Corporate Report City Council

Report from: Office of the Chief Administrative Officer, Administration

Report Date: May 21, 2019 Meeting Date: June 10, 2019

Report Number: CAO-112-2019 File: 10.4.99

Subject: Community Issues Update

Strategic Pillar:

Recommendation That Council receive report CAO-112-2019 for information. FORTHWITH Summary Communities across are dealing with impacts from a variety of social challenges, including lack of affordable housing, homelessness, the national opioid crisis and a lack of adequate mental health resources. Cities are increasingly becoming key stakeholders and leaders as communities seek to respond to these issues since cities see first-hand the impact of these social issues in their downtowns, neighbourhoods, parks and public venues. As a lower-tier municipality, the City is challenged in what it can do to respond given that many of these issues are outside municipal jurisdiction; however, staff is committed to taking a leadership role where possible.

This report provides updates to Council on how the City is responding to these issues and leading proactively with community partners to address the immediate needs while also identifying long-term solutions. This work aligns with the City’s strategic vision, the strategic pillars and the Mayor’s Compassionate City initiative. Background Cities across North America are dealing with the opioid crisis, overdoses and public health and safety concerns. At the same time, many communities are also dealing with an increasing need for affordable housing, emergency shelters and limited mental health services. St. Catharines is experiencing these issues at a community-wide level, which also impacts the day-to-day operations of staff in parks and City facilities.

As a lower-tier municipality in a regional system, the City of St. Catharines is not directly responsible for many of the front-line services that support the health and well-being of individuals in the community, including housing, public health and social services. However, this does not mean that City staff, facilities or programs are not impacted by the soci-economic issues in the community. The City works closely with partners at Niagara Region and public sector agencies to respond to the changing needs of residents in the areas that are outside of municipal jurisdiction.

As the largest urban centre in Niagara, downtown St. Catharines is host to a variety of public and private services, including provincial courts, City administration, financial and business services, restaurants, retail and social / health services. As a result, City staff along with business and residents have an interest in ensuring that the downtown remains safe and accessible for everyone. As the downtown continues a positive transformation into a hub of arts, culture, education and tourism, it also continues to be a hub for social / health services and poverty alleviation. By working with Niagara Region and community partners, the City is striving to ensure that downtown remains safe and accessible to everyone and that the changing, socio-economic needs of residents are being met. Report Homelessness and Emergency Shelter Rapid changes in the real estate and housing market across the Greater-Toronto- Hamilton Area have put increasing pressures on the housing market in Niagara and across . The region is experiencing low rental vacancy rates, increasing rents and housing prices. The stock of publicly available affordable housing is limited to respond to pressures in the private market. As a result, emergency shelters are also experiencing pressures.

Niagara Region Community Services has responded where possible by adding emergency shelter beds to the system and working together with agency partners to increase other interventions, such as Housing First and prevention programs. However, consistent with the experience across southern Ontario, and further impacted by the opioid crisis, there is still an increase in visible homelessness and marginalized populations in parks and public spaces, particularly around the downtown.

In summer 2018, Niagara Region conducted a federally-mandated bi-annual point-in- time count to measure the extent of homelessness across the region. See Niagara Region Report COM-16-2018 (linked here; copies available upon request) for information. The data collected is being used to update the Niagara Region 10-year Housing and Homelessness Action Plan. This information was used to present updates to the Action Plan in March 2019 and next steps. See Niagara Region Report COM-10- 2019 (linked here; copies available upon request) for more information on the 10-year plan and review.

In addition to the 2018 point-in-time count, this spring City staff have been working with Niagara Region Community Services, agencies and outreach workers to do a follow-up

Report Page 2 of 8 survey of individuals in City parks and public spaces in and around the downtown. The goal of this work is to ensure that service providers have a fulsome understanding of their needs and ensure that people are connected to services as appropriate. This project also supports an overarching desire to improve the safety and well-being of everyone in the downtown area.

In winter 2018 / 2019 the City partnered with Start Me Up Niagara and the Niagara Folk Arts Multicultural Centre to provide a City-owned facility (Robertson Hall) for use as an emergency respite / out of the cold shelter three nights per week when the program was at risk due to a lack of venues. Niagara Region and Start Me Up Niagara are currently discussing a plan for Out of the Cold in 2019 / 2020 and long-term plans for emergency shelter needs that fit the community. Affordable Housing Despite housing being a regional responsibility, the City has taken action to support the development of affordable housing where possible, including through the Housing Action Plan (linked here; copies available upon request), an on-going review of the Community Improvement Program (CIP), as well as Council-direction to partner on new affordable housing projects where possible, including projects like the Penn Terra / Bethlehem development on Church Street, with the YWCA for a new affordable housing building on Oakdale Avenue.

The City has recently issued an expression of interest for the purposes of gauging interest from the private and non-profit housing sectors to propose a land development plan that includes a component of affordable housing for City-owned property at 320 Geneva St. Staff is also exploring partnership opportunities to repurpose City-owned property at 6-8 Academy St. for affordable housing uses.

Staff are reviewing the CIP and the Housing Action plan in an effort to refine workplans, resourcing and priorities. A report on the workplan to implement the Housing Action Plan is anticipated in Q3 2019 and the report on the CIP review is expected in Q1 2020.

The Opioid Crisis and OPENN Like many mental health and addictions issues, the opioid crisis is often connected to issues of drug-seeking behaviours, housing instability and homelessness. It is also visible on city streets, in parks and public facilities. According to Niagara Region Public Health, at the end of 2018, Niagara Emergency Medical Services (EMS) responded to 496 suspected opioid overdoses, with 41% of the calls in St. Catharines. Niagara’s rate of opioid overdoses increased over 90% in the past year and St. Catharines had the third highest rate of overdose deaths per capita in Ontario.

Again, as a lower-tier municipality, the City does not have direct responsibility for public health or law enforcement, but has been a proactive partner in responding to the opioid crisis where possible.

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In early 2018, City Council unanimously approved a motion in support of an application by Positive Living Niagara for a temporary overdose prevention site in St. Catharines. The site opened on a temporary basis in late 2018 and received approval to continue in spring 2019 at 120 St. The consumption and treatment services site provides support to users to reduce harm to themselves and the public (by not using in public spaces), to access treatment and addiction services, referrals and emergency medical aid. The site operates under strict operating guidelines and with provincial funding. It is permitted under an exemption to the Controlled Drugs and Substances Act from the federal government.

There are currently 11 sites in the province and the St. Catharines site is the only site in Niagara. Since opening at its permanent location on April 1, 2019, the supervised consumption site has had over 700 visits and serves approximately 200 regular users. The staff have reversed more than 100 overdoses since December 2018. The data collected from the site will be used for an upcoming re-application to the provincial government for funding to continue operations. Public Health provides regular updates on opioid usage in Niagara on its public website.

Also led by Positive Living Niagara (and funded by Niagara Region Public Health), the agency provides safe needle exchange, needle collection and a peer-led outreach program and community clean ups. New this spring, with support from the St. Catharines Downtown Association, the peer-led program sees individuals with lived experience of addiction helping to safely clean-up and discard used needles from public spaces.

The City is also a member of the Overdose Prevention and Education Network of Niagara (OPENN), which is a network of social and health agencies and front-line service providers responding to the opioid crisis and harm reduction strategies. The group meets regularly to share information, develop best practices and respond to community needs. St. Catharines Fire and Emergency Services (FEMS) and the Mayor’s Office regularly participate in OPENN meetings and other staff as needed. More information from OPENN is included in Appendix 1. Naloxone Directly related to opioids, the overdose-reversing drug naloxone has become widely available at social and health agencies and shelters across Niagara. St. Catharines Fire and Emergency Services (FEMS) began to carry and administer naloxone in early 2018. Support and training is provided by Niagara Region Public Health, equipping first responders with the training and tools they need when responding to overdose emergency calls. Naloxone kits also help protect staff from the potential of exposure to opioids. As outlined in report FEMS-054-2018 (linked here; copies available upon request), the City was one of the first municipalities to take this step. Many other local agencies and first responders have since equipped their staff and facilities with naloxone kits.

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According to Niagara Region Public health, naloxone kits were used 980 times in Niagara by the end of 2018. While FEMS continues to respond to an increase of overdose calls, to date naloxone has only been administered once by FEMS staff.

The St. Catharines Central Library has also teamed up with Positive Living Niagara to offer naloxone training. In March, over 20 people, including library staff and patrons, attended the training and some picked up naloxone kits. The library also worked with the John Howard Society to provide a wellness and self-care program to the public and is planning to offer these types of programs on a regular basis. Outreach City staff is working with Niagara Region Community Services to better understand community needs and organize and increase outreach services to respond to social and security issues in the downtown. This includes:

 Outreach and information gathering by community partners and service agencies to better understand the needs of the people using City parks and facilities, and connect individuals with shelter, housing and social / health services (if they are not already connected)  Niagara Regional Police Service foot patrol and directed patrol initiatives  Supporting community partners in developing more outreach programs and clean up in the downtown area  Monitoring the situation to determine if additional security is needed.

The goal of this work is to improve the safety and well-being for all individuals in the downtown area, including residents, local business and individuals who are marginalized in our community. Downtown Foot Patrol and Security In combination with the outreach work, the City is also working with the Niagara Regional Police Services (NRPS) and the St. Catharines Downtown Association to enhance citizens’ feelings of safety and to build bridges between citizens, businesses and the police.

In March 2018, Council and the Downtown Association formally requested the NRPS to resume a permanent downtown foot patrol. The request was modelled on an earlier pilot foot patrol program that began in 2007. Over the past years, the foot patrol has been a partnership between the City, the NRPS and the Downtown Association with the Downtown Association maintaining a $30,000 budget for safety and policing each year. In 2016 the foot patrol was redirected to the Centennial Gardens / Queenston Street / Gale Crescent area and partnered with a mental health worker from the Canadian Mental Health Association on a pilot basis, however, the pilot did not continue.

In spring 2019, a dedicated foot patrol service returned to the downtown area. Officers regularly patrol areas of concern. The foot patrol officers are senior officers with vast experience dealing with challenging behaviours, drug issues, physical altercations,

Report Page 5 of 8 mental health needs and other incidents. The NRPS also deploys directed patrols to the downtown core on bicycles and on foot when staffing resources are available throughout the year.

Staff is also working with the NRPS to identify ways to improve public safety through crime prevention through environmental design principles. This includes improved lighting and sightlines, use of CCTV cameras and security.

Many of these initiatives will also be addressed through a new Community Safety and Well-Being (CSWB) plan mandated by the province to be completed by December 2020. The objectives of a CSWB plan are to proactively address locally-identified community risks and support safe and healthy communities. This work is being led by Niagara Region Community Services, which will be working in partnership with an advisory committee of police, health service providers, mental health services, education, community services, children and youth services to implement a local CSWB plan. As mandated under provincial legislation, the City will be an important stakeholder and participate in local committees and planning for the CSWB plan. Central Library The downtown Central Library branch is an active public space and community hub. The Central Library sees regular use of the public space and library amenities by individuals experiencing homelessness every day. The City is in regular communication with the library about ways to support their work and community safety.

Since 2018, the library has hired a private security company as a necessary presence during all open hours of the Central Library. The first priority is to proactively ensure the safety of all patrons and staff. On a daily basis, security is able to diffuse negative patron interactions related to mental health and other challenges. In addition, the security cameras installed at the Central Library have been instrumental in assisting police and staff as needed.

The downtown location is also challenged dealing with used needles and debris, which library staff clean up daily. Staff Training With an approved budget in 2019, the City is coordinating new training programs for front-line staff to be able to respond appropriately to the situations they are dealing with in parks and public spaces. The first priority for training is mental health first aid and non-violent crisis intervention. The program began in the spring for staff in parks, recreation and community centres, and will eventually roll out to all staff. The intent for this training program is to be able to broaden the program to include all staff as well as the possibility of community partners including the Downtown Association and community.

This new training is in addition to information sessions by community agencies for staff to learn about what other resources and supports are available in the community i.e. Niagara Distress Centre, In Communities (211) and the Niagara Folk Arts Multicultural Report Page 6 of 8

Centre. Many of these agencies are highlighted in the Compassionate City Guide as resources for staff to draw on when serving the public. (See Appendix 2).

This spring, City staff also participated with the St. Catharines Library staff in online and in-person training sessions to understand and develop strategies to support people experiencing homelessness and mental health issues. Five speakers from Niagara Region, Toronto Public Library and Oshawa Public Library presented topics on Homelessness in Niagara, strategies to help the vulnerable population, and development of collaboration and partnership in community. Over 100 people, including City staff and community partners, attended the training. Video recordings and PowerPoint slides of the training have been shared with the City for future use. Financial Implications The costs associated with social issues are difficult to track. However, in 2018 Municipal Works has begun tracking the associated costs directly attributable to needle pick up, litter clean up, incremental security in parks and facilities and other ancillary expenses related to these issues.

The Corporation has engaged private security to patrol parks during overnight hours and fencing has been installed in areas of concern. In addition, Council approved a grant to Niagara Folk Arts to support the use of Robertson Hall as a temporary shelter for winter 2018/19 with enhanced security. Staff estimate that approximately $180,000 is directly attributable to the costs of security, staff clean up and repairs due to vandalism and graffiti in city parks and facilities.

The St. Catharines Library estimates that it has spent $110,000 for security since 2018. As part of the 2019 budget, the City provided $100,000 from its Tax Stabilization Reserve to the Library to be used to fund security and social services at the Library. Relationship to Strategic Plan This report relates directly to the Strategic Plan Vision: to be the most dynamic, innovative, sustainable and livable city in North America.

Economic: attract private investment, support local businesss; be an affordable city for young people, families and older adults; develop partnerships to enhance the economic vitality of the community.

Social: strive for the highest quality of life for all citizens; connect people, places and neighbourhoods; provide excellent customer service and communication. Conclusion Much like other communities, the City of St. Catharines is dealing with a variety of overlapping issues that impact the operations of City staff, parks and public spaces, downtown businesses and community partners. As a lower-tier municipality, the City is challenged with having the experience and resources needed; however, staff is committed to taking a leadership role and working together with Niagara Region, downtown Report Page 7 of 8 businesses and community partners to ensure that downtown remains safe and accessible to everyone and that the changing socio-economic needs of residents are being met. Prepared by: Julie Rorison Mayor’s Chief of Staff Submitted and Approved by: David Oakes Deputy Chief Administrative Officer Appendices:  Appendix 1 - OPENN Newsletter  Appendix 2 - Compassionate City Guide

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1

Overdose Prevention & Education Network of Niagara Newsletter 2019 Volume 2

Overdose Prevention Site still going strong and gets a new lease on life!

With support on-site from Quest, CMHA, the Hep-C team and CASON, the OPS has continued to make a difference in the Community at its temporary site at 120 Queenston St. The site has overturned 54 overdoses in just three months. There has been over 1000 visits to date and has finally received approval to open a Permanent Site. The permanent site (CTS) is aiming to open by the end of April and will be located at 105 Queenston St.

Safe injection site gets a new lease on life in St. Catharines Ministry approval comes with a government-recommended name change for Queenston Street clinic News Mar 31, 2019 by ill Sawchuk The St; atharines Standard

https://www;stcatharinesstandard;ca/news-story/9249576-safe-injection-site -gets-a-new-lease-on-life-in-st-catharines/

niagararegion.ca/living/health_wellness/alc-sub-abuse/drugs/overdose-prevention.aspx

1 New Video for Safe Needle Pick Up

Streetworks and Positive Living Niagara has released a new video that demonstrates proper techniques to safely pick up and dispose of needles. The video can be found at: https://www.facebook.com/StreetWorksNiagara/ posts/2289932061282587? notif_id=1553200423557726¬if_t=page_post_reaction

New Needle Tracking Pilot PLN, the JHS, and the city of St. Catharines Parks and Rec. Department is developing a system to track where needles are being left. A heat map will eventually be created, and there will be a Sharepoint system outlining the date, who is reporting, where needles were found, and any other particulars. This will help guide what needs to be done and in what areas. Other municipalities will be able to join if the pilot is successful!

Consultations for the Prevention and Planning Working Group have begun The first round of lived experience consultations have taken place at Positive Living Niagara on March 21st. PLN consultations are scheduled for April. Further lived experience consultations are being explored with other groups, such as LEAN advisory group, and SMART Recovery groups. Planning for the community consultation with the support of the SHARE unit at Niagara Region Public Health will commence shortly.

2 Data collected across Niagara

2016 2017 2018 (Jan-June)

Total ED Visits: 297 521 325

Average ED Visits: 25 per month 43 per month 54 per month

Rate of ED Visits: 65 per 100,000 114 per 100,000 -

Ontario Comparison: 32 per 100,000 55 per 100,000 -

Total Hospitalizations: 87 124 57

Average Hospitalizations: 7 per month 10 per month 10 per month

Rate of Hospitalizations: 19 per 100,000 27 per 100,000 -

Ontario Comparison: 14 per 100,000 15 per 100,000 -

Total Deaths: 40 74 42

Average Deaths: 3 per month 5 per month 7 per month

Rate of Deaths: 9 per 100,000 16 per 100,000 -

Ontario Comparison: 6 per 100,000 9 per 100,000 -

OPENN Data Collection: Trends observed in the community Date (Month !gency/ Information Provided Might Help Explain (Trend) and Year) Representative January 2019 Positive Living -Started to hear about the purple/blue hero- -Increased numbers of overdoses Niagara in which was identified by alerts from other starting closer to the end of the (StreetWorks) cities as a substance being sold as heroin/ month, increased deaths being re- fentanyl but also contained the synthetic ported cannabinoid ‘!M-FUIN!!’, plus acetyl, butyrfentanyl, caffeine, cocaine, benzocaine, phenacetin, ketamine, methamphetamine, codeine, MDM! and acetaminophen; -People reported going down faster, staying down longer

February 2019 Positive Living -Heard about blue heroin, some confusion -We usually observe drug trends Niagara around whether or not it was the same sub- change quickly, the continued in- (StreetWorks) stance from the alert crease in numbers may not be the -Some people reported the blue heroin as same drug as in the alert potent fentanyl, without the extra chemicals -rystal meth behaviours likely won’t – people still found it to be dangerous contribute to reports of overdoses but is important information to un- -ad batches of crystal meth in the region derstand substance use trends in the that were causing what seemed to be muscle region; spasms, and uncontrollable ridged move- ments;

3 Program Updates Across Niagara

Niagara Regional Police Service

90% of the NRP front line officers have been trained to administer Naloxone. They have administered Naloxone 4 times so far. 3 doses were successful, with one dose being unsuccessful. In the past year only specialty units such as court services & prisoner management had access to Naloxone. Each kit will contain 2 doses of Naloxone and will be in a pouch for all officers to wear on their person. This decision was made due to the SIU lifting the need to contact them after an officer used Naloxone. This expansion is being funded through the Ministry of Health and Long-term Care, and EMS will assist with training. Naloxone will be used on potential overdose patients, as well as any potential exposure for the officers themselves.

Niagara Health

Niagara Health will be moving to 264 Ave. as of April 16th. The space is being shared with CMHA - safebeds & withdrawal management services, ABC (A Better Choice), the hep c satellite office, and Dr. Kimakovich.

Positive Living Niagara PLN is working with downtown St. Catharines for safer needle disposal, and biohazardous bins if needed, and also training around compassion, and harm reduction. The Toronto Aids Bureau is responsible for all naloxone in Ontario. Out of 10960 kits that were administered in Ontario, 1750 kits were used in Niagara. That is 12% of the provinces total kits.

Next Meeting: May 23rd @ Niagara Region HQ

4 NOTES 2

St. Catharines A Compassionate City

ABORIGINAL Compassion = Care Action CANADIANS NEW HOMELESS CANADIANS

THE COMMUNITY

SINGLE­ DISABLED PARENT FAMILIES SENIORS

We Can Help Navigating the social services within your city. 3RD EDITION 2019 – MAY GENERAL INFORMATION HEALTH SERVICES Community Service Information ...... 211 – InCommunities Niagara Health ...... 905-378-4647 A go-to agency for information for clients and service providers. Service in more than 150 Public Health Department ...... 905-688-3762 languages. The Health Bus...... 905-688-8248 ext. 7512 Hepatitis C Clinic ...... 905-378-4647 SHELTERS & HOUSING ASSISTANCE Quest - Community Health Centre ...... 905-688-2558 St. Catharines City Services: Citizen’s First ...... 905-688-5600 Positive Living Niagara and supervised consumption site ...... 905-984-8684 Out of the Cold (November 1st - March 31st) ...... 905-685-5678 or 211 Sexual Health Centre ...... 905-688-3817 Gillian’s Place ...... 905-684-4000 Hospice Niagara ...... 905-984-8766 Housing Help Centre ...... 905-984-8955 Salvation Army Booth Centre...... 905-684-7813 MENTAL HEALTH & ADDICTION SERVICES YWCA ...... 905-988-3528 Kids Help Phone ...... 1-800-668-6868 The Raft (Youth) ...... 905-984-4365 Canadian Mental Health Association (CMHA) ...... 905-641-5222 Southridge Shelter ...... 905-682-2477 Community Addiction Services Of Niagara (CASON) ...... 905-684-1183 Niagara Mobile Outreach (Day Phone) ...... 905-935-4311 ext. 23 or 26 Pathstone Mental Health (for children and youth) ...... 905-688-6850 ...... 289-219-2981 Brain Injury Community Re-Entry (BICR) ...... 905-984-5058 Niagara Regional Housing ...... 905-682-9201 Addiction Services (Withdrawal Management) ...... 905-682-7211(Male) Bethlehem Housing ...... 905-641-1660 ...... 905-687-9721 (Female) EMERGENCY SERVICES/CRISIS LINES Distress Centre Niagara (Crisis Line) ...... 905-682-1242 Crisis Outreach and Support Team (COAST) ...... 1-866-550-5205 Niagara Region Gatekeepers (Seniors) ...... 905-984-0968 Crisis Outreach and Support Team (Coast) ...... 1-866-550-5205 DROP IN CENTRES Emergency ...... 911 Ontario Early Years Centre ...... 905-938-9392 Police ...... 905-688-4111 Fire ...... 905-684-4311 Start Me Up Niagara ...... 905-984-5310 Ambulance ...... 905-688-2191 Westview Centre 4 Women ...... 905-684-4848 Victim Services Niagara - 24 Hr Crisis Line ...... 905-682-2626 Niagara Regional Native Centre ...... 905-685-8547 Distress Centre Niagara ...... 905-688-3711 Niagara Region Sexual Assault Centre ...... 905-682-7258 MEALS Family and Children Services Niagara (FACS) ...... 905-937-7731 Out of the Cold ...... 6 PM November 1st - March 31st Kids Help Phone ...... 1-800-688-6868 Ozanam Centre, 235 Church St...... 11:30 AM -12:45 PM (Monday – Friday) Pathstone Family Crisis ...... 1-800-263-4944 St. George’s Church, 83 Church St...... Breakfast daily - 7:30-8:30 AM The Raft, 17 Centre St...... 6:30-8 :00 PM SERVICES FOR IMMIGRANTS Start Me Up Niagara,17 Gale Cres...... Saturday & Sunday 11:15 AM -1:00 PM Niagara Folk Arts Multicultural Centre ...... 905-685-6589 Chez Marie (Refugee Hostel) ...... 905-682-5795 FOOD & CLOTHING YMCA Newcomer Centre ...... 905-684-3500 Community Care ...... 905-685-1349 YMCA Settlement Worker in Schools Program ...... 905-684-3500 Salvation Army Family Services ...... 905-935-4311 St. Catharines A Compassionate City