Medical Model Supportive Housing Project

Council is currently discussing a medical model Supportive Housing Project. This project would put people dealing with cognitive disabilities and mental health challenges into a residential building with on-site medical care and social workers.

Council received a recommendation to locate this project on 105 Ave in South Avondale. I’m supportive of the concept of Supportive Housing, but am not convinced that this is the correct location.

When it comes to addressing homelessness, mental health, and addictions in our community I’ve got a number of priorities. These include:

Giving people the best possible chance to get and stay healthy
Reducing social disorder (property crime, loitering in inappropriate places, etc…) in our communities
Eliminating the need for people to wander the streets, store property outside, and find a place to use the washroom
Saving taxpayers money by reducing City resources spent on responding to complaints and cleaning up public places, and reducing the amount of money other levels of government spend on the medical and justice systems

To address these priorities, I strongly believe that Supportive Housing is needed.

However, believing in the general need for Supportive Housing is not the same as backing a particular project.

Following is more information about what is being proposed, and my take on it.

WHY SUPPORTIVE HOUSING IS NEEDED

Supportive Housing is needed to help people dealing with severe cognitive and mental health challenges get and stay healthy. It also gets them away from living on our streets.

Too often, people with mental health and addictions issues end up living in emergency shelters or living rough on the street. This leaves them chronically sleep deprived, constantly stressed about the safety of themselves or their possessions, with little dignity, often hungry, and easily accessible to people who will victimize them or encourage them to make poor choices. People living in shelter or on the street have little to no chance of getting healthy. They also cause concern for others living in the community.

People need to have a safe place to sleep, store their possessions, use the washroom, and eat. They need to be able to choose to spend their time away from others who may harm them or be bad influences. And they need to have positive social interactions with other humans. Without all of these things, there are very few of us who could remain mentally healthy. So it isn’t reasonable to expect someone dealing with mental health issues to heal without them.

It also isn’t reasonable to expect someone to not be wandering our streets if they have to sleep in one place, store their possessions in another, get social interaction in another, eat in another, and access services in multiple other places.

Making sure someone has a place to live addresses these challenges.

However, Supportive Housing isn’t just about a living space. It also provides on-site health and social services to help, monitor, encourage residents and to hold them accountable for their behaviours. This on-site care gives them the best possible chance of staying housed and getting healthy.

By making sure someone has a place to live, we make sure they have the pre-requisites of mental health. By making sure there are services and social interactions on-site, we give them far less reason to be wandering the community. And by giving them daily interaction with professionals, we give them the best chance of staying on a path to health.

Supportive Housing is needed to get people stabilized and on a path to wellness. Getting people into Supportive Housing also means that they spend far less time on our streets. And by helping people get to a healthy place, it decreases the use of expensive resources such as emergency police, fire, and ambulance response.

WHAT MEDICAL MODEL SUPPORTIVE HOUSING LOOKS LIKE

The Supportive Housing development that was proposed for 105 Ave is a Medical Model project.

This facility would be for people who have cognitive and mental health struggles that are so severe that they will likely never live independently. However, these people have potential to be a lot more healthy and contribute more positively to our community than they do now.

Many of the people who will be placed in it are currently living in emergency shelters or living rough throughout the community. However, this is not an emergency shelter where people come and go with little expectations.

To live in this facility, people will need to have an interest in improving their lives and mental health. The people living in this facility will also pay rent: rooming is not being given to them for free.

Being part of the facility will include taking part in counselling and other mental health wellness programs. Support staff will always be onsite to provide supervision and support. On site care and programs will be delivered by mental health nurses, social workers, and other professionals. Residents will also have restrictions on substance use, and be held to agreements that govern their behaviour both within the building and in the surrounding community.

This will not be temporary lodging for facility residents. Instead, it will be their permanent home. This means that there won’t be significant and regular turn over in the facility.

CONCERNS I HEAR

Whenever we talk about Supportive Housing, there are a number of concerns I hear. Here’s my thinking in regards to the most common concerns I receive:

“There are already too many people wandering our streets.” Everyone has a right to be on our streets and in parks as long as they are behaving appropriately and staying on public property. However, people who are living rough will spend less time out in the community if they are transitioned into supportive housing. We often have people wandering our neighbourhoods because they have nowhere else to be, and because they have to go different places to sleep, eat, socialize, and access various services such as counselling or medical treatment. Giving them a place to be 24/7 and delivering services they need on-site will lead to them spending a lot less time walking through communities. The monitoring on-site will also help make sure people aren’t acquiring possessions that aren’t theirs. And possible eviction is a new accountability tool available to address any misbehavior that might happen in the neighbourhood.
“These people need accountability, not hand outs.” People in supportive housing pay rent: unlike shelter space, they don’t get it for free. And there is next to nothing the City can do to hold people accountable to anything when they are living rough. Our police are limited by federal and provincial legislation and courts, and those provide little to no tools to hold someone accountable when they are living on the streets. However, to be in supportive housing, people have to sign and get held to a housing agreement. And the relationships they build with staff on-site is the best way to hold them accountable to working towards sobriety and health.
“These projects will just draw more street engaged people to our community.” Supportive housing requires rent to be paid and a housing agreement to be adhered to. It won’t attract people to our community who are just looking for a free place to be with no steps towards getting healthy. Additionally, most people who are street engaged in our city are long-time residents of our community. Last year, we had “Tent City” pop up, and City staff surveyed everyone living in it: over 90% of the people in it were longtime residents of our area. And when someone from another community shows up on our streets, we do work to get them back to their home communities.
“We shouldn’t be encouraging drug use.” There is no “safe consumption” elements of these projects, and public intoxication has consequences under the housing agreements. Supportive housing doesn’t encourage drug use. Quite the opposite. One of the big goals of it is to get people mentally healthy and sober by making them physically safe, giing them proper sleep, and engaging them with on-site health and social workers.
“We should just incarcerate, institutionalize, or banish these people.” The City does encourage and help people from elsewhere to get back home. However, it has no legal ability to prohibit someone from being in Grande Prairie, nor to incarcerate or institutionalize people, even if it wanted to.
"There are better priorities for tax dollars.” Saving taxpayers dollars is a priority for me. Which is one reason supportive housing is needed. We spend a HUGE amount on homelessness. The City spends money on having RCMP, Bylaw, and Fire responding to emergencies and complaints generated by people living rough, having Parks and Bylaw cleanup encampments, and funding emergency shelters. Our community also loses money as social disorder drives investment (and therefore tax revenue) from our core. Homelessness also costs the province a lot of money in terms of medical and justice resources. Someone living rough costs taxpayers a lot of money. Getting them into supportive housing is less expensive in the short term, and WAY less expensive in the long-term when it succeeds in getting someone healthy enough to live and work independently.

CONCERNS I HAVE

If done properly, Supportive Housing is good for our community. It helps the people within it get healthy. By reducing social disorder, it makes the surrounding community better for everyone else. And it is a lot less expensive for taxpayers than having constant emergency and criminal justice responses to people with mental health and addictions challenges.

But supporting Supportive Housing in general is not the same as supporting a particular project.

This project is still at the conceptual stage. Detailed planning has not happened yet. So I cannot know at this point whether or not I will support it when details are flushed out.

Here are the concerns I have which need to be addressed for me to support the project:

Security and supervision planning. If operated properly, I don’t think this project will have a large impact on the surrounding community. But that doesn’t mean there will never be challenges. There needs to be good security and supervision in place to monitor residents and the surrounding neighbourhood, and quickly respond to any concerns that arise.
Expectations for facility residents. There needs to be strong and enforced expectations of the residents of this facility. Included in this is expectations around engaging in wellness programming, substance use and public intoxication, and behaviour in the surrounding neighbourhood.
Costs and funding. There has been no firm capital or operating budget created yet. When these budgets are created, they need to make sense and be reasonable to me for me to support the project. And Supportive Housing is largely about getting people diverted from health and justice systems, which are the responsibilities of senior levels of government. The City shouldn’t fund this project on its own: other levels of government should be partners.
Alberta Health Services resources. The whole idea of this project is to get and keep people connected with medical and other support. For this project to go forward with my support, Alberta Health Services needs to be a committed partner in it.
Design. As I’ve toured similar facilities in other communities, I’ve discovered that residents of them like to spend the large majority of their time on-site if they can. I want this option to be available to residents of a Grande Prairie facility. Which means the building needs to be designed with adequate space to offer health, education, and social programs. Communal space for residents to socialize with each other. And outdoor space for them to get some fresh air.
Land use Planning. The facility needs to have a size, orientation, and lot layout that makes sense with adjacent properties.

LOCATING THE PROJECT

If Council does approve a Medical Model Supportive Housing project, it needs to decide where to locate it.

The original recommendation was to locate this project on City-owned land in South Avondale:

Council is still considering this location. However, it is also considering locating the project in Gateway, near the new hospital:

In my opinion, Gateway is the far preferable location.

We’ve had a lot of residents in Avondale and VLA express concern about the 105 Ave location. They fear that it will make their neighbourhoods worse if located within them. I don’t agree with that opinion: the people who will be in this project are already living rough downtown. I fail to see how getting them into a living situation where they don’t have a need to travel through the community to go about their daily life, where they are under professional supervision, and where they are engaged in wellness programs will make them MORE disruptive.

If this project is done right, I think it will improve our downtown neighbourhoods, no matter where it goes.

But I still don’t think Avondale is the right location for this it there are other options. Here are my concerns with the Avondale location:

Close to Rotary House and on a block with existing criminal activity. This facility is meant for people with large cognitive and mental health challenges. For their benefit, I want them to have a place as far away as possible from people who might victimize or be a bad influence on them. Downtown isn’t an ideal place to house them.
Safe feeling neighbourhoods. It isn’t just important for our residents to BE safe. They also have a right to FEEL safe. And while I do think that this facility will improve our downtown neighbourhoods no matter where it goes, I also completely understand why VLA and Avondale residents have big concerns. They’re already experiencing huge impacts from the Opioid Crises and homelessness, and Council is moving forward with another Supportive Housing project near VLA (the old Fletcher building out front of City Hall). It is completely understandable for residents to have big fears about two projects happening at the same time, one on either end of their neighbourhood.

Here are reasons why I think the Gateway might be a better location:

Close to services. The people living in this facility need access to groceries and other essential shopping. I hope that some of them will need access to a place of employment. And I’d like them to be able to easily get to quality outdoor park space. All of these are currently available in Gateway.
Future development is complementary. Due to the proximity of the hospital, some of this commercial and institutional development is likely to be health oriented. It makes sense to build this facility in a place where it is in a residential development, but near to commercial and institutional services.
Further away from downtown. The people living in this facility will be susceptible to bad influences and to being victimized. Having them live further away from their current downtown environment is more likely to set them up for success in getting healthy.

Council has directed administration to bring forward more information about the Gateway land. We need to know more about how it would work in terms of roads and utility services, what type of build could fit on the land, and what residents have to say about that location.

However, based on what I know now: Gateway might be the more suitable neighbourhood. I’m more likely to support this project going forward on this land. And I probably need to be convinced that the Gateway location is unviable for me to even consider supporting building on 105 Ave.

Re-Zoning, development permits, and federal funding

I don’t currently support building this project on 105 Ave. However, I’m likely to support re-zoning this land in order to apply for federal funding. Why that is is a bit complicated…

The federal government is currently giving grants for Supportive Housing builds. These grants are operating on a “first come, first served” basis- they aren’t allocated based on regional need, but based on which municipalities apply for funding first. And there is a high risk that they will be the last major grants available for many years to come.

Since our community pays more than its fair share of federal taxes, I want us to get our fair share of federal funding. And Supportive Housing is a need in our community that the City cannot fund on its own. Which means we need to get an application in for Supportive Housing funding ASAP.

To apply for this funding, we need to have available land that is zoned for Supportive Housing. However, if new zoned land becomes available after the application is submitted, the application can likely be change without having to be re-started.

Re-zoning needs to follow a process laid out in provincial legislation. It takes several months to carry out, and has just started on the Gateway land. But the process is already well underway in Avondale: it can be completed on November 2.

I’m likely to support us re-zoning land in Avondale to start a funding application and hold our place in the funding application line. However, I’d then like to see go through the process of seeing if there is more suitable land in the City to move this application to.

Something important to note about development processes: for this project to get authorized by Council, re-zoning the land is a first step. However, it isn’t the final step. A Development Permit still needs to be issued by Council, and it won’t be applied for until detailed planning is completed.

I’m in favour of re-zoning land so that funding can be applied for and that detailed planning can get underway. But I’ll need to see the results of that planning before I vote in favour of a Development Permit. On either parcel of land, all the concerns I listed above need to be addressed before I can support building. And I don’t see myself supporting building on 105 Ave unless information comes forward that convinces me Gateway is not viable.

That’s my thinking on this Medical Model Supportive Housing development.

I’d love to hear your thoughts, and any questions or concerns you might have.

My preferred way to chat is by meeting for a cup of coffee. But I’m also happy to talk through email, over the phone, or on Zoom.

If you want to connect, my email is dbressey@cityofgp.com and my phone number is 780-402-4166.

Thanks for reading!

-Dylan

Dylan BresseyOctober 24, 2020Comment