Hospital CEO outlines plan to establish HART Hub in Windsor-Essex

Windsor-Essex will apply for money to create a HART Hub — the new provincial model that brings homelessness and addiction services together in lieu of the supervised drug consumption sites that have been restricted by the Ontario government.

If the application is successful, the region's Homelessness and Addiction Recovery Treatment Hub is expected to be co-led by Hôtel-Dieu Grace Healthcare and — ideally — a partner based in Essex County, said hospital CEO Bill Marra. 

"In order to truly put forward a regional approach, we need to find a county partner," Marra said. "Because one of the biggest barriers, frankly, for people who live in the county, is access to services and transportation, at times. So that would lend itself well to a regional approach."

A letter of intent was recently submitted to the province. Applications are due in October.

City officials said this week that Hôtel-Dieu Grace Healthcare will be the region's "transfer payment agency" or TPA — essentially, the organization that receives provincial funding and works with others to put it to use.

Marra said HDGH is well-suited for that role because it has the capacity and infrastructure to handle the  accountability reporting required, and is currently a significant provider of similar services to the community. 

The announcement of HART Hubs — Homelessness and Addiction Recovery Treatment — follows the Ontario government's announcement in August that it will no longer support drug consumption and treatment services (CTS) sites.

A review of CTS sites was prompted by the fatal shooting of a woman outside a Toronto site last summer. 

While the review was against closing the sites, the provincial government said it intends to focus on treatment options. 

About $378 million in funding will go to 19 HART Hubs across the province. Marra called that a "considerable" investment per hub. Ten locations will be brand new, while nine will replace existing CTS sites. 

In preparing HDGH's proposal, Marra said two dozen local service providers were found to already be working in the areas of homelessness, housing, treatment, and recovery. HDGH is researching how those service providers can be augmented.

Marra said he's confident Windsor's proposal will be on the province's discussion table.

"The fact that we were on our way with a … safe consumption site, and it was closed — I think we were identified as a community that has a need for services," Marra said.

Marra noted that he has spoken with both Windsor Mayor Drew Dilkens and Essex County Warden Hilda MacDonald about a regional HART Hub. 

"The other reason why I have a lot of confidence in our community: We have outstanding partners. We really have our act together… We have a regional approach, a regional focus, (and) great service providers."

Marra said the new model should help address gaps in the system — such as the wait time for a treatment bed after a person enters withdrawal management services at HDGH.

"That's what we need to mitigate, because there's a lot of risk associated with that. How do we support that individual while they're waiting for a bed, or how do we get them to a treatment bed a lot quicker."

HDGH has already looked at possible locations for a HART Hub, but Marra said he does not wish to make those locations public just yet.

But Marra offered that a regional HART Hub is unlikely to be a single address — instead resembling a "spoke wheel."

Marra added that the provincial funding is meant for operational purposes. Little capital funding is available, the location will involve existing buildings.

But, he noted that there is very little capital funding available — the money is operational, so they're looking at existing buildings. 

According to Marra, the HART Hub should be "very complementary" to the city's plans to establish its own Homelessness and Housing Help Hub (H4).

Andrew Daher, the city's commissioner of health and  human services, said the combined efforts of a HART Hub and the city's H4 should better enable individuals experiencing homelessness to "get off the street" and enter treatment — if they're ready for it.

If HDGH's application is successful, a Windsor-Essex HART Hub will begin operating on a three-year pilot program.

Marra said HDGH will work to show that the model should become permanent.

"It might look different in three years … but (we'll) at least establish the foundational piece that a HART Hub should be a permanent investment. Because personally, I don't see any of these issues going away anytime soon," Marra said.

"And ultimately, it's a healthcare issue — and healthcare needs to evolve with the needs of the community."

The province's deadline for HART Hub applications is Oct. 18.

Ontario's Ministry of Health has expressed that HART Hubs should be operational by the winter of 2025.