Effective immediately, the Toronto Shelter Standards (TSS) Section 10.2.1 Harm Reduction is being replaced by the version contained in this directive.

Shelter providers are directed to review the Updated Section 10.2.1 Harm Reduction with your staff, senior management and board of directors and to implement all requirements.

Updated Toronto Shelter Standards Section 10.2.1 Harm Reduction – December 1, 2018

(a)  Shelter providers will have a harm reduction policy and procedures including, but not limited to whether and how substances are used onsite, preventing/responding to overdose, whether and how needles are safely distributed, collected and disposed.

(b)  Shelter providers will ensure naloxone kits (injectable or nasal spray) are available at all sites. All program staff on each shift will be trained in the administration of naloxone.

(c)  Shelter providers will post signage in washrooms and washroom stalls noting the availability of naloxone and encouraging substance users to let someone know they are using.

(d)  Upon the request of a client, shelter providers will

(i)       Provide safer injection equipment, safer smoking equipment, safer sex products, training and related supports if qualified to do so or

(ii)      Refer clients to Toronto Public Health’s The Works program, The Works Van service, or an organization listed by Toronto Public Health (see Appendix D: Links to References and Resources) or similar program that offers harm reduction supplies, training and related support services.

(e)  Shelter providers will ensure sharps containers are secured against tampering and available throughout a site and in each bathroom stall.  Providers will inform clients of the availability of sharps containers and how to use them.

(f)   Upon the request of a client for any of the following services, shelter providers will refer clients to Toronto Public Health’s The Works or similar program for

(i)       Opioid substitution clinic

(ii)      Supervised injection services

(iii)    Free testing for HIV (anonymous and Rapid testing available), Hepatitis A, B and C, Gonorrhea, Chlamydia and Syphilis

(iv)    Free vaccinations for Hepatitis A and B, Tetanus, Diphtheria, Pertussis, Pneumococcal pneumonia and Influenza

(v)      Naloxone distribution and training

(vi)    General nursing services (e.g., injection-related abscesses, counselling, pregnancy testing and supportive decision-making, referrals to internal and external services).

(g)  Shelter providers will refer clients who are seeking methadone/suboxone treatment to Toronto Public Health’s Methadone Works program or a similar program.

(h)  Shelter providers will neither prohibit nor confiscate the following items from clients

(i)       Life-saving medications (e.g., Epi-pens, nitroglycerin tablets, asthma inhalers, naloxone, etc.) or medications that have been prescribed

(ii)      Safer injection equipment, safer smoking equipment and/or safer sex products.

(i)    Shelter providers will support clients who wish to engage in harm reduction programs by offering public transit fare to attend such programs or related appointments.


Contact Information

Please contact your SSHA Agency Review Officer for more information about this directive.