The Waterloo Region has submitted an application for a Homelessness and Addiction Recovery Treatment (HART) Hub—a model created by the government of Ontario.
According to the government of Ontario website, HART Hubs will work to connect marginalized individuals experiencing many overlapping issues, including homelessness, mental health challenges, substance abuse, unemployment and social service support needs.
HART Hubs will not offer supervised consumption, safe supply, needle exchange programs, or harm reduction. “[Waterloo Region’s application] will certainly align with what the province was looking for,” Dorothy McCabe, mayor of Waterloo, said.
“We’re looking to really bolster local capacity and provide access in a really culturally appropriate, trauma-informed and evidence based way…that’s the hallmark of how the work is currently being done,” she said.
The provincial government’s call for HART Hub proposals came alongside the decision to close Consumption and Treatment Service (CTS) sites across Ontario within 200 meters of schools or child-care centres.
The Kitchener CTS site, which falls under this category, will have to close its doors by Mar. 31, 2025, as a result. In the announcement, the provincial government stated its hope to have the new HART Hubs operational by winter 2025, before CTS sites are closed.
The province said that municipalities with CTS sites that have to close will be prioritized.
While the Region of Waterloo is playing a coordinating role in curating and submitting an application, McCabe said that House of Friendship and Community Healthcaring KW will be the co-leads of the application and will ultimately co-operate the HART Hub should the region be successful in receiving funding. According to McCabe, during one of many discussions surrounding the application, she was able to inquire about the plan to allocate funds to specific groups in need of support, such as women.
“There’s been a chronic underfunding of women’s mental health, addictions and homelessness,” McCabe said. “A key part of the application will begin to address some of those gaps.”
In addition, Waterloo’s application included a satellite option for easier access. “Presumably, if the HART Hub were in Kitchener, there would be a satellite in Cambridge or vice-versa,” McCabe said.
Through HART Hub funding, the Ontario Government has committed to funding 365 supportive housing beds throughout the province over the next four years.
“We continue to say we appreciate the initiative. We wish the pieces of the safe consumption, treatment and drug testing could remain. We need the province to understand that it’s a good start, there’s more to do and more we need to address this crisis,” McCabe said. Michael Parkinson, Drug Strategy Specialist and volunteer with the Waterloo Region Drug Action Team, concurred with McCabe, stating that while the HART Hub has the potential to improve the lives of those it serves, there is more action to be taken.
“Municipalities right across Ontario are desperate for relief from senior levels of government and the province in particular,” Parkinson said.
“[HART Hubs] will help, but it is a very different scheme than the services provided by supervised consumption sites. They are not the same thing unequivocally,” he said.
In addition to the restrictions surrounding harm reduction within the new HART Hub model, the loss of the CTS site also eliminates the connections made between clients and CTS staff—a key pillar when it comes to healthcare for those struggling with addiction. Since opening in 2019, Kitchener CTS has provided more than 20,000 referrals to services such as addiction treatment, mental health, primary care and social services.
“Harm reduction is a key pathway into accessing services; that off-ramp for people is now closed and for no good reason,” Parkinson said. “Ideally, this community would benefit from both. They’re not mutually exclusive. There’s a fundamental misunderstanding or refusal to accept evidence at the provincial level about the value of harm reduction services.” According to the Ontario Government website, CTS’ “lack of focus on treatment leaves people trapped in the cycle” of addictions.
Local advocates, including Parkinson, dispute the closure of CTS.
“[Without CTS,] people will die, and they will die very quickly. When the Ministry of Health says they’re protecting children and day cares—we know that’s not true here in Kitchener. The day care across from the [CTS] is concerned about the closure of the CTS,” Parkinson said.
“The Drug Action team suspects this decision is more based on opinions and ideology versus anything grounded in real-world experience,” he said.
In addition to the concerns surrounding the loss of CTS and harm reduction, Parkinson cited concerns about a longerterm strategy for homelessness, addictions, and mental health. “The scale of need now is so large that it’s doubtful we’ll ever keep up. We are still years and years from voluntary, evidencebased addiction treatment on demand,” Parkinson said.
According to Parkinson, the mortality rate in Ontario relating to drug poisoning and overdoses is one death every two and a half hours. In the Waterloo Region, the mortality rate is one death every two and a half days.
This excludes individuals experiencing homelessness or other vulnerable groups.
“It is a humanitarian disaster suffering from the absence of a provincial strategy on homelessness, suffering from the absence of a provincial strategy on drug-related issues and, more importantly, the rapid deployment of resources that would mitigate, if not prevent, the harms that are consuming municipalities across Ontario,” Parkinson said.
Similarly, McCabe noted the importance of a long-term funding commitment from the federal and provincial governments, noting the limitations of municipal capacity to fund healthcare initiatives such as HART Hubs.
“[Property tax is] a funding formula that we’ve had since the 19th century; it’s not an appropriate tool and it does not provide municipalities the resources that we need to solve complex social issues like mental health and addictions [crises],” McCabe said.
“We continue to pull on the federal and provincial government to sit down with municipalities and figure out a fiscal funding formula—that would make a huge difference for our ability to continue to do this support and work,” she said.
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