Item - 2025.HL21.6

The Board of Health:

1. Urged the Government of Ontario to:

a. Increase access to Supervised Consumption Services and Consumption and Treatment Services Sites consistent with the location requirements within the Community Care and Recovery Act, 2024 to prevent overdose deaths and facilitate pathways to substance use treatment; and

b. Permit needle exchange services within Homelessness and Addictions Recovery Treatment (HART) Hubs to reduce the transmission of communicable diseases.

c. Share provincial plans for mitigating healthcare system impacts due to the closures of Supervised Consumption Services and Consumption and Treatment Services Sites, as part of implementation planning for Homelessness and Addictions Recovery Treatment (HART) Hubs.

2. Requested and authorized the City Solicitor to:

a. Seek leave to intervene on behalf of the Board of Health in the Superior Court Application bearing Court File No. CV-24-00732861-0000 (the “Application”) and to intervene in the Application if granted leave by the Court; and

b. Take any further steps necessary and consistent to give effect to this authorization, in consultation with the Chair of the Board of Health, or in the Chair’s absence, the Vice-Chair of the Board of Health.

3. The Board of Health directed that Confidential Attachment 1 to the report (January 17, 2025) from the City Solicitor remain confidential in its entirety as it contains advice which is subject to solicitor-client privilege and information about litigation or potential litigation that affects the Board of Health.

4. The Board of Health directed that the confidential information contained in Confidential Attachment 1 to the report (January 7, 2025) from the City Solicitor remain confidential in its entirety as it contains advice which is subject to solicitor-client privilege and information about litigation or potential litigation that affects the Board of Health.

The Board of Health recessed its public meeting to meet in closed session to consider the item as it pertains to advice or communications that are subject to solicitor-client privilege and information about litigation or potential litigation that affects the Board of Health.

On December 4, 2024, the Government of Ontario passed the Community Care and Recovery Act, 2024. This legislation introduces new requirements for operating supervised consumption service sites in Ontario and will lead to a reduction in supervised consumption services available in Toronto by March 31, 2025.  

On November 18, 2024, the Board of Health requested the Medical Officer of Health, in consultation with the Toronto Police Service, Toronto Fire Services, and Toronto Paramedic Services to provide a summary of likely service impacts related to the anticipated closure of supervised consumption sites in Toronto. This staff report provides an overview of anticipated service impacts to Toronto Public Health's clinical service and emergency services in the city as a result of this provincial policy change.

The Board of Health also requested the Medical Officer of Health, in consultation with the City Solicitor, to provide a summary of any legal issues related to the Provincial decision to close supervised consumption sites in Toronto. An overview of the legal implications and advice related to the closures of the supervised consumption sites is provided in the supplementary report from legal services.

Supervised consumption sites are healthcare facilities that allow people to bring their own drugs to use in the presence of trained healthcare professionals. These facilities save lives, connect people to social services and are pathways to treatment. The new legislation will reduce access to an evidence-based clinical healthcare service leading to an anticipated increase in preventable fatal and non-fatal overdoses.

Toronto Fire Services, Toronto Paramedic Services and Toronto Police Service were consulted in the development of this report.

The Community Care and Recovery Act, 2024 (the “CCRA”) received Royal Assent on December 4, 2024. The CCRA creates new restrictions on harm reduction services in Ontario, including a prohibition on the operation of a supervised consumption site within 200m of a school, private school, child care centre, and EarlyON child and family centre. It also limits the power of boards of health and municipalities to apply for new exemptions under the Controlled Drugs and Substances Act, to apply for funding from Health Canada for safer supply services, and to support applications that relate to the aforementioned.

Confidential Attachment 1 provides further information and advice regarding the Community Care and Recovery Act, 2024.

The Community Care and Recovery Act, 2024 (the "CCRA") received Royal Assent on December 4, 2024. On December 9, 2024, a Notice of Application was issued in the Ontario Superior Court of Justice which challenges the constitutionality of the CCRA (the "TNG Application").

A supplementary report to Item HL21.6 was submitted by the City Solicitor on legal issues related to the CCRA and TNG Application on January 7, 2025. This second supplementary report provides an update on the TNG Application and seeks instructions from the Board of Health regarding participating as an intervenor.