Long before the COVID-19 pandemic upended life across the City, many Bostonians were already dealing with a public health tragedy: the convergence of mental and behavioral health, homelessness, and substance use disorder crises at the intersection of Mass Ave and Melnea Cass Blvd (Mass & Cass). Tackling this head-on is one of Boston’s greatest challenges — it is untenable for the people who spend time there, the residents living and working there, and the businesses in the area.
Andrea knows this area well, growing up just blocks away in Roxbury and the South End. She understands that the challenges at Mass & Cass are complex and have developed over many years — which means solutions must be multifaceted and results can not be achieved overnight. Andrea deeply respects the Mass & Cass Task Force and Boston’s leaders from the community, non-profit, public and private sectors who continue to work on this tirelessly. Many have advocated for decentralization of services throughout the City, increased investment from the Greater Boston region, and improved health and safety protocols.
However, violence and tragedy continue. The Massachusetts Department of Public Health reports over 8,150 opioid-related EMS incidents in Boston from 2018 through the first half of 2020 and over 900 people dying of opioid-related overdoses from 2015 through 2019. Andrea has partnered with the community and public health and public safety experts to develop a comprehensive response: she met with civic resident leaders in September 2020 and subsequently offered recommendations to Mayor Walsh and Governor Charlie Baker, participated in a dedicated City Council hearing in November 2020, and has continued to engage community leaders since.
Building on this ground-up process, Andrea will nimbly deploy the City’s assets toward both short and long term solutions, decentralize services, help struggling Bostonians get on a sustainable path to shelter and recovery, and restore health and safety to residents living in the area.
How did we get here?
Boston has faced chronic homelessness and behavioral and mental health challenges for years, the national opioid crisis that intensified beginning in 2013, and the loss of a critical local center of social services in 2014 when the Long Island Bridge was destroyed. Long Island is Boston’s largest harbor island and a site for social service delivery for decades; hundreds of residents accessed it daily via bus from Boston through Quincy and over the Long Island Bridge. Originally built in 1951, the bridge was deemed unfit in 2014, transportation to the Island was abruptly terminated, and residents were displaced. Boston announced plans to rebuild the bridge in 2018 and was quickly ensnared in legal battles with Quincy, where many fervently oppose the reconstruction. These legal battles continue — ensuring the bridge will not be rebuilt for years.
Meanwhile, the needs in Boston were growing and displaced residents sought services they had previously received on the Island, which became concentrated at Mass & Cass. Many individuals seeking treatment come to the area from surrounding municipalities, adding yet another layer of complication as Boston is a regional hub and bears a disproportionate burden of the state’s opioid crisis. Mass & Cass has devolved into an encampment, open-air drug market, and center of violence, right in the middle of asset-rich Boston. These dynamics do not serve residents engaged in substance use or seeking treatment with dignity, and also understandably frustrate residents from surrounding Roxbury, South End, South Boston, Dorchester, and Newmarket Square neighborhoods. In the last several years, they have experienced everything from human waste and needles on sidewalks to overdoses to violence, and can no longer use the community’s parks and playgrounds, or feel safe walking children to school. Small businesses in the area have also been impacted, and there are numerous vacant storefronts along Mass. Ave. All of this was only exacerbated by COVID-19.
Yet at the same time, Long Island sits vacant — it has gone unutilized since 2014, while conditions in Boston have continued to worsen. The lack of regional coordination and sustainable, cohesive funding for programming, lack of supportive housing, and additional complexities brought on by the pandemic combined to create an unacceptable situation at Mass & Cass — one that demands courageous and inclusive leadership, urgency, and ingenuity in response.
As Mayor, Andrea Will:
Appoint A Mass & Cass Chief
This is a public health crisis that demands singular focus. Andrea will appoint a Mass & Cass Chief to drive a coordinated team and decentralize services by providing access to shelter, treatment, and permanent supportive housing. With the mandate to purposefully develop and drive an urgent, innovative, and sustainable decentralizing process, the Chief will report directly to the Mayor and coordinate with all relevant city and state secretariats, including Public Health, Public Safety, Housing and Economic Development, and others, to ensure the necessary data utilization, information sharing, and cohesive oversight. The Chief will also partner with civic resident leaders, clinicians and community health workers, and private sector leaders to increase capacity and implement a fulsome response that is well-integrated throughout the community and service provision network. Importantly, a “one size fits all” approach will not be successful in serving impacted residents — an empowered leader can instead work to coordinate resources and provide a range of targeted solutions to the various specific problems underlying this public health emergency, with a focus on both immediate actions and longer-term systemic change.
- Create more safe spaces. Boston has been able to quickly activate several underutilized spaces to care for those impacted by the COVID-19 pandemic and some have been extended to our homeless population, including Boston HOPE. Under Andrea’s leadership, similar low barrier spaces, including city-owned locations, will be provided to individuals impacted by homelessness, behavioral health, and substance use disorder with as much urgency and expediency. Throughout the City, Andrea will work to create additional shelter and supportive housing through hotels or other vacant spaces, in partnership with the state, local healthcare community, social services providers, and others; this will require creativity, commitment, and partnership. Andrea will also consider non-traditional approaches and best practices from other cities that have had success and advocate for sustainable funding sources to make this possible. She will partner with anchor institutions to activate adjacent vacant commercial spaces on Mass. Ave to bring greater safety resources, triage, and service expansion to the area. These spaces must be activated in a coordinated response from the City, utilizing incentives to re-establish the foundation of a local small business community.
- Increase treatment locations. Decentralizing services is not only about equity, it is also necessary for effective recovery: individuals at various points in the recovery process find it unspeakably hard to get sober when widespread use areas are right next to recovery services. Those in early recovery and in local programs are vulnerable and negatively impacted because they have to go through the crowds of people at Mass & Cass to access care at Boston Medical Center (BMC) or Boston Health Care For the Homeless. Substance Use Disorder (SUD) is a complex problem and providers need more capacity to stabilize and effectively serve suffering Bostonians. Andrea will partner with the healthcare community to further scale syringe exchange and overdose prevention sites around the city, including mobile teams that can rotate across sites as BMC does. Boston benefits from a robust network of Community Health Centers that are well-positioned to provide treatment in various locations throughout the City, and Andrea will ensure they have the resources they need to be part of decentralization as well. Healthcare institutions can also provide PPE, infection control, and critical triage services at greater scale. For those with acute SUD, a treatment facility in Boston is necessary to engage patients who are experiencing both homelessness and SUD and are not able to access standard pathways into the treatment continuum.
- Develop permanent supportive housing. In addition to short term solutions, Andrea will prioritize increasing access and connectivity to long term treatment and housing supports. One of the key long term solutions is supportive housing, which provides wrap-around services and supports our residents need to be able to live full lives. To make this a reality, Andrea will partner with existing housing facilities and healthcare providers who can enhance onsite services, and she will identify and fund new spaces for development of dedicated permanent supportive housing. She will also work with the courts, including directly coordinating with the Boston Municipal Court and Trial Court’s Probation Department and special services sessions to ensure that the Commonwealth’s efforts to find housing, wrap-around services and other placements for Boston-based defendants is more seamless and consistent.
- Measure progress. City Hall currently collects and publishes relevant data; Andrea would enhance this and hold leadership accountable to specific objectives. First, she will conduct a sufficiency review to determine if there are gaps in data or relevant context that could provide critical linkages in implementing solutions. The review would create a more transparent, reliable, and current baseline from which progress can be measured. Measures would include clear evidence of decentralization of services throughout the City, including units of supportive housing, dispersion of methadone clinics and needle exchanges; decreased homelessness, overdoses, and incidents of crime at Mass & Cass; and improved public health and public safety for all impacted residents. Andrea will use this data to establish initial and year-over-year goals and inform evidence-based policy and practice, and review it annually with input from independent experts. Longer term, Andrea will leverage this process as a scalable model for other targeted areas across the city facing complex problems.
Establish A Dedicated Mass & Cass First Responder Unit
Mass & Cass is located at the intersection of numerous legal jurisdictions/police districts, further complicating the environment and how public safety matters are handled. Andrea will align all the relevant stakeholders and execute a plan to reduce violence, deploy first responders equipped to address specific resident needs, and improve public safety.
- Streamline first responder services to close jurisdictional gaps. Mass & Cass lies at the intersection of three Boston Police districts and in the direct vicinity of numerous public, quasi-public, institutional, and private first responder districts, including Boston Public Health Commission, Boston Police Department, Massachusetts State Police, MBTA, Boston University, BMC, Boston Housing Authority, City of Boston Municipal Security, and the Suffolk County Sheriff’s Department. This creates significant challenges for emergency response, service parity, information sharing, and general coordination of efforts. A dedicated first responder sub-district will streamline response efforts and better protect people living and working in the neighborhood, service providers working in the area, and vulnerable residents spending time at the intersection.
- Deploy Boston’s leaders. We have a cadre of professionals across public safety, mental health, and recovery working hard to address substance use disorder and homelessness and whom we can call upon to serve in an integrated and dedicated way — and this public health crisis demands it. These selfless, dedicated, and well-trained public servants — including mental health counselors, recovery specialists, and police officers — would work collaboratively, with Mayoral oversight and leadership, to de-escalate violence and provide residents streamlined access to available resources. Andrea will also deploy Community Health Workers as part of this solution, who are equipped to partner with residents and ensure they are connected to shelter, treatment, recovery, and healthcare services they need to get on a path to security, stability, and recovery. This response must draw on Boston’s robust network of first responders and service providers including culturally relevant, linguistically diverse, and trauma-informed services, which are critical to successful implementation.
Reactivate Long Island
Long Island offers a unique place for recovery and healing, but it has been unavailable to residents for seven years since the bridge was demolished. While the Walsh Administration committed over $100 million to a Recovery Campus there, entrenched legal battles and construction timelines mean a new bridge will not be operational for several years. Yet, ferries could run to Long Island much more quickly. While it would require investment, a ferry service could connect those in recovery to treatment, reactivate the unutilized buildings on the island, and alleviate pressure from Mass & Cass. Opponents dismiss ferries due to concerns about weather and emergencies, but comparable New England cities run ferries year-round, operate on-site infirmaries and use helicopters for medical emergencies in remote locations — Boston can deploy similar best practices. Andrea believes we must be both realistic and thoughtful and courageous and creative in putting new solutions to work. She will develop a plan, leverage our resources, and execute with urgency.
- Activate ferry infrastructure in the short term. The MBTA contracts with operators to provide a range of ferry services to islands throughout the Boston Harbor. Working in partnership with Boston’s transportation and logistics experts, Andrea will conduct a thorough economic and feasibility analysis of establishing connectivity between the City and Long Island via this existing infrastructure. She would then build a plan to implement it for the subset of residents who are seeking recovery services, have lower risk of needing acute medical care, and able to utilize this method of transit. This approach would accelerate access to services that residents desperately need now, while the long-term plan to rebuild the bridge continues. Andrea would secure funding for ferry boats, ensure access to adequate docks in both locations, identify ferry service operators and safety and medical staffing, acquire necessary licensing and insurance, and facilitate the workforce, vehicles, and funding necessary for transport to and from docks. Executed well, ferries could potentially be viable longer term and open up more productive dialogue with municipalities throughout the region, including Quincy.
- Prioritize retrofitting Long Island. The City has already determined that Long Island is an ideal site for recovery, and has been planning to utilize it for this long term purpose. However, while strategic planning is underway, we can accelerate reactivating at least some of the spaces — as Mayor, Andrea will fast track construction necessary to retrofit the Island and ensure adequate medical services are available there. Treatment providers for those seeking recovery services would need to be able to operate on the island and utilize ferry service for their needs, and these leaders will be engaged in the process. The infrastructure, including docks, roads, waste removal, and transportation capabilities would need to be readied — projects which could be initiated swiftly and provide high quality jobs for Boston residents.
In developing new, innovative solutions to one of our City’s greatest challenges, we must be clear-eyed about costs, feasibility, and implementation. We must also center our response in courage, compassion, and community and decisively move forward. Andrea will deploy the tremendous assets Boston has at its disposal to responsibly and effectively serve all Bostonians with dignity and respect.