Item - 2017.HL19.16

The Board of Health recommends that:

1. City Council increase the 2017 Toronto Public Health operating budget by $177.9 thousand gross, $44.5 thousand net, fully funded from the first quarter Operating Variance, to fund three permanent positions to implement Toronto Public Health actions in Toronto's Overdose Action Plan.

There is an overdose crisis in Toronto as in other cities across Canada, in particular overdoses related to opioids such as heroin and fentanyl. There is broad agreement in the community and among all orders of government that urgent action is needed to reduce the number of people who are experiencing and dying from drug overdoses.

At its March 20, 2017 meeting, the Board of Health unanimously approved the report entitled Toronto Overdose Action Plan: Prevention and Response. Toronto Public Health (TPH) developed the Action Plan in consultation with the Toronto Drug Strategy Implementation Panel and its Overdose Coordinating Committee, and the broader community. The Action Plan provides a comprehensive set of actions to help address the overdose crisis in our city, most importantly, actions that we can take at the local level.

The Toronto Drug Strategy Secretariat, which is a small staff team in Toronto Public Health that supports implementation of our City's drug strategy, has been dedicated as the coordination lead for implementing the Toronto Overdose Action Plan. This role is critical to ensuring the Action Plan is implemented. However, to take on this role the Secretariat has suspended work on drug strategy recommendations that fall outside the scope of the Action Plan, and some epidemiological work at TPH is delayed in order to direct staff resources to implementing the Action Plan. As supervisor is also needed for The Works harm reduction program to manage the overdose prevention and response training and policy/protocol development program for municipal and community services, which is a key component of the Action Plan.

In the staff report accompanying the Toronto Overdose Action Plan, the Acting Medical Officer of Health stated that a funding request for the additional resources required for the Action Plan would be included in the TPH 2018 Operating Budget request for consideration during the City's 2018 budget process.

At the March 20, 2017, the Board of Health passed a motion "requesting the Ministry of Health and Long-Term Care to fund three permanent positions at a cost of $374,709.95 gross/ $0 net in 2017 to implement TPH actions in Toronto's Overdose Action Plan; and, if the Ministry of Health and Long-Term Care does not provide this funding, the Board of Health direct the Medical Officer of Health to assign the necessary staff to implement the TPH actions recommended in the Plan on an interim basis until the resource requirements to implement the Toronto's Overdose Action Plan can be considered by City Council as part of the 2018 TPH Operating Budget process." And further, "That the Medical Officer of Health report back to the May 17, 2017 meeting of the Board of Health with an update on the above funding request from the Province of Ontario."

At the March 23, 2017 meeting of the Toronto Drug Strategy Implementation Panel, members discussed the Action Plan and expressed serious concern about the lack of staff resources allocated to implement the Action Plan and the drug strategy, both of which are urgently needed. In response, the Panel passed the following motion:

If the Province of Ontario has not committed to fund the City of Toronto's portion of the Toronto Overdose Action Plan, the Toronto Drug Strategy Implementation Panel requests City Council to identify and allocate the necessary new funds immediately in order to conduct this work. Further, that the source of these new funds should not be found at the expense of any other critical public health or social services.

The Medical Officer of Health has informed me that the Ministry of Health and Long-Term Care has indicated that they cannot confirm any funding for additional staff at this time as they are considering a provincial approach to these requests coming from local health units across Ontario.

Given the urgency of this issue, I request the Board of Health to consider the motion from the Toronto Drug Strategy Implementation Panel, as noted above. The overdose crisis continues to grow in Toronto, and the City needs to demonstrate leadership and commitment to this issue by ensuring the necessary resources in place to implement the Action Plan while also ensuring the important work of the drug strategy continues.