Agenda Index City of Vancouver

ADMINISTRATIVE REPORT

TO:

Vancouver City Council

FROM:

Director of Carnegie Centre, in Consultation with the Chief Constable and the Drug Policy Coordinator

SUBJECT:

Vancouver Agreement Health and Safety Initiative: Carnegie - Health Connections Outreach Program

 

RECOMMENDATIONS

CITY MANAGER'S COMMENTS

GENERAL MANAGER OF COMMUNITY SERVICES' COMMENTS

COUNCIL POLICY

On November 5, 1998, Council confirmed principles for the general guidance of Downtown Eastside actions and planning which include providing adequate services for treatment of addiction, improving conditions at the street level, reducing the level of drug-related crime, and encouraging legitimate commercial activity.

On November 5, 1998, Council approved funding for the Carnegie Outdoor Street Program to offer positive alternatives to the undesirable activities taking place on the corner of Main and Hastings.

On May 15, 2001, Council adopted the Framework for Action: A Four Pillar Approach to Drug Problems in Vancouver as the basis for the City's continuing effort to work with the Vancouver Agreement partners and the community to address the issue of substance misuse. This includes development of an implementation plan to monitor not only drug-related crime, but also the general well-being of residents and business people, the effect on tourists and the progress of revitalization in the community.

PURPOSE AND SUMMARY

This report seeks Council approval of funding for the Carnegie - Health Connections Outreach Program as a key component of the Vancouver Agreement Health and Safety Initiative. This initiative is intended to help people addicted to drugs move toward recovery and to reduce the impacts of the illegal drug trade in the Downtown Eastside and surrounding communities. It also includes expansion of local health clinics, development of a Life-Skills Centre, and a redesign of the corner of Main and Hastings. These proposals are the result of widespread public discussion and debate and are consistent with the City's Framework for Action as well as recent decisions by the Development Permit Board and Board of Variance.

The recommended funding will support continuation of the Outdoor Street Program through the end of October of this year when it will be transformed into the Health Connections Outreach Program for a two-year time-limited period at a cost of $335,845 per year.
The Outreach Program will be run in concert with the Health Contact Centre at the Roosevelt Hotel. Both will be operated in partnership with the Vancouver Richmond Health Board, Police and the City. Community stakeholders and an independent evaluator will participate with staff in Program Advisory and Neighbourhood Liaison committees to advise on program development and to monitor and address any neighbourhood impacts.

BACKGROUND

The Main and Hastings Corner
The corner of Main and Hastings is an important crossroads for the Downtown Eastside, Chinatown, Gastown and Strathcona communities. Over the last decade this intersection -especially the area immediately adjacent to the Carnegie Centre - has become a primary focus of the illegal drug trade. This is due to a variety of factors including its central location, as well as its configuration with site lines to three corners, covered washrooms, alcoves and transit access. For much of the decade, it has been a place where more than one hundred people regularly congregate to sell, buy, and consume drugs and there is also an active drive-by delivery and purchase business.

The mixture of drug users, public washroom users, Carnegie Centre patrons, transit passengers, and other pedestrians who live, work or shop nearby has made this area very congested, unstable, and, at times, unsafe. The physical characteristics of the corner and the almost complete absence of 24-hour referral and support services for addicts have created an intractable problem for the area. The perceived lack of safety generated by these factors has had significant negative impacts on both the operation of the Carnegie Centre and the viability of the nearby commercial areas along Hastings Street and in Chinatown.

The Carnegie Outdoor Street Pilot Program
The Carnegie Outdoor Street Program was established in May of 1999 as part of a Program of Strategic Actions endorsed by Council to address Downtown Eastside issues. Staff worked on the corner at Main and Hastings and, in the initial 18 months, also worked at Pigeon Park. The primary focus, however, has been at Main and Hastings.

The Street Program was a pilot project to test various programming and data-gathering activities that would create a degree of safety and stability on the corner for Carnegie patrons, the public, and addicts. It was also intended to provide information about the street addict population, and about appropriate methods of working with them. It grew out of several successful projects including "Speaking in Chalk" and the "Walls of Change" which engaged large numbers of street-involved people in positive activities, contributed to a sense of community pride and connected them to other services in the area.

The Street Program has had four primary responsibilities:
· to contribute to a level of safety for the public,
· to improve access to and from the Carnegie Centre,
· to provide front-line information and referral, first-aid and support activities to addicts, and
· to learn as much as possible about the characteristics of street addicts, effective methods for working with them, and the kinds of services they require.

The Street Program has been carried out in collaboration with the Vancouver Police Department, the Vancouver Area Network of Drug Users (VANDU), the Vancouver Richmond Health Board, the Street Nurses, the Needle Exchange and the Carnegie Centre.
A list of activities is attached as Appendix A.

It is important to note that, by intent, there has not been an attempt to permanently disperse addicts from the corner. After analysing what has been done in many other cities, it was concluded that until a comprehensive Four Pillar Approach can be developed, dispersal would likely move illegal drug activity to more sensitive locations in surrounding neighbourhoods. Furthermore, there aren't the enforcement resources to prevent people from drifting back to Main and Hastings.

It is estimated that, over the course of a week, Street Program staff have contact with several hundred people. As a key component of their work, staff ensures that underage people are not involved at the corner and are referred to available youth services where possible.

In addition to their ongoing daily programming work, Street Program staff have carried out a survey of the characteristics of the street addict (available at the City Clerk's Department). They have also developed innovative public processes to receive input from the community about a variety of issues including the redesign of the corner of Main and Hastings and the admissions' policies and practices of the Carnegie Centre.

This spring, the Street Program also conducted an experimental life-skills and pre-employment training initiative - "The Historic Markers Project." Working with the guidance of fifteen East Vancouver artists and Street Program staff, 175 street people with addictions participated in literacy and personal health management workshops and constructed seventeen mosaic tile markers that commemorate historic events, people, and places in the Downtown Eastside. This project has demonstrated how to involve street people in ways that build self-confidence and skills in activities that also make a positive contribution to the community as a whole.
The Vancouver Agreement Health and Safety Initiative
Building on the knowledge gained by the Street Program about the daily drug activity on the corner of Main and Hastings, the Vancouver Agreement First Focus announcement contains a range of treatment and enforcement initiatives that respond to the urgent situation on the corner. These include the following:

· the establishment of the Health Connection Centre as a 24-hour respite, treatment and referral centre
· the creation of a Life Skills Centre
· expanded detox and treatment services outside of the Downtown Eastside
· the redeployment of 22 Vancouver Police Department officers
· the assignment of a Special Police Inspector for the Downtown Eastside
· the assignment of Police officers to specific geographic areas
· the assignment of neighbourhood Police officers to Community Police offices
· the assignment of a Police constable to work on the Health and Safety Initiative and to liaise with Carnegie Security and Street Program supervisors
· the development of a Program Advisory Committee to provide input from diverse community stakeholders into the functioning of the health facilities
· the development of a Neighbourhood Liaison Committee help monitor and address community impacts
· the appointment of an independent evaluator to monitor program activities, effectiveness and community impacts.

These initiatives are intended to improve the abilities of the Carnegie Centre, the Vancouver Richmond Health Board, Vancouver Police Department and representatives of local agencies, businesses and residents to work together to move addicted individuals toward increased contact with existing, expanded and new resources in the health care system. As these and other initiatives begin to provide positive treatment alternatives for addicts seeking help, the strategy is to step up Police enforcement against commercial dealers at this and other locations.

DISCUSSION

The Health and Safety Initiative is now underway with the facilities scheduled to begin operation between the fall of 2001 and the spring of 2002. The Roosevelt Hotel main floor will be opened as the Health Contact Centre in December of this year by the Vancouver Richmond Health Board. It is anticipated that the VRHB will be providing nursing staff, health care workers, and activity workers for the 24-hour, seven day a week operation. It will enable Carnegie Centre staff and the Police to refer street-involved addicts to the Health Contact Centre and assist Police efforts to isolate and arrest commercial dealers of illegal drugs. These measures are intended to reduce the utility of the corner of Main and Hastings for illegal drug activities and thereby improve access and outdoor space for the Carnegie Centre and provide a more safe and secure gateway to Chinatown.

Under this plan, the Carnegie Outdoor Street Program will be transformed into the Carnegie -Health Connections Outreach Program. In this way it will bring the Street Program's operational experience and extensive relationships with addicts into the operation of the Health Contact Centre. This is important in establishing credibility for the Contact Centrewith the addict population. The Outreach Program staff will work in a complementary and integrated manner with the health personnel. The inside location will provide more in-depth programming, similar to that done this spring for the Historic Markers project. The Program will continue to do extension work on the streets as well, providing a bridge between addicts outside on the street and the resources within the Health Contact Centre and the Carnegie Centre.

The purpose of the work remains the same: to offer programs which provide respite from the drug scene, leading to opportunities for addicts to move into more stable activities: healthier addictions' management, proper shelter, detoxification, counselling, treatment, life-skills and pre-employment training. Many of the methods for doing this have been thoroughly tested and demonstrated during these past two exploratory years of the Carnegie Outdoor Street Program.

Evaluation
As required in the Good Neighbour Agreements for the Health Contact Centre and companion facilities, the Vancouver Richmond Health Board will be implementing a comprehensive evaluation plan for the Vancouver Agreement First Focus Health and Safety Initiative. Undertaken by an independent evaluation agency, this work will provide a very detailed, comprehensive assessment of each component of the Initiative, including the Health Contact Centre. Qualitative and quantitative measures will be employed that will focus on three key evaluation areas: measuring access; measuring population health outcomes; and measuring neighbourhood impact. This will be done in consultation with the community and in cooperation with the Program Advisory Committee and the Neighbourhood Liaison Committee.

VANCOUVER POLICE DEPARTMENT

The Vancouver Police Department views the Carnegie - Health Connections Outreach Program as an integral part of the First Focus Health and Safety Initiative and of the services planned for the Health Contact Centre. The Department will be working closely with the Program staff in referring addicted people to the Contact Centre, and in ensuring safety in and around the corner of Main and Hastings.

PUBLIC PROCESS

Over the last two years there has been a great deal of public consultation, discussion and debate about the Carnegie Outdoor Street Program, the Framework for Action and the facilities proposed in the Vancouver Health and Safety Initiative. This report has been informed by this extensive public input and debate.

Strongly divergent views have been expressed in the community as to whether there are too many or too few services available for people with addictions, about whether services draw addicts from outside the area, and about the appropriateness and efficacy of these services. The Street Program has been included in this debate. The redesign of the corner of Main and Hastings, coordination of the Outreach Program with the Health Contact Centre, expanded community policing efforts and the limited-limited approval of new facilities have been proposed to respond to these concerns.

Most people in the community, whether or not they support all of the specific components of the Vancouver Health and Safety Initiative, believe that the time has come for action. Whatever action they support, they all agree that there is a need for an independent evaluation process as well as ongoing and widespread community involvement in both program development and monitoring neighbourhood impacts. This is consistent with input from citywide public information meetings and opinion polling sponsored by Vancouver's Coalition for Crime Prevention and Drug Treatment which have indicated that the general public strongly supports taking action through the Four Pillar Approach.

FINANCIAL IMPLICATIONS

Since its inception in May 1999, the Street Program has received basic operating funding from the City of Vancouver ($225,800), the National Crime Prevention Centre ($88,702) and Health Canada ($85,000). In addition, Western Diversification Canada contributed $200,000 for the Historic Markers Project. This was project specific funding to hire additional temporary staff and local artists, and to provide training allowances and materials.
In keeping with the City's Framework for Action and the Vancouver Agreement's Downtown Eastside Health and Safety Initiative, it is recommended that the Street Program be transformed into the Carnegie - Health Connections Outreach Program. It will be operated in conjunction with the Health Contact Centre at the nearby Roosevelt Hotel. This will be a partnership between the Vancouver Richmond Health Board, Police and the City. The Health Board is expected to provide the management and health personnel for the overall operation of the Centre on a 24-hour basis, seven days per week. It is anticipated that senior governments will cover the costs of renovations. In addition to the expanded Policing resources, the City will contribute the expanded Outreach staffing as described below. The Carnegie Centre will continue to provide supervision for the Outreach Program out of its existing staffing complement.

Basic operation for the Street Program currently costs about $15,300 per month for the full time equivalent of four staff to cover programming in front of the Carnegie Centre, six hours a day, six days per week. The Health Connections Outreach Program will require that funding be increased to about $28,000 per month starting in November. This will allow for staff hiring and training in preparation for the scheduled December opening of the HealthContact Centre. The new Outreach program will provide the full-time equivalent of six staff, seven hours per day, seven days per week, reflecting the new in-door responsibilities of the program, the continuation of an outdoor presence (reduced), and the requirement to be present 7 days a week.

The recommended contribution from the City to this outreach component of the Downtown Eastside Health and Safety Plan is $335,845 per year, broken down as follows:

Staffing: (six temporary positions) $ 305,845
Program supplies, equipment, honoraria: $ 30,000

The funding period is for two years, commencing with the opening of the Health Contact Centre in December 2001, following which the Outreach Program will be reviewed within the overall evaluation plan that has been stipulated for the Vancouver Agreement Health and Safety Initiative. This two-year period is consistent with the time-limited permit approved by the Development Permit Board for the Health Contact Centre.

Staff recommends that Council utilize Gaming revenues to fund the Carnegie Outreach Program. Council policy is to restrict the use of Gaming revenues to time-limited projects to ensure the City budget does not become dependent on these revenues and face the possibility of negative impacts if the revenue declines.

This source of revenue is appropriate for the Carnegie Outreach Program, in part because of the nature of the issue being addressed and primarily due to the fact that the program is time-limited. Several of the limited time expenditures identified in 2001 can continue to be supported by Gaming revenue in 2002. However, budget planning, in general, excludes provision for continuation of revenue from this source. Should the Gaming funds not be available, an increase in the operating budget without offset will be required. Furthermore, if the program proves to be effective and is extended beyond the two-year pilot other sources of revenue will likely be required.

In addition, funding at the Carnegie Outdoor Street Program's current level is required to be continued for three months until the Outreach Program begins in conjunction with the Health Contract Centre, for an expenditure of $45,900 from Contingency Reserve.

CONCLUSION

The experience of the Carnegie Outdoor Street Program will help ensure the success of the Health Connections Outreach Program, the Health Contact Centre and the other health and employment training services planned in the community. It will permit the corner to be redesigned without dispersing addicts into more sensitive parts of the surroundingneighbourhoods of Chinatown, Gastown and Strathcona. It will also enable the drug market at the entrance to the Centre and on the east side of the building to be closed. Access to the Carnegie Centre will be improved and pedestrian movement south toward Chinatown on Main Street will be unimpeded by heavy drug activity.

- - - - -

Appendix A

SUMMARY OF CARNEGIE STREET PROGRAM ACTIVITIES

Safety
· Defuse incipient violence: a verbal de-escalation; have the protagonists move on; take weapons
· Intervene when violence occurs: separate the public and bystanders from the incident; separate the protagonists; call 911
· Work with police regarding removal of minors from the corner
· Regular information and coordination meetings with police
· Work with street population to develop self-responsibility for nonviolent behaviour

Health
· Administer first aid
· Respond to overdosing
· Call 911
· Provide a setting for Street Nurses and Vancouver Richmond Health Board nurses to work with street addicts: inoculations, health education
· Alternative therapies: aroma therapy, foot massage, Aboriginal healing practices
· Free haircuts

Information and Referral
· Advocacy and support for addicts wanting to obtain detox and treatment services
· Assistance with emergency and temporary housing
· Referral to social assistance, food and other front-line resources
· Assist in reunification of individuals with their families
· Encourage and assist people to leave the corner and return to their home communities
· Provide support for the Vancouver Area Network of Drug Users self-help and peer-support work with addicts on the corner.

Education and the Arts
· Literacy education: helping with writing letters home and to friends, especially on special occasions (Christmas, Valentines); learning to write prose and poetry
· Painting: making paint and materials available for people to express themselves on canvasses
· Music: organizing musical jam sessions with instruments street people can use to join in
· Providing personal and community-building programs through the arts: the Historic Markers Project - involved 175 street people in a literacy, life-skills, personal health care and arts construction project. Working with the guidance of 15 East Vancouver artists, 17 historic markers were created from mosaic tiles and imbedded in thesidewalk in the Downtown Eastside. Links were established to business and resident groups in the surrounding neighbourhoods.

Recreation and Special Events
· Celebration of birthdays of street and homeless people
· Organize tributes and memorials to those who have died
· Special occasion days: Thanksgiving - provision of food and entertainment; Christmas - Santa Claus
· Movies and Videos: selected to support particular themes as well as for entertainment - development of cultural awareness and pride
· Dancing
· Checkers, chess

Information and Research
· Maintain daily logs on the corner activities: incidents to record; actions taken
· Conduct surveys to aid the planning and provision of services (because of the Street Program's credibility, it has ready access to addicts for purposes of social research): demographic and geographic profiles; opinions and preferences about appropriateness, availability and desirability of services.

THE SPIRIT INSIDE

A Poem About the Street Program, by a Participant

The people on the street,
That's what it is about
Their spirit inside gets to come
out

It's amazing to see
The difference it makes
Some love and acceptance
Is all that it takes.

- March 2001

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