Item - 2025.HL23.8

The Board of Health:

1. Directed the Acting Medical Officer of Health to begin implementation of the interim Downtown HART Hub model, as set out in the update from the Medical Officer of Health and in accordance with the City of Toronto’s application to the Ministry of Health for HART Hub funding.

2. Directed the Acting Medical Officer of Health to report back once confirmation of Provincial funding is received with:

a. An update on the interim HART Hub model, including rollout of services, partnerships, and opportunities to enhance wrap-around case management supports;

b. Information on the permanent HART Hub model, including planned services, partnerships, and timelines for completion; and

c. Any agreements and authorities required to enable the Downtown HART Hub.

3. Directed the Acting Medical Officer of Health to develop a comprehensive client case management, aggregate reporting, and outreach coordination plan and report back by the June 3, 2025 Board of Health meeting.

4. Directed the Acting Medical Officer of Health to collaborate with City divisions to continue to support stakeholders in proximity to 277 Victoria Street including but not limited to Toronto Metropolitan University and the Downtown Yonge Business Improvement Area until September 30, 2025, including participating in the Yonge-Dundas Safety Network, and supporting their outreach teams with access to naloxone kits, and safe needle collection and disposal services, within the guidelines of the Ontario Naloxone Program and the Ontario Harm Reduction Distribution Program.

The Associate Medical Officer of Health gave a presentation on the Update on the City of Toronto’s Downtown Homelessness and Addiction Recovery Treatment (HART) Hub.

Last December, the Government of Ontario passed the Community Care and Recovery Act, requiring five Supervised Consumption Service (SCS) sites and Consumption and Treatment Services (CTS) sites in Toronto to close their doors no later than March 31, 2025.

Alongside these legislative changes, the provincial government also announced a new funding stream to support the creation of Homelessness and Addiction Recovery Treatment (HART) Hubs, including a total of $378 million to implement these hubs across Ontario.

The new Homelessness and Addiction Recovery Treatment (HART) Hub model will help address the needs of our most vulnerable communities, offering a comprehensive suite of supports, which can include, addiction care, primary care, supportive housing, employment support, and more.

As part of the Homelessness and Addiction Recovery Treatment (HART) Hub announcement, Supervised Consumption Service sites impacted by the new legislation were encouraged to apply for funding, with an aim to transition their services to the new model.

In response, Toronto Public Health (TPH) and partners across City divisions, healthcare, and community organizations submitted a Downtown Homelessness and Addiction Recovery Treatment (HART) Hub application to the Ministry of Health. The Ministry approved this application ‘in principle’ on January 2, 2025.

The City of Toronto’s Downtown Homelessness and Addiction Recovery Treatment (HART) Hub application outlines a range of proposed services that could be implemented pending suitable funding. These include 24/7 Intake, Medical Monitoring and Referrals. Supportive Housing Connection, Substance Use Treatment and Primary Care, Outpatient Medical Specialty Services, Assertive Community Therapy, Withdrawal Management Beds, and more.

Toronto Public Health has been working with partners to develop and implement plans for year one of the Hub, with some services initiating on April 1, and more becoming available throughout the year.

As we work to mitigate the impacts of the March 31 closures of Supervised Consumption Service sites and continue collaborating with our partners to establish our own Downtown Homelessness and Addiction Recovery Treatment (HART) Hub, I am requesting an update be provided to the Board of Health.