ADDRESSING COMMUNITY SAFETY CHALLENGES AND DEFICIENCIES IN BC’S RESPONSE TO TOXIC DRUG SUPPLY (2024)

Issue

The pressing social challenges of homelessness, opioid addiction, and mental health crises in British Columbia have demanded swift action from government and service agencies. However, the response has inadvertently led to negative community repercussions, stemming from the inadequate operations of certain street-level services. These issues have exacerbated the stigmatization of the displaced population, heightened community concerns regarding safety, and adversely affected the viability of small businesses in affected areas. Additionally, this situation has resulted in an inconsistent delivery of services, often failing to effectively meet individual needs and ensure community safety. 

Background

Since the province declared a public health emergency in 2016, more than 14,000 people have died due to the toxic drug supply. The Ministry of Mental Health and Addictions and the Ministry of Health lead BC’s response, including two harm reduction programs.[1] The Auditor General audited the ministries’ implementation of overdose prevention and supervised consumption services.

The audit examined whether the ministries effectively implemented (1) overdose prevention and supervised consumption services, and (2) the initial phase of prescriber safer supply. The Audit found that ministries:

• Monitored operational performance;
• Monitored funding and adjusted when necessary; and
• Reported publicly on the implementation of overdose prevention and supervised consumption services.

The audit found deficiencies in key areas, including:

• Operational guidance lacked minimum service standards and did not always reflect engagement with health authorities, people with lived and living experience, and Indigenous Peoples.
• Persistent challenges and barriers to province-wide implementation were not addressed.
• There were deficiencies in target setting and evaluation.

For these reasons, the Auditor General concluded that the Ministry of Mental Health and Addictions and the Ministry of Health did not ensure effective province-wide implementation of overdose prevention and supervised consumption services by the health authorities.[2]

In addition to the Auditor General's findings, many communities have experienced significant challenges stemming from criminal activity, social disruptions, and a deficient standard surrounding shelters and supervised consumption services. There has been a movement among the business community to call on the government to address these challenges.

In October 2023, the British Columbia community and business groups, concerned citizens and well-known BC retailers and businesses came together to create SOS: Save Our Streets, a new public safety coalition demanding governments step up to end the growing crime and violence crisis in local communities across the province. [3]

Individual communities have also started working in this space to address their unique challenges. For example, in Kamloops, The Kamloops North Shore Business Improvement Area Association (NSBIA) serves as the representative agency for 299 Class 5/6 property owners and approximately 420 commercial business owners situated on Kamloops’ North Shore. Over the past five years, their membership has faced significant challenges.

In order to grasp the scope and impact of these issues, they have conducted ongoing surveys of our members since 2018 to assess associated costs and ramifications. In 2022, this was expanded to encompass the entirety of Kamloops. Through this concerted effort, it has been realized that similar issues affect the entire city to varying extents.[5]

_{Table 1 – Impacts Survey responses on issues affecting businesses from respondents in the Kamloops region.}

^{Source: Impacts 2023}

Further analysis of the data has distinctly revealed that the majority of respondents to surveys reside in areas of the city characterized by a high concentration of shelters or street-level services. This observation becomes more pronounced when examining individual street addresses, as it is evident that a significant portion of these respondents are located within 1 to 3 blocks of the street-level programs. 

When examining other communities, as evidenced by a recent Nanaimo heatmap report[6], it becomes evident that many disruptions are concentrated within specific zones. This observation is not an indictment of operator negligence; instead, it underscores a lack of clarity regarding expectations for managing social programs concerning community interface and site maintenance. 

Between 2018 and the spring of 2023, the NSBIA engaged in numerous discussions with agency leads, government representatives, and members to evaluate the impacts outlined above and identify opportunities for enhancing the operation of social programming. The aim was to diminish stigmatization, enhance the effectiveness of street-level services, and ensure accountability to the community, positioning programming as a positive driver of outcomes for all stakeholders. 

During these discussions, the NSBIA formulated the ten core operating principles for managing a shelter or site. These could be suggestions for individual communities to consider when new service locations are opening or if communities are facing challenges:

1. The site is a 24/7 facility: The facility operates around the clock, ensuring continuity of support for individuals. Requiring individuals to vacate premises each morning disrupts stability, undermines efforts to connect them with services, and forces them to shelter elsewhere until the facility reopens. This practice often leads to conflicts between local businesses, residents, and individuals seeking refuge in doorways to escape harsh weather conditions. Additionally, it fosters congregations that may contribute to increased criminal activity, substance abuse, and other undesirable behaviours due to the anonymity of group settings. 
2. The site is a contained site: The facility is enclosed within a fenced perimeter, providing a contained environment that is separated from the surrounding community. This offers a semi-secure space where individuals can store their belongings, such as carts, within a designated parking area. However, it necessitates ongoing monitoring to prevent the establishment of entrenched encampments and unauthorized sheltering outside the premises.
3. The site must have access to supervised consumption services: The facility provides access to supervised consumption and testing services around the clock to ensure safety and access to essential services, health authority and/or agency representatives must be present onsite 24/7 to monitor drug use and facilitate connections to detoxification and other treatment options. 
4. Housing placement supports are onsite: The facility offers onsite support for housing placement, aligning with the principles of the "4 pillars" model112F[7] for promoting healthy outcomes. Emphasizing access to stable housing, the facility provides comprehensive wrap-around services to encourage and facilitate the transition to permanent housing solutions. 
5. Mental Health supports available: Mental health support services are readily accessible onsite to address the complex needs of individuals experiencing homelessness. These services include situational counselling, psychiatric nursing, and PTSD support to assist individuals during crises and promote their overall well-being.
6. Site maintenance is constant: Continuous site maintenance is paramount to uphold cleanliness and minimize negative impacts such as clutter and litter. Maintaining a clean environment contributes to a safer and more welcoming atmosphere for both patrons and the surrounding community. 
7. Staffing or Security onsite 24/7: Adequate staffing or security presence is maintained onsite 24/7 to ensure patron safety, promptly address disruptions, and implement appropriate measures in case of escalating situations. 
8. Community Interface Management is entrenched: Community interface management strategies are integrated into the operational framework to mitigate the impact of the facility on the surrounding area. Regular patrols extending at least 75 meters from the site direct individuals to the facility while managing any resulting impacts through proactive maintenance of the interface zone.
9. Reputable Operators Required: Operators selected to manage the facility must demonstrate a track record of operating robust sites and a commitment to collaborating with the broader community to address emerging issues effectively.
10. Placement off Commercial Corridors: Priority is given to locating facilities away from primary commercial and transportation corridors. Instead, sites are situated in areas with adequate access to transportation and essential services necessary for the facility's operation and the well-being of its participants. This strategic placement minimizes negative impacts on the business community, reduces stigmatization, and enhances overall effectiveness. 

These ten conditions are examples of a community-led process of determining guardrails to mitigate issues that impact the business community.

THE CHAMBER RECOMMENDS

That the Provincial Government:

1. Develop and implement new minimum service standards within a year to support consistent quality, access, and availability of services to minimize impacts.
2. Consult with individual communities and all stakeholders in those communities, including but not limited to: health authorities, harm reduction facility operators, shelter operators, local governments, Chambers of Commerce, Business Improvement Associations, neighbourhood associations and other associated or impacted organizations to ensure that issues raised by the community in relation to the facilities are addressed in a matter that leads to higher levels of support and resolves issues that negatively impact the community.
3. Adequately resource these new minimum standards and consultation work through a designated annual and ongoing provincial budget allocation to support the sustained and successful implementation of the standards.