CITY OF VANCOUVER

ADMINISTRATIVE REPORT

 

Date:

November 19, 2004

 

Author:

Rob Whitlock

 

Phone No.:

604-873-7432

 

RTS No.:

4638

 

CC File No.:

2605

 

Meeting Date:

November 30, 2004

TO:

Vancouver City Council

FROM:

Director of the Housing Centre, in consultation with the Directors of Drug Policy and Social Planning and the Chief of Police

SUBJECT:

DE408451: 5616 Fraser Street (Triage Special Needs Residential Facility)

RECOMMENDATION

GENERAL MANAGER'S COMMENTS

The General Manager of Community Services RECOMMENDS approval of A and B.

CITY MANAGER'S COMMENTS

The City Manager RECOMMENDS approval of A and B.

COUNCIL POLICY

Council's housing priorities are low and modest income families with children, seniors, low-income singles living in downtown rooming houses and hotels, and those with mental or physical disabilities and others at risk of homelessness. The City has undertaken several initiatives to prevent homelessness, including development of new social housing and provision of community services.

July 2000, Council approved the acquisition of 5616 Fraser Street for non-market housing.

On May 15, 2001, the Council endorsed `A Framework for Action - A Four Pillars Approach to Drug Problems in Vancouver'.

July 9, 2003, Council approved, in principle, a 60-year lease to Triage, as well as a grant equal to the prepaid rent of 75% of the purchase price ($431,250), and that the lease and grant be contingent on project funding commitment under the Independent Living BC provincial program, provision of tenant support services as well as capital funding from the Vancouver Coastal Health Authority (VCHA), and funding from Human Resources Social Development Canada (HRSDC).

SUMMARY AND PURPOSE

This report provides Council with the background and community response to a 39 residential unit Special Needs Residential Facility proposed for a City-owned site at 5616 Fraser Street to house individuals who have a mental illness and an alcohol or drug addiction.

Many local residents and community representatives are strongly opposed to the project, citing significant concerns with the location close to two schools, and the size of the proposal. The community is clear in its position that it would prefer that the project not proceed any further. Alternatively, some opponents of the project have indicated support if the project were substantially reduced in size (e.g. 12 units).

City staff believe that the project should proceed, as it is an essential component of the Four Pillars strategy for addressing Vancouver's drug problem.

The report advises Council on the issues raised by the proposed project and provides a recommendation that Council advise the Development Permit Board of their support for the development application.

VCHA has advised that it wishes to amend its application to reduce the number of units from 39 to 30, and has committed to a minimum of two (2) staff for all shifts for at least the first year of operations.

BACKGROUND

On July 11, 2000, City Council approved purchase of the site at 5616 Fraser Street, located on the east side of Fraser Street just north of 41st Avenue. At the time, no specific housing project was identified; however the report did suggest the site could be used for either "a homeless at risk or family project". The purchase price was $575,000.

Initially, discussion related to this site ear-marked it for consideration as a project serving low-income singles (LIUS) under the HOMES BC 2001/2 housing program. In 2001, the City and the Vancouver Richmond Health Board (now VCHA) sent out a request for expressions of interest for a housing development for the site, specifically to provide alcohol and drug free supported transitional housing for adult men and women who have made a commitment to be drug and alcohol free. In October 2001, Council named Triage Emergency Services and Care Society as the sponsor for the site.

The Homes BC program was cancelled in 2002, including this specific project. In 2003, however, the project was resurrected under a new partnership, involving significant funding from the Federal Government's Supportive Community Initiative (SCPI - most commonly called SCIPPY) and VCHA.

Project Description: The site is zoned C-2 commercial and measures approximately 31.77 m x 31.55 m (104.25 ft. x 103.50 ft.), for a total area of 1 002.4 m² (10,780 ft.²). The development proposal for which a development application has been applied for and which has been reviewed by the community consisted of a four-storey building containing 39 self-contained residential units above an amenity level at grade. The bachelor/studio residential units will range in size from 32 - 40 m² (350 - 430 ft.²) with approximately 418 m² (4,500 ft.²) of amenity area. The development application (DE 408451) was submitted to the City on May 5, 2004. The use is defined as a Special Needs Residential Facility - Group Living because of the programming component.

The development is intended to provide transitional housing for individuals who have a mental illness and are addicted to alcohol or drugs, but who have been in treatment and have not used alcohol or drugs for a period of at least 60 days. The residential component of the project occupies the upper three floors, and the first floor will include meeting rooms, a library, work spaces and recreational areas for the residents. Staffing will be on-site 24 hours a day, seven days a week. A critical requirement for residents of the project will be the necessity to remain alcohol and drug free on and off site. Residents who are not able to meet this requirement will be relocated to other housing operated by Triage or within the VCHA network of housing.

Figure 1: Site Location

Revised Project: Triage and the VCHA have now decided to amend the application by reducing the number of units to 30. Further, staffing will be increased to two staff members on site for all day and night shifts for at least the first year of operation. These decisions have been reached in response to community concerns and in recognition that residents will be best served by a residential setting of 30 units and this will serve as a model for other locations in the city.

Public Process: Specific discussion on site development began early in 2004. City staff advised Triage and VCHA to sponsor a preliminary meeting in the community before submission of their formal development application. Triage hosted a public information meeting on April 15, 2004, attended by approximately 20 people and City staff. Initial concerns expressed at the meeting were as follows:

On May 5, 2004, DE 408451 was submitted for a 39-unit drug and alcohol free Special Needs Residential Facility, to house individuals with mental illnesses and a history of drug or alcohol addictions. A notification sign was posted and a notification letter dated June 28, 2004 was sent to registered property owners. City staff began to receive a number of telephone calls, letters and emails. In response, staff have worked to ensure that the community is fully aware of the development, through the following actions:

Council Involvement: Under the Vancouver Charter, City Council can, and has, delegated its authority on development approval decisions to either the Development Permit Board or the Director of Planning and may only provide advice to staff in respect to a development application matter. This report is structured to allow Council to provide its advice, and the Board will receive Council's opinion along with a staff report in early 2005.

Synopsis of Community Response: Letters, emails and petitions containing over 3,100 names have been submitted to the City. An extended summary of the material is contained in Appendix A of the report, and original copies are on file with the City Clerk, along with copies of information panels which were available at the two open houses in October.
Almost all of the written correspondence is strongly opposed to the proposal. A summary of concerns is as follows:

A number of groups and individuals have also expressed support for the facility:

Vancouver Coastal Health Authority: The VCHA has submitted a letter to the City, which is attached as Appendix C to the report.

Vancouver School Board: The Vancouver School Board has indicated that it does not consider the proposed development to be potentially harmful to the operations of the nearby schools of Alexander Mackenzie Elementary (960 East 39th Avenue) and John Oliver Secondary (south-west corner of East 41st Avenue and Fraser Street).

Vancouver Police Department: The issue of treatment for drug addicted individuals is significant for the Vancouver Police Department (VPD).  The majority of property crime in the City is committed by substance addicted people.  Treatment that breaks the crime/drug cycle is supported by the VPD.  The proposed Triage facility represents a move toward breaking the cycle and placing the dual diagnosed person in an area where the drug culture is not entrenched and their chances of rehabilitation increase. 

The neighbourhood of the proposed Triage site is diverse and active. There are issues of disorder such as sex-trade workers, homelessness, panhandling, and congregating youth that some residents find ominous.  Although these are issues of concern, they have not translated into significant crime. In reality, the crime statistics for the past three years have declined in this particular area.   The VPD is sensitive to the concerns of the community and will work closely with Triage staff, Vancouver Coastal Health Authority, Vancouver School Board and local neighbours to ensure that those concerns do not overshadow the proposal. 

DISCUSSION

In 2001 Vancouver City Council endorsed A Framework for Action: A Four Pillar Approach to Drug Problems in Vancouver, including Prevention, Treatment, Enforcement and Harm Reduction, as Vancouver's drug policy. Since then, City staff have worked closely with Vancouver Agreement partners and Vancouver's Four Pillars Coalition to develop an implementation plan for the Framework for Action. The development of treatment services and related transitional supportive housing are major components of the Four Pillars approach.

The City in conjunction with the VCHA and the Province of British Columbia have worked together for many years to develop supportive housing for those with mental illness and addictions. The project at 5616 Fraser Street specifically provides a response to the treatment pillar of the Vancouver Agreement, by combining affordable housing and addiction program services designed to support mentally-ill individuals recovering from addictions within an abstinence based environment. Consequently, City staff continue to maintain a position of strong support for the project, despite strong community opposition.

Many concerns and questions have been raised by the community with staff of the City, Triage and the VCHA. An extensive question and answer response has been prepared and is attached to the report as Appendix B. The following commentary addresses major issues:

Process: Some feeling exists within the community that City staff had purposefully undertaken notification at the beginning of the summer to avoid dealing with the community. When it became apparent that the project would be controversial in the community, staff quickly let the community know that the time for response would be extended, and this has been done on several occasions. The under estimation of the community's concerns about the project was the result of the relatively low turn-out at the pre-application open house.

Project Size and Staffing: Two major issues raised in the community are the size of the project at 39 units and understaffing. Triage and the VCHA have responded to community concerns about size and staffing by proposing to reduce the proposal from 39 to 30 units, and provide two full time staff members for day, evening and night shifts. These changes are made to provide greater assurance that the project will be adequately managed and there will be no negative consequences for the community.

Location: The City's guidelines for Special Needs Residential Facilities (SNRF) outline a number of considerations pertaining to location:

The site on Fraser Street was chosen because:

The location of the site in proximity to both elementary and senior secondary schools was not taken into consideration because the residents of the development are not seen to pose any danger to school children or the broader community. Indeed, the general objective of supportive housing is to provide residents with the opportunity to integrate into society by assisting those who are ready and committed to be drug and alcohol free in their transition back into the community.

A number of comments were received from residents opposed to the project in this location about the need to locate supportive housing city-wide. The Draft Homeless Action Plan currently under discussion in the community contains an action calling on the City to work with the VCHA and the Provincial Government to develop a strategy to locate supportive housing throughout the city. City and VCHA staff will be initiating a policy discussion on the city-wide distribution of projects as part of their upcoming 2005 work programs.

The Triage project is the first supportive housing project in Vancouver which is specifically for people with a mental illness recovering from a drug or alcohol addiction in a context of no tolerance for drugs or alcohol on or off site. There are an additional 36 SNRFs (serving 366 people) in 12 different parts of the city for people with mental illnesses including a six bed facility for individuals with a mental illness in recovery from addictions. As well a number of supported housing projects (serving 440 people) with varying levels of staff support for the same dual diagnosis clientele have been in operation for 10 to 20 years. These supported housing projects have been very successful in assisting individuals to live successfully in their communities.

Operational Management: While all conditions pertaining to the development application that will be part of a report to the Development Permit Board for a meeting in early 2005 have not been finalized at this stage of the process, development of a draft management plan has been discussed with Triage and VCHA. The plan would be to the satisfaction of the Directors of the Housing Centre and Social Planning, with the following operational requirements:

Neighbourhood Relations: It is a standard requirement for facilities such as the project proposed for 5616 Fraser Street that an agreement defining neighbourhood contact and consultation be put in place prior to the project being undertaken. While experience indicates that such formalized contact and consultation is in the long run often unnecessary as problems in such facilities seldom arise; staff believe strongly that such contact provides assurances to the community that any concerns will be addressed, particularly at the start up stage. Along with the management plan, Triage and the VCHA will be required to undertake the following actions if approval is obtained for the development:

The management plan will be further finalized in discussion with the afore-mentioned Advisory Committee.

FINANCIAL IMPLICATIONS

There are no financial implications.

SOCIAL IMPLICATIONS

The Draft Homeless Action Plan recently received by City Council (November 2, 2004) notes that two-thirds of the people who are street homeless have substance addictions, mental illness or both. That report outlines that to effectively tackle homelessness, there needs to be an increase in mental health and addiction services. The ability of individuals to overcome the problems of both mental illness and drug and alcohol addictions is made more difficult when stable and affordable supportive housing is not available. Approval and development of this project will add critically needed housing resources in the necessary supportive context, in particular housing that is alcohol and drug free.

CONCLUSION

The vast majority of residents in the community do not support the proposed housing project and request that Council not proceed with the approved lease to Triage Emergency Services.

The proposal to develop supportive housing for individuals with both mental illnesses and drug and alcohol addictions is clearly in response to the Four Pillars approach, specifically the treatment "pillar", and therefore the Directors of the Housing Centre, Social Planning and Drug Policy, and the Chief of Police recommend to Council support of DE408451.

- - - - -

APPENDIX A

SUMMARY OF COMMUNITY RESPONSES

This appendix provides a summary of written submissions to the City related to DE408451 FOR 5616 Fraser Street. Copies of the original documents will be on file with the City Clerk from November 30, 2004, until after completion of the Special Meeting of Council scheduled to start on December 7, 2004.

The following table indicates the actual number of names that the City have received indicating a position of support or opposition to the proposal.

Form of Response

Support

Opposition

Letters

10

38

Form letters

  

466

Emails

  

30

Petition signatures

  

2,541

Meeting Response Forms

6

96

Total Responses

16

3,171

Summary of Written Responses:

Comments in Opposition: Comments were divided into 7 categories: Site Location; Safety and Security; Local Vehicle Traffic and Parking; Public Consultation Process; Crime, Loitering and Drug Use; Facility Operation, Staffing, and Management Plan

Site Location: Of highest concern was the proximity of the proposed site to both John Oliver Secondary School and Mackenzie Elementary School. The proximity of the site to parks, daycares, and other schools in the community were also noted concerns.
Opponents also noted that there are a disproportionate number of social services in this community, and that such services should be spread more evenly around the city as a whole.
Those opposed noted that this facility does not fit into the social fabric of the neighbourhood, due to the family oriented nature of the community. Other areas would be more suitable.

Safety and Security: Those who opposed the application noted safety and security as a big concern about the facility. As a result of its proximity to schools and South Memorial Park, opponents felt that the safety of both children and vulnerable seniors would be seriously compromised.

Opponents feared the possibility of confrontations near the school, or in local parks, as a result of the residents or their associates/friends. Opponents also feared an increase in local prostitution, local crime, and drug trafficking as a result of the facility.

Opponents noted that the parks will no longer be safe for residents and families, as a result of loitering, and hazardous waste (i.e. used needles). Those opposed also noted that the residents of the facility are unstable, and would create fear and stress among neighbours.

Local Vehicle Traffic and Parking: Those who opposed the application noted concerns about traffic and parking. Opponents did not see any provision for the replacement of the existing parking spaces presently on site. As a result, some opponents felt that local traffic would be impacted.

Public Consultation Process: Opponents of the application had several concerns about the consultation process. Opponents noted that the process was not thorough enough, the notification area was too small, and more opportunities for public involvement should have been provided. Opponents also noted that the public process should have been conducted after September, to allow schools and local PTA's to adequately review the application. Several opponents felt that the process lacked transparency.

Opponents felt that the meeting facilitator, Michael Fogel, was biased in his chairing of the meetings.

Crime, Loitering, and Drug Us: Opponents felt that as a result of the facility, crime in the community would increase. Break-ins and vandalism would increase as a result of "undesirable" associates, or as a result of relapsing residents trying to support their addictions.
Those opposed to the application noted that the residents of the facility would have a high potential for crime and lawlessness as a result of their histories.
Opponents also felt that the simple presence of the site would invite transient "undesirables" and drug dealers into the community.
Prostitution is also a noted concern. Opponents felt that relapsing residents might be drawn into local prostitution.

Facility Operation, Staffing, and Management Plan: Opponents had several concerns about the operation of the facility. Several opponents noted that the number of residents proposed for the facility is too large (39 residents). Opponents also noted concerns about the qualifications of staff members, and the number of staff members on site at all times.
Opponents were concerned that the one strike rule for relapse will not be enforced. Opponents also noted that extra police resources would also be necessary to deal with security issues around the premises.
Opponents noted that the site is too small to include a garden or any patio space.

Other Comments in Opposition: Opponents noted that this project is a social experiment. Also noted was that this facility will have many other negative impacts on the community.

Summary of Form Letters

Safety and Security: Opponents felt that the proposed facility would put the community at risk. Those opposed noted that the behaviours and actions of residents of the facility, and an increase in loitering and panhandling (as a result of the facility) would negatively impact community safety, quality of life, and safety of the children and the elderly.
Increased drug trafficking and hazardous waste (used needles) are also a concern.

Opponents also felt that Fraser Street Businesses will also be negatively impacted by the facility, as residents will be hesitant to shop in an area regarded as "unsafe and at risk".

Notification and Public Consultation: Opponents felt that the notification area was too small, and that this `large facility' would affect a larger area than the one notified.

Opponents also felt that the public consultation process for this application was inadequate, and that a more thorough consultation should have been conducted after September, when Parent/Teacher groups could consider possible impacts.

Site Selection: Those opposed to the application had several concerns regarding the site selection. Opponents noted the site's proximity to John Oliver Secondary School and Alexander Mackenzie Elementary School, South Memorial Park, and local businesses.
Opponents noted that other schools and daycares are also within a few blocks of the site.

Extracts of Petition Statements

Seven separate forms with signatures have been submitted. The following are extracts of the three with vast majority of signatures, all in opposition.

Petition 1: "We the undersigned strongly disagree with the location of the Triage Centre on 5616 Fraser Street. The location is across the street from John Oliver High School, one block from Sir Alexander McKenzie Elementary School, there are also daycare centres and parks very close to this facility. The potential health risks are numerous. We feel although it is a good idea, a different location is more suitable. Our children, business owners, landowners and community at large deserve a safe place to live, work and play. Please help us to stop this drug centre in our community by sending this petition to the Vancouver City Hall before August 6th. Thank you."

Petition 2: "To the Director of Planning, City of Vancouver City Council

R: 5616 Fraser Street DE408451

We, the undersigned residents of Vancouver, are firmly opposed to the development of a Special Needs Residential Facility - Group Living building. We strongly urge the Director of Planning to NOT consider 5616 Fraser Street as the location of this building due to the area that it is in.

This neighbourhood is a residential area that is home to many people, especially children and youth as Sir Alexander McKenzie Elementary School and John Oliver High School are within one to three blocks of the proposed building site. The addition of a facility that hosts individuals who had been living a substance lifestyle could greatly endanger and/or influence our children and families.

We believe it is very important to keep our children and families safe, and a building that houses "people with mental health and substance use issue in their lives" from "neighbourhoods in Vancouver and the Lower Mainland" does not appear to achieve the safe environment we wish to have."

Petition 3: "We the undersigned strongly object to this development application for the following reasons.

Overview of Comments from Meeting Feedback Forms (October 18, 2004)

A number of staff were available in the cafeteria at John Oliver Secondary School to answer questions and listen to residents. Feedback forms were given out. The following is a summary of the responses.

There are a total of 93 feedback collected, 21 of them in Chinese. Out of the 93 feedbacks, six supported the proposal, 90 opposed.

Summary of Points in Support:

· Because it is a worthwhile facility that will help people who are trying to help themselves.
· Some would support the proposal on the condition that the facility is smaller, properly managed and monitored, with more staffing and added police for the neighbourhood.

Summary of Suggestions:

· Explicit information should be provided to the community about the residents, program, management and fall-back plan.
· Supporting evidence in medical literatures and statistics will help alleviate fears.
· More consultation/information sessions will also educate area residents.
· Need to communicate to Chinese residents in Chinese.

Summary of Points in Opposition:

· The site is too close to schools, park and residential area. Opponents expressed concerns about safety and negative impacts to students, seniors and local business along Fraser Street.
· The proposed facility is too big and staff levels are too low.
· There is enough crime, prostitution and drug trade in the area already, the proposed facility will bring more of these unwanted activities.
· Too many of these types of facility in the east side of the city. It should be distributed in the west side or on the outskirt of the city where there is no "temptation".
· Notifications were done poorly.
· Residents should have the right to vote on it.

APPENDIX B

BACKGROUND INFORMATION

5616 FRASER STREET SUPPORTED HOUSING PROGRAM

Vancouver Coastal Health (VCH) and Triage Emergency Services & Care Society (Triage) are partners in a proposed transitional supported housing program for individuals with a mental illness who have quit using drugs and alcohol. The program will be operated in an apartment building to be constructed at 5616 Fraser Street in Vancouver. Additional partners in the project include BC Housing, the Federal Government (via the Supporting Community Partnership Iniatitive), and the City of Vancouver.

VCH has a long-established relationship with Triage in their delivery of mental health services at the Society's emergency shelter and supported housing programs. Triage has a proven reputation for providing housing to some of the most vulnerable people in our community. Triage is also committed to being a good neighbour.

Triage is committed to responding to the concerns of residents in the vicinity of 5616 Fraser, and will supply neighbours and business owners with 24 hour/7 day a week contact information. A Neighbourhood Advisory Committee will also be established to ensure concerns are dealt with. Neighbours are welcome to join Triage on the Neighbourhood Advisory Committee.

The following questions and answers respond to some of the concerns heard from home and business owners in the vicinity of 5616 Fraser Street.

What is the proposed housing project?
The project is a planned 39 unit studio apartment building that will provide housing along with 24 hour a day on-site support services to 39 adult men and women who have a mental illness and have quit using street drugs and/or alcohol.

Who is going to be involved in running the project?

Triage will be providing all the on-site support services and taking care of the day-to-day running of the building. VCH staff will provide regular and ongoing mental health treatment and rehabilitation services for every resident. Both organizations will be working in close partnership with each other.

Who is funding the project's capital and operating costs?

The City is providing the land for a 60-year lease with a grant of $575,000; the Provincial government through BC Housing is providing a capital grant of $975,000; the Federal government is providing a grant through the Supporting Communities Partnership Initiative for homelessness of $2,398,203 and Vancouver Coastal Health is providing a contribution to capital of $1,600,000 as well as operating funding. Residents will pay monthly rent.

Are there written criteria for suitability for Special Needs Residential Facility uses.

Assessment of an application for a SNRF will consider program characteristics such as staffing and supervision, hours of operation, client type, facility capacity, referral and intake procedures, length of stay, and amount and type of traffic generated and parking demands.

It will also consider physical characteristics such as the site area, distance between proposed facility and adjacent dwellings or other uses, existing traffic patterns on adjacent streets and any other factors which may have a bearing on the compatibility of the facility with the surrounding neighbourhood.

Why was this location chosen selected? What was the city process?

The site was purchased for social housing to serve low-income singles who cannot afford to pay more than the shelter component of welfare ($325/month) on rent. This project would be the sixth project for low-income singles built outside the downtown in the past six years.

This site was considered a good site for low-income singles as it is close to transit, on a quieter commercial corridor and close to services. The proximity to John Oliver and Alexander MacKenzie schools was not considered an issue as low-income singles, including those with a mental illness and addictions, live throughout the City and many live near schools.

A call for Expression Of Interest was undertaken in 2001 and Triage was selected from 5 proposals received. The funding for the 2001 proposal (alcohol and drug free housing) was cancelled with the end of the HOMES BC programs in 2002. The project was revived in 2003 when alcohol and drug free housing was identified as a priority and funding became available.

The Vancouver School Board is part of the City's review of the Development Permit application and Triage has been in contact with the principals of John Oliver and Alexander MacKenzie schools.

How did the City decide on the notification area?

City staff in Development Services first instruct applicants to post an 8 ft. by 4 ft. sign on the property with a summary of the proposed development. This ensures there is broad awareness of the application. Once the applicant confirms that the sign has been installed, City staff typically issue formal notification letters to property owners within a few blocks of the subject property seeking feedback on the application.

What were the dates and public process decisions for this application?

Triage held a public information meeting for neighbouring residents in April, and then applied for a Development Permit on May 5, 2004. The City notified approximately 300 neighbouring property owners by letter in June. In response to community concerns regarding the timing of the notification, the response period was extended until Oct 25, 2004. Public meetings were announced in early September and held Oct 4th and Oct 18th.

A Special Meeting of Council to hear delegations will take place over three days, December 7th, 8th and 9th. Council will be asked to offer advice to the Development Permit Board, which will render a decision on this application in a public meeting in early 2005.

Why does the notification include an advisory for home buyers?

In the past the City received complaints from purchasers of condominiums who had bought their units before construction commenced and did not receive notification information. Council instructed staff to ensure that in the future pre-purchasers waiting for the completion of their homes are notified of planned developments before they occupy the homes.

Will there be a City staff person on Neighbourhood Advisory Group?

The City is prepared to assign a staff person to the Advisory Panel.

Can the public see the Triage proposal made to the City on which they were selected for this project?

Triage is prepared to make this proposal available to the public on request.

Have alternate locations been considered: older retrofitted facilities, secondary suites?

Clients and their families prefer an apartment setting to a small group home. It allows the client greater independence and privacy, and assists in making the transition to independent living.

Would a smaller scale model work better?

There are significant benefits to having a larger building. A sense of community is established, just like any other apartment building. Residents who have been there longer will help the newer residents settle in and offer advice and insight from their own experiences. Longer-term residents will have a vested interest in maintaining a safe and secure environment.

What are the admission criteria?

People admitted to this program will have a history of mental illness such as depression, bi-polar or schizophrenia. They will also have a history of problematic substance use.

People will only be admitted to this program if they are psychiatrically stable and have been free of alcohol and drugs for a minimum of two months. Part of the assessment process will be to determine a person's ability to live an alcohol and drug free lifestyle and to take an active part in a rehabilitation program. They will have to demonstrate that they are very committed to the program.

People will only be admitted if they are receiving treatment from one of VCH's mental health teams and agree to maintain this contact and to be involved in rehabilitation programs.

Who sits on the admissions committee (are community members included)?

VCH's professional mental health staff in partnership with Triage will thoroughly assess every applicant to make sure they are suitable to move in.

Community members will not be allowed to sit on the admissions committee, to ensure an individual's right to privacy.

VCH and Triage will meet regularly with the Neighbourhood Advisory Committee, to offer regular reports as people progress through the program.

What staffing will be available to support people living in the building?

The building will be staffed 24 hours a day, seven days a week. Two shifts of two health care workers will be on site during the days and evenings, and one will supervise the building overnight. Additionally, a full-time project manager will be available on-site from Monday to Friday; a half-time Occupational Therapist Monday to Friday; and a half-time Administrative Assistant Monday to Friday. In consultation with the community the level of staffing will be reviewed. A dedicated case manager will also be located at the local Mental Health Team.

How was the size and staffing levels arrived at?

The staffing levels are based on similar models of supported housing already successfully operating in Vancouver. In response to community concerns, VCH will carry out ongoing reviews of staffing levels to ensure they are appropriate and that employees are addressing the needs of the community.

How does staffing and funding for Triage compare with smaller group homes?

The cost of this model of supported housing is approximately $70/day/client. A group home on average will cost about $100 /day/client. It is difficult to compare the two models as individuals in group homes generally have a less stable mental illness and require higher levels of support than individuals who are ready to live in supported housing.

This model of housing provides a combination of independent living with support staff available 24hours /day. Mental health consumer groups much prefer to live this independent type of setting rather than a small group home.

Is Triage's staff medically trained?

Triage staff is not medically trained. Triage staff is trained in both mental health and addictions, and provides support to medical and clinical professionals who work for VCH.

Triage has 22 years of experience working with people challenged by mental illness and substance use. The agency runs an emergency shelter, long-term housing and transitional housing. Staff will have training from community colleges and/or some university training.

Will staff ensure residents take their medications?

Residents are required to be psychiatrically stable. Triage staff, where necessary, will provide medication support programs for individual residents. This involves making sure that medication is taken as prescribed by the physician.

It is important to note someone with a mental illness does not immediately become psychotic if they stop taking their medications. Mental Health workers and Triage staff are trained to pick up on whether a resident is becoming ill. When this state is allowed to progress (in a case where there is no supervision) the resident is more likely to hurt himself or herself than a stranger.

What backup services exist? What happens if the night supervisor is busy?

Residents will be very stable, and the assumption that the overnight staff will have to deal with multiple difficulties is inaccurate.

Triage will ensure that staff has access to back-up at all times in the event of emergencies. Additionally Triage will have available on-call back-up from VCH's `out of hours' services.

Are the services only for the people living in the building or can others attend?

The services are only for the 39 people living in the building.

What will people do when they are not in programs?

People are likely to do many of the things any of us do when we are not at work or school. They will watch TV, clean their apartments, do laundry or go out to community activities. On the ground floor of the building there is a tenant lounge, a computer room, a library/reading room, two garden spaces and two rooms for activities. The staff will organize daily activities in the building that people can attend, including celebrations such as Thanksgiving, Canada Day and birthdays.

Will the residents have any unstructured time?

All the residents will have a dedicated case-manager and access to professional rehabilitation programs through VCH's mental health teams.

All the residents will have access to Community Link, an assertive outreach rehabilitation program providing rehabilitation assessment and specialized in skills training in the areas of personal life, leisure, education and work.

Additionally the project the will have access to a range of rehabilitation services. For example:
Coast Foundation, on East 11th, Clubhouse/Employment Services program
Theo BC-supported employment and supported education
Gastown Vocational Services Education/Employment

In the recreational/leisure area, residents will have access to the Art Studios program and CMHA recreation services.

Additional programs and activities available to residents include `Adopt a Street' volunteering, acting and Tai Chi classes, and meetings related to their recovery.

How long will people live in the project?

It is expected people might live in the building for anywhere between 12 and 18 months, enough time to make sure that they are able to stay clean and sober when they leave and move on to housing on their own. Triage will provide everyone who is leaving with help in finding a place to live, and with ongoing support in making a transition to living independently outside the project.

What services will people receive on-site? How many hours a day will the programs operate?

Core services will include:

The amount of time each resident spends involved in activities and services will be based on their individual need and could vary from a few hours per week to several hours per day.

Where are the resources to deal with problems right now?

VCH already houses 1,700 people within our mental health housing programs across the city of Vancouver. Research shows that approximately 50% to 70% of adults with a mental illness also have problematic substance use. These existing buildings are not alcohol and drug free.

What is different about this proposed building is that it will be completely alcohol and drug free and substance use will not allowed by the residents either inside or outside the building.

The resources already available to assist people in supported housing through VCH include:

Eight professionally staffed, multidisciplinary community mental health teams, providing treatment and rehabilitation services for people with a mental illness and problematic substance use throughout the City of Vancouver.

The Dual Diagnosis Program - A specialist treatment resource for people with mental illness and problematic substance use. The program has 3 main goals: firstly to assist clients in reintegrating back into the community; secondly to provide them with the ability to live as positive role models of recovery from mental illness and substance abuse and finally to achieve an improved overall quality of life.

Mental health housing programs - These provide residential and supported housing throughout the city of Vancouver.

Berman House - A 6 bed facility for individuals with a mental illness and problematic substance use that is abstinence based, located on Lakeview Drive, East Vancouver.

What other treatment services will people in the building receive off-site to help with recovery?

The people living in the building will have regular meetings with professionally trained mental health staff who will provide counselling and make sure that medications are appropriate. They will also help set up programs to link people with community activities, employment training or educational opportunities. Residents will receive ongoing counselling to learn strategies to stay off drugs and alcohol and to learn how to manage their commitment to a drug free life. This may involve peer group meetings and treatment sessions with professionals. A dedicated case manager will be added to the local Mental Health Team to support the individuals in this program. Psychiatrist support will also be available.

Why is the abstinence requirement set at two months? Why not 12 months?

A two-month period of abstinence demonstrates a commitment to recovery. Most alcohol and drug free support recovery/treatment programs in Vancouver last only 60 to 90 days.

In addition to being a minimum two months clean the potential resident will have to demonstrate to VCH and Triage how they plan to maintain their commitment to recovery.

Will there be drug testing?

No, drug testing will not be utilized. The Canadian Charter of Rights and Freedoms protects the rights of individuals from such tests.

There are practical issues with testing; there is always the risk of false positives, this risk is particularly enhanced for people who are on a range of psychiatric medications. Additionally testing may give false positives for very common non-prescription medications such as Tylenol.

Drug testing can easily build a false sense of security. Best practice shows that it is better to promote an environment in the project that stipulates clearly that substance use will not be tolerated.

Will participants be prescribed methadone?

Our experience with this population shows that very few, if any, will require, methadone. Should methadone be required a pharmacist, under tightly controlled conditions, will dispense it off-site.

How do you recognize drug use relapse?

Someone who begins using drugs or alcohol again, after a period of sobriety, exhibits several changes in behaviour including withdrawal from staff, isolating oneself in their room, avoiding planned activities, and a change in sleep patterns. All these changes are noticeable in a facility with 24-hour staffing. They are also noticeable by other residents.

How realistic is the relapse contingency plan

If a resident relapses they will be issued a 48-hour eviction notice. This notice will only be rescinded if they recommit themselves to a recovery plan. If the resident re-commits, they will be permitted to stay in the housing. If they do not choose to recommit to living without drugs and alcohol after a relapse or relapse again, they will be immediately removed from the housing and placed in Triage's emergency shelter or Princess Rooms.

The relapse contingency plan will protect the community and residents. Residents are not simply evicted and left at-risk in the 41st and Fraser community, but by ensuring they are housed in one of Triage's projects downtown. Space will be available to make these moves as required.

Will alternative therapies be considered?

Where appropriate a range of alternative therapies, such as acupuncture, will be considered. There is evidence that such therapies can be important additions to the treatment residents will receive from mental health professional staff.

How will this project meet the needs of multicultural clients?

Triage and VCH will ensure that this program is accessible to the diverse range of ethnic communities that live in this city. Multicultural workers from our Multicultural Mental Health Program and peer support program will be called on to help residents, as needed.

How will visitors be managed?

All visitors must enter the building through the front door and pass the main counter, which will be staffed 24/7. Unwelcome visitors will not be permitted.

How will this facility impact the Fraser Street community?

City staff's preliminary assessment is that a well run and properly funded alcohol and drug free housing project for persons with a mental illness would be supportable at this location.

VCH provides housing in a number of supported apartment buildings across Vancouver. Some are very close to schools and day care facilities, sometimes in the same block. None of these buildings have impacted negatively on children, the schools or the neighbours. See the attached maps for information on the distribution of mental health housing services across Vancouver.

Residents of this facility will have highly structured lives with daily schedules that preclude their simply "hanging around" the front of the building. It has been VCH's experience that these types of buildings actually act as a deterrent to street crime, as on-site staffing, awake at night, provides additional safeguards for the community.

Will Vancouver Police respond in a timely way to calls related to this facility? Can there be a guarantee that there will be no increase in crime?

The police have indicated they will provide the same response to this facility that they provide to other establishments in the community. Similar facilities report that crime declines in the vicinity of the facility because of the 24/7 surveillance provided. The facility will not be home to anyone with a history of violence or sexual offenses. Residents will be stable people who do not need to engage in crime to support a drug habit.

Does Triage have another similar facility?

Triage has a 45-bed supported transitional housing project for people with a mental illness who are actively using drugs and alcohol called Princess Rooms, which is located in the Downtown Eastside. Because this housing permits the use of drugs and alcohol, it is not the same as the proposed housing at 5616 Fraser Street. In addition to supporting people who are actively using drugs and alcohol, the Princess Rooms program also supports residents who are working on attaining and maintaining a clean and sober lifestyle, focusing on techniques for relapse prevention.

The Fraser Street project will provide an environment that is exclusively alcohol and drug free.

What specific experience does Triage have with abstinence-based programs for concurrent disorder populations?

Triage is currently working with many dually diagnosed people who want to live an abstinent lifestyle. Some of the residents living in Princess Rooms are abstinent, as well as some of the residents of their housing partnership at 668 Powell Street (21 self-contained units, much like those proposed for 5616 Fraser Street) and in the Wind Chimes apartment building (27 self-contained apartments). Triage has significant experience working with people who want to attain and maintain a clean and sober lifestyle and has designed specific programs that help people prevent relapses.

What is the timeline for success and how will it be measured?

On an individual basis the timeline for success will be 12-18 months with an extended possible stay of two years. We expect most people will move on into regular housing within 12 to 18 months, be able to maintain abstinence, have stable housing and be involved in work and/or rehabilitation programs.

On a program basis, the number of people that can successfully maintain a drug and alcohol-free life over the longer term will be the measure of success.

Are there Canadian success stories for similar housing programs?

Supported housing has been available in Vancouver for 20 years. VCH funds 1,700 supported housing units for individuals with a mental illness through a variety of contracted service providers. About 500 of these units are in apartment buildings in which all the residents have a mental illness. The buildings range in size from 9 units to a 52 unit building presently under construction.

It is important to note that while the studies cited reflect significant improvements for individuals around housing stability and health, they do not require abstinence nor do they provide an alcohol and drug free environment as proposed with the Fraser Street program. A reasonable assumption would be that the Fraser Street program would have higher success rates as it is dealing with individuals already committed and demonstrating recovery.

Supported housing results in significant stability for the individual. In Vancouver supported housing, the turnover is very low at about 6% a year and for the most part reflects people who are moving on to fully independent living. We know that 87% of the people living in this housing have lived there more than a year and 51% have lived there more than 4 years. 1

A 2002 study of 96 individuals with mental illness in supported housing found a 34% reduction in admissions to hospital for mental health reasons when comparing the year before supported housing to the year after. People also spent 36% less time in hospital. 2

A 1996 study by the Housing Ministry in BC looked at the impacts of seven social housing projects on neighbouring property values. The study demonstrated that social (non-market) housing projects have not had a negative impact on the sale prices of nearby homes based on a comparison with a control area. 3

Additional Research Findings-These findings demonstrate the benefits of providing supported housing for people with concurrent disorders.

A San Francisco study of 250 people almost all with a concurrent disorder and not required to be clean and sober or in treatment found that 81% were still in supported housing after 1 year and 62% were there at the end of 2 years. There was a 58% reduction in emergency room visits, a 57% reduction in hospital use and a complete elimination of the need for residential mental health care. 4

A similar study in New York City tracked 4,679 homeless people with mental illness who went into supported housing. They found emergency hospital stays dropped by 21% and use of psychiatric centers dropped 50% after people went into supported housing. 5

The Pathways project in New York City looked at a sample of 242 people with mental illness and addictions who were homeless, and examined the impact of housing on stability. After 5 years, 88% of the program tenants remained housed although the rates were slightly less for individuals with a concurrent disorder. 6

A 1996-2001 study in Connecticut looked at the impact of 9 supported housing programs (25-40 units each) on a sample of clients, many of who were mentally ill and had an addiction. They found tenants functioned at a higher level, were able to set goals and be more independent. They found that there was a significant decrease in the use of hospital services. The study also found that property values of homes near the sites increased or stayed steady. 7

Harbour House, a 45 unit abstinence-based supported housing project in the Bronx for individuals with both a mental illness and an addiction, found that there were fewer episodes of psychosis and that if they did occur, they were mild and could be handled within the program by medication adjustment, reduced demands and increased support. They also found that if hospitalization was required it was generally brief and people returned to housing. The residents exhibited substantial personal growth and development. 8

An outcome study by Central City Concern in Portland, Oregon found supported alcohol and drug free housing was of critical importance in obtaining success with addictions treatment. Success was defined as abstinence, employment and stable housing. They found an average success rate of 48% at 6 months, but those in alcohol and drug free supported housing were 88% successful compared to a 25% success rate for those not housed in alcohol and drug free supported housing. 9

Cascadia Behavioural Health Care in Portland, Oregon operates a supported housing project for 40 individuals with a mental illness and addictions in two side-by-side apartments (12 and 28 units). There is no published research but direct dialogue has identified that the residents have not created any negative impacts on the community and have been very stable in the housing.

Footnotes

APPENDIX C


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