Minutes Confirmed on October 25, 2021

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

These measures were necessary to comply with public health guidelines and prevent the spread of COVID-19.

The Board of Health recommends that:

1.  City Council request the Medical Officer of Health to monitor the implementation of the Province of Ontario's vaccine certificate program and to report back to the Board of Health in the first quarter of 2022 with an update on the program's impact in Toronto.

The Board of Health:

1.  Requested the Province of Ontario to require COVID-19 vaccination for students who are eligible based on their age/year of birth.

2.  Requested the Medical Officer of Health to monitor the implementation of the Province of Ontario's vaccine certificate program and to report back to the Board of Health in the first quarter of 2022 with an update on the program's impact in Toronto.

3.  Requested the Medical Officer of Health, in consultation with the Deputy City Manager, Community and Social Services, to review the response to COVID-19 by Toronto Public Health, the City of Toronto, community agencies and health care partners and to report to the Board of Health in the first quarter of 2022, including the following:

a.  identify successful strategies and programs arising from TO Supports: COVID-19 Equity Action Plan, the City of Toronto's Immunization Community Engagement and Mobilization Plan and other efforts to target equity-deserving populations, including people who are Indigenous, Black, South Asian and experiencing homelessness;

b.  consider the role of Toronto Public Health and the City of Toronto in delivering on the following three components of primary health care as defined by the World Health Organization: meeting people's health needs throughout their lives; addressing the broader determinants of health through multi-sectoral policies and actions; and empowering individuals, families and communities to take charge of their own health; and

c.  make recommendations to transition successful emergency COVID-19 responses into permanent, long-term embedded supports for equity-deserving populations and "hot spot" neighbourhoods, including the alignment of public health, health care and social services, wherever appropriate.

The Medical Officer of Health gave a presentation on Response to COVID-19: September 2021 Update.

The City of Toronto (the City) is currently in the fourth wave of the COVID-19 pandemic. At the time of this report, we are observing an average of 153 daily COVID-19 cases over a 7-day period. As of September 9, 2021, 77.9 percent of individuals over the age of 12 have been fully vaccinated in Toronto. While the ongoing uptake of vaccination by Toronto residents is positive, analysis and modelling of the fourth wave demonstrates that ongoing vigilance is required to both promote increased vaccination and monitor progress towards reducing COVID-19 transmission.

This report provides an update on the response to the COVID-19 pandemic as of September 2021, and responds to Board of Health direction from March 2021 for the Medical Officer of Health to report on COVID-19 workplace vaccination policies. This report also responds to direction from the Board of Health in June 2021 to provide an update on Toronto Public Health (TPH) efforts to support the safe return to school. Finally, this report makes a recommendation for the Medical Officer of Health to monitor ongoing vaccine policy developments at the provincial level and request the Province of Ontario (the Province) to require school-age children who are eligible for the COVID-19 vaccine to be vaccinated.

The Board of Health:

1.  Requested the Medical Officer of Health to arrange an Indigenous cultural safety training session for the Board of Health in 2022 to build the Board's capacity to respectfully advance Indigenous health and reconciliation through its public health policy mandate.

2.  Requested the Chair to call a Special Meeting of the Board of Health in 2022 for the training session referenced in Part 1 above.

3.  Requested the Medical Officer of Health, in collaboration with Indigenous community partners and City of Toronto divisions, to continue the implementation of the Toronto Indigenous Health Strategy's actions and operating principles using an approach that allows for transparency and accountability.

4.  Requested the Medical Officer of Health to review and advance the recommendations from the Toronto Indigenous Health Strategy Implementation Assessment, including:

a.  implementing an Indigenous cultural safety framework aimed at decolonizing Toronto Public Health's programs, services, policies and approach;

b.  engaging Toronto Public Health's Senior Management Team in a facilitated discussion to further define and act on the Toronto Indigenous Health Strategy's operating principles;

c.  exploring mechanisms to ensure that Indigenous communities' perspectives are represented at the Board of Health;

d.  strengthening Toronto Public Health's relationships with Indigenous partners such as the Toronto Aboriginal Support Services Council, the City of Toronto's Aboriginal Affairs Advisory Committee and Indigenous community organizations;

e.  continuing to invest in staff development opportunities to strengthen cultural safety and Toronto Public Health's capacity to respectfully and effectively serve Indigenous Peoples in Toronto;

f.  reviewing Toronto Public Health's hiring practices and exploring opportunities to recruit and retain Indigenous employees; and

g.  reviewing and revising Toronto Public Health's policies and practices to support Indigenous cultural safety.

Due to the ongoing impacts of colonization, Indigenous Peoples in Toronto continue to experience inequities within a number of health outcomes.

This report provides a progress update on Toronto Public Health's (TPH) implementation of the Toronto Indigenous Health Strategy (2016-2021). It also provides key recommendations for advancing the implementation of the strategy, specifically focused on enhancing cultural safety across TPH programs and services, strengthening partnerships with Indigenous communities, and advancing Indigenous health and reconciliation through a public health policy mandate.

The recommended next steps will better position TPH to work with Indigenous Peoples in Toronto to reduce health disparities and to support strong and vibrant Indigenous communities.

The Board of Health:

1.  Received the report (August 27, 2021) from the Medical Officer of Health for information.

This report provides an update to the Board of Health on the Toronto Public Health (TPH) Operating Budget Variance for the six months ended on June 30, 2021.

As of June 30, 2021, TPH gross expenditure was overspent by $17.8 million gross and revenue was overachieved by $18.4 million, resulting in a net favourable variance of $0.6 million.

At year end, gross expenditure is expected to be overspent by $59.0 million gross and revenue will be overachieved by $58.8 million, resulting in net expenditure being over budget by $0.2 million.

The Board of Health:

1.  Received the report (August 27, 2021) from the Medical Officer of Health for information.

This report provides an update to the Board of Health on the Toronto Public Health Capital Budget Variance for the six months ended on June 30, 2021.

As of June 30, 2021, Toronto Public Health spent $1,089.5 thousand representing 21.7 per cent of the 2021 Approved Capital Budget of $5,032.0 thousand. 

Similar to last year, projects planned for 2021 continue to be affected by the impact of COVID-19 on the availability of resources within Toronto Public Health and its partners.

The Board of Health:

1.  Received the letter (September 10, 2021) from Councillor Joe Cressy for information.

Director Kate Mulligan, the Board of Health's appointee to the Association of Local Public Health Agencies' (alPHa) Board of Directors and Board of Health Section, will provide a verbal update.

The Board of Health:

1.  Appointed Director Stephanie Donaldson to the Association of Local Public Health Agencies' (alPHa) Board of Directors and Board of Health Section for a term of office starting September 27, 2021 and ending December 31, 2021, and until a successor is appointed and authorized the reimbursement of expenses for attending alPHa's 2021 meetings and semi-annual meetings/conferences within the 2021 Approved Operating Budget for Toronto Public Health.

On behalf the Board, I would like to thank Director Kate Mulligan for her exceptional service and dedication as the Toronto Board of Health's representative on the alPHa Board of Directors and Board of Health Section.

I have spoken to Director Stephanie Donaldson and recommend that the Board appoint her to fill this vacant position.

The Board of Health:

1.  Requested the Medical Officer of Health to review the local Health Impact Assessment, produced by the South Riverdale Community Health Centre and Save Jimmie Simpson regarding the Ontario Line in Riverside/Leslieville, once completed.

2.  Requested Metrolinx to extend the commenting period for the Draft Lakeshore East Joint Corridor Early Works Report beyond the October 24, 2021 deadline in order to allow the Medical Officer of Health to review the local Health Impact Assessment, produced by the South Riverdale Community Health Centre and Save Jimmie Simpson regarding the Ontario Line in Riverside/Leslieville, and to provide proper comment.

I am introducing this item on behalf of Councillor Paula Fletcher.

At its meeting of August 2010, the Toronto Board of Health considered a report on Metrolinx' noise and vibration assessments for the Georgetown Rail Expansion and Air-Rail Link, now known the Union Pearson Express. The report, from the then Medical Officer of Health Dr. David McKeown, revealed several shortcomings in Metrolinx's work. For example, the report noted:

A review of the consultants' report identified several limitations in the noise and vibration assessments. In particular, noise impacts at City parks in the vicinity of the Georgetown Corridor were not evaluated and could be significant.

This report, over ten years old, underscores the historical issues that Metrolinx has had with building trust with local communities around issues like health impacts, noise, and vibration. With the proposed Ontario Line many residents in Toronto-Danforth are concerned that future Metrolinx assessments for the upcoming Ontario Line and GO Expansion could suffer from similar deficiencies.

When asked by community members, Metrolinx stated publicly that "it is not standard Metrolinx practice to conduct health impact assessments." So South Riverdale Community Health Centre (SRCHC) and Save Jimmie Simpson (SJS) have worked together to produce a Health Impact Assessment regarding the Ontario Line in Riverside/Leslieville. This HIA compares the proposed 1.5 kilometres of above-ground subway in this neighbourhood to a community-supported below ground option based partially on the approved TTC Relief Line proposal. It was conducted by a former Toronto Public Health specialist and is almost near completion.

Just this past week Metrolinx released their Early Works Report for the Joint Corridor and set a commenting deadline of October 24th. The documents are over a thousand pages and contain many technical studies that the community is keen to digest and respond to properly. This leaves little time to review the Metrolinx documents against the HIA.

Announcements

The Vice 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 Vice Chair also acknowledged that Toronto is covered by Treaty 13 with the Mississaugas of the Credit. The Vice Chair recognized Director Peter Wong who elaborated on the Land Acknowledgement Statement.

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.