CITY OF VICTORIA For the Meeting of To: Committee of the Whole Date: August 18,2016 From: Subject: Paul Bruce, Fire Chief RECOMMENDATION That Council receive this report for information relating to the Hoarding Education and Action Team (H.E.A.T). EXECUTIVE SUMMARY Reports of hoarding are received through various methods including emails, phone calls, walk-in reports to the Fire Department, fire crews attending residences or occupancies for unrelated matters but primarily through the H.E.A.T phone line. The H.E.A.T. phone line is hosted by the City of Victoria Fire Department and the voicemail box is monitored regularly by staff. This phone line is accessed for various purposes including general inquiries into the disorder, services provided through H.E.A.T., seeking information on peer support, how to help an individual, the risks associated with hoarding, as well as the reporting of a potential hoarding concern. The phone line is not only accessed by citizens in the Greater Victoria Area, but a resource for residents throughout Vancouver Island, as these services are in coordination and collaboration with Island Health. Reports of issues related to hoarding are received from landlords, friends, family, neighbours, or other through other social or commercial agencies. The incoming calls to this hotline have increased to 161 calls in 2015. Victoria Fire Department staff hours dedicated to hoarding has increased from approximately 94 hours in 2014 to over 127 hours in 2015. As a result of the program and included in the hours related to 2015, 65 separate hoarding events were identified. To date, in 2016, 22 cases of hoarding have been identified in the City of Victoria. In addition to monitoring phone lines, interviews, site visits, attending H.E.A.T meetings, and contributing to the organization of the team, a hoarding training seminar is currently in the process of creation. These seminars are planned for presentation in collaboration with Island Health and are intended to be presented to staff in various housing societies. The inclusion of City of Victoria staff in this program was the result of preliminary discussion with partnering agencies on how to best address the issues and potential dangers of hoarding, in the absence of any direct funding or allocated resources. Staff recognized a need to include fundamental assessment of the issue and, established a phone line to enable and determine the extent and scope of the issue(s) through review of the metrics as they related to inclusion in a more vigorous management or servicing strategy. Page 1 of 5
PURPOSE The purpose of this report is to provide Council with updated information relating to the services associated with the. BACKGROUND The w.as created in 2012 to provide a unified network to support the increasing reports of hoarding activities in our communities. The recognition and awareness of hoarding has increased over the last several years. The program foundation was created through collaborative contributions of staff of the City of Victoria, Island Health Services, concerned non-profit groups, for-profit landlords, volunteers, and de-cluttering services. The intent was to bring together interested parties and formulate the identification of a "resource" list. This enabled H.E.A.T to create a flow chart to define the best solutions to assist those exhibiting hoarding tendencies and potentially increase safety for themselves, first responders and neighbours. The core operators of the program today are the Victoria Fire Department, Saanich Fire Department, and Island Health. The access to this support network was enhanced through the information made available on the City of Victoria and Island Health websites and the creation of the H.E.A.T phone line, hosted and monitored at the City of Victoria Fire Department Current Statistics: Number of incoming calls to H.E.A.T phone line: 2014 = 57 (April to December) 2015 = 163 2016 = 108 (January to end of July) Numbers of hours Prevention Officers have dedicated to H.E.A.T related files and work (approximate): 2014 = 94. 2015 = 127 2016 = 65 (January to end of July) Number of confirmed cases in City of Victoria: 2015 = 24 2016 = 22 (January to end of July) ISSUES & ANALYSIS Opportunities for Enhancement The provision of services to support H.E.A.T. include: City of Victoria: Fire Prevention Officer- H.E.A.T meetings and site visits Monitoring the H.E.A.T hotline for Vancouver Island Provision of information to callers Collection of information and distribution of hoarding reports to the appropriate jurisdiction Page 2 of 5
H.E.A.T. phone line and voicemail Hoarding information on City of Victoria website Effective public messaging through Citizen Engagement staff and Island Health Vancouver Island Health: Karen Wysiecki - Oversees the team, takes minutes, agenda, IT and risk assessment Dr. Eric Ochs (Registered Psychologist) Facilitation of the peer-led hoarding group until an adequate peer leader can step up and take over the group Island Health Clinicians Facilitation of Peer led hoarding support group Meeting Facility "Buried in Treasures" Workbook Hoarding page on the Island Health Website Delivery of informative workshops when requested to housing agencies and in home care support workers The majority of the residents, which have been visited in the City of Victoria through this process have limited incomes, physical impairments, and may have other mental health issues. These circumstances impact the reduction of clutter in two ways. The first is the availability and accessibility of therapy and the second, is the removal and disposal of clutter. If the client is already in the Island Health system there may be support already in place, if not, there are limited options. The team has worked collectively to provide two fundamental management solutions. The first phase was to support individuals with a hoarding disorder where treatment and care will be through a longer term process. To provide an initial form of therapy and support to individuals, H.E.A.T. established a "drop in" hoarding peer support group, which is facilitated by Dr. Eric Ochs, a registered psychologist. In his role, he does not provide any therapy or counselling services. The purpose of his involvement is to facilitate meetings until such a time as an adequate peer leader is able to take over the group. The intent of the peer led sessions is to share stories of success, challenges, and methods to effectively deal with the associated emotional and physical challenges of hoarding. Included in this program is a workbook titled "Buried in Treasures" which, attendees progress through as a tool for their development. There is a core group of individuals who attend these sessions regularly and have provided very positive feedback. In April of 2016, demand from attendees resulted in the scheduling of an additional meeting each month which is facilitated by a student of Dr. Ochs. This peer led group meets every second and fourth Wednesday of the month at the Royal Jubilee Hospital. The support and information for this group are provided through regular contact with Dr. Ochs. The second and potentially most important stage in the process, is the reduction of clutter which has proven challenging on several fronts. Most clients in this process have limited funds to cover costs associated with the reduction and disposal of clutter. There are also limited companies who will work with extreme clutter cases. There are companies, which specialize in this area, but their fees are up to twice the cost of a regular cleaning company and may not include disposal. All of these companies would also require sensitivity training prior to interaction with clients. To assist with decluttering for clients with limited financial resources, the program has been dependent on volunteer services. For the past few years, a volunteer group from a local community church has assisted in the region with moving boxes, organizing, and cleaning. This group was provided sensitivity training from the Island Health Clinician. The use of volunteer services has been limited to residences with no associated hazards. Volunteers have been integral to the success of this program but the uncluttering process is very overwhelming and one Page 3 of 5
must be aware of the potential burnout. As this is the case, volunteers were used sparingly. On a few occasions, City of Victoria Public Works has provided a bin to dispose of some refuse items. Towards the end of 2015, the volunteer group that was providing this invaluable service decided to help the community through another venue and we no longer have volunteer services at this time. Having lost the volunteers, members of H.E.A.T have had to look into the community for other alternatives that may be affordable for lower income households. Starting this year, the Kool Aid Casual Labour Pool has been utilized for some cases with initial positive results. To enhance safety awareness, BC HAZMAT has offered to provide free training for volunteers and other workers on hazard recognition and actions to take to protect themselves. They have also included the use of their facility to host training session. This program is under development and once completed, will allow H.E.A.T to film the safety presentation to provide to future workers. H.E.A.T has made many advancements since its inception, including increased awareness and understanding through access to information on the City and Island Health websites, public education sessions and the H.E.A.T hotline. This increased access to information has benefited the general public as well as citizens in need of hoarding support. Before the inception of H.E.A.T, there was limited access to information relating to hoarding or support at an accessible local level. H.E.A.T plans to continue increased public awareness of hoarding through the City and Island Health website. The implementation of seminars for housing societies will provide an increased understanding and awareness of issues they may encounter in their "day-to-day" operations. These seminars could be expanded to include first responders, building officials or any others who may request or benefit from it. As not all people are computer literate or have regular access to a computer, the development of a brochure on clutter and, assistance the H.E.A.T, could be provided and made available in community centers and housing complexes. To ensure stability of the phone lines, an additional staff resource is undergoing training to monitor the H.E.A.T phone line, respond to callers and make referrals. The primary challenge of H.E.A.T at this point, is the inability to effectively assist residents in need of decluttering services without the use of the Kool Aid Casual Labour Pool. Some of these cases are simply beyond the ability of these workers and require specially trained personnel. Island Health staff provide their assistance within the scope of their positions as psychologists and clinicians. The structure of this program operates without any identified budget or funding, outside of the allowance of staff to monitor the H.E.A.T. phone line. During this stage, staff collects information and distributes reports to the appropriate jurisdictions to schedule onsite visits. Support from the City of Victoria includes the provision of a dedicated phone line and voicemail account for the H.E.A.T. contact "voicemail", and the creation of a hoarding information page on City of Victoria website. These contributions have been essential to the program. OPTIONS & IMPACTS 2015-2018 Strategic Plan This program involves the following objectives of Council's Strategic Plan: 1. Innovate and Lead 2. Engage and Empower the Community Page 4 of 5
3. (7) Facilitate Social Inclusion and Community Wellness 4. (12) Plan for Emergencies including Climate Change; short and long term Impacts to Financial Plan: On average, approximately 9.75 hours/month of staff time are dedicated to this program. Additionally, a dedicated phone line w/voicemail is established. Estimated monthly expenditures: $475.00 (2016) Funding for this service is presently accommodated through the operational budget assigned to the Fire Department. Official Community Plan Consistency Statement Section 15- Community Well Being CONCLUSIONS The H.E.A.T is providing a valuable and important aspect to community wellness and inclusiveness at different levels and through differing strategies. Importantly, the identification of hoarding as a mental disability and potentially a symptom of another disorder signifies the requirement for fundamental assessment and possibly issues relating to social inclusion. The creation of the team, in the absence of detailed resource allocation, indicates the operational level of awareness and the dedication to assistance, staff have either directly or indirectly experienced in their employment duties. The initial implementation for phone line support, internet awareness and effective peer counselling are important as a baseline program to maintain a focus on this particular disorder. Staff can maintain the present level of servicing to this program with minimal operational impact and will continue to monitor and report to Council the metrics included in the quarterly reporting. Paul Brdoe Fire Chief Report accepted and recommended by the City Manager: Date: Page 5 of 5