TABLE OF CONTENTS

REPORTS OF THE STANDING COMMITTEES

AND OTHER COMMITTEES

As Considered by

The Council of the City of Toronto

on May 11 and 12, 1999

COMMUNITY AND NEIGHBOURHOOD SERVICES COMMITTEE

REPORT No. 5

1 Final Report on the Review of the Use of Motels for Homeless Families

2 Expansion of Hostel Services - Public Health Initiatives to Reduce the Spread of
Communicable Diseases,In Particular TB

3 Management of the Capital Revolving Fund for Affordable Housing

4 Change in Membership - Children and Youth Action Committee

5 Operational Review of Ontario Works and Child Care

6 Other Items Considered by the Committee

APPENDIX "A"

City of Toronto

REPORT No. 5

OF THE COMMUNITY AND NEIGHBOURHOOD SERVICES

COMMITTEE

(from its meeting on April 22, 1999,

submitted by Councillor Chris Korwin-Kuczynski, Chair)

As Considered by

The Council of the City of Toronto

on May 11 and 12, 1999

1

Final Report on the Review of the Use

of Motels for Homeless Families

(City Council on May 11 and 12, 1999, amended this Clause by deleting from Recommendation No. (1) embodied in the report dated April 8, 1999, from the Commissioner of Community and Neighbourhood Services, the words "contingent on provincial funding for replacement affordable housing units", and adding thereto the following:

"and that the Province of Ontario be requested to facilitate the phase-out of the use of motels by partnering with the City of Toronto in the planning and funding of a capital building program for emergency shelter facilities for homeless families.",

so that such recommendation shall now read as follows:

"(1) the Commissioner of Community and Neighbourhood Services develop a plan to phase-out the use of motels over a three to five year period and that the Province of Ontario be requested to facilitate the phase-out of the use of motels by partnering with the City of Toronto in the planning and funding of a capital building program for emergency shelter facilities for homeless families;".)

The Community and Neighbourhood Services Committee recommends the adoption of the report dated (April 8, 1999) from the Commissioner of Community and Neighbourhood Services, subject to amending Recommendation No. (8) by deleting the word "refugees" and inserting in lieu thereof the words "refugee claimants", so that such recommendation reads as follows:

"(8) the Chair of the Community and Neighbourhood Services Committee communicate with the federal Minister of Citizenship and Immigration to request federal funding for dedicated community-based settlement services to meet the need of refugee claimants entering emergency shelters along Kingston Road;".

The Community and Neighbourhood Services Committee reports, for the information of Council, having requested the Commissioner of Community and Neighbourhood Services to report to the Community Services Committee:

(a) in September 1999, providing a plan to implement the recommendations contained in the Final Report on the Review of the Use of Motels for Homeless Families; and

(b) on the amount of federal funding required to ensure appropriate settlement services for families accommodated in motels.

The Community and Neighbourhood Services Committee submits the following report (April 8, 1999) from the Commissioner of Community and Neighbourhood Services:

Purpose:

To provide the Community and Neighbourhood Services Committee with the findings and recommendations of the review of the use of motels for homeless families.

Funding Sources, Financial Implications and Impact Statement:

A phase-out of the use of motels over a three to five-year period is recommended contingent on provincial funding for replacement affordable housing. The cost to the City in capital and operating costs for new family shelter development is estimated at approximately $6.6 million per year over five years. Provincial funding for replacement affordable housing will be sought to support these efforts and to ensure that long-term responses to family homelessness are developed.

Recommendations:

It is recommended that:

(1) contingent on provincial funding for replacement affordable housing units, the Commissioner of Community and Neighbourhood Services develop a plan to phase-out the use of motels over a three to five-year period;

(2) the Chair of the Community and Neighbourhood Services Committee communicate with the provincial Minister of Municipal Affairs and Housing to request funding for affordable housing units as a replacement for the use of motels for homeless families;

(3) the Commissioner of Community and Neighbourhood Services report on an implementation plan to develop family shelter capacity on an equitable basis City-wide, and identify the planning tools required to make this goal a reality;

(4) to enhance accountability of the family shelter system, the Commissioner report on a plan to:

(a) establish standards for the use of motels as emergency shelter;

(b) develop a new process for the management and issuance of motel contracts, including consultation to respond to community interests; and

(c) dedicate appropriate staffing resources to monitor contracts with motel operators;

(5) Toronto Hostel Services, as part of its service planning, engage in ongoing consultation with:

(a) community reference groups and local Councillors about motel capacity and contract issues which affect the local community;

(b) a range of service providers to better co-ordinate services, improve service access, and enhance the quality of services available to homeless families;

(6) the Chair of the Community and Neighbourhood Services Committee immediately convene a meeting with the Chairs of the Toronto District School Board, the Toronto Catholic District School Board, the Steering Committee Reviewing the Use of Motels, and the Children's and Youth Advocate to address the need for additional resources in local schools and for co-ordinated service planning City-wide;

(7) the Chair of the Community and Neighbourhood Services Committee communicate with the provincial Minister of Community and Social Services to request provincial funding for children's counsellors in schools in the Wards of Scarborough Bluffs and Scarborough Highland Creek;

(8) the Chair of the Community and Neighbourhood Services Committee communicate with the federal Minister of Citizenship and Immigration to request federal funding for dedicated community-based settlement services to meet the need of refugees entering emergency shelters along Kingston Road;

(9) the Chair of the Community and Neighbourhood Services Committee communicate with the Settlement Directorate, Ontario Region, to request that the Settlement and Education Partnerships in Toronto program allocate funding to schools in the Wards of Scarborough Bluffs and Scarborough Highland Creek which reflects the level of need in those communities, and that eligibility for this program be assured for refugee claimant children;

(10) this report be forwarded to the provincial Minister of Municipal Affairs and Housing, the provincial Minister of Community and Social Services, the federal Minister of Citizenship and Immigration, the Chair of the Toronto District School Board, and the Chair of the Toronto Catholic District School Board; and

(11) the appropriate City officials be authorized and directed to take the necessary action to give effect thereto.

Council Reference/Background/History:

The Community and Neighbourhood Services report, "Review of the Use of Motels for Homeless Families" (May 19,1998), recommended a review of the practice of using motels to shelter homeless families. A review was necessary for two reasons: to establish a policy context for this key component of the family shelter system, and to address the long-standing concerns of residents in the wards of Scarborough Bluffs and Scarborough Highland Creek.

A steering committee comprised of the four City Councillors from the Wards of Scarborough Bluffs and Scarborough Highland Creek, and Councillors Raymond Cho and Olivia Chow from the Community and Neighbourhood Services Committee was established in July of 1998. The steering committee met for the first time in September and consulted through the fall with local residents, social agencies, community groups, faith communities, and local schools. Since that time, the steering committee has reviewed an options paper prepared by staff, and developed a set of final recommendations. A summary of the steering committee's findings will be forwarded to those who participated in the public consultations.

Comments and/or Discussion and/or Justification:

(I) History of the Use of Motels:

The use of motels to accommodate homeless families was first authorized by the Municipality of Metropolitan Toronto in 1986. Family shelters were full, and motels offered a reasonable alternative because of their small scale, proximity to residential neighbourhoods and schools, and the relative privacy they provide homeless families. The use of motels for family shelter was initially intended as a short-term use to respond to sudden changes in family shelter admissions. As demand for family shelter grew, and options for new shelter capacity were limited, reliance on motels increased as well.

More than half of all family shelter capacity is located along Kingston Road. In 1997, for the first time, the City was forced to use motels outside of Toronto to accommodate homeless families. Approximately 900 individuals are accommodated in motels along Kingston Road, and an additional 150 individuals are accommodated in motels outside of the City.

(II) Community Concerns:

The primary concern articulated during public consultations is that the concentration of homeless families along Kingston Road is too great. Residents of Scarborough are concerned that the number of homeless families accommodated in motels along Kingston Road overburdens the local school system and places strain on community-based services. Local school principals and community-based service providers do not feel they have the resources they need to adequately meet the complex needs of the local community. This situation is exacerbated by a community-based service infrastructure which is limited by contrast to the City as a whole.

The local community and social service providers raised concern about the adequacy of motels to accommodate homeless families. They expressed concern about children playing in motel parking lots, families living together for long periods of time in one room, the safety of cooking in small spaces and the adequacy of motel compliance with building, fire and safety codes. For the homeless families accommodated in motels, concerns about the need to find stable housing and to meet basic needs were added to the daily stresses of living in close quarters.

For many in the local community, the presence of motels regardless of whether they are used to accommodate homeless families, contribute negatively to an already distressed community. These residents are concerned that illegal activities may be taking place at some motels, that City by-laws are not enforced at motel properties, and that some motels are in a general state of disrepair.

(III) The Need for Action:

After more than ten years of use, action must be taken to address the use of motels from a policy and planning perspective. The City must work with local District School Boards to address the immediate needs at local schools in Scarborough, and to better plan for future services across the entire City. Contingent on adequate provincial funding support, the use of motels should be phased-out over a three to five-year period. Because this is a long-term objective, the City must, in the interim, enhance the accountability of the motel program. This will ensure adequate standards for families, clarify City expectations for motel operators, and enhance the responsiveness of this service to local communities. The need to relieve pressure on Toronto's emergency shelter system through enhanced services and supports in other municipalities in Ontario is addressed in the Mayor's Homelessness Action Task Force final report and has received support from Toronto City Council.

In the long-term, growth in demand for family shelter must be addressed by reducing the factors which place families at-risk of homelessness. These risk factors include, growth in the breadth and depth of family poverty, increasing numbers of evictions, and a shortage of affordable housing. The Mayor's Homelessness Action Task Force found that 100,000 people in Toronto, including 31,000 children are on the social housing waiting list, and that 106,000 tenant households face severe affordability problems.

The City has already initiated a number of programs with a prevention focus. These include a rent bank pilot project for women with children, an eviction prevention program, and a strategy to encourage the creation of more affordable housing. A report which addresses these issues for homeless families will be submitted to the Community and Neighbourhood Services Committee in May.

(IV) Phasing-out the Use of Motels:

The level of concentration of family shelter capacity along Kingston Road is not sustainable. To address the impact of concentration on local service systems and the local community, the use of motels should be phased-out over a three to five-year period, contingent on adequate provincial funding support for replacement affordable housing. Provincial funding should be sought to off-set the significant cost to the City of creating new family shelter capacity, and to ensure that permanent solutions to family homelessness are developed as part of this process.

Toronto Hostel Services estimates the cost of new shelter construction at $50,000.00 per bed. A five year phase-out of the use of motels has been estimated at a cost to the City of approximately $6.6 million per year. However, this does not include the cost of shelter construction to meet potential increases in demand for family shelter. Although permanent housing solutions are critical to address the long-term stability of families who are homeless or at-risk, new family shelter capacity will likely be required to meet growing demand for family shelter, and to meet demand created by the phase-out of the use of motels.

(V) Planning for Family Shelter Capacity:

Throughout the 1990s, the use of motels has increased in response to growing pressures on the family shelter system, rather than as a planned response to family homelessness. Expansion in the motel program has appeared to the community to be extremely ad hoc. This is a particular concern given anticipated increases in demand for family shelter.

Family shelter capacity is expected to grow by an additional 600 people over the next year. Although City staff believe they can accommodate new demand through expansion of the motel program outside of the City, this is only a stop-gap measure to respond to immediate needs. The City of Toronto must address the need for increased family shelter capacity by adopting a system-wide planning approach to new family shelter development. This will ensure that new family shelter capacity is developed on an equitable basis City-wide, and that new family shelters are well-integrated into local communities.

A motion which supports this objective was passed at the March 24, 1999, meeting of the Community and Neighbourhood Services Committee. To implement this policy, Toronto Hostel Services must have appropriate planning and zoning tools. A plan for new family shelter capacity, which identifies the tools necessary for Toronto Hostel Services to implement a "fair share" policy will be forwarded to the Community and Neighbourhood Services Committee by the fall of 1999.

(VI) Enhancing Accountability of the Motel Program:

(A) Setting Standards:

Although Toronto Hostel Services has operating policies, procedures and standards for the delivery of emergency shelter service in general, these policies were not developed to meet the specific requirements of families accommodated in motels. Given that homeless families have specific service needs and that the use of motels creates a unique service delivery context, standards for motels are warranted. Establishing standards for motels will enhance accountability by ensuring that operators understand the City's expectations and by providing the City with the tools to evaluate this significant component of the family shelter system.

Toronto Hostel Services must develop standards for motels in consultation with other City Departments. Standards should address the need for appropriate indoor and outdoor play space for children, appropriate private space for children to sleep and complete homework, the ability to cook safely in small spaces, and average lengths of stay of three months.

(B) Contract Management and Compliance:

Although City contracts with motel operators provide Toronto Hostel Services with a significant tool to ensure compliance, current staffing resources are not sufficient to allow for systematic monitoring of motel contracts. This makes it difficult for Toronto Hostel Services to follow up on concerns raised by homeless families or the public. To address this concern, a new process for contract management must be developed. The process should assess the operational suitability and financial viability of potential operators, and should require operators to demonstrate their compliance with City standards on a regular basis. In addition, Toronto Hostel Services must dedicate an additional FTE to monitor motels and conduct regular site visits. This can be accomplished within existing budget allocations. There are currently two full-time staff who already perform this function for purchased hostel services in the non-profit sector.

As part of the new contract management process, Toronto Hostel Services must seek opportunities to establish exclusive contracts with some motel operators. Exclusive contracts will ensure that homeless families are accommodated alongside other families, rather than alongside other motel clients. In addition, exclusive contracts will provide Toronto Hostel Services with greater opportunities to secure enhancements to motel properties and to enforce contract compliance.

(C) Community Input:

Residents in the Wards of Scarborough Bluffs and Scarborough Highland Creek are frustrated by the lack of City consultation about the use of motels, particularly when new motel contracts have been undertaken. The community has voiced concern about the significant impact of the use of motels on local schools and on local services for many years. The City of Toronto must support opportunities for the community to raise and resolve these issues.

On an ongoing basis, Toronto Hostel Services must consult with local Councillors and community reference groups about motel capacity and contract issues which impact on the local community. Local Councillors and community reference groups must also be consulted as a new process for contract management and contract issuance is developed. In addition, City of Toronto staff should continue to work with community-based groups like the Scarborough Homelessness Committee, the Scarborough East Community Analysis Group, and the Caring Alliance to identify and address service planning and operational issues, as well as other community concerns.

(VII) Planning for Other Services:

(A) Education:

Local schools which support children who are homeless need more resources to meet the needs of both homeless and housed students. The transient nature of a homeless child's participation in a local school creates a distinct set of challenges which current school funding, curriculum and administrative policies are not well-suited to address. In the Wards of Scarborough Bluffs and Scarborough Highland Creek, this reality is exacerbated by the high number of children enrolled from emergency shelters.

Unfortunately, local schools do not receive adequate funding to respond to these demands under current funding guidelines. As a result, schools experience greater classroom disruption, teachers are stretched too thin, and local school programs like English as a Second Language and Special Education cannot keep up with community needs. This compromises the quality of education for all children in the community.

Although the emergency shelter system provides a number of supports to local schools, these supports cannot address broader school funding and resource issues, nor can they replace the expertise and experience of educators and other specialized service providers. While the emergency shelter system must continue to work collaboratively with local schools, planning, funding and resource options which address system-wide needs must be sought.

The City cannot move ahead in this area without the participation of local District Schools Boards. To begin the planning process, the Chair of the Community and Neighbourhood Services Committee should convene a meeting of the Chairs of the local District School Boards, the Chair of the Steering Committee Reviewing the Use of Motels, and the Child and Youth Advocate. This meeting should identify opportunities to address immediate needs at the local level, as well as opportunities to plan for future services City-wide.

To respond to the immediate need for more resources in local schools, the City of Toronto and the local District School Boards should request provincial funding for dedicated children's counsellors and federal funding for settlement workers in the classroom. These additional classroom resources would relieve the strain on classroom teachers, address student needs, and minimize disruption to the student body as a whole.

Although the Federal Government has initiated a pilot project to place settlement workers in local schools, there are concerns that the level of support available under this program will not be sufficient to meet the high level of need in the Wards of Scarborough Bluffs and Scarborough Highland Creek. Funding resources under the Settlement and Education Partnerships in Toronto program must be allocated to reflect local needs. In addition, eligibility for refugee claimant children must be assured.

(B) Settlement and Immigration:

At times, newcomers to Canada have arrived at motels along Kingston Road in relatively high numbers over short periods of time. This has added to the level of concentration in the area and created concern in the local community. In addition, limited access for newcomers to appropriate settlement services places tremendous strain on newcomers and on local community-based services. To respond to the immediate needs of refugees entering the emergency shelter system, federal funding for settlement services must be targeted to homeless families accommodated along Kingston Road. These services should be delivered through the community-based settlement services sector.

Ensuring that all newcomers are entitled to receive critical settlement supports is one of the most important ways to help them become independent. It is also a critical way to ensure that community-based services have the necessary funding to deliver needed programs and services. This principle was supported by the Mayor's Homelessness Action Task Force and is addressed in the report, entitled "The Mayor's Homelessness Action Task Force Final Report: Policy Directions for Community and Neighbourhood Services," before the Committee at its May 3, 1999, meeting. The need for the Federal Government to engage the City of Toronto in direct discussions about the local impacts of settlement and immigration policy is also addressed.

(C) A Service System Planning Approach for Families:

Consultations with service providers in Scarborough, as well as the specific education and settlement service issues identified in this report, highlight the importance of service system planning for homeless families. A service system planning approach provides the benefit of engaging service providers across sectors to enhance the co-ordination, accessibility and quality of the network of services supporting families. This planning approach utilizes the expertise of diverse service sectors and builds on the natural linkages between different service strategies. The Mayor's Homelessness Action Task Force recommended this approach for key populations sub-groups, and, in particular, for homeless families.

The City of Toronto should take the lead in adopting a service system planning approach for homeless families building on the work of existing organizations including the Scarborough Homelessness Committee, the Scarborough East Community Analysis Group, and the Refugee Protocol Group. This issue will be further addressed in a report to the Community and Neighbourhood Services Committee at its May 19, 1999, meeting.

Conclusion:

After more than ten years of use, action must be taken to address the use of motels from a policy and planning perspective. The City must work with local District School Boards to address the immediate needs of schools in Scarborough, and to address education issues as part of a systems planning approach. Contingent on provincial funding support, the use of motels should be phased-out over a three to five-year period. In the interim, the City must enhance the accountability of the motel program to ensure adequate standards for families, to clarify City expectations for motel operators, and to enhance the responsiveness of this service to local communities. Increasing demand for family shelter can no longer be met through the motel program within Toronto. Furthermore, placing families in motels outside the City is only a stop-gap measure. As a result, the City must develop a plan to enhance family shelter capacity, in addition to focussing on long-term solutions which prevent homelessness.

Contact:

Karen Mann

Tel: 392-8334

The Community and Neighbourhood Services Committee also submits the following communication (April 21, 1999) from Councillor Ron Moeser, Chair, Steering Committee to Review the Use of Motels:

At its April 19, 1999, meeting, the Steering Committee to Review the Use of Motels for Homeless Families put forward a number of recommendations for consideration by the Community and Neighbourhood Services Committee regarding Item No. 3 on the April 22nd agenda, titled "Final Report on the Review of the Use of Motels for Homeless Families."

The Steering Committee recommends that Recommendation No. (1) of the "Final Report on the Review of the Use of Motels for Homeless Families" be amended so that the phrase "contingent on provincial funding for replacement affordable housing units" be struck. Recommendation No. (1) would now read:

"(1) the Commissioner of Community and Neighbourhood Services develop a plan to phase-out the use of motels over a three to five year period;".

In addition, the Steering Committee would like two additional recommendations considered as follows:

(1) the Commissioner of Community and Neighbourhood Services report to the Community and Neighbourhood Services Committee in September 1999, with a plan to implement the recommendations in the final report; and

(2) staff report on the amount of federal funding required to ensure appropriate settlement services for families accommodated in motels.

The Steering Committee requests that the Community and Neighbourhood Services Committee consider these recommendations along with the "Final Report on the Review of the Use of Motels for Homeless Families" at the April 22, 1999, meeting of the Community and Neighbourhood Services Committee.

--------

The following persons appeared before the Community and Neighbourhood Services Committee in connection with the foregoing matter:

- Ms. Gretta Vosper, Scarborough East Community Analysis Group; and submitted a brief in regard thereto;

- Mr. Peter Vanderyagt, The Caring Alliance; and

- Councillor Ron Moeser, Scarborough Highland Creek, and Chair of the Steering Committee to Review the Use of Motels.

2

Expansion of Hostel Services - Public Health

Initiatives to Reduce the Spread of

Communicable Diseases, In Particular TB

(City Council on May 11 and 12, 1999, amended this Clause by adding thereto the following:

"It is further recommended that Council request the Federal Minister of Health to meet with the Medical Officer of Health, the Chair of the Board of Health and the Chair of the Community Services Committee to review the federal government's tuberculosis screening procedures for immigrants from countries where tuberculosis is endemic, with a view to having the federal government tighten up such procedures.")

The Community and Neighbourhood Services Committee recommends the adoption of Recommendations Nos. (2) to (5) contained in the report dated March 26, 1999, from the Medical Officer of Health.

The Community and Neighbourhood Services Committee reports, for the information of Council, having received Recommendation No. (1), contained in the report of the Medical Officer of Health in that the Public Health's Operating Budget is being considered by Council on April 26 and 27, 1999, as part of the budget process.

The Community and Neighbourhood Services Committee submits the following report (March 26, 1999) from the Medical Officer of Health:

Purpose:

To inform the Community and Neighbourhood Services Committee of the expansion of public health initiatives which would be required to reduce the spread of communicable diseases with an expansion of hostel services, in particular TB.

Financial Implications:

Tuberculosis (TB) in the homeless and underhoused population in the City of Toronto cannot be controlled unless there is a comprehensive TB control program for the entire population. Provision of this service level for the City would be at an additional cost of $634,830.00 in 1999 (including one-time costs of $103,377.00) and $1,594,358.00 in 2000 and subsequent years.

On March 23, 1999, the Province of Ontario announced that it will fund 50 percent of the cost of provincially-approved Mandatory Health Programs and Services retroactive to January 1, 1999. The actual impact of this announcement on Toronto's Public Health Budget is not known at the time of writing this report.

Recommendations:

It is recommended that:

(1) the Community and Neighbourhood Services Committee continue to support the optimal service level for Toronto Public Health's TB program;

(2) current Public Health initiatives pertaining to communicable diseases other than TB should be harmonized across the City and workloads associated with both the current and new hostels should be monitored with a view to considering provincial cost-sharing of hostel-specific public health services;

(3) prior to the construction of any new hostels, Toronto Public Health should be consulted regarding ways to minimize the risk of communicable diseases within the new environments;

(4) the Community and Neighbourhood Services Committee continue to advocate with the Province for provincial funding for appropriate accommodation for people without housing who have active TB in order to reduce disease transmission and promote stability and health, as requested by the Board of Health on January 25, 1999; and

(5) the Community and Neighbourhood Services Committee continue to support the recommendations in the Report of the Mayor's Homelessness Action Task Force, which state that no one should be discharged from an institution to the street and that the Ministry of Health should fund infirmary beds in appropriate locations for homeless people recovering from illness or surgery.

Background:

On February 11, 1999, the Community and Neighbourhood Services Committee recommended to Council that the commitment by the Community and Neighbourhood Services Department to expand hostel services by adding smaller full-standard facilities and developing a range of harm reduction shelters be supported. Also recommended was that the existing contract with the Salvation Army for the Lighthouse shelter at 37 Dundas Street East be increased by 30 beds on Monday, Tuesday, Wednesday and Thursday nights effective February 15, 1999 to April 14, 1999.

The Medical Officer of Health was directed to report back to the Community and Neighbourhood Services Committee on the expansion of public health initiatives to reduce the spread of communicable diseases, in particular TB, which should accompany an expansion of hostel services.

On January 25, 1999, the Board of Health approved, in principle, the provision of an optimal service level for TB control for the City of Toronto (see Appendix 1) and requested the Medical Officer of Health to submit a report to the Board at its next meeting on additional cost implications for the options in the context of the 1999 budget submission for Public Health. On February 22, 1999, the Board of Health gave final approval for the provision of optimal service levels in TB Control and recommended that the final costs for this program, which were not included in the 1999 Operating Budget request, be submitted to the Budget Committee for consideration. On March 24, 1999, the Community and Neighbourhood Services Committee supported in principle the service level recommended by the Board of Health for TB control.

Discussion:

The current number of homeless in the City of Toronto is not known. In 1996, almost 26,000 people used the hostel system in Toronto. This number underestimates the total number of homeless, as some people never use hostels. As of November 1998, there were approximately 4,000 beds in 46 shelters throughout the City. Between December 1 and March 31 yearly, a network of churches and other faith groups provide overnight shelter, drop-in services, and meals for homeless and socially isolated people through a program known as "Out of the Cold". There are 46 such facilities, of which 25 provide overnight services one or more nights a week, for between 150 and 400 youths and adults each night.

Homeless people are at higher risk of infectious diseases than the general population. They are also at an increased risk of suicide, mental health problems, chronic health problems, and substance abuse. This situation is exacerbated when people are living in circumstances which expose them to crowded conditions, poor ventilation, poor nutrition, lack of access to facilities to maintain adequate personal hygiene, and an increased likelihood of experiencing violence or trauma. All of these factors contribute to poor immunity and increased susceptibility to infectious diseases, such as respiratory diseases including TB, gastrointestinal diseases and skin infections and infestations.

Thirty to 40 percent of homeless individuals are infected with TB and are at a high risk of progression to active TB. Approximately 2 percent to 3 percent of Toronto's 450 to 500 active TB cases per year occur among persons who are homeless or underhoused. With respect to other infectious diseases, it is currently not known what proportion of Toronto's approximately 20,000 cases of communicable diseases (other than TB) each year occur in the homeless/underhoused population.

Shelter operators and staff are well aware of the health issues identified above. Shelters work in partnership with Public Health, local Community Health Centres, local hospitals and with individual physicians to provide the health services which shelter residents require. Nevertheless shelter operators indicate that it is still difficult for many shelter residents to access appropriate health care when they need it.

The City of Toronto Hostel Standards includes a section on Health and Safety which discusses the issue of communicable disease and appropriate staff training regarding various illnesses. It further requires shelters to develop clear policies and procedures for managing and treating communicable diseases. Hostel Services staff worked with Public Health on the development and distribution of handbooks on Infection Control and TB which were made available to services assisting homeless and underhoused people, as described below. At the present time, the Toronto Hostels Training Centre offers a course on Communicable Diseases and Prescription Drug Awareness. Additionally, a monthly course is offered on the Hostel Standards which involves a discussion of health and safety issues. Despite all of this, Hostel Services also recognizes that there are locations where crowded conditions exist and staff are working to address that issue.

Toronto Public Health provides services to the homeless and underhoused community to help control infectious diseases. These services are provided at various locations, including drop-in centres, shelters, and local area public health offices. All suspect/confirmed cases of communicable disease are investigated by the local area office to ensure that cases are diagnosed, treated, and isolated as appropriate; that potential contacts are identified and treated; and that all appropriate infection control measures are taken to reduce the spread of disease. Preventive education/outreach services for TB and infection control are generally provided upon request. Immunization clinics and infestation treatment are regularly offered in the former Toronto only.

Toronto Public Health is not currently able to meet the provincial mandatory requirements regarding TB control due to lack of resources and the volume of the problem. If anything less than the optimal service level for TB is approved, we will not be able to meet provincial standards in the current shelters within the City.

Below is an inventory of current public health initiatives related to communicable disease control for the homeless/underhoused population and comments as to whether these initiatives would need to be expanded to accommodate an expansion of hostel services.

(A) TB Control in Homeless/Underhoused Populations:

(i) Assess and investigate all reported active cases of TB. Provide directly observed therapy (DOT). Attempt to find stable housing for clients.

It is difficult to predict the impact of an expansion of hostel services on the number of cases of active TB.

(ii) Conduct contact tracing, including risk assessment and clinics at the facility involved, with education sessions and TB skin testing. Refer those who test positive for follow-up. Special arrangements have been made with a clinic at St. Michael's Hospital and a variety of community health centres for follow-up of clients without health cards.

An expansion of hostel services will have an impact on contact tracing clinics done by staff, as there would be more shelters where a case of TB may have spent time.

(iii) Advocate with hospitals on behalf of homeless/underhoused clients with TB to prevent premature discharge to high risk settings. This issue was addressed in the Report of the Mayor's Homelessness Action Task Force, which recommended that no one should be discharged from an institution to the street and that the Ministry of Health should fund infirmary beds in appropriate locations for homeless people recovering from illness or surgery. These advocacy positions will assist in the prevention of outbreaks of TB in crowded and poorly ventilated settings and the control of TB in individuals on treatment.

(iv) Provided a training session for shelter staff in 1996, with distribution of a comprehensive manual on TB prevention (former Toronto only).

With an expansion of hostel services, an updated manual and a full day training session should be provided to all new shelter staff throughout the City.

(v) Provide educational sessions every fall and January/February for "Out of the Cold" program volunteers throughout the City (six sessions in 1998). Additional sessions for shelter staff, volunteers and clients are given upon request as resources permit (18 sessions in 1998).

An expansion of hostel services would result in an increased number of requests for TB education sessions.

(vi) Routine screening for TB is currently not provided in the shelters, due to inadequate resources, despite being specifically required in the provincial Mandatory Health Programs and Services Guidelines.

If screening programs are implemented to meet Ministry requirements, increasing the number of shelters would result in an increased number of sites where screening would need to be undertaken.

(B) Control of Other Infectious Diseases in Homeless/Underhoused Populations:

(i) Assess and investigate all reports of suspect communicable disease (e.g., influenza, hepatitis A, invasive Group A Streptococcal disease).

An expansion of hostel services would likely increase the number of reportable disease investigations, because the total number of enclosed environments would increase and there would be a potential for increased exposure to communicable diseases due to the close living conditions within the shelters. Therefore, prior to the construction of any new hostels, Toronto Public Health should be consulted regarding ways to minimize the risk of communicable diseases within the new environments.

(ii) Offer monthly immunization clinics at two drop-in centres in the former Toronto. Routine immunizations, as well as hepatitis B, influenza and pneumococcal vaccines are available. These clinics are promoted throughout the former Toronto through the co-ordinators of the drop-in centres. There are preliminary plans to expand the number of clinics in the future to make the service more accessible to the homeless throughout the City.

An expansion of hostel services, would have limited impact on the immunization clinics as they are a centralized service.

(iii) Offer influenza and pneumococcal vaccines during influenza season at shelters and drop-in centres located in the former Toronto. During 1998, 868 people were immunized at 23 shelters. These clinics are promoted through posters at the shelters in the former Toronto. There are preliminary plans to increase the number of influenza clinics in the future to make the service more accessible to the homeless throughout the City.

With an expansion of hostel services, there would be an increased number of influenza clinics needed to provide influenza and pneumococcal vaccines at the new sites, or alternatively, there would need to be promotion of the current clinics at these new sites.

(iv) Provide an infestation control program targeting the homeless population and those who serve them, in partnership with Parks and Recreation, the Toronto Community Care Access Centre (CCAC) and two Community Health Centres. Two days a week treatment is offered for lice and scabies in a facility in the former Toronto. The site also offers participants facilities to wash their clothes.

An expansion of hostel services may have an impact on the infestation control program.

(v) Provided a training session for shelter staff in 1996, with distribution of a comprehensive manual on infection control (former Toronto only).

With an expansion of hostel services, an updated manual and training session would need to be provided to all new shelter staff throughout the City.

(vi) Assisted Metro Hostels and Salvation Army in development of a corporate manual distributed to all shelters.

(vii) Provide educational sessions to "Out of the Cold" volunteers (five sessions in 1998) and shelter staff (approximately 25 sessions in 1998) upon request (in former Toronto). Common concerns among the facilities were antibiotic resistance and body substance precautions.

An expansion of hostel services would likely result in an increased number of requests for infection control education sessions.

Conclusions:

Toronto Public Health is currently involved in a number of initiatives targeting the homeless/underhoused population. Public health initiatives focusing on the prevention of communicable diseases need to be harmonized across the City. Any expansion of hostel services should be accompanied by an expansion of public health initiatives to reduce the spread of communicable diseases within these environments. Also, in order to minimize the risk of communicable diseases within new shelter environments, Toronto Public Health should be consulted early in the site selection and construction stages when refinements are still possible.

The homeless/underhoused population is at an increased risk of many diseases, including TB. The conditions for a resurgence of TB exist in Toronto. TB in the homeless/underhoused cannot be controlled without a comprehensive TB control program for the entire population. TB screening in the current shelters, as required under the Ontario Ministry of Health's Mandatory Programs and Services Guidelines, is not carried out. In order for screening to be initiated, Toronto Public Health requires additional resources.

Preventive measures in this population should be considered cost effective in the long run. Not only will they reduce needless illness, suffering and premature death, but they will also save future expenditures on public health.

Contact Name:

Dr. Barbara Yaffe, Director, Communicable Disease Control and

Associate Medical Officer of Health, Toronto Public Health

Tel:392-7405/Fax: 392-0713

E-mail: byaffe@toronto.ca

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Appendix 1

Tuberculosis Program

Purpose:

To inform the Board of Health about options for meeting provincial standards for tuberculosis control across the City.

Recommendations:

It is recommended that:

(1) the Board of Health select one of the following service options for tuberculosis (TB) control and recommend the additional funding required within the 1999 budget approval process:

(a) provision of an optimal service level for the City of Toronto at an additional cost of $726,159.00 in 1999 (including one-time costs of $100,000.00) and $1,878,478.00 in 2000 and subsequent years; or

(b) provision of the minimum service level mandated by the Province, at an additional cost of $567,572.00 in 1999, (including one-time costs of $87,000.00) and $1,441,715.00 in 2000 and subsequent years; and

(2) the Board of Health request Council through the Community and Neighbourhood Services Committee to advocate with the Board of Health and local hospitals for provincial funding to provide appropriate accommodation for people without housing who have active TB in order to reduce disease transmission and promote a stable environment which will assist them to regain their health.

Background:

For the TB control program, there is a provincial protocol under the Mandatory Health Program and Service Guidelines which has specific program standards and requirements. Therefore, there is little flexibility or discretion in terms of interpreting the minimum standards.

Need:

There are approximately 2000 new cases of Tuberculosis reported in Canada each year, including 800 in Ontario. The City of Toronto has 450-500 cases of TB per year with an incidence rate three times the provincial rate. Three key factors have contributed to the increased prevalence of TB in Toronto:

(1) Toronto experiences high immigration from countries where TB is endemic (over 90 percent of the TB cases in Toronto occur in the foreign-born). TB rates in some major source countries are 30-40 times the Toronto rate and 30 percent of all immigrants to Canada settle in Toronto, a City which has 6 percent of the Canadian population.

(2) Socio-economic factors - numbers of unemployed, low-income singles and families with children, people who are homeless - are all above the provincial average; poverty and crowded conditions increase the risk of acquiring and spreading TB among vulnerable groups.

(3) Toronto's HIV infection/AIDS incidence rate is three times the provincial rate. Having HIV greatly increases the risk of developing TB and prolongs the TB treatment period when TB does occur.

Drug resistant tuberculosis is of great concern and has been linked to outbreaks in cities such as New York and San Francisco. In 1996, 16 percent of Toronto cases demonstrated resistance to one or more antibiotics (compared to 8.7 percent nationally); multi-drug resistant (MDR-TB) cases reached 2.6 percent in 1996 compared to less than 1 percent for Canada as a whole. Mortality in drug resistant cases ranges between 18-70 percent. Drug resistant strains result primarily from incomplete or improper treatment; a drug resistant TB case costs $230,400.00 (U.S.) to treat compared to $14,500.00 (U.S.) for a case of nonresistant TB. TB prevention directly lowers future public health costs, while also reducing expenditures in other sectors (e.g., acute care hospitals).

Conversely, failure to invest in TB prevention can lead to escalating disease rates and associated costs, as occurred in New York City where complacency about declining numbers of TB cases led to cut-backs in the TB program during the 1980s. Within a short period of time TB rates tripled and drug resistance increased to 23 percent, with mortality in resistant cases reaching more than 80 percent. In response to this growing epidemic, the U.S. Center for Disease Control (CDC), expanded its budget to support TB programs from $25 million in 1991 to $104 million in 1993. With the additional funding New York City embarked on a massive expansion of its Directly Observed Therapy (DOT) program, going from 137 persons on DOT in 1991 to 1,282 DOT patients by 1993. That year the number of new TB cases fell for the first time in 15 years. This reversal was attributed to the expanded DOT program. In 1997, New York City had a population of 8.6 million and 1,737 cases of TB, for an incidence rate of 21.6/100,000 population; it also required a $40 million TB program with over 500 staff. While it can be argued that the structure of the health care and social service systems are very different in the U.S., it is important to pay attention to the New York lesson and implement an effective TB program that will save lives and money in the long run.

TB is now regarded world-wide to be the leading cause of death among people who are HIV positive. In the City of Toronto in 1996, 4.2 percent of TB cases had HIV/AIDS listed as a risk factor, up from 3.7 percent for 1992-96. The mortality rate in persons who have TB and who are also HIV positive ranges between 20 percent to 35 percent, in part because TB accelerates the natural progression of HIV infection. Targeted programming and strategic interventions are required to prevent co-infection in Toronto.

Effective Prevention:

In 1993, the World Health Organization (WHO) declared TB a "global emergency." It recommended universal use of Directly Observed Therapy (DOT). DOT consists of closely supervised treatment by watching patients swallow their medication to make sure every dose is taken; it is the most effective way to cure TB as it ensures patients adhere to treatment. Non-adherence is difficult, if not impossible, to assess in advance and variables such as age, income, occupation, education do not reliably, consistently or accurately predict adherence to therapy. Incomplete treatment of TB is worse than no treatment at all because it leads to drug resistance. DOT is labour intensive but it works. The World Bank describes DOT as one of the most cost-effective health strategies.

The Canadian Expert Committee on Tuberculosis (ECOT), through the National Consensus Conference on Tuberculosis held in December 1997, made recommendations including:

(a) Directly Observed Therapy as the standard treatment;

(b) screening of high-risk groups for case finding and prophylaxis (e.g., drop-ins, homeless shelters, correctional facilities, alcohol and drug rehabilitation programs);

(c) improved communication and collaboration between AIDS and TB programs;

(d) case manager for each case of active TB (to monitor compliance, check drug toxicity monthly); and

(e) monitoring of clients on INH prophylaxis for toxicity.

The provincial Mandatory Health Programs and Services Guidelines (1997) state that the "Board of Health shall have in place an effective program for TB prevention and control which shall include case finding, case holding, treatment and follow-up". The minimum requirements outlined for TB prevention and control in Ontario, detailed in a provincial protocol, are consistent with the recommendations of the WHO, expert committees, and scientific research and experience concerning cost-effective TB prevention and control except in the case of DOT. The guidelines state that the Board of Health must "ensure that all persons with active tuberculosis complete the prescribed course of chemotherapy through the provision of DOT or another appropriate intervention." Other interventions are not described and to date no intervention has been shown to cure TB as cost-effectively as DOT. There may be strategies whereby DOT can be used in a modified manner but these have not been evaluated.

Current Service Issues:

There is considerable variation in the degree to which the new 1997 Mandatory Health Program and Services Guidelines are being met in the six former health units:

(a) Less than 20 percent of cases are followed with DOT (Toronto offers DOT to all cases, Etobicoke and North York offer DOT selectively; Scarborough, East York and City of York do not have DOT programs).

(b) Educational sessions and updates to physicians, other health care workers and high risk groups are provided only on as-time-permits basis (e.g., Toronto offers education to shelter and hostel staff; North York and Etobicoke offer education only upon request; and Scarborough cannot offer any educational sessions because of a lack of staff).

(c) Screening of high risk groups, other than contacts of active cases, is not available anywhere in the City.

(d) Monitoring of adherence to chemoprophylaxis is not available anywhere in the City.

(e) Monitoring of individuals on surveillance for inactive TB (Post Landing Surveillance of immigrants and refugees) varies from one contact only (Scarborough and City of York) to annual follow-up for five years (Toronto).

Options for Harmonizing the TB Program:

Option A: Optimal Prevention:

With the addition of 28 FTEs to the current 35.25 FTEs, Toronto will be able to provide DOT to all TB cases and select high risk contacts and provide TB education, including regular updates to physicians and other health care workers throughout the City. It will permit more careful monitoring of clients on chemoprophylaxis and screening of selected groups at high risk of developing TB (e.g., injection drug users, English as a Second Language [ESL] students, homeless and underhoused persons living in shelters). The increase will enable Toronto to meet the requirements set out in the Mandatory Health Programs and Services Guidelines. It also provides equal access across the City to the most cost-effective form of treatment for active tuberculosis and the best protection against increasing TB drug resistance and preventable TB mortality. While DOT currently is primarily provided by RPNs (six-seven community visits per day), a variety of other strategies are currently being explored to provide DOT in the most cost-effective way possible (persons coming to the health unit or community clinic, contracting out, using non-professional staff for low-risk cases).

The additional budget required is $1,878,478.00 (a 90 percent increase in the current budget of $2,100,000.00 for a total budget of $3,978,478.00) to begin implementation in September 1999 with an increase in operational costs of $626,159.00 in 1999 plus one-time computer costs of $100,000.00.

Option B: Minimum Mandatory Program Standards:

With limited expansion (budget increase of 69 percent and 19.75 staff) full DOT will be available to only 40 percent of TB cases. This will be a reduction in the DOT program in the Toronto district while it increases the services available in other parts of the City. All new cases will start on DOT for the first month until treatment is well established. During this period the client will be assessed for risk factors commonly associated with non-adherence (e.g., failure to keep appointments) and a decision regarding the necessary support he/she requires will be made. The DOT program will be restricted to select high risk cases (e.g., persons who have drug resistant TB, persons who are co-infected with HIV, children and teenagers, persons who are homeless or under-housed, persons with substance abuse problems and individuals who are experiencing adverse reactions to TB medication). In other cases an enhanced follow-up program will be used as a strategy to ensure adherence to treatment. Persons deemed to be at low risk can be followed at progressively longer intervals (e.g., initially weekly then tapering to monthly).

This expansion of the DOT program in some parts of the City will ensure improvement in completion of treatment and decline in relapse rates. This option also establishes enhancement to educational outreach as required in the new Mandatory Health Programs and Services Guidelines. Education will be available to targeted high-risk groups (e.g., new immigrant and refugee centres) and annual updates will be provided to health professionals. In addition, contact follow-up of new cases will be expanded to meet the new requirements. Limited screening of high risk groups (e.g., homeless shelters, ESL classes) will be undertaken and monitoring of individuals on chemoprophylaxis will be enhanced to the minimum level specified in the guidelines. Direct contact with individuals on post landing surveillance for inactive TB will be initiated.

This option increases access to DOT from the current 20 percent of cases to about 40 percent of cases. While it is anticipated that this option would comply with the minimum requirements of the 1997 Mandatory Health Programs and Services Guidelines, it would be difficult to provide the majority of persons with active TB with the treatment that has been proven to be most cost-effective. This requires a budget increase of $1,441,715.00 with implementation to begin in September 1999 with a budget increase of $480,572.00 for operational costs in 1999 plus one-time costs of $87,000.00.

Implications of No Additional Funding:

With no budget increase, existing resources would be redistributed to reflect patterns of health needs across the City. As a result, TB services would be decreased in the districts of Toronto, Etobicoke and North York, with expansion in Scarborough, East York and the City of York. DOT would only be available on a selected basis to high-risk pulmonary cases who are deemed to be most likely to be non-adherent to treatment.

Since it has been established that health care providers are unable to predict adherence to and completion of TB treatment, the incidence of non-adherence, acquired drug-resistance and TB mortality would be expected to rise. This would particularly occur in the districts where DOT services are cut-back. Educational outreach would be limited to select high-risk settings on an as-time-permits basis which may have a negative impact on timely case identification and contact follow-up.

In my opinion, as Medical Officer of Health, many of the provisions specified in the Mandatory Guidelines would not be met. The dollars not invested in prevention and follow-up will put pressure on future budget requirements to treat cases that could have been prevented. This prediction is based on the American experience where it has been estimated that the health system cost of treating a single outbreak of drug resistant TB approaches $1,000,000.00 (U.S).

Program Budget and Budget Options:

Operating Budget*	Staffing (FTEs)
Current: staff costs: $1,909,550 non-staff costs: $ 190,450 Total: $2,100,000	24.5 (15.25 PHNs, 5 RPNs, 3.25 RNs, 1 outreach worker) 2.0 managers 8.0 clerical staff .25 physician 34.75 Total
Option A: staff costs: $3,601,478 non-staff costs: 377,000 Total: $3,978,478 plus one-time cost in 1999 of: $ 100,000	46.0 (22 PHNs, 20 RPNs, 4 RNs) 4.0 managers 10.0 clerical staff 1.0 health promoter 1.0 dedicated educator 0.25 program evaluator 0.5 physician 62.75 Total
Option B: staff costs: $3,135,425 non-staff costs: $ 401,990 Total $3,541,715 plus one-time cost in 1999: $ 87,000	41.0 (22 PHNs, 15 RPNs, 4 RNs) 3.0 managers 9.0 clerical staff 1.0 dedicated educator 0.5 physician 54.5 Total

* The cost of drugs for TB treatment and chemoprophylaxis is paid by the Province.

Conclusion:

Tuberculosis is a global emergency, a major cause of death in many countries and a leading cause of death among people who are HIV positive. Toronto has high immigration from many countries where TB is endemic. Drug resistant forms of TB are increasing world-wide and in Toronto. Other conditions for increasing TB are homelessness, poverty, substance abuse, crowded living conditions, and HIV.

Evidence of the cost-effectiveness of TB prevention and control interventions is mounting and clear about the importance of infrastructure to ensure early identification of cases, directly observed therapy, follow up of all contacts and education for high-risk populations and health care providers. Experience is also clear in demonstrating that the costs of failure to invest in prevention are many times higher when a TB crisis results.

This report presents options for meeting provincial standards including optimal level to effectively prevent and control TB and minimal level to meeting provincial standards. The Board of Health (and ultimately City Council) has to make policy decisions determined by financial, economic, social and political factors and constraints as to which option is ultimately selected.

References:

Bayer R, Wilkinson D. Directly Observed Therapy for Tuberculosis: History of An Idea. The Lancet, Vol. 345, June 17, 1995. Pp. 1545-1548.

Chaulk CP, and Kazandjian VA. Directly Observed Therapy for Treatment Completion of Pulmonary Tuberculosis. JAMA, March 25, 1998, Vol. 279, p. 944.

Faning EA. Globalization of Tuberculosis [editorial comment]. CMAJ 1998; 158: Pp 611-2.

Moore RD, Chaulk CP, Griffiths R, Cavalcante S and Chaisson RE. Cost-Effectiveness of Directly Observed Versus Self-Administered Therapy for Tuberculosis. Am J Respir Crit Care med, 1996; Vol. 154, Pp. 1013-1019.

Park MM, Davis AL, Schluger NW, Cohen H and Rom WN. Outcome of MDR-TB Patients 1983 - 1993. Am J Respir Crit Care Med, 1996; Vol. 153, Pp. 317-324.

Prevention and Treatment of Tuberculosis Among Patients Infected with Human Immunodeficiency Virus: Principles of Therapy and Revised Recommendations, Morbidity and Mortality Weekly Report, October 30, 1998, Vol. 47, p. 7.

Report of the National Consensus Conference on Tuberculosis, held in Toronto December 3-5, 1997. Pp. 8-13.

Reported Tuberculosis in the United States, 1997. U.S. Department of Health and Human Services, Public Health Services, Centres for Disease Control and Prevention, National Centre for HIV, STD and TB Prevention, Division of Tuberculosis Elimination. Pg. 43.

TB Programme. TB a global emergency: WHO report on the TB epidemic Geneva. Switzerland: World Health Organization 1993 (WHO/TB 1993-177).

Weis SE, Slocum PC, Blais FX, King B, Nunn M, Matney GB, Gomez E and Foresman BH. The Effect of Directly Observed Therapy on the Rates of Drug Resistance and Relapse in Tuberculosis. The New England Journal of Medicine, Vol. 330, April 28, 1994, Pp. 1179-1184.

3

Management of the Capital Revolving

Fund for Affordable Housing

(City Council on May 11 and 12, 1999, amended this Clause by deleting Item No. (8), headed "Reporting and Decision-Making", from the Terms of Reference for the Reference Group for the Capital Revolving Fund, as embodied in Appendix "A" to the joint report dated April 6, 1999, from the Commissioner of Community and Neighbourhood Services and the Chief Financial Officer and Treasurer, and inserting in lieu thereof the following new Item No. (8):

"(8) Reporting and Decision-Making:

The Reference Group will report to the Commissioner of Community and Neighbourhood Services, the Chief Administrative Officer and the Chief Financial Officer and Treasurer, who will make recommendations to Council on the use of the Fund, such recommendations to be accompanied by information regarding the advice provided on that matter by the Reference Group.")

The Community and Neighbourhood Services Committee recommends the adoption of the following joint report (April 6, 1999) from the Commissioner of Community and Neighbourhood Services and Chief Financial Officer and Treasurer:

Purpose:

(i) To seek Council approval of management guidelines for the Capital Revolving Fund for Affordable Housing which was established by Council at its meeting on February 2, 3 and 4, 1999.

(ii) To report on the establishment of an external reference group on affordable housing.

Financial Implications:

There are no immediate financial implications arising from this report. Specific proposals for community projects to be supported by the Capital Revolving Fund will be brought forward for Council approval at a later date.

Recommendations:

It is recommended that Council:

(1) adopt Terms of Reference for a Reference Group to advise the Commissioner of Community and Neighbourhood Services on management of the Capital Revolving Fund for Affordable Housing, as set out in Appendix A.

(2) adopt Management Guidelines for the Capital Revolving Fund for Affordable Housing, as set out in Appendix B.

(3) appoint Councillor Feldman as the Council representative to the Reference Group for the Capital Revolving Fund.

(4) authorize the Commissioner of Community and Neighbourhood Services to select community members of the Reference Group per the criteria in the Terms of Reference.

(5) authorize appropriate City officials to take the necessary action to give effect to these recommendations.

Background:

At its meeting of July 29, 30 and 31, 1998, Council approved an affordable housing strategy for the City, with the following goal: to create an environment in which the private sector and community partners will be willing and able to develop affordable housing for people with a range of housing needs that are not currently being met in the market. One element of this strategy is the provision of support for community projects that demonstrate the City's role in facilitating the creation of affordable housing.

At its February 2, 3 and 4, 1999, meeting, Council redesignated $10.9 million in existing funds, primarily contained in the Social Housing Reserve Fund of the former City of Toronto, to establish a new Capital Revolving Fund for Affordable Housing. This Council initiative is consistent with Recommendation No. 77 of the Mayor's Homelessness Action Task Force. Staff were asked to report back on management guidelines for the fund. The guidelines are intended to ensure the viability of projects to be supported, who and what types of projects would access the funds, and how projects would be monitored and evaluated.

As part of the affordable housing strategy, staff were also directed to establish an external reference group consisting of private sector, financial and community representatives. This report provides an update on the reference group and endorsement of its role in advising staff with regard to the Capital Revolving Fund.

Staff have also been asked to report back on options for future contributions to the Capital Revolving Fund from the City or other sources and the potential establishment of a permanent endowment fund for affordable housing. These issues will be addressed in a subsequent report to Council.

Comments:

As the Mayor's Homelessness Action Task Force has noted, it is more cost-effective to provide permanent housing for low income people than to provide emergency shelter. While some homeless people require support services in order to maintain permanent housing, most need access to affordable, adequate housing that is very scarce in the housing market in Toronto.

In the absence of senior government housing programs, the City strategy is to use tools available at the municipal level to mobilize the private sector and the community to create affordable housing, and to find new ways to involve the provincial and federal governments. While the City is taking a number of steps to encourage the private sector to build new rental housing (e.g., special property tax class for new multi-residential housing), the capital fund is intended to support housing for those who cannot afford market rent levels.

As shown by economist Greg Lampert (in a presentation made to the Budget Committee on January 19, 1999), it is now possible, through a combination of discounted land costs and capital or equity contributions, to develop housing at a level that social assistance recipients can afford in Toronto. The revolving fund is a vehicle whereby the City can provide limited capital contributions in order to lever the development of housing projects by community and private groups.

This report sets out the next step toward implementing the use of the Capital Revolving Fund, including the creation of an external Reference Group and establishment of management guidelines. Future reports will recommend specific funding proposals based on advice from the Reference Group.

Reference Group:

Appendix A provides terms of reference for an external reference group that would act in an advisory capacity to the Commissioner of Community and Neighbourhood Services. It is recommended that the following initial membership be approved (pending Council endorsement of the Terms of Reference):

City Councillor (1):

Councillor Mike Feldman

Private development and property management industry (4):

John Latimer, President, The Monarch Group

Tom Schwartz, President, Intraurban

Marvin Sadowski, Executive Vice-President, Sterling Silver Development Corp.

John Fogolin, President, Tornat Construction

Financial sector (2):

Stewart Pearson, President, Mortgage Capital Co.

Mike Braid, Vice-President, Toronto-Dominion Bank

Community-based housing and services sector (2):

Maria Crawford, Executive Director, Eva's Place

Rick Egan, Co-ordinator, St. Christopher House

Ontario Ministry of Municipal Affairs and Housing (1):

To be determined

Canada Mortgage and Housing Corporation (1):

Len Bulmer, Portfolio Manager, Social Housing

Housing expert (1):

Don Richmond, Consultant

If confirmed by Council, Councillor Feldman will continue to chair the group. This group has met twice informally, in order to review draft management guidelines for the Fund.

The Terms of Reference also contains specific provisions to ensure that potential conflicts of interest for members will be declared and addressed. While advisory committees are not subject to the Municipal Conflict of Interest Act, the group has made a policy decision to abide by such requirements and members will be signing statements to that effect. As a result, members cannot participate in any discussion of projects or funding proposals in which they have a pecuniary interest.

Management Guidelines for the Capital Revolving Fund:

Appendix B proposes specific management guidelines for Council approval. Individual funding proposals must be approved by Council; however the guidelines provide a framework for development of such proposals. They are based on draft guidelines that were attached to the staff report of December 1, 1998, but have been modified to reflect the advice of the informal Reference Group. They also reflect comments provided by the City Solicitor.

The guidelines address a number of issues raised by Councillors at the time the fund was approved, as follows.

Ensuring the Viability of Projects:

A key objective of the fund is to encourage community partners to develop affordable housing projects, but at minimum financial risk to the City.

There is significant experience in the United States with capital funds supporting affordable housing development, and a number of Canadian cities that have launched such funds. The proposed guidelines draw from this experience. The resulting approach is one that is significantly different from previous housing programs which were based on ongoing, largely open-ended subsidy arrangements.

Use of the Fund will be limited to one-time capital contributions to community-led projects. The fund will not be used for on-going operating requirements or rent-subsidies. This reduces the direct risk to the City of increased costs due to rising project operating costs. The guidelines clearly state that community groups are expected to contribute equity to their project, and to fundraise for the balance of costs. It is intended that the fund contribution be no more than 15-25 percent of the total project cost. In most cases, the primary financing will be in the form of a private mortgage insured by the Canada Housing and Mortgage Corporation.

Funding proposals must provide a detailed business case and a financial pro forma that will be reviewed by the Reference Group. As noted above the Reference Group includes significant private development and financial expertise to advise staff on the economic viability of proposed projects. While no project will ever be risk-free, the objective is to provide the best advice possible to Council. At the two informal meetings held to date, the Reference Group has discussed at length the means by which the City can limit its future financial risk exposure for the proposed project at the Lawrence/Allen City-owned site. Specific recommendations for that project will be presented to Council shortly.

Who Will be Eligible:

The proposed guidelines in Appendix B set out eligibility requirements for projects. The Reference Group is interested in supporting both private and non-profit sponsors of affordable housing development. However, given restrictions of the Municipal Act with regard to commercial bonusing, only non-profit corporations can be eligible for funding currently. The Reference Group will be working with City program and legal staff to explore options for supporting private sector development of affordable housing. This may or may not include use of the Fund, and staff will report to Council on the results of these discussions.

As the guidelines indicate, project selection will be based on a competitive, proposal call process. Requests for proposals may be issued for specific types of projects or there may be a request for expressions of interest, followed by invited proposals from a short list.

Key requirements for each project proposal include:

- a detailed business plan to demonstrate financial viability;

- successful track record and financial competence for the community partners involved;

- sufficient funding for the balance of project costs, including equity contribution from the group;

- commitments of support service funding where needed;

- sufficient attention paid to social and neighbourhood factors and the land use approval process.

As noted above, all project proposals must be approved by Council, based on recommendations from staff with advice from the Reference Group.

Monitoring Projects:

As noted in the proposed guidelines, the City contribution to projects will generally be secured by way of a land lease or other agreement registered on title to the land, to the satisfaction of the City Solicitor.

Such an agreement will include provisions related to the nature of City funding, the type and amount of affordable housing provided in exchange for funding the mechanism, monitoring of the ongoing provision of affordable housing, and remedies available to the City if the project ceases to be operated as affordable housing.

Conclusion:

Establishment of a capital revolving fund is a key element of the City's affordable housing strategy and was specifically recommended by the Mayor's Homelessness Action Task Force. The guidelines proposed in this report provide a framework for the City to lever affordable housing to be developed by the community in Toronto and support from senior levels of government.

Appendices:

A Reference Group - Terms of Reference

B Capital Revolving Fund for Affordable Housing - Management Guidelines

Contact Name:

Joanne Campbell

Tel: 392-7885/Fax: 392-0548

Joe Farag

Tel: 392-8108/Fax: 392-3649

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Appendix A

Reference Group for the Capital Revolving Fund

Terms of Reference

(1) Context:

Toronto City Council has established a Capital Revolving Fund for Affordable Housing, as part of a strategy for developing affordable housing. "Affordable housing" may include ownership, rental, or transitional/supportive housing.

The Fund will be used to provide financial assistance to non-profit groups, and possibly others, in the development of affordable housing. Capital from the fund is intended to be combined with other resources, from the City or elsewhere, to result in viable projects.

(2) Purpose and Function:

The purpose and function of the Reference Group is twofold:

(a) to provide expert advice to the Commissioner of Community and Neighbourhood Services on use of the Fund, including setting general priorities, assessing viability of projects, and selecting projects for recommendation to Council for funding;

(b) to help develop strategies for creating affordable housing, including ways to lever contributions from other parties, and ways to combine resources from the Fund with other resources.

(3) Membership:

(a) The membership of the Reference Group will be 10 to 12 persons appointed by the Commissioner of Community and Neighbourhood Services, with a maximum number as follows from different sectors or areas of expertise:

1 City Councillor;

4 from the private development and property management industry;

2 from the financial sector;

2 from the community-based housing and services sector;

1 from the Ontario Ministry of Municipal Affairs and Housing;

1 from Canada Mortgage and Housing Corporation; and

1 other housing expert.

(b) Members of the Reference Group will be appointed for terms which end at the same time as the term of City Council.

(c) No honoraria will be paid by the City of Toronto to members of the Reference Group.

(4) Conflict of Interest:

(a) Although the Reference Group has only an advisory role, it will adopt and abide by a conflict of interest policy, whereby each member of the Reference Group will:

(i) upon being appointed to the Reference Group, sign a document acknowledging awareness of and stating intention to abide by these conflict of interest provisions;

(ii) declare in advance any conflict of interest he or she has regarding any item considered by the Reference Group;

(iii) abstain from all Reference Group discussions of any item on which he or she has a conflict of interest; and

(iv) abide by any other conflict of interest provisions that may be adopted.

(b) A conflict of interest arises if a member of the Reference Group has a pecuniary interest as described in the Municipal Conflict of Interest Act.

(5) Confidentiality:

Members of the Reference Group will not disclose any sensitive information on particular properties, applicants for funding, project proposals, or related matters, to persons other than Reference Group members and associated City staff.

(6) Conduct of Meetings:

(a) The Reference Group will choose its own chair.

(b) Meetings will be public except when matters listed in subsection 55(5) of the Municipal Act are considered.

(c) Meetings will be held at the call of the chair on the advice of City staff, or as determined by the Reference Group.

(d) Minutes will be kept of the Reference Group's meetings, but these minutes will not contain sensitive project information.

(7) Committees:

Ad hoc subgroups or committees of the Reference Group may be formed to engage in detailed review, advice, or other close collaboration with City staff on particular proposal calls, project proposals, or other matters; such committees will report to the Reference Group.

(8) Reporting and Decision-making:

The Reference Group will report to the Commissioner of Community and Neighbourhood Services; staff recommendations to Council on use of the fund will be accompanied by information regarding the advice provided on that matter by the Reference Group.

Appendix B

Capital Revolving Fund for Affordable Housing

Management Guidelines

(1) Purpose

(1.1) The purpose of the Capital Revolving Fund for Affordable Housing is to provide financial assistance for the development of affordable housing.

(1.2) The fund was established as part of a City strategy for affordable housing development. The City is seen as facilitator and partner in that process.

"The goal of the Affordable Housing Development Strategy is to create an environment in which private sector and community partners will be willing and able to develop affordable housing for people with a range of housing needs that are not currently being met in the market." (Approved by Council, July 1998.)

(2) Definition of Affordable Housing:

(2.1) Affordable Housing means low- and moderate-income housing at rents or prices which in the City of Toronto are not generally found in the private housing market, or the market for new housing.

(2.2) Affordable Housing may include rental, transitional/supportive housing, or affordable ownership.

(2.3) A more precise definition of Affordable Housing will be adopted by Council, to apply to the fund. This may define more than one category of Affordable Housing.

(2.4) Development of affordable housing may include acquisition, rehabilitation, or conversion of existing residential or non-residential buildings, in cases where Affordable Housing would not otherwise be created or preserved.

(3) Nature of Support from the Fund:

(3.1) Capital from the fund is intended to lever and combine with other resources that will jointly make projects viable. Other resources may include fundraised equity, private capital, contributions of land, the new multi-residential property tax class, exemption from development charges, help to access financing or mortgage insurance on favourable terms, federal or provincial capital support, and other resources as appropriate.

(3.2) Funding will be provided to non-profit corporations and may be provided to private corporations subject to any restrictions in the Municipal Act and other legislation.

(3.3) Recipients of funding must raise or borrow additional funds from other sources to the extent needed to cover the full project capital costs.

(3.4) The fund will not provide ongoing or operating funding.

(3.5) The nature and amount of support provided by the fund may depend on the amount of resources or risk on the part of the recipient of funding, and the number and type of affordable units provided.

(3.6) Assistance may be provided in the form of grants, loans, or forgivable loans. Affordable ownership housing will be eligible only for repayable loans.

(4) Priorities for Use of the Fund:

(4.1) Funds available in each year will be allocated in a diversified way among several projects.

(4.2) The Capital Revolving Fund Reference Group will assist the Commissioner of Community and Neighbourhood Services in advising Council on overall priorities for the fund and on specific funding allocation decisions.

(4.3) Priorities and broad targets for the fund, or for any particular proposal call, may be set from time to time by the Commissioner of Community and Neighbourhood Services on the advice of the Reference Group, and reported to Council. Such priorities and broad targets may pertain to volume of funds to be allocated, number of units or projects, types of housing to be funded, and/or levels and forms of support.

(4.4) The overall priority for use of the fund will be to cover construction costs and related soft costs. This may include interim financing during construction. Proposal Development Funding (PDF) may be provided to cover approved costs (such as architectural and technical consultants, legal costs, etc.) for short-listed applicants to develop their proposals more fully.

(5) Process For Allocating Funds:

(5.1) Funding will be allocated through a competitive proposal call process. There may be one or more than one proposal call each year that funds are available.

(5.2) Proposal calls may be by way of an initial Request for Expressions of Interest, followed by invited proposals from a short list, or by way of a one-step request for proposals (RFP).

(5.3) The Reference Group will advise on how broad or specific each proposal call will be. A proposal call may target one or more particular housing types or forms of assistance.

(5.4) Proposal calls will be issued on behalf of the City by the General Manager of Shelter, Housing and Support, within the parameters of any relevant policies of Council.

(5.5) The General Manager of Shelter, Housing and Support will review and evaluate proposals received, recommending a short list or preferred proposal to the Reference Group for review. The General Manager will negotiate with the selected party or parties to determine the form of assistance to be recommended to Council.

(5.6) The General Manager of Shelter, Housing and Support will seek the advice of City staff in the Finance Department and the Legal, Facilities and Real Estate, City Planning, and other divisions, as required.

(5.7) Final approval of funding for each project will be by City Council, based on a report from the Commissioner of Community and Neighbourhood Services through a standing committee.

(6) Eligibility Requirements:

(6.1) Recipients of funding must be incorporated. Unincorporated groups may receive funding through an incorporated trustee organization.

(6.2) Projects supported by the fund must be within the boundaries of the City of Toronto.

(6.3) The following criteria will apply to selection of project proposals, along with other criteria determined by the Commissioner of Community and Neighbourhood Services as appropriate:

(i) a viable business plan including other elements named here;

(ii) sufficient funds for the balance of project capital costs;

(iii) a viable operating budget;

(iv) commitments of support service funding, where required;

(v) ability of private-sector partners to meet due diligence requirements and demonstrate financial competence and track record;

(vi) a solid track record as a housing management organization (may apply to one but not all parties in a partnership), and a management plan;

(vii) land use planning approvals progressing to the satisfaction of the General Manager of Shelter, Housing and Support;

(viii) due attention paid, in project planning, to social and neighbourhood factors;

(ix) meeting any special requirements applying to particular proposal calls.

(7) Financial and Legal Management:

(7.1) The fund will be invested and managed financially by the Chief Financial Officer and Treasurer, within the parameters of relevant City policies.

(7.2) Each recipient of funding will enter into an agreement with the City, to the satisfaction of the City Solicitor. This agreement will include provisions on the nature of City funding, the type and amount of Affordable Housing provided in exchange for funding, monitoring of the ongoing provision of Affordable Housing, remedies available to the City if the project ceases to be Affordable Housing, and other matters to the satisfaction of the City Solicitor. Such an agreement may be registered on title.

(7.3) Undertaking to enter into such an agreement will be a condition of approval of funding.

(8) Replenishment of the Fund:

(8.1) A portion but not all of the assistance provided from the fund will be repaid on a short-term or long-term basis, and used for further affordable housing projects.

(8.2) The fund will be replenished in part from a share of developer contributions to affordable housing under agreements authorized by Section 37 of the Planning Act.

(8.3) The fund will also be replenished from other sources to be determined by City Council.

(9) Reporting:

The Commissioner of Community and Neighbourhood Services will report to Council on each specific allocation from the fund, and will report annually to Council on overall allocations from the fund and the results achieved.

4

Change in Membership - Children and Youth

Action Committee

(City Council on May 11 and 12, 1999, adopted this Clause, without amendment.)

The Community and Neighbourhood Services Committee recommends the adoption of the recommendation of the Children and Youth Action Committee embodied in the following communication (April 6, 1999) from the City Clerk:

Recommendation:

The Children and Youth Action Committee recommended to the Community and Neighbourhood Services Committee that Mr. Ian Wood be appointed as the alternate member to Mr. David Rew for the Boys and Girls Clubs of Greater Toronto.

Background:

The Children and Youth Action Committee on March 25, 1999, had before it a communication (March 22, 1999) from Mr. David Rew, Boys and Girls Clubs of Greater Toronto requesting that Mr. Ian Wood be appointed as the alternate member for the Boys and Girls Clubs of Greater Toronto.

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(Communication (March 22, 1999) from Mr. David Rew,

Boys and Girls Clubs of Greater Toronto, addressed to the

Children and Youth Action Committee)

Please be advised that Mr. Ian Wood is to be the alternate voting designate to the Toronto Children and Youth Action Committee for the Boys and Girls Clubs of Greater Toronto in my absence.

The Board of Directors of the Boys and Girls Clubs of Greater Toronto approved this motion at its last meeting on Wednesday, February 24 1999.

Should you require any further information please do not hesitate to contact the undersigned at (416) 281-0262 Ext. 201.

5

Operational Review of Ontario Works

and Child Care

(City Council on May 11 and 12, 1999, adopted the following recommendation:

"It is recommended that the Chair of the Community Services Committee be requested to negotiate with the Province of Ontario with respect to the provision of child care for the 34,000 children whose parents would be required to participate in the Ontario Works Program.")

The Community and Neighbourhood Services Committee reports having directed that, given the delay by the Provincial Government in releasing its Operational Review of Ontario Works and Child Care, the Commissioner of Community and Neighbourhood Services be requested to report directly to Council for its meeting on May 11, 1999, providing an update on the number of children in need of child care now that their parents qualify for Ontario Works.

(City Council on May 11 and 12, 1999, had before it, during consideration of the foregoing Clause, the following report (April 30, 1999) from the Commissioner of Community and Neighbourhood Services:

Purpose:

The purpose of this report is to provide the update requested by the Community and Neighbourhood Services Committee at its April 22, 1999 meeting on the number of children in need of child care by virtue of their parents' qualification for Ontario Works.

Funding Sources/Financial Implications:

Funding for the childcare service component of the Ontario Works program is cost shared 80:20 by the Province and the City. Provision to fund 2050 units of childcare service in support of the Ontario Works program has been approved as part of the 1999 Children's Services budget.

Recommendation:

It is recommended that this report be received for information.

Background/Council Reference:

Given the delay in the release of the Provincial Operational Review of Ontario Works and Child Care the Community and Neighbourhood Services Committee, at its April 22, 1999 meeting requested that an update be provided directly to Council on the number of children in need of child care by virtue of their parents' Ontario Works requirements. This report confirms and updates the information originally provided in a March 12, 1998 report entitled "Child Care Demand Related to the Ontario Works Program".

Comments:

There are approximately 65,000 children aged 0 to 9 years whose parents have a mandatory participation requirement in the Ontario Works program. Of these, approximately 40,000 children are from families who have a participation deferral because of the age of the youngest child. The remaining 25,000 school-aged children (including those of junior kindergarten age) are from families whose parents have a mandatory and non-deferred participation requirement. This estimate of 25,000 children is conservative. If children up to the age of 12 years are included, the number of children in families with a non-deferred participation requirements increases to 38,000. Given that approximately 4,000 of these children are already in receipt of care, the remaining unmet care demand is in the 21,000 to 34,000 range depending on the upper age cut-off limit adopted for the children.

There are currently 5,736 children of 3,984 families in receipt of social assistance on the subsidized childcare waiting list. Of this total, 1,171 children are in 949 social assistance families who have a mandatory participation requirement under the Ontario Works program.

There are currently 8,872 children in 5,805 social assistance families who are receiving subsidized childcare. Of these children, 2,080 are in receipt of Ontario Works funded childcare subsidies. The balance, 6,792 children are in receipt of regularly funded childcare subsidies.

Conclusions:

All available childcare fee subsidies in both the Ontario Works funded stream and the regularly funded stream are currently being utilized. New placements are basically occurring now on a "one in for one out" basis. There is an insufficient supply of childcare subsidy, childcare licensed stock, and other care options to meet the current and future service demand associated with the Ontario Works program. It is important to note that the Social Services Division ensures that no client with children is penalized for not meeting Ontario Works program participation requirements if they can not obtain appropriate childcare.

This report was prepared for the information of Council at the request of the Community and Neighbourhood Services Committee.

Contact Person:

Petr Varmuza, Assistant General Manager, Children's Services Division

Tel: 392-8284; Fax: 392-4576; E-mail: varmuza@csis.csis.csd.metrotor.on.ca)

6

Other Items Considered by the Committee

(City Council on May 11 and 12, 1999, received this Clause, for information.)

(a) The Learning Enrichment Foundation's Business Plan for an Ontario Works Project in Ontario.

The Community and Neighbourhood Services Committee reports having concurred in the recommendation contained in the following report from the Commissioner of Community and Neighbourhood Services; and having referred the following communication from the City Clerk and the brief from The Learning Enrichment Foundation to the Commissioner of Community and Neighbourhood Services for report thereon to the May 19, 1999, meeting of the Committee:

(i) (April 8, 1999) from the City Clerk advising that York Community Council on March 30, 1999, recommended to the Community and Neighbourhood Services Committee that consideration be given to the Business Plan submitted by The Learning Enrichment Foundation regarding an Ontario Works Project for social assistance recipients in Toronto, over a three-year period; and that York Community Council endorsed the aforementioned proposal.

(ii) (April 12, 1999) from the Commissioner of Community and Neighbourhood Services respecting the proposal for an Ontario Works Project in Toronto submitted by The Learning Enrichment Foundation (LEF); advising that staff of the Department are meeting on April 19, 1999, with LEF and Ministry representatives to discuss the proposal in greater detail; and recommending that staff report back to the Community and Neighbourhood Services Committee for its May 19, 1999, meeting, after consultation with the appropriate parties has occurred.

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Mr. Peter Frampton and Mr. Donald McDonald, President, The Learning Enrichment Foundation, appeared before the Community and Neighbourhood Services Committee in connection with the foregoing matter; and submitted a brief requesting that the Terms of Reference for the LEF pilot project evaluation include items Nos. (1) to (8) outlined in such brief.

(b) Client Services and Information Unit Annual Report.

The Community and Neighbourhood Services Committee reports having received the following report:

(April 6, 1999) from the Commissioner of Community and Neighbourhood Services respecting the role of the Client Services and Information Unit (C.S.I.U.); providing a summary of the C.S.I.U.'s activities in 1998, and an update of ongoing development by the Social Services Division to ensure consistent application of policy across the Division, and the creation of new service quality initiatives; and recommending that the report be received for information.

(c) "On The Move" Pilot Project.

The Community and Neighbourhood Services Committee reports having referred the following communication to the Commissioner of Community and Neighbourhood Services for a report thereon to the Committee:

(March 26, 1999) from the General Secretary, Toronto Transit Commission, advising that the Toronto Transit Commission on March 23, 1999, had before it Clause No. 15 of Report No. 5 of The Strategic Policies and Priorities Committee, headed "Evaluation of the 'On the Move' Pilot Project," wherein it recommended that the Commission be requested to consider a discount on bulk ticket purchases, beyond the one percent currently provided to TTC ticket agents, for community-based agencies providing services for the homeless and socially isolated persons; and that the Commission approved the following:

(1) That the sale to the City of Toronto Community and Neighbourhood Services Department of $100,000.00 of fare media for appropriate 'On the Move' projects, as certified by the City of Toronto, be subject to a 5 percent discount, and if the Province of Ontario matches this funding, a discount of 10 percent apply on the sale of $200,000.00 in TTC fare media to the City of Toronto Community Services Department; and further that staff conduct a review after one year to measure the success of this initiative.

(2) That the City of Toronto Community and Neighbourhood Services Department be requested to develop a long term plan for this initiative which would provide a non-TTC funding source.

(d) Update on Situation at StreetCity.

The Community and Neighbourhood Services Committee reports having received the following verbal update:

The Director of Hostel Services provided the Community and Neighbourhood Services Committee with a verbal update on the situation at StreetCity, and the discussions that have been held with Homes First Society, the Toronto Police Service and residents of the facility; and noted that a written report will be submitted to a future meeting of the Community and Neighbourhood Services Committee.

Respectfully submitted,

CHRIS KORWIN-KUCZYNSKI

Chair

Toronto, April 22, 1999

(Report No. 5 of The Community and Neighbourhood Services Committee, including an addition thereto, was adopted, as amended, by City Council on May 11 and 12, 1999.)