Supervised consumption sites set to close confirm plans to apply for HART hubs as deadline hits

At least a few of the supervised consumption sites slated to close at the direction of the Ford government have confirmed they will apply to become Homelessness and Addiction Recovery Treatment hubs.

On Aug. 20, Health Minister Sylvia Jones announced the province would close 10 consumption and treatment services (CTS) sites within 200 metres of schools or child-care centres and ban future ones. The sites would need to shut their doors by March 31, 2025 or convert to a Homelessness and Addiction Recovery Treatment (HART) hub.

These hubs, the government said, would connect people to services such as primary care or mental health treatment and add up to 375 "highly supportive housing units" along with "addiction recovery and treatment beds."

HART hub applications are due Friday. 

The move to close existing CTS sites has been controversial, with advocates and health groups warning it will lead to preventable deaths. The sites have workers who can reverse overdoses and connect people to mental health and treatment options. 

The health minister has denied the closures would lead to more deaths, previously saying, “People are not going to die."

The Trillium reached out to the 10 following sites set to close, all of which, except for the Kensington Market site, receive provincial funding, to ask whether they'd be applying for funding for a HART hub.

• Guelph Community Health Centre – 176 Wyndham Street North, Guelph
• Hamilton Urban Core Community Health Centre – 70 James Street South, Hamilton
• NorWest Community Health Centre – 525 Simpson Street, Thunder Bay 
• Parkdale Queen West Community Health Centre (Bathurst) – 168 Bathurst Street, Toronto
• Regent Park Community Health Centre – 465 Dundas Street East, Toronto
• Region of Waterloo Public Health and Emergency Services – 150 Duke Street West, Kitchener
• Somerset West Community Health Centre – 55 Eccles Street, Ottawa
• South Riverdale Community Health Centre (Queen) – 955 Queen Street East, Toronto
• Toronto Public Health (The Works) – 277 Victoria Street, Toronto 
• Kensington Market Overdose Prevention Site, The Neighbourhood Group – 260 Augusta Avenue, Toronto

The South Riverdale Community Health Centre said in an Oct. 11 email to The Trillium that it was planning to apply in partnership with 11 other organizations for HART hub funding. Several of the other groups provide housing and the collaboration is being co-ordinated through the East Toronto Health Partners — an Ontario Health Team. 

The centre said it decided to partner with other groups because it supports team-based care.

"It will increase access to programs and services, such as social connection, access to healthcare (primary care, midwifery, low barrier treatment for mental health and substance use), harm reduction, which minimizes the spread of blood-borne infections, such as HIV and Hep C, and the social support and referrals our most vulnerable community members require on a daily basis.  In addition, it will improve access to housing/supportive housing," the South Riverdale Community Health Centre said in a statement. 

But the centre added that it would have preferred a model that included a CTS. 

"The fact remains that it would be very beneficial to have the range of the HART Hub’s enhanced services, including mental health and substance use treatment, working with the CTS, in order to reach the full population and provide additional services for CTS users who are supported by dedicated CTS staff to improve their health/lives," the centre stated. 

"Unfortunately, the HART Hub model does not provide CTS services, which is an essential entry point to healthcare programs and services and an integral component to the continuum of care for people who use drugs. The delivery of care in a CTS is specifically designed to keep people alive in the context of the ongoing toxic drug crisis/overdose crisis, and we remain concerned that our current clients will not have sufficient access," the centre stated. 

"These life-saving services are needed now more than ever. The people we serve often have highly complex health-care needs who face extreme stigma. We connect them to onsite comprehensive wrap-around care."

The centre said the closure of several Toronto sites would "result in unnecessary overdoses" and prevent vulnerable individuals from getting necessary health care.

Dr. Eileen de Villa, Toronto's medical officer of health, said Toronto Public Health (TPH) would stop supervised consumption services at its CTS site  — The Works  — by the end of March, but that the city, TPH and other health and social service organizations would partner to submit a HART hub application. 

The Region of Waterloo is also planning to do the same.

"We are working with our local network of community partners and health services providers to develop a community-based application to bring a HART hub to Waterloo Region. We know that our community needs better access to primary care, mental health and addiction care, housing and the social supports associated with the model," said the region in a statement.

On Thursday, the NDP's Kristyn Wong-Tam joined health and other professionals at Queen's Park to call on the province to reconsider its plan to close the CTS sites. 

Wong-Tam said she'd like to see the sites stay open with expanded service hours, more treatment beds, funding for sites that have already closed due to a lack of funding, and a guarantee of "access to treatment and recovery services, including detox and treatment beds within 24 hours of requests."

Matthew Kellway, director of policy with the Registered Nurses' Association of Ontario, said the "harm reduction" services CTS sites provide are something "deeply embedded in nursing practice."

"To pose harm reduction in opposition to treatment as this government does, is profoundly dishonest or ignorant," Kellway said. "It is all part of the same complicated continuum of care for people with substance use disorder."

Dr. Samantha Green, a family doctor in Toronto who also has a child attending a daycare close to one of the CTS sites set to close, said she's opposed to the government's "reckless decision" to close the sites. 

"And it's so shameful that this is being done in my name," she said.

The government stood its ground on the CTS closures and said it's taken steps to expand treatment beds and invested $20 million for mobile crisis response teams. 

“Communities, parents, and families across Ontario have made it clear that the presence of drug consumption sites near schools and daycares is leading to serious safety problems. We agree. That’s why our government is taking action to keep communities safe, while supporting the recovery of those struggling with opioid addiction," Hannah Jensen, a spokesperson for the health minister, said. 

"We recognize Ontarians deserve more than a health care system that is focused on providing people struggling with addiction with tools to use illegal drugs and our government is taking the next step to create a system of care that prioritizes community safety, treatment and recovery by investing $387 million to create HART Hubs," she added. 

EDITOR’S NOTE: This article originally appeared on The Trillium, a Village Media website devoted to covering provincial politics at Queen’s Park.