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From YouTube: Board of Health - May 6, 2019
Description
Board of Health, meeting 6, May 6, 2019
Agenda and background materials:
http://app.toronto.ca/tmmis/decisionBodyProfile.do?function=doPrepare&meetingId=15391
Meeting Navigation:
0:02:02 - Call to order
Agenda Item:
0:05:08 - HL6.1 - 2019-2020 Ontario Budget Announcement for Toronto Public Health - Update (Ward All)
1:59:56 - HL6.2 - 2019 Student Nutrition Program Service Subsidies (Ward All)
0:03:56 - HL6.3 - Service Agreements Awarded and Executed by the Medical Officer of Health for 2019 (Ward All)
2:01:15 - HL6.4 - Board of Health's Meeting Procedures (Ward All)
2:00:36 - HL6.5 - 2018 Performance Appraisal - Medical Officer of Health (Ward All)
A
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A
So,
ladies
and
gentlemen,
there's
a
bit
of
a
some
noise
in
the
background,
we're
gonna
get
started.
Welcome
to
meeting
six
of
the
Board
of
Health,
welcome
to
members
of
the
board
two
other
members
of
council
and
two
members
of
the
public.
You
can
follow
the
agenda
and
debate
on
your
computer
tablet
or
smartphone
at
Toronto
dot
see
a
slash
council.
We
will
begin
as
we
always
do
by
acknowledging
the
land
we
are
meeting
on.
A
Is
the
traditional
territory
of
many
nations,
including
the
Mississauga's
of
the
credit,
the
Anishinaabe,
the
Chippewa,
the
hona
shown
a
and
the
wind
at
people's
and
is
now
home
to
many
diverse
First,
Nations,
Inuit
and
Maine
Teeples.
We
also
acknowledge
that
Toronto
was
covered
by
treaty
13
with
the
Mississauga's
of
the
new
credit
into
Board
of
Health
members.
Thank
you
for
yet
another
meeting.
It
has
been
an
exceptionally
busy
period.
A
Let
me
begin
by
seeing
if
there
are
any
declarations
of
interest
under
the
conflict,
the
municipal
conflict
of
interest
Act,
seeing
none
could
I,
have
a
someone
move
the
confirmation
of
the
minutes
from
the
April,
8th
and
April
15th
meetings
moved
by
Peter
Wong.
All
those
in
favor
opposed,
if
any
that
carries.
You
have
in
front
of
you
on
the
green
sheets,
a
list
of
speakers
and
please
note
that
a
number
of
speakers
are
being
added
to
the
first
item.
We
are
going
to
begin
by
going
through
our
yellow
sheets
orange
sheets.
A
So
let
me
begin
our
first
item:
the
2019-20
ontario
budget
announcement
for
Toronto
Public
Health.
We
have
a
staff,
presentation
and
speakers
so
that
will
be
held.
The
second
item
hl6
point
to
the
student
nutrition
program,
I'd
like
to
hold
that
please
so
that
will
be
held.
The
third
item:
H
L
6.3
service
agreements
awarded
and
executed
by
the
medical
officer
of
Health
for
2019,
seeing
okay,
nobody
to
hold.
Would
somebody
like
to
move
the
recommendations
there?
A
Angela
Johnson,
all
those
in
favor,
opposed
if
any
that
is
carried
item,
HL
6.4,
Board
of
Health
meeting
procedures?
That's
the
exciting
item
on
the
agenda
today,
the
couple
it's
the
it's
exciting
to
councillor
perks,
very
controversial.
It's
he
know
when
holding
that.
Would
somebody
liked
him
counselor,
perks,
I
trust,
you'll,
oh
we're
holding
that
for
a
presentation.
Okay,
my
forgiveness.
We
are
holding
that
for
a
presentation
and
finally
HL
6.5,
2018
performance
appraisal,
medical
officer
of
Health,
our
subcommittee
dish
did
meet.
We
have
recommendations
in
front
of
us.
A
Would
somebody
like
to
move
those
trusty
Donaldson?
All
those
in
favor
opposed
of
any
carried
the
recommendations
are
confidential,
but
I
think
we're
planning
to
keep
you
Eileen
all
right,
we're
gonna.
We
are
going
to
return
right
off
the
bat
to
item
6.1,
the
2019-20
Ontario
budget
announcement
for
members
of
the
public,
we're
gonna
start
with
a
presentation
from
our
medical
officer
of
Health.
We're
then
gonna
move
to
hear
from
speakers
before
taking
it
in
committee.
So
at
this
time
let
me
turn
it
over
to
dr.
Davila
Thank.
B
B
Those
items
can
be
found
on
budget
document
pages
119,
125
and
277,
so
they
were
sprinkled
throughout
the
budget
document.
But
they've
been
summarized
for
you
here
on
this
slide.
The
first
comment
that
was
made
in
the
budget
document
was
the
provinces
intent
to
adjust
the
provincial
municipal
cost-sharing
arrangement
in
respect
to
public
health.
B
So
moving
on
to
the
next
slide,
those
were
the
details
that
were
provided
back
on
April
11th
at
the
budget
document
and
the
budget
launch
itself
the
week
following
more
details
were
provided
through
various
teleconferences
that
were
held
between
local
public
health
officials,
chairs
of
boards
of
health
and
representatives
from
the
Ministry
of
Health
and
long-term
care.
The
details
with
respect
to
the
change
in
provincial
municipal
cost
sharing
arrangements
was
one
of
the
what
that
was
one
of
the
details
that
was
provided
in
the
subsequent
week
and
in
particular
for
Toronto.
B
This
is
premise
taun
certain
key
assumptions.
First,
that
estimate
is
based
on
the
2018
approved
allocation
for
toronto,
public
health.
Second,
its
premise
on
the
2019,
a
city
council
approved
budget
for
Terron,
public
health
and
finally,
it
supposes
or
assumes
an
effective
date
for
the
funding
changes
of
April
1st
2019.
B
Just
by
way
of
reminder,
I've
already
mentioned
some
of
these
points,
but
just
want
to
be
clear
that
the
funding
Arrangements
on
the
go
forward
basis
as
they've
been
described
by
representatives
of
the
Ministry
of
Health
and
long-term
care
for
the
year
2020
2021.
The
cost-sharing
arrangement
has
been
proposed
as
being
6040
and
for
2021
2022.
B
I
will
also
remind
you
just
on
the
final
point
on
this
slide,
that,
as
per
the
budget
document,
one
of
the
intentions
expressed
by
the
provincial
government
through
their
budget
document
is
this
notion
of
achieving
200
million
dollars
in
annual
savings
through
that
regionalization
process
and
the
governance
changes
that
they
described
again,
not
in
great
detail,
but
what's
been,
you
know
provided
at
a
high
level.
What
we
don't
know
is
that
clearly
there
must
be
some
element
given
that
Toronto
is
one
of
the
local
public
health
units.
B
B
We
have
heard
that
there
is
a
proposed
mitigation
strategy
to
support
boards
of
health
as
they
go
through
the
transition.
That's
been
put
forward
by
the
provincial
government
through
its
budget
document
and
through
the
subsequent
conversations
that
we've
had
to
date,
and
it's
our
understanding
that,
amongst
the
mitigation
measures
that
are
available
to
those
of
us
in
the
public
health
sector,
one
of
them
would
be
a
one-time
funding
to
help
mitigate
the
financial
impacts
on
municipalities
and
the
other
that's
been
floated
or
proposed
by
Ministry
of
Health
and
long-term
care.
B
That
being
said,
we
do
know,
as
I've
mentioned
earlier,
that
there
is
a
governance
model
change.
This
is
the
extent
of
the
detail
that
we
know
at
this
point
in
time,
ten,
regional
public
health
entities
governed
by
autonomous
boards
of
health,
and
this
is
the
straight
wording.
These
are
not
my
words.
These
are
wordings
our
words
selected
or
lifted.
B
If
you
will
from
the
provincial
budget
document,
that's
how
they've
described
it
as
having
strong
municipal
and
provincial
representation
and,
as
I
mentioned
earlier,
they've
indicated
an
intent
to
create
these
entities
by
2020
2021,
a
pretty
ambitious
timeline,
given
that
it
is
may
20
19
effecting
a
new
organizational
structure
and
having
new
entities
in
place
in
less
than
a
year
is
ambitious.
I
would
say
at
the
very
least,
and
we
don't
have
yet
any
details
in
respect
of
what
that
looks
like.
B
B
But
for
now
it's
characterized
as
a
Toronto
Regional
Public
Health
entity
in
terms
of
next
steps-
and
this
is
the
final
slide,
the
Ministry
of
Health
and
long-term
care
has
indicated
an
intent
to
engage
in
conversations
with
public
health
units
on
a
one-by-one
basis
in
order
to
discuss,
hopefully
in
greater
detail.
The
plan
changes
for
2019
related
mitigation
opportunities
and
to
understand,
what's
required,
what
might
be
the
next
steps
in
terms
of
planning
in
terms
of
ensuring
that
local
needs
continue
to
be
met?
B
What
the
priorities
look
like
as
far
as
they're
concerned,
so
that
we
can
understand
the
agenda
and
how
it
can
actually
be
managed
how
we
can
ensure
that
we're
protecting
and
promoting
local
public
health
in
all
this
transition?
That's
currently
being
proposed.
So
with
that.
Thank
you.
Mr.
chair
and
I'll
turn
it
back
over
to
you.
I.
A
Thank
you,
dr.
Davila,
we're
now
gonna
go
to
deput
ins
before
bringing
it
back
into
committee
for
questions,
so
we're
gonna,
hear
from
speakers
first
before
we
bring
it
back
for
questions.
We
have
a
series
of
speakers
and
some
new
additions
to
the
green
sheets.
Our
first
speaker
is
dr..
Robert
Kyle,
president
of
the
association
of
local
public
health
agencies,
as
well
as
the
medical
officer
of
Health
for
Durham.
Do
I.
Have
that?
Yes,
dr.
Kyle
good
to
see
you
again
under
the
circumstances
I
you'll
have
you
can
take
a
seat
there?
A
C
Okay,
so
good
morning
at
chair
and
members
of
the
Board
of
Health
and
dr.
Davila
and
your
team
members
who
are
present
I
do
have
prepared
remarks
and
I've,
given
them
to
the
secretary
for
distribution,
so
I'm,
dr.
Robert
Kyle,
president
of
the
association
of
local
public
health
agencies,
known
as
alpha
and
I'm
pleased
to
be
back
before
you
today
and
with
me
as
Loretta
Ryan,
who
is
Alfa's
executive
director
and
just
as
a
reminder,
alpha
represents
all
Ontario's,
35
boards
of
health
and
medical
officers
of
Health.
C
Since
my
last
appearance,
alpha
has
continued
to
be
very
engaged
and
has
supported
its
members
with
what
the
Ontario
government
calls
Public
Health
modernization
in
the
short
time
that
I
have
here.
I
want
to
bring
to
your
attention.
For
example,
what
we
believe
are
two
important
pieces
of
Correspondence
that
we
have
prepared
in
support
of
our
members
on
April
23
2019
really
released
the
Alpha
position
statement
in
an
alpha
stated.
It
remains
concerned
about
the
proposed
cuts
to
provincial
funding
for
public
health,
especially
for
Toronto.
C
Moreover,
Alpha
urged
its
members
to
meet
with
their
local
municipal
officials
and
MPPs
to
make
use
of
alphas
resources
that
were
listed
in
the
state
and
to
amplify
and/or
modulate.
The
messages
contain
there
and,
as
members
saw
fit
later,
on,
May
3
2019
alpha
wrote
a
letter
on
public
health,
modernization
to
the
Deputy
Minister,
a
deputy
premier,
sorry
and
Minister
of
Health
and
long-term
care.
C
The
letter
stated
alpha
supports
public
health
modernisations
goals
of
broader
municipal
engagement,
more
efficient
service
delivery,
better
alignments
with
the
health
care
system,
improved
staff,
recruitment
and
retention,
and
improved
public
health
protection
and
promotion.
Alphas
chief
concern
remains
public
health
funding
cuts,
namely
its
members
need
specific
information
about
their
2019-20.
C
Provincial
grants
need
coverage
of
any
immediate
local
shortfalls
and
need
assurance
that
the
total
investment
in
public
health
does
not
increase
over
time.
Alpha
eagerly
anticipates
more
details
about
the
plans
to
streamline
public
health
ontario,
given
that
this
agency
is
an
essential
partner
to
public
health,
especially
with
respect
to
evidence
to
inform
decision
making
locally
and
finally,
Alpha
welcomes
a
conversation
about
the
status
of
the
interior,
public
health
standards
protocols
and
guidelines.
If
changes
are
being
considered
and
stresses
the
importance
of
an
inclusive
and
reciprocal
stakeholder
conversation.
C
D
As
well
as
your
values
from
the
Alpha,
so
is
alpha
prepared
to
take
on
the
responsibility
to
track
an
evaluation
of
the
so-called
modernization,
because
somebody
has
to
look
at
this
whole
by
the
word.
Modernization
is
cut,
so
is
alpha
as
the
national
provincial
organization
looking
towards
evaluating
this
modernization
of
Health
Unit
across
the
province.
So
what.
C
I
would
say:
is
this
we're
driven
by
the
preferences,
requests
priorities
of
our
members?
So
if
our
members
want
us
to
act
as
kind
of
a
clearinghouse
with
respect
to
actual
impacts
on
front-line
public
health
services,
to
the
extent
that
we
have
that
capacity
to
do
so,
we're
quite
prepared
to
do
that.
On
behalf
of
our
members,
the.
D
Second
question
is
I
recall
the
last
question:
I
asked
you
when
you
were
here
to
the
board
that
you
were
not
consulted
as
an
organization
about
this
so-called
regionalize
health
unit.
So
how
did
the
government,
or
how
did
the
ministry
determine
10
Regional
Health
Unit
is
best
for
the
province.
Do
you
have
any
idea
how
this
number
came
to
be
I?
Don't.
D
C
Let
me
answer
it
this
way.
Currently,
our
members
are
focused
on
the
cuts
and
they're
focused
on.
If
you
will,
the
ambitious
timelines
and
the
risks
associated
with
restructuring
I
think
we
all
have
heard,
or
at
least
anticipate
that
there's
a
fairly
short
runway
between
now
and
the
fall,
which
seems
to
be
the
earliest
opportunity
to
open
up
our
governing
legislation
to,
for
example,
establish
Regional,
Public
Health
entities
during
that
time.
C
C
A
A
C
So
I
they
may
have
on
a
health
unit
by
health
unit
basis,
they're
right
now
going
through
I
guess.
Preliminary
conversations
with
public
health
units
primarily
focused
on
what
to
expect
in
terms
of
their
provincial
grants
for
2019-20,
and
if
the
draft
regional
configurations
come
up
in
that
discussion,
then
that's
happening
at
a
local
level.
There's
not
been
a
master
plan
that
I'm
aware
of
that
has
mapped
out
the
boundaries
of
the
ten
regional
entities.
So.
A
C
A
Are
all
my
questions?
Thank
you
very
much.
Thank
you.
Dr.
Cobb,
our
next
speaker
is
Carrie.
Davies
Carrie
is
the
vice
chair
of
the
Peterborough
Board
of
Health
Carrie.
You
can
come
forward.
Take
a
seat.
You'll
see
Carrie
to
my
right,
the
clock.
There
you'll
have
up
to
five
minutes
and
then
generally
friendly
questions,
because
you
have
a
nice
audience.
E
Thank
you
very
much.
I
do
apologize
for
my
voice,
but
it's
better
than
it
was
yesterday.
So,
as
you
heard,
my
name
is
Carrie
Davies
and
I
am
the
vice
chair
of
the
Board
of
Health
for
Peterborough
public
health,
I'm,
a
provincial
appointee
and
I'm
serving
in
my
fifth
year.
Peterborough
public
health
serves
an
urban
rural
population
at
approximately
a
hundred
and
thirty-five
thousand
people
made
up
of
nine
municipalities,
including
the
city
of
Peterborough,
seven
townships
in
the
in
the
county
of
Peterborough
and
as
well.
E
We
have
the
privilege
of
serving
two
First
Nations
curve,
Lake
and
Hiawatha
First
Nations,
since
1995
I'm
pleased
to
be
here
today
to
address
the
board
at
Iran,
Ohio
and
our
guests
here
today
to
add
our
voice
to
the
critical
conversation
about
the
preservation
of
public
health
in
our
province.
I
would
first
like
to
state
the
Peterborough
public
health
echoes,
Alfa's
support
of
the
Minister
of
Health
proposed
policy
direction
to
maintain
public
health
as
closely
connected
to
its
municipal
councils
and
funders.
E
Ontario's
communities
need
Public
Health
on
the
ground,
with
them
as
accessible
and
responsive
partners.
So
we're
glad
to
hear
this
important
relationship
is
being
preserved.
However,
we
are
concerned
about
the
plan
downloaded
public
health
funding
to
municipalities.
We
all
know
what
happened
the
last
time,
the
province
downloaded
and
inquiries
into
both
SARS
and
Walkerton
called
for
greater,
not
less
provincial
investment
in
a
strong
and
local
public
health
system.
E
Given
that
municipal
and
Board
of
Health
budgets
for
219
have
already
been
finalised,
a
change
at
this
critical
time
will
result
in
significant
funding
shortages
and
potential
reduction
in
important
public
health
service
delivery.
We're
also
concerned
about
Minister
of
House
comment,
Minister
of
Health
Eliot's
comments
regarding
Toronto
Public
Health.
In
regard
to
bicycle
lanes
on
Yonge
Street.
We
know
through
experience
that
working
with
municipal
partners
to
design
healthier
built
natural
environments
is
just
as
much
a
core
Public
Health
Service
as
our
immunizations
and
outbreak
control.
E
In
fact,
with
85%
of
Ontario
deaths
resulting
from
chronic
disease
like
cancer,
diabetes
and
heart
disease,
healthy
public
health
policy
by
Board
of
Health
and
their
staff
is
none
more
critical
in
keeping
Ontarians
healthy
and
preventing
hallway
medicine
for
every
dollar
invested
in
policy
actions
like
building
infrastructure
for
active
transportation
results.
We
reap
high
returns
on
investment
and
policies
that
affect
disease
prevention,
such
as
those
limiting
tobacco
marketing,
access
to
alcohol
and
Florida's
ation
of
water
results
could
be
almost
double
the
median
cost-benefit
ratio
of
$8.30
return
for
every
dollar
invested
in
health
programs.
E
Benjamin
Franklin
had
it
right
when
he
said
almost
300
years
ago
that
an
ounce
of
prevention
is
worth
a
pound
of
cure.
Finally,
in
support
of
Toronto
Public
Health
I
want
to
point
out.
The
Peterborough
recognizes
that
Toronto
is
our
first
line
of
defense
against
emerging
diseases
of
Public
Health
significance.
An
outbreak
may
only
be
a
plane,
car
or
train
right
away.
We
need
Toronto
to
be
strong
and
well
resourced
in
order
for
smaller
communities
like
ours
to
be
fully
protected.
E
In
addition,
because
of
Toronto's
size,
its
diversity
and
its
capacity,
it
is
often
the
municipality
that
breaks
new
ground
for
Public
Health
by
laws
protecting
the
health
of
communities,
often
get
developed
and
tested
in
Toronto
and
then
spread
across
the
province.
For
example,
Toronto
Public
Health
was
the
first
to
push
for
a
ban
on
the
cosmetic
use
of
pesticides.
More
recently,
Toronto
Public
Health
is
leading
the
charge
to
address
vaccine
hesitancy
and
calling
on
Health
Canada
to
explore
ways
of
stopping
the
spread
of
misinformation
about
vaccines
and
Toronto.
E
Bylaws
often
lead
to
provincial
legislative
changes
as
well.
Toronto
Public
Health
is
a
health
leader
and
a
resource
for
this
province.
We
must
be
careful
not
to
put
this
at
risk.
I
just
like
to
briefly
recap.
In
the
last
30
seconds,
I
have
we
have
been
working
closely
with
our
local
MP
and
we
met
on
Friday.
We've
asked
for
three
things
for
him
to
champion.
For
us
number
one
is
to
work
together
for
boundaries
that
make
sense
for
Peterborough,
including
our
rural
and
urban
mix.
E
We
need
consultation
to
understand
the
unique
challenges
of
our
rural
community.
Secondly,
we
would
like
to
understand
better
how
a
20%
reduction
will
not
result
in
the
loss
of
services
if
the
province
has
a
plan
we'd
like
to
hear
that
and
thirdly,
that
new
boards
will
include
representation
and
a
governance
model
that
reflects
our
community
and
understands
our
needs.
We
must
work
together
to
ensure
the
Peterborough
public
health
and
indeed
public
health
across
Ontario
is
second
to
none.
Thank
you
and
I'm
open
for
questions.
Thank.
F
F
E
G
Thank
you
very
much
mr.
chair
and
with
respect
to
perhaps
the
provinces
and
tensions
with
all
these
big
announcements
and
very
little
detail
to
come.
Can
you
speculate
and
I
recognise
that
you
won't
necessarily
have
the
full
answer,
but
can
you
speculate
on
the
true
intentions
of
the
province
of
why
they're
doing
this
beyond
their,
but
their
public
facing
claim
that
it's
about
looking
for
efficiencies,
I.
E
Think
there's
a
lot
of
people
that
would
like
to
be
able
to
have
that
crystal
ball
to
understand
what
their
intent
is.
I,
don't
think
we're
surprised
to
see
more
downloading
to
the
municipalities.
I
know
that
at
the
end
of
the
day,
there's
only
one
taxpayer
so
one
way
or
the
other
someone
is
going
to
be
paying
for
this,
and
if
we
don't
pay
for
it
now
we're
gonna
pay
a
heck
of
a
lot
later
down
the
road,
but
as
to
their
long-term
intent.
I
I,
don't
know,
and.
G
With
respect
to
the
the
the
impacts
of
Toronto,
I
mean,
obviously
you
you
recognize
that
the
announcements
in
the
funding
formula
for
Toronto
are
going
to
change
dramatically.
I
think
that
it
was
it
was.
It
was
very
good
for
us
to
hear
as
someone
who's
not
working
in
the
City
of
Toronto,
your
perspective
of
Toronto's
position
and
being
the
front
line
of
defense.
Can
you
can
you
tell
me
like?
Is
there?
G
E
Good
question:
do
they
recognize
what's
happening?
I?
Think
I,
don't
think
so.
I
mean
we're
only
a
few
months
past
an
election,
so
I
think
I
would
hope
that
part
of
the
challenge
with
leading
our
mpps
to
an
understanding
and
hoping
that
they
will
rally
for
us,
is
that
many
of
them
are
new
in
their
positions
and
I'm
certain
with
the
councillors
in
this
room,
and
we
understand
that
you
have
a
lot
to
wrap
your
head
around.
E
So
if
I
could
be
hopeful
in
this,
perhaps
it
is
in
the
work
that
we
can
do
in
rural
Ontario
in
the
bigger
cities
in
meeting
with
our
MPs
and
doing
our
best
to
help
to
educate
them
and
to
help
them
see
that
the
invisible
work
that
Public
Health
does
when
it
comes
to
light.
When
you
learn
what
we
do,
it's
oftentimes
too
late
to
reverse.
So
we
just
just
been
closing.
E
We
had
a
Jains
walk
on
Friday
night
in
Peterborough
to
celebrate
130
years
of
public
health,
and
we
just
walked
down
a
number
of
city
blocks
and
we
called
our
walk,
making
the
invisible
visible
and
we
went
from
doing
food
food
safety
checks
to
I
work
with
the
youth
to
our
water
that
flows
through
our
city.
We
used
to
have
an
abattoir
that
dumped
into
the
little
lake,
and
we
hope
we
had
both
40
people
with
us.
I
think
we
need
to.
It
would
have
been
nice
if
our
MPP
had
been
with
us
that
night.
A
Thank
you
any
other
questions
for
members
of
the
board.
I
just
have
one,
if
that's
all
right.
Karen
we've
spent
a
lot
of
time
here
in
the
city
and
at
the
Board
of
Health.
Talking
about
the
implication
these
cuts
in
recent
weeks,
but
we've
been
focused
largely
on
an
urban
context.
Can
you
give
us
an
insight
into
the
dynamics
of
potential
public
health
cuts
and
the
change
in
the
number
of
units
in
a
rural
and
urban
consideration?
A
E
I
think
the
funding
first
of
all
would
be
the
the
biggest
challenge.
We
know
that
our
First
Nations
I
can't
afford
any
increases
on
and
the
municipal
representatives
that
I've
spoken
to
are
very
concerned
about
where
they're
going
to
find
the
funding.
As
you're
probably
aware,
there
appears
to
be
some
opportunities
for
municipalities
to
make
discretionary
decisions
on,
perhaps
not
delivering
some
programs.
We
have
no
idea
that
how
that
would
work
or
how
they
would
even
be
able
to
come
to
make
such
decisions,
so
that
is
certainly
a
concern.
E
We
have
a
lot
of
isolated,
older
adults
in
our
community
and
I
think
that
that
is
going
to
be
certainly
of
critical
importance.
We
also
have
a
significant
opioid
crisis
in
Peterborough
people
are
going
to
die.
We
we
need
to
be
able
to
continue
to
have
a
safe,
downtown
location
where
our
community
can
come
to
as
well
as
reach
out
into
our
rural
communities
to
take
public
health
to
where
people
live.
Yeah.
E
A
A
H
Very
much
Jared
Krissy
and
members
of
the
Board
of
Health
and
doctor
I'm
very
pleased
that
you
and
your
staff
in
your
mayor
are
strongly
advocating
for
public
health
across
Ontario.
In
addition
to
my
responsibilities,
chair
of
the
public
health
board,
I
sit
on
the
governor's
body
for
our
local
paramedic
group,
which
covers
the
city
of
Kingston
in
Frontenac
County.
Our
Public
Health
Unit
also
covers
a
very
large
area
from
the
islands
at
the
East
End
of
Lake
Ontario
north
through
Kingston
Nappanee,
up
to
Bon,
Echo,
Park
and
just
south
of
the
Algonquin
Park.
H
To
get
to
the
average
of
one
point
point
four
million
people
needed
in
each
of
the
proposed
ten
regions.
Ours
would
likely
run
from
the
halliburton
Peterborough
area
straight
through
that
the
Quebec
border.
We
work
closely
with
health
units
on
both
sides
and
if
we
combine
the
three
of
us,
it
does
make
some
sense
and
it
would
be
relatively
easy
to
do
without
disruption
but
merging
all
the
Eastern
Ontario
health
units.
It
would
cause
unnecessary
and
unintended
consequences.
H
The
new
region
would
end
up
with
well
over
a
hundred
municipalities,
and
it
would
be
impossible
to
have
effective
representation
from
the
property
taxpayers
who
will
be
paying
for
the
service.
Thus,
we
would
have
taxation
without
representation
in
both
public
health
and
in
the
paramedic
service.
There
is
only
one
taxpayer.
The
measures
announced
do
not
save
taxes,
they
merely
shift
property
taxes
to
the
taxpayers,
our
most
immediate
problem
in
the
Kingston
areas.
We
now
cover
11
new
municipalities
and
our
budget
for
219
was
set
in
November
to
18.
H
So
now
that
the
rules
of
the
game
have
changed,
it's
impossible
to
go
back
and
ask
for
more
money.
The
province
froze
their
contribution
to
our
public
health
unit
for
many
years
now,
and
we're
currently
at
a
60/40
split
already.
So
if
we
proceed
with
these
terrible
draconian
measures
will
be
well
over
50%.
It
could
flip
the
other
way.
6040
I
have
already
heard
nothing
from
the
province
with
reducing
the
current
service
levels
for
public
health.
H
So
therefore,
without
significant
cuts
in
staff
and
other
drastic
measures,
like
closing
our
rule,
3
or
4
satellite
offices,
we
will
be
in
big
trouble
in
eastern,
coupled
with
the
proposed
paramedic
changes
which
could
result
in
closing
small
rural
paramedic
stations.
We
will
end
up
with
a
lot
of
ghost
towns
across
Eastern
Ontario,
as
people
simply
won't
want
to
live
there
with
the
reduction
in
service.
Evidence
shows
that
public
health
delivers
an
excellent
return
on
investment.
H
The
levels
of
cut
in
the
recent
announced
provincial
budget
will
result
in
cuts
in
the
front
line
programs
and
staff
people
will
lose
their
jobs.
We
are
aggressively
working
with
on
saving
health
system
money
and
reducing
hallway
medicine
through
key
public
health
actions,
including
vaccination
harm
reduction
services
and
many
more.
Our
rate
of
vaccination
is
98.6
high
enough
to
ensure
herd
immunity
against
illnesses
such
as
measles,
but
we
are
very
worried.
We
will
not
be
able
to
maintain
this
success
without
adequate
funding
for
every
dollar
invested
in
the
immunization.
H
The
public
health
care
system
saved
16
in
cost.
This
reduces
hallway
medicine.
We
simply
cannot
afford
to
have
another
infectious
outbreak
like
SARS
or
water
contamination
event
like
an
Walker
than
these
events,
kill
Ontario
ins
and
cost
us
millions
of
dollars.
The
government
to
the
government
Ontario
I
say
you
cannot
be
open
for
business
if
you
aren't
preventing
illness
and
promoting
good
health.
The
Conference
Board
of
Canada
estimates
ours,
lower
GDP
by
1.5
billion
dollars.
H
Investment
in
public
health
is
we.
We
are
extremely
worried
about
the
upcoming
flu
season
being
very
severe.
Public
health
is
essential
to
respond
to
any
emerging
infectious
diseases
such
as
Lyme
disease,
influenza,
Ebola,
etc.
History
tells
us
the
next
threat
is
just
around
the
corner.
We
asked
the
province
to
please
reconsider
the
funding
cuts.
Our
Hospital
hallways
cannot
take
the
pressure,
and
our
business
cannot
succeed
in
face
of
these
threats.
H
D
H
D
H
So
we
have
quite
a
few
partnerships
in
that
regard
so,
but
we
are
very
worried
because
a
leaked
paper
shows
that
the
part
of
the
paramedic
change
is
cutting
300
ambulance
vehicles,
that's
a
lot
of
people
and-
and
that
will
result
in
a
lot
of
people
dying
because
we
won't
be
able
to
get
to
the
locations
fast
enough
to
save
the
person.
That's.
H
Within
the
city
of
kingston,
it
may
go
from
say
seven
minutes
to
seven
a
half
for
eight
minutes.
The
problem
is
in
the
outlying
areas
in
the
community.
I
live
in
we're
serviced
by
ferries.
Only
so
if
you
don't
have
a
station
on,
you
have
to
jockey
the
ferry
back
and
forth,
and
the
round-trip
is
an
hour.
So
you
know
instead
of
responding
in
ten
minutes
or
so
it
could
be
well
over
an
hour.
So
you
know
what
happens
if
you've
a
heart
attack
or
a
stroke.
Thank.
G
H
It
would
probably
be
something
120,
I
think
I,
just
like
Toronto.
Our
impression
is
that
Ottawa
will
be
left
alone
and
we've
got
a
group
in
Eastern
Ontario
called
the
Easterns
Warden
caucus,
which
is
already
a
well-established,
well-defined
area,
and
that's
why
I
say
that
I'm
thinking
that
that's
probably
what
they
would
like
to
do.
The
eastern
warden
caucus
doesn't
include
cities
like
Kingston,
Brockville,
Belleville
and
so
on,
or
Port
Hope
or
Peterborough
as
far
as
that
goes,
but
if
they
were
included
it
brings
it
up.
G
G
Marriages,
some
on
I,
think
for
us
who
live
and
work
in
Toronto
oftentimes.
We
have
been
a
bit
of
the
the
political
football
of
premier
fort
and
so
we're
kind
of
used
to
things
happening
to
the
City
of
Toronto
and
the
merit.
The
the
premier
has
stood
up
on
numerous
occasions
that
he's
going
to
stand
up
for
the
little
guy,
the
average
guy,
that
this
government
is
for
the
people.
G
It's.
What
would
do
you
believe
what
would
be
the
true
motivation
here
because
I'm
trying
to
understand
why?
Why
is
this
happening
and
and
given
the
area
that
you
represent
and
the
deep
connections
that
you
have
with
with
the
wide
range
of
political
actors
out
there?
Can
you
can
you
give
us
a
sense
of
why
this
is
happening
and
what
the
true
intentions
are
for
these
cuts?
We've.
H
All
been
asking
ourself
that
same
question,
and-
and
we
can
only
speculate
why,
but
it
seems
that
this
government
wants
to
have
much
tighter
control
on
every
aspect
of
what's
going
on
in
Ontario.
So
I
guess
why
real
worry
is,
as
next
announcement
will
be.
The
MAL
view
made
all
our
small
municipalities,
which
will
then
be
much
more
difficult
to
have
representation
of
the
people
and
the
last
go-around
of
amalgamations
nobody's
male
to
prove
that
there
was
a
nickel
saved
across
the
province.
So
we're
very
worried.
H
A
Very
much
any
other
questions,
so
I,
just
I
just
have
one
mayor
Doyle,
so
we
in
Toronto
were
hearing
from
a
range
of
constituencies
with
concerns
school
board,
some
of
whom
are
represented
here.
Doctors,
associations,
nurses,
associations,
but
we're
hearing
about
it
in
our
communities.
So
are
you?
Are
you
hearing
concern
across
the
communities
in
France
and
AK
and
Addington
and
Lennox?
Is
this
permeating
to
the
communities
the
concerns
it.
H
A
Okay,
those
are
all
my
questions.
Thank
you
very
much,
Mary
doll.
Thanks
for
your
time.
Okay,
our
next
speaker
and
I
apologize
if
I
mispronounce,
the
name
is,
is
Arne
Wynn
from
the
University
of
Toronto
Faculty
of
Medicine.
What's
that
close,
so
can
I
say
dr.
Wynn.
Are
you
a
doctor
yet
yeah
yeah,
all
right,
just
try
and
soon
you'll
have
five
minutes
soon
to
be
dr.
Wynn,
you
have
a
clock
on
my
right
sure.
I
Good
morning,
my
name
is
use
Arnie,
Wynn
and
I'm,
a
third-year
medical
student
at
the
University
of
Toronto
I'm,
here
to
speak
on
behalf
of
over
90
medical
students
who
have
expressed
concern
about
the
initial
decision
by
provincial
government
to
cut
an
estimated
1
billion
dollars
to
Toronto
Public
Health
over
the
next
decade.
We
have
created
and
disseminated
an
open
letter
to
our
Minister
of
Health
Christine
Elia
last
week
regarding
the
cuts
and
it
managed
to
engage
hundreds
of
views
via
social
media.
I
We
are
particularly
vested
in
this
issue
because
we
are
the
future
frontline
of
health
care.
We
are
the
ones
who'll
be
taking
care
of
patients
soon
to
be
subjected
to
the
consequences
of
a
debilitated
public
health
system.
I'm
here
today
to
tell
you
not
about
the
statistics
or
the
resulting
losses
of
the
1
billion
dollar
cut
to
the
next
to
public
health
in
the
next
decade.
I
These
are
numbers
that
you've
already
compiled
and
are
probably
well
aware
of
already
I'm,
also
sure
that
you're
well
aware
that
28
mayor's
representing
67%
of
the
Ontario
population,
already
stand
with
you
I'm
here
to
convey
a
concern
from
a
healthcare
perspective
and
what
these
cuts
mean
for
patients
and
for
our
clinical
practice.
Moving
forward,
Public
Health
differs
from
health
care
in
many
different
ways,
but
the
two
are
intrinsically
linked.
I
If
the
proper
supports
were
in
place
to
promote
the
health
of
the
patient,
this
may
mean
a
child
with
a
new
diagnosis
of
meningitis
because
of
a
lack
of
herd,
immunity
from
a
weakened
immunization
program,
or
it
may
mean
a
young
man
with
a
new
diagnosis
of
HIV,
due
to
lack
of
accessibility
to
a
test
and
treat
clinic,
as
recently
mentioned
in
a
Toronto
article,
Toronto
Star
article
by
emergency
physicians,
dr.
shake
and
dr.
Venugopal
health
and
emergency
medicine
are
two
sides
of
the
same
coin.
I
Less
supervised
injection
sites
mean
a
spike
in
overdoses,
particularly
against
our
city's,
most
marginalized
citizens,
less
food
and
water
safety.
Precautions
such
as
the
water
contamination
crisis
and
Walkerton
Ontario
in
the
year
2000
means
an
increase
in
acute
diarrheal
illnesses,
particularly
harmful
for
those
already
managing
chronic
illnesses.
Less
infectious
disease
surveillance
means
an
even
further
increase
in
the
number
of
measles
cases
amongst
children
in
Toronto
and
in
our
GTA.
Unless
emergency
preparedness
means
an
even
bigger
outbreak
and
death
toll
the
next
time,
our
city
is
threatened
by
the
next
pandemic,
such
as
SARS
or
h1n1.
I
These
cuts
will
exacerbate
the
demand
on
emergency
departments.
Hospital
wards
and
will
reinforce
rather
than
relieve
the
practice
of
hallway
medicine
in
our
city
and
in
our
province.
We
speak
to
you
today,
not
only
out
of
obligation
as
future
physicians
to
advocate
for
health,
but
also
because
simply
put,
we
are
afraid
for
our
future
patients
and
for
our
loved
ones
who
live
in
Toronto.
These
are
easily
preventable,
but
incredibly
difficult
to
treat
conditions
that
will
only
become
more
common
with
an
underfunded
public
health
system.
I
We're
scared
for
the
citizens
of
our
city,
who
are
already
marginalized,
will
be
further
disadvantaged
due
to
lack
of
health
protection
that
they
deserve
as
human
beings.
We're
also
scared
for
the
children,
who'll
be
denied
access
to
the
services
needed
to
promote
their
health
as
they
grow
and
move
towards
tomorrow's
adult
population.
In
summary,
the
cuts
to
public
health
will
relieve
short-term
debts
at
the
cost
of
intergenerational
downstream
poor
health
consequences
for
our
city's
population.
I
Today,
we
are
urging
the
Board
of
Health
to
continue
back
against
the
provincial
government
in
order
to
protect
the
health
and
safety
of
our
city.
We
ask
that
you
demand
transparency
and
clarification
from
our
premier
and
Minister
of
Health
as
to
the
rationale
to
these
cuts
and
how
the
provincial
funding
of
health
care
plans
on
paying
for
the
repercussions
of
these
cuts,
knowing
that
for
every
one
dollar
invested
in
public
health,
16
dollars
in
healthcare
is
saved
in
the
future.
I
This
may
seem
like
an
effort
to
preach
to
the
choir,
but
from
a
healthcare
perspective,
we
cannot
stress
enough
the
importance
of
protecting
our
city.
We
stand
with
the
Board
of
Health
and
will
continue
to
advocate
for
health
protection
of
our
city
at
an
institutional
level,
but
we
also
hope
that
you
continue
supporting
our
grassroots
initiatives
and
that
you
elevate
our
concern
to
the
provincial
government.
Thank
you.
Thank.
J
Firstly,
I
just
want
to
thank
you
for
coming
in,
because
I
know,
scientists
and
medical
students
tend
not
to
be
political
by
nature
and
I
think
it's
very
important
what
you're
doing
so.
Thank
you
for
that.
My
question
is
as
you're
going
through
Medical
School.
How
important
is
the
preventive
health
aspects?
How
much
is
that
stressed
in
in
your
coursework
and
in
your
practicals,
for
example?
Definitely.
I
So
I'm
a
third-year
student
right
now
and
this
entire
year
is
rotating
through
various
clinical
specialties.
So
I've
already
had
the
opportunity
to
go
through
my
family,
medicine
rotation
and
recently
my
emergency
medicine,
rotation
and
kind
of
connecting
those
pieces
together.
You
can
really
see
a
lot
of
the
gaps
in
care,
in
particular
during
my
emergency
medicine,
rotation,
I
rotated
through
Toronto
General,
Hospital,
Toronto,
Western
Hospital,
and
in
that
experience,
I
saw
numerous
patients
coming
in
with
complications
related
to
transplants
or
chronic
illnesses
or
cancer.
I
Patients
on
that
required
emergency
services
and
in
the
same
emergency
department,
I
saw
patients
coming
in
with
intoxication
who
are
have
no
fixed
address
or
who
are
coming
in
with
fentanyl
overdoses.
So
you
really
see
such
a
range
of
very
preventable
illnesses
that,
unfortunately,
the
emergency
departments
in
our
city
aren't
able
to
fully
address
all
at
once
when
all
these
demands
are
happening
at
once
and
I
think
connecting
it
back
to
more
of
a
primary
care.
Family
matters
perspective.
J
I
I
would
definitely
agree
with
that
and
I
think.
Historically,
it
has
shown
that
any
investment
in
public
health
results
in
greater
returns
in
health
care
later
on,
I
think
just
given
and
the
climate
that
we're
in
right.
Now,
it's
really
important
to
protect
what
we've
already
had
in
place
and
then,
hopefully,
eventually
moving
forward
to
increase
our
investments
in
public
health.
G
Thank
you
very
much
for
your
your
very
powerful
deputation
I
want
to
ask
if
I
may
we're
having
I
think
we
might
have
I
just
have
an
honest
conversation,
because
that's
how
we
operate
here.
We
are,
as
I
read
your
deputation
and
as
I
also
just
sort
of
think
about
the
words
that
you
said
you.
You
asked
us
to
push
back,
to
continue,
to
stand
strong,
to
demand
transparency
and
to
just
keep
advocating
and
to
help
elevate,
your
voices
and
your
concerns
and
and
the
concerns
of
your
colleagues.
Here
we
have
been
doing
that.
G
I
think
you.
You
could
probably
recognize
that
through
the
chair
and
and
dr.
Davila
through
the
mayor
and
obviously
even
the
are
out
of
town
speakers
today,
there
is
this
rising
opposition,
but
it
doesn't
seem
to
so
far
have
too
much
effect,
yet
at
Queen's
Park.
What
do
you
think
we
need
to
do
next?
It's.
G
I
I
Think
all
of
us
are
worried
about
health
in
different
ways,
and
we
all
have
different
strategies
that
we
think
might
be
beneficial
in
the
future,
but
I
think
going
back
to
our
communities
going
back
to
the
patients
and
having
them
speak
on
our
behalf,
as
well
as
a
really
important
step.
Moving
forward
and.
G
I
Think
moving
forward,
that's
definitely
something
that
we
would
want
to
continue,
including
in
our
advocacy
efforts
as
well
I.
Think
as
a
preliminary
step,
this
was
very
much
from
the
voice
of
a
medical
student
and
kind
of
our
experiences
so
far,
but
I
think
moving
forward.
It's
it
would
definitely
be
important
on
aren't
also
include
patient
voices
and.
G
Then
that
means
the
City
of
Toronto
must
also
engage
in
awareness
and
to
sort
of
ask
the
residents
of
Toronto
to
rise
with
us.
So
it's
not
necessarily
the
the
same
talkers
and
the
same
talking
heads
all
the
time
like
a
presence
of
Toronto
needs
to
engage
with
their
MPs
to
call
them
the
premier.
That's
what
is
really
required.
This
wider
Mamluk
education
campaign
completely.
I
Yeah
and
I
think
it's
our
job
and
also
everyone's
draw
up
here
to
continue
educating
the
public
as
well,
because
again,
a
lot
of
people
may
be
neutral
on
the
issue
currently,
but
again
by
hearing
the
patient
voices
hearing
about
what
our
concerns
are
for
the
future,
there
might
be
a
really
good
opportunity
to
sway
a
lot
of
those
voices.
Okay,.
F
You
almost
dr.
Winn
and
thank
you
for
the
advocacy
that
you
are
providing
and
all
the
medical
students
with
you,
and
we
know
that
the
the
foundation
of
our
medical
curriculum
is
based
on
community
health,
and
we
know
that
people
in
medical
school
that
choose
public
health
as
a
career,
a
very
special
doctors.
How
do
you
think
these
cuts
and
these
reduced
number
of
units
are
going
to
affect
medical
students,
career
choices
with
regard
to
public
health?
Sure.
I
I
can't
speak
completely
on
kind
of
career
decision-making.
On
behalf
of
all
my
colleagues,
I
know
that
the
from
my
limited
understanding
of
the
public
health
residency
that
every
year
there
is
an
increasing
interest,
not
just
in
public
health
as
a
medical
specialty,
but
also
generally
in
primary
care
as
well
and
I
think
this
has
been
a
growing
trend
over
many
years.
I
I'm,
not
exactly
sure
how
these
cuts
are
going
to
affect
our
decisions.
Kind
of
from
an
institutional
level
in
terms
of
the
careers
that
we
decide
to
go
in,
but
I
know
that
there
has
been
an
increasing
trend
towards
primary
care,
specialties
and
preventative
medicine
in
the
past
few
years
and
decades
and
I
really
hope
that
continues
as
well,
because
I
think
we
can
all
agree
that
it's
one
thing
to
kind
of
treat
illnesses
once
they
happen.
I
A
A
K
K
It
also
I
would
say,
is
a
body
that
is
part
of
a
legacy
over
almost
30
years
of
a
food
policy
council
that
is
renowned
around
the
world
for
having
brought
that
level
of
engagement,
Democratic
engagement
on
food
to
City
Hall
and
often
we
are
visited
by
other
food
policy
councils
who
come
to
Toronto
to
understand
how
we
make
food
so
vibrant.
Here
the
role
of
elevating
and
advising
the
Board
of
Health
on
food
is
critical.
It's
part
of
that
complexity.
K
It's
part
of
the
value
that
that
is
I,
think
mirrored
and,
and
what
I
think
is
true
is
that
members
of
the
Toronto
Food
Policy
Council
appreciate
the
complexity
of
Toronto
Public
Health
because
of
their
experience
within
the
food
system,
but
I
come
today
and
I
don't
want
to
talk
about
food
issues.
If
that's
alright,
I
will
talk
broadly
about
Public.
Health
I
will
leave
aside
for
the
time
being
the
potential
loss
of
two
hundred
and
ten
thousand
meals
for
children
in
this
city.
K
Because
of
these,
the
proposed
budget
cuts
I'll
leave
aside
the
issue
of
inspections
and
restaurants,
remembering
how
important
restaurants
are
to
the
economy
of
this
city.
I
won't
speak
about
the
good
food
markets,
the
mobile
good
food
markets
that
bring
food
to
neighborhoods
where
food
is
not
easily
accessed,
especially
healthy,
good
food
and
I
won't
talk
about
the
Community
Food
works
project,
which
is
both
a
strategy
for
integrating
newcomers
and
a
workforce
development
project
that
has
seen
great
success
here
in
the
city.
K
Well,
the
Toronto
Food
Policy
Council
has
not
had
a
chance
to
meet,
yet
we
will
be
meeting
on
Wednesday
and
will
be
mode
eight,
a
voting
on
a
motion
to
support
the
Board
of
Health
and
to
call
for
the
reversal
of
these
cuts
because
we
believe
there
really
is
a
tremendous
amount
at
risk.
Toronto
is
a
very
young
city
when
the
first
medical
officer
of
health
was
appointed.
These
lands
right
here
were
referred
to
as
the
ward.
K
They
were
slums
and
the
medical
officer
of
health
was
working
through
issues
like
typhoid
and
smallpox
through
deliberate
reform
and
education.
Over
close
to
150
years,
we
now
have
a
well-regarded
system
that
keeps
us
well
that
appreciates
that
children
will
do
better
if,
for
example,
they're
able
to
learn
in
classrooms
and
not
worry
about
being
hungry.
We
know
that
our
provincial
economy
and
our
city
economy
will
do
better.
If
we're
not
navigating
things
like
SARS
and
Walkerton
I
would
say
oftentimes.
K
I
will
be
very
sure
to
tell
them
today
that
at
the
Toronto
Board
of
Health
time
after
time,
history
was
referenced
and
I
believe
that,
in
more
than
you
know
anything,
we
need
to
look
at
the
history
of
this
city
immediately
around
here
to
reach
out
to
others
across
the
province
who
recognize
that
history
teaches
us
that
we
cannot
live
without
the
system
of
Public
Health
and
must
not
only
call
for
the
reversal
of
the
cuts
but
increased
support
for
public
health
units
across
the
province.
Thank
you.
A
A
A
L
Excuse
me,
thank
you,
I
actually
thought
we
were
on
the
list,
but
that's
okay.
Here
we
are
so
thank
you
for
inviting
us,
and
it
actually
is
a
great
honor
to
be
here
and
speak
on
behalf
of
the
relationship
between
Toronto
Public
Health,
specifically
but
public
health
generally
and
community
health
centers.
L
So
all
of
the
information
that
was
shared
before
is
actually
rests
within
the
context
of
CHCs
jason
and
I
come
from
south
Riverdale
community
health
center,
there's
73
of
us
in
the
province
and
all
of
us
work
closely
with
with
Public
Health
I
would
say
that
Toronto
Public
Health
has
been
a
leader
in
many
ways
that
we
have
benefited
by,
as
have
our
clients,
so
south
Riverdale
community
health
center
is
located
in
southeastern
Iran,
oh
and
we
work
with
the
people
that
the
soon-to-be
dr.
Winn
is
talking
about
in
terms
of
marginalized
communities.
L
South
Riverdale
works
with
about
11,000
clients,
and
these
are
folks
that
really
are
marginalized
and
have
access
to
some
things,
but
not
everything
and
that's
in
a
system
that
actually
has
been
well
resourced,
comparatively
to
get
primary
care,
for
example,
at
specialist
care
and
to
actually
consider
healthy
communities.
So
we
are
here
actually
to
connect
our
work
and
put
a
face
on
the
few
issues
that
we
work
with
Public
Health
on
and
without
public
health
to
support
us.
We
would
not
be
able
to
do
this
work,
so
this
is
really
in
the
trench.
L
Work
I'm
going
to
talk
about
harm
reduction
to
begin
with,
and
Toronto
Public
Health
supplies
us
with
the
supplies
that
we
distribute
to
public
health
and
in
the
last
year,
just
to
quantify
this.
There
we
distributed
four
hundred
thousand
needles
syringes
and
other
supplies
in
the
East
part
of
the
city.
They
also
support
our
our
mobile
outreach
services
and
I
just
want
to
reflect
on
a
little
bit
of
history
in
terms
of
AIDS,
and
it
was
during
the
AIDS
epidemic
that
Public
Health
was
able
to
prevent
the
spread
of
AIDS
through
the
distribution
of
this.
L
This.
These
supplies
today,
HIV
and
AIDS
and
other
infectious
diseases
are
in
fact
improving
because
of
Public
Health.
So
it
is
not
about
HIV
and
AIDS,
as
we
know,
has
not
been
eradicated,
but
they,
but
things
have
been
improving
because
of
Public
Health
and
the
their
vigilance
and
distribution
and
engagement
with
community.
L
It's
interesting
that
a
government
that
has
actually
now
launched
or
approved
community
treatment
teams,
in
spite
of
the
numbers
of
overdoses,
is
now
limiting
those
and
actually
looking
at
ways
to
potentially
and
reduce
the
distribution
of
supplies.
So
it
feels
mushy
have
those
services
that
have
been
approved,
but
to
date,
we'd
actually
have
no
more
detail
on
what
that
actually
means
and
there's
been
a
request
to
increase
them
with
Toronto
public
health
support
and
leadership
in
harm
reduction.
We
have
been
able
to
actually
gain
the
attention
of
this
current
government.
L
I
want
to
actually
talk
about
numbers,
I
think
I,
think
we've,
we've
all
talked
about
the
overdose
crisis
and
our
responsibility
in
addressing
that
in
the
role
of
Public
Health
to
assist
us
in
in
Toronto
in
since
last
October,
there
have
been
ten
point:
seven
thousand
people
that
have
gone
to
hospital
as
a
result
of
overdoses.
Two
thousand
deaths
are
were
related
to
overdose
crisis
and
over
six
hundred
connait
Ontarians
died
of
an
overdose
in
the
first
six
months
in
2018.
So
generally,
there's
an
increase
in
overdoses.
L
There
is
an
increase
in
hospital
visits
and
there's
an
increase
in
overdose
deaths.
These
deaths
will
continue
to
rise
if
we
don't
do
more
to
prevent
them,
and
the
question
has
been
asked.
What
do
we
do
about
this?
What
we
do
about
this,
as
we
actually
enhance
the
work
of
Public
Health,
this
also
increases
hallway
medicine.
So
it's
no
way
to
address
the
issues
that
they
have
put
on
the
table
and
they've.
Also,
no
one
has
discussed
yet
that
what
they
have
announced
is
looking
at
mental
health
and
addictions.
L
We've
talked
about
kids,
we've
talked
about
women,
we've
talked
about
people
that
lived
experience
and
the
public
health
postpartum
to
host
pardon
adjustment
program
that
we
do
with
public
health,
Michael,
Guerin,
Hospital
and
others
is
something
we
will
not
be
able
to
do
if
Public
Health
is
not
funded
to
do
so.
This
we
we
all
know
in
fact,
that
this
is
not
something
that
speaks
only
to
marginalized
communities,
but
also
to
the
general
community.
So
there
are
concerns
that
we
have
that
back
to
our
community
in
general.
L
Gonna
actually
wrap
up.
Okay,
let
me
get
to
my
conclusion.
I
think
I
think
the
role
of
community
health
centers
is
critical
in
terms
of
working
upstream,
as
dr.
Davila
has
always
advocated
community
health
centers
also
work
with
marginalized
communities
and
the
work
we
do
in
concert
with
Public
Health
has
extremely
important
keeping
people
well
before
they
go
to
the
hospital
and
use
other
parts
of
the
health
care
system
and
only
a
health.
Only
a
public
health
system
that
is
strong
will
be
able
to
do
that.
Thank.
A
C
A
J
Thank
You
mr.
chair,
looking
through
your
annual
report,
you
break
down
the
immense
return
on
investment
that
you
have
in
different
areas,
ranging
from
immunization
for
every
dollar
spent.
Save
16
fluoridation
for
every
dollar
spent
says
38
saves
38
dollars.
So
in
general,
these
savings,
though
they're
not
born
to
us
to
the
city.
Those
savings
are
born
to
the
province
right.
Could
you
just
walk
us
through
that?
A
little
bit
so.
B
B
Through
the
chair,
simply
yes,
every
in
every
program,
and
that
includes
being
prepared
for
and
being
able
to
respond
to
emerging
issues,
outbreaks
and
other
emergencies,
those
programs
plus
every
other
program
that
we've
described
that
we
engage
in
whether
it
has
to
do
with
food
and
nutrition
infectious
diseases.
Early
childhood
development,
every
single
one
of
our
programs
is
affected
by
these
kinds
of
funding
changes
that
are
being
proposed.
Thank
you.
Thank.
D
You
very
much
mr.
chair,
so
your
presentation
I
want
to
go
back
on
that
thing.
Slide
number
two
talks
about
the
90
million
dollar
of
investment
for
this
budget
deals
with
a
new
dental
program.
So
what
does
that
mean
translation
to
the
City
of
Toronto?
How
much
is
that
90
million
dollar
to
this
of
the
eternal,
and
how
much
would
that
you
anticipate
will
be
fatahna
public
health,
so.
B
Through
the
chair
at
this
stage
of
the
game,
I
don't
have
details
that
are
that
I
can
share
with
you
in
respect
of
this
particular
program.
What
we
have
right
now
is
that
there's
an
approximately
90
million
dollar
pool
for
a
low-income
seniors
dental
program.
This
is
from
the
budget
document.
However,
the
specific
details
have
yet
to
be
provided
to
local
public
health
organize
okay,
so.
D
Thank
you
for
that.
The
other
question
is
so
am
I
assuming
on
slide
number
three
that
all
the
100%
funded
program
starting
this
year,
we're
going
to
be
going
to
split
with
the
province
like?
Can
you
elaborate
further
which
program
right
now
by
the
province
that
they're
funding
one
hundred
percent
of
Toronto
Public
Health,
and
that
we're
immediately,
because
this
is
2019,
that
we
have
to
cough
up
40
percent
to
deal
with
these
programs?
What
does
that
really
mean
the
nuts
and
bolts
before
the
people
of
Toronto?
So.
B
There
are
roughly
right
now
about
eighteen
million
dollars
in
hundred
percent
provincially
funded
programs
that
are
received
at
Toronto,
Public
Health,
and
they
cover
a
wide
variety
of
different
programs,
largely
under
the
smoke-free
Ontario
Act.
There
are
healthy
smiles
Ontario,
which
is
a
dental
program,
a
prevention
and
treatment.
That's
provided
to
low-income
children
and
there
are
some
infectious
disease
infection
control
initiatives.
Those
make
up
the
bulk
of
the
hundred
percent
provincial
funding
programs
right
now.
B
So
the
interesting
thing
is
is
that
as
we
move
forward
right-
and
you
know,
given
the
proposed
funding
changes,
it
doesn't
necessarily.
It
changes
the
nature
of
the
pools
that
we
have
available
to
us
to
fund
programs
at
Toronto,
Public,
Health,
I.
Don't
think
that
it's
appropriate
at
this
point
in
time
until
we
actually
under
and
the
details
which
we
have
yet
to
receive,
to
start
commenting
specifically
on
what
programs
and
what
specific
implications
it
has
on
Toronto,
Public
Health
and
therefore
to
the
people
of
Toronto.
B
D
A
G
You
very
much
I
just
want
to
have
a
fuller
understanding
about
the
I
mean.
Obviously
we
don't
have
the
details.
You're.
Looking
for
details,
the
province
has
indicated
that
they're
going
to
individually
communicate
with
each
individual
Public
Health
Unit
about
their
concerns.
There's
a
timeline
to
change
all
the
funding
moving
forward.
I
mean
obviously
some
of
Israel.
Some
of
it
is
retroactive.
Some
of
it
is
moving
forward
in
22n
them,
and
the
model
of
governance
is
changing
in
2020.
How
can
they
get
this
done?
We're
halfway
through
the
year
just
about
so.
B
Through
the
chair,
I,
don't
think
there's
anybody
in
this
room
who
wants
to
answer
that
question
more
than
me,
but
unfortunately,
I
think
until
we
get
the
details
it
is,
it
is
impossible
to
really
be
able
to
plan
and
to
talk
about
what
the
substantive
implications
are
and
what
this
looks
like
on
the
ground.
What.
G
Happens
if
we
don't
get
those
details,
so
therefore,
all
we
have
is
the
announcement
that
we're
all
responding
to.
But
no
details
are
forthcoming.
Do
do
they
need
to
pass
legislation
to
change
this,
or
is
this
just
by
way
of
announcement,
a
decree
that
we're
just
going
to
change
the
way
we
do
business
and
do
we
have
do?
We
have
contracts
and
I'm
assuming
we
must
have
contracts
and
writing
around
the
funding
formula
and
how
the
allocations
are.
What
what?
What
do
we
need
here
so.
B
Through
the
chair
in
respect
of
the
funding
changes
again
from
a
physician
perspective
and
I
would
defer
to
my
legal
colleagues
who
are
probably
better
verse
in
respect
of
what
the
legislation
prescribes,
but
I
would
say
to
you
that
the
funding
changes
can
occur.
You
know
at
the
provincial
behest
the
governance
changes
I
described
would
require
legislation
to
be
introduced
and
would
require.
You
know,
follow
up
activities
related
to
that.
Okay,.
G
Thank
you
and
I
get
the
sense
from
the
province
that,
because
Toronto
I
mean
there's
a
lot
of
uncertainty
going
from
35
units
to
10
units,
but
Toronto
is
definitely
going
to
have
its
own
reach,
no
Toronto,
Public,
Health,
Unit
that
we
should
be
covered
and
somehow
there's
some
safe
ground
there.
How
would
you
interpret
that
so.
B
Through
the
chair,
what
we
have
been
advised
through
the
various
teleconferences
that
have
occurred
and
with
the
details
are
the
information,
let's
say
they're,
not
particularly
detailed,
but
the
information
we've
received
to
date
suggest
that
the
plan
includes
a
Toronto,
Regional,
Public
Health
entity
and
that's
about
as
far
as
we've
gotten,
okay,
so
nothing
more
nothing
further.
Okay,
thank
you
very
much.
J
Well,
the
post
announcement
provincial
budget
for
you,
dr.
Davila
I,
have
step
in
any
conversation
with
the
province
like
I
mean,
did
they
invite
us
to
talk
to
them
and
communicate
with
them
on
any
kind
of
these
things
that
shortfall
that
we
have
were
there
any
conversation
with
the
province
on
this
or
just
the
one
sided
thing
that
they
wanted
to
cut
and
that's
it
so.
B
Through
the
chair,
we
actually
haven't
had
the
opportunity
to
engage
in
what
I
would
characterize
as
real
conversation.
What
we
have
had
is
some
information
very
high-level
without
an
opportunity
to
really
dig
into
the
details
that
just
hasn't
been
provided.
Yet
what
we
have
had
is
again
this
very
high
level
information
provided,
but
but
not
yet
the
opportunity
to
engage
in
very
specific,
very
locally
focused.
You
know
with
details
on
numbers
programs.
B
J
B
J
Actually,
for
each
councillor
we
receive
what
specific
you
know
what's
going
to
affect
our
warden.
Are
that
with
different
wards
you
know:
are
these
child
care
inspection
program,
cuts
and
student
with
nutrition
program
cuts
and
on
a
school
immunization
in
all
those
public
health
issues
that
is
Commons
gonna
be
cut?
My
question
is
that
this
this
cut
is
retroactive
to
the
beginning
of
the
year.
Is
that
correct,
so.
B
Through
the
chair,
the
funding
changes
are
indeed
retroactive.
However,
the
list
that's
provided
is
not
necessary:
a
list
of
cuts.
It's
a
list
of
the
programs
that
are
provided
on
a
ward
by
ward
basis
by
Toronto
Public
Health,
to
give
councillors
a
sense
as
to
what
programs
are
at
risk.
Given
the
current
proposals
by
the
provincial
government
to.
J
B
J
B
J
I
want
to
dig
a
little
bit
into
this
issue
of
the
new
governance
model,
so
we
we
have
a
variety
of
entities
in
the
City
of
Toronto
that
have
provincial
and
municipal
rules.
Both
we
have
the
police
service
board,
say
the
Ontario
Municipal
Board
and
public
health
Toronto
Public
Library.
Each
of
them
have
very
different
sort
of
governance
arrangements,
I'm
wondering
if
you've
been
given
any
indication
of
what
the
new
Board
of
Health
arrangement
might
be.
There's.
J
J
B
J
B
B
Sorry
through
the
chair
with
the
funding
changes
that
have
been
announced
thus
far
are
specific
to
Ministry
of
Health
and
long-term
care
funded
programs.
Those
programs
that
you
speak
of
are
actually
funded
through
a
different
ministry,
and
we've
heard
that
we've
heard
nothing
different
in
respect
of
the
current
funding
model
on
those
or.
B
B
M
B
No,
in
fact,
there
are
Ontario
public
health
standards
with
associated
protocols,
and
the
expectation
is
that
local
public
health
units
will
deliver
on
those
and
what
are
some
examples
of
those
standards.
So
the
standards
cover
the
full
range
of
Public
Health
practice,
everything
from
surveillance
and
health
status
assessment.
The
diagnosis,
if
you
will
of
the
health
status
of
a
community
through
to
a
child
or
early
child
development,
and
child
health
and
development
programs
to
infectious
disease
case
management
prevention
and
control
to
healthy
environments.
M
B
A
B
If
I
can
through
you
mr.
chair,
if
you
refer
to
slide
five
in
the
presentation,
it
gives
you
the
pictorial
representation
of
what
we
expect
this
year.
So
we
did
have
we're
in
again
its
premise:
taun
the
assumptions
as
outlined
on
the
2018
allocation,
the
2019
city
approved
budget,
an
ineffective
start
date
for
changes
of
April
1st.
So,
in
fact,
what
we're
looking
at
is
a
total
funding
envelope
of
about
a
hundred
and
a
little
over
190
million
dollars.
B
Given
that
we're
changing
from
a
7525
model
to
a
60-40
model,
effective
April
1st
again,
it
depends
on
how
you
look
at
it
either
you
look
at
it.
A
25
million
dollar,
further
investment
over
and
above
that,
which
the
city
had
planned
for
in
its
budget
is
required
for
2019
or
if
the
city
cannot
come
up
to.
You
know
any
proof
to
provide
any
additional
funding.
We're
talking
about.
Roughly
a
sixty
five
million
dollar
hole
going
forward.
B
It
gets
a
little
challenging
to
determine
what's
happening
because
as
I
try
to
mention,
we
know
that
there's
an
intent
to
move
to
regional
models
and
that
there's
an
intent
expressed
to
reduce
the
funding
envelope
to
effect
annual
cost
savings
of
two
hundred
million
dollars.
So
if
we
presume
that
the
total
funding
envelope
doesn't
change,
Toronto
Public
Health,
you
end
up
with
a
certain
projection
in
terms
of
dollars:
loss
to
Toronto,
Public
Health.
B
However
I
think
we
have
to
imagine
that
if
regionalization
is
going
to
result
in
a
two
hundred
million
dollar
annual
savings,
the
new
governance
model
and
the
reduction
from
35
local
public
health
units
to
ten
is
to
have
a
savings.
Surely
Toronto
would
be
part
of
that
to
what
tune
I
don't
know.
So
it
becomes
difficult
to
predict
the
future,
but.
A
B
A
So
let
me
just
make
sure
I
have
all
of
this
based
on
what
we
know
and
what
we've
been
provided
if
the
province.
If
the
city
does
not
contribute
more,
we
are.
We
have
a
sixty.
Five
million
dollar
cut
this
year,
an
85
million
dollar
cut
next
year,
a
hundred
and
two
million
dollars
the
year
after
and
on
a
go-forward
basis.
107
million
thereafter.
Is
that
accurate?
Yes,.
B
A
A
A
B
A
A
A
B
A
B
Was
increased
in
recognition
of
the
importance
of
Public
Health
and
the
desire
to
ensure
that
coverage
and
important
public
health
services
were
provided
across
the
province
in
a
more
consistent
and
standardized
way
so
from
about
it
was
2004
2005
the
province
increased
its
investment
over
a
3-year
period
of
time
to
that
7525
level.
Okay,.
D
Sweet
we
have
a
budget
subcommittee
meeting,
so
I
think
we
need
to
drill
down
some
hummus
a
chair.
What
dr.
Daley
a
presentation
today,
because
I
think
my
main
concern
is
not
just
this
year's
I'm
funded
sixty
five
million
dollar
but
they're
going
forward
over
one
hundred
million
dollars
and
this
impact
to
the
system,
but
also
programs
and
services.
So
I'm
gonna
reserve
my
comments
but
I
think
next
weeks,
I
believe
next
week's
budget
meeting.
We
need
to
have
a
very
robust
conversation
with
staff.
What
does
this
really
mean?
D
What
is
plan
B,
C
and
D?
If
there
is
any
and
and
doing
some
really
critical
for
moving
forward
basis?
Because
not
just
about
the
budget?
The
governance
issue,
we
hear
the
word
Toronto
Regional,
Health
Runa.
This
may
not
be
just
a
City
of
Toronto,
my
friends,
it
may
be
GTHA
because
we
have
seen
the
word
Toronto
bantering
around
the
board
all
the
time.
D
So
it
may
not
be
exclusively
the
City
of
Toronto
Regional
Health
Unit,
but
will
be
including
the
other
Toronto
area,
our
neighbors
I'm,
not
saying
we
don't
include
our
neighbors
and
our
conversations.
But
having
said
that,
I
think
we
need
to
look
at
what
does
this
really
really
mean
mr.
chair,
but,
more
importantly,
we
need
to
anticipate
and
plan,
because
this
is
not
helpful
for
us.
We
have
a
lot
of
dark
lenses
out
there,
but
we
need
to
start
anticipating
the
changes
coming
forward.
So
thank
you
for
this
comment.
D
A
F
A
F
You
mr.
chair
in
the
provincial
government's
proposed
funding
model
to
modernize,
streamline
and
be
more
responsive
to
the
health
of
all
Ontarians.
It's
really
hard
to
imagine
how
these
significant
cuts
will
not
impact
or
worsen
the
health
of
the
citizens
of
Toronto,
but
all
Ontarians
are.
We
know
that
public
health
really
works
to
keep
the
health
of
communities
and
families.
F
Strong
I
am
particularly
concerned
about
the
health
of
our
most
vulnerable
populations,
specifically
children,
and
we
know
that
from
Statistics
that
every
dollar
invested
in
immunizing
children
saves
many
more
dollars.
Sixteen
dollars
in
the
health
care
system,
every
dollar
invested
in
early
childhood
development
will
save
nine
dollars
in
social
and
health
programs.
So
I
am
very
concerned
that
these
diminished
programs,
especially
for
youth
and
children,
will
result
in
erosion
of
the
significant
gains
we've
made
in
many
areas
in
nutrition,
oral
health
and
immunization.
F
N
These
are
being
reinforced
in
practice
and
that's
everything,
as
you
said,
from
primary
care
all
the
way
up
to
to
tertiary
care
and
the
other
piece
I
talked
about
was
advocacy,
so
students
are
taught
something
values,
medical
values
that
are
coined
the
can
med
roles
and
one
of
those
can
med
roles
is
to
be
an
advocate
and,
and
that's
what
you
guys
have
been
today
and
I
hope
you
continue
to
be
advocates
for
your
patients
in
the
future.
So
that's
the
education
piece.
The
other
piece
is
as
a
primary
care
provider
here
in
downtown
Toronto.
N
My
main
patient
population
are
newcomers
and
refugees
to
the
city
and
part
of
the
orientation
that
we
do
for
newcomers
is
explaining
to
them
how
the
Ontario
health
system
works
and
how
to
access
care
and
Toronto
Public
Health
is
the
foundation
of
that
and,
and
our
patients
are,
are,
are
taught
and
instructed
on
on
the
role
that
Toronto
Public
Health
public
health
care
programs
actually
enhance
their
health.
Some
have
actually
come
to
see
me
very
afraid
in
the
last
couple
of
weeks
of
how
these
cuts
are
going
to
impact
the
access
they
have.
N
So
dental
dental
is
the
main
one:
vaccination
administration
catch
up.
Surveillance
are
the
other.
The
prenatal
programs,
so
I
think
those
are
the
three
programs
that
we
can't
really
as
a
provider.
I
can't
really
tell
my
patients
not
to
worry
that
they
won't
have
access
to
these
programs
and
again
I.
Don't
have
a
contingency
plan
for
them
to
provide
those
services
elsewhere
to
the
degree
that
Toronto
Public
Health
provides
them
now
in
terms
of
other
vulnerable
populations.
N
You
know
high-risk
patients,
HIV
patients,
commercial
sex
worker
patients-
again,
who
are
part
of
existing
programs
where
Toronto
Public
Health
have
expressed
concerns
about
what
their
future
is
going
to
be
like
and
as
a
provider
I'm
quite
concerned,
because
we
collaborate
with
Toronto
Public
Health
every
day,
and
if
we
don't
have
that
support,
I'm
afraid
of
what
the
implications
those
implications
will
have
as
a
primary
care
provider.
If
we
don't
have
other
resources
to
fill
in
those
gaps
which
I'm
not
optimistic
for.
G
Thank
you
very
much.
Mr.
chair
I
had
asked
the
question
why?
Why
is
this
happening
to
a
number
of
the
speakers
and
what
are
the?
What
is
the
provinces?
True
intentions,
with
these,
these
big
announcements
around
efficiencies
and
asking
the
City
of
Toronto?
Now
much
of
Ontario
healthcare
providers,
public
health
care
providers
to
sort
of
do
more,
with
less
and
I.
G
Think
that
the
the
answer
that's
now
coming
to
light
and
I
think
that
we're
seeing
this
with
the
other
big
announcements,
quite
honestly,
whether
it's
the
upload
of
the
subway
or
the
reduction
of
the
gas
tax,
bringing
back
the
Ontario,
Municipal
Board
and
the
elimination
of
funding
to
housing.
All
this
is
about
taking
power
from
communities
and
local
governments
and
local
decision-makers,
and-
and
so
if
we
were
to
get
to
the,
why
and
the
true?
Why?
G
G
Obviously
there
will
be
those
where
we
have
to
sort
of
bring
back
the
the
patient
and
the
client
experience
and
talk
about
that.
But
really
what
is
at
stake
is
our
local
democracy
and
everything
that
that
that's
connected
to
that
on
how
we
make
decisions
for
our
local
community,
from
health
to
transit,
to
housing,
everything
so
I.
G
Just
wanted
to
say
that,
because
I
know
that
we're
we're
grappling
with,
let's
invite
them
to
talk
to
us,
let's
ask
them
very
nicely
to
to
stop
and
reverse
the
cuts
and
I
think
we
need
to
really
just
get
louder
and
angrier
till
the
only
thing
that
I
know
from
my
experience
that
the
premier
will
respond
to
is
power
and
strength,
and-
and
that's
what's
going
to
reverse
this
and
stop
the
future
announcements,
and
between
now
and
2020
I'll
just
say
it.
We
change
government
by
bullet
and
ballot.
G
M
A
reminder
of
how
deeply
entwined
public-health
work
is
with
the
work
of
municipalities,
but
also
the
work
of
the
province
and
the
healthcare
system
and
I
think
it
is
incumbent
on
us
as
a
board
to
think
very
deeply
about
what
the
future
of
Public
Health
really
needs
to
look
like
what
is
the
role
of
the
province?
What
is
the
role
of
the
municipality,
and
how
do
we
keep
local
voices
community
governance
at
the
forefront
right?
We
know
the
importance
of
having
those
local
voices
and
we
managed
to
change
bill.
M
We're
called
to
leadership
I
think
as
this
board
as
Toronto
Public
Health
Board,
not
just
here
for
the
people
that
we
are
serving,
but,
as
we've
heard
from
the
speaker's
today
for
those
all
right
across
the
province
and
as
I
think
Canada's
biggest
board
nationally
as
well.
So
the
actions
that
we're
taking
here
are
vital.
M
They
are
our
moment
to
take
this
leadership
and
so
I
think
it
is
important
for
us
to
think
not
just
about
the
immediacy
of
cuts
that
are
retro
actively
affecting
us
in
our
urgent,
but
also
about
the
medium
term
and
longer
term
conversations
about
where
Public
Health
is
going
and
what
is
the
collateral
damage
for
all
of
our
partners
and
allies.
So
we
heard
from
the
South
Riverdale
Community
Health
Centre
about
their
work,
that
they
do
that's
directly
funded
by
public
health.
But
what
about
the
work
that
they
do?
That
will
be.
M
M
We
had
the
O'connor
report,
2002
Campbell
report,
2004
CRC,
2006
expert
panel
report,
2017
right
and
I
just
wanted
to
read
for
one
one
of
them.
The
Campbell
report
after
SARS
that
basic
protection
against
disease
should
not
have
to
compete
for
money
with
potholes
and
hockey.
Arenas
right.
We
shouldn't
be
put
in
a
position
of
making
those
kinds
of
choices
when
the
funding
is
is
available
for
us
collectively
as
a
society.
So
let's
think
about
that,
as
we
move
forward,
Thanks.
A
Thank
You
kay
I'll
begin
and
I
have
a
motion
to
place
which
is
being
advanced
circulated.
It
is
for
City
Council
to
express
its
strong
opposition
to
the
funding
cuts,
to
call
on
the
province
to
reverse
the
cuts
and
to
direct
our
city
staff,
along
with
the,
in
consultation
with
the
MOH
to
utilize
city
advertising
locations,
to
inform
Torontonians
of
the
risks
associated
with
the
cuts
to
request
the
medical
officer
of
Health
to
inform
key
stakeholders,
including
partner
program,
partner
programs
and
agencies
of
the
impacts
and
tasks.
A
Our
medical
officer
of
Health
to
report
directly
to
Council
next
week
on
the
potential
impact.
Let
me
begin
my
comments
first
by
thanking
sincerely
dr.
Davila
and
her
whole
team
for
not
only
their
leadership
in
the
public
eye,
but
amongst
a
department
of
frontline
staff
who
are
feeling
deep
angst
today,
and
they
should
not
be
feeling
that
and
I
want
to
thank
and
commend
dr.
A
Davila
for
her
leadership
in
seeking
to
provide
reassurance
and
comfort
both
to
her
own
team
and
to
the
public
at
large
and
I
also
want
to
begin
my
comments
by
thanking
both
of
our
trustees
at
this
table.
Trustee
libretti
and
trustee
Donaldson,
who
have
been
outspoken
and
unwavering
in
their
work
with
their
own
school
boards
on
this
issue
in
the
last
few
weeks.
A
But
what
we've
seen
and
I
think
you've
seen
it
here
today
and
we've
certainly
seen
it
in
the
news-
is
that
this
is
now
a
province-wide
controversy
that,
since
the
cuts
were
announced
two
and
a
half
weeks
ago,
without
any
notice,
without
any
consultation
without
any
warning
and
which
came
in
place
retro
actively,
we
have
seen
a
wave
of
opposition
that
transcends
political
lines
and
geographical
boundaries.
The
twenty-eight
mayors
of
the
largest
cities
in
Ontario
have
spoken
out
against
these
cuts.
A
Today,
the
mayors
and
regional
chairs
of
Ontario,
representing
nearly
10
million
people
in
our
province,
officially
spoke
out
in
opposition
to
these
cuts.
The
northwestern
Association
of
municipal
so
of
municipalities,
representing
240,000
constituents
in
the
Northwest,
have
spoken
out,
along
with
12
boards
of
health,
from
Sarnia
to
Thunder
Bay,
to
Peterborough,
to
Sudbury
from
the
doctors
to
the
nurses,
the
OMA,
the
ona,
even
the
Ontario
pediatric
society.
A
It
takes
a
lot
to
piss
off
all
three
of
those
groups,
but
this
province
has
somehow
done
it
and,
of
course,
the
Toronto
District
School
Board,
the
Toronto
Catholic
District,
School
Board,
and
the
Association
representing
all
Catholic
trustees
in
the
province
have
spoken
out
and
so
I
think.
The
message
here
to
our
province
is
clear
to
premier
Ford
and
Minister.
Elliot,
reverse
the
short-sighted
and
dangerous
cuts
and
I
want
to
convey
a
message
to
our
staff
in
Toronto
Public
Health
to
the
members
of
this
board
in
to
residents
of
this
city.
A
As
the
chair
of
this
board,
we
will
not
let
these
programs
stop.
We
will
fight
these
cuts.
We
will
convince
the
province
to
reverse
them
and
we
will
not
under
any
circumstance,
allow
a
child
who
needs
a
breakfast
program
or
a
restaurant.
That
needs
to
be
inspected
to
stop
or
do
not
happen,
and
with
that
I
will
ask
for
a
unanimous
vote
on
the
motion
or
with
that
sorry
counselor
perks,
I
can
ask
you
don't
have
to
agree
with
me.
I
can't
ask
with
that.
I
would
ask
for
a
recorded
vote
on
this
motion.
A
D
I
remember
one
conversation
we
had
on
the
board
to
making
sure
when
we
advertised
that
is
a
multi
languages,
okay
and
then
the
last
piece
mr.
chair
with
regard
to
the
stakeholder,
because
we
have
multiple
presentation
recently
with
dr.
Kyle
from
Alpha
that
one
of
the
key
stakeholder
we
got
to
make
sure
we
work
with
is
alpha
so
just
just
making
sure
that,
because
they
are
the
Association,
we
have
representative
from
our
board
to
alpha
to
making
sure
that
stakeholder
is
including
alpha.
They.
A
You
we
have
two
last
items:
I'm
gonna
go
very
quickly
as
I
know,
amount
number
of
members
of
this
board
have
to
be
in
another
meeting
at
11:30.
The
next
item
is
item
6.2.
This
is
student
nutrition
program
services.
I
I
will
have
a
motion
to
defer
this
to
next
month.
Are
there
any
questions
of
staff?
A
First,
on
this
item,
seeing
none
speakers
aye
I
will
speak
first
and
that,
in
light
of
the
uncertainties
regarding
our
budget,
that
consideration
of
this
item
be
deferred
to
the
next
meeting,
I
have
confirmed
with
our
staff
that
that
in
no
way
impacts
any
of
the
programs
before
the
end
of
the
year.
So
there
is
no
risk
to
that
deferral.
Any
other
speakers
seeing
none
all
those
in
favor
opposed
if
any
that
carries
and
then
on
item
HL
6.5
I
have
to
reopen.
This
is
the
performance
appraisal
and
I
have
to
move
an
amendment.
A
So,
first
of
all,
emotion,
I
have
to
move
an
amendment,
all
those
in
favor
of
reopening
carried
and
then
clerks.
If
I
can
place
the
amendment
that
the
board
of
health
direct
that
the
2019
work
plan
for
the
MOH
remain
confidential,
as
it
contains
personal
information,
I
needed
to
move
that
my
apologies,
all
those
in
favor,
opposed
if
any
item
as
amended,
all
those
in
favor
opposed.
If
any.
Thank
you
very
much,
and
my
thanks
for
the
quick
end
to
our
meeting
today.
Thank
you.
Oh
good,.