Item - 2026.HL31.3

The Board of Health:

1. Requested the Medical Officer of Health to extend the Downtown Community Outreach Response and Engagement (CORE) pilot program and report back to the Board of Health in the third quarter of 2027 with final recommendations on the program and as part of this work:.

a. assess the feasibility and potential impact of expanding the Downtown CORE Program primary service area boundaries to explicitly include Union Station; and

b. engage with key stakeholders, including the NAIOP Greater Toronto, Financial District Business Improvement Area, Waterfront Business Improvement Area, and Toronto Downtown West Business Improvement Area on the expansion of the Downtown CORE Program.

2. Requested the Medical Officer of Health to continue collaborating with health system partners and relevant City of Toronto divisions and agencies on initiatives to improve the health and wellbeing of people experiencing homelessness.

The Medical Officer of Health gave a presentation on Health Impacts of Homelessness and Update on the Downtown CORE Pilot.

At the end of January 2026 there were 11,094 people experiencing homelessness in Toronto - a circumstance that can lead to extensive health harms and negatively impact the health trajectory of an individual over their lifetime. When compared to their housed counterparts, people experiencing homelessness are at increased risk of dying prematurely and suffer a higher incidence of chronic and acute health conditions including infectious disease, diabetes, cardiovascular disease and respiratory disease.

This report provides a short overview of the health impacts of homelessness and identifies key actions taken by Toronto Public Health to protect and promote the health of this population. This includes a summary of Toronto Public Health's evaluation of the Downtown Community Outreach Response and Engagement (CORE) pilot program. The Downtown CORE pilot pairs public health nurses with police constables to deliver integrated, low-barrier, mobile outreach and case management services to individuals experiencing homelessness and challenges with mental health and substance use in the Yonge-Dundas (Sankofa Square) area. The evaluation found that the program is connecting clients with medical care and social supports and identified opportunities to strengthen and refine the model. This report explores opportunities to extend this pilot program.