GUELPH – With just over a month to go before the new Homelessness and Addiction Recovery Treatment (HART) Hub is supposed to be up and running in Guelph, the Guelph Community Health Centre (GCHC) still has not received confirmation that its plan will be supported financially.
“There is still quite a bit of uncertainty, especially with the election being called,” said GCHC chief executive officer Melissa Kwiatkowski.
Last summer, the province announced that nine safe-injection sites in Ontario, including the one in downtown Guelph, would be forced to close due to their proximity to schools or child care centres.
At the same time, the government said the sites would be given the chance to submit a proposal to transition into a HART Hub offering addiction treatment services rather than the harm-reduction model of the current Consumption and Treatment Services (CTS) site.
Early this year, the GCHC received word its application to transition to a HART Hub site had been successful, but as of Feb. 12, Kwiatkowski said the organization had still not received confirmation of funding it requires to move forward with its plan.
“Without confirmation of funding, a lot of the things we need to do to be ready to implement, we can’t do those things,” Kwiatkowski said, noting that includes things like hiring new staff.
The province has mandated the CTS site close down on March 31, and has set a goal of having HART Hubs operational by April 1.
While the Guelph hub is expected to operate out of the GCHC at 176 Wyndham St. N., where the CTS site is currently located, it will not be a replacement for that site.
Services the CTS site currently offers include distribution of harm-reduction supplies like clean needles and naloxone; supervised injection services with medical oversight and monitoring; medical assessments; foot and wound care, hepatitis C, HIV and STI screening and care; support and referrals to addiction treatment, primary care, mental health supports and other community resources.
The HART Hub transition plan includes maintaining “all of the wrap-around care teams that we have in Guelph,” Kwiatkowski said. “Many of these are existing teams.”
The key service changes will be the loss of the supervised drug consumption services, and the addition of withdrawal management beds, she said.
But lack of information about funding means uncertainty about when those beds might open up and where they will be located.
“Ideally, we’d like to have things co-located at our downtown site,” Kwiatkowski said.
But the Wyndham Street site doesn’t currently have treatment beds of any description, and it’s not clear whether there will be funding provided to create the necessary setup.
“We need to assess the feasibility and see if capital funding will be available at some point,” said Kwiatkowski.
In the interim, she said the organization has come up with a plan that would see addictions and mental health supports provided to people through a “scattered sites” approach, and has identified about 150 existing housing units across the city and the county that could be part of this approach.
“It’s teams that would go to multiple sites to support people,” Kwiatkowski said. “It’s not 24/7, but it is intensive support for mental health and addictions.”
She said the HART Hub plan also includes the expansion of the current “safe bed” program, a four-bed part-time program operated by Stonehenge Therapeutic Community that provides short-term crisis stays for people dealing with substance-use or mental-health issues.
“We’re looking to expand that program … into eight full-time beds,” Kwiatkowski said.
Those beds would ideally be located downtown at the GCHC, but there is “an alternate location” for the first year, she said.
While the organization awaits news about funding for its HART Hub plan, it is already working with local partners, such as the Wellington Guelph Drug Strategy, on mitigating the risks associated with the CTS closure.
“We know these sites have a proven track record of preventing overdoses,” Kwiatkowski said.
The closure could mean more public substance use, more needles discarded in public spaces, and more overdoses or drug poisonings, so the organizations have created online resources to let people know what to expect and where to find alternative support.
They are also offering training to business owners and people who live and work in the downtown on things like what to do if they find needles or what to do if they encounter someone who has overdosed.
“We’re trying to equip the community,” said Kwiatkowski.
The CTS section of the GCHC website (guelphchc.ca/cts) has been updated to include some information about the HART Hub transition, and links to additional resources.
Important to note is that the “Stay Sharp” program, which offers needle exchange services, will stay open; although, it’s unclear where it will be located.
“A needle exchange cannot be part of the HART Hub,” states a fact sheet on the website. “However, the HART Hub staff will be able to refer to harm reduction services, including Stay Sharp.”
Because the program has different funding than CTS, it will be maintained after the closure, it states. People are advised to go to guelphchc.ca/stay-sharp for program updates.
“We are working on creating easy referral pathways to Stay Sharp from the HART Hub,” the site states.
The harm reduction resources link also includes information about drug testing offered through the Wellington Guelph Drug Strategy group and a link to the National Overdose Response Service, which has a website and app people can use for “full service virtual safe consumption.”
Kwiatkowski said the goal is to maintain resources and referral pathways for clients.
While there are elements of the approval of the HART Hubs across the province that are good news, the hubs don’t provide all that is needed, Kwiatkowski said.
“They’ll provide different support to fewer people,” she said.
For many the services that CTS sites provide are an entry point into the continuum of care, she said.
“Now the doorway we have into the continuum is going to close,” she said.
