City limited in how it oversees the kind of care home Attila Csanyi was evicted from, inquest hears

Despite subsidizing their tenancies, the City of Hamilton has little input when it comes to ensuring vulnerable individuals' needs are met in residential-care facilities, the inquest into Attila Csanyi's death heard Wednesday. 

The inquest heard Wednesday about the City of Hamilton's role in pairing people with residential-care facilities (RCFs) and overseeing those homes.

A senior city manager described his department's role as "triage and referral," stating that if a resident whose bed is subsidized left or was evicted, the city would not necessarily be notified why or where they went. 

Csanyi lived in an RCF in downtown Hamilton from about November 2019 to March 2020, when he was evicted. The 28-year-old died of an overdose at Hamilton's Jackson Square mall on May 2, 2020.

The inquest seeks to prevent similar deaths and is expected to last up to three weeks. It features a five-member jury who will hear from Csanyi's family, experts and witnesses including from the city, police and health-care providers. They may make recommendations in the end.

Testimony focused on Hamilton's role in residential-care facilities

On Wednesday, lawyers for the inquest, Csanyi family, and other parties involved questioned Rob Mastroianni, the City of Hamilton's manager of emergency services, and Jane Murrell, a city supervisor of health hazards. Inquest counsel Jai Dhar asked the two about their teams' respective roles when it comes to residential-care facilities. 

Mastroianni said his department acts as a "liaison" between people in emergency situations and prospective RCFs. He said the city provides subsidies for people in need, such as those experiencing homelessness, to have beds in RCFs. That subsidy is currently about $65 per day, he said, but was about $52 per day when Csanyi was living in one. 

Comprehensively assessing someone's needs is the responsibility of other government bodies such as the Ministry of Health that the city collaborates with, Mastroianni said. He also said RCFs share limited information with his team. In response to questions from Csanyi family lawyer Merima Menzildzic, Mastroianni said an eviction would prompt notice that a subsidized resident had left, but not necessarily explain why or where they went. 

He described the subsidized RCF beds as an "outflow destination for people experiencing a homelessness crisis," and noted Hamilton plans to reevaluate its RCF funding in the coming years, saying plans to do so several years ago were delayed due to the pandemic.   

Murrell described her department as ensuring homes follow the city's rules and regulations under Schedule 20 of Hamilton's licensing bylaw. She said they are not responsible for determining if an RCF is equipped to meet their residents' needs. 

The most common complaints her team deals with are about food and pests, she said, adding that the city works with homes to get them up to standard and that it would be rare for an inspection to lead to a closure. "We've never really closed one down."

On its open data portal, Hamilton lists 69 licensed RCFs in the city. The inquest heard most RCFs in the city are privately operated, and roughly 30 RCFs are retirement homes geared toward seniors. 

Family lawyer asks about possible changes to RCFs

Up until now, much of the inquest has been focused on Csanyi's time at the RCF, called Sampaguita Lodge and Rest Home. While there, he hoarded, used drugs, threatened staff and assaulted residents, the owner of the home, and a person who worked there at the time told the inquest last week. However, lawyers raised questions about whether the home documented or reported those alleged issues. 

The inquest also heard Csanyi was improperly evicted from the home with the manager, Amy Acierto, saying she kicked him out without going through Ontario's Landlord and Tenant Board. He was evicted on March 11, 2020, the day the World Health Organization declared COVID-19 a pandemic.

The inquest heard he stayed at the Salvation Army shelter downtown before leaving on May 2, the night he died. 

On Tuesday, Csanyi's social worker Brittany Horodecki contradicted what Sampaguita staffer April Lay told the inquiry, saying the home never told her about Csanyi allegedly threatening staff or using drugs in his room.

Last week, the inquest heard a doctor with expertise in homelessness, who said living unhoused halves one's life expectancy. Csanyi's twin brother Richard and father Alex Geczi told the inquest about Csanyi's difficult and traumatic childhood. 

A psychiatrist who treated Csyani said he had severe schizophrenia and would have fared better if he had his own room. He said schizophrenia lowers one's life expectancy and added that his team loses five or six patients per year, including one who died of an overdose following an eviction a few weeks ago. 

On Wednesday, Menzildzic asked Mastroianni if the city could or would push for changes in RCFs to make care more responsive to individuals' needs. 

"We're always interested in that and exploring that and advocating for that," Mastroianni said, adding that although he believes needs in the city have increased, Hamilton must work with other levels of government to make big changes.

The inquest continues Thursday and is publicly streamed online. Upcoming witnesses include members of the Hamilton Police Service and a McMaster University researcher.