GUELPH – The Homelessness and Addiction Recovery Treatment (HART) Hub that is expected to replace the city’s safe consumption site will not mean any new buildings to provide supportive housing, and it’s still unclear how many new supportive housing units might be eked out of the existing social housing stock.
“What we do know is that we’re not allowed to build a new building. We’re not allowed to do … total renovations,” said Guelph Community Health Centre CEO Melissa Kwiatkowski.
“There may be some money for minor renovations, so we’re looking at a number of options that are within those constraints.”
Kwiatkowski was speaking to members of the county’s joint social services and land ambulance committee on Oct. 9.
She attended the meeting to provide an update on the HART Hub application, a process that started when the province announced in August that it was forcing the closure of 10 supervised drug consumption sites, effective March 31.
Following her presentation, Guelph city councillors Linda Busuttil and Dominique O’Rourke expressed concern about the housing part of the plan.
“We all know there’s a need for additional capacity, especially supportive housing in the community,” Busuttil commented.
“Where is it going?”
“We would hope to have all of the services co-located,” Kwiatkowski answered.
“But if they can’t be, we’re looking at building really integrated pathways.”
Kwiatkowski said there are a number of variables that have not yet been confirmed, including any capital that may be allowed to support the transformation.
Busuttil pushed for more information about capital funding, noting that housing is in short supply.
“If we’re already at a deficit in the community, how is this magically going to happen?” she asked.
“It seems like it’s setting up for failure.”
“We do not have confirmation yet of what amount of capital might be available and what the eligibility criteria of that will be,” Kwiatkowski said.
County social services administrator Luisa Artuso spoke about how a plan might come together through the health and housing sectors working together.
“We are looking for some creative ways to potentially look at some of the current stock that we have,” Artuso said.
“We will share the information once the plan has been solidified by the end of this month,” but generally speaking, she said housing would provide the units, and health would provide the services.
Busuttil expressed some disappointment.
“Naively when I heard about this, I thought there would be a lot of capital money, and you could add a floor to your Guelph Community Health Centre with some beds … but it doesn’t sound like that’s going to be coming,” she said.
Her sentiment was echoed by O’Rourke.
“I also thought the plan or the goal was to have housing with wrap around services to coincide with the closure of the CTS, and I’m shocked frankly to hear that it’s not that,” O’Rourke said.
She asked how many net new housing units might be included in the plan.
“That is a tricky question, because what does $1.3 million buy you?” Artuso answered.
She made a point of saying that one thing that is known is that there will be units in Guelph and in Wellington County.
“We have more details to figure out,” she said.
Kwiatkowski added the HART Hubs have been labelled as “demonstration projects,” and funding is limited to three years.
“We have to see what that would look like and what we can do with existing buildings that the health system has available,” she said.
In her presentation, Kwiatkowski said efforts are being made to mitigate as many risks from the closure of the consumption and treatment services (CTS) site as possible.
“We’re looking at it very holistically,” to reduce impacts to clients who use the sites, as well as emergency medical services and emergency department impacts.
“We don’t have to guess what’s going to happen when these sites close,” Kwiatkowski said.
“We have a lot of evidence that shows what some of the impacts are going to be.”
She said the site has reversed 311 overdoses in the five years it has been open, with only 12 of those needing transfer to hospital emergency department.
“That doesn’t account for all of the drug poisonings that we completely prevent from happening,” she said.
The effort to mitigate impacts of the closure includes a “HART Hub working group,” made up of partners who have been working on these issues for years, she said.
“We’re going to be investing in housing and treatment teams which will attach 1,500 clients with wrap-around health and housing supports, and they will flow with clients regardless of where they are,” she said.
In an effort to address gaps in the system, new treatment bed capacity will be added, with a focus on withdrawal-management beds as well as crisis-stabilization beds, said Kwiatkowski.
“I’ve worked in health care for 20 years; we’ve never had withdrawal-management beds or crisis stabilization beds in this community,” she said.
“We’ll really be looking at all the ways we can get people to the next level of care to match their needs.”
But when county councillor Matthew Bulmer asked about what would happen to the services currently offered at the CTS site – things like needle exchange and drug testing – the answer was not positive.
“These sites are not to include supervised consumption, safer supply … or needle exchange,” Kwiatkowski said. “We run all of those programs.”
She said the organization is waiting on some clarity about whether those services can be offered in the same building, but not as part of the program, or whether they might need to be relocated.
“All of those programs are funded via different branches and streams,” she said.
She expressed concern about the potential risks associated with no longer being able to offer a drug-checking program – where people bring their drugs to the centre to be tested before they’re consumed.
“It’s a really important input that provides important public health information,” she said.
“About 20 per cent of people that do the drug-checking program, they make a different decision based on the information that they get.”
She said the goal is to preserve all of these programs, but within the constraints that the Ministry of Health has set.
Kwiatkowski said it’s hard to predict what the impact might be on, for example, land ambulance service if these programs cease.
She said one thing that has already been seen is that numbers have dropped off at the CTS site.
“Many clients have already started to disengage,” she said.
“What they are taking from this policy decision is that this government does not care.”
She noted there were two recent health alerts and a number of drug poisonings in the community.
“I think we’re having some early indications of what things are going to look like,” she said.
The HART Hub application is due Oct. 25 for sites transitioning from CTS sites.
