Item - 2024.HL18.2

The Board of Health:

1.  Continued to recognize the drug toxicity epidemic as a public health crisis and continued to commit to actions that are evidence-based and urgently needed to promote wellbeing and community safety and aligned with the Our Health, Our City strategy.

2. Reiterated its request to the Government of Ontario to:

a.  Protect community health, well-being and safety by continuing to fund, and permit the operation of, all currently operating Supervised Consumption Services and Consumption and Treatment Services Sites beyond March 31, 2025; and

b.  Permit the co-location of Homelessness and Addiction Recovery Treatment Hubs (HART Hubs) and Supervised Consumption Services and Consumption and Treatment Services sites to provide for life-saving medical services, primary care, and increased pathways to treatment services.

3. Reiterated City Council's request to the Government of Ontario to consider the inclusion of Supervised Consumption Services in their new Homelessness and Addiction Recovery Treatment program proposals that demonstrate outcomes for life-saving medical services, primary care, and increased pathways to treatment services and that include mandatory neighbourhood and operational safety plans.

4. Requested the Our Health, Our City Implementation Panel to provide advice on the next set of priority actions, and to especially consider recommendations related to alcohol and tobacco.

5. Reiterated its request to the Government of Ontario to fund the proposal submitted to Ontario Health for the Substance Use Crisis Centre - Toronto (SCC-T).

6. Requested the Medical Officer of Health, in consultation with the City Solicitor, to provide a summary to the January 20, 2025 meeting of the Board of Health of any legal issues related to the Provincial decision to close Safe Consumption Facilities in Toronto.

7. Requested the Medical Officer of Health, in consultation with the Chief of Police, Toronto Police Service, the Fire Chief and General Manager, Fire Services, and the Chief, Toronto Paramedic Services to provide a summary to the January 20, 2025 meeting of the Board of Health of likely service impacts related to the Provincial decision to close Safe Consumption Facilities in Toronto.

8. Expressed its support of Bill S-269, An Act respecting a national framework on advertising for sports betting.

9. Forwarded this item to the Federal Minister of Health and the Federal Minister of Mental Health and Addictions to express its support for the passing of Bill S-269, An Act respecting a national framework on advertising for sports betting.

The Medical Officer of Health; the Director, Strategy and Clinical Services, Toronto Public Health; the Member of Our Health, Our City Implementation Panel; the Associate Director, Stakeholder Relations and Health Equity, Toronto Public Health; and the Executive Director, Social Development, Finance and Administration gave a presentation on Our Health, Our City: Annual Progress Report 2024.

In November 2023, the Board of Health adopted Our Health, Our City: A Mental Health, Substance Use, Harm Reduction and Treatment Strategy for Toronto, which is a comprehensive five-year and city-wide strategy to address both mental health and substance use related issues in Toronto. The Board of Health also directed the Medical Officer of Health to report back to the Board with annual progress reports on the implementation of Our Health, Our City.

This staff report provides an update on the current landscape, including the ongoing drug toxicity epidemic, as well as an overview of progress made in 2024 towards the implementation of the strategy, such as establishing the Our Health, Our City Implementation Panel, which includes representatives with lived and living experience of substance use and/or mental health challenges and a range of community partners.  

Over the last year, significant progress has been made towards the first-year priorities identified in the strategy. For example, the City has made advances on affordable and supportive housing, partners are taking steps to increase access to 24-7 crisis support services, and the Toronto Police Service has established a new pilot project to improve hospital transitions. Most notably, the Toronto Community Crisis Service has been expanded city-wide, which improves access to appropriate services and support for people in crisis.

Partners across the City have demonstrated action in areas that are well-aligned with Our Health, Our City recommendations, as well as continued partnership and collaboration to advance the strategy. Some examples of divisional initiatives are highlighted in this report, and a comprehensive status overview is provided in Attachment 1: Our Health, Our City Status Overview 2024. The Our Health, Our City Implementation Panel was also established in September 2024 following a public application process, and this panel will provide ongoing advice to further implement the strategy, including exploring priority areas of action for the following years.

Finally, this report also provides an update on recent actions to reduce harms specifically associated with cannabis, vaping, and smoking for youth. Toronto Public Health continues to provide an inspection and enforcement function, as well as health promotion, prevention, and education to reduce the harms associated with youth vaping.

Children's Services, Economic, Development and Culture, Toronto Employment and Social Services, Fire Services, Municipal Licensing and Standards, Parks, Forestry and Recreation, Senior Services and Long-Term Care, Social Development, Finance and Administration, Toronto Paramedic Services, Toronto Police Services, Toronto Public Library, Toronto Shelter and Support Services, and Toronto Transit Commission were consulted in the development of this report.

Parallel work on a co-developed Indigenous Wellness strategy is also underway at Toronto Public Health. An Indigenous Wellness Table and Indigenous Harm Reduction Circle with Indigenous-led service providers in the city were established and both groups continue to convene to advance Indigenous wellness, with a particular focus on harm reduction and promoting mental health and wellness.