Ontario says it has “successfully transitioned” nine former supervised drug consumption sites across the province into abstinence-based HART hubs, providing health care, housing and treatment to people looking to get clean.
Without funding agreements with the Ministry of Health, however, many of the sites' promised services — from withdrawal management to supportive housing, to primary care — won’t be up and running for a while yet.
Health Minister Sylvia Jones’ office said the nine sites — including four in Toronto — have received startup funding but don’t yet have their yearly operational budgets. The Ministry of Health will look to finalize that funding by mid-April, spokesperson Hannah Jensen said.
She did not say when the ministry expects the full suite of services to be up and running.
The ministry has committed $6.3 million per hub per year.
“As of today, we have still not received a written funding agreement from the province,” Coun. Chris Moise, chair of Toronto’s board of health, said on Tuesday. Toronto Public Health will operate one hub in the downtown core.
“We’ve received promissory notes but we haven’t received anything in writing,” he said.
The city will have a better idea of what services it can offer once the funding flows, though some are available right away. The money will also allow the city to develop fulsome plans for the facility going forward, he said.
Moise cautioned that “this new hub will not replace safe consumption services” and said other Toronto sites are in the same boat.
“Many of the former [supervised consumption sites] who are now HART hubs have not received confirmation of funding.”
Doors remain shut without funding agreement
The nine former consumption sites were forced to transition into HART hubs or shut down entirely under the Ford government’s law that banned the sites within 200 metres of a school or child-care centre. Despite a court injunction allowing them to stay open, provincial funding is contingent on banning on-site consumption. All nine chose to become HART hubs.
“Our government is proud to announce the successful transition of these nine sites into new Homelessness and Addiction Recovery Treatment Hubs that will keep our communities safe, while giving those struggling with mental health and addictions challenges hope and the tools they need to break the cycle of addiction,” Jones said in a release on Tuesday.
Despite the government claiming all nine sites will offer services starting on Tuesday, at least one — the South Riverdale Community Health Centre in Toronto’s east end, which shut down on March 21 — is closed. A source with knowledge of the negotiations said the groups running the new HART hub won’t be able to open it until they’re sure of their funding.
Guelph’s only supervised consumption site, the Guelph Community Health Centre, transitioned into a HART hub on Tuesday. Without a funding agreement from the province, CEO Melissa Kwiatkowski said the site’s supportive housing, withdrawal management beds and crisis stabilization beds will be phased in over the coming months.
The site isn’t offering any services it wasn’t offering as an SCS, including health care and addiction and mental health supports, Kwiatkowski said. The main change has been working with the community to take on a “much bigger role in terms of responding to the drug poisoning crisis,” she said. Downtown Guelph has started to see an increase in public drug use as the SCS has wound down over the past month, she said.
“This represents a really big change in the community for low-barrier services that people have access to, a space where they could come, they were welcome, they were safe, they were connected and supported, and now don't have that anymore,” Kwiatkowski said.
Kitchener-Waterloo’s new HART hub is offering services like addiction medicine, employment help and some primary care as of Tuesday, but a five-day/week full-service primary care and addiction counselling team — as well as mobile outreach services, food, laundry, showers and 12 transitional beds — won’t be available for three to six months.
'If they want to use, they’re going to use'
Joseph Ascenzo, an SCS site user and peer worker in Toronto, said he doesn’t believe any of the people he works with will make use of the HART hubs.
“If they want to use, they’re going to use. They’re going to use in alleyways, they’re going to use in public washrooms — they’re going to use,” he said.
Ascenzo, who mainly uses crystal meth, said his usage was “out of control” before SCS sites came online in 2018. The sites have allowed him to become a “functioning addict” and hold down a steady job, he said.
“These (SCS) sites need to become an essential service like the hospital’s an essential service,” he said.
Ascenzo’s wife, who also used drugs, died of an overdose a decade ago, he said.
“To be honest, if these places were around when my wife was still alive, she’d still be here,” he said.
Toronto outreach worker Diana Chan McNally said she expects libraries and homeless drop-in sites to bear the brunt of the reduction in harm reduction services.
“When I used to work in drop-ins, before we had SCS, all we did was reverse overdoses. It's going to go back to that because it's already where people are going. They trust the staff there. It's safe and indoors, and they're more likely to use those locations than to go halfway across the downtown to access a new service,” she said.
As the process plays out on the ground, a judge is considering a Charter challenge to the Ford government’s law. Justice John Callaghan, who ruled on the injunction last week, said the issues are “complex” and will require time to consider, which could take months.
