B.C.’s addiction treatment laws in bad need ofafix
The holes in British Columbia’s addictions treatment regulation and enforcement regime are on full display in a neighbourhood drama playing out in Osoyoos.
Michelle Jansen and her son Nicholas plan to open a treatment centre there in a residential neighbourhood — one of four planned for the Okanagan.
Each is called the Brandon Jansen Memorial Recovery Centre in honour of Michelle’s son Brandon, who died of a drug overdose two years ago in the Sunshine Coast Health Centre in Powell River, where he was being treated for opioid addiction. It was his 12th treatment centre in three years.
Based on what Michelle learned from that experience, coupled with Nicholas’s own addiction problems, they set up the Brandon Jansen Foundation to run treatment and recovery homes.
The Community Care and Assisted Living Act requires centres with more than two residents to be registered. Failure to register can result in a fine of up to $10,000 for operating unlawfully. It also requires supportive housing to be licensed and inspected by the health authorities.
Neither the Brandon Jansen Foundation nor the Brandon Jansen Memorial Recovery Centre is on the assisted living registry. Neither is licensed by Interior Health.
The foundation’s application to Interior Health was rejected in November.
“The application was assessed and it was determined the proposed services did not meet the threshold for a residential care license,” Aaron Miller, Interior Health’s corporate director of population health, wrote in an email. “The applicant was encouraged to consult with the Assisted Living Registry.”
The foundation didn’t apply for registration.
By then, Jansen said in an interview, plans for 10- to 12-bed centre in Penticton had fallen through after neighbours purchased the property.
Another undisclosed site was found and is operating. It has three residents, according to Jansen. Because it has fewer than six residents, she doesn’t believe that it needs to be either licensed, or registered.
What’s holding back the Osoyoos home is zoning. But Jansen said she’s been working hard with the town administrators to have the zoning bylaw amended to allow supportive housing in residential neighbourhoods. That amendment will be dealt with at a public meeting Monday.
Jansen doesn’t plan to attend. But Lyle and Margaret Warmington will be there.
The Warmingtons live next door to the proposed treatment centre, and have first-hand experience with grief and addiction.
Their son, Gerry Graham, committed suicide in 2012. In his last note, Graham wrote that he’d been neglected by the system, that the care that he received for his addictions and mental illness wasn’t good enough for him to help him heal.
Reached by telephone, Lyle Warmington declined to comment.
But he did write a letter to council. In it, he asked that it delay its decision either until after the B.C. government has implemented provincial standards for addictions treatment and evidence-related treatment procedures, or until after the town completes an official community plan.
Last week, one of the recommendations of the coroner’s death panel review into illicit drug overdose deaths was better regulation, evaluation and monitoring of both public and private treatment facilities and services by September 2019.
Recovery centres, it said, are “generally not licensed but are required to register if they offer three or more beds. These homes are often short-lived business operations in rented housing.”
Marshall Smith, chairman of the B.C. Council for Recovery Excellence, agrees that there ought to be better regulation.
“If you were doing unlicensed dentistry in your basement, the cops would be at your door,” he said.
“You’d be handcuffed and perpwalked. The cops would say it’s because you’re hurting people. So why is the response different for unlicensed treatment centre operators?”
But until that changes, Smith said robust enforcement of the existing legislation is urgently needed.
The assisted living registrar (a.k.a. the assistant deputy health minister) already has the authority to enter and inspect both assisted living residences and their records. The registrar has the power to fine operators of unregistered residences up to $10,000.
Regional medical health officers are responsible for issuing licences to registered residences and can attach terms and conditions related to policies and standards of practice. They are, however, forbidden from issuing a licence unless the applicant “has the training, experience and other qualifications required under the regulations” and agrees to provide financial and other relevant records.
Beyond that, municipalities regulate through zoning and business licences.
No one can remember when the government ever fined an unregistered operator. What people might remember is a Surrey mom murdered four years ago outside a hockey arena by a man who lived in an unlicensed home.
At the time, an estimated 250 of them were operating in Surrey alone. After a concerted effort, the city got that number down to 50 registered houses and 20 unlicensed ones by 2016.
Jansen is swift to differentiate her unlicensed centres. Hers, she said, will have bespoke treatment including group and private counselling, holistic therapies, 24-hour security and frequent drug testing of residents.
In fact, Jansen said she’d welcome tougher regulations.
“Unregulated centres,” she said. “It has to change. It’s killing people.”
It should give Osoyoos council and other municipalities pause. Yes, there’s a desperate need for addictions treatment. But the quality of the care and services is at least as important as the quantity of the beds.