It's a major stumbling block in the Middlesex London Health Unit's bid to open two permanent supervised consumption sites in the city.
The Ford government has rejected the health unit's funding application for the proposed site at 446 York St. Health officials learned of the decision through a letter from the province sent last week.
"The letter indicating that we would not be funded did not have any particular reasons attached," said London's Medical Officer of Health Dr. Chris Mackie when asked why the funding request had been denied.
The health unit had been seeking $1.2 million for capital upgrades to the former York Street music store and another $1.3 million annually for operating costs.
During previous conversations about the York Street site, Ministry of Health and Long-Term Care staff asked health unit officials repeated questions about the level of community support for the facility and whether they had looked at other potential sites.
"We did spend almost two years looking for sites and were able to tell them about literally dozens of other locations that didn't work for one reason or another," said Mackie. "It's a tough site to locate because we have got issues around need. We looked at needle waste, we looked at Hepatitis C cases which is spread by injection drug use and then we also looked at the City of London's zoning criteria. On top of that, you have the challenge of convincing a landlord that this is a good use for their property. It was many, many sites we looked at and this was, we believe, the best one."
The province has instead expressed an interest in making the temporary overdose prevention site at 186 King St. a permanent fixture. But that would come with its own challenges, according to Mackie.
"For 186 King St. to become permanent we would have to have a number of discussions with the landlord, which the landlord had indicated wouldn't be their preference," said Mackie. "But also we would have to do some significant upgrades to that facility. There are real problems with the access, the entrance ways, and the heating/cooling HVAC systems. So that site would need a capital upgrade too."
London’s temporary drug overdose prevention site opened in February of last year in the same building that houses the Regional HIV/AIDS Connection. Over its first year in operation, 13,719 visits were made to the site, staff reversed 83 overdoses, and hundreds of people were referred to a range of community services.
Mackie noted the province continues to be supportive of the work being done at the temporary site and has encouraged the health unit to apply for a mobile facility.
"Our next steps will be working with the province and the landlord to see if we can do those capital upgrades and stay at 186 King," said Mackie. "We will also open our minds to other locations if something happens to have come forward over the last year or so since we last looked. We will be submitting a mobile application sometime in the next few months as well."
The funding application for the second proposed permanent supervised consumption site at 241 Simcoe St. has not yet been filed.
When contacted for comment, the Ministry of Health and Long-Term Care provided the following statement:
"As was announced at the end of March, the government is moving forward with 15 approved Consumption and Treatment Services (CTS) sites in communities with high need, including one site in London located at 186 King Street.
Regional HIV/AIDS Connection and Middlesex-London Health Unit also submitted two other CTS applications — one for 446 York Street and one for a mobile service. The ministry continues to work with RHAC and MLHU on its CTS applications and options.
The proposed mobile CTS service in London, which was never previously open, is currently under review.
Zoning appeals have been filed in relation to the proposed CTS site at 446 York Street and these appeals are still underway. Services will continue to be offered at 186 King St. in the interim.
Based on extensive consultation with experts, the ministry is confident the model brought forward is the right approach to connect people struggling with addiction with the care they need and deserve. Applications from interested organizations will continue to be considered on an ongoing basis, based on the previously-outlined criteria.
The government is taking a system-wide approach to building a connected mental health and addictions system. That’s why the ministry announced last week an intention to create a Mental Health and Addictions Centre of Excellence within Ontario Health. The proposed centre would ensure Ontario patients and families are able to access integrated, standardized, evidence-based care and services no matter where they live.
The government also announced an intention to join British Columbia’s national class action lawsuit launched last year against more than 40 opioid manufacturers and wholesalers. The government intends to invest any award from this litigation directly into frontline mental health and addiction services.
The ministry also recently announced an investment of an additional $174 million this year to address the critical gaps in our mental health and addictions system and support patients, families and caregivers in their communities struggling with mental health and addictions. To ensure service providers have stable, long-term funding, the government will be making this additional funding available every year. This investment is part of the government’s commitment to invest $3.8 billion over the next 10 years to develop and implement a comprehensive and connected mental health and addictions strategy.
The government will continue to make mental health and addictions a priority and work toward creating an Ontario where everyone is fully supported in their journey toward mental wellness."
