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From YouTube: Board of Health - January 22, 2018
Description
Board of Health, meeting 24, January 22, 2018
Agenda and background materials:
http://app.toronto.ca/tmmis/decisionBodyProfile.do?function=doPrepare&meetingId=12981
Meeting Navigation:
0:10:10 - Call to order
Agenda Items:
0:10:10 - HL24.1 - Election of Chair for 2018 - Board of Health (Ward All)
0:12:37 - HL24.2 - Election of Vice Chair for 2018 - Board of Health (Ward All)
0:17:53 - HL24.3 - 2018 Board of Health Committees and Appointments (Ward All)
0:22:31 - HL24.4 - Toronto Overdose Action Plan Implementation Update (Ward All)
0:14:09 - HL24.5 - Towards 5 Percent by 2035: Renewal of the Smoke-Free Ontario Strategy (Ward All)
0:15:03 - HL24.6 - Appointment of Associate Medical Officer of Health (Ward All)
0:15:28 - HL24.7 - The Toronto Action Plan to Confront Anti-Black Racism (Ward All)
0:16:15 - HL24.8 - Re-affirming City of Toronto as a Nuclear Weapons-Free Zone (Ward All)
0:22:31 - HL24.9 - Drug Amnesty Boxes at Music Festivals and Other Events (Ward All)
1:40:49 - HL24.10 - Public Health Review of REimagining Yonge Municipal Class Environmental Assessment (Ward All)
A
A
A
So
the
first
item
of
business
is
election
of
the
chair
members.
Are
there
any
nominations
for
chair
councillor
do
said:
I
would
like
to
nominate
councillor
Joe
havoc,
so
councillor
Doucet
has
nominated
council
Irma
havoc
I'm
asking
for
nominations
again.
Are
there
any
further
nominations
for
chair
I'm
calling
for
nominations
the
second
time?
Are
there
any
further
nominations
for
chair
and
I'm
calling
for
nominations
a
third
and
final
time?
B
That's
right:
if
only
this
could
happen
in
October,
then
that
would
be
so
good
and
you
know
what
we
have
to
do,
that
this
is
a
function
of
this
of
the
health
protection
and
promotion.
Act,
there's
a
clause
that
requires
that
the
board
chair
and
vice
chair
be
elected
every
every
year,
so
welcome
to
meeting
number
24
of
the
board
of
health
to
both
members
present
and
to
the
public
for
those
in
the
room
here,
there's
a
screen
at
the
back.
B
That
gives
real-time
updates
concerning
where
we
are
at
the
agenda,
and
you
know
if
you're,
not
here,
if
you're
at
home,
you
can
also
follow
us
at
WCA
for
council,
it's
a
live
stream
and
I've
been
known
to
actually
follow
councils
and
committees.
When
I've
been
in
other
parts
of
the
world,
you
can
just
kind
of
do
it
anywhere.
B
B
Are
there
any
declarations
of
interest
pursuant
to
the
municipal
conflict
of
interest
Act,
seeing
none
conformation
of
Menace
November
27th
moved
by
Angela
Johnson,
all
in
favor
opposed
the
penny.
That's
carried
we'll
go
through
the
agenda,
while
it's
dude
number
24
point
to
election
of
vice-chair
for
2018
Board
of
Health
I
would
like
to
nominate
Sarah
Doucet.
As
vice-chair
are
there
any
other
nominations
going
once
going
twice
going
three
times?
Congratulations,
sir,
to
set
place
chair.
B
Okay,
number:
three
of
twenty
four
point:
three
is
2018
Board
of
Health
committees
and
appointments
through
a
bit
of
pushing
back
and
forth.
We
have
all
our
positions
filled,
except
for
alpha
so
alpha.
So
when
we
get
to
it,
if
you
could
be
thinking
it's
a
great
body,
it's
the
body
that
brings
together
the
public
health
agencies
across
Ontario
and
they're
a
great
resource
lots
of
opportunity
to
learn
lots
of
opportunity
to
lead
there
and
to
network
with
boards
of
health
and
other
folks
across
the
province.
B
C
B
B
Twenty
four
point:
eight
is
Lynn
Adamson
for
so
long
in
the
peace
movement
she's,
the
one
deputed
here
so
I
did
get
a
call
with
some
of
the
folks
in
the
in
the
piece
of
movement,
and
they
are
asking
that,
given
that
the
we
did
or
resident
of
the
City
of
Toronto
received
the
Nobel
Peace
Prize,
that's
Sukho
thorough
on
this,
and
that
was
the
occasion
of
the
motion
going
to
council.
She
wanted
to
come
and
a
group
of
others
wanted
to
come
as
well
to
speak
to
the
item.
B
They
can't
come
because
one
of
them
is
is
Sukho,
herself
is
under
the
weather,
so
they
they
would
like
us
to
defer
this
to
the
April
meeting
of
the
Board
of
Health.
But
I
don't
see
Lynn
here.
So
if,
if
you
don't
we'll
move
it
and
if
we
have
to
open
it,
if
she
really
insist
that
she
wants
to
speak
now
rather
than
in
April,
then
we'll
reopen
it.
If
that
serves
people's
pleasure
so
deferred
to
the
April
meeting
of
the
Board
of
Health,
a
moved
by
Councillor
Fletcher
on
favor
opposed
to
thing.
B
B
So
the
pieces
that
we
needed
to
do
is
the
Board
of
Health
Budget
Committee,
and
we
have
myself
constitu,
said:
councilor
Chrissy
capital,
councilor,
Qian,
Angela,
Johnson
and
Paul,
a
nag
nag
Paul
on
the
Board
of
Health
Budget
Committee,
alpha
Board
of
Directors.
That's
pause
at
first
SEC
for
the
Toronto
Urban
Health
review
panel.
We
are
looking
for
one
person
either
councillor
or
citizen
member
of
the
of
that
the
panel
and
Peter
Wong,
who
has
declined
to
work
further
on
alpha.
A
Thank
you,
doctor
and
Joe.
Alpha
is
the
organization
which
helps
with
governance
of
and
providing
resources
for
all
the
health
units
across
Ontario
I
think
there
are
35
units
Toronto
being
the
largest
unit,
but
there
are
many
small
units
with
very
few
resources,
but
play
an
integral
part
in
public
health
across
Ontario.
A
So,
as
the
representative
from
the
City
of
Toronto,
you
will
have
an
opportunity
to
understand
the
barriers
and
the
difficulties
that
other
smaller
units
face
throughout
on
their
you
know,
their
geographic,
the
population,
differences,
socio-economic
differences
and
importantly,
govern
governance,
differences
and
problems
faced
through
governance.
So
they
provide
modules
and
help
with
that,
and
it
gives
a
great
understanding
and
exposure
of
what
happens
throughout
the
whole
of
Ontario
and
a
very
good
learning
experience
about
public
health
in
our
area.
Thanks
Joe.
B
B
Is
anyone
else
interested
okay,
so
we're
putting
Stacey
beard
Stacey
berry
in
there,
so
I
will
read
out
the
names
as
being
the
first
meeting
of
the
year
and
we
have
to
get
reorganized
every
year
here.
So
the
the
motion
is
to
approve
the
staff
recommendations
amended
by
the
by
this
following
a
column
and
I'll
give
this
to
the
clerk.
B
So
Board
of
Health
Budget
Committee,
myself
counselor,
said:
council
crest
accounts
are
San:
Angelo
Johnson,
Paul,
nag,
Paul,
alpha
Board
of
Directors,
amended
by
including
Stacey
barriers
are
representative
Toronto
Urban
Health
Review
Panel
amended
by
including
dr.
Peter
Wong
in
as
the
Board
of
Health
citizen
member
and
the
MOH
performance
appraisal.
Committee
myself,
casa
de
said,
councillor
Shan
Stacey
berry.
B
A
E
F
B
B
Okay,
so
the
last
piece,
medical
officer
helped
performance
appraisal.
Committee,
myself,
counselor
said
counselor
Shan
and
ELISA
levy,
okay,
great
so
motion
to
amend
the
recommendations
from
staff
by
including
this
chart
on
it
all
in
favor,
opposed
if
any
we
are
organized
for
the
year
okay.
So
we
have
then
really
frankly,
the
presentation
from
staff
we
have
one
deputy
tenth,
so
we'll
hear
the
presentation
room
staff
first,
we'll
hear
the
deputy
take
it
in
and
take
it
from
there
dr.
develop.
E
Thank
You
mr.
chair,
so
in
front
of
you,
you
will
see
that
I'm
going
to
be
presenting
this
afternoon
on
an
update
on
the
implementation
of
the
Toronto
overdose
action
plan
and
before
I
launch
into
my
presentation.
I
just
want
to
say
that
while
I
am
the
one
who's
here,
presenting
I'm
over
at
the
back
of
the
room
is
Susan
Shepherd.
She
will
be
driving
the
slides
as
it
were,
and
not
only
does
she
drive
the
slides,
but
frankly
she
drives
a
significant
amount
of
the
work
with
respect
to
the
Toronto
overdose
action
plan.
E
So,
while
we
are
doing
a
presentation
today,
we
will
be
submitting
a
report
to
the
Board
of
Health
in
this
spring,
but
this
is
an
urgent
and
an
important
issue
for
our
community,
which
is
why
we
felt
it
was
important
that
we
bring
you
an
update
today
and
give
you
a
sense
as
to
what's
happening
in
certain
key
areas
of
activity.
So,
just
to
give
you
a
little
bit
of
background,
you
probably
will
recall
that
the
Board
of
Health
approved
the
Toronto
overdose
action
plan
in
March
2017,
so
not
quite
a
year
ago.
E
E
So
moving
into
more
specifics,
one
of
the
things
that
you've
heard
us
talk
about
several
times
as
we
talk
about
the
Toronto
overdose
action
plan
is
that
we
continue
to
have
challenges
with
respect
to
accessing
real-time
data
and
despite
the
fact
that
we're
having
these
challenges,
we're
continuing.
You
know
very
much
to
work
on
this
issue
with
our
partners.
E
I
can
tell
you
that
they're
multi,
sectoral,
Toronto
overdose,
early
warning
and
alert
Partnership
was
convened
last
January,
and
it
continues
to
meet
to
this
day
so
that
we
can
share
information
amongst
the
key
partners
working
in
this
arena.
We
worked
with
members
of
this
group
to
develop
the
Toronto
overdose
information
system,
and
this
is
available
on
our
website
and
I
would
encourage
you
to
have
a
look
on
our
web
site
to
see
what
kinds
of
information
are
available.
E
You'll
note
that,
on
that
website,
we
regularly
update
all
sorts
of
opioid
related
data
and
we
do
try
to
keep
it
as
current
as
possible.
The
kind
of
information
that
you'll
find
there
includes
emergency
room
visits,
opioid
overdose
deaths,
treatment
uptake
and
the
number
of
people
using
the
supervised
injection
services
at
the
works,
the
specific
location
that
is,
or
the
specific
supervised
injection
service.
That's
operated
by
Toronto
Public
Health
in
recent
months.
E
We've
also
added
data
on
opioid
overdose,
calls
from
Toronto
paramedic
services
and
we're
continuing
to
work
on
getting
data
that
can
actually
help
us
target
services
in
those
particular
areas
of
the
city
where
overdoses
are
occurring.
I
think
that
while
there's
been
great
progress
in
terms
of
acquiring
these
data
and
we're
continuing
to
have
conversation
and
I
would
say
very
fruitful
conversation
with
partners,
these
are
formal
data.
E
So
what
we're
recording
and
what
we're
able
to
report
on
are
those
incidents
that
actually
come
to
the
attention
of
the
formal
system,
the
healthcare
system,
whether
it's
paramedics,
hospitals,
etc.
So
those
who
choose
not
to
engage
or
cannot
engage
with
the
formal
health
system,
for
whatever
reason
that
might
be
is
those
data,
those
incidents.
E
So,
looking
now,
specifically
at
opioid
overdose
deaths,
the
office
of
the
Chief
Coroner
for
Ontario
recently
released
preliminary
estimates
of
the
number
of
opioid
overdose
deaths
in
Toronto
for
the
period
from
May
to
July
of
last
year,
as
you'll
see
on
the
slide
depicted
in
front
of
you
for
that
three-month
period
there
were
a
total
of
82
deaths
reported.
This
is
nearly
double
the
number
of
people
who
died
from
opioid
or
doses
during
the
same
time
period
in
the
preceding
year.
E
Moving
to
the
next
slide
as
I
mentioned
earlier,
we
are
also
monitoring
the
number
of
calls
to
paramedics
for
suspected
opioid
overdoses
and
emergency
department
visits
for
all
drug
overdoses
in
Toronto
and
the
graph
on
the
slide
that
you
see
in
front
of
you
shows
the
most
recent
six
months
of
available
data.
As
you
can
see
from
this
slide,
both
indicators,
that's
called
paramedic
services
for
suspected
opioid
overdoses
and
emergency
department.
Visits
for
all
drug
overdoses
are
declining
and
have
been
declining
since
the
high
number
of
cases
seen
this
past
summer.
E
Moving
on
to
the
next
slide
again
giving
you
a
bit
more
of
a
sense
as
to
the
kind
of
data
that
we're
reporting
out
in
respect
of
drug
overdose
in
Toronto.
What
you
see
here
is
a
map
showing
the
location
of
opioid
overdose,
calls
received
by
Toronto
paramedic
services
over
the
last
five
months
of
2017.
E
So
the
areas
with
the
highest
density
of
cases,
just
to
take
you
through
at
a
very
high
level,
would
include
clearly
by
this
map
the
downtown
core,
the
Parkdale,
neighborhood,
Eglinton,
Dufferin
area,
the
area
around
Jane
and
Lawrence
and,
as
you
can
see
by
that
purpley
red
area
in
and
around
the
Danforth
from
the
Danforth,
from
about
Pape
to
Victoria
Park.
So
I'm
going
to
remind
you
that
these,
in
fact,
are
the
data
for
the
last
five
months
of
2017.
E
Even
during
that
last
five
month
period
of
2017,
there
is
some
degree
of
variability
with
respect
to
the
number
of
calls
that
are
generated
or
the
interactions
between
paramedics
and
suspected
opioid
overdoses.
That
varies
from
location
to
location
and,
in
fact,
we're
showing
you
these
five
month.
Data
and
I
think
you
can
expect
that
the
geographic
patterns
will
vary
over
time
and
even
within
the
time
window
that
we've
prepared
and
that
we're
demonstrating
to
you.
E
So
turning
now
from
a
geographic
perspective
to
looking
at
specific
subpopulations
amongst
people
who
are
homeless,
overdosed
stands
out
as
a
predominant
cause
of
death,
and
this
is
demonstrated
through
the
slide
in
front
of
you
now.
Our
current
estimate
for
the
number
of
deaths
of
people
who
are
homeless
in
Toronto
for
2017
stands
at
ninety-four
of
these
53
were
considered
sudden
or
unexpected
deaths
which
were
investigated
by
the
regional
coroner's
office.
As
you
can
see
from
the
slide,
23
of
those
cases
were
found
to
be
deaths
resulting
from
drug
overdose.
E
This
represents
almost
one
quarter
of
the
total,
updated
information
on
the
deaths
of
homeless
people
for
all
of
last
year.
2017
will
be
made
available
this
week
on
our
website
and
I'll,
be
reporting
additional
information
on
this
issue
to
the
board
in
April.
So,
turning
now
to
the
next
component
of
the
Toronto
overdose
action
plan,
you
can
now
talk
a
little
bit
about
public
education
and
what
we've
done
and
what
we
have
in
mind
in
Toronto
Public
Health
in
terms
of
activity.
E
This
requires
a
particular
kind
of
expertise,
as
you
can
well
imagine
one
of
the
main
components
and
one
of
the
main
reasons
for
which
we
would
want
to
undertake
this
kind
of
public
education
campaign
is
to
actually
reduce
the
stigma
associated
with
substance
use
to
help
reduce
risk
factors
for
over
overdose.
Hence
the
need
to
actually
acquire
some
specific
expertise
from
an
external
agency.
It's
a
complicated
issue,
stigma
as
I
know.
Many
of
you
around
this
table
will
understand
is
not
a
simple
issue
to
dispel.
E
We
also
made
sure
that
information
and
resources
were
sent
out
to
particular
subpopulations
I,
sent
out
a
communication
earlier
in
the
fall
to
school
boards,
talking
about
overdose
prevention
and
encouraging
school
board
officials
to
have
and
share
the
information
with
parents
and
caregivers.
We
also
sent
out
communications
to
universities
and
colleges,
with
an
outline
specific
that
they
can
take
as
post-secondary
administrators
and
also
gave
them
information
that
could
be
provided
directly
to
students
on
how
they
can
prevent
and
respond
to
overdoses.
E
E
They
also
piloted
a
train-the-trainer
session
with
winter
respite
and
out
of
the
cold
programs,
where
staff
leads
were
trained
on
overdose
response,
including
the
administration
of
naloxone,
and
this
kind
of
training
approach
is
going
to
be
continued
to
be
rolled
out
throughout
2018.
A
series
of
overdose
protocols
and
policies
across
agencies
were
providing
support
to
those
agencies
to
make
sure
that
they
have
some
expert
resources.
They
seek
to
develop
their
own
protocols
and
policies
to
manage
clients
for
their
agencies
and
they've.
E
Also,
our
our
folks
at
the
works
have
also
worked
towards
an
creating
an
organisational
overdose
risk
assessment
tool
to
help
agencies
determine
what
kinds
of
respond
as
they
should
have
in
place,
given
the
nature
of
their
setting
and
their
clients
still
more
on
the
subject
of
overdose
prevention
and
response,
those
kinds
of
activities
are
not
exclusive
to
Toronto
Public
Health.
There
is
also
overdose
prevention
and
response
training,
with
support
from
Toronto
Public
Health
as
needed
in
other
city
divisions,
including
the
Toronto
Public
Library.
E
Our
colleagues
at
parks,
forestry
and
Recreation
are
also
or
have
worked
again,
with
Toronto
Public
Health
colleagues
to
have
training
specific
to
their
setting.
Our
colleagues
at
shelter,
support
and
housing
also
have
undertaken
prevention
and
response
training
and,
in
addition,
I
can
advise
you
that,
with
respect
to
fire
and
police
in
December,
the
Ministry
of
Health
and
long-term
care
announced
that
they
would
fund
naloxone
kits
for
fire
and
police
for
amongst
those
who
are
interested
in
having
access
to
those
resources.
E
We've
also
tried
to
expand
the
distribution
of
naloxone
by
contracting
with
community
agencies.
We've
got
several
agencies
already
on
board,
who
have
expressed
interest
and
we've
successfully
contracted
with
them.
Many
many
others
who've
also
expressed
interest
and
were
in
the
process
of
working
through
the
necessary
arrangements
to
allow
further
other
community
agencies
to
received
a
lock
zone
from
us
for
further
distribution
to
their
clients.
E
Just
a
reminder
that
broadening
the
distribution
of
naloxone
was
one
of
the
key
recommendations
in
the
Toronto
overdose
action
plan.
There
are,
of
course,
a
wide
variety
of
other
routes
by
which
naloxone
is
made
available
to
members
of
the
community.
There
is
a
pharmacy
naloxone
program.
Hepatitis,
C
programs
throughout
the
province
have
long
been
engaged
in
the
distribution
of
naloxone,
methadone
providers
or
methadone
treatment.
Service
providers
are
also
working
on
providing
naloxone
hospital
emergency
rooms,
a
number
of
expressed
interest
in
also
being
naloxone
distribution
sites
and
again,
given
that
this
is
an
important
part.
E
Naloxone
distribution
is
an
important
component
and
a
key
component
and
recommendation
in
the
Toronto
overdose
Action
Plan
we're
continuing
to
work
with
as
many
partners
and
actually
having
conversation
around.
Where
are
the
places
that
can
actually
distribute
naloxone
to
those
who
might
actually
benefit
from
having
it
available
through
their
programs
and/or
services.
E
E
I
can
tell
you
that
the
Works
has
expanded
its
street
outreach
and
mobile
outreach
services
targeting
those
key
key
areas
where
overdoses
are
occurring
in
the
last
quarter
of
2017
Toronto
Public
Health
did
provide
one-time
funding
to
five
community
health
agencies
in
Toronto
who
well
established
in
the
harm
reduction
arena
so
that
they
could
increase
their
peer
outreach
efforts.
The
Ministry
of
Health
and
long-term
care
is
flowing
more
funding
to
community
harm
reduction
services
through
the
lens,
and
this
is
an
area
that
continues
to
expand
and
grow.
E
E
Just
to
give
you
an
update
with
respect
to
the
Good
Samaritan
overdose
act.
You
may
recall
that
in
2017
the
federal
government
passed
the
Good
Samaritan
overdose
Act,
which
protects
people,
I,
should
say
from
arrests
for
drug
possession
at
an
overdose
scene.
We've
met
with
police
to
actually
talk
about
this
legislation
and
I
understand
that
officers
are
being
trained
on
this
new
law.
The
federal
government
is
also
engaging
in
an
education
and
information
campaign
regarding
the
act.
There's
a
downloadable
poster
which
has
been
posted
in
transit,
shelters
and
other
locations
around
the
city.
E
In
addition,
the
Canadian
hiv/aids
legal
network
has
worked
with
community
partners
to
develop
a
wallet
card
for
people
who
use
drugs
so
that
they
can
understand
and
have
with
them
at
all
times
information
around
what
offences
the
law
protects
them
from
and
what
things
the
law
may
not
protect
them
from,
so
that
they
have
an
understanding
as
to
what
the
meaning
of
the
law
is
bear
with
me.
We're
getting
close
to
the
end
of
the
presentation.
E
There's
a
lot,
as
you
can
tell,
there's
been
quite
a
bit
of
activity
over
the
last
little
while,
anyway,
with
respect
to
supervised
injection
services.
This
is
a
story.
That's
likely
familiar
to
many
of
you
around
the
table
at
Toronto,
Public
Health,
our
interim
supervised
injection
services
opened
on
the
21st
of
August
and
the
permanent
supervised
injection
services
opened
on
November,
the
eighth.
It
is
currently
operating
from
10:00
a.m.
to
10:00
p.m.
Monday
to
Saturday,
and
it's
anticipated
that
we'll
be
operating
seven
days
a
week,
starting
in
March.
E
So,
just
to
give
you
a
sense
as
to
the
usage
of
this
particular
supervised
injection
service
between
August
21st
and
the
end
of
December
2017,
there
were
1977
so
just
under
2000
client
to
the
supervised
injection
services
at
the
works
at
Toronto
Public
Health.
There
are,
of
course,
other
supervised
injection
service
services
provided
in
the
city.
E
South
Riverdale
Community
Health
Center
opened
their
supervised
injection
service
on
November
27th
of
last
year,
and
it's
anticipated
that
the
supervised
injection
services
at
Queen,
West,
Community,
Health
Center
and
at
Fred
Victor's,
Queen,
Street,
East
location,
will
open
in
February
of
this
year.
Unfortunately,
I
don't
have
a
precise
date,
but
we're
hoping
that
sometime
in
the
not-too-distant
future
and
we're
looking
at
the
month
of
February
right
now,
turning
now
to
overdose
prevention
sites,
these
are
facilities
that
have
been
operating
for
some
time
in
other
jurisdictions
in
Canada,
most
notably
British,
Columbia
and
Alberta
and
they're.
E
Seen
and
I
think
we
should
see
them
as
part
of
the
continuum
of
strategies
in
order
to
respond
to
the
overdose
crisis.
I
think
what
has
drawn
our
other
partners
and
other
jurisdictions
around
the
country
towards
opening
these
particular
services
is
that
in
fact,
they
can
be
opened
much
more
quickly
than
supervised
injection
services.
So
it's
an
important
part
of
the
continuum.
We
have
to
have
a
wide
variety
of
strategies
to
address.
You
know
the
situation,
which
has
many
many
dimensions
to
it.
E
As
you
know,
on
August
the
12th,
a
group
of
community
volunteers,
opened
an
overdose
prevention
site
in
Moss
Park
in
response
to
an
increase
in
overdoses
in
that
particular
neighborhood.
The
service
has
been
operating
since
that
time
on
November
15th,
the
Federal
Minister
of
Health
announced
plans
to
make
it
easier
for
the
provinces
to
implement
overdose
prevention
sites
and
on
the
7th
of
December.
E
The
Ontario
Health
Minister
announced
that
he
had
asked
the
federal
government
for
a
class
exemption
to
allow
overdose
prevention
sites
to
operate
in
Ontario,
and
this
was
granted
so
that
leads
us
to
January
11th
of
this
year,
when
the
Ministry
of
Health
and
long-term
care
launched
the
provincial
overdose
prevention
sight
program.
There
are
a
number
of
organizations
in
Toronto
that
have
expressed
interest
in
providing
this
emergency
service
and
will
endeavor
to
keep
you
informed
as
we
hear
about
which
services
are
actually
approved
to
operate
under
the
ministry's
new
auspices.
E
Just
to
let
you
know
you
know,
we
do
know
that
the
Board
of
Health
has
supported
supervised
injection
services
as
part
of
our
overdose
response
board.
Support
for
overdose
prevention
sites
would
clearly
help
facilitate
the
implementation
of
these
services
in
Toronto
with
respect
to
drug
drug
checking
services.
These
are
services
that
actually
allow
people
to
test
their
drugs
before
they
use
them.
This
gives
people,
then,
once
they
have
results
with
respect
to
what
the
drugs
they've
got
it
might
contain.
E
This
allows
people
the
opportunity
to
decide
whether
or
not
to
use
the
drug
or
whether
they
might
consider
reducing
the
amount
of
drug
which,
in
turn,
can
help
prevent
an
overdose.
The
provincial
government
has
provided
fentanyl
test
strips
to
all
supervised
injection
services
and
overdose
prevention
sites
in
Ontario.
E
We
are
also
working
with
the
International
Centre
for
science
and
drug
policy
on
a
project
that
links
three
Toronto
supervised
injection
services
with
hospital
labs
to
provide
drug
checking
services
and
evaluate
how
the
model
is
working.
This
is
still
in
its
early
stages.
We've
confirmed
funding
for
the
project
which
allows
the
project
to
get
underway,
but
we're
still
working
through
the
process
with
the
Canadian
Institutes
of
Health
Research,
in
order
to
make
sure
that
got
adequate
research
funding
for
that
particular
project.
E
E
Looking
for
other
methods,
recognizing
that,
if
a
significant
component
of
our
problem
is
you
know,
a
toxic
or
a
dirty
drug
supply,
then
actually
exploring
different
options
outside
of
supervised
injection
services
and
overdose
prevention
sites
would
include
something
like
ensuring
a
cleaner
drug
supply,
something
that
we're
actively
talking
with
other
partners
about
and
seeking
to
learn
from
other
jurisdictions
that
have
gone
ahead
and
proceeded
with
this
route.
We're
also
working
with
community
and
health
partners
on
strategies
to
implement
a
wide
variety
of
treatment
strategies,
including
low-threshold
models.
E
I
think
I
would
be
remiss
if
I
didn't
talk
to
you
about
the
indigenous
overdose
strategy.
With
respect
to
overdose
and
our
indigenous
community,
we
recommended,
through
the
overdose
action
plan,
the
need
for
a
separate
process
led
by
an
indigenous
facilitator,
to
develop
a
specific
overdose
prevention
and
response
strategy
for
indigenous
peoples
in
our
community.
I'm.
E
Happy
to
tell
you
that
the
Toronto
central
Lin
recently
confirmed
funding
for
this
initiative
that
a
facilitator
has
been
hired
and
we're
now
working
with
her
our
indigenous
facilitator
on
a
consultation
plan
with
the
indigenous
community,
so
that
we
can
understand
what
would
best
meet
their
needs
and
we'll
report
back
to
the
Board
of
Health
in
this
spring.
On
the
results
of
that
collaboration.
E
A
strong
theme
that
emerged
through
the
community
consultations
was
the
need
to
decriminalize
and
even
regulate
drugs,
so
we've
been
working
on
actually
having
a
community
dialogue
to
further
explore
this
issue,
and
we
have
a
diverse
steering
committee
to
help
us
figure
out
how
best
to
establish
and
implement
that
community
dialogue
process
on
this
topic
and
we'll
be
reporting
back
to
the
Board
of
Health
in
June
on
this
particular
and
very
important
public
policy
issue.
So
that
takes
me
to
the
end
of
a
long
presentation.
C
See
well,
thank
you
Eileen
for
the
presentation
and
thank
you,
Susan
I'm
sure,
for
creating
the
presentation
and
for
both
of
you
for
doing
all
your
good
work.
Just
one
point
clarification
on
your
presentation
and
then
a
couple
brief
questions.
I
guess
the
clarification,
the
slide
where
we
went
through
opioid
overdose
deaths
and
the
monthly
over
opioid
overdose
deaths
May
to
July
yeah.
E
C
E
E
So
as
you
can
see
it
took
until
it
took
quite
a
bit
of
time
and
I
know
that
our
colleagues
at
the
Office
of
the
Chief
Coroner
have
been
working
very
hard
on
improving
their
system
and
improving
the
timeliness
for
data,
so
we'll
be
in
touch
with
them
to
see
what
we
can
get
and
whether
we
can
get
it
in
a
more
timely
fashion.
Okay,.
C
That
would
be
helpful.
Thank
you,
as
we
look
ahead
to
2018.
I
know
that
your
team
at
Toronto,
Public
Health,
are
doing
a
lot
of
work
related
to
expanding
harm
reduction
services.
Looking
at
both
supervised
injection
as
well
as
overdose
prevention,
do
we
have
a
sense
of
what
the
next
steps
are
for
that?
Are
there
community
meetings
that
are
going
to
be
held?
When
do
you
anticipate
coming
back
with
an
update
to
this
board
on
the
outcome
of
those,
as
time
is
of
the
essence
essence,
as
always
so.
E
I
think
we
I
can
tell
you
that
we
have
definitely
planned
to
come
back
to
the
board
in
June
for
sure,
with
an
update
and
a
more
formal
report
on
that
which
has
happened
on
the
overdose
action
plan,
let
me
put
it
to
you
this
way
with
respect
to
overdose
prevention
sites.
You
know
the
sands
have
shifted,
as
they
constantly
do
shift
the
December
announcement
from
the
province
and
the
launch
of
the
new
program
in
January
actually
has
made
things
frankly
much
easier
for
community
agencies.
E
It
made
its
made
overdose
prevention
sites,
a
much
more
tangible
reality
for
many
many
community
agencies.
So
we
would
like
to
see
what
you
know.
What
kind
of
uptake
were
we're
going
to
get?
What
kind
of
interest
might
be
expressed
by
community
agencies,
and
my
understanding
is
that
our
partners
at
the
Ministry
of
Health
and
long-term
care
will
keep
us
informed
of
the
interest?
That's
there.
E
C
I
get
that
bring
it
back
to
that
point
there.
So
is
the
work
that
the
Toronto
Drug
Secretariat
is
doing
now
to
a
both
the
need
for
those
harm
reduction
services
which
communities
need
them,
how
the
response
is
going
to
be
what
services
are
going
to
be
requested?
What
are
the
next
steps
and
the
timelines
for
those
pieces?
I
know
as
a
councillor
in
my
ward
in
some
communities,
I've
had
agencies
reach
out
to
me
and
work
with
the
city,
so
I
just
want
to
understand
what
those
steps
are
so.
E
As
far
as
I
see
it,
what
we're
doing
is
we're
conversing
with
community
partners,
both
through
the
Toronto
drug
Secretariat
and
Toronto
Public
Health,
trying
to
understand
who
has
actually
put
forward
requests
to
host
overdose
prevention
sites
and
then
go.
You
know
once
we
actually
have
a
map
of
where
the
activity
is
and
what
services
are
going
to
be
in
place.
We're
then
in
a
better
position
to
actually
speak
to
what's
next,
perhaps
what
I
might
do
is
in
terms
of
specific
timing.
F
So
the
plan
right
now
is
to
try
to
get
the
better
data
that
we
have
we're
pulling
that
together
and
going
out
in
targeted
meetings
with
communities
across
the
city
with
agencies
and
service
providers.
To
say
these
are
where
the
overdoses
are
occurring
in
the
community
and
here's
the
kind
of
range
of
options
to
think
about
in
terms
of
respeto
responding
to
the
needs
in
your
area.
So
it
could
be
expanding
your
harm
reduction.
F
Outreach
could
be
implementing
over
as
prevention
sites
or
supervised
consumption
sites,
and
that
our
team
would
be
there
as
a
resource
to
support
them
and
submitting
their
applications
and
that
sort
of
thing.
So
we
do
want
to
do
a
targeted
conversation
in
those,
in
particular
in
those
areas
where
we're
seeing
overdoses.
So.
C
C
Then
one
last
question
I
know,
madam
chair,
you
haven't
put
my
clock
on
so
I'll
assume
I'm
near
it
is
I
know
that
a
lot
of
there's
been
a
lot
of
discussion
and
work
done
within
the
shelter
system
and
the
out
of
the
cult
and
I
see
we
have
shelter,
support
and
housing
administration
here
so
I
wonder
if,
if
mr.
Tanner,
you
could
give
us
an
overview
of
the
work
done
within
the
shelter
system
to
date,
but,
additionally,
what
other
supports
you
need?
Given
the
escalation
in
the
shelter
usage
we're
seeing
this
this
season.
A
We've
been
working
with
public
health
and
city
legal,
really
to
identify
the
processes
and
policies
and
put
them
in
place
to
support
our
staff
to
be
able
to
use
this
essential
intervention
in
the
workplace
and
throughout
the
summer
we
trained
180
of
our
shelter,
support
and
housing
city
staff
and
now
have
naloxone
at
all.
Our
city
operated
sites.
Naloxone
has
been
distributed
to
all
of
our
winter
respite
programs
and
through
our
out
of
the
call
programs
through
our
provider
at
Dixon
Hall.
In
terms
of
what
we
need
I
mean.
A
You
know
we're
always
interested
in
getting
more
support
for
health
services
and
and
harm
reduction.
Support
through
you
know
the
Toronto
central
Lane
and
others.
I
continue
to
work
very
closely
with
with
Toronto
Public
Health
and
the
works
with
respect
to
you
know
the
needs
of
our
staff
and
our
partners
in
the
community
and.
C
One
quick
follow-up
is:
are
you
with
the
training
and
distribution
of
naloxone
to
frontline
staff
in
our
shelter
system,
our
respite
programs,
as
well
as
through
the
out
of
the
cold
network?
Do
you
have
any
data
at
this
point?
Perhaps
it
could
come
later
on
if
naloxone
has
been
administered
and
if
so,
how
often,
within
our
shelter
system,
I
only.
A
Have
very
proven
preliminary
data
on
that
and
I'd
have
to
come
back
to
you
to
explore
of
the
hundred
and
eight
kits
that
we
initially
distributed
how
many
of
those
have
been
used
to
date.
I'll
tell
you
the
most
prevalent
spot
where
naloxone
is
used
is
at
Seton
House
and
that's
in
conjunction
with
our
near
City
family
health
team.
That
also
has
the
supply
of
naloxone
through
st.
Michael's
Hospital.
Thank
you
very
much.
Yes,.
G
G
E
So
through
the
chair,
we
actually
have
that
Toronto
overdose,
an
early-warning
partnership,
and
we
have
many
venues
and
many
opportunities
to
discuss
with
our
paramedics.
Colleagues,
so
as
I
understand
it,
the
the
specific
data
around
the
calls
are
provided
to
our
surveillance
and
epidemiology
staff
who
in
turn
then
convert
the
data
into
this
map.
Format
that
you
see
before
you
so.
E
We
do
have
we
have
different
sources
for
deaths
and
we
try
to
combine
the
many
sources
of
data
that
we
receive
in
order
to
come
up
with
a
fulsome
picture
that
we
can.
Then
you
know
share
with
partners,
as
my
colleague
Susan
informed
us.
What
we're
trying
to
do
is
make
sure
that
we
have
a
sense
as
to
where
the
need
is
is
located
where
the
services
seem
to
be
arising,
as
demonstrated
by
partnerships
and
then
try
to
put
together
to
try.
G
B
G
All
where
their
attendant
at
a
death,
then
they
do
let
you
know
I
believe
that
is
the
case.
Yes,
can
we
find
that
out
exact?
We
can
what
that
looks
like
and
I'm
just
looking
at
this
map
and
quite
surprised
to
see
the
Danforth
with
such
hot
blue
spots,
there
is
that,
is
there
any
way
that
anyone
can
comment
on
that
and
it's
second
to
Yonge
Street
as
far
as
dark
blue.
E
G
D
D
E
If
I
can,
through
the
chair,
we
get
the
death
data
through
the
coroner's.
If
there
are
data
on
the
paramedic
call
sheet
where
the
patient
had
died
in
the
care
of
the
paramedics,
presumably
we
would
get
those
data
through
the
paramedic
call
sheet.
However,
there
are
calls
for
opioid
overdoses,
where
the
paramedics
attend
to
the
patient,
deliver
them
to
hospital.
The
death
occurs
after
transfer
from
paramedic
service
to
hospital.
The
paramedics
data
would
not
reflect
necessarily
that
death,
but
we
would
get
those
death
data
through
the
coroner's
office
and.
G
E
G
E
G
G
G
G
G
G
E
Through
the
chair,
I
think
that's
an
excellent
question
and
I'll
be
very
upfront.
I
think
this
is
something
that
requires
further
investigation.
What
we're
able
to
provide
you
with
are
the
data
with
respect
that
map
out
the
density
of
calls
and
interactions,
specifically
that
paramedic
services
has
with
those
who
are
calling
for
opioid
related
or
suspected
opioid
overdoses.
Thank
you.
The
underlying
reasons,
I
think,
are
very
much
still
the
subject
of
investigation.
Thank.
H
H
H
Okay,
that's
fine
I'll
table
that
question.
Okay,
I'll
go
back
to
the
other
one
though
I'm
very
curious
about
this
data,
and
first
of
all,
I
do
want
to
thank
you
know
everybody
for
all
the
work
that's
gone
into
this
and
I
want
to
thank
councillor
Krusty,
there's
leadership
on
this
issue
over
the
last
couple
of
years,
because
it's
been
I
mean
this
is
the
biggest
health
crisis
that
we're
facing
in
the
city.
Right
now,
it's
pretty
clear.
I
looked
at
the
numbers
and
and
I
know
it's.
H
You
know
risky
to
average
things
out,
but
if
we
take
82
deaths
in
a
three-month
period-
and
we
multiply
that
by
four-
we
get
over
300
deaths,
potentially
over
300
deaths
in
in
one
year
in
the
city
from
opioid
overdose.
The
other
question
I
have
has
to
do
with
the
line
graph
here
on
the
next
page,
and
you
said
that
there's
31
to
111
overdose
cases
suspected
overdose
cases
per
week
do
these.
So
this
is
cost
paramedic
services
and
emergency
department
visits.
They
vary
slightly,
but
do
they
cancel
each
other
out?
H
E
H
F
H
E
If
I
may,
through
the
chair,
I,
would
caution
a
little
bit
around
averaging
out.
It's
not
quite
that
simple,
but
I
would
again
point
out
that,
with
respect
to
you're
absolutely
right,
there
is
reason
to
be
concerned
and
we
were
concerned
and
we
continue
to
be
concerned
around
opioid
overdose
deaths.
There
was
a
significant
increase
in
that
three-month
period
between
May
and
July
year-over-year
from
2016
to
2017.
There
was
a
peak
that
was
reached
in
respect
of
activity
in
the
suburb
and
I.
Think
what
we're
trying
to
demonstrate
to
you
through
that
slide.
H
The
then
I
mean
just
and
and
I
recognize
that
and
I.
You
know
thank
you
for
that
explanation.
It
is
good
to
know
that
it
was
going
down
at
the
end
of
the
year,
so
hopefully
those
numbers
don't
average
out
as
as
horribly
as
they
seem
to
and
I
recognize
like
it's
wonderful
all
the
things
that
are
happening,
all
the
different
departments
and
everybody
that's
coordinating
you've
got
this
multi
sectoral
response.
You,
you
mentioned
ensuring
a
cleaner
drug
supply.
What
would
that
look
like?
H
E
I,
don't
think
through
the
chair,
I'm,
not
sure
that
I
can
say
or
describe
a
completely
fulsome
picture
of
that
which
would
happen
here
in
our
context,
I
can
comment
on
what
has
happened
and
what
is
happening
in
other
jurisdictions.
So
there
are
certain
initiatives,
including
in
other
jurisdictions,
in
Canada,
Vancouver
being
among
them
where
prescription
opioid
therapy
is
provided
to
clients
in
order
to
help
them
get
access
to
meet
the
needs
that
they
have
to
prevent
the
risk
of
overdose
and
to
do
so
in
a
way
that
doesn't
require.
E
You
know
the
purchasing
of
drugs,
which
may
very
well
be
contaminated
with
a
series
of
other
drugs,
so
I
think
that's
one
method
that
we
can
look
at.
Certainly
other
European
jurisdictions
have
had
greater
experience
and
some
of
them
rather
lengthy
experience
in
providing
opioid
substitution
therapies
of
a
variety
kinds,
the
most
basic
I
guess
and
one
that's
very
common
here-
is
methadone
or
suboxone
therapy,
but
there
are
many
other
variations
on
the
theme.
So
what
the
complete
picture
looks
like
here,
I
think
we'll
will
rest
on
policy.
H
E
I,
don't
know
that
I
can
speak
to
the
exact
figures
with
respect
to
any
of
those
jurisdictions.
You
did
speak
of
decriminalization
and
again
I.
Don't
have
the
exact
finger
figures
at
my
fingertips,
but
we
do
know-
and
it's
certainly
one
of
the
things
that's
been
discussed
quite
a
bit
in
the
popular
media,
the
experience
in
Portugal
as
the
country
that
has
undertaken
decriminalization
significantly.
E
That
happened
back
in
the
early
2000s
2003
and
at
the
time
they
had
extremely
high
rates
of
overdose,
related
deaths
and
actually
high
rates
of
HIV
and
hepatitis
C
associated
with
drug
sharing
of
drug
equipment
and
those
numbers
have,
you
know,
seen
significant
decreases
in
that
country.
So
we
are
actually
looking
at
the
experiences
across
many
jurisdictions
to
help
inform
that
which
we
should
be
doing
here
to
address
our
situation.
It
seems.
H
Then
that
we
should
really
be
looking
at
when
we're
making
the
argument
about
ensuring
that
cleaner
drug
supply,
we
should
be
looking
at.
You
know,
trying
to
make
as
clearly
as
possible
that
this
would
save
lives
and
it
would
save
a
significant
number
of
lives
and
we
may
even
be
able
to
put
if
you
know,
depending
on
the
data
and
the
comparability
of
the
data,
maybe
go
to
put
a
rough
estimate
on
the
number
of
lives
that
could
be
saved
and
I.
H
E
Through
the
chair,
I
think
that's
exactly
what
we
were
aiming
towards
when
we
included
within
the
Toronto
overdose
action
plan,
the
need
for
a
public
health
approach
to
drug
policy,
so
I
think
that
the
work
that
has
been
done
over
the
last
several
months
and
some
would
argue
years-
has
been
very
important.
But
when
I
look
at
the
work,
that's
been
done
over
the
last
several
months
again,
very,
very
important
work,
but
the
establishment
of
such
things
as
supervised
injection
services,
the
establishment
of
things
such
as
overdose
prevention
sites.
These
are
fairly
downstream.
E
When
we
look
at
the
situation
itself,
if
we're
looking
to
prevent
the
negative
health
impacts
associated
with
drug
use,
when
we're
talking
about
things
such
as
supervised
injection
services
and
overdose
prevention
sites,
these
are
fairly
what
we
would
call
downstream
and
endeavors.
You
know
when
we
start
to
look
higher
upstream.
You
know
on
areas
like
drug
policy,
you
actually
need
that
comprehensive
set
of
strategies,
not
just
those
that
are
downstream
in
order
to
effectively
address
the
situation
in
a
very
fulsome
manner.
Well,.
C
A
Yes,
thank
you
very
much
just
very
quickly.
The
the
overdose
prevention
site
at
Moss
Park
is
reporting
some
rather
impressive
numbers
for
the
effectiveness
of
that
service,
given
that
the
works
and
South
Riverdale
have
been
in
operation
for
one
month
and
four
months,
respectively
or
I'm,
just
I'm
just
curious.
If
we
have
any
measures
to
report
out
on
their
effectiveness,
sorry.
A
E
Indeed,
we
do
so
it's
in
and
around
the
range
of
about
thirty
thirty-one
clients
that
we,
which
we've
had,
who
have
we've
successfully
reversed
and
overdosed
I.
Think
the
interesting
thing
if
I
may
through
the
chair
in
respect
of
this
question,
is
that
it's
it's
actually
challenging
to
you
know,
have
a
common
definition.
You
know
it's
a
it's
a
very
heated
circumstance
when
you're
actually
addressing
a
particular
overdose
and
without
trying
to
get
too
technical
about
it.
E
There
are
the
expected
effects,
intoxicating
effects
of
a
drug
and
it
crosses
over
into
what
would
be
characterized
as
overdose,
and
there
isn't
a
hard
and
fast
line
between
expected
drug
effect,
and
you
know
when
you
start
to
move
into
something
that
one
might
characterize
as
overdose.
So,
while
I
think
it's
important
to
have
a
sense
and
to
be
able
to
evaluate
the
effectiveness
of
our
measures,
it's
not
always
easy
to
make
straight-up
comparisons
across
services.
One
of
the
many
challenges
I
think
that
faces
us
in
this
situation.
Fair.
A
E
I
think
at
this
stage
of
the
game,
if
I
can,
through
the
chair
there
have
been-
and
there
was
an
initiative-
and
there
is
an
endeavor
to
try
to
provide
drug
checking
services
through
supervised
injection
services
and
through
overdose
prevention
sites,
as
I
try
to
describe
in
at
my
presentation.
There
are
some
challenges
currently
with
respect
to
the
test
strips
and
how
they're
being
used
and
they're
they're
a
little
on
the
technical
side.
E
So
I
won't
bore
you
with
the
details,
but
suffice
it
to
say
that
it's
important
to
actually
get
the
testing
procedure
right
so
as
not
to
actually
use
the
strips
to
give
you
false
negatives.
You
know
what
you
want
to
do
is
to
have
a
reliable,
accurate
test
that
gives
the
user
some
sense
of
security
around.
E
Does
the
drug
actually
contain
harmful
substances
so
that
they
can
then
make
informed
decisions
around
what
they
choose
to
do
either
not
use
the
drug
or
use
a
smaller
amount
or
use
it
in
a
slower,
more
measured
fashion,
so
as
to
minimize
the
risk
of
overdose.
So
the
challenge
has
been
making
sure
that
you're
getting
accurate
information
I
would
suggest
that
it's
you
know,
while
the
notion
of
testing
theoretically
is,
is
a
good
thing
to
go
forward
with
it
has
to
be
done
right.
E
A
E
Through
the
chair
as
I
understand
it,
it's
the
the
we
have
a
particular
issue
with
the
the
testing
kits
that
we've
got
here
on
site.
This
is
done
at
the
provincial
level,
so
I
don't
know
that
I
can
speak
in
great
detail
to
the
challenges
that
they've
had
and
why
they
have
particular
test
kits,
but
suffice
it
to
say
that
there
are
groups,
including
those
who
are
working
in
the
supervised
injection
services,
actively
in
conversation
with
our
provincial
partners,
to
try
to
resolve
those
issues.
So
we
can
actually
get
accurate
testing
available,
strikes.
E
B
D
Right,
thank
you
so
much
for
having
me
here
today.
So
just
a
quick,
related
piece
to
what
we
were
just
talking
about,
and
so
music
festivals
drugs
happened
there
and
events,
and
one
thing
that
we'd
like
to
make
work
better.
I
guess
are
the
drug
amnesty
boxes
which
currently
can't
be
called
that
that
occur
or
that
are
placed
around
the
festivals.
So
right
now,
they're
called
harm
reduction
boxes
and
labeled
as
such,
which
doesn't
actually
describe
what
they
are.
It
doesn't
make
any
sense,
and
it
is
honestly
kind
of
misleading.
D
Normally
a
harm
reduction
box
would
be
distributing
harm
reduction
supplies
rather
than
somewhere
to
drop
off
things.
You
don't
want
anymore.
What
we
would
like
to
see
happen
is
something
related
to
the
firearm.
Amnesty
I
don't
know
what
to
call
it
exactly,
but
where
people
can
drop
off
firearms
they
no
longer
want
or
need
or
use,
or
have
found
and
have
amnesty
to
do
that.
So
we
would
like
something
similar
for
substances
or
drug
related
items
to
be
safely
disposed
of
on
the
grounds
of
music
festivals.
D
Without
any,
you
know
persecution
of
the
people
putting
things
into
the
boxes
and,
of
course
you
know,
there's
logistics
around
how
they're
placed
and
if
they're
attached
to
things
and
who
heads
control
over
the
boxes.
But
you
know
sort
of
using
the
laws
around
the
firearm
amnesty,
creating
something
similar
for
substances.
C
Thank
you,
Laurie
for
the
deputation
and
being
here
and
I
know,
your
request
is
already
being
endorsed
by
the
Toronto
Drug
Strategy
panel.
Just
two
questions.
The
first
is-
and
this
is
a
question
I
have
been
getting
fairly
frequently
when
this
issue
came
up
is
with
drug
amnesty
boxes.
Why
would
someone
choose
to
use
them
like
what
would
be
the
rationale
for
using
the
drug
I've
missed
a
box
so.
D
For
one
reason,
if
people
find
something
on
the
ground
and
they
want
a
safe
place,
to
put
it
without
getting
you
know,
seen
by
security,
picking
up,
you
know,
drugs
off
the
ground
and
putting
them
in
their
pocket,
which
you
know
has
happened
and
then
getting
in
trouble
or
ejected
from
the
event,
and
the
other
reason
is,
if
somebody
has
something
or
their
friends.
Group
of
friends
has
something
they
take.
It
ends
up
making
them
feel
sick
or
unwell,
or
unexpected
results
they're
just
like
Oh
gross
drugs.
D
I,
don't
want
these
anymore
somewhere
to
safely
dispose
of
them,
so
they
don't
end
up
on
the
ground
for
somebody
else
to
pick
up
and
find,
or
they
don't
end
up
in
just
the
garbage,
and
it
would
also
be
great
to
be
able
to
have
anything
that
is
disposed
of
in
these
boxes
tested
to
find
out.
You
know
what
actually
was
in
these
substances
that
people
are
disposing
of
and.
D
C
If
I
can
pivot,
because
the
trip
project
of
which
you're
you're
a
member
of
working
for
all
the
rest
in
charge
of
you've,
done
a
lot
of
advocating
for
drug
testing
on
sites
not
just
supervised
injection
service
sites,
this
was
a
question
councillor
Layton
had
I
was
wondering
if
you
could
go
into
what
some
of
the
hurdles
you've
experienced
through
your
organization
and
trying
to
secure
support
for
testing.
Is
it
the
provincial
government?
Is
it
the
federal
government?
Is
it
the
willingness
of
Music
Venues
to
agree?
Where
are
the
hurdles
in
us
being
up?
D
So
there's
it's
sort
of
sometimes
at
every
level
there
is
some
pushback.
Obviously
partiers
attendees
people
who
use
drugs
want
to
be
able
to
check
their
drugs,
friends
and
family
members.
You
know
would
like
to
see
that
as
well.
Nobody
who
runs
festivals,
you
know,
or
police
or
government-
want
people
to
die
either,
but
it's
sort
of
seen
in
some
ways
as
well.
If
people
know
their
drugs
are
safe,
then
they're
going
to
keep
using
them,
which
is
kind
of
an
not
as
harm
reduction
model
of
it.
D
I'm
thinking,
but
but
currently
the
biggest
issue
is
really
the
venues
or
the
promoters
and
their
insurance
companies.
So
in
the
pool
you
know,
agreement
with
police
on
site.
So
a
lot
of
the
events
that
happen
on
city
or
provincial
or
government
property
require
a
certain
number
of
police
officers.
On-Site
totally
make
sense,
but
for
us
to
have
a
big
we're
testing
drugs
here,
sign
and
the
police
just
sort
of
putting
their
blinders
on
around
that
isn't
gonna
happen.
So
there
has
to
be
some
kind
of
agreement
with
you
know.
D
C
D
So
usually,
they
happen
on
private
property,
where
there's
an
agreement
with
the
local
security
or
the
security
company,
and
then
the
local
police
may
or
may
not
interact
with
the
drug
checking
services,
most
notably
at
Shambhala
in
British,
Columbia
they've
been
doing
it
for
twenty
years.
They
have
a
great
history,
a
huge
you
know,
backlog
of
data
around
what
kinds
of
interactions
they're
able
to
have
with
people
with
the
service
and
the
reaction
to
the
local
police,
which
has
been
largely
positive
but
yeah.
D
A
It's
causing
people
stigma,
you
know
they
go
to
a
concert
and
jeepers
I'm
using
drugs
makes
them
feel
guilty
and
stigma
that
drug
prohibition
is
causing
the
problems
in
the
first
place
and
I
could
suggest,
maybe
that
you
treat
people
train
people
for
overdoses
at
concerts
along
with
these
amnesty
boxes.
So
you
empower
someone
when
you
empower
someone,
then
they
feel
worth
because
what's
happening
from
the
report
on
the
overdoses,
is
it's
happening
to
homeless
people,
the
most
disenfranchised
of
us
all?
A
B
C
Well,
thank
you
mister
chair,
and
I
have
two
motions.
If
they
could
be
placed
the
first
motion,
they
have
to
be
placed
on
the
screen,
so
the
first
motion
is
a
request
for
our
Toronto
Public
Health
drug
Secretariat,
to
convene
those
series
of
meetings
that
were
that
Susan
Shepherd
talked
about
partnering
with
frontline
harm
reduction
organizations,
harm
reduction
alliance
and
Toronto
Community
Housing
to
discuss
the
expansion
of
supervised
injection
that
should
reach
supervised
injection,
not
self
injection
and
overdose
prevention
sites.
C
If
that
could
just
be
edited
there
police
to
the
clerk's
and
then
the
second
motion,
if
it
can
be
placed
that
the
Board
of
Health
support
the
implementation
of
overdose
prevention
sites
as
part
of
the
continuum
of
response,
this
is
in
in
response
to
our
mo
HS
call,
which
I
heard
that
this
would
be
helpful.
Let
me
just
say
a
couple
things
very
quickly,
because
we
as
a
board
have
spent
a
lot
of
time
on
this,
and
you
don't
need
a
long
speech
for
me.
C
First
of
all,
I
just
want
to
start
by
thanking
our
Toronto
Public,
Health
and
staff
that,
when
you
think
about
the
amount
of
work,
the
whole
team
from
the
Toronto
drug,
Secretariat
and
Susan
and
her
team
right
on
up
to
our
MOH
Eileen
and
Jen
Houston
and
and
before
them
Barbara
and
before
them
doctor
McEwen.
The
whole
amount
of
work
on
this
file
over
three
years
and
I
should
single
out
in
particular
Shaun
Hawkins
at
the
works.
It
has
been
relentless.
C
It
has
been
life-saving
and
it's
something
to
behold
and
I
just
want
to
thank
our
Toronto
Public
Health
staff
team
for
for
being
on
the
front
lines
and
saving
lives
and
on
that
our
frontline
workers,
as
well,
not
just
at
the
city,
but
all
the
agencies
and
the
activists
for
their
work
in
this
board.
I
want
you
to
know.
C
B
See
I
have
a
quick
question.
It
really
has
a
way
of
asking
you
to
add
some
words.
Would
you
be
open
to
convene
a
convening
to
adding
to
the
meetings
with
frontal
harm
reduction
organizations
to
Toronto
harm
reduction
alliance,
join
a
commune
housing
and
also
add
health
care
providers
like
neighborhood
community
health
centers
sounds
fabulous.
Thank
you.
B
B
Now
we
have
Fred
Victor
operating
or
to
operate
that
has
required
a
monumental
effort
and
I
can't
believe
how
complicated
these
things
get
with
three
orders
of
government
and
different
agencies
and
the
police
and
the
Criminal
Code.
This
really
was
like
trying
to
work
our
way
through
through
a
maze,
but
the
world
has
changed
in
the
last
in
the
last
year.
There
is
there.
It
just
feels
differently
on
the
street
that
people
are
engaged
in
an
active
kind
of
way,
away
from
a
punitive
and
criminalized
approach
to
a
health
care
and
public
health
approach.
B
I
think
that
transition
has
happened
through
the
pushing
and
shoving
that
has
occurred
in
the
last
year
and
that's
all
owed
to
the
folks
here,
who've
been
in
the
advocates
and
the
front
line,
workers
and
alliances
that
have
really
pushed
that
conversation
away
from
from
negative
stereotypes
to
really
focusing
on
saving
lives
in
providing
a
support
and
I.
Think
that
has
been
the
biggest
shift,
and
you
know
I
I'm.
B
B
Emotion,
it
is
downtown,
but
it
is
also
in
other
areas
of
the
city
and
I.
Think
one
of
the
next
steps
for
us
recognizing
that
we
are
not
a
healthcare
providing
organization,
but
we
do
have
that
power
to
convoke
to
bring
together
people
and
that's
actually
a
great
for
Public
Health
Eve
in
the
areas
where
we
cannot
or
do
not
provide
direct
service
because
we
have
this
Toronto
wide
mandate
and
because
we
just
know
lots
of
folks.
B
We
have
a
great
rolodex
electronic
rolodex
with
the
Linz
with
the
front
line
workers,
harm
reduction,
advocates
the
different
community
health
centers
with
the
hospitals
with
emergency
folk
folk.
We
can
bring
people
together
to
have
conversations
that
no
other
body
is
as
aptly
suited
to
do
as
we
are
so
I
think
the
TAT
one
of
the
tasks
ahead
is
to
convoke
to
bring
people
together
and
I.
Think
well.
The
motion
does
that,
but
I
know
they're
already.
Staff
is
already
doing
that.
B
The
other
thing
that
I
think
this
last
year
has
taught
taught
me,
is
our
need
to
convoke
and
also
provoke
and
provoking
other
orders
of
government
to
do
the
right
thing.
Like
we
have
to
have
that
conversation
around
the
decriminalization
of
street
drugs,
that's
a
conversation
we
have
to
have
a
year
ago.
We,
it
is
our
policy
actually
as
a
board
of
health,
but
it's
kind
of
really
small,
written
and
very
small
Inc.
B
There's
a
report
coming
in
June
I
hope
that
that
report
includes
a
large
section
on
the
next
step
when
you
have,
when
you
have
so
many
drugs
laced
with
fentanyl,
a
different
approaches
required
all
the
approaches
that
we've
around
harm
reduction.
They
are
affecting
the
net
result
of
the
fentanyl
lacing
all
these
drugs.
We
have
to
go
up
that
river,
as
we
do
very
well
in
public
health
to
say
how
can
we
be
even
more
preventative
than
we
are
now
so
I
hope
that
that
report
is
bold.
B
It
says
the
says
really
where
we
need
to
be
moving
this
conversation,
not
just
intron,
not
just
Ontario,
but
Canada,
wide
and
I.
Think
if
we
do
it
in
Vancouver,
follow
suit
and
a
few
other
folks
follow
suit.
We
can,
and
we
can
maybe
push
the
ball
in
the
direction.
Call
it
a
more
Portuguese,
friendly,
Portuguese
style
national
policy.
Around
around
the
drugs,
the
decriminalization
of
currently
street
drugs,
so
this
is
a
good
update
and
but
there's
a
lot
more
work
to
be
done
across
Toronto
and
frankly,
across
across
the
country.
G
G
B
Anybody
else,
okay,
so
do
we
need
to
separate
on
any
motions
feel
free,
so
it's
to
receive
the
presentation
from
staff
and
the
two
motions
by
councillor
Fletcher
and
the
two
motions
by
councillor
Cressy.
This
is
this
is
with
respect
to
0.4
twenty
five.
Twenty
four
point:
four
and
we'll
do
twenty
four
point:
nine,
all
in
favor
of
all
of
that
post.
If
any
that
carries
and
then
number
nine
the
motion
there
is.
B
B
C
Just
very
briefly,
there's
an
important
street
redesign
coming
to
the
City
of
Toronto
in
a
couple
months,
and
our
board
has
previously
done
a
lot
of
work
on
complete
Street
guidelines
and
I
want
to
make
sure
that
we
have
a
safety
assessment
from
our
medical
officer
of
Health
available
to
Council.
For
this
Yonge
Street
redesign.