New safe consumption site in Hamilton, and safer use in shelters, gains momentum at board of health


Published February 13, 2023 at 9:37 pm

Marcie McIlveen of HAMSmart. (YouTube)

With nary a nay, elected leaders in Hamilton backed a not-for-profit’s bid to add a second consumption and treatment services (CTS) site, and further study of adding safer user spaces in shelters.

At a board of health meeting Monday, Mayor Andrea Horwath and city councillors heard that confirmed or probable opioid-related deaths have more than doubled in the past half-decade. That includes some 139 people in Hamilton who died in the first 10 months of 2022.

All present voted 12-0 to endorse the application from The AIDS Network (TAN) to the province for a CTS site that could be at 746 Barton St. E., in the east end, where a landlord is willing to host it. City council was previously told that local politicians’ endorsement of a CTS application can give it a boost with the Ontario Ministry of Health.

Another motion that directs city staff examine the possibility of shelters being allowed to have safer use spaces also sailed to a 12-0 approval. The YWCA Hamilton has been offering that and has seen its calls to paramedics and police go from more than one per day to one in the last nine months.

“It would be quite an enhancement of the services that The AIDS Network has already been providing at our current location, and there are many life-saving reasons for a location there (on Barton), for a program there,” TAN executive director Tim McClemont told the board on Monday morning, referring to the potential CTS and TAN’s site at 140 King St. E. in the downtown.

“And a central part of our application is to provide strong on-site wraparound services including mental health services, Indigenous-based services, addiction medicine services, and peer programming. We want to develop a centre of excellence for the populations we serve. We have groups that are committed to us, such as HAMSmart (Hamilton Social Medicine Response Team), the Canadian Association of Mental Health, Alternatives for Youth, and Hamilton Public Health.”

McClemont confirmed that men between 25 and 44 years old are especially vulnerable to drug poisoning, particularly those who work in skilled trades. Paramedics and police services employees are also at risk.

The first CTS site in Hamilton will soon be moving to a new building at 430 Cannon St. E. The first recommendation that Hamilton needs a second one to was made in 2017. There have been more than 600 opioid-related deaths in the city since then. TAN has been trying since 2021 to land the CTS site, and expects to hear from the province soon.

The motion that Horwath moved includes a call for Hamilton Public Health to support community engagement, site confirmation, an evaluative framework, and the creation of an open data program that shows how CTS sites help the general good in Hamilton.”

While McClemont noted an application involves creating a “community mitigation strategy,” there is opposition to the site location. Former mayor and member of Parliament Bob Bratina was in the gallery supporting two delegates, Walter Furlan and Scott Gervais, who averred that there was a lack of community consultation.

Both were called on points of order by Ward 8 Coun. John-Paul Danko — Gervais for using a map as a prop, and Furlan for accusatory comments against Ward 3 Coun. Nrinder Nann, who beat him by 16 percentage points (1,386 votes) in the municipal election last fall.

Bratina finished a distant third in the mayoral race with 12.27% support — more than 41,000 fewer votes than Horwath captured to become the first woman mayor of Hamilton.

Nann said that at BOH, the focus is on public health interventions, not politics. City council is the board of health in Hamilton, but that is currently under review after a vote last week.

“My job at this board of health table is to make decisions that are going to necessarily move the needle as it relates to population health outcomes that we are contending with,” Nann said.

Advocate: ‘Thanks to that space, I am alive today’

Furlan left documents showing that 1,200 people in Ward 3 oppose the location.

The objections were evidently not enough to sway the councillors. They also heard from Marcie McIlveen of HAMSmart and YWCA Hamilton about how an early form of a CTS — in a trailer in in her hometown Ottawa — was a life-saver for her more than once.

“There will always be a fear and stigmatization around CTSes,” said McIlveen, who is program manager for HAMSmart and co-coordinator of YWCA Hamilton’s safer use space, as well as sessional instructor at McMaster University. “Quantitative data is great at city budget time, but all the stats and quantitative data doesn’t get past that fear. And those feelings and fears are valid.

“But if it wasn’t for a space in Ottawa and a space that was not wanted by the public, but nonetheless opened, and no one wanted, I would be dead. I overdosed in that trailer at least four times. And thanks to that space in that community, I am alive today … and there is a landlord willing to have a site.”

In response to a question from Ward 2 Coun. Cameron Kroetsch, McIlveen explained the value of having prominent public space where people with substance use disorder are supported.

“I think having it in the forefront in a public-facing space allows it to build community, because people are going to see the humanity,” McIlveen said. “We’ll get to know the neighbours in a meaningful way — if we are allowed to meet them.

“It’s not us-and-them, it’s not drug users versus sober people.”

Later, Ward 12 Coun. Craig Cassar commented on the community objections by saying, “I suspect the answer would be ‘no,’ no matter where it was located… It’s a very important service and there will probably always be objections.”

McClemont acknowledged that communication with the community could have improved.

“We could have done more to inform, put out more flyers,” McClemont said said. “We will definitely do that during the community consultation.”

Couns. Maureen Wilson (1), Tammy Hwang (4), Esther Pauls (7) and Mike Spadafora (14), were not present for the vote, whose timing pushed against a public works committee meeting.

There was also across-the-board support for a motion from Ward 13 Coun. Alex Wilson to direct city staff to look into whether shelters in Hamilton could be permitted to have a safer use space. As noted, the YWCA Hamilton has done so and is seeing results.

“They (YWCA Hamilton) have only had to call emergency medical services once since they started offering a safer use space last April — after previously having had to do some upwards of once per day,” harm reduction advocate Olivia Mancini told the BOH. “I had similar experiences in the shelters where I worked.

“Doing this would significantly reduce the pressure on the health-care system — EMS, the police, and the emergency department of hospitals, which I’m sure you have heard are under strain.”

Staff were directed to bring back findings about safer use spaces in shelters to a BOH meeting in four months, on June 12.


Mayors’ five-point plan

The debate and the seeming double validation of a genuine harm reduction in Hamilton came almost simultaneously with an announcement that Ontario’s Big City Mayors are adopting a health and homelessness strategy. It includes a five-point plan for the Ontario government to make an immediate impact on the mental health, addictions, safety and housing-deprivation crises:

  • Centralized and integrated intake and dispatch process
  • More provincial investment in low barrier hubs
  • More stabilization and treatment beds with experienced staff to support those in their treatment journey
  • More flexible and predictable funding for supportive housing
  • More provincial ministry and agency collaboration to reduce red tape and duplication

The mayors’ missive came after a meeting last Friday with Finance Minister Peter Bethlenfalvy and Municipal Affairs and Housing Minister Steve Clark in regard to the upcoming provincial budget.

The big-city mayors’ media release said they would present this plan to the Deputy Premier and Minister of Health Sylvia Jones at the meeting they want to have to address the aforementioned crises.

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