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From YouTube: Board of Health - June 10, 2019
Description
Board of Health, meeting 7, June 10, 2019
Agenda and background materials:
http://app.toronto.ca/tmmis/decisionBodyProfile.do?function=doPrepare&meetingId=15393
Meeting Navigation:
0:07:24 - Call to order
Agenda Items:
0:12:51 - HL7.1 - Toronto Overdose Action Plan: Status Report 2019 (Ward All)
0:12:51 - HL7.2 - Toronto Indigenous Overdose Strategy (Ward All)
1:13:05 - HL7.3 - Fetal Alcohol Spectrum Disorder - Activities to Address Key Priorities (Ward All)
0:09:23 - HL7.4 - 2019 Student Nutrition Program Service Subsidies (Ward All)
0:09:48 - HL7.5 - Toronto Public Health Operating Budget Variance for the Twelve Months Ended December 31, 2018 (Ward All)
0:12:28 - HL7.6 - Toronto Public Health Capital Budget Variance for the Twelve Months Ended December 31, 2018 (Ward All)
0:12:37 - HL7.7 - Toronto Public Health Operating Budget Variance for the Four Months Ended April 30, 2019 (Ward All)
0:10:38 - HL7.8 - Toronto Public Health Capital Budget Variance for the Four Months Ended April 30, 2019 (Ward All)
1:51:18 - HL7.9 - Board of Health's Meeting Procedures (Ward All)
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A
Welcome
to
meeting
seven
of
the
Board
of
Health
two
members
of
the
board
in
two
members
of
the
public.
You
can
follow
the
agenda
and
the
debate
on
your
computer,
your
tablet
or
your
smoke
smartphone
at
Toronto
da
ta,
slash
council.
The
board
acknowledges
the
land
we
are
meeting
on
is
the
traditional
territory
of
many
nations,
including
the
Mississauga's
of
the
credit,
the
Anishinaabe,
the
Chippewa,
the
Honan
has
shown
a
and
the
one
dat
peoples
and
is
now
home
to
many
diverse
First,
Nations,
Inuit
and
maytee
peoples.
A
A
Seeing
none
I
would
can
I
have
a
confirmation
of
the
minutes
from
the
6th
of
May
2019
moved
by
trustee
libretti,
all
those
in
favor
opposed.
If
any
that
carries
I,
and
you
have
we're
now
going
to
quickly
go
through
the
the
order
paper
item
7.1,
we
have
a
presentation
in
a
deputing,
so
that
will
be
held
item
7
point
to
the
indigenous
overview
strategy.
We
will
have
a
presentation
from
Michelle
sue
and
those
are
going
to
be
dealt
with
together.
Item
7.1
and
seven
point
to
item
7.3
FASD
activities
to
address
key
priorities.
A
We
have
a
deputation
so
that
will
be
held
item,
7.4
student
nutrition
program
services
and
subsidies.
We
had
deferred
this
because
at
our
last
meeting
we
didn't
know
if
we
had
money
this
year.
Apparently
we
now
do
again
so
can
I
have
somebody
to.
Would
anybody
like
to
move
the
recommendations
moved
by
Peter
Wong,
all
those
in
favor
opposed
if
any
carried?
That's
item,
7.4
item
7.5
the
Toronto
Public
Health
operating
budget
variants
for
12
months?
We
do
not
have
any
deputations
on
this.
A
A
So
item
7.7
I
will
move
those
recommendations,
all
those
in
favor
opposed
if
any
carried
item,
7.8
Toronto,
Public,
Health
capital
budget
variants
for
the
first
four
months.
But
anybody
like
to
move
the
recommendations.
Councillor
Layton,
all
those
in
favor
opposed
penny
carried
item
7.9.
We're
gonna
have
a
presentation
on
that.
So
that
takes
us
to
the
top,
maybe
just
before
we
dive
right
in
I
just
want
to
take
a
moment
to,
on
behalf
of
the
board,
thank
the
medical
officer
of
Health,
dr.
A
Davila
and
the
exceptional
team
at
Toronto,
Public
Health,
the
last
two
and
a
half
months
have
been
nothing
short
of
exhausting
for
our
staff,
emotionally
exhausting
due
to
the
uncertainty
of
what
was
happening
in
the
provincial
context
and
physically
exhausting
because
they
worked
flat-out
to
define
and
publicly
articulate
the
value
of
the
work
we
do
and
why
we
do
it
and
the
net
result,
as
you
all
are
aware,
is
that
the
retroactive
cuts
have
been
reversed.
We
do
not
know
what
the
future
holds
yet.
A
I
can
advise
members
of
the
board
that
the
premier's
office
has
told
our
mayor,
both
directly
and
in
subsequent
conversations
with
his
office
that
future
cuts
are
on
hold
subject
to
a
full
review
with
us.
That
is
what
they
have
said,
and
so
we
are
going
to
hold
them
to
their
word,
that
this
isn't
a
delay
in
a
cut,
but
rather
a
reset,
and
so
that
is
what
our
work
now
moves
to.
But
again
I
want
to
commend
and
thank
dr.
A
You
all
right
all
right
and
then
I
noticed
that
I
omitted
item,
seven
point:
six
Toronto,
Public,
Health
capital
budget,
variance
for
the
first
12
months,
moved
by
trustee
Donaldson,
all
those
in
favor
opposed
money
carried
in
item
seven
point:
seven:
Toronto,
Public,
Health
operating
budget
variance
for
the
first
four
months,
moved
by
trustee
Donaldson.
All
those
in
favor
opposed
to
many
carry
all
right
with
that.
We
are
going
to
go
back
to
the
formal
agenda.
A
B
Thank
You
mr.
chair,
and
thank
you
for
the
acknowledgement
as
well
in
your
opening
remarks.
I
would
like
to
add
to
that
as
well.
My
own
personal
thanks
to
the
entire
team
at
Toronto,
Public
Health.
It
has
been
I
agree
with
you
I,
rather
emotionally
and
physically
a
challenging
time.
So
I
can't
thank
the
team
at
Toronto,
Public
Health
enough,
however,
I
think
it's
also
worth
it
while
I
have
the
microphone
to
say.
B
B
So
with
that
I'm
going
to
call
your
attention,
members
of
the
Board
of
Health
and
those
of
you
who
are
visiting
us
here
today,
we've
got
a
presentation
on
two
screens
up
here
in
front
of
you
in
respect
of
the
Toronto
overdose
action
plan.
It
is
a
status
report
for
2019.
It
is
that
period
of
time.
I
think
we're
at
a
point
where
it
is
time
to
update
you
as
members
of
the
board
and
I'd
like
to
focus
in
particular
on
the
key
actions
that
we've
taken
over
the
past
year.
B
I
will
also
provide
an
overview
of
a
2019
update
to
our
Toronto
overdose
action
plan.
It's
attached
to
the
staff
report,
which
I
believe
you
should
all
have
in
front
of
you
I,
would
be
remiss
if
I
didn't
tell
you
that
we
are
bringing
forward
this
report
and,
in
particular,
I'm
bringing
forward
this
report
with
very
grave
concerns
around
the
situation
in
which
we
find
ourselves.
B
We
continue
to
be
in
the
midst
of
an
opioid
poisoning
crisis.
It
continues
here
in
Toronto,
it
continues
elsewhere
in
Canada,
and
the
crisis
is
indeed
claiming
thousands
of
lives.
A
recent
statistics
Canada
report,
which
was
written
up
in
the
mass
media,
and
you
may
have
seen
it
yourself,
found
that
life
expectancy
in
Canada
has
actually
stopped
increasing,
so
I
want
you
to
just
think
about
that.
B
This
is
the
significance
of
the
crisis.
That's
in
front
of
us.
It
continues
on
and
it's
something
that
we
must
continue
to
be
vigilant
about
and
I
think
you'll
have
heard
me
say
this
before,
and
you
will
probably
hear
me
say
it
again.
I
do
believe
that
this
is
the
defining
health
crisis
of
our
time.
B
So,
by
way
of
background,
just
to
refresh
everyone's
memory,
the
Board
of
Health
endorsed
the
Toronto
overdose
action
plan
back
in
March
of
2017
and
as
you'll
likely
recall,
the
plan
does
actually
target
actions
towards
each
level
of
government.
We
at
Toronto
Public
Health,
continue
to
work
collaboratively
with
other
divisions
throughout
the
city
with
other
levels
of
government
with
community
and
institutional
partners,
in
furtherance
of
this
action
plan
and
in
furtherance
of
the
targets
that
are
set
there.
B
So
here,
unfortunately,
is
the
rather
grim
situation.
That's
before
us
in
Toronto,
in
2018,
there
continued
to
be
an
alarmingly
high
number
of
deaths
caused
by
opioid
poisonings
for
2018.
Our
preliminary
data
show
that
there
were
about
294
opioid
overdose
deaths,
and
this
is
still
again
why
I
realized
were
into
June
of
2019.
There
are
some
data
that
continue
to
be
confirmed
by
coroner's.
I
would
expect
that
this
number
will
go
up,
but
right
now
our
preliminary
data
suggests
that
the
total
number
of
opioid
overdose
deaths
for
2018
is
just
under
300.
B
So
we
can
see
that
the
increase
in
deaths
has
really
been
unprecedented
in
the
city
started
in
2015
and
continues
on.
Unfortunately,
preliminary
though
I
can't
speak
this
morning,
let
me
try
that
again.
Preliminary
data
for
the
province
as
well
unfortunately
shows
the
same
trend
in
2018
for
Ontario.
There
were
an
estimated
1,300
and
63
opioid
overdose
deaths
and
again
we
expect
that
this
number
will
continue
to
rise
as
the
coroner's
office
continues
and
completes
a
number
investigations
that
are
ongoing.
B
During
that
time,
our
paramedics
colleagues
responded
to
over
1,000,
non-fatal
and
51
fatal
suspected
opioid
overdose
calls
those
are
alarming,
alarming
numbers.
Turning
to
2018,
we
know
that
our
paramedics
colleagues
responded
to
over
3,000
non-fatal
calls
and
146
fatal
suspected
opioid
overdose
calls.
B
Turning
to
the
next
slide,
we
have
a
bit
of
a
graphic
representation
of
drug
overdose
in
Toronto,
and
here
you
actually
see
the
location
of
opioid
overdose,
calls
that
are
attended
by
Toronto
paramedic
services.
These
are
data
on
the
slide
for
2018.
It
actually
shows
the
locations
where
paramedics
made
contact
with
individuals,
which
may
in
fact
be
different
from
the
location
of
the
9-1-1
caller.
As
you
can
see
by
this
graph
or
this
pictorial
representation,
the
highest
concentration
of
calls
were
in
the
downtown
area.
B
So,
let's
reflect
on
that.
These
are
you
know,
unbelievable
numbers
50,000
visits
at
the
work
since
we
opened
reversed
almost
900
overdoses.
In
the
first
four
months
of
2019
alone,
our
staff
responded
at
the
works
to
253
overdoses,
and
I
will
remind
you
again
that
these
numbers
actually
only
represent
the
figures
for
one
supervise
consumption
service
in
the
city
right
our
site
at
the
works.
B
Collectively
these
services
have
had
over
a
hundred
and
six
thousand
client
visits
together.
They
have
reversed
almost
2,000
overdoses
and
looking
only
at
the
first
four
months
of
2019,
they
recorded
just
over
40,000
client
visits
and
almost
850
overdoses
reversed.
These
are
very
significant
numbers.
B
B
All
nine
of
the
existing
services
supervised
consumption
services
in
Toronto,
applied
under
the
new
model
put
forth
by
the
province
called
the
consumption
and
treatment
services
program
and
towards
the
end
of
March.
The
province
announced
the
approval
of
15
such
consumption
and
treatment
services
across
Ontario,
including
six
in
Toronto.
B
Two
of
the
services
that
were
operating
here
in
the
city
were
not
approved.
As
part
of
this
program
and
those
are
the
services
at
Street
Health
and
at
st.
Stephen's
Community
House,
fortunately,
both
programs
continue
to
operate
their
operating.
However,
with
short-term
funding
that
they've
managed
to
put
together
with
the
help
of
variety
of
community
partners.
B
However,
what
is
important
is
that,
in
order
for
them
to
continue
to
operate,
they
need
to
find
sources
of
sustainable
and
ongoing
funding
with
respect
to
the
ninth
of
the
nine
services,
because,
again,
only
six
were
approved
under
the
consumption
and
treatment
services
program
of
the
province.
That
ninth
one
is
our
service
at
Toronto,
Public
Health,
the
works.
Our
application
continues
to
remain
under
consideration
by
the
province.
However,
we
do
continue
to
receive
provincial
funding.
In
the
meantime,.
B
Turning
now
to
the
activities
that
are
happening
across
other
city
divisions,
there
is
a
fair
amount
of
activity
and
there
is
active
participation
in
the
overdose
response
from
other
city
divisions.
So
I
can
tell
you
that
the
majority
of
shelters
and
24-hour
rest
pretended
by
our
colleagues
at
shelters,
support
and
housing
administration
have
staff
on-site
that
are
trained
to
recognize
and
respond
to
overdoses,
and
they
have
naloxone
on-site
as
well.
B
With
respect
to
the
activity,
that's
happening
in
our
parks,
forestry
and
Recreation
Division,
all
of
our
parks,
ambassadors
are
trained
to
administer
in
the
lock
zone
and
they
do
carry
it
with
them,
and
all
of
our
Toronto
Public,
Library
branches
and
locations
are
stocked
with
overdose
emergency
kits
that
include
naloxone,
and
it
is
mandatory
for
all
staff
at
library
branches
to
complete
overdose
training.
So
you
can
see
that
we're
partnering.
These
are
just
some
of
the
examples
in
which
we're
partnering
with
our
other
partners
throughout
the
city
divisions.
B
Turning
now
to
the
subject
of
harm
reduction
services,
we
know
that
having
more
harm
reduction
workers
is
a
critical
component
to
our
response
to
the
overdose
crisis.
I
can
tell
you
that
Toronto
Public
Health
staff
at
the
works
have
expanded
their
outreach
efforts
and
continue
to
do
so
to
reach
more
people
for
struggling
as
part
of
this
crisis.
We
also
continue
to
support
community
based
services
to
expand
their
overdose
prevention
efforts,
including
outreach
through
a
variety
of
activities,
including
the
Toronto
urban
health
fund.
B
Turning
to
the
subject
of
treatment,
we
know
that
access
to
effective
treatment
is
key
and
a
critical
component
of
addressing
the
overdose
crisis.
We
know
that
the
provincial
government
has
committed
or
they've
stated,
their
commitment
for
more
resources
for
treatment,
and
last
year
they
actually
signed
an
agreement
with
the
federal
government.
To
this
effect,
however,
what
we
don't
know
yet
is
how
much
of
this
new
funding
will
actually
flow
here
to
Toronto.
B
B
We
are
also
actively
working
as
Toronto
Public
Health
staff,
with
our
health
and
community
partners
to
try
to
get
managed
opioid
programs
implemented
here
in
our
city.
This
would
certainly
expand
the
range
of
treatment
options
that
are
available
and
help
move
people
out
of
the
toxic
illicit
drug
market
into
a
safer
supply.
I
hope
that
you'll
recall
as
members
of
the
board
that
we
brought
a
report
here
in
February
on
this
subject.
However,
we
have
yet
to
see
provincial
funding
committed
to
these
critical
services.
B
Turning
now
to
the
Toronto
indigenous
overdose
strategy,
there
was
such
a
strategy
that
was
developed
for
indigenous
peoples
in
our
city.
You'll
recall
that
the
board
endorsed
this
strategy
in
February,
just
at
a
very
high
level.
I
don't
want
to
take,
and
not
that
I
ever
could
don't
want
to
take
any
thunder
from
Michelle
who
is
here
to
present
on
this
shortly.
B
But
I
will
tell
you
at
a
high
level
the
recommendations
and
the
strategy
focus
on
prevention,
on
harm
reduction
and
treatment,
and
I
would
like
to
just
say
upfront
that
we
are
committed,
as
Toronto
Public
Health,
to
working
with
our
partners
in
the
indigenous
communities
here
in
our
city
to
implement
these
actions.
But
you
will
hear
about
this
in
far
greater
detail
and
probably
far
more
eloquently
than
I
can
provide
to
you
from
Michelle
sue.
Who
is
the
principal
consultant
on
this
initiative
and
she'll
be
giving
us
a
presentation
very
shortly.
B
So
turning
now
to
the
subject
of
drug
policy,
we
did
host
a
community
dialogue
on
a
public
health
approach
to
drug
policy.
Last
year
we
worked
with
an
expert
advisory
committee
and
with
Ipsos
public
affairs
to
facilitate
a
community
dialogue,
and
we
heard
from
people
throughout
our
city
that
our
current
approach
to
drugs
in
Canada
is
not
working
and
that
drug
use
should
be
treated
as
a
public
health
and
a
social
issue,
not
a
criminal
issue,
so
I
think
I
will
leave
it
at
that.
B
For
that
slide,
I
I
suspect
we're
going
to
continue
to
have
these
conversations
you'll
be
pleased
to
hear
kate
mulligan
just
inform
you
that
there
is
a
meeting
currently
of
the
association
of
local
public
health
agencies.
We
as
Toronto
Public
Health,
sponsored
a
resolution
there
in
respect
of
decriminalizing
drugs
for
personal
use
in
Canada
that
was
approved,
I
understand
at
the
Alpha,
the
association
of
local
public
health
agencies.
B
Annual
general
meeting
just
happening
right
now,
so
we're
continuing
to
advance
the
discussion
on
that
issue
and
we'll
continue
to
do
so.
I
suspect
for
quite
some
time
now,
as
I
mentioned
before,
the
Toronto
overdose
action
plan
was
actually
approved
in
March
of
2017.
It
seemed
like
it
was
an
appropriate
time.
You
know
two
years
in
to
update
the
plan
and
we
wanted
to
check,
in
with
respect
to
our
community
stakeholders,
to
ensure
that
the
action
plan
continues
to
reflect
current
needs.
B
We
actually
gathered
input
through
an
open
online
survey
and
we
actually
held
a
number
of
consultation
groups
with
people
who
use
drugs
very
high
level
summary
and
the
the
action
plan,
and
some
of
the
summaries
are
all
included
in
your
board
board
packages
today.
Just
to
give
you
a
little
sense
as
to
what
we
got
from
those
consultations.
B
First
and
foremost,
there
was
general
agreement
and
general
consensus
amongst
those
who
were
included
as
part
of
the
consultation
that
this
continues
to
be
an
urgent
issue,
an
urgent
public
health
issue
for
this
city
and
clearly
that
more
action
is
needed
urgently
by
all
levels
of
government.
We
are
committed
to
undertaking
the
work
that
we
have
articulated
is
required
in
order
to
address
this
successfully
and
again,
you'll
find
far
more
by
way
of
detail
in
the
community
consultation
summary
which
is
attached
to
the
staff
report
as
part
of
your
package.
B
What
we
heard
were
there
were
key
areas
for
action
and
we
are
actually
advancing
that
you
will
see
those
in
the
recommendations
in
today's
report.
We
need
to
actually
provide
more
service
and
to
better
serve
those
who
are
frankly
underserved
in
our
community,
whether
we're
talking
about
specific
populations
or
geographic
areas
of
our
city.
We
need
to
advance
in
respect
of
managed,
opioid
programs
so
that
people
are
not
forced
into
a
situation
where
they're
having
to
go
to
a
very
toxic
drug
supply
in
the
illicit
market.
B
Other
areas
for
action,
as
described
through
the
community
consultation
or
is
obtained
through
the
community
consultation
and
is
described
in
our
report.
We
know
that
more
efforts
are
needed
to
ensure
overdose
measures
are
available
in
housing
settings.
We
know
that
one
of
the
greatest
risks
is
in
using
a
loan,
so
we
know
that
we
need
more
by
way
of
overdose
measures
in
social
housing.
B
We
heard
that
the
community
wants
to
run
a
public
health
to
focus
on
public
education
and
awareness
about
the
opioid
poisoning
crisis.
We
know
that
people
are
interested
in
us
continuing
to
advocate
on
decriminalization.
We
need
to
reduce
the
impacts
of
criminalizing
drug
use
and
we
need
to
reduce
stigma
and
I
would
suggest
to
you
that
the
feedback
overall
complements
what
we've
currently
got
in
our
overdose
action
plan
in
the
Toronto
indigenous
overdose
strategy
and
provides
us
with
a
great
deal
of
direction
on
the
go
forward
basis.
B
So
with
that
I
realize
I've
taken
up
quite
a
bit
of
your
time.
I
hope
that
that
provides
you
with
a
useful
summary
of
that
which
is
in
the
report
and
in
the
community
consultation
summary
attached.
I
will
turn
it
over
now
to
Michelle
sue.
She
is
here
to
provide
a
bit
of
a
presentation
to
the
board,
and
those
of
you
are
here
in
attendance
as
she
was
hoping
to
actually
provide
this
presentation
back
at
our
February
board
meeting.
B
Unfortunately,
I
think
the
the
weather
gods
were
not
cooperating
with
us
that
day,
but
Michelle
is
here
today
and
she
will
give
that
presentation
on
the
Toronto
indigenous
overdose
strategy
very
pleased
to
have
her
join
us,
and
she
will
provide
you
with
great
detail,
I'm
sure
about
this
very,
very
important
initiative.
Thank
You
mr.
chair,
you.
B
A
C
C
Okay,
where
we
were
is
in
in
February
when
I
was
supposed
to
be
here,
and
there
was
a
snowstorm
and
I
was
stuck
in
my
driveway
sweating.
Well,
my
assistant
was
here
saying
it's
buying
in
Toronto.
It
really
wasn't
fine,
so
this
document
is
dedicated
to
the
indigenous
adviser,
who
sat
quietly
and
shared
that
the
love
of
his
life
had
died.
C
This
document,
so
really
the
reality
of
the
situation
is
I,
went
to
the
people.
I
didn't
go
to
the
researchers.
I
didn't
even
go
necessarily
to
those
that
are
service
providers,
except
for
one
day,
I
spent
an
entire
day
with
24
service
providers
who
validated
everything
that
I
heard
on
the
streets.
Essentially,
most
of
the
people
who
shared
in
these
documents
are
very
intelligent.
Human
beings
who
are
suffering
with
addiction,
and
many
of
these
people
were
homeless.
Many
of
them
were
precariously
housed.
C
So
I
was
able
to
utilize
the
support
of
some
of
the
agencies
in
Toronto
and
some
of
the
navigators
who
are
also
working
with
these
individuals
to
bring
them
into
circle
whereby
they
shared
what
it
was
that
they
felt
they
needed
either
for
themselves
to
live
or
the
people
that
they
cared
about,
so
that
they
would
live
because
some
of
the
people
when
I
asked
them.
What
is
it
that
you
need?
What
do
you
need
so
that
you
can
continue
to
live?
C
They
said
I
don't
want
to,
but
I
said
how
about
the
person
next
to
you
and
that
got
them
thinking.
So
what
it
is
is
caring
human
beings,
you
care
about
the
next
person
who
may
not
in
this
moment
care
about
themselves.
Okay,
what
I'm
trying
to
do
here
is
bring
you
back
to
your
heart
center
to
remember.
There
is
data,
and
there,
with
numbers
that
were
thrown
around
in
this
room
and
I
watched
the
room.
C
I
watched
what
people
were
on
their
phone
I
watched
what
people
were
distracted
and
every
one
of
those
numbers
is
a
human
being
with
a
family
attached
with
a
community
attached.
So
the
impact
of
this
is
rippling
and
it
doesn't
have
to
just
wait
for
somebody
in
our
own
lives
for
something
to
happen
to
them.
In
order
for
us
to
do
something
really
critical
here,
let
me
talk
about
the
pathway.
If
somebody
can,
how
did
I
get
here?
C
I'm
a
facilitator,
I
guide,
strategic
process
with
smart
human
beings,
oftentimes
leaders
and
I
help
them
to
move
forward
through
a
direction
of
something.
In
this
case,
I
happened
to
be
the
facilitator
for
this
reclamation
of
well
being
an
awesome
strategy,
health
strategy
that
we
are
continuing
to
implement,
hey
we're
not
doing
any
readers,
because
I
only
have
ten
minutes.
C
Everything
begins
in
a
circle.
So
let
me
tell
you
about
how
I
got
the
information,
so
I
shared
a
little
bit
about
bringing
together
folks
that
were
indigenous
people
who
were
using
substances
or
had
been
cleaned
for
some
time.
The
longest
person
who
had
was
experiencing
sobriety
at
that
point
was
about
two
months,
so
anyone
who
was
really
really
keen
would
lead
dialog
in
small
circles
and
I've
used
a
gentle
approach.
You
can
keep
going
to
build
their
trust
amongst
themselves.
C
First
and
to
allow
them
to,
let
me
lead
them
through
a
process
which
was
really
going
to
unearth
a
lot
of
stuff.
So
essentially
it
is
where
all
the
reasons
why
it
is
that
you
are
where
you
are,
and
these
folks
would
tell
me
a
lot
of
historical
trauma,
grief,
her
pain,
institutional
injustice.
Perhaps
all
right,
you
just
put
a
mic
in
my
hand,
all
right,
so
I
would
ask
them
that
to
collaborate
with
one.
C
All
of
the
reasons
why
and
are
where
they
are
today
and
then
I
would
gently
say
all
right.
We
got
some
concrete
stuff
here,
but
we
also
have
some
emotional
stuff
and
I'll.
Tell
you
something
that
a
strategy
cannot
do.
It
cannot
address
the
emotion
you
can't
address
someone's
grief,
but
you
can
provide
them
a
service
and
supports
in
order
for
them
to
address
the
grief.
C
C
All
of
the
recommendations
that
are
intelligently
poised
here
came
from
them.
They
bubble
up.
They
know
where
the
gaps
are.
They
know
where
the
services
are
that
are
needed
and
they
know
what
it
is
that
they
need.
Okay,
so
they
began
to
then
disseminate
from
this
group
of
concrete
actionable
items.
Some
of
the
key
recommendations
that
began
to
surface
through
the
report-
that's
not
as
pretty
so.
C
I
would
say
one
of
those
things
where
you
say
what
do
you?
What
do
you
do
to
address
this
kind
of
stuff?
We're
human
trauma
is
really
at
the
base
of
why
people
use
in
the
first
place
right
so
I
was
gonna.
Tell
you
some
stories
about
the
youth
and
some
of
the
brilliant
women
that
I
met.
You'll
read
in
the
back
of
the
document
you
have
I
see
you
have
copies
of
just
the
presentation,
but
I
do
have
11
copies
of
the
overdose
strategy
and
hard
copy.
C
If
you
would
like
it
and
in
the
back,
you'll
read
some
of
the
I
suppose
the
nuances
of
personalities
that
came
out
of
the
circles
and
the
individuals
that
I
met
and
these
women
I
would
say
very
strong
and
a
very
resilient
women
and
a
story
of
why
they
come.
This
is
a
this
photograph.
I
facilitate
and
I
guides,
as
I
said
strategic
process,
but
I
also
work
in
housing,
violence
against
indigenous
women
and
education
all
for
and
on
behalf
of
indigenous
people.
C
So
this
is
why
some
of
them
come
to
Toronto,
because
this
is
where
they
are
born
and
brought
back
to
next
slide.
Please,
okay!
In
the
overdose
strategy,
one
of
the
things
that
came
out
was
this.
There
was
a
focus
on
men
and
there
should
be
a
focus
on
men,
because
I
think
oftentimes
society
expects
that
men
should
be
just
they're.
C
The
strong
ones
and
they
should
be
able
to
just
handle
this
okay,
our
men
are
amongst
men
and
some
of
the
most
vulnerable
are
indigenous
men,
especially
having
identity
taken
from
them
their
roles
taken
from
them.
They
continue
to
see
intergenerational
cyclical
violence
and
vulnerability,
and
our
services
don't
respond
to
them.
C
They
respond
to
children
and
they
respond
to
women,
because
the
women
are
generally
the
mothers
of
the
children
and
that's
where
we
go
to,
because
that
is
what
society
tells
us
we
should
do,
but
I
would
say
if
Toronto,
if
there's
anything
I
can
say
to
encourage.
You
is
to
really
start
to
look
at
the
men
and
focus
on
some
of
those
services
for
them,
because
you
bring
your
man
back
into
their
families
and
they
strengthen
them
and
they
hold
their
women
up
and
they
will
hold
those
children
up.
C
Was
it
alright
brother?
Thank
you
alright.
So
this
was
off
your
slide.
You
probably
have
done
this
before
and
you
actually
have
the
latest
statistics,
so
we
can
move
past
that
slide
and
into
the
next
one
back
to
the
basics.
So
the
report
itself,
it's
back
to
what
I
said,
are
the
basics.
I
was
seeing
a
trend
happening
nationally
with
efforts
to
try
and
address
the
issue
with
some
of
the
research
and
some
of
the
medical
interventions
that
could
happen
and
I
think
that's
important
to
happen
in
tandem
with
the
basic
services.
C
So,
when
I
ask
people
who
are
living
on
the
streets
over
precariously
housed
what
they
needed,
they
said
this.
They
need
a
place
to
shower,
to
wash
their
clothes,
to
get
a
bowl
of
soup
and
for
someone
to
care
about
them
and
hug
them
touch
them.
Show
them
that
they're,
human
and
I
had
shared
a
story,
and
I
will
share
this
one
because
I'm
gonna
start
to
close
this
down
before
I
get
into
the
exciting
news
of
the
interest
for
this
strategy
nationally
and
what
has
occurred.
C
C
C
C
C
Okay,
it
needed
to
have
some
attention
from
those
policymakers
and
those
folks
who
have
access
to
the
budgets
to
see
this
as
a
relevant
document,
not
only
for
Toronto,
but
that
could
be
something
that
could
start
in
other
cities,
okay
going
in
and
asking
those
because
we
say
that
in
the
research
go
and
ask
the
people
who
are
the
ones
who
are
end-users?
It's
not
that
easy.
It's
really
really
not
that
easy,
but
we
did
it
and
I
think
that
it
can
happen
in
other
cities,
and
so
with
this
particular
report.
C
C
Yeah-
and
there
was
also
three
other
agencies-
Thunderbird
foundation
nationally-
there
is
interest
in
this
strategy,
which
means
I
think
the
Toronto
may
be
an
opportunity
where
we
could
see
some
federal
in
intervention
and
supports
in
this
city,
because
you're,
the
only
one
in
the
country.
In
fact,
we've
done
our
research
there's
no
other
indigenous
overdose
strategy
in
the
world.
So
we
know
in
Canada
and
in
Ontario
in
particular,
we're
seeing
such
drastic
changes
to
the
system.
I
see
it
as
an
opportunity.
C
Okay,
Toronto.
You
have
an
opportunity
to
be
the
champion
on
behalf
of
indigenous
specific
supports
and
services,
because
that
happens
to
be
the
conversation
nationally.
Okay,
but
I
will
tell
you
when
those
services
hit
the
ground.
No
worker
is
gonna.
Ask
whether
you're,
polish
or
indigenous,
let's
find
a
way
to
help
the
people
who
are
on
the
streets,
the
majority
of
whom
happened
to
be
my
people
when
I,
walk
by
I,
see
them
they're
visible
to
me.
I
want
to
see
some
action
on
this
Action,
Plan
and
I.
C
Think
the
folks,
the
individuals
I've
been
working
with
at
Toronto
Public
Health,
are
incredible
and
I'm
really
pleased
to
continue
to
support
them.
So
I,
don't
know
how
well
I
did
with.
Let
me
go
to
the
last
slide.
If
I
have
a
last
slide.
Okay,
that's
it!
This
is
all
just
some
okay.
Let's
leave
it
at
that.
All
right
significance
of
gender.
Again
I'll
reiterate
that
in
British,
Columbia
they're
also
focusing
on
the
men.
Okay
do
I
have
any
more
minutes.
Anybody
have
any
questions
comments.
What.
A
A
So,
thank
you.
Michelle
members
of
the
board
will
recall
we
had
a
detailed
discussion
in
February
on
the
indigenous
strategy
and
a
series
of
deputations.
There
was
a
snowstorm
that
day
and
unfortunately,
we
weren't
able
to
hear
from
Michelle
then,
but
we
thought
it
was
critical
that
she
have
the
opportunity
to
bring
forward
the
full
presentation
so
I'm
gonna,
we
have
we're
gonna
hear
from
deput
intz
before
bringing
it
in
for
questions
of
staff.
I
have
Diana
McNally
from
the
Toronto
drop-in
network
is
Diana
here,
don't
see
Diana.
A
A
E
Big
city
in
Canada
is
a
lovely
city,
saw
a
city
of
all
nation
and
we
really
need
to
reach
out
it's
a
native
land,
and
this
is
our
oath,
this
our
anthem.
This
is
something
that
we
all
took
as
a
Canadian
I'm,
not
sure,
because
most
of
you
guys
are
born
here.
I
guess
you
haven't,
took
the
pledge
to
the
Queen.
So
you
don't
know
this.
What
I
did
and
became
a
Canadian
citizen,
97
and
I
respected
since
to
honor
everyone?
E
E
Now
it's
time
for
the
leaders
to
become
a
leader,
there's
a
lot
of
things
that
people
could
overpower
government
and
show
them
what
people
is,
and
people
are
the
government
not
corporation,
it's
good
to
take
from
corporation
to
build
our
own
city
build
our
own
country.
This
is
why
we
let
them
in
not
to
take
away
from
the
table
of
the
people.
E
E
We
have
an
invincible
wall
against
the
u.s.
just
like.
Oh,
they
build
a
physical
wall
against
himself.
We
don't
like
hate
than
we
love
love,
but
today
is
a
day
we're
going
to
show
the
globe
what
a
city
could
do
to
province
to
a
country
to
the
whole
world.
These
are
my
words
what
I
said
trying
to
run
as
a
campaign
individually
independently,
not
taking
a
handout
from
no
one
and
Here
I
am
today,
thank
you,
god,
blessed
father
we're
the
children.
We
have
his
breath
inside
of
us
without
it,
it's
only
death.
E
C
A
A
B
So
through
the
chair,
as
I
alluded
to,
there
are
certainly
many
interested
parties
within
public
health.
There's
conversation
I
know
happening
out
in
the
west
coast
and,
as
I
mentioned
to
the
board
as
part
of
my
presentation,
we
put
forward
a
resolution
at
the
annual
general
meeting
of
the
association
of
local
public
health
agencies
and
that's
an
Ontario
based
agency.
So
increasingly
it
is
entering
the
conversation,
however,
I
think
with
respect
to
what's
happening
at
the
federal
level.
B
My
sense
is
that
there
is
there's
conversation
we
certainly
have
raised
it,
and
I
can
assure
you
that
I
have
raised
it
personally
with
the
federal
bureaucracy.
However,
I
think
at
the
political
level
there
is
still
some
I
would
characterize
it
as
reticence,
but
it
is
an
active
part
of
the
conversation
and
we
are
continuing
to
push
the
point.
The.
D
B
Through
the
chair,
a
very
interesting
question
that
you
asked
and
I
can
tell
you
that,
along
with
some
staff
from
Toronto
Public
Health,
we
had
the
opportunity
to
meet
with
provincial
staff
from
the
Ministry
of
Health
and
long-term
care.
Not
very
long
ago,
the
notion
of
needing
more
service
was
raised.
It
will
continue
to
be
raised
again
and
I
have
been
also
talking
with
academic
health,
science
partners
and
other
healthcare
partners
to
see
what
they
might
be
able
to
do
to
support
us
in
this
regard.
B
D
F
My
understanding
is
that
both
Street
Health
and
st.
Stephen's
house
were
denied
in
their
reapplications
and
that
they
were
told
at
that
time
that
the
province
would
not
be
entertaining
anymore
in
the
City
of
Toronto
any
more
sites.
But
given
the
map
that
you've
shown
us
and
the
need
outside
the
core
and
within
is
have
you
received
that
any
information
so
through.
B
The
chair
I
have
not
received
any
further
information
around
the
interest
that
the
province
has
in
respect
of
expanding.
We
did
raise
it.
The
meeting
was
maybe
a
week
ago
at
best,
if
that,
so
we
will
continue
to
press
that
point
and
talk
about
the
the
need
for
health
care
to
actually
take
place
where
the
need
is
and.
F
B
Through
the
chair,
we've
continued
to
receive
funding
and
I
admit.
I
have
not
had
the
opportunity,
but
I'm
happy
to
raise
that
issue
on
behalf
of
the
other
sites.
When
we
last
met
with
the
Ministry
of
Health
and
long-term
care
representatives,
we
did
not
talk
about
the
funding
for
the
other
sites,
but
certainly
at
my
next
opportunity
to
discuss
that
with
them.
I'd
be
very
happy
to
raise
that.
Thank
you.
G
Has
to
do
more
so
mr.
chair
I
have
several
question
for
the
for
the
medical
officer
heavily
regarding
to
report.
So
with
regard
to
the
follow-up
question
to
Kate,
is
there
any
legal
consideration
that
we
could
consider,
given
the
fact
that
there
to
site
does
not
being
proof?
Is
there
any
legal
consideration
that
we
should
be
considering
asking
the
lawyers
to
look
at
this?
Because
this
we
have
a
city
crisis?
We
have
vulnerable
people,
don't
have
right
and
we
that's
a
sport
advocating
for
their
health
care.
So
is
there
any
conversation
for
the
staff?
Mr.
G
B
Through
the
chair,
not
being
a
legal
expert,
it's
challenging
for
me
to
answer
that
question.
That
being
said,
we
have
pursued
all
kinds
of
opportunities
and
have
opened
up
discussions
both
at
the
federal
level
and
where
there
is
some
willingness
at
the
provincial
level
as
well.
Clearly
we're
in
regular
communication
with
our
provincial
bureaucratic
partners.
G
So
I
know
in
the
report,
mr.
chair,
through
you
to
the
medical
office
of
Health,
that
there's
recommendation
dealing
with
the
advocacy
work
dealing
with
advocate
evening
to
the
federal
government.
So
is
there
works
between
yourself
as
well
so
chair
since
the
chairs
been
so
vocal
about
our
recent
budget
crisis
to
meet
with
all
MP
in
the
City
of
Toronto?
Because
now
that
we
are
in
to
the
middle
we're
starting
with
the
federal
election
cycle?
G
B
Through
the
chair,
we
certainly
have
been
pushing
as
much
as
possible
with
respect
to
anyone
who
will
listen,
and
that
includes
the
federal
MPs
who
represent
toronto
writings.
But
I
will
tell
you
that
the
vast
majority
of
our
conversation,
because
we
feel
that
that's
where
we
can
most
advance
the
conversation-
happens
in
concert
with
our
federal
bureaucratic
partners,
both
at
Health
Canada
and
at
public
health
agency
of
Canada
I'll.
Leave
it
to
you,
mr.
chair
I'm,
not
sure
I
think
there
were
some
questions
that
were
specifically
with
respect
to.
A
F
C
Is
this
cool,
yeah,
okay,
I
think
your
hope
with
that
particular
one
is
going
to
be
with
federal
intervention
and
supports
testing
and
indigenous
specific
consumption
site
here
in
Toronto
I
know,
there's.
You
know
Vancouver's
way
ahead
of
us
on
this
conversation,
and
they
just
are
right.
It's
difficult
because
we
have
these.
C
What
Toronto
has
is
you
have
a
foundation
of
support
services
and
indigenous
specific
support
services
and
a
population,
and
that's
what
the
federal
government
will
be
looking
for
and
I
say,
this
could
be
a
test
site
in
terms
of
what
can
happen
if
you
do
intensive
on
the
ground
in
interventions
and
supports.
At
this
point,
utilizing
federal
supports
there's
at
least
four
specific
bodies
interested
in
this
strategy,
how
they
tie
in,
and
we've
been
given
access
to
individuals
who
have
some
pots
of
money.
So
let's
talk
about
that.
C
So
this
board
is
the
creator
of
a
you
birth,
the
Toronto
urban
health
fund,
the
Toronto
urban
health
fund.
Now
we'll
have
I,
don't
know
whether
it's
come
to
you
yet,
but
an
indigenous
specific
stream
I
think
in
any
funding
that
you
provide
to
indigenous
or
non
indigenous
agencies,
there
should
be
accountability
mechanisms,
but
let
me
say
that
there
for
indigenous
specific
services,
they
are
in
competition
with
their
non
indigenous
service
providers,
whose
provide
service
to
indigenous
people.
Okay,
and
that
is
because
that's
necessary
and
that's
where
the
people
are
going.
C
Okay,
but
from
an
accountability
perspective.
How
many
of
these
agencies,
billed
in
the
term
indigenous
or
have
indigenous
specific
in
their
reporting?
Yes,
but
in
their
strategic
plans,
was
this
an
afterthought
because
funding
came
down
or
is
this
something
that
happens
as
part
of
your
planning
processes
as
you
move
forward?
Are
you
looking
to
target
supports
to
indigenous
people
and
how
many
agencies
are
you
connecting
with
other
indigenous
specific?
That
means
the
human
beings
that
you're
talking
to
our
indigenous
and
the
folks,
you're
partnering
with
our
indigenous,
so
accountability
comes
with.
C
Let
me
see
how
you
planned
for
this.
Let
me
see
your
reports
and
really
focusing
on
whether
or
not
they
are
looking
to
recruit
indigenous
staff,
even
though
their
mandate
may
not
be
specifically
staffed.
So
it
happens
on
the
front
end
middle
and
tail
end
of
this.
We
often
just
look
at
the
tail
end
when
we're
looking
at
reporting
and
accountability,
but
accountability
begins
right
at
the
very
beginning
of
a
conversation,
yeah.
C
F
F
I
think
we
have
a
hundred,
and
ten
secondary
schools
and
I
also
want
to
share
that
youth
and
students
are
really
engaged
and
really
fully
understand
the
crisis
that
this
is
and
they've
been
contacting
their
trustees
to
ask
for
more
action
to
and
with
the
miss
schools.
So
it's
it's
important
to
note
that
everyone's
in
this
together
in
our
city.
That's
all
thanks.
A
A
I
would
like
to
thank
our
staff
in
Toronto,
Public
Health
and
the
Toronto
Drug
Strategy
Secretariat,
as
well
as
the
frontline
workers
within
Toronto,
Public
Health
and
in
a
number
of
the
community
agencies
and
I
think
the
work
that
they
do
not
only
saves
lives,
but
it
does
so
in
a
manner
that
shows
dignity
and,
as
Michelle
Sioux
spoke
about,
also
demonstrates
kindness
and
love
to
the
clients
who
use
those
services.
It
has
been
two
years
since
we
endorsed
the
overdose
action
plan
in
March
of
2017.
A
He
saved
lives
every
single
day
and
even
with
all
his
knowledge
and
all
his
expertise,
he
was
not
immune
from
passing
away
from
a
preventable
death
and
so
I'm
tired
of
those
memorials.
I
I'm
deeply
proud
that
in
this
city,
we
have
in
part
stemmed
the
tide
of
this
epidemic,
but
it
has
not
abated,
and
when
you
hear
that
we've
had
in
nineteen
months,
50,000
client
visits
to
the
works
and
845
overdoses
reversed.
We
can
and
should
take
deep
pride
in
the
work
of
city
staff
in
their
role
in
in
confronting
this
epidemic.
A
But
we
know
that
it
is
not
abated,
and
so
the
recommendations
in
front
of
us
for
all
levels
of
government
are
to
scale
up
the
work
and
to
continue
to
scale
aboard
untreated
on
prevention
and
on
harm
reduction
and
yeah.
I
I
often
remind
myself
that
if
this
was
anything
other
than
drugs
and
illicit
substances,
governments
would
have
solved
this
crisis
a
long
time
ago.
A
And
so,
when
we
you
hear
from
the
medical
officer
of
health,
that
for
the
first
time
in
four
decades
that
life
expectancy
in
Canada
has
gone
down
because
of
the
overdose
crisis.
I'd
asked
us
all
to
let
that
sink
in
and
and
to
grieve.
And
then,
if
you're
like
me,
to
get
really
angry
and
to
demand
better.
And
so
our
resolve
will
continue
at
this
board
and
in
the
city
to
demand
better
and
to
provide
more
services,
and
one
day
this
epidemic
will
stop.
A
Is
unanimous,
thank
you.
We're
now
going
to
move
towards
our
next
item
on
the
agenda,
which
is
item
7.3,
fetal
alcohol
spectrum
disorder
activities
to
address
key
priorities.
We
have
a
deputy
listed
and
so
I
would
like
to
invite
Sharon
Richards
from
the
Toronto
fetal
alcohol
spectrum
disorder
network
to
come
forward.
Sharon.
It's
always
a
pleasure
to
see
you
I'm
sorry,
I'm!
No
longer
your
counselor
that
that
claim
now
belongs
to
councillor
Leighton.
H
Good
morning,
everyone
and
this-
the
previous
conversation
I
would
like
to
suggest-
is
a
wonderful
segue
into
a
conversation
about
fetal
alcohol
spectrum
disorder,
which
is
more
commonly
known
as
FASD,
because
I
couldn't
help,
but
ask
myself
how
many
of
the
people
were
talking
about
who
are
struggling
with.
Addictions
are
also
struggling
with
FASD,
so
that's
it.
I
would
like
to
begin
my
presentation
by
reading
a
note
recently
shared
with
me
by
the
mother
of
a
14
year
old
son
diagnosed
with
FASD.
H
Some
of
you
know
me
some
of
you
think
you
know
me
some
may
not
care
to
know
me,
but
regardless,
let
me
tell
you
who
I
am
I,
am
a
wife,
a
very
proud
mom
of
two
amazing
young
men
who
chose
me
to
be
their
parent,
a
pet
owner
and
a
business
owner
pretty
standard
stuff.
I
am
a
fierce
advocate
a
volunteer,
an
educator,
an
advisor
a
nurse
a
doctor,
a
referee
I
am
the
one
who
stood
between
conflict
conflict
in
order
to
heavy
innocent,
not
hurt.
H
I
am
the
one
who
learned
the
mental
health
and
judicial
system
quickly
and
how
unfair
and
underfunded
it
truly
is.
But
what
most
of
you
don't
know?
I
am
the
parent
of
a
young
man
with
FASD.
I
may
not
like
him
some
days,
but
I
love
him
to
bits
regardless
of
the
troubles
and
would
not
have
done
life
differently.
Days
are
hard
and
at
times
seem
never-ending.
People
don't
understand,
and
I
am
looked
at
as
a
bad
parent,
always
judged,
but
I
know
the
truth
and
that's
all
it.
Matters.
H
I
have
lived
a
lifetime
of
sadness
in
the
last
few
years,
but
get
great
joy
out
of
what
most
would
seem
trivial.
When
my
son
remembers
what
day
of
the
week
it
is
I
am
so
proud
or
when
the
school
didn't
call.
It
was
reason
to
celebrate.
I've
been
hit,
punched
bit,
kicked
battered
and
bruised
and
called
every
name
imaginable
in
both
public
and
private,
and
always
having
to
remember
that
every
day
is
a
new
day,
but
life
is
good.
H
I
have
the
boys,
my
husband,
my
animals,
a
roof
over
my
head,
I,
don't
want
pity
or
sad
emojis.
All
I
want
from.
You
is
for
you
to
make
just
one
person
aware:
please
do
not
drink
while
pregnant
or,
if
you
are
thinking
of
getting
pregnant,
FASD
is
totally
preventable
and
that
was
written
by
Laurie
M.
H
So
the
Toronto
our
network,
the
Toronto
faz
network,
has
submit
that
written
documents
telling
you
who
we
are,
what
we
do
and
what
we
recommend
the
city
can
do
to
better
serve
the
city's
children,
youth
and
adults
affected
by
FASD
and
those
who
care
for
them.
We,
you
urge
you
to
not
only
read
these
documents
but
to
really
give
strong
consideration
to
implementing
the
recommendations
in
them.
So
in
the
few
minutes
I
have
remaining,
which
is
not
many
I
would
like
to
leave
you
with
these
key
messages
related
to
FASD.
H
First
of
all,
it
is
a
brain-based,
a
neurodevelopmental
disability
resulting
from
prenatal
exposure
for
a
fetus
to
alcohol,
and
it
impacts
physical
behavioral,
emotional,
social
and
cognitive
functioning.
It
is
the
leading
cause
of
developmental
disabilities
in
North
America,
and
it
is
now
believed
to
be
at
least
as
if
not
more
common
than
autism.
H
People
effect
it
can
be
of
average
to
above-average
intelligence,
so
they
are
assumed
to
be
able
to
behave,
perform
and
achieve
like
everyone
else,
whereas
in
reality
they
simply
cannot
because
of
their
disability
everyday.
They
experience
failure
when
they
are
expected
to
live
up
to
expectations
that
are
unrealistic
and
do
not
take
into
account
their
damaged
brains.
H
Fasd
is
preventable,
but
it
is
not
curable
so
those
effect
it
will
require
lifelong
support
and
because
the
disability
impacts
one's
adoptive
and
executive
executive
functioning,
those
affected
in
all
likelihood
will
not
manage
to
live
into
independently,
but
they
can
successfully
with
support
live
independently.
This
maturity
is
a
hallmark
of
FASD.
H
The
rule
of
thumb
is
that
those
affected
function
at
a
level
about
half
of
their
chronological
age,
that
has
significant
implications
for
service
and
when
service
systems
fail
to
understand
and
accommodate
the
disability,
it
is
harmful
to
those
living
with
FASD
and
leads
to
poor
service
outcomes.
Those
affected
are
beginning
to
demand
to
be
heard
and
involved
in
making
decisions
about
themselves.
The
campaign
nothing
about
us
without
us
reflects
this
demand.
The
real
FASD
experts
among
us
are
those
living
with
the
disability
and
those
caring
for
them.
H
H
We
would
be
wise
to
listen
to
them
to
what
they've
learned,
so
they
can
teach
us
how
to
better,
serve
and
support
them,
and
the
good
news
is
that
when
children,
youth
and
adults
affected
by
FASD
their
disability
recognized,
can
access
appropriate
assessment
and
diagnostic
services
can
access
throughout
their
lifetime
services,
resources
and
supports
that
understand
and
accommodate
their
disability
are
appropriately
supported
to
live
independently
rather
than
dependently
and
have
their
strengths,
identified
and
nurtured.
They
will
experience
positive
service
outcomes
and
lead
full
and
productive
lives.
I'm.
H
H
Okay,
Joe
bringing
the
motion
forward
and
I
want
to
say
Bravo
to
all
of
you
on
the
Toronto
Board
of
Health
I.
Don't
know
how,
if
you
have
any
appreciation
for
how
important
having
this
conversation
today
at
the
City
of
Toronto
as
a
public
discussion,
is
for
the
those
affected
and
for
those
who
care
for
them
because
they
feel
like
they're
alone
and
not
heard
so
Bravo
to
you
all
and
go
Raptors.
Go.
A
H
It
was
created
or
established
in
about
2005,
it's
had
its
ups
and
downs,
but
at
the
current
moment
there
are
about
43
members
of
the
network.
They
are
parents
and
caregivers,
they
are
service
providers.
They
are
some
representative
from
the
ministry
of
community
of
children,
community
and
social
services,
and
then
there
are
some
community
volunteers
like
myself
and.
H
One
of
the
documents
that
I
have
passed
on
to
Julie
is
a
background
on
who
it
is
and
what
we've
accomplished
and
we've
done
a
lot
over
the
course
of
the
year,
so
we're
very
active
now.
Our
four
priorities,
just
established
in
April,
will
be
prevention
and
awareness,
supportive,
housing,
big
need
for
people
with
FASD
intervention
and
support
which
will
cover
a
case
management.
H
A
Some
of
those
so
supportive
housing
prevention,
access
to
services.
Some
of
the
priorities
you
mentioned
yeah,
you
know
cross
different
jurisdictions.
So
can
you
give
me
a
cent
on
FASD
specifically
about
what
networks
may
exist
or
partnerships
working
across
levels
of
government,
specifically
on
FST,
because
we're
looking
here
at
the
City
of
Toronto,
where
our
part
to
play
is
so
how
do
what
are
the
current
forms
of
partnership
or
relationships
with
other
levels
of
government?
And
are
you
aware
of
any
with
the
city
currently
well.
H
H
So
we
attended
that
then
I
think
it
was
a
major
April
I
can't
remember:
we've
had
someone
from
we've
had
a
conversation
with
someone
from
your
shelter
system,
so
we're
we're
trying
we're
making
connections
we're
always
connected
to
the
provincial
FASD
body,
and
so
those
are
the
connections
that
we
with
the
city.
Okay,
no.
F
You
so
much
for
your
presentation,
I'm
interested
in
learning
a
little
bit
more
if
you,
if
you
can
tell
us
about
how
diagnosis
happens
and
at
what
point.
In
what
age
and
stage
it's
best
to
happen,
and
if
you
are
aware
of
experienced
any
trends
and
the
barriers
that
exist
to
those
diagnoses,
alright,.
H
So
let
me
try
to
remember
all
those
questions.
First,
I
just
wanna
say
an
early
diagnosis
with
an
appropriate
intervention
plan
is
absolutely
critical
and
crucial
in
supporting
and
helping
people
affected
by
FASD,
because
it
will
prevent
some
of
the
later
disabilities
that
that
are
associated
with
the
with
FASD,
the
the
as
I
understand
it.
It's
usually
better
to
wait
until
a
child
is
above
four
years
old
or
older.
H
Our
well
provide
diagnostic
services
for
indigenous
community
and
a
diagnosis
is
a
is
difficult
to
obtain
and
it's
difficult
to
obtain,
because
you
need
a
confirmation
that
mum
drank
during
pregnancy.
That
is
very
difficult
information
to
get.
First
of
all,
we
have
all
the
stigma.
That's
attached
to
women
drinking
period,
let
alone
drinking
when
they're
pregnant,
so
women
are
very
reluctant
for
very
good
reasons
to
come
forward
and
and
acknowledge
that
they
drank.
H
Secondly,
our
service
providers,
who
are
seeing
women
at
the
intake
level
and
in
our
service
agencies,
are
not
asking
the
right
questions,
so
they
need
everybody
needs
to
be
trained
about
FASD
and
about
how
you
ask
those
questions
in
a
way
that
you
can
get
the
information
you
need.
So
we've
had
some
success
if
there's
a
family
member
or
someone
who
knew
the
mom,
who
can
say
yes,
mom
struggled
with
alcohol
addiction
and
drank
during
the
pregnancy
and
we've
had
some
diagnostic
service
as
well.
H
Now
some
accept
that,
but
we
just
don't
the
services,
aren't
there
to
be
honest
with
you
Surry
place
for
a
long
time,
because
it's
their
mandate,
they
serve
people
with
developmental
delays.
There
was
an
IQ
requirement
for
children,
youth,
but
they've
just
recently
done
away
with
that,
which
is
a
wonderful
piece
of
information.
So
now
any
child
can
be
referred
for
diagnosis,
so
the
if
you
had
an
IQ
of
70
or
more
you
weren't
eligible
for
their
service.
If
they've
done
away
with
that,
but
that's
that
that
was
their
mandate.
H
That
I
mean
that
was
that
their
agency
was
set
up
to
serve
that
population.
They
are
also
doing
wonderful
work
in
providing
adult
diagnosis,
did
I,
get
all
your
questions
or
did
I
miss
one
okay,
but
it's
it's
really
important,
so
training
for
everybody
in
all
of
your
services
here
in
the
city
and
Joe.
Just
so
you
know,
I've
also
submitted
the
report.
We
wrote
for
the
Board
of
Health
to
Julie,
so
I,
don't
know
if
you've
got
it,
but
hopefully
you'll
get
it
at
some
point.
I
will
be.
H
A
Just
some
members
of
the
board
know
you'll
see
from
the
Toronto
fetal
alcohol
spectrum
disorder,
coordinating
Network
a
communication
that
includes
a
report
that
is
being
written
for
our
board.
You
have
that
package,
any
other
questions
for
sharing,
okay,
seeing
none
we're
gonna
bring
this
into
committee.
Thank
you.
Thank
you.
Are
there
any
other
members
of
the
public
who
wish
to
depute
on
this
item?
A
I
I
We
tried
to
support
him
at
home
about
two
years
ago,
because
there
was
no
housing
and
he
lost
his
housing
and
he
was
the
big
man.
We
didn't
mind
him
living
on
the
street.
Long
story
short
I
almost
lost
my
daughter
because
of
it
husband
and
I
have
been
struggling
because
we
can't
work
looking
after
him
and
our
nerves.
I
I
My
son
has
fetal
alcohol
spectrum
disorder
and
my
daughter
does
not,
and
she
said,
I've
lost.
My
friends.
I've
lost
my
job
I'm
about
to
lose.
My
housing
I've
lost
my
husband,
I'm
alone,
looking
after
this
child
that
I
can't
let
go
because
they
deserve
something
and
you've
got
to
do
something.
This
is
ridiculous.
Canada
is
a
developed
country,
we're
only
as
strong
as
our
weak
and
we're
just
conveniently
ignoring
them.
I
see
ads
for
these
opioid
overdoses
and
I'm
thinking
how
many
of
them
are
fasting.
I
Why
can't
we
get
ads
out
there
to
stop
people
from
it?
Take
a
second
look
at
drinking
they're
pregnant
one
of
the
western
provinces.
When
you
go
into
the
bar,
they
have
condom
dispensers,
they
have
tampon
dispensers
and
they
have
pregnancy
tests.
We
are
so
far
behind
honest
to
god.
You
do
not
want
the
life
of
someone
put
fatty
and
you
just
have
no
idea
the
cost
that
it's
that
it's
taking
on
the
society.
We
are
no
longer
paying
into
the
coffers.
I
Our
family
is
drying
on
the
coffers.
Now
you
have
no
idea
how
expensive
this
is
because
you're
not
looking
at
their
overall
costs,
it's
so
easy
to
prevent
fazzy,
because
most
of
the
people
who
are
drinking
are
not
addicts.
They're,
not
alcoholics,
they're
next
door,
they're
down
the
street
they're
in
the
next
block,
faz
D,
is
not
born
of
addiction.
Faz
D
is
born
of
ignorance
and
unawareness.
I
I
I
20
years,
faz
world's
been
trying
to
draw
attention
to
this
thing
and
nothing's
happening
network
12
years
12
years
and
nothing
I'm
in
touch
with
Ford's
office,
and
they
come
back
with
said
what
we've
only
been
in
a
year
and
I
said
that
we've
been
working
on
this
for
twenty
years.
It
means
that
we,
you
had
it
in
your
bailiwick
three
years
before
the
Liberals
took
over
I
met
with
mr.
Ford.
Personally,
he
was
unaware
that
it
was
as
d-day.
I
He
was
unaware
that
it
was
fast
that
it
was
September
as
fast
d
months,
they've
had
conversations
with
people
from
Ford's
office,
one
for
an
hour
and
when
I
tried
to
reach
her
again,
the
number
was
disconnected
so
I
went
to
my
MPP
yet
again,
who
have
been
working
with
for
over
four
years
and
out
another
number
to
phone
to
find
out.
It
was
disconnected
and.
I
Deputy
mayor
about
the
situation
and
nothing
seems
to
be
happenin,
they
actually
voted
against
shelters.
I.
Only
reason,
I
hope
that
they
voted
against
increasing
the
shelter's.
Temporary
shelters
is
because
they're
hoping
that
somebody
is
going
to
make
permanent
once
please,
please,
please.
You
have
no
idea
the
ripple
effect
of
this
nasty
thing
that
can
be
rear-ended.
We
need
awareness.
Thank
you.
Thank
you.
Thank.
A
G
Still
remember
the
FASD
item
on
this,
for
when
councilor
Kate
Gardner
was
the
counselor
here,
and
this
was
the
same
issue
so
now
we're
20
years
into
the
FASD.
We're
still
talking
about
it
as
a
more
pressing
mr.
chair
I
want
to
say
thank
you
to
the
staff
for
this
update
dealing
with
the
FASD.
The
report
I
think
there's
more
question
that
need
to
be
asked
dealing
with
the
whole
issue.
We
just
heard
the
two
deputy
and
dealing
with
the
education
and
especially
with
their
school
boards.
I
can't
stress
enough
so
through
you,
mr.
G
chair,
can
I
get
and
so
dealing
with
the
prevention
and
the
policy
piece
as
it
relate
to
the
TDSB
to
Toronto
Catholic
District
School
Board,
because
we
heard
consistently
there's
enough
data
that
prevention
is
an
ounce
of
prevention.
But,
more
importantly,
what
is
the
staff
doing
in
support
their
education
and
awareness
to
support
the
education
community
because
I
don't
see
it
in
the
report,
particularly
the
fact
that
I
remember
when
I
was
at
the
province.
The
Select
Committee
on
adult
with
disability
has
a
huge
section
dealing
with
the
education
and
winner.
So
through
you,
mr.
G
B
Through
the
chair,
thank
you
for
the
question.
At
a
very
high
level,
we
have
a
healthy
schools
and
substance
misuse
program
as
one
of
our
components
of
Public,
Health,
programming
and
clearly
alcohol
and
discussion
is
one
of
the
substances
that
will
be
actively
discussed
as
part
of
the
education
program
that
we
have.
B
I
would
also
suggest
to
you
that
we
are
actively
engaged
on
alcohol
policy
writ
large
beyond
education
at
the
school
I
think
there
is
a
significant
amount
of
work
that
should
be
done
in
the
prevention
realm
that
actually
has
to
do
with
policy
and
you'll
be
hearing
as
a
board
about
this
at
an
upcoming
board.
Meeting.
Okay.
G
Thank
you
so
my
second
question
was
to
charity
to
the
medical
office
of
Health.
With
respect
to
the
whole
issue
of
our
strategy.
Is
there
conversation
given
that
we
just
passed
a
provincial
budget?
There
will
be
proliferation
of
the
sale
of
alcohol
and
what
is
this
stuff
is
about
to
undertake
I
know
the
problems
doesn't
like
I
said:
do
any
advocacy
work,
however,
we
got
to
do
advocacy
work.
G
You
were
going
to
get
to
get
to
the
bottom
of
this
issue,
so
what
measures
is
the
stuff
is
going
to
be
considering
in
terms
of
awareness,
I,
think
it's
more
than
just
a
poster
in
the
liquor
store
or
than
the
bars.
What
conversation
we're
having
in
planning
piggybacking
is
in
campaign
that
we
will
be
considering
in
the
fall
so
through.
B
The
chair,
I
would
suggest
you
that
there
are
certainly
some
awareness
activities
that
we
will
participate
in,
but
I
I
would
put
to
you
and
to
the
rest
of
the
board
that,
in
fact,
I
think
the
policy
levers
are
the
most
significant
ones
we
have
at
our
disposal
right
now.
So
with
respect
to
the
the
province
is
the
is
the
key
decision
maker
in
respect
of
alcohol
policy.
Right,
as
is
you
know,
that's
the
case
here
in
Ontario
and
you'll
see
that
throughout
other
jurisdictions.
B
We
know
that
our
current
provincial
government
is
making
a
lot
of
decisions
in
respect
of
alcohol
policy.
I
can
tell
you
that
I
personally,
as
a
member
of
the
Council
of
medical
officers
of
health
of
this
province,
actually
had
the
opportunity
to
speak
with
the
Ministry
of
Finance
representatives,
specifically
on
this
subject
and
gave
them
some
very
clear
advice
on
the
public
health
concerns
and
issues
that
we
saw
with
the
current
direction
that
is
being
taken
by
the
province
on
alcohol.
That
was
the
opening
salvo.
B
There
is
still
more
conversation
that
we're
having
were
actively
pursuing
on
the
policy
front
and
I,
as
I
mentioned
in
the
answer
to
the
earlier
question,
we
will
be
bringing
forward
a
report
to
this
board
on
the
activities
that
we
foresee
as
key
in
ensuring
that
we
mitigate
the
public
health
risks
associated
with
alcohol,
education
and
awareness
is
one
component
of
that
I
think
there
are
other
activities
that
I'm
sure
you'll
find
very
interesting
that
we'll
be
putting
forward
as
well.
Thank.
D
You
mr.
chair,
my
question
is
about
other
programs
are
also
connected
with
FASD
programs,
so
things
like
mother
risk
I
know
we're
just
cut.
I
was
wondering
if
you
could
kind
of
give
an
overview
of
what
sorts
of
cuts
have
been
happening
in
this
area
right
now,
and
is
there
anything
we
need
to
be
doing
because
I
know,
mother
risk
I
think
also
did
FASD
working.
That's
now
non-existent.
So.
B
Through
the
chair,
that's
a
program,
that's
actually
outside
of
our
scope,
it's
funded
as
part
of
the
hospital
network
as
I
understand
it,
I'm
going
to
turn
over
to
our
staff
to
see
if
they
have
specific
information
on
that.
If
we
don't
have
information
today
happy
to
bring
that
back
to
the
board
so.
D
Through
the
chair,
as
a
deputy
I
mentioned,
there
were
previous
program,
st.
Mike's
and
other
risk
that
work
HUD.
There
are
too,
as
you
note
in
the
report
that
are
available,
they're
very
pressed
for
the
volume
that
they
deal
with,
and
those
are
programs
that
are
available
for
screening
or
diagnosis
and
the
follow
up
programs
again
as
a
deputy
mentioned,
are
a
range
of
things
all
the
way
from
social
housing
to
various
kinds
of
coping
mechanism.
D
Programs,
those
aren't
our
purview,
but
what
we
have
done
working
over
the
years
with
this
particular
advocacy
group,
is
help
them
access.
The
city's
huge
plans
around
housing
that
have
now
grown
citywide
and
are
looking
very
deeply
at
the
supportive
programming
that's
offered,
as
well
as
the
location
in
the
bricks
and
mortar.
So
there's
a
lot
of
hope
there,
because
the
city's
taken
a
real
citywide
approach
to
looking
at
this,
with
FDA,
with
shelter,
support
and
housing
and
looking
at
it
across
the
continuum.
So
I
think
it's
been
a
long,
hard
struggle.
D
We
certainly
appreciate
that
and
have
been
with
this
group,
but
there's
some
really
positive
hope
in
the
work
that's
going
on
on
the
ten-year
housing
and
homelessness
plan,
that's
going
to
come
forward
to
council
in
the
fall,
as
well
as
with
the
overall
housing
strategy.
So
we
have
been
working
hard
to
connect
this
group
to
those
folks
who
are
actually
able
to
have
direct
within
the
mandate,
both
the
programming
and
the
housing
issues.
J
A
A
And
this
is
and
there's
a
third
it
had
been
advanced
circulated,
but
there's
a
third
which
is
the
third
to
ensure
that
this
report
is
forwarded
to
all
the
school
boards.
I
didn't
list
them
individually,
because
that
we
wanted
to
include
the
French
and
Catholic
and
English
and
others
one
piece
specifically
related
to
Toronto
Public
Health
on
prevention
and
awareness
and
the
second
on
supportive
housing.
I.
A
A
In
today's
the
report
is
that
I
certainly
recognized
that
we
have
a
stronger
role
to
play
in
our
city,
whether
it's
on
prevention,
access
to
services,
housing,
be
it
in
shelters
or
supportive
housing
to
give
prominence
to
response
as
necessary
to
FST,
but
also
to
use
this
as
a
moment
to
push
prod
and
raise
awareness
for
other
levels
of
government.
And
the
staff
recommendations
in
here
are
to
bring
this
to
the
departments
that
deal
with
service
deliveries.
So
whether
that's
Social,
Development
and
finance
administration
or
shelter,
support
and
housing
administration
on
the
supportive
housing
fronts.
A
And
so
there
is
much
more
to
be
done
on
this
I'm
glad
that
staff
I
want
to
thank
staff
for
bringing
this
board
here.
But
this
is
going
to
be
a
conversation
that
will
carry
on
as
we
look
to
scale
up
our
work
and
to
give
prominence
where
it
deserves,
and
with
that
I'll
conclude
my
remarks
so
those
are.
Is
there
anybody
else
to
speak
on
this
item?
G
Laer
accessing
to
service
is
a
challenge.
They
want
to
make
sure
not
just
the
housing
piece
that
we're
concerned
about
the
supportive
vulnerable
community,
but
also
Parks
and
Recreation
staff,
that
aware
of
these
challenges,
because
they
have
children
with
fasds
in
those
program
how
to
support
those
stuff
to
ensure
that
they
don't
get
discriminated
or
being
asked
to
put
aside.
So
we
need
to
make
sure
that
our
frontline
staff
across
all
department
is
aware
of
these
young
people
or
seniors
or
adults.
G
With
this
particular
diagnosis,
I've
been
properly
supported,
but,
more
importantly,
to
make
sure
the
future
reporting
from
the
staff
on
this
particular
item.
That
tells
us.
What
can
we
do
more,
because
this
this
issues
not
going
to
go
away?
In
fact,
it
is
a
point
of
more
challenge
than
actually
the
autism
file,
because
there's
a
huge
awareness
about
autism,
there's
very
few
discussion
about
FASD,
so
future
reporting.
Mr.
chair
about
this
particular
issue
of
module
who
has
completed
this
program
but,
more
importantly,
ensure
frontlines
that
are
supported
so
that
they
can
forward
to
continued
support.
A
Thank
you
any
other
speakers.
Seeing
none
can
we
take
the
amendment
and
the
staff
recommendations
as
a
package.
All
right,
I'll
ask
for
all
those
in
favor
of
adopting
the
amendments
and
staff
recommendations
as
a
package
any
opposed,
seeing
none
that
carries
unanimously.
Thank
you.
Our
final
item
on
the
agenda
is
item
7.9.
This
is
the
Board
of
Health's
meeting
procedures.
This
is.
We
had
deferred
this
once
before
many.
J
Thank
you
good
morning,
everyone,
my
name,
is
Jennifer
Forks
I'm,
the
manager
of
the
committees
and
boards
team
in
the
City
Clerk's
office
in
the
Secretariat
unit,
I'd
like
to
thank
the
chair
and
the
medical
officer
Hall
for
the
invitation
to
come
speak
to
you
this
morning
about
the
board's
meeting
procedures
and
the
board's
meeting
procedures
were
adopted
back
in
January
of
2019,
and
since
that
time
a
few
new
members
have
been
appointed
to
the
board.
However,
the
board
has
also
met
about
four
times
since
that
time,
and
so
I
expect.
J
My
presentation
will
be
more
of
a
recap
and
a
confirmation
that
you
are
following
the
board's
meeting
procedures
rather
than
any
new
information,
so
the
board's
procedures
can
be
found
in
bylaw
to
2019.
They
are
linked
both
in
the
description
of
the
board
in
our
city
of
Toronto
team,
our
system
and
can
be
also
found
online
as
you've
experienced
through
this
meeting
and
many
other
meetings.
There
is
a
sort
of
regular
rhythm
to
the
way
that
boards
consider
matters
as
part
of
their
order
of
business.
J
So
I
won't
go
over
that
since
I
watched
it
happened
this
morning
and
it
looked
like
it
went
very
smoothly
as
you've
experienced
on
most
the
items
in
today's
debate.
They
they
also
father,
follow
a
rather
predictable
process.
Well,
there'll
be
a
presentation,
then
hearing
from
the
public,
the
board
members
can
ask
questions
of
the
members
of
the
public
who
speak.
J
We
issue
your
minutes
and
one
of
the
key
services
that
we
do
provide
is
that
we
assist
members
with
the
wording
and
writing
of
their
motions.
This
service
is
offered
on
a
confidential
basis
to
all
members
of
the
board,
and
we
also
provide
procedural
advice
to
the
chair,
but
obviously
the
chair
or
the
vice-chair
will
issue
any
rulings.
If
a
matter
comes
up
during
a
meeting
I.
J
One
is
how
matters
become
placed
on
the
board's
agenda,
so
matters
can
be
put
on
the
agenda
by
members
of
the
board
City
Council
or
one
of
its
committees,
the
medical
officer
of
how
Thoreau's
that
other
city
officials,
we
also
put
any
written
communications
about
agenda
items
into
your
agenda
packages
as
well
as
the
views
experienced
today.
We
circulate
them
in
the
room
once
they're
submitted
to
us.
J
One
of
the
key
things
is
that
the
agenda
deadline
to
submit
new
business
items
to
the
board
secretaries
ten
business
days
before
the
meeting,
so
all
board
members
are
allowed
to
submit
items
to
the
board's
agendas.
We
just
ask
that
we
are
receive
them
from
you
at
least
ten
business
days
before
the
meeting.
The
agendas
are
provided
to
the
members
and
they
are
also
made
public
five
business
days
before
a
meeting,
and
you
will
receive
confidential
materials
under
separate
cover
from
your
agenda.
J
J
However,
sometimes
things
can't
be
avoided.
They
come
up
very
quickly,
and
so
our
teams
will
remind
you
if
you
are
only
making
a
verbal
declaration,
that
you
also
need
to
submit
that
form
of
writing.
We
also
maintain
a
public
registry
online
of
all
those
written
declarations
which
is
a
provided
as
an
open
data
source
and
available
again
online.
J
J
Again
as
you've
experienced
today
and
at
your
other
meetings,
members
of
the
public
are
entitled
to
come
and
speak
to
the
board.
They
are
asked
to
register
with
us
in
advance,
but
obviously
the
chair
may
invite
to
make
sure
that
everyone
who
is
wants
an
opportunity
to
speak
to
the
board
on
a
matter
has
the
opportunity.
So
we
do
the
meeting
procedures
to
allow
for
persons
to
speak,
even
if
they
hadn't
registered
in
advance.
J
Being
able
to
ask
questions
of
your
officials
as
well
as
making
speeches
and
placing
motions,
let's
get
through
some
of
the
mechanics.
The
last
thing
that
might
be
different
from
some
of
the
other
bodies
you've
served
on
is
the
rules
around
voting.
So,
if
you
are
present,
you
must
vote
unless
you
have
declared
an
interest
and
therefore
recusing
yourself
from
the
vote,
in
which
case
you'll
be
marked
absent.
J
A
What
I
might
suggest
in
the
in
the
interest
of
time?
Thank
you.
First
of
all,
sorry
thank
you.
Is
we
wanted
to
make
sure
everybody
collectively
had
that
briefing
the
clerk's
office
is
available
prior
to
meetings
after
this
meeting
here
now,
if
you
ever
have
questions,
if
you're
going
into
a
meeting,
if
you're
wondering
how
to
prepare
a
motion,
how
to
come
in
forward
and,
of
course,
I'm
at
your
disposal
as
well,
if
you
ever
want
to
speak
to
it,
but
we
wanted
to
make
sure
we
had
that
opportunity.
A
I
know
our
intention
had
been
to
have
it
sooner
and
we
deferred
it
on
my
account.
So
thank
you
for
that,
and
rather
than
do
questions
in
a
group
unless
there's
a
dying
urge,
okay,
Kate
has
a
dying,
urge
and
then
I
would
suggest,
and
so
I'll
turn
it
over.
You
Kate
and
then
suggest
for
further
questions
we'll
take
it
offline.
After
thank.
F
You
thank
you.
I
took
this
question
to
our
board
secretary
earlier
and
she
asked
me
to
bring
it
to
this
forum
right.
So
that's
what
I'm
doing
my
question
is
whether
there's
a
bylaw
related
to
the
the
practice
at
this
board
that
refers
to
trustees
and
counselors
by
their
titles,
but
citizen
members
by
their
first
names,
in
my
view,
that
create
that
seems
to
create
a
hierarchy
amongst
board
members.
That
is
not
entirely
appropriate.
A
Its
grace
and
my
mother
called
me
Joseph
all
right.
That's
excellent,
no
I,
appreciate
that,
and
so
on
a
go-forward
basis
and
to
those
who
are
elected
too
bad
y'all
from
now
going
forward.
You
all
will
be
referred
to
by
your
first
name.
Does
that
include
not
referring
to
Peter
Wong
as
dr.
Wong,
no
I
really
enjoy
calling
him
doctor.
A
Everybody
shall
go
by
their
first
name,
all
right.
Thank
you,
dr.
Mulligan,
for
dropping
the
mic
and
setting
this
down
all
right.
So
with
that
we
are
concluded
our
agenda.
Thank
you.
Everybody
and
a
motion
to
receive
the
presentation
moved
by
Kate,
all
those
in
favor
opposed
if
any
carried.
Thank
you.