access to care for the Ontario Seniors Dental Care Program.

Announcements

The Chair acknowledged that the Board of Health was meeting on the traditional territory of many nations including the Mississaugas of the Credit, the Anishnabeg, the Chippewa, the Haudenosaunee and the Wendat peoples and is now home to many diverse First Nations, Inuit and Métis peoples. The Chair also acknowledged that Toronto is covered by Treaty 13 with the Mississaugas of the Credit.

The Chair welcomed two new Directors, Director Paul Ainslie and Director Brad Bradford, to the Board of Health. The Chair also welcomed Dr. Na-Koshie Lamptey to her new role as the Deputy Medical Officer of Health at Toronto Public Health.

Where the Directors of the Board of Health listed in the attendance for this meeting participated remotely, they were counted for quorum as permitted by Section 189(4.2) of the City of Toronto Act, 2006, and the Board's Procedures.