Item - 2025.HL25.2

The Board of Health recommends that::

1. City Council approve the creation of the Downtown Homelessness Addiction Recovery and Treatment (HART) Hub.

2. City Council authorize the Medical Officer of Health to enter into agreements and other arrangements, on an ongoing basis, with other entities, including City divisions, hospitals, health care organizations, physicians and other health care providers, and community organizations for the purpose of delivering programs and services through the Downtown Homelessness Addiction Recovery and Treatment (HART) Hub in Toronto that are fully funded by the Government of Ontario and within the approved Toronto Public Health budget, in accordance with applicable program and funding guidelines, on such terms and conditions that are satisfactory to the Medical Officer of Health and in a form approved by the City Solicitor.

3. City Council direct the Deputy City Manager, Community and Emergency Services to convene an outreach and case management coordination table comprising of relevant City divisions and agencies to streamline pathways into programs and services and monitor outcomes.

The Board of Health:

1. Directed the Medical Officer of Health to report back to the Board of Health in the fourth quarter of 2025 with a status update on the implementation of the Downtown Homelessness Addiction Recovery Treatment Hub, including work to finalize indicators for reporting on the performance of its programs and services.

In 2024, the City of Toronto, in collaboration with health care and community partners, applied to the Ministry of Health to establish the Downtown Homelessness and Addiction Recovery Treatment (HART) Hub. The Downtown Homelessness and Addiction Recovery Treatment Hub aims to improve the health of Toronto residents by facilitating access to health care services for people who use drugs, including improved access to treatment and recovery services, and integrated pathways to wraparound supports such as mental health care and housing.

On January 2, 2025, the Ministry of Health confirmed that the City of Toronto had been approved ‘in principle’ to implement a Downtown Homelessness and Addiction Recovery Treatment Hub. This report provides an overview of plans to establish the City of Toronto’s Downtown Homelessness and Addiction Recovery Treatment Hub and seeks authority for the Medical Officer of Health to enter into agreements with external parties to implement the Homelessness and Addiction Recovery Treatment Hub.

This report also provides an overview of the client case management, aggregate reporting, and outreach coordination plan for the Downtown Homelessness and Addiction Recovery Treatment Hub as directed by the Board of Health on April 1, 2025.