DATE: June 5, 2013 REPORT NO. PHSSS TYPE OF REPORT CONSENT ITEM [ ] ITEM FOR CONSIDERATION [ X ]

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1 DATE: June 5, 2013 REPORT NO. PHSSS TO: FROM: PREPARED BY: Chair and Members Social Services Committee Dan Temprile, General Manager Public Health, Safety & Social Services Sue Evenden, Manager Strategic Planning 1.0 TYPE OF REPORT CONSENT ITEM [ ] ITEM FOR CONSIDERATION [ X ] 2.0 TOPIC Update on Withdrawal Management/Addiction Rehabilitation Centre Initiative 3.0 RECOMMENDATION A. THAT report PHSSS outlining the current status of the local Withdrawal Management/Addiction Rehabilitation Centre Initiative BE RECEIVED; and B. THAT the process outlined in this report to create a funding proposal BE APPROVED. 4.0 PURPOSE The purpose of this report is: 1) to update members of Social Services Committee on progress towards obtaining initial and ongoing funding for a proposed residential addiction treatment facility and associated services to enhance those currently Public Health, Safety and Social Services 220 Colborne Street, P.O. Box 845 Brantford, ON N3T 5R7 Phone: Fax:

2 Date: June 5, 2013 Page 2 available to residents of Brantford and the surrounding area who find themselves in crisis due to substance abuse; and 2) to seek approval from Council through Social Services Committee to proceed with the recommended approach to create a comprehensive, communityendorsed proposal for provincial funding within the required timeframes. 5.0 BACKGROUND In February 2012, MPP Dave Levac hosted a Community Forum on Substance Abuse, citing frequent concerns raised by residents to his constituency office. The forum was attended by more than 40 individuals representing a cross section of community stakeholders, and yielded general agreement that the absence of a local residential treatment facility represents a significant gap in services. As a next step, a joint proposal by St Leonards Community Services (SLCS) and Brant Community Healthcare System (BCHSYS) to complete a needs assessment was funded by the Trillium Foundation and the research was completed in the summer of A link to the full report is below. MPP Levac convened a second community meeting in February 2013 to present the findings and data from the Brant Community Healthcare System Emergency Room and Crisis Response services. This presentation is linked below bgh.html At both half-day forums, many ideas from speakers and attendees were captured and catalogued by MPP Levac s office. As the data presented by key health partners were indicative of a potential need for residential withdrawal management and associated enhanced services, a next step was identified at the 2013 Forum: to develop a proposal for the creation of a residential withdrawal management facility to the Hamilton-Niagara- Haldimand-Brant LHIN (Local Health Integration Network), working with interested community partners. 21 individuals and organizations expressed interest in being involved in this process at the forum, and additional expressions of interest have been received since. The task of facilitating the funding proposal process was subsequently handed to the City of Brantford, and the matter was discussed at the April 3, 2013 Social Services Committee meeting. This report responds to the resolution approved at the April 3 meeting: A. THAT The General Manager of Social Services, Public Safety and Health

3 Date: June 5, 2013 Page 3 BE REQUESTED to give an outline of the process that would be undertaken to initiate a community study group that would engage community partners; and B. THAT the information that has been collected through reports BE COLLECTED and reported through the Social Services Committee for review of the information and provide a recommendation to Council on a process. 6.0 CORPORATE POLICY CONTEXT High Quality of Life & Caring for all Citizens Brantford will be recognized as a safe and healthy community one that promotes and enables the well-being of its citizens, and supports access of all citizens to a full range of health and community services. 7.0 INPUT FROM OTHER SOURCES Hamilton Niagara Norfolk Brant LHIN St. Leonard s Community Services Brant Community Healthcare System Brant County Health Unit 8.0 ANALYSIS Since April, department staff has initiated informal consultations with key informants and experts in the addiction and mental health sectors and have conducted a site visit to St Joseph s Withdrawal Management Centre in Toronto. Significantly, a discussion was held with the Executive Director and Chair of the Board of Directors from the Hamilton-Niagara-Haldimand-Brant LHIN. Advice from the LHIN was to submit a business case (including budget) for the proposed treatment centre before the end of June A regional approach inclusive of Six Nations, New Credit, Brant County, Haldimand and Norfolk Counties was strongly endorsed by the LHIN. Staff from the LHIN were assigned to support the working group with this process. A conference call was held on May 10, 2013 in which the LHIN outlined the elements required for inclusion in the proposal. Substantive technical knowledge regarding the current addictions and mental health service continuum and broader health system will be necessary to successfully meet the LHIN s proposal requirements.

4 Date: June 5, 2013 Page 4 The compressed timeline and input from the group of key informants has shaped the approach which being recommended by staff. The suggested workplan is attached in Appendix A. A phased approach is suggested. Phase 1 is underway and continues until July 30, 2013 or until a final funding decision is received from the Ministry of Health and Long Term Care (MOHLTC). Phase 1 will be led by the City of Brantford and is comprised of the research, coordination, compiling, and submission of the community-endorsed business case for the proposed treatment centre. This proposal will be inclusive of the concepts and input that were voiced by residents and stakeholders at the two community forums held in 2012 and Phase 1 will also include negotiations on budget allocation. In Phase 1, an expert working group with the requisite knowledge and experience, identified and invited by the City, will work on a draft proposal. Particular efforts will be made to engage First Nations health providers in the discussion. Major proposal elements will then be presented and discussed at an open community meeting. All stakeholders who indicated interest in participating in the process will be invited to this meeting, which will also be open to all community members. The draft proposal will also be made available electronically for residents and a deadline provided for feedback to be received. The target date for the completed submission is June 24, Phase 2 commences once provincial funding is confirmed with a focus on bringing the concept to completion. A LHIN stipulation requires that the MOHLTC funding be received by an existing transfer payment agency. Therefore, a new (LHIN funded) lead agency will be selected for Phase 2 and new, broadened working groups assembled from interested community stakeholders to plan and open the new facility. While City staff could remain active as participants, it is most appropriate for the lead role to be held by an agency that will be directly operating the facility on an ongoing basis. 9.0 FINANCIAL IMPLICATIONS No financial implications associated with this report. The City contribution to the project is in-kind through staff time and internal resources CONCLUSION The Social Services department is currently working with the community towards the goal of delivering a comprehensive, community endorsed proposal for the establishment of a residential addiction treatment facility in Brantford. This proposal will be submitted to the Hamilton-Niagara-Norfolk-Brant LHIN before the

5 Date: June 5, 2013 Page 5 end of June Although the timeframes are ambitious, an expert working group has been initiated and is working towards developing a draft proposal which will be shared with interested community members for discussion. The submission of the final proposal and subsequent funding decision from the Ministry of Health and Long Term Care will complete Phase I of the project. Council will remain informed, through Social Services Committee, on the progress of this initiative. Sue Evenden, Manager Strategic Planning Dan Temprile, General Manager Public Health, Safety & Social Services Attachments: Appendix A: Work Plan Copy to: N/A In adopting this report, is a by-law or agreement required? If so, it should be referenced in the recommendation section. By-law required [ ] yes [ ] no Agreement(s) or other documents to be signed by Mayor and/or City Clerk [ ] yes [ ] no Is the necessary by-law or agreement being sent concurrently to Council? [ ] yes [ ] no

6 APPENDIX A: Work Plan Detox/Rehabilitation Initiative PHASE I Lead: City of Brantford Public Health, Safety and Social Services Strategic Planning & Community Development Goal: To enhance local and regional treatment options for individuals who find themselves in crisis with addictions. Objective: Proposal to the Hamilton, Niagara, Haldimand, Brant Local Health Integration Network (HNHB LHIN) by no later than June 30, 2013 Major Activities Timeline Assigned to Result ENGAGE EXPERT WORKING GROUP & KEY STAKEHOLDERS Establish expert working group with subject May 1 23 matter knowledge and experience in proposal writing to LHIN standard City BCHSYS to provide outreach to health sectors partners Brant Community Healthcare System (BCSYS) confirmed St Leonards Community Services (SLCS) confirmed Community representative Andrew McRoberts, former Director of Addiction and Mental Health BCHSYS confirmed Norfolk General Hospital invited Community Addiction and Mental Health Services of Haldimand and Norfolk invited Holmes House invited Public Health, Safety and Social Services 220 Colborne Street, P.O. Box 845 Brantford, ON N3T 5R7 Phone: Fax:

7 Date: June 5, 2013 Page 7 Major Activities Timeline Assigned to Result Conduct key informant interviews to obtain input from selected stakeholders Elicit support/endorsement for proposal May 20- June 7 (approx.) City Approach will be made to: Six Nations Health Services Brantford Native Housing Mississaugas of the New Credit First Nation Canadian Mental Health Association (CMHA) Brant County and Haldimand Norfolk branches Grand River Community Health Centre Victoria Park Clinic Brantford Police Brant County OPP Community and Crime Prevention Task Force Grand River Council on Aging Addictions and Mental Health Regional Network RESEARCH & PROPOSAL DEVELOPMENT Establish proposal requirements per LHIN May 3, 2013 City Completed staff Compile data to substantiate best estimate of need: demographic, benchmark, prevalence, treatment usage May City Data requests from: Brant County Health Unit BCHSYS SLCS Norfolk General Hospital LHIN Community Addiction and Mental Health Services of Haldimand and Norfolk (CAMHS) Six Nations New Credit Investigate leading practices in withdrawal May City with Potential sources:

8 Date: June 5, 2013 Page 8 Major Activities Timeline Assigned to Result management services substantial St Joseph s Health Care (Toronto) involvement of Windsor Regional Withdrawal expert working Management Services group Province of Ontario Withdrawal Management Services Standards 2008 Create model for facility and associated services using input from community May 21 June 1 City and expert working group Develop project budget including estimated construction costs June 1 14 City Use internal resources in Housing and Building services to assist with budget development and cost estimates Final Draft to LHIN Target June 24/2013 COMMUNITY ENGAGEMENT & ENDORSEMENT Community meeting to review draft model Target week of June 10 City All interested groups/individuals from February community forum will receive an invitation to participate and/or provide Proposed model posted electronically for public input Target week of June 10 Deadline for public input June 19 City feedback All interested community members can view the proposed model and provide confidential input and feedback