Item - 2025.HL21.5

The Board of Health:

1. Recognized that access to affordable, well-supported, and appropriate housing, alongside equitable income supports, is essential for improving population health and well-being.

2. Requested the Medical Officer of Health:

a. Assess Toronto Public Health services for accessibility and the use of trauma-informed approaches as discussed in the Health and Homelessness Working Table in Attachment 3 to the report (December 31, 2024) from the Medical Officer of Health to advance these practices across the organization;

b. Share the report from the Health and Homelessness Working Table in Attachment 3 to the report (December 31, 2024) from the Medical Officer of Health with relevant City of Toronto divisions and agencies, and propose collaborative interventions to support implementation of the recommended actions and report back on the status of these recommendations to the Board of Health in Q1 of 2026; and
 

c. Share the report from the Health and Homelessness Working Table in Attachment 3 to the report (December 31, 2024) from the Medical Officer of Health with relevant local health care partners and Ontario Health - Toronto Region, to propose collaborative interventions such as peer support navigator programs to navigate the health care system and establish pathways to bring health care to meet people where they are.

3. Requested the Medical Officer of Health share the report (December 31, 2024) from the Medical Officer of Health with the City Manager for consideration with the work that is being done addressing the City's acute homelessness issues to support implementation of the recommended actions from the Health and Homelessness Working Table in Attachment 3.

4. Urged the Government of Ontario and the Government of Canada to collaborate with the City of Toronto to provide the necessary policy, funding, and intergovernmental support to sustain and strengthen the health, mental health and harm reduction services under the Homelessness Health Services Framework.

5. Requested that the Medical Officer of Health collaborate with Toronto Shelter and Support Services (TSSS) to support the continued delivery and advancement of the Homelessness Health Services Framework (HHSF) by:

a. Collaborating with the Homelessness Health Services Framework Steering Committee to provide public health expertise, align Toronto Public Health services, and foster intersectoral collaboration to advance the health and well-being of people experiencing homelessness;

b. Working with partners to increase equitable access to health care, including the full continuum of evidence-based prevention, harm reduction, and treatment supports for people experiencing homelessness; and

c. Advocating for sustainable funding from Ontario Health and the Ministry of Health to enhance prevention-focused mental health and crisis intervention services, expand supports for individuals with complex mental health and social needs, address systemic barriers, strengthen shelter safety, and ensure equitable access to care for people experiencing homelessness.

6. Requested the Government of Canada and Government of Ontario partner with the City of Toronto to establish an intergovernmental collaborative group to advance actions to address the health and well-being of people experiencing homelessness in Toronto that:

a. Includes representation from people with lived and living experience of homelessness, organizations serving people experiencing homelessness, healthcare and social service providers, and municipalities; and

b. Is informed by the expert advice in the report from the Health and Homelessness Working Table, as outlined in Attachment 3 to the report (December 31, 2024) from the Medical Officer of Health.

7. Requested that the Medical Officer of Health engage in ongoing advocacy with all orders of government for an increase in affordable, well-supported, and appropriate housing options, as a key determinant of population health and well-being.

8. Affirmed that Torontonians who are undocumented and without status experience unique vulnerabilities within the intersection of health and homelessness and that the Access to City Services for Undocumented Torontonians policy (AccessTO) exists to provide them protection.

9. Requested that the Federal Government consider a proactive cannabis record expunging for convictions of simple possession.

The Acting Director of Strategy, Toronto Public Health and the Member, Homelessness Working Table, gave a presentation on Feedback from the Toronto Public Health and Homelessness Working Table.

In January 2023 the Board of Health requested that the Medical Officer of Health develop a working table to review the intersection of health and homelessness. In response, Toronto Public Health convened a group of experts and individuals with lived and living experience, including representatives from healthcare, academia, frontline services, and various City of Toronto divisions to create the Health and Homelessness Working Table. This group participated in a series of eight meetings from August 2023 to May 2024.

The primary objective of the Health and Homelessness Working Table was to provide input on and share recommendations addressing health-related issues affecting individuals experiencing homelessness in Toronto. Each meeting focused on specific health issues or populations, such as healthy environments, chronic disease management, refugees and asylum claimants, safety and injury prevention, mental health and substance use, and health across the lifespan.

Throughout the series of meetings, participants emphasized the need for enhanced multi-sector collaboration involving all levels of government. They identified gaps and opportunities for improving access to and coordination of services between healthcare and social services, as well as for better communication and resource sharing with individuals experiencing homelessness. The overarching recommendation was the establishment of an intergovernmental collaborative group to address the needs of people experiencing homelessness, with consideration of the feedback provided by this group.

Children's Services, Senior Services and Long-Term Care, Social Development, Finance and Administration, Toronto Shelter and Support Services, and Housing Secretariat were consulted in the development of this report.