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When it comes to Toronto's supervised injection sites, who's in charge? Here's what you need to know

When it comes to Toronto's supervised injection sites, who's in charge? Here's what you need to know

CBC
Monday, August 28, 2023 9:24 AM GMT

A Toronto supervised consumption site has been in the spotlight after an employee was charged in connection with a fatal daytime shooting near the centre in July, spurring a provincial government review of all sites in the province. 

But when it comes to who's responsible for the sites, the answer is complex.

The federal, provincial and municipal governments are all part of a system of approvals, funding and oversight that allow the sites to operate. According to Toronto Public Health, there are 10 sites in the city and six of them — including the South Riverdale Community Health Centre (SRCHC) — are provincially funded consumption treatment services. Among the sites that are not provincially designated consumption treatment service locations, one is not open to the public, one is Toronto Public Health's and another relies on donations.

People in the community around the SRCHC have pointed to increasing concerns in the past year on safety and cleanliness in the area. As a not-for-profit, the site says the more funding it dedicates to security, less gets spent on providing care for clients. Meanwhile, the city councillor for the area hopes the province will provide more funding to help offset that cost.

Jeri Brown lives in the community and helped organize a town hall for residents to voice their concerns around the centre after 44-year-old Karolina Huberner-Makurat was killed by a stray bullet. 

"There's no clarity at all in terms of how these programs are supposed to run from a government and city perspective in terms of who's responsible for what," Brown said. "It's a tangled web that we've been working hard for the past several weeks to try to untangle."

One man has been charged with second-degree murder in connection with the death of the mother of two. A second man has been charged with manslaughter, robbery and failure to comply with probation. And a woman employed by the centre, charged with accessory after the fact to an indictable offence and obstructing justice, is currently on bail.

Supervised consumption sites do provide multiple benefits, says Dr. Ahmed Bayoumi, a physician and researcher at St. Micheal's Hospital in Toronto. Bayoumi was part of a team that was tasked with looking at whether the cities of Toronto and Ottawa would benefit from the implementation of supervised injection facilities.

"There is research showing that people who use supervised consumption sites have lower rates of overdose and lower rates of fatal overdose than people who don't," Bayoumi said. "The sites help to connect people to other services that are useful, both social services and health services, things like stable housing and employment."

Before a site is approved, it must apply for a federal exemption under the Controlled Substances Act. Provincially, there's an application process that unlocks funding. Municipally, the city is tasked with some oversight duties by the province such as inspecting for infection control and responding to needle cleanup requests. The sites themselves are tasked with developing community engagement and security procedures, according to the application guide for provincial funding.

"An application includes consultation with a broad range of people in the community," Health Canada told CBC Toronto in an emailed statement.

The application also asks that procedures be in place for disposing of sharp materials and dealing with unidentified substances, as well as security measures "to minimize risks to the health, safety and security of all persons at the site." 

One aspect of both the federal and provincial approvals process is community engagement. The province's application guide says the centre needs to develop an engagement and liaison plan that would include "engagement mechanisms to identify and address community concerns on an ongoing basis." 

To hold the centres accountable, the centres report to the province on "issues raised and how they have been mitigated," reads the application guide for provincial funding.

Read full story on CBC
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