3. ENHANCEMENTS TO THE
CLEAN-UP/RECOVERY COMPONENT OF THE PROVINCIALLY MANDATED HARM REDUCTION
STRATEGY
AMÉLIORATIONS À LA COMPOSANTE DÉSINTOXICATION ET
RÉCUPÉRATION DE LA STRATÉGIE DE RÉDUCTION DES MÉFAITS IMPOSÉE PAR LA PROVINCE |
COMMITTEE
RECOMMENDATIONS AS AMENDED
That Council approve the following:
1. Request
that the Province provide the $200,000 required to fund the Medical Officer of
Health’s proposed enhancements to the clean-up/recovery component of the
Provincially mandated harm reduction strategy and that any expansion of the
Black Box program be done in consultation with affected communities.
2. That
the issue of picking up needles on private property be discussed with the Legal
Department in order to resolve the issue and provide service to private
property.
RECOMMENDATIONS
MODIFIÉES DU COMITÉ
Que le Conseil approuve les points
suivants :
1. Que l’on demande à la province de fournir
le montant requis de 200 000 $ pour financer les améliorations
proposées par le médecin chef en santé publique en matière de la composante
désintoxication et récupération de la stratégie de réduction des méfaits
imposée par la province et que toute autre prolongation du programme Boîtes
noires soit effectuée en consultant les communautés touchées.
2. Que la question du ramassage
d’aiguilles sur une propriété privée soit discutée avec les Services juridiques
afin de trouver une solution au problème et d’assurer un service aux propriétés
privées.
For the
Information of Council
That the following be direction to staff:
That the most effective group for the needle pick up be provided with the contract, not necessarily the lowest bidder.
Pour la gouverne du Conseil
Que le personnel soit avisé de
l’énoncé suivant :
Que le contrat soit octroyé au groupe le plus
efficace pour assurer la collecte d’aiguilles, et pas nécessairement au
soumissionnaire le plus bas.
DOCUMENTATION
1.
Coordinator, Community and Protective
Services Department report dated 4 April 2008 (ACS2008-CCS-CPS-0015).
2. Extract
of Draft Minutes, 17 April 2008.
Report to / Rapport au:
Comité des services communautaires et de
protection
and Council/et au Conseil
4 April 2008 / le 4 avril 2008
Coordonnatrice de comité
|
City Wide / À l'échelle de la Ville |
Ref N°:
ACS2008-CCS-CPS-0015 |
SUBJECT: enhancements to the clean-up/recovery component of the
Provincially mandated harm reduction strategy
OBJET: AMÉLIORATIONS
À LA COMPOSANTE DÉSINTOXICATION ET RÉCUPÉRATION DE LA STRATÉGIE DE RÉDUCTION
DES MÉFAITS IMPOSÉE PAR LA PROVINCE
That
the Community and Protective Services Committee recommend that
Council request that the Province provide the $200,000 required to fund the
Medical Officer of Health’s proposed enhancements to the clean-up/recovery
component of the Provincially mandated harm reduction strategy.
Que le
Comité des services communautaires et de protection recommande au Conseil de
demander à ce que la province fournisse les 200 000 $ requis afin de
financer les améliorations proposées par le médecin chef en santé publique à la
composante désintoxication et récupération de la Stratégie de réduction des
méfaits imposée par la province.
On 3 April 2008, the Community and Protective Service Committee received
the following Notice of Motion from Councillor Diane Holmes:
WHEREAS the occurrence of
public encounters with discarded needles has increased since the cancellation
of the safer inhalation program;
AND WHEREAS these encounters can
present health and safety hazards;
AND WHEREAS numerous community
groups have requested that the City make improvements to the current Needle
Hunter Program;
AND WHEREAS the current program is
limited by current funding levels;
AND WHEREAS the Medical Officer of
Health has proposed the following enhancements to this program:
· The addition of one more sector (Vanier)
to the City’s existing three sectors
· Increase to the number of daily hours of
collection
· Allowance for an extra crew based on the
need and size of geographical area covered
· Addition of a permanent FTE Public
Health Inspector trainee position to manage 311 calls
· Addition of the use of a City vehicle
for the new position to provide for a "rapid response" capability
· Further deployment of the black box
program
· Implement a public awareness campaign on
safe needle disposal and information about the City’s integrated response
system to discarded needles
AND WHEREAS the proposed enhancements
will cost approximately $200,000;
THEREFORE BE IT RESOLVED THAT the Community and Protective Services Committee direct City Council to request that the Province provide the $200,000 required to fund the Medical Officer of Health’s proposed enhancements to the clean-up/recovery component of the Provincially mandated harm reduction strategy.
In 2001, the City engaged Causeway Work Centre to provide
community needle clean-up services, through their Needle Hunter Program. To date, this contractor has been meeting
the City’s contractual requirements. In
2006, there was a significant increase in the number of discarded needles
reported in Ward 12. Measures were
implemented to increase the responsiveness of the Needle Hunter Program.
Ottawa Public Health (OPH) has, since the beginning of the
needle exchange in 1991, implemented measures to respond to public concerns of
discarded needles and public safety issues, including the installation of
needle drop boxes in areas experiencing significant numbers of discarded
needles; a by-law prohibiting the disposal of needles as household waste; the
initiation of a Needle Hunter Program in 1998; creation of a central data
collection system to accurately track the number of discarded needles reported;
and, the distribution and web access of public education materials on safe
disposal procedures.
The above measures now form key parts of the City
integrated response system to discarded needles, which was introduced in
2001. This system was coordinated
through the City’s Call Centre, now 311, to provide residents a central point
of access to address their concerns.
Causeway Work Centre, a non-profit agency, was awarded the
Needle Hunter contract in 2001 and again in 2004. The Needle Hunter Program operates from April through November
(subject to weather conditions), two-hours per day, seven days per week. In 2003, Ottawa Public Health obtained
Council approval to increase the ‘needle hunter’ program budget by $10,000 to a
total of $50,000, to increase the program’s ability to respond to additional
locations where discarded needles were being reported. Three teams of a total of 18 individuals
conduct daily operations in three geographical locations in the City including
Hintonburg, Centretown and the Byward Market.
On an ongoing basis, a liaison is maintained with the contractor and
City officials, to direct the “Needle Hunter” crews of two or three people to
conduct daily early-morning search and clean-up operations at emerging hot
spots. Causeway Work Centre provides an
annual report on its activities related to the contracted services.
At present, the specific city sectors and respective
targeted locations covered by the Needle Hunter Program include:
a. Hintonburg/Somerset
West area: parks, school yards, day care centres, community centre, Bronson
Avenue, Preston Street and various other hot-spot locations
b. Centretown/Chinatown:
parks, school yards, community health centre, day care centres, Gladstone, Bell
and Bank Streets locations and various other hot-spot locations
c. Byward
Market/Lowertown: parks, school yards,
bridges, day care centres, Shepherds of Good Hope, Union Mission, Salvation
Army areas, Sandy Hill Community Health Centre, Rideau Street and Montreal
Road, as well as various other hot spots
The following is a
breakdown of the total number of discarded needles reported to the City each
year.
Year
|
2000 |
2001 |
2002 |
2003 |
2004 |
2005 |
2006 |
2007 |
Total
|
813 |
497 |
644 |
562 |
809 |
714 |
1,523 |
2,029 |
It would appear that OPH’s objective numbers are mirroring the community’s subjective experience. This is a complex phenomenon that defies easy explanation or solution. One contributing factor for the increase is that the Needle Hunter contract was extended for an additional month in 2006 because of the mild weather and increased by $10,000 again in the fall of 2007. Other factors may include large numbers of needles clustered in a “single find” reported. The 2007 numbers also include a number collected by a community activist in ward 12. The recent increase of discarded needle reports to 3-1-1 and in the media has been exclusively in Ward 12. These finds are all within close proximity to shelters.
Current
Status
Causeway Works Centre is
responsible for 70-90% of the total number of discarded needles collected by
the City’s response system. The
remainder is collected by Surface Operations, By-law officers, Public Health Inspectors
and Site Program staff. In 2006, the
Needle Hunter Program collected 1,381 of the 1,526 discarded needles
reported. This represents less than
0.5% of the needles distributed by the needle exchange program. It has been observed that clients are increasingly
using the “black box” program to dispose of their used needles.
A recent study conducted by the
Departmental Site Consultative Group indicated that 110-150% of syringes
distributed by the Needle Exchange program are recovered through the City’s
integrated response system in any given month.
Legitimate purchases from pharmacies and other sources represent a
significant portion of the needles “on the street.”
To date, Causeway Work Centre has fulfilled its contractual
obligations to the City’s satisfaction.
Causeway has been very responsive to emerging hot spots.
OPH is working with community
members and Causeway Work Centre staff to explore strategies to address the
number of discarded needles in Ward 12.
These include: completing site visits with community members; the
doubling of the number of daily sweeps; improving the City’s internal
communication and responsiveness; and, community education sessions on safe
disposal of needles, delivered in partnership with the AIDS Committee of Ottawa.
The current annual budget
available for the Needle Hunter program is $50,000, which provides 1,470 hours
of ‘needle hunter’ work at a rate of $31.20/hour. These funds cover the cost of the crews and the ongoing support
services that are provided by the contractor.
The contract is currently being tendered and is usually awarded to the
cheapest bid, as long as it meets the standards specified in the tender.
Proposed Program Restructuring and Expansion
Despite the program's notable success,
a program restructuring may be required to increase clean-up coverage in
response to growing concerns in certain wards.
A proposed restructuring would include the addition of one more sector
to the City’s existing three sectors, an increase to the number of daily hours,
and an allowance for an extra crew based on the need and size of geographical
area covered. The proposed
restructuring would include the following components.
Budget
|
Sector of City |
Vanier |
By Ward/Lowertown |
Hintonburg |
Centretown |
|
Estimated cost* |
$16,000 |
$42,000 |
$21,000 |
$16,000 |
|
Cost of supplies |
$750 |
$2,500 |
$1,000 |
$750 |
Total estimated cost: $100,000.00
* Estimated cost is based on figures
from previous tender: 2005-2008. Costs may increase depending on the bids
submitted by prospective contractors (2008 tender closed on 20 March).
As part of its commitment to service improvement, OPH also
recommends the following:
Review the possibility of permanently
increasing the number of sweeps with additional funding of approximately $84,000:
Implement a public awareness campaign
on safe needle disposal and information about the City’s integrated response
system to discarded needles.
To implement all these proposed
enhancements, the total estimate, per year for the Needle Hunter Program would
be $200,000.
CONSULTATION
The following groups were consulted in the
preparation of the Motion:
Dalhousie Community Safety Committee
Bank St. Safety Committee
Action Sandy Hill
Hintonburgh Community Safety Committee
McNabb Neighbourhood Improvement Bunch
Neighbourhood Watch - District 23
Concerned Citizens for Safer Neighbourhoods
Community and Protective Services
Comments – Ottawa Public Health
Ottawa Public Health cares about community health and safety. The Medical Officer of Health endorses this proposal as an approach to respond to community concerns and address health risks.
There are no
financial implications associated with this report.
Upon Council approval, the City Clerk will prepare the necessary letter to Province.
ENHANCEMENTS TO THE CLEAN-UP/RECOVERY COMPONENT
OF THE PROVINCIALLY MANDATED HARM REDUCTION STRATEGY
AMÉLIORATIONS
À LA COMPOSANTE DÉSINTOXICATION ET RÉCUPÉRATION DE LA STRATÉGIE DE RÉDUCTION
DES MÉFAITS IMPOSÉE PAR LA PROVINCE
ACS2008-CCS-CPS-0015 CITY WIDE / À L'ÉCHELLE DE LA VILLE
The Committee received the following
correspondence in support of the report recommendation, copies of which are
held on file:
a. McNabb
Neighbourhood Improvement Bunch, 16 April 2008
b. Centretown
Community Health Centre, 16 April 2008
Dr. Salisbury, Medical Officer of Health
indicated his full support of the recommendation, noting the frustration that
Public Health have felt in their ability to be able to respond to citizen
concerns about inappropriately discarded needles.
Councillor Cullen supported the proposal to
improve clean up, but inquired what the likelihood was of the province acceding
to this funding request. Dr. Salisbury
was not optimistic that funding would be forthcoming, especially as Public
Health’s current budget is already at its limit that the province has
authorized. He confirmed, however, that
the City’s current expenditures for cleaning up needles are consistent with
provincial policy.
Councillor Leadman proposed that the report
recommendation be amended to include the following:
“…and that any
expansion of the Black Box program be done in consultation with affected
communities.”
Councillor Holmes accepted this amendment.
Stephanie Strudwick, Central Ottawa
Neighbourhoods Safety Alliance
spoke in support of the Motion, adding that it was not fair for businesses and
residents to have to deal with discarded needles. She noted that bags of needles and nodules were retrieved from a
small park on Somerset Street, which is frequented by children. In a letter dated 14 April 2008, the
Alliance made recommendations to enhance the current clean-up recovery component
of the harm reduction strategy. A copy
of the letter is held on file.
When asked whether the Alliance would assist in
the City’s efforts to get the additional funding from the province, Ms.
Strudwick indicated she would forward the letter referenced above to all MPPs.
Responding to a question posed by Councillor
Leadman with regard to the effectiveness and quality of the crews who have been
contracted to collect the needles, Ms. Strudwick suggested they need people who
are more responsible and who know what they are doing. The individuals hired to provide clean up do
not seem to be properly trained and are not properly equipped as they are
picking up used needles with salad tongs.
The councillor asked what training and
equipment requirements (if any) are required as part of the contract for the
existing program and Dr. Salisbury explained that the tender does have some
performance standards associated with it.
Given the amount of the contract, however, the level of training that
can be purchased is minimal and as much as possible, Public Health staff will
assist in that training. He confirmed
that the tender process does not get into details regarding the equipment used
to retrieve the needles, and he would ensure the program manager responsible
looks at the techniques used by the contractor and advises them on the
appropriateness of the tools used.
Dr. Dona Bowers, Director of Health Services,
Somerset West Community Health Centre spoke in support of the recommendation. The more salient comments made were as follows:
·
having worked in
this particular community for over 20 years, she has seen the effects of drug
abuse on their clients and the community they serve
·
drug addiction is
a huge issue in this community and requires a very comprehensive strategy to
address it - from prevention to treatment
·
the rate of HIV
in Ottawa is alarming and is higher than Toronto
·
the profile of a
drug user is: male, 30 to 35 years old,
is homeless and uses health services frequently; the cost to treat each person
diagnosed with HIV is well over $150,000, which does not not include the costs
associated with emergency services, policing, housing, health services, etc.
When asked to comment on the proposal for a
one-for-one needle exchange in order to eliminate the disposal of syringes in
the community, the delegation indicated that initially there was great
resistance for Ottawa to embark on that program (prior to it being provincially
mandated) and the rate of spread of HIV at that time was very low, but they saw
the numbers escalate to the alarming rate they are at today. After that, that restriction was
eliminated. She stated that the drug of
choice in Ottawa is cocaine and given that users will inject over 10 times a
day, to impose a one-for-one exchange is limiting. And, when they need their fix, and they do not have a clean
needle, they will resort to using pre-used, dirty syringes, thereby enhancing
the spread of HIV, HEP B and C. She was
therefore quite nervous about reverting back as she felt it would be very shortsighted.
Councillor Leadman inquired about the success
of retractable needles and Dr. Bowers advised that they are about 10 times the
cost of regular needles and are not reusable.
She confirmed that the Needle Exchange Program (NEP) only puts out a very
small portion of the actual needles used so they are getting them through a lot
of other sources and SITES. Therefore,
if the City’s program wants to endorse movement for retractable needles, it
would not solve the entire problem.
Following on this, Councillor Qadri asked that
if the ultimate goal of the NEP is to help protect people from the spread of
disease, would she support using retractable needles if the province paid for
them. Dr. Bowers indicated that she has
not had any discussions with users and suggested they should be consulted.
Councillor Bédard indicated that when there is
a needle exchange, there is discussion with users and asked if that was not
something that should be investigated when they come in. Dr. Bowers agreed it was a good suggestion
and would do that through the Health Centre; outreach workers who are in the
community could also do that. When
asked to comment, Dr. Salisbury explained that that issue has been addressed
with a different technology of retractable needles and at the time, users
indicated an unwillingness because of the way the needle retracted. He added that they are currently looking at
a different technology with respect to the NEP and is conducting a survey to
determine usability and the willingness of clients to use that kind of
syringe. He agreed the cost is a
concern but indicated that usability is also a concern because in the health
care setting, retractable needles are not used for intravenous administration
but for intramuscular types of injections.
This would be the subject of a future report to Committee and Council.
Natalie Tasker supported the recommendation and spoke of her
personal experience of almost stepping on a used syringe (filled with blood) on
her front lawn on Cooper Street last year.
In the fall of 2007, she organized a clean up and they came across
approximately 150 needles within a two-block radius on Cooper. She wanted to highlight the fact that the
numbers of discarded syringes are increasing and she suggested the following: providing drug rehabilitation for addicts (long-term)
and, making the downtown liveable (short term).
Pamela Connolly, Chair, Dalhousie/Somerset
Safety Committee explained
that they are one of three groups in Somerset Ward that address safety issues
such as needles in schoolyards and parks, etc, and fully supported the
recommendation. She suggested that if
the community does not address the issue of discarded drug paraphernalia, it
risks losing the downtown neighbourhoods and it is totally unacceptable for residents
to have to face this every day. She
emphasized the need for the immediacy of what is being recommended, for the
safety of residents.
Lisa Grinham, Safer Ottawa explained how she and her husband Chris
founded Safer Ottawa because discarded needles are a danger and a health risk
that needs to be cleaned up. She also
believed that changes were necessary to the needle distribution program, i.e.,
one-for-one, which will allow them to deal with the program and the source,
rather than having to deal with the deadly spillage, thereby drastically
reducing the amount of discarded needles and funnelling this money into
treatment, prevention and education programs that deal directly with the
problem.
On a personal note, Mrs. Grinham indicated that
since 1 April 2007, she and her husband have picked up 250 needles. She wondered how the one-for-one proposal
would affect users because there is no limit to the number of needles they can
get at various locations. She noted
that the report states that a significant portion of the needles on the street is
bought at pharmacies; however, when presented with the types of syringes
retrieved, the pharmacies confirmed that they do not dispense those
syringes. She stated that the needles
are coming from the SITE. She believed
that if the City is considering a one-for-one option there will be a decrease
in the number of needles discarded. By
way of example, she indicated that when the Shepherds of Good Hope conducted a
trial period of a one-for-one last fall, their numbers dropped dramatically and
people are returning the needles.
Councillor Bédard asked the delegation if they
picked up needles from the Clarence Street clinic and she indicated they
had. Further, they have also picked up
needles on Clarence more than once and she confirmed that the needles are
coming from that particular clinic.
When asked if she was supportive of the proposal to enhance the amount
of clean-up in the area, Mrs. Grinham advised she and her husband are in
support of clean-up, but stressed the fact there has to be effective clean up
as she did not feel that Causeway was the venue for this; their methods are
unsafe due to a lack of proper equipment and clothing to protect
themselves. While she firmly believed
in more clean up, she maintained that the one-for-one would eliminate some of
the need for that.
Shirley Mosley spoke as a concerned grandmother and
great-grandmother who believed the downtown has become totally unacceptable
because of the drug paraphernalia in the downtown and market areas. She agreed the needles being discarded are
not from pharmacies because they sell by the dozen and not individually the way
the City’s clinics do. She was also
very concerned that what was happening in the downtown is spreading to other
areas of the city. Ms. Mosley was in
favour of whatever it takes to clean it up.
Councillor Holmes sought staff comment on the
following that she wanted to put forward:
That the most
effective group for the needle pick up be provided with the contract, not
necessarily the lowest bidder.
Carey Thomson from Legal Services explained
that if the current tender is not already closed, an addendum could be issued
with it so that rather than the lowest bidder being the winner, the tender
would look at either pre-qualifying the bidders to ensure they have experience. He agreed to follow-up with the Medical
Officer of Health and Supply Management accordingly.
Moved by D. Holmes
That the issue
of picking up needles on private property be discussed with the Legal
Department in order to resolve the issue and provide service to private
property.
CARRIED
Moved by D. Holmes
That the following be direction
to staff:
That the most
effective group for the needle pick up be provided with the contract, not
necessarily the lowest bidder.
CARRIED
That the Community and Protective Services Committee recommend that
Council request that the Province provide the $200,000 required to fund the
Medical Officer of Health’s proposed enhancements to the clean-up/recovery
component of the Provincially mandated harm reduction strategy and that any
expansion of the Black Box program be done in consultation with affected
communities.
CARRIED,
as amended