The nexus of substance use, homelessness, and mental health is impacting all Boston residents. Nowhere is that more evident than at Massachusetts Avenue and Melnea Cass Boulevard, a crisis that has worsened over the years. The city needs a visionary leader and an actionable plan in order to address the current situation that is endangering lives and impacting quality of life throughout Boston. As a resident near Massachusetts Avenue, an ER physician at Boston Medical Center, and as the local state representative, Jon is best prepared and wholly focused on making sure that Boston remains a leader in substance use treatment and homeless services while improving quality of life for everyone.

As a state representative, Jon has secured millions of dollars in state funding directed to Boston and substance use disorder providers; organized multiple community forums to engage, educate, and increase awareness among local residents; authored legislation to (1) address the lack of specific substance use disorder services in the continuum of care; (2) increase physician awareness of, and willingness to prescribe, medication-assisted treatment for opioid use; and (3) expand access for patients seeking dual-diagnosis treatment. Jon has also co-sponsored legislation to divert non-violent drug offenders into treatment and not jail.

Upon taking office, Jon will immediately direct the Boston Public Health Commission to declare a public health emergency at Mass and Cass, allowing the Boston Public Health Commission to dramatically scale up resources and staffing to respond to the mental health, homelessness, and substance use crisis.

As Jon scales up resources, he will appoint a Mass and Cass Director of Services to coordinate efforts while partnering with public and private stakeholders to ensure the community’s voice is heard. As mayor, Jon will:

1. Decentralize, Regionalize, and Modernize: Our services and current approach haven’t caught up to today’s reality. At Mass and Cass, homelessness is associated with unprecedented levels of addiction, often coupled with mental illness and trauma. Boston has increasingly become the de facto service provider for the entire region, with 60% of our shelter guests not from Boston. We must re-envision homeless services in Boston and regionally, under a new model that is housing-first focused, decentralized, and attuned to today’s realities. As mayor, Jon will:
   
   • Decentralize and regionalize the Boston-area shelter infrastructure. The concentration of substance use and homelessness services has resulted in an untenable situation, creating challenges to service delivery while creating an atmosphere rife with violence and persistent drug use. Decentralizing services to an accessible Long Island Recovery Campus and increasing supportive housing at the Shattuck Campus is necessary. On Long Island, Jon will focus on public-private partnerships that will not only offer services, but will be filled with educational and training opportunities. Jon aims to build a robust, state-of-the-art recovery campus that will be the envy of the country not only by offering treatment, but by developing a workforce and better ways to treat addiction and mental health illness. As mayor, Jon will also explore mechanisms to permanently acquire recently vacated hotel buildings and repurpose them to provide supportive housing. Many of the properties currently in use or potentially available are located outside Boston and will serve to decentralize homeless services.
     

• Shift our homeless services model away from traditional large shelters and toward supportive housing opportunities in which people receive wrap-around services to address addiction, mental health as well as other social services.
  
• Establish a Regional Municipal Task Force made up of municipal leaders to facilitate a regional approach to substance use disorder and homeless issues. The task force will aim to create coordinated and efficient care by streamlining regional services and eliminating regional gaps in treatment.
  
• Expand “low threshold spaces”, indoor and outdoor facilities where people can access basic services, seek medical treatment, and be referred for additional services.

2. Retool and expand Boston’s substance use disorder efforts, with services and strategies proven to promote recovery and reduce deaths. Major strides have been made to decrease the rate of opioid overdose in the Commonwealth over the last 5 years. However, there has been a resurgence due to COVID-19. Investing in and planning a comprehensive response is crucial in order to address the concerning rise. The increased role of polysubstance use has complicated the situation as methamphetamine use poses additional challenges. As mayor, Jon will:
   

• Close gaps in the continuum of care. Currently, the availability of short-term recovery beds after detox are insufficient and can often leave those most vulnerable without treatment. In partnership with the state and private providers, Jon will work to expand services, particularly short-term residential programs that are needed the most. Establishing a recovery campus on Long Island and increasing services at the Shattuck Campus will also add capacity to the continuum of care.
  

• Implement a “super-utilizer” strategy with partner organizations to identify those people most at-risk for relapse and provide intensive and comprehensive services.
  
• Provide community-focused and accessible substance use disorder services. We need to meet people where they are at. Utilizing mobile van-based services that offer preventive care, treatment, and referrals to services throughout the city will expand care. This includes expanding access to medication-assisted treatment (MAT) at community-based health centers. MAT is the use of FDA-approved medications, such as buprenorphine (e.g., Suboxone), naltrexone (e.g., Vivitrol), and methadone, in conjunction with behavioral counseling, to treat opioid addiction and help people stay in recovery.
  
• Develop pathways to assess and treat the rise of methamphetamine and polysubstance use. There has been a significant increase in the use of methamphetamines across the city and specifically at Mass and Cass, resulting in more complicated health outcomes and public safety issues. However, there are very limited options when it comes to treating methamphetamine and other types of polysubstance use. Jon will partner with leading academic medical centers and community-based health centers to establish treatment protocols and programs.
  
• Expand dual-diagnosis treatment and programming. Jon will invest in and expand dual-diagnosis services to address the worsening mental health crisis and its relationship with substance use disorder and homelessness.

3. Improve quality of life at Mass and Cass for all. End unsafe and inhumane conditions that adversely impact those seeking recovery, neighborhoods, and the local businesses community. The concentration of services and shelters in the small area has led to conditions that have had the unintended consequence of endangering people’s pathway to recovery while disrupting the lives of residents and surrounding businesses. As Mayor, Jon will:
   

• Immediately direct the Boston Public Health Commission to declare a public health emergency at Mass and Cass, allowing for the dramatic scale up of resources and staffing to respond to the mental health, homelessness, and substance use crisis. A declared public health emergency will result in increased funding from the state and federal government.
  
• Institute an immediate moratorium on siting of new public homeless and addiction services within a one-mile radius of Mass and Cass. Without question, Boston needs more services, not fewer, but the pattern in which these default to Boston and the Mass and Cass area has led to an untenable and unhealthy environment. Jon will set a 5-year goal of reducing the number of shelter beds at Mass and Cass and the surrounding area to its census prior to the closure of Long Island. This will be achieved by overhauling the homeless service model toward smaller, long term supportive housing programming and moving away from the traditional, large scale shelter model that has proven unsafe in the era of COVID.
  
• Develop rapid response and intervention teams able to respond in real time to people in medical distress, encampments, mental health crises, and other emergencies. These teams will consist of a varying city staff with specialized skills in mental health counseling, rapid rehousing, and medical skills, including substance use disorder treatment.
  
• Create a specific Mass and Cass police sub-district to curb drug dealing and better respond to violent crime. We must recognize that addiction is a disease, not a crime. Any non-violent drug arrest should primarily be met with access to treatment and supportive care. However, we must ensure that those seeking to harm vulnerable residents through drug dealing or violence be addressed with an appropriate response. Jon will better coordinate multiple police and public safety forces in the area by creating a special Boston Police Department (BPD) sub-district specifically responsible for Mass and Cass (an area currently divided up among three different BPD districts).
  

• Improve quality of life and dignity for all people in the area and local businesses. As a resident of the area, Jon has experienced the daily difficulties of living near Mass Ave, including picking up needles, witnessing countless overdoses, and indecent acts. Jon will increase basic city services to address issues related to needles, waste, and trash. For example, Jon will bolster the existing public-private partnership program that has effectively reduced the amount of discarded used needles by incentivizing needle collection.
  
• Work with the Newmarket Business Association to swiftly create a Business Improvement District to establish a geographic area where business owners can organize, finance, and create additional services to support the local business community at Mass and Cass.