Ontario is grappling with intertwined housing and opioid crises — and local leaders say municipal resources alone are not enough to support those in need.
Earlier this month, the Association of Municipalities of Ontario, which represents the province’s 444 municipalities, published two reports calling for increased provincial and federal investment in resources to support these vulnerable populations.
These supports include targeted funding for social housing, shelter beds, treatment, and harm reduction, as well as provincial guidance to shape their response to homeless encampments.
As of 2023, there were at least 1,400 homeless encampments across the province in municipalities of all sizes. Since 2016, the number of opioid-related toxicity deaths in Ontario has nearly tripled, going from 864 to about 2,600 in 2023.
“This is happening in large cities, small towns, and rural municipalities across the province,” says Kingston mayor Bryan Paterson. “We very much feel we are on the front lines of a very complex and challenging situation that, quite frankly, we are unable to solve alone.”
A crisis “decades in the making”
Lindsay Jones, director of policy at AMO, says the challenges municipalities face have their roots in policy decisions made in the mid-to-late 1990s.
That was when the federal government put the responsibility for developing and funding social housing in the hands of provincial governments. In Ontario, the responsibility was passed down even further, to municipalities.
Today, AMO says, Ontario is the only jurisdiction where municipalities are responsible for funding their own social housing. Together, they spend about $1 billion a year in connection with provincial and federal programs to make this happen.
Lindsay Jones is director of policy at AMO. (Courtesy of Lindsay Jones)
“That has left us in dire need of a supply of deeply affordable housing,” says Jones. “We definitely see this as a crisis decades in the making.”
AMO is calling on the province and the federal government to increase the supply of social housing — especially supportive housing — and to provide supports such as rent subsidies. It notes that, as of 2018, there were 215,000 people on the wait-list for subsidized-housing assistance.
“We need an estimated 30,000 to 60,000 supportive-housing units to meet demand,” Jones says. “That would require a coordinated effort from the federal, provincial, and municipal governments.”
A spokesperson for Minister of Municipal Affairs and Housing Paul Calandra told TVO Today via email that the government’s policies “have delivered historic results in getting more housing built faster and complement our nearly $700 million annual investment to grow and enhance community and supportive housing to help address homelessness,” adding that “this record investment represents an increase of over 40 per cent.”
AMO is also urging the province to expand the emergency shelter system, cost-match federal encampment funding, and establish guidelines on addressing the encampments that already exist in the province.
“So many of these encampments that have evolved over the last few years are quite unsafe and have unsanitary conditions,” says Jones. “But, at the same time, there are rights obligations that have to be considered.”
In the absence of provincial guidance, the question of how to meet the needs of the residents of Ontario’s homeless encampments are being left up to the court system.
February 6, 2023: What does Ontario law say about clearing encampments?
“Letting things play out in the courts is incredibly expensive, it’s divisive, and it leads to this adversarial approach that grows at the community level,” Jones says. “Ultimately, the courts are not well positioned to be making social policy either. So we’re looking for leadership and guidance from the province to help manage the situation in a way that’s consistent across the province and that is in line with all the rights obligations that exist.”
Need for treatment, harm reduction
AMO also says that municipalities need greater investments in treatment, harm reduction, and prevention to address the opioid epidemic.
It cites a 2018 survey by Employment and Social Services Canada that found substance use was “the most commonly cited reason” for housing loss. Another study from the Institute for Clinical Evaluative Sciences found that one in six people who died from opioid overdoses in 2021 were homeless, compared to one in 14 in 2017.
“Our first responders, in particular police officers, are really challenged with what to do with folks who are in crisis, especially those on the street,” Jones says. “The two options that exist right now are taking folks to overcrowded emergency rooms or taking them to jail — neither of which is an effective way of accessing treatment and support.”
As per the reports, Ontario is once again the only jurisdiction where municipalities are responsible for cost-sharing and delivering public-health programs, including prevention and harm-reduction programs and treatment and recovery services.
“I think we, as municipalities, know what the solutions are,” says Paterson. “But we just don’t have the resources or expertise to be able to deliver them on our own.”
In Kingston, he notes, there is only one treatment centre; available only to men, it has a six-month waiting list.
“There are no accessible treatment options for women in our community,” he says.
While his city has spent money on shelter beds and on acquiring properties for supportive housing, he says, the community’s needs still outstrip the resources the municipality is able to provide. The properties it has acquired require further investment from the province and the federal government so that they can be renovated and staffed with health-care professionals.
Bryan Paterson is serving his third consecutive term as mayor of Kingston. (Courtesy of Bryan Paterson)
“The case we are putting forward is that it’s taking an enormous amount of resources just to be able to manage things where they are right now,” he says.
“Think, for example, of the number of vulnerable individuals that end up in the emergency room, which is the most expensive health-care service there is. Certainly, we can see from the front lines that there’s a better way to use those tax dollars more effectively. Aiming at harm reduction and treatment can ultimately save dollars elsewhere in the health care system.”
Moving beyond rhetoric
The bottom line, according to AMO, is that there must be a new fiscal framework to meet the needs of an increasingly vulnerable population that includes those on the street and with chronic substance-use disorders and also those Ontarians who are precariously housed, under-employed, or dependent on social-assistance programs insufficient to meet their day-to-day needs.
“The fiscal framework municipalities have to deal with cannot manage all of these challenges,” says Paterson. “We are spending millions on health care alone, and what that means is that there’s less money available for us to reinvest into roads, parks, and other services that we are responsible for. A new fiscal framework is needed to address a very challenging and complex landscape that is unique to Ontario because of the additional responsibilities we have.”
September 2, 2022: Northern Ontario's opioid challenge
Jones says it has never been more crucial to move beyond rhetoric and formulate a coordinated response.
“Particularly when it comes to the opioid crisis, we’ve seen some rhetoric evolving over the past few years that has the potential to be very divisive,” she says. “I think our message is just that this issue is too important to be politicized. We all need to come together to find balanced, evidence-based solutions to a really devastating problem.”
Paterson says the first step should be to bring higher levels of government to the table to discuss committing necessary resources.
In a statement to TVO Today, a spokesperson for the minister of municipal affairs and housing said the provincial government looks “forward to engaging in productive discussions with our municipal partners at this year’s AMO conference and understanding how we can work collaboratively to advance shared priorities and tackle pressing issues in Ontario including the importance of safe and stable housing for people in the province.”
“We really need the province to engage on this issue in a far more meaningful way than we’ve seen in the past,” Paterson says. “Because the status-quo is not working for anyone right now.”
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