47 replies to this topic

[Ms. B. Havin]

Basically, the program cost is around $17,500 to $47,000 per person per year, which is less than what we are currently spending on our "at risk" population ($50,000 per year per person in policing, health etc.) In addition there are the hidden costs of private security and cleaning, loss of business and tourism revenue and the unquantifiable cost of a decrease in the quality of life of all citizens and visitors.

But which end of the cost spectrum did the panel suggest was a realistic expense (if they did that at all)? $17,000 and $47,000 is an extremely vast range to play with and doesn't end far from the estimated $50,000 we're supposedly already spending.

To follow up on that, how will the authorities/ executors of the program identify / limit the "at risk" population? And then, how will the program deny similar levels of service or treatment or support to persons not deemed "at risk," but who could arguably be identified as "at risk" by advocates from various sectors?

Put the question another way: what triggers are in place to prevent the program costs from ballooning (beyond supporting x-number of pre-identified "at risk" people)? And will those triggers be successful and understood, so that the perception won't be "Oh well, there goes another program that ran out of money..."?

I guess I should read the report, but I'm really pressed for time right now...! If we do this, we should do it right and do everything possible to guarantee success.

[Mike K.]

I'm afraid this task force is just going to fuel the "build it and they will come" problem. And judging by how things are progressing, our policy makers are not only dead-heading towards it, they're running all the lights.

[Rob Randall]

But which end of the cost spectrum did the panel suggest was a realistic expense (if they did that at all)? $17,000 and $47,000 is an extremely vast range to play with and doesn't end far from the estimated $50,000 we're supposedly already spending.

That wasn't specified. Some people will only need a little rent subsidy to get their life together. Some with [url=http://www.heretohelp.bc.ca/publications/factsheets/concurrent.shtml:cf7b7]Dual Diagnosis[/url:cf7b7] will cost much more to get stable. Housing costs are had to predict. Even if the cost were the same, why would you choose the status quo?

how will the authorities/ executors of the program identify / limit the "at risk" population? And then, how will the program deny similar levels of service or treatment or support to persons not deemed "at risk," but who could arguably be identified as "at risk" by advocates from various sectors?

Put the question another way: what triggers are in place to prevent the program costs from ballooning (beyond supporting x-number of pre-identified "at risk" people)? And will those triggers be successful and understood, so that the perception won't be "Oh well, there goes another program that ran out of money..."?

Eliminating the current silo mentality will be made easier with VIHA's [url=http://www.rohcg.on.ca/programs-and-services/assertive-community-treatment-e.cfm:cf7b7]Assertive Community Treatment[/url:cf7b7] and [url=http://www.psychservices.psychiatryonline.org/cgi/content/abstract/55/11/1285:cf7b7]Forensic Assertive Community Treatment[/url:cf7b7] teams that will work individually with people who will be triaged according to determine the best solution; youth, women, aboriginal, mentally ill, elderly, criminal etc. etc.

[amor de cosmos]

City to clean up streets within four months
Mayor promises to find homes for 50 of the most troubled homeless people; plan expected have 'enormous' impact
Cindy E. Harnett and Rob Shaw, Times Colonist
Published: Wednesday, October 24, 2007
Victoria Mayor Alan Lowe promises the city will sweep off the streets 50 homeless people who are shooting up drugs and causing conflict downtown within four months.

The move, which makes good on recommendations contained in task force report released last week, should have an immediate and dramatic effect as the the group is one of the most visible symbols of the substance-abuse, mental-health and homelessness problems plaguing the city.

Lowe, reached Tuesday in Thailand, said the first community outreach team called for in the report will be "up and running immediately," and will find homes for the 50 "hardest to house" homeless people within 120 days.

*snip*

Victoria lawyer Stewart Johnston, who is leading a court action to shut down the needle exchange near his law office, said helping those individuals and finding them a place to live will change the entire look and feel of downtown Victoria. "If you take the worst 45 to 50 off streets, and then another 300, the difference would be enormous," he said.

Police have estimated about 45 people are causing most of the problems around the needle exchange, Johnston said.

Housing that group of people "would make all the sense in the world," said Rev. Al Tysick of Our Place Society. A meeting on Friday should better clarify how the 50 people will be selected, he said.

*snip*

of course it's great that they're doing this but I want to know how they're picking the 50 people also

[Holden West]

of course it's great that they're doing this but I want to know how they're picking the 50 people also

I'm sure the cops could tell you who they are and where they hang out and what their drug of choice is and their whole life history. It ain't rocket science.

[Mike K.]

Wasn't it just a few months ago that cops were telling us only about two-dozen people were causing the majority of problems? Now that figured has doubled, hey?

Problem is, once those 50 (or whatever the number of the day is) are dealt with another 50 will take their place sooner or later. It'll be a merry-go-round of expenditures until we stop gently prodding and pinching these groups.

[Caramia]

I think any downtown business person could tell you who those 50 are. Certainly anyone at a shelter, the police, the ambulance drivers, emergency room staff and the walk in clinics can.

I probably could.

You could pick half of those, and only remove the people who show up in emergency or the drunk tank every few days, instead of every couple of weeks. You could pick double those, and remove the people who show up every couple of months. I would guess the way that they decided at this amount was something like: Cost of preventable crises intervention compared to maximum cost to house. Where you get a total savings, you house. Kind of brutal, true, but since no one on the street calls 911 on themselves, so it is one way that is harder to manipulate.*

Mike your point that 50 more people will replace them would work if we were talking about drug dealers, yeah - you remove 50, that just opens up the positions for more to move up the ladder. It doesn't work for crazy people though. You remove 50 crazy people, the 50 next less crazy do not become crazier as a result.

However, it is possible that the tolerance of the other people who use downtown may shift, so that behaviour that looks relatively harmless in contrast to some of the true tweakiness we see regularly, will suddenly seem less acceptable. You take away that guy walking down the street screaming and twitching, and people will start complaining about the guy sitting quietly on a bench looking scruffy.

*Rob or anyone know for sure what the criteria was?

[mat]

I am glad the homeless, drug and mental health issues are being taken collectively, rather than piecemeal. The top 50 known to police and emergency services were noted by the Vic police spokesman has having multiple health and addiction issues which means they require expert support.

One issue was not addressed and that is the movement of homeless into other regions within the CRD. Anyone who regularly drives Mackenzie near UVIC may have noticed one older man with a loaded shopping cart. He is quite obviously mentally disturbed but harmless. I talked to him - he is currently living in the woods around UVIC and left downtown as he felt it was dangerous. He claims others will follow soon.

So is this a CRD task-force, or just concentrating on downtown? What may occur is simply dumping the problem into other communities.

[Mike K.]

Mike your point that 50 more people will replace them would work if we were talking about drug dealers, yeah - you remove 50, that just opens up the positions for more to move up the ladder. It doesn't work for crazy people though. You remove 50 crazy people, the 50 next less crazy do not become crazier as a result.

I know, but we were originally looking at ~25 people and now that figure has doubled to 50 (without an explanation -- a change in the criteria or what?). My greatest concern is we'll be looking after individuals who choose to make their way to Victoria from other parts of the country to receive the sort of care their own communities are unwilling to provide for them.

[Caramia]

The figure of 25 didn't come from the Task Force, and it doesn't represent the number of homeless. It was the number the police used to talk about the "most" troublesome. That is a ratio - not an absolute number.

There are a handful of people who the police constantly have to babysit, maybe 25 people whose day to day routines they know intimately, maybe 200 people who they know by name and see daily, or 500 people who they get called to remove from various places regularly. There are around 1500 people who just don't have homes, or have no housing stability.

As long as housing an individual costs less than the emergency services they consume as a direct result of homelessness, it makes sense to do it.

IMO they are going about it the right way - starting with the most severe cases and using economic sense instead of moral arguments to say where it stops. Most likely, there will be constant reviews to make sure that the bottom line still works, and that the savings are in fact being realized.

It is interesting, Mike, you are concerned that other people from the rest of the country will come here to take advantage of our services. Mat is concerned about the opposite - that homeless people will leave the CRD. Downtown Victoria is already the gathering place for people whose families and communities are not providing for them. Vancouver Olympics is only making that more acute. The province was at the table for the task force, and really the feds should be too imo.

Some Reading:

Here is the City's webpage regarding the Mayor's Task Force Reports:

http://www.victoria....rc_brcycl.shtml


*******************************************


The Supportive Housing Definition that the City is using:

Supported housing: affordable housing where tenants have access to support services in
addition to housing. These services vary and can include: life skills training, income management,
job training, medication management, medical care, social activities, rehabilitation programs and
case management.

The situation that they are dealing with:

MAYOR’S TASK FORCE ON BREAKING THE CYCLE OF MENTAL ILLNESS, ADDICTIONS AND HOMELESSNESS
High Cost of Inaction 10/19/2007
High Cost of Inaction


It costs taxpayers more than $50,000 per year to support each homeless resident in British
Columbia.1


With a homeless population growth factor estimated at 30 per cent, compounded for each year of
inadequate housing stock and supports, Victoria’s homeless population could double by 2010.

The Victoria Police Department has identified a group of 324 homeless residents—many of whom
are mentally ill and suffer from substance use problems or a dual diagnosis—who are responsible
for 23,033 police encounters over a period of 40 months, at a cost of $9.2 million to the City of
Victoria.2


The City of Victoria has spent over $1.4 million already this year in expenditures associated with
homelessness; including clean-up costs, needle pick-up, damages to sensitive ecosystems,
security and responses to complaints.


Without proper access to health services, homeless residents rely on emergency and acute care
health services—66 per cent of all homeless residents admitted to hospital by Vancouver Island
Health Authority have a mental health or substance use related condition.


The Task Force found that there are over 200 organizations in the Greater Victoria area currently
engaged in addressing the needs of homeless, addicted and/or mentally ill people in our
community. Over 20 funding agencies already spend an estimated $76 million annually on
housing, mental health and addiction services. By not addressing the needs of the homeless
population in Greater Victoria, we are spending at least $62 million in other services, such as
policing, prisons, hospital services, emergency shelter, clean up, etc.


A study conducted by the province of B.C. in 2001 showed that the cost of service use under the
status quo was 33 per cent higher than the cost of housing and supporting individuals.3

Draft report by CARMHA, Housing and Support for Adults with Severe Addictions and/or Mental Illness in British Columbia.
2 Victoria Police Department, 2007.
3 The Cost of Homelessness in BC, February 2001. A study conducted by the province of B.C.

http://www.victoria.... ... inactn.pdf

More numbers:

MAYOR’S TASK FORCE ON BREAKING THE CYCLE OF MENTAL ILLNESS, ADDICTIONS AND HOMELESSNESS
A Look at the Numbers 10/19/2007
A Look at the Numbers

How much does the status quo cost taxpayers today?
The Expert Panel has highlighted emerging evidence that the current cost estimates of the status quo
are more than $50,000 per annum, per client.1

Why did the Expert Panel develop a model for 1,000 individuals?
The Expert Panel developed the service configuration and order of magnitude costs for 1,000
individuals for ease of calculation. It can be scaled up or down depending on need. It does not mean
only 1,000 people need housing and supports.

If a homeless count noted 1,242 individuals, why does the report speak to 1,550?
A homeless count conducted in February 2007 counted 1,242 homeless individuals in the Capital
Regional District. It is recognized that this is likely an under-reporting, so the Gap Analysis Team has
assumed 1,550 people need to be housed immediately.

How many housing units are needed to address the homeless population?
The Task Force recommends a minimum of 1,550 net new units must be secured over the next five
years. This assumes efforts to slow down the number of people falling into homelessness can be put
in place.

Will 1,550 housing units adequately house all homeless residents in Victoria?
While 1,550 units will make a substantial impact, it does not account for growth in homeless residents
over the next five years. The Task Force is targeting 1,550 housing units because it is an aggressive
but achievable target given current market conditions.

Why is there an estimated homeless growth rate between 5 and 30 per cent?
The growth rates of 5-30 per cent demonstrates what will happen if we do not get moving on securing
additional housing units now. An additional 1,550 net new units will provide housing for:
· People who are homeless with severe addictions
· People who are homeless with mental illness
· People who are homeless with co-occurring disorders
It will not address the growing demand for affordable housing but it will address the highest need
population who require the most support, are the highest cost to the system and divert much needed
resources from other programs and services
.
How much will the recommend service delivery model cost?
In 120 days, the Task Force did not have the time or the necessary financial data to determine the
definitive costs to implement the Expert Panel’s model in its entirety. What we know:
· The costs to current housing, mental health and substance use services expenditures
· The cost of inaction is $50,000 per homeless resident, or over $62 million per year
· The cost to house and support a severely addicted and mentally ill population is $17,500-
$47,000 per person, per annum
1 Patterson, M., Somers, J, Shiell, A., & Frankish, J. (2007). Center for Applied Research in Mental Health and Addiction, Simon
Fraser University. Housing and supports for adults with severe addictions and/or mental illness in B.C.

[Rob Randall]

I don't know where you got the 25 figure from. I think you could come up with numbers from 15 to 100 depending on the criteria.

This is the relevant quote from the Action Plan:

Actions:

2.2
Identify 50 people with the highest health care needs and with chronically recurring acute health care issues (e.g. behavioural developmental disability, blood borne infections, addictions) and house and support them

[...]

These 50 people will be the first cohort to be served as part of the 175 clients to be housed under the Housing First Strategy.

Will this attract homeless from other communities? Maybe. That's why Provincial and Federal funding and support is crucial. This problem is not the exclusive domain of the City of Victoria. Other cities should implement plans of their own. If you were a talented architect or rare cancer sufferer, you'd probably want to live in a big city rather than a small town, anyway.

This is worth repeating:

The Victoria Police Department has identified a group of 324 homeless residents—many of whom
are mentally ill and suffer from substance use problems or a dual diagnosis—who are responsible
for 23,033 police encounters over a period of 40 months, at a cost of $9.2 million to the City of
Victoria.

[Ms. B. Havin]

I thought the press release (via CivicInfoBC on this initiative/ action plan was usefully concise and to the point ...so I'm reproducing it here (saves going through the bigger documentation, but avoids the newspaper articles). Ok, it does nothing to quell the unrest about how many are served or how they're chosen (in the conversation above), but that topic won't ever be satisfied anyway...

Wednesday, October 24, 2007
Victoria Mayor’s Task Force Calls for Change to Current System
By City of Victoria

VICTORIA — A report prepared over the last 120 days by the Mayor's Task Force on Mental Illness, Addictions and Homelessness calls for a supported Housing First approach with assertive engagement and treatment, coordinated funding and integrated service delivery model. An action plan outlines aggressive targets for 1,550 net new units over the next five years.

"Homelessness didn't happen over night and it won't be solved overnight, but it can end if we all commit to this evidence-based model and plan for action," noted Mayor Alan Lowe. "The Victoria model recommended by this task force is a paradigm shift that will help us end homelessness, not just manage it."

The task force acknowledges the challenge is three-fold and recommends:

1. Immediately start to house the high-risk, high-needs population concentrated downtown in Victoria and support them with Assertive Community Teams
2. Followed by a second, prevention focused strategy to reduce new cases of homelessness; and
3. Establish a community-based governance structure to integrate planning, policy, funding and drive the integration of our fragmented programs and services.

Key report recommendations include:

* A supported Housing First strategy
* Targets of 1,550 net new supported housing units over the next five years, with 350 new units targeted for the first year
* Assertive Community Teams (ACT) to more effectively meet the needs of the addicted and mentally ill homeless population
* Immediate rental subsidies
* Consideration of harm reduction strategies such as substitution therapy and supervised consumption
* Fast-tracked development of "Safe Downtown" strategy
* The need for a regional governance model to drive change
* Bring all sectors of the community -business, health, three levels of governments, social service providers, faith- together to determine governance model

The action plan outlines a five year timeline to fully implement recommended changes. The following are the immediate next steps, to take place over the next 120 days:

* Partner with the provincial government to approve rent subsidies for the 350 people who will be housed in the first year
* Establish an assertive community treatment (ACT) team with existing resources
* Identify and engage 50 homeless residents located in the downtown "hot spots" with the highest health care needs for immediate support and housing
* Host community information sessions to engage the community in creating actionable solutions at a community level
* Establish an inter-agency team to identify additional housing units and integrate housing registries
* Conduct a one-day summit in November to establish what type of regional governance structure will work best for this Victoria model

Mayor Lowe added, "the City of Victoria can not address this issue alone and it will take political will, commitment and hard work. We are committed to continuing to work in partnership with business, the Province, social service agencies, the faith community, the Aboriginal community, and our neighbouring municipalities, to implement these recommendations. The partnerships built during the past 120 days will serve us well as we tackle the hard work ahead."

The Mayor's Task Force on Breaking the Cycle of Mental Illness, Addictions and Homelessness: A Victoria Model report is available on the City of Victoria website at http://www.victoria.ca, by clicking on Mayor and Council, and then Task Force.

*View the full text of this press release

[Ms. B. Havin]

The fourth article on "The Street," a series by Jody Paterson, is up on the T-C's website. See The Street: Doing business on the front lines (published yesterday, Nov.25/07). Some excerpts:

Thornton-Joe has been the downtown liaison for city council for five years. In kinder, gentler times, that job might have entailed fielding concerns about a crumbling section of sidewalk, or a discordant busker getting on people's nerves.

But with 1,500 chaotic, impoverished and ill people now living hard on downtown streets, things are a little different these days. Thornton-Joe is OK with that, noting "the folks we see on our streets are someone's brother, sister, parent or child."

I'm not sure what Paterson means by that ("...is OK with that"). Sounds like there's a war going on, and somehow being a Red Cross volunteer who's "OK with that" doesn't cut it. I'm not necessarily ragging on Thornton-Joe, but more on the attitude conveyed in the article. What's to be OK with in this situation?

"A month ago, somebody put their butt up against the wall and took a crap down my front window," says Wright. "I had to buy a power washer to deal with it."

Wright's doorway has been urinated in so often that the uric acid has damaged the door frame. He regularly has to fish discarded needles from a ground-level pipe at the corner of his shop. Another downtown business had to tear out the carpet at its front entrance after urine seeped in from the outside.

"I'm not down on the homeless and addicted people," stresses Wright. "I just think we need to find a better solution. I don't mind some of my tax dollars going toward it, but I do think I have the right to run my business reasonably without having to clean up all over every single day."

Again, strange that a business owner is in a position where he has to defend the idea of the obvious (i.e., that he, too, has rights).

Thornton-Joe knows all about that last point. [i.e., the sentence in the previous paragraph, not quoted: "We're a small city with big-city problems."] Victoria's downtown carries the social burden of a city of 400,000 -- the number of people living in the region. But in fact, it's just one of 13 municipalities in the region, with an actual population of only 90,000. That leaves the city out of the running anytime "big city" funding from higher levels of government is on the table.

I don't see how we're doing ourselves any favours by inflating the numbers. I have never anywhere else seen the number 400K quoted for the CRD or 90K for the City of Victoria. Any idea where those numbers came from?

Centennial Square is the drug-using hot spot of the moment for people with severe addictions, due to police crackdowns near the AIDS Vancouver Island needle exchange on Cormorant Street that have displaced problems into the square.

Reeson Park -- near the "Whale Wall" mural -- is both a hangout for teenagers and a major drug-dealing area. On our way into the Regent Hotel, we hear a teen tell an older, well-dressed man looking for drugs that the boy has "only a gram left."

Hotel manager Wilde says Victoria police regularly set up surveillance in the hotel to catch people selling drugs at Reeson Park. Today, there's a group of about 20 people in the park, but no easy way to tell the drug dealers from the kids just hanging out.

Lumping teens and drug dealers together does a disservice to disaffected teens (not all of whom are drug dealers), and lets the drug dealers blend in ("...a teen tell[s] an older, well-dressed man looking for drugs that [he has just a small amount to sell]"). On the one hand, Paterson quotes Regency Hotel manager Wilde saying that some of the people hanging out are teens and others are drug dealers, and in the next sentence, she has blended them together again. She's effectively exacerbating a perception issue ("all teens are druggies"), even though the hotel manager just pointed out that they're not.

With an office looking onto Centennial Square, Downtown Victoria Business Association manager Ken Kelly is reminded several times a day of the need for urgent action. As we chat, a drug deal goes down outside his window.

Kelly supports more housing, mental-health services and help for people with addictions. But he also suspects there are "a lot of criminals flying below the radar under the guise of homelessness."

The fact that 324 chronic street offenders racked up more than $9 million in police costs in less than four years speaks to the need for strategies that go well beyond housing, says Kelly.

"I worked it out -- that group makes up .004 per cent of the total population of the City of Victoria," he says. "That's not just the tail wagging the dog -- that's the flea bench-pressing the dog."

That is an interesting comment. Kelly is saying the obvious (that there are "a lot of criminals flying below the radar under the guise of homelessness"), but somehow he's saying it solo. Why is that, and where is his back-up choir?

I'm in favour of supportive housing for those who can't function otherwise. But I'm against lumping criminals in with those they prey on, and then looking at both criminal and homeless/ addicted/ mentally ill person as simply 2 points on the same spectrum. Drug dealers are predators.

[aastra]

In kinder, gentler times, that job might have entailed fielding concerns about a crumbling section of sidewalk, or a discordant busker getting on people's nerves.

But with 1,500 chaotic, impoverished and ill people now living hard on downtown streets...

Yeah, things were so much simpler back in the good old days, when there were only a few hundred street people in Victoria.

Makes me wonder if there's a lesson for us in there somewhere.

[aastra]

I don't see how we're doing ourselves any favours by inflating the numbers. I have never anywhere else seen the number 400K quoted for the CRD or 90K for the City of Victoria. Any idea where those numbers came from?

Methinks they just inflated the numbers by 10% or so, as Victorians tend to do when talking about social problems. Victoria is a big city when people talk about social problems, but it turns into a tiny town when people talk about improvements to infrastructure.

[G-Man]

Yup last time I checked we were at 80 000 in the City proper and 350 000 in the region. But you know there is this building boom going on, so the numbers must have jumped by 50 000 since the 06 census.

[Mike K.]

The figure of 400,000 may not be that far off. Statscan and the CRD have looked into adding the southern portion of the Cowichan Valley to the "metro" population of the region so if you add the residents of Malahat, Mill Bay, Cobble Hill, Shawnigan, etc, otherwise known as the northern-most area of our commuter shed, we'll be sitting pretty at around 380k.

[Edit: I'm not saying Jody P. is aware of this, though.]

[Holden West]

Victoria's infrastructure caters not only to its residents and businesses. Don't forget the nearly four million tourists that visit annually.

For comparison, Paris (pop. 2.2 million) has 42 million tourists and 11.3 business visitors annually.

The question I have for you is what is the actual population of Victoria at this moment, ie: how many human beings are within Victoria's borders right now? Subtract the residents who work outside the City and those on vacation and add tourists and businesspeople etc. Any guesses? How about August? A city is made up of more than just a number on a census form.

What I'm getting at is 80,000 is a gross underestimation.

[Mike K.]

I think TJ's comment on population has more to do with taxes/funding than anything else. Point is, 20% of the population is paying for 100% of the problem (using crude numbers -- I don't know if any other munis pay into any of CoV's social services).

[davek]

Homelessness on this scale may be relatively new to Victoria, but I saw this when I lived in the US. There's nothing new about what government is doing, and what it's proposing. It's all been tried before, and it always fails. TJ's right about these folks being someone's brother, son, etc. What she doesn't say is that the welfare state has destroyed the interdependence and mutual aid links that kept family and community strong.

Now frankly, I don't think anyone should be forced to hand over their money for social welfare, or the greater good, or what ever it gets called, but since so many people are determined to use government to take something from one person and give it to another, why not use tax credits? If 10% of a taxpayer's payment goes for charity, then let the individual pick the charity they wish to support, and deduct the donation from their taxes. That will also make more money available for the charities, since there will be fewer government bureaucrats to pay for.