Province’s homeless hubs plan may differ from London’s in one key way

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London is poised to cash in on a new provincial plan to create homeless hubs, but there could be a catch.

The province may not pay for hubs using harm-reduction principals that are envisioned in the city’s system, and Premier Doug Ford has made clear his opposition to the safe supply and supervised drug-use sites that are part of London’s landscape.

“We have a lot of questions we don’t have a lot of answers to, but I am cautioned around some of the pieces,” said Chuck Lazenby, head of the Unity Project and co-coordinator of the city’s hubs implementation group.

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“What I’m curious and cautioned about is: Are they (the province’s hubs) abstinence-based programs? I’m not sure where people who use substances actually fit in, outside of the desire to see people off of drugs entirely through the programming.”

The province recently announced a $378 million investment in 19 homeless and addiction recovery treatment (HART) hubs. They will offer primary care, mental health and addiction help, social services, beds and supportive housing.

In those elements, the provincial hubs parallel the ones developed by London’s health and homelessness system, unveiled in February 2023.

But in its announcement, the province made clear that “with a focus on treatment and recovery, HART hubs will not offer safer supply, supervised drug consumption or needle exchange programs.”

London’s hubs aren’t offering safe consumption services or safer supply programming. But operators of the hubs are supposed to allow substance use – with guidelines – and not insist on abstinence.

“A low-barrier and harm reduction-informed approach recognizes that some people will use substances and so practices must exist to ensure this happens in the safest possible way,” the city’s website states about its hubs.

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The city hubs are one of two key elements in a new system, called the whole-of-community response to health and homelessness, developed by a collaboration of organizations. Supported housing is the other foundation.

London can’t turn its back on nearly $400 million for a provincial hub plan inspired by its own efforts, Mayor Josh Morgan said.

“The province has dictated where the operating dollars are going to be. So, if you want to create an integrated hub in our city you’re going to have to follow the parameters they put out.”

The city can use both the hubs developed by the community and hubs paid for and overseen by the province, Morgan said.

“There’s nothing to say we have to change the other things we’re doing,” Morgan said. “We need not be locked into one specific path because all of us will be focused on the goal, getting people into housing and off the street.”

It’s too early to tell what exact parameters the province will put on its hubs, he added. “There is a level of speculation exactly where the province is going to draw the line on harm reduction.”

Details about the province’s plan and application process should be known soon, Morgan said.

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Applying for provincial funding for a hub may affect the city’s plans to seek applications for its own hubs this fall, he added.

“We have another option here to deploy some of the capital we have and we have to be strategic about making the money we have go as far as it possibly can go.”

The capital dollars are largely made up of a $25 million private donation to the city’s health and homelessness system developed by city organizations. It’s not clear if there are any strings on using and leveraging those private dollars for a provincial hub that may not align with harm-reduction principles.

The developers of London’s whole of community response were hoping to build five hubs in the first year, but so far only two have opened.

It’s taken time for coordinators of the new system to work through some challenges, said Sean Warren, with Lazenby co-chair of the hubs implementation group. He is the care facilitator at London InterCommunity Health Centre.

The city’s application process for funding wasn’t set up to handle multiple partners in a proposal, which is essential given the resources needed to run a hub, he said.

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“The hubs plan was developed in partnership and the application process was not conducive to that sort of partnership continuing,” Warren said.

The hubs implementation table has been working with the city to modify the process, he said.

“There continues to be a lot of of interest in the hubs plan. We have partnerships working behind the scenes to see what is possible,” he said.

The province announced its new hubs plan at the same time it announced new rules that will lead to the closing of 10 supervised drug-use sites, where people can use drugs while under medical supervision.

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The Ford government made the move despite recommendations from experts it consulted, who said the sites prevent overdoses and overdose deaths.

As the opioid crisis in Canada shows no signs of abating, Conservative politicians and supporters have waged a battle on harm-reduction measures that aim to keep people alive regardless of where they are in treatment or recovery.

It’s a false battle, Lazenby said.

“There has been too much focus on harm reduction versus recovery when they are part of the same scope of tools that people need in order to live better lives,” she said.

Recovery and treatment programs aren’t “miracle cures” that people think they are, Lazenby added.

“The reality for people is recovery from using substances in a problematic way can take years and many engagements with various types of treatment. The idea that safer consumption and safer supply shouldn’t be a part of that scope of treatment options is very problematic,” Lazenby said.

rrichmond@postmedia.com

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