Item - 2019.HL3.1

The Board of Health:

1.  Endorsed the Toronto Indigenous Overdose Strategy, as outlined in Attachment 1 to the report (February 6, 2019) from the Medical Officer of Health.

2.  Again urged the Government of Canada and the Province of Ontario to fund and support the development of Indigenous-led overdose prevention and response action plans at the federal and provincial levels.

3.  Urged the federal and provincial governments to align 2019/2020 (and beyond) funding calls with practical and immediate overdose responses, in particular, access to funding supports for Indigenous agencies to create, strengthen, and enhance culturally-safe outreach, mobile, and peer support services to Indigenous Peoples who use substances.

4.  Urged the federal and provincial governments to contribute funding to Toronto Public Health's Toronto Urban Health Fund Indigenous Stream, which is under development, to support Indigenous agencies.

5.  Urged the federal and provincial governments to contribute funding to Toronto Public Health's Toronto Urban Health Fund to enhance support to Indigenous-specific programs and services in mainstream organizations to expand their outreach and harm reduction capacity.

6.  Urged the Ministry of Health and Long-Term Care to dedicate funding for 24/7 Indigenous-led Consumption and Treatment Services in Toronto, as part of the new Consumption and Treatment Services Program.

7.  Urged the Ministry of Health and Long-Term Care to ensure the availability of culturally-safe medical care to Indigenous Peoples who use substances now and into the future. Health care providers should explore opportunities to support the use of traditional medicines and approaches to healing, including facilitating access to Ceremony, Healing Circles, Elders, and/or Healers, for their Indigenous clients.

8.  Urged the Ministry of Health and Long-Term Care to require all provincially-funded health care providers that provide medical services to Indigenous Peoples in Toronto to demonstrate accountability through formal mandates and strategic plans for their investments and outcomes related to culturally-safe care for Indigenous Peoples, including ongoing Indigenous cultural-safety training and education for non-Indigenous health care providers.

9.  Urged the Ministry of Health and Long-Term Care to increase and target funding to support the development and operationalization of culturally-safe, appropriate, and on-demand abstinence-based treatment spaces for Indigenous Peoples.

10.  Directed that the Toronto Indigenous Overdose Strategy, as outlined in Attachment 1 to the report (February 6, 2019) from the Medical Officer of Health, be forwarded to the Ministry of Health and Long-Term Care, the Toronto Indigenous Health Advisory Circle, the City’s Aboriginal Affairs Committee, the City’s Indigenous Affairs Office, the City’s Shelter, Support and Housing Administration Division, the Toronto Aboriginal Support Services Council, and all local public health units in Ontario.

 
11.  Directed the Medical Officer of Health to provide a one-year progress report on the implementation of the Toronto Indigenous Overdose Strategy to the Board of Health and the Toronto Indigenous Health Advisory Circle in 2020.

12.  Requested that Michelle Sault, Principal Consultant, Minokaw Consulting, make a presentation on the Toronto Indigenous Overdose Strategy at a future Board of Health meeting in 2019.

The opioid poisoning crisis continues unabated in Toronto and in communities across the country. Indigenous individuals and communities have experienced profound grief and loss from this crisis. While there is limited data available, we know that many Indigenous People in Toronto have overdosed and some have died as a result of the toxic illicit drug supply. New prevention, harm reduction, and treatment initiatives have been implemented in recent years, but not on the scale or with the urgency required. For Indigenous communities in Toronto, the lack of culturally-safe services that reflect the diversity of Indigenous values and traditions are contributing to this crisis.

The need for a separate Indigenous-led process to develop an overdose prevention and response strategy for Indigenous People in Toronto was recommended in the Toronto Overdose Action Plan (TOAP). This staff report provides an overview of the recently-developed Toronto Indigenous Overdose Strategy (TIOS), which is intended as a companion document to the TOAP. Development of the TIOS was led by an Indigenous facilitator, in collaboration with an Advisory Committee comprised of Indigenous service providers and community members and Toronto Public Health (TPH) staff. Indigenous service providers and non-Indigenous service providers that work with Indigenous People who use substances were consulted as part of this initiative. However, this report is deeply rooted in the perspectives and advice received from a diverse range of Indigenous People who use/have used substances and who were the main stakeholders consulted for this Strategy.

The directions in the TIOS align well with those of the TOAP. The TIOS directs recommendations to all levels of government and community service providers in the areas of prevention, harm reduction, and treatment. The recommendations are grounded in an Indigenous world view that seeks to reconnect Indigenous People to their culture and traditions as part of improving health and well-being holistically. Overall, people said they want Indigenous services delivered by Indigenous service providers, in particular, Indigenous peer workers with lived experience of substance use.

TPH is strongly committed to supporting implementation of the recommended actions in TIOS, and will undertake the actions directed to TPH. TPH will dedicate an Indigenous staff resource to assist in supporting the implementation of TIOS in collaboration with Indigenous service providers and community members, including Indigenous People who use/have used substances, and City divisions.