1 Final Report of the Seniors' Task Force

2 Request to Enact the Emergency By-Law to Assist Homeless People

3 Aboriginal Homelessness Steering Committee

4 Proposed Framework for the Homelessness Report Card

5 Release of 1998 Community Services Grant - Friends of Shopping Bag Ladies

6 Funding for Homeless Services - Appeals Report

7 Food Related Capital Grants - Second Round Allocations

8 Enhanced Employment Placement - Ontario Works

9 National Children's Agenda - Round Table Discussions

10 Homes for the Aged - Uncollectible Account

11 Annual and Planned Giving Programs - Homes for the Aged

12 Other Items Considered by the Committee

(City Council on October 26 and 27, 1999, adopted this Clause, without amendment.)

The Community Services Committee recommends the adoption of the recommendations of the Seniors' Task Force embodied in the Final Report attached to the following communication (September 20, 1999) from Councillor Anne Johnston, Chair, Seniors' Task Force, subject to approval of the report requested in Recommendation No. (2) with respect to the implementation strategy and funding implications:

I am pleased to forward the Final Report of the Seniors' Task Force to the Community Services Committee and City Council. I have the following recommendations:

(1) that the 55 recommendations contained in the report be adopted; and

(2) that the Commissioner of Community and Neighbourhood Services submit a follow up report on the implementation strategy, the development of the proposed Seniors' Assembly and the funding required to support the Assembly.

This report represents the input from the public consultations and the members of the Task Force. It identifies the issues and priorities affecting seniors in the City of Toronto, proposes a citizen participation model called the Seniors' Assembly and outlines the initiatives undertaken to celebrate the International Year of Older Persons 1999. The recommendations outline a blue print which will be the subject of a follow up report on the implementation strategy and the development of the proposed Seniors' Assembly.

Many of the recommendations can be implemented in part or in total with existing resources. Staff from the Toronto Transit Commission have indicated they will include funding information for the public transportation recommendations in their next budget submission. It is recognised that developmental and ongoing funding will be required to support the activities of the Seniors' Assembly. This funding will be identified within the follow up report to Council by Community and Neighbourhood Services Department staff.

On November 2, 1999, a Seniors' Summit will be held that provides an opportunity for City staff, provincial representatives, community-based agencies and seniors to respond further to those issues identified within the Task Force report. It is expected that a meeting of key stakeholders will be convened shortly after the Seniors' Summit to determine the appropriate community placement of the Seniors' Assembly.

I wish to thank the many seniors and staff who participated in this process and especially the members of the Seniors' Task Force who worked hard to make the most of this opportunity. This document is City Council's contribution to the International Year of Older Persons 1999 in Toronto. It can act as a guide to upcoming initiatives. I am very pleased to have chaired this important Task Force.

Executive Summary:

How we got started:

Early in 1998, the Toronto City Council established a Seniors' Task Force to identify the needs of seniors in Toronto and to develop a seniors' strategy to address priority issue areas which are to:

- develop structures to advise City Council on issues affecting seniors and to involve seniors in this process;

- ensure that policies, programs and services developed and delivered by the municipality meet the needs of seniors;

- value the involvement of seniors in the life of the City;

- identify a role for the City in the International Year of Older Persons 1999; and

- provide a process for rationalization of all previous municipal seniors' committees.

City Council adopted the Terms of Reference in March 1998.

The Task Force consists of 25 members representing the geographic areas of the City. Seven are City Councillors and 18 are senior citizens.

What we did:

The Seniors' Task Force undertook a highly inclusive consultation process. In partnership with about 65 community organizations and associations, the Task Force listened to the needs and concerns of 1,064 seniors in 39 public consultations held in the Fall of 1998. Consultations were held simultaneously in many languages including Chinese, Italian, Korean, Portuguese, Spanish and Tamil. Dedicated telephone lines were available, some in local communities, as well as a two-day staffed telephone line provided by Access Toronto using the ATT language line. Fax, e-mail and a mailing address were made available for feedback from seniors who did not attend the consultations.

The consultation process was based on a facilitated workshop model and sought input from seniors on the following questions:

- What are the major issues and priorities for seniors living in the new City of Toronto?

- What citizen participation models should be adopted to advise City Council on seniors' issues?

- What suggestions did they have for marketing 1999 as the International Year for Older Persons in Toronto?

The Seniors' Task Force NEWS was developed to let the public know about the Seniors' Task Force and circulate information on the public consultation schedule. Three issues of the newsletter were produced. Approximately 13,400 copies of the newsletters were printed and distributed to interested individuals. Community newspapers, local television and a 55+ radio station were also used to disseminate information about the consultations.

Seniors in Toronto:

The Seniors' Task Force also reviewed key demographic data about seniors in Toronto and found that the population of the City of Toronto is aging. In 1971, seniors represented 8 percent of the total population of Toronto; in 1996, seniors represented 13 percent of the population. By 2029, the proportion of seniors is expected to increase to about 20 percent of the total population.

Other key demographic points include:

- One in four seniors live alone. The majority is female.

- The number of older seniors (over 75 years of age) is increasing.

- About a third of seniors use languages other than French and English. The top five languages, aside from English, are Italian, Chinese, Portuguese, Polish and Greek.

- The 1995 median income for Toronto's seniors, according to Statistics Canada, Taxfile Data, was $40,027.00, not far from the median income of all Toronto families at $41,629.00. The percentage of seniors, however, that received an income equal to or less than $30,000.00 annually was a little over 34 percent for husband/wife families, almost 33 percent for lone-parent families, and a dramatic 78 percent for single seniors.

- The income for the majority of single seniors (36 percent) was between $10,000.00 and $15,000.00. Most of these are widows.

What we heard:

The Seniors' Task Force began its work in a time of social and political change. These changes have been rapid and wide ranging and have directly affected the daily lives of seniors.

Seniors acknowledged and valued the many programs and community supports they had been able to access and contribute to through the years. At the same time, however, they expressed deep concerns about the potential loss of familiar, local services and the feeling of community due to the amalgamation process.

The seniors consistently identified the following issues as major concerns for them living in the new City of Toronto. They were:

- Access to Information:

Seniors want consistent, clear information about who delivers services to seniors and how these services are delivered. This information needs to be delivered in many languages and using formats that seniors can easily see, hear and understand.

- Health and Health Services:

Seniors were very concerned about many health care issues, especially the protection of community and public health programs, and accessible and affordable health care. They have many of the same concerns as others living in Toronto about the lack of long-term care and acute care beds, long waits in emergency wards, lack of staff, inadequate community-based health care, and a general perception that health services are declining.

- Transportation:

Seniors expressed support for both the TTC and Wheel Trans. They are vital to seniors. Their suggestions and concerns focused on accessibility and affordability of public transportation.

- Housing:

Although housing concerns are common to the population as a whole, seniors were particularly concerned about property taxes and fees for service. Seniors living in public housing were concerned about privatization, security and maintenance. Seniors who may be leaving their homes were concerned about affordability of rental units and being able to stay within their community.

- City Services and Supports:

Seniors expressed concern about loss of service due to amalgamation. Services that are delivered by local government and through senior centres and agencies are important.

- A Voice for Seniors:

Seniors said they wanted to have input into local government policy decisions that affect their lives and how services are delivered to them. Any group representing seniors in Toronto should reflect the cultural and ethno-racial diversity of the City.

It is timely that the Seniors' Task Force final report will be on the City Council agenda in 1999, the International Year of Older Persons. This report, which outlines recommendations to address issues and priorities raised by seniors living in the new City will become part of the legacy for City Council, staff and seniors to working together to make the new City of Toronto a society for all ages.

Seniors' Task Force Vision Statement:

The following vision statement was adopted by the Seniors' Task Force on June 15, 1999.

"By 2005, the City of Toronto will be a leader in supporting quality of life for seniors by providing reasonable access to services, a safe physical environment, choices in work and social opportunities, and a voice in local government decisions which affect their lives.

Toronto will be recognized as a caring City that respects and values its seniors and their contributions to the life of the City."

Summary of Recommendations:

Access to Information:

The Seniors' Task Force recommends that:

(1) The Information and Communication Division through Access Toronto consolidate information on all senior-specific programs or services operated by the City and, in partnership with Community Information Toronto and local community information centres, assess existing information for seniors and collaboratively seek ways to address gaps and identify promotional models to inform seniors of these services.

(2) Access Toronto, Toronto Social Housing Connections and Community Information Toronto develop strong linkages with the Community Care Access Centres for information sharing and elimination of duplication and that this linkage be communicated to the local information access points for seniors in the community.

(3) All information delivery to seniors be based on best practices so that the communication is:

- in clear language;

- linguistically accessible;

- clear in font, layout, print size and colour;

- given by "real" people answering main information lines;

- culturally appropriate;

- disseminated through the community newspapers, community centres and libraries;

- available to seniors with low literacy skills; and

- able to use public service announcements on radio and cable TV which can be made available at no cost.

(4) Training and Development conduct training sessions for City staff in both oral and written communication with seniors to develop effective skills to deliver information that is "senior-friendly."

(5) The City recognize that resources for technical upgrades at local community information centres has not kept up with the need and that community grants criteria recognize this as an important funding need in information provision.

(6) The Province establish and fund a health information clearinghouse for seniors.

Health Care:

The Seniors' Task Force recommends that:

(7) The provincial government reinvest funding into the health care sector to ensure that the principles of access and high quality care are not compromised; and that the funding be significantly enhanced for nursing services, Community Care Access Centres (to expand community long term-care services), and mental health services for seniors.

(8) The Province ensure that the criteria for funding health care services include access to services as a measure of meeting the needs of the diverse populations in the City of Toronto and address specifically the barriers to accessing health care services for ethno-cultural and linguistic seniors.

(9) The Province eliminate co-payment charges for seniors for prescription drugs and expand the benefit coverage to include supplies required for the administration of prescription drugs such as insulin.

Public Health:

The Seniors' Task Force recommends that:

(10) City Council continue to support and fund local public health programs and services for seniors (including chronic disease and injury prevention, substance abuse prevention, communicable disease control, elder abuse prevention, informal/caregiver support initiatives and dental programs).

(11) Toronto Public Health work with Community Care Access Centres and other agencies to address the needs of the "at risk" frail elderly.

(12) Toronto Public Health continue to work with community agencies and groups to advocate for policies and practices which ensure equal access to health care and an equitable distribution of resources and services for seniors.

Housing:

The Seniors' Task Force recommends that:

(13) The City urge the Province of Ontario to amend the Tenant Protection Act to restore rent control.

(14) The City, as part of its affordable housing strategy, encourage a fair share of affordable housing units be developed within the City to target seniors.

(15) The City urge the provincial and federal governments to ensure the housing needs of seniors are included in any new housing developments, recognizing that a solution to the affordable housing crisis in Toronto must involve all levels of government.

(16) The City of Toronto approach the Ontario Non-Profit Housing Association to facilitate discussions on accessible housing needs in Toronto, through its local Toronto network. The Toronto Housing Company, Co-op Housing Federation of Toronto and the Metropolitan Toronto Housing Authority should participate in these discussions so that a mutual exchange of learning and experience occurs between City-operated and community-based housing providers.

(17) The City continue to negotiate with Canada Mortgage and Housing Corporation to expand the City's administration of the federal Residential Rehabilitation Assistance Program across the new City of Toronto.

(18) The City of Toronto conduct public information sessions for seniors in the community explaining the details of the new Property Tax System, how to read the new bill, where the money is going and how the assessment worked.

Public Transportation:

The Seniors' Task Force recommends that:

(19) The Toronto Transit Commission continue the discounted seniors' fare.

(20) The TTC develop mechanisms which allow for reduced rates for seniors during off-peak times. One of these should be the development of a seniors' day pass which would be valid during off peak times and available for purchase at stations and community outlets.

(21) The TTC recognize that low-income seniors have difficulty having enough money to purchase transit fares even at a discounted seniors' rate. It is recommended that appropriate City staff explore the possibility of a transit subsidy for those seniors receiving the Provincial GAINS (Guaranteed Annual Income Supplement) and that staff approach the provincial government with a proposal .

(22) The TTC change the current "courtesy seating" system to "designated seating" with the additional phrase "Be prepared to give up your seat." The current "elderly and disabled" signage can still be used. The program be supported by the drivers and a marketing program using the International Year of Older Persons theme and logo.

(23) Signage throughout the system be improved and include signs, brochures and schedules with larger print, information in languages other than English, and international graphic signage. Information on improvements should be communicated to seniors' organizations, particularly ethno-racial groups and seniors' centres.

(24) Training for TTC staff on seniors' special needs be introduced to enhance sensitivity and improve customer service. An effective course would facilitate staff understanding about what it is like for a seniors to use the regular system and what they can expect to encounter.

(25) Notification be posted in subway stations to advise passengers that escalators and/or elevators are out of service. If seniors can only exit that station using these services, they need to know before they exit to avoid paying an additional fare to travel to a station which they can exit.

(26) The sound system be upgraded to make it useful for seniors and others.

(27) The TTC and the Works Department install more benches at bus stops and shelters. Locations should be identified with the assistance of the Seniors' Assembly.

(28) The TTC develop an accessibility map which would plot out trips between stations that are accessible and link them with accessible bus routes.

(29) A geriatrician be added to the Wheel Trans review panel to assess the needs of aging seniors who do not need mobility devices except for canes.

(30) The ability to challenge the decision of the Wheel Trans review panel be addressed. Many seniors are unclear about the criteria and their rights. They have a fear about speaking out and many do not speak English easily. The review panel should offer community locations, perhaps at seniors' centres, community or recreation centres. The panel should be prepared to provide services in languages other than English, with notices that reflect that service.

(31) Community bus routes be expanded and the TTC staff work with the community to develop, support and promote these routes.

(32) The City champion the Community Transportation Action Program that is vital to the transportation needs of a number of sectors and promotes efficient use of community agency vehicles.

City Services and Supports:

The Seniors' Task Force recommends that:

(33) All public and community meetings sponsored by the City provide for seniors' full participation include:

- information that can be read easily, e.g., adequate font size, clear language;

- a public address system to ensure all can hear the speakers; and

- accessible buildings.

(34) Parks and Recreation services and programs which value seniors be supported and developed to meet the needs of the growing seniors' population. Programs for seniors create a balanced program in each community centre.

(35) Parks and Recreation continue to evaluate the impact of user fees on access and participation in seniors' programs.

(36) Parks and Recreation staff develop a broad range of recreation and leisure opportunities that accommodate variances in interest, culture and level of ability to participate, and that seniors are involved and consulted in this process.

(37) Works and Emergency Services continue to make regular formal inspection of sidewalks and curbs and that repairs to hazardous conditions be a priority.

(38) Works and Emergency Services develop a well-publicized reporting system that enables members of the public to report hazardous sidewalk or curb conditions.

(39) All sidewalk snow and ice clearing by-laws be rigorously enforced.

(40) The Seniors' Assembly work with the Task Force on Community Safety, City Cycling Committee and the Pedestrian Committee on safer sidewalk strategies.

(41) The Seniors' Assembly work with the Task Force on Community Safety, the Pedestrian Committee and Transportation Services on appropriate timing for multi-laned intersection pedestrian crossings.

(42) The Fire Department promote the "Older and Wiser" program through public service announcements.

(43) The Fire Department promote a program to "train the trainer" through a wide range of seniors' organizations especially groups in the ethno-racial community so that awareness can be promoted in languages other than English.

(44) The Seniors' Assembly work with members of the Task Force on Community Safety on common issues and that any brochures, campaigns or advertisements include seniors issues.

(45) The membership of the Task Force on Community Safety include seniors.

(46) City Council recognize the importance of anti-fraud community initiatives such as The East York Community Task Force to Combat Fraud Against Seniors and the ABC's of Fraud program.

(47) Public service announcements be routinely developed on the latest fraud/scam, with encouragement to report incidents to police along with a list of community agency programs to contact. These should be announced by the Mayor and/or the Chief of Police and carried on television, radio and in community and City newspapers.

(48) City Council support affordable access to life long learning.

(49) Information on literacy programs for seniors at the Toronto Public Library be distributed to community and seniors' organizations.

(50) The City of Toronto's Community Service Program Grants staff re-examine supports to community-based seniors' services and target appropriate funding to vulnerable, at risk groups within seniors' communities.

(51) That prevention and awareness of elder abuse be an important criteria in awarding the Breaking the Cycle of Violence grants.

Burial Ground:

The Seniors' Task Force recommends that:

(52) Staff from the Aboriginal Office, Access and Equity meet with appropriate members of the Aboriginal community to develop a process to acquire a site for an Aboriginal burial ground and that the appropriate City staff be requested to provide any necessary expertise.

International Year of Older Persons:

The Seniors' Task Force recommends that:

(53) City Council continue its support and fund the improved street signage program, and that funding be allocated each year until completion.

(54) City Council encourage property owners to put well-lit numerical addresses on the building, offices and homes on their property. In the development of the improved street signage program, it was noted that many buildings do not display their numerical address.

Seniors' Assembly:

The Seniors' Task Force recommends that:

(55) City Council adopt the model described as the "Seniors Assembly" and appoint a Seniors' Advocate for the City.

Introduction:

(1) Seniors' Task Force: Who are we?

In January 1998, Toronto City Council established a Task Force to Develop a Strategy for Issues of Concern to the Elderly. City Council was responding to recommendations from the Toronto Transition Team Report, "New City, New Directions."

The name of the Task Force was later changed to the Seniors' Task Force.

City Council mandated the Seniors' Task Force to "identify emerging needs of senior residents in the City of Toronto and to develop a seniors' strategy to address priority issue areas which are to:

- develop structures to advise City Council on issues affecting seniors and to involve seniors in this process;

- ensure that policies, programs and services developed and delivered by the municipality meet the needs of seniors;

- value the involvement of seniors in the life of the City;

- identify a role for the City in the International Year of Older Persons 1999;

- provide a process for rationalization of all previous municipal seniors' committees."

City Council adopted the Terms of Reference in March 1998.

The Task Force consists of 25 members representing the geographic areas of the City. Seven are City Councillors and 18 are senior citizens. The seniors were chosen because they are:

- active in seniors' organizations and associations;

- able to reflect their own views and experiences as well as those of their members; and

- able to consult others within their communities.

Councillor Anne Johnston chairs the Seniors' Task Force.

City Councillors on the Task Force are:

- Lorenzo Berardinetti, Scarborough City Centre;

- Michael Prue, East York;

- Ron Moeser, Scarborough Highland Creek;

- Joanne Flint, North York Centre South;

- Elizabeth Brown, Rexdale-Thistletown; and

- Bill Saundercook, York-Humber.

Citizen members selected to the Seniors' Task Force are:

Edna Beange Hugh Betts Ruth Brown

Bill Campbell Margaret Campbell Toni Ciccarelli

Rosa Chan Walter Stewart Culbertson Stuart Hill

Boyd Hipfner George Johnson Dorothy MacKinnon

Beverly McClelland Bill Nemerson Joan Osler

Marlene Scorrano Iria Vieira Bill Wilson

(2) Background: Who are we talking about?

Profile of Seniors in Toronto:

The population of the City of Toronto is aging. While total population increased by 14 percent over the last 25 years, seniors (those 65+) increased by 87 percent over the same time period. In 1971, seniors represented 8 percent of the total population of Toronto; in 1996, there were 319,800 seniors 65+ in Toronto, representing 13 percent of the population. A 1997 Statistics Canada update estimates that the senior population has increased to 340,000. By 2029, the proportion of seniors is expected to increase to about 20 percent of the total population.

The following key demographics provide scope and context for the current population of seniors in Toronto:

- The City's population of seniors is expected to increase at an average annual rate of about 2 percent per year.

- One in four seniors live alone. The majority is female.

- About 40 percent of seniors are at least 75 years of age and this population is projected to increase by 35 percent in the new City between 1995 and 2003. (Harmonization of Dental and Oral Services, January 15, 1999, Board of Health)

- 15 percent of seniors (65+) in Toronto do not know either French or English. This is higher than the overall population where 8 percent do not know either official language.

- 31 percent of seniors speak a language other than English or French at home. In the overall population, 24 percent speak a non-official language at home.

According to 1996 census data, the top five languages, aside from English, spoken at home by seniors in the City of Toronto were Italian, Chinese, Portuguese, Polish and Greek. Overall, seniors speak 25 different languages in the City. Census data also identified ten larger ethno-racial senior communities in the City.

Seniors and Their Incomes:

It is well recognized that in the senior years, affordability problems become more common. The 1995 median income for Toronto's seniors, according to Statistics Canada, Taxfile Data, was $40,027.00, not far from the median income of all Toronto families at $41,629.00. The percentage of seniors, however, that received an income equal to or less than $30,000.00 annually was a little over 34 percent for husband/wife families, almost 33 percent for lone-parent families, and a dramatic 78 percent for single seniors. The income for the majority of single seniors (36 percent) was between $10,000.00 and $15,000.00. It has been estimated that these lower-income seniors are primarily widows who have no Canada Pension Plan or employer pension incomes. Many of these women live in the large stock of the City's Toronto Housing Company seniors' units.

Younger seniors of today (and prospective seniors of tomorrow) are generally financially more solvent than their counterparts of several decades ago, largely due to working in the prosperous post-war period where real gains in retirement pensions were made. Nevertheless, a significant number, especially women, have inadequate incomes. It is well documented that isolation and poverty among seniors are problematic to health and wellness with both personal and economic ramifications for the whole population.

The current (January 1999) minimum level of income guaranteed by the Province for seniors is $11,785.00 per year for individuals and $19,483.00 for couples. (GAINS Program - Province of Ontario). The GAINS program provides up to $996.00 per year to those whose incomes are below the above levels. Currently, 46,331 seniors in the City of Toronto receive the funds through the GAINS supplement program.

(3) Methodology: How we did it and who we spoke to:

Outreach:

The Seniors' Task Force began its work in a time of social and political change. These changes have been rapid and wide ranging and have directly affected the daily lives of seniors. The Task Force members expressed real concerns about the:

- loss of familiar services;

- continued access to needed services; and

- availability of community based programs.

The Seniors' Task Force wanted to hear from as many seniors, and people who serve seniors, as possible. It held public consultations across the new City in places where seniors meet and are comfortable in their communities:

- thirty-nine consultations were held with 1,064 seniors, including representatives of senior organizations and associations as well as representatives of agencies serving seniors;

- staff whose mandates include seniors' issues were asked to provide input on their issues and priorities;

- consultations were held simultaneously in many languages including Chinese, Italian, Korean, Portuguese, Spanish and Tamil;

- dedicated phone lines were available, some in local communities, as well as a two-day staffed phone line provided by Access Toronto using the ATT language line; and

- fax, e-mail and a mailing address were made available for feedback from seniors who did not attend the consultations.

The consultation process was based on a facilitated workshop model. Seniors were asked to work individually at first followed by small group and large group discussions. The workshop was designed to identify major issues and trends with maximum input from seniors on the following questions:

- What are the major issues and priorities for seniors living in the new City of Toronto?

- What citizen participation models should be adopted to advise City Council on seniors' issues?

- What suggestions did they have for marketing 1999 as the International Year for Older Persons in Toronto?

The Seniors' Task Force NEWS was a newsletter designed to let the public know about the Seniors' Task Force and circulate information on the public consultation schedule. Co-edited by citizen volunteers and staff as support, three issues of the newsletter were produced. Approximately 13,400 copies of the newsletters were printed and distributed to interested individuals. Extra copies were available for interested individuals through public libraries, parks and recreation centres, civic centres and City Councillors' offices. Copies were also sent to agencies and their staff that serve seniors, including the Metro Toronto Housing Company residential buildings.

Many community newspapers published information about the Seniors' Task Force and the consultation schedule. Local television and a 55+ radio station included announcements on dates and locations for the consultations in their programming.

What We Heard: Issues and Recommendations:

"A wide consultation like this with seniors has never happened before - it's a real opportunity."

Seniors actively participated in the consultation sessions. They acknowledged and valued the many programs and community supports they had been able to access and contribute to through the years. At the same time, however, they expressed deep concerns about the potential loss of local services and the feeling of community due to the amalgamation process.

The seniors consistently identified five issues as major concerns for them living in the new City of Toronto. They were:

- access to information;

- health and health services;

- housing;

- transportation; and

- services.

The following segment of the report provides detailed context for the main areas of concern for seniors. Each section includes information about the current status of the issue in Toronto, and what the seniors had to say about the issue. The seniors' comments included here closely reflect the tone and content of the seniors' discussions during the consultations. The recommendations, numbered in the same sequence as in the Summary of Recommendations, follow each section to which they are connected.

(4) Access to Information:

"Seniors are not aware of what services, resources and programs are out there. How do seniors find out about them?"

Seniors identified access to information as a priority. All are aware of the current changing climate of local and provincial services. Consistent, clear information about who delivers services to seniors and how these services are delivered is critical during this time of change.

Access to information is the key to open understanding of all the areas identified in this report. Seniors expressed concern about understanding new links to information. The challenge may not be information itself but in communicating to seniors where and how they can get information. The existing community communication infrastructure is important to recognize and use in any reorganization or promotional projects.

Seniors and their caregivers need information on services specific to seniors, such as home supports, financial assistance, health and housing. Seniors also need the same information as any other citizen concerning issues such as property taxes, elections and events. During the consultations, having information readily available about the types of currently existing health-related services, and how to access them, continually emerged. Concern was also raised about translation services and information in other languages, and information acknowledging those with disabilities, especially hearing impairments.

All this information must be written, designed and disseminated with the needs of seniors in mind to achieve effective access and empowerment.

Seniors suggested ways to make information more accessible to them, e.g., information should be:

- delivered by a 'real person';

- 'senior friendly', that is, large, clear type and accessible for the hard of hearing;

- available in many languages;

- co-ordinated to reflect services delivered by local government, agencies and institutions and senior centres and identify access points to other levels of government; and

- produced regularly by an identified source.

Accessibility Issues for People with Hearing Impairments and Disabilities:

The Hearing Society states that hospitals should ensure that communication is barrier free to seniors with hearing loss. Seniors constitute a high percentage of the hospital consumers. Seniors with hearing impairment say that accessibility is very much an issue when they are in hospital. Hospital staff should be able to access technical devices, i.e., communicator, so that hearing impaired seniors can understand what is being said to them. A variety of telephones needs to be available, i.e., amplifying and voice carry over telephone, and telewriter, for people with hearing disabilities.

The identified formal information providers include:

- Access Toronto - local City services;

- Community Information Toronto - community services, government, referral and advocacy;

- Community Information Centres - local community information centres that provide citizens with local information but are connected to the larger network;

- Community Care Access Centres - six centres in the City run by the Province that provide information on all levels of health care services.

Seniors currently access information from community and neighbourhood sources of information including community agencies, community centres, community health centres, seniors' centres and public libraries.

Access Toronto:

Access Toronto is the public information service for the City. It provides information about local government. One main number (338-0338) provides "one stop" service. TTY callers use 338-0889, a staffed information service that offers callers information delivered by a "real person" in over 140 languages through the AT&T language line service.

Access Toronto outreach staff travel to malls, information fairs and other community events to let people know about the new City government. Community groups or services clubs can invite speakers from Access Toronto to deliver a presentation to their meeting. Topics include:

- an overview of the new City government;

- current issues at City Hall;

- how to get involved with City government;

- making a deputation; and

- the City's budget process.

Brochures are available at information centres at local civic centres. Staff at the centres can answer questions and concerns about any of the City government programs and services. Tours of Toronto City Hall are also available for groups.

Community Information Toronto:

Community Information Toronto at 397-4636 (397-INFO) is a City-wide information and referral service on a wide range of community, social services and government programs. Information counsellors assess, refer and advocate to assist people in contacting appropriate services. Information is provided by telephone, mail and personal interviews. The service is free and confidential. The Community Helpline answers over 120,000 calls a year and is open seven days a week from 8:00 a.m. to 10:00 p.m. About 12 percent of the callers are seniors.

The database contains information on over 3,200 community, social services and government organizations. Detailed information about programs, services, eligibility, application procedures, language availability, location and degree of access for people with physical disabilities is available. The database can produce a variety of resources for a varied audience.

The Directory of Community Services, known well as "The Blue Book," represents 60 percent of the database and contains information on over 1,250 organizations. Professionals and volunteers from 3,000 organizations use the Blue Book. This resource provides thousands of referrals.

Community Information Toronto provides two other resources aimed at seniors. "55 Plus Ontario" provides detailed information on services for older adults in Toronto plus basic information on the GTA and the rest on Ontario. The "Seniors' Independence Through Information - A Guide for Providing Information and Referral to Seniors" describes how information delivery can be "seniors friendly and effective." It was produced with help from an advisory committee of seniors and several organizations serving seniors.

Community Information Centres:

There are 12 local Community Information Centres in the City. Information Scarborough, Parkdale Community Information Centre and People and Organizations in North Toronto (POINT), to name a few, provide information about local services as well as how to access local clubs, recreation activities, fairs or places of worship. The Community Information Centres download the Community Information Toronto database monthly. Each centre adapts the database to the community it serves in terms of need, language and services. Many provide assistance in filling out government forms and applications, maintain a housing registry, provide access for social housing connection, have a childcare registry, do advocacy work, provide job search information, provide volunteer training and opportunities, and offer caregiver relief for seniors.

Currently, Community Information Centres are experiencing difficulty accessing external information systems because of the lack of resources to update equipment.

Community Care Access Centres:

Recently, the Province of Ontario created six Community Care Access Centres (CCACs) in the City of Toronto. The CCACs provide information on health care and health care facilities such as long-term care facilities. The CCACs staff a central call number in each of the former municipalities that is accessible in 150 languages through the AT&T language line. The centres have a walk-in service Monday-Saturday and an Ontario Health card is required for service.

Areas of service include information on how to access:

- in home health care - home care;

- placement in long-term care facilities;

- in home services;

- family services;

- information on acquired brain injuries;

- respite for caregivers;

- crisis placement; and

- information and assistance in linking to existing community support services i.e., attendant care, meals on wheels and volunteer transportation.

Despite a recent budget increase, CCACs are struggling to cope with dramatically increasing demands for home care placements, and increasing acuite care needs of long-term care consumers both within long-term care facilities and within the community are dramatically increasing.

"The limitations placed on the Community Care Access Centres means that many seniors are not receiving the services that they require to optimize their health."

Health Care Information and Communications:

Seniors clearly identified the need for increased awareness and understanding of individual health, health care options and available services in the City of Toronto. Some of the issues they raised included the need for co-ordinated information and referral for senior care facilities in Toronto, general health information about diagnosed ailments, more public education regarding health issues affecting the elderly, and basic information on health and emergency services in the City and when and how to access those services. In addition, seniors explained that they wanted information to be senior friendly, i.e., access to a live voice and not an automated machine that instructs callers to press digits for information, increased interpretation services at health care sites (hospitals, dental offices, etc.) and use of technological equipment to aid hard-of-hearing seniors (amplified communications equipment).

Seniors have repeatedly asked for a "one stop shopping" approach to accessing information. It is evident that seniors are looking for a health information clearinghouse to inform seniors about general health issues and the broad range of health supports available to seniors.

Given the information organizations that currently exist, the following recommendations outline suggested ways of building connections and linkages within the existing systems and awareness in the community of seniors as well as ways that the services will be useful and accessible to seniors.

Toronto Social Housing Connections:

The Toronto Social Housing Connections is a housing service designed to help people find permanent, affordable rental housing across Toronto. Housing Connections replaced the Seniors' Central Housing Registry, Cityhome's rent-geared-to-income intake office and the Metro Toronto Housing Authority's intake services.

Information and applications for rent-geared-to-income housing managed by the Metro Toronto Housing Authority, the Toronto Housing Company, and many co-operatives, private non-profits, and supportive housing providers in Toronto, are available to the public. Housing Connections maintains waiting lists for over 600 housing locations in Toronto.

Housing applications and information are available across the City at a variety of locations: the four Housing Connections offices, most non-profit or co-op offices, legal clinics, Community Information Toronto and the Housing Help Centre.

Seniors' Services at the Library:

The Toronto Public Library, newly amalgamated with 98 branches, is one of the largest library systems in Canada. In keeping with its tradition of responding to the needs and interests of everyone in the community, it has developed a variety of services and programs for Toronto's seniors.

The library has an extensive collection of books for and about seniors which also includes magazines and newspapers, large print books, talking books and books on tape, as well as closed captioned videos and descriptive videos. Along with the reference and referral service to seniors' resources and community agencies, the library offers services such as films, speakers, Internet training, telephone service for questions, renewals and requests.

For people who cannot get to the library because of age, illness or disability, and are homebound for more than three months, the Home Library Service delivers items to them free of charge. This includes books in regular or large print, in languages other than English, and talking books.

Most branches of the Toronto Public Library are wheelchair accessible. Several offer reading aids which include magnifiers, bookstands, page-turners, reading lamps and cassette players.

Recommendations - (4) Access to Information:

The Seniors' Task Force recommends that:

(1) The Information and Communication Division through Access Toronto consolidate information on all senior-specific programs or services operated by the City and, in partnership with Community Information Toronto and local community information centres, assess existing information for seniors and collaboratively seek ways to address gaps and identify promotional models to inform seniors of these services.

(2) Access Toronto, Toronto Social Housing Connections and Community Information Toronto develop strong linkages with the Community Care Access Centres for information sharing and elimination of duplication and that this linkage be communicated to the local information access points for seniors in the community.

(3) All information delivery to seniors be based on best practices so that the communication is:

- in clear language;

- linguistically accessible;

- clear in font, layout, print size and colour;

- given by "real" people answering main information lines;

- culturally appropriate;

- disseminated through the community newspapers, community centres and libraries;

- available to seniors with low literacy skills; and

- able to use public service announcements on radio and cable TV which can be made available at no cost.

(4) Training and Development conduct training sessions for City staff in both oral and written communication with seniors to develop effective skills to deliver information that is "senior-friendly."

(5) The City recognize that resources for technical upgrades at local community information centres has not kept up with the need and that community grants criteria recognize this as an important funding need in information provision.

(6) The Province establish and fund a health information clearinghouse for seniors.

(5.1) Health Care:

"Patients in Toronto should not have to travel outside of Toronto to receive medical services, not be taken care of and then die."

The 1990s will be remembered as the decade in which Canadians witnessed a "reinvention" of health care by government. Federal transfer payments for health care to the provinces were reduced, government funding for prescription drugs was cut back, the private share of financing total Canadian health care expenditures and of delivering health care services was considerably increased, and significant reform and restructuring of health care were initiated by the provinces. This in combination with a growing demand for health care as the population grows, and ages and health care needs become more complex, has impeded the capacity of governments to provide the necessary supports to its people.

The public sees Medicare as one of the fundamental premises upon which our Canadian identity is positioned. The public is concerned that government cuts to health care and health care restructuring jeopardize the equitable access to high quality care which is seen as the basis of Medicare.

In the consultations, seniors across the City of Toronto brought attention, through first hand experiences, to the erosion of the health care system. They identified the stress indicators as cancellation of surgeries, ambulance services on hospital bypass, patients lying in beds in the hallways due to bed shortages for critically ill people, and waiting lists for a variety of diagnostic treatments including radiation therapy for cancer care. They also said that the community based long-term care system is not working effectively to ensure that individuals receive the care they need. Community Care Access Centres and the recent changes in the delivery of home care were mentioned specifically.

"It's a revolving door (hospitals). You go to emergency, wait for hours, are sent home with some pills to a situation where adequate home care is either too expensive or unavailable and you end up back in the emergency ward in short time."

Seniors were most concerned about the following health care issues:

- the protection of community and public health programs that keep seniors well and active particularly injury prevention, fitness, social and nutrition;

- accessible and affordable dental care, eye glasses and hearing aids;

- delivery of health care in their mother tongue whether it be in the hospital or in the community;

- lack or high cost of home care;

- accountability of services through the CCAC after hospital discharge;

- appropriate training for home care workers;

- home care workers who speak languages other than English; and

- support for caregivers - funding and caregiver relief.

"We have to preserve our medical services - no more cutbacks."

Health Care Spending:

Canada's health care system is one of the few in industrialized countries to have declined as a share of the economy over this past decade. In 1992, health care peaked at 10.1 percent of the Gross Domestic Product. Last year, it fell to under 9 percent.

Health Canada has documented that public funding for health care had increased in real per capita terms between 1 percent and 3 percent every year between 1978 and 1992, but has been steadily falling since that time. Between 1993 and 1996, health care spending fell for Canada as a whole about 6.3 percent, which indicates that Canadians are personally spending more on health. Annual household spending on health care items that are not covered by a government health plan apparently jumped 15 percent between 1996 and 1997, from $1,000.00 to $1,150.00. Statistics Canada indicates that these costs are out-of-pocket expenditures such as prescription drugs, dental care, eyewear, hospital care not covered by an insurance plan and over-the counter medicines. For the most part, these personal expenditures seem to be the result of health care insurance companies changing their deductibles.

Ontario residents face new user fees for chronic care, more fees for home care, new fees for services no longer covered by OHIP and increased drugs costs, as they are discharged from hospitals earlier. Seniors must now pay $2.00 per prescription (low-income seniors) or $100.00 per year and $6.00 per prescription (higher income seniors) for drugs.

For the most part, the general public is unaware of the actual costs of providing health care: direct medical care (physician, nursing), operating costs (food services, medical supplies, laundry services, etc.). In comparison to overall costs, some felt increases in personal spending were insignificant. Others, however, more adamantly believed that this move to personal financing was a more fundamental retrenching by government on a public health care system.

"We must retain appropriate nursing levels in hospitals - current levels have reduced the quality of care."

Quality of Care:

The recently released report "Good Nursing, Good Health: An Investment in the 21st Century" by the Nursing Task Force set up by the Province documented survey results from two separate organizations on the quality of health care. The report acknowledged that the November 1998 Ontario Hospital Association Report Card recorded that 50 percent of hospital patients surveyed perceived that staffing adequacy was poor or fair. A survey of family physicians conducted by the College of Family Physicians of Canada revealed that almost 70 percent of the respondents believed that the health or well-being of their patients has been adversely affected by the inadequate or delayed access to home care and in particular nursing supports.

The Nursing Task Force also heard anecdotal information from their focus group discussions with health care consumers. Increasingly consumers feel they must now act as their own case managers of health care when in the past they often depended on the expertise of frontline health care practitioners, especially nurses, in accessing health care. With limited nursing staff available in downsized hospitals and through redesigned home care services, as well as increasingly reduced continuity in nurse-patient relationships, manoeuvring health care has become an arduous task.

Seniors across the City saw access to health care services as a primary issue. The concerns included the availability of appropriate services, the long waiting periods for health care services, the geographic location of services, the language barriers in accessing services, a lack of culturally appropriate health care services, the limited access to primary care in off hours such as evenings and weekends, and the inconsistencies in the provision of services across the City. Seniors felt that they spend an inordinate amount of time waiting: waiting for medical specialists, major operations, medical tests, nursing beds and home care.

"Stop changing (health) systems - start giving (health) services."

Hospital Care:

Ontario hospitals have experienced exceptional change over the last few years. An approximate 11percent reduction in budget allocations over the last two years in combination with health care restructuring directions from the Health Services Restructuring Commission has resulted in the closure of emergency rooms across the City of Toronto, the amalgamation of hospital corporations, the shift from institutional to community-based care and the massive displacement of nursing staff as they leave hospitals for community-based care services or leave the country altogether to pursue nursing careers outside of Canada. This has occurred during a time when the demand for medical services has increased by an estimated 20 percent over the last five years.

Seniors identified the dire conditions of hospital care in the City. They identified the long wait for medical attention in emergency rooms and the costs for using ambulance services. They identified the lack of critical care beds to meet the health care needs of seniors, the depressed state of nursing services in hospitals (in terms of availability and continuity of nursing staff), the lack of appropriate discharge planning between hospitals and community health care services, resulting in early discharges to homes where community home care supports are inadequate to meet patient needs, and the inability to access appropriate care when language becomes a barrier for patients.

"Hospital changes are resulting in far more sicker seniors having to be served by seniors' agencies in the community with insufficient funds."

Long-Term Care:

According to Statistics Canada, approximately 92 percent of all people aged 65 and older lived in a private household in 1996; 29 percent of these lived alone. In particular, 38 percent of all senior women and 50 percent of those aged 85+ lived alone in the community. Increasingly the preferred form of health care supports are those provided in the community, through home care.

Canadian public home care expenditures more than doubled in the last seven years, from a little more than $1 billion in 1990/91 to approximately $2.1 billion in 1997/98, averaging an annual increase of almost 11 percent. In Ontario, the corresponding amounts were $59 million and $1 billion.

In 1996, the Minister of Health announced changes to Ontario's long-term care system, which substantially changed community-based long-term care. The Province's 74 existing Home Care programs and existing Placement Co-ordination Services were merged to form 43 new Community Care Access Centres (CCACs). In Toronto, six CCACs were established, according to the six previous municipal boundaries. The Ministry of Health mandates the CCACs to process and authorize applications for admissions to all nursing homes and homes for the aged in their area, and arrange for community-based in-home services, on behalf of eligible clients.

The Ontario Minister of Health announced in 1998 that annual spending would be increased by $1.2 billion to improve access to high quality long-term care services across Ontario. This reinvestment is expected to add 20,000 new long-term care beds and community-based services for an additional 100,000 Ontario residents. The Province targeted $125.5 million for Toronto's community long-term care sector over eight years. Seventy-five per cent ($11.8 million annually for the next eight years) would go to the CCACs and 25 percent ($3.9 million annually for the next eight years) to volunteer-based community supports such as meals on wheels, day programs, friendly visiting and other community supports.

"The limitations placed on the Community Care Access Centres means that many seniors are not receiving the services that they require to optimize their health."

With the shift to community-based care, home care placements have significantly increased and the acuite care needs of long-term care consumers both within long-term care facilities and within the community are dramatically increasing. With no signs of relief from these pressures and increasing health care demands, the recently-established CCACs, touted as the one-window access to long-term care services, are attempting to cope with these pressures within their budget allocations.

"The expectations for health has been downgraded for seniors - this is not acceptable."

Recently, CCACs have adopted new eligibility criteria developed by the Ministry of Health that place priority on services for people in critical care and in danger of being hospitalized. As a result, people at risk in the community, such as the frail elderly, are not receiving services to which they are entitled as outlined in the Ministry of Health policy directions. These applicants are now being referred to other programs such as the City's Homemaker and Nurses Services Program (HMNS), administered by the Homes for the Aged Division, and other community support agencies. With increasingly priorized access to home care supports through the CCACs, the City has had to introduce waiting lists for its programs through HMNS. Many of the community support organizations are also at capacity.

The "Good Nursing, Good Health" report by the Nursing Task Force identified that differing levels of nursing care are being provided in different health care settings, regardless of the fact that the health care needs of the consumer are the same. This is primarily a result of the different sector-specific funding formulas and guidelines for health care organizations. The Nursing Task Force goes on to say that this is further exacerbated by the introduction of managed competition in the home care sector for nursing services.

The Seniors' Task Force agrees with the Nursing Task Force that it is crucial that health care consumers receive the level of nursing services they need, regardless of the setting in which the care is delivered. These funding inequities among health care agencies must be addressed to ensure quality patient care. The lack of incentives for nurses to turn to home care provision because of depressed wages due to "competitive" pricing will result in a shortage in nursing services and a failed health care restructuring exercise.

Long-term care services were first and foremost in the minds of seniors across the City of Toronto. Consistently we heard how home support for the frail elderly and convalescing hospital patients must be increased in terms of enhanced government financing to meet the growing demand and in revised eligibility criteria for receiving home care both in terms of length of time allotted per visit and frequency of visits. Seniors felt home care support staff need to be better trained in issues related to senior care and in sensitivity in working with seniors. In particular, palliative and respite care were seen to be essential in ensuring appropriate supports for families with critically ill family members.

Seniors across the City agreed that the newly-established CCACs are not working. Comments included:

- the need for better co-ordination between CCACs;

- consistency in eligibility assessments to ensure equitable access to services across the new City of Toronto;

- increased funding for the CCACs to support the growing demand for home care so that consumers have access to those services they require to optimize their health;

- expanded eligibility criteria for homemaking services, currently seen to be too restrictive and serving primarily the acute care needs of patients rather than applying a broader preventative approach; and

- and better access to the CCACs, themselves.

Seniors identified gaps in the system and the growing number of residents who are being left without service. The current demand for service is creating a strain on available services.

Seniors acknowledged that as the number of older seniors is expected to increase dramatically, the more complex care needs of very senior "seniors" may be best served through facilities. Although home care is the preferred form of health care, it does not meet the health care needs of all its patients. Currently, approximately 5,700 people are waiting for admission into a long-term care facility in Toronto. Increasingly, the acuity care needs of these people are also growing. Seniors across the City recognized the increasing demands being placed on long-term care facilities and the need for improved services. In most cases this need can be addressed through enhanced funding levels that better recognize the higher levels of care facilities currently must provide to meet their residents' needs.

"Attention should not only be paid to physical health but to psychological health as well."

Mental Health:

As the population ages, it is expected that Alzheimer disease and other dementia will dramatically increase. According to the Canadian Study of Health and Aging, approximately 225,000 people in Canada have dementia. This figure is expected to grow to about 778,000, 10 percent of the population over the age of 65, by the year 2030, as the capacity to successfully treat physical illnesses improve and people live longer.

Clinical research conducted by Dr. Robert Hopkins of Kingston Psychiatric Hospital and published in his research bulletin "Dementia Projections for the Counties, Regional Municipalities and Districts of Ontario," showed that the rate of dementia in Toronto will increase 81 percent by the year 2021. This amounts to approximately 44,251 people, almost double the 1995 Toronto figures of 22,315.

Approximately 65 percent of the City's Homes for the Aged residents suffer from cognitive impairment, mental health problems and/or dementia. The severity of the dementia has also increased among applicants and residents of the homes and clients of the City's supportive housing and homemakers' programs.

The supports provided for this population are limited. There are 83 beds in the 68 long-term care facilities across Toronto (19 beds within the ten City-operated Homes for the Aged) for short-term respite care relief (beds to admit people with dementia for short periods to provide relief to caregivers). The City's Homes for the Aged also operate five Adult Day Centres which serve people with dementia. None of these centres receives the higher level funding set aside for designated Alzheimer's Day Programs.

There are 15 Alzheimer's Day Centres within the City, six Day Centres which specialize in services to the frail elderly, and five integrated Day Centres which serve cognitively impaired individuals within its regular day centre activities to mentally capable seniors. The Community Services Grants Program also funds a number of community-based organizations that deliver services to this client group.

These limited facility and community programs will be inadequate to meet the projected future need. Unless provincial investments are made now to expand community programs and to retrofit existing long-term care facilities to meet the specialized needs of this population, service gaps for these consumers and their families will increase.

Seniors expressed frustration at the limited availability of mental health supports for the needs of older seniors. They believe that attending to the mental health care needs of an aging population should be part the overall health care strategy for seniors.

Seniors called for more funding for health promotion, wellness and disease prevention programs, including emotional and mental health care services, focusing on prevention rather than treatment.

Ottawa's Renewed Commitment to Medicare:

The recent federal budget was viewed by most as a renewed commitment to health care. Ottawa has announced that it will increase its health transfer payments to the provinces by $11.5 billion over the next five years, $3.5 billion of which will come in the form of an immediate one-time supplemental payment over the next three years to be accessed by provinces as they require. The current federal $12.5 billion floor for health and social transfers to the provinces will increase to $15 billion in the fiscal year 2001/02. In addition, the Finance Minister announced that funding social programs, including health care, would be provided on a per capita basis to the provinces. The Premier of Ontario indicated that these changes would see the federal share of Ontario's health care funding increase from the current 7 cents of every dollar to 11 cents. The Premier also announced that its priorities for health care funding include hiring more nurses, reducing waiting lists, improving emergency care, and fast tracking the expansion of long-term care beds and home care.

It is clear that frontline emergency services, such as the hospital emergency rooms and nursing services, should be targeted for increased funding to help alleviate the immediate stresses of health care. But this alone will not address current and future demands for health care, especially in an environment where home care is the preferred option. The new health funding must equally target home care expansion, especially for nursing services. Speeding up the development of long-term care beds is a longer-term investment. The challenge will be for the Province to immediately direct funding to those health care areas most in need while still planning for the future needs of long-term care consumers.

Reinvesting in Health Care:

The issues related to the range of health care services, levels of service provision, quality of care, and the need to provide a continuum of health care services all speak to the need for the reinvestment in the health care sector. The federal government has announced its recommitment to health care with its recent federal budget. The provincial government has announced that it will direct the federal dollars to areas of nursing, emergency services and long-term care supports. Specifically, funding needs to be enhanced for:

Nursing services:

- in hospital emergency services and acute care follow-up;

- through the development of appropriate compensation levels for nursing provided through home care to promote the move of nursing services from institutional care to community care; and

- by establishing appropriate funding levels to enhance nursing services in long-term care facilities to respond to growing acuite care needs of long-term care residents.

Community Care Access Centres, to expand long-term care services provided and arranged for within the community to:

- eliminate the rationing of services to critical care and to adequately meet the health care needs of Toronto's aging population; and

- ensure consistency and equity in eligibility requirements, types of service and levels of service provided across the City of Toronto.

Mental health services for seniors by:

- expanding community services for seniors with mental health problems, Alzheimer's disease and other dementia; and

- allocating appropriate levels of funding to recognize increased levels of care provided by long-term care facilities to residents with growing acuity care needs.

Responding to the Health Care Needs of Diverse Senior Communities:

Seniors identified that, to be effective and meet their mandates in providing health care supports, hospitals, home care providers, and long-term care facilities must ensure that their programs and services better respond to and serve the City's diverse senior populations. This includes eliminating language barriers to ensure that appropriate diagnoses, treatment and after care are provided; ensuring culturally sensitive and appropriate support services are provided; and training health care practitioners and support staff to be sensitive to seniors' needs, coupled with meeting the ethno-specific special needs of Toronto's diverse senior communities.

"Seniors should not have for pay for medications or dispensing fees."

Drug Expenditures:

Since 1992, there have been significant cuts in government funding of drugs. This decrease has been somewhat matched by private expenditures on drugs. According to Health Canada, the private share of total drug expenditures (out-of-pocket costs to consumers and premiums paid by employers or employees) increased from 60.9 percent to 64.8 percent between 1992 and 1996, while the public share (government spending) fell from 39.1 percent to 35.2 percent. This increase in private expenditures can be attributed to a number of health care initiatives:

- increased personal responsibility for prescriptions as day surgery procedures continue to increase and hospital in-patient care is reduced, thereby eliminating the traditional coverage of prescription costs by hospitals as part of the care provided for patients recuperating in-house;

- the de-listing of some drugs and the release of newer, and usually more expensive drugs that have yet to be assessed for approval by the provincial government for public coverage; and

- the provincial move to enforce co-payments by seniors for drug expenditures.

Drug expenditures, regardless of who pays, continues to increase as a relative share of the total health care expenditures. This relative share increased from 12.9 percent in 1991 to 14.4 percent in 1996, according to Health Canada statistics.

With growing complex health care needs, the rising costs of drugs are becoming difficult for many seniors on fixed incomes. These prescriptions have often become vital for seniors to maintain optimum functioning and improve their quality of life. Consistently seniors felt that the co-payment charges implemented by the Provincial government to be unfair.

In addition, seniors have expressed concerns that some drugs are covered under the Ontario Drug Benefit Program while supplies required to administer the drugs are not. A prime example is the coverage of insulin for diabetic patients but not the needles. Many felt some of the policies and practices of providing health care coverage are not well co-ordinated and need review.

Conclusion:

Many seniors viewed cuts in health care funding as the reason for the demise of our health care system; others viewed health care restructuring to be the cause. Many saw health care threatened by increasing user fees, private sector provision of services, and the growing gap between health care for the rich and health care for the poor. Whatever the reason, all agreed that health care is in trouble.

The passion with which seniors speak about health care is grounded in history, as many of the seniors of today fought to establish a public health care system across Canada, decades ago. The struggle to re-establish confidence in health care is one that is vested not in seniors for seniors, but for future generations as consumers of health care.

Recommendations - (5.1) Health Care:

The Seniors' Task Force recommends that:

(7) The provincial government reinvest funding into the health care sector to ensure that the principles of access and high quality care are not compromised; and that the funding be significantly enhanced for nursing services, Community Care Access Centres (to expand community long-term care services), and mental health services for seniors.

(8) The Province ensure that the criteria for funding health care services include access to services as a measure of meeting the needs of the diverse populations in the City of Toronto and address specifically the barriers to accessing health care services for ethno-cultural and linguistic seniors.

(9) The Province eliminate co-payment charges for seniors for prescription drugs.

(5.2) Public Health:

"Public health nurses used to come and visit us in our homes. They would check up on us, take our blood pressure and could see if we were taking our medications the right way. They tell us they don't do that any more."

Public health programs and services promote health, maintain independence and seek to improve the quality of life for seniors and all residents of our City. The comments from seniors during the consultations reflected an understanding of the role of prevention programs in keeping seniors healthy and stressed the importance of proactive measures for seniors both individually and for the health care system as a whole.

In the consultations, however, seniors raised concerns about the changes in public health programs and services for seniors that have occurred in the past few years. Seniors called for increased funding for health promotion, wellness and disease prevention programs including mental health services that focus on prevention rather than treatment.

The Mandatory Health Programs and Services Guidelines (December 1997) set out the minimum provincial requirements for public health programs and services aimed at prevention of disease, health promotion and health protection. The programs and services address broad population health issues and standards to enable residents of the community to realize their fullest health potential.

Programs and Services:

Current public health programs and services for seniors include chronic disease and injury prevention, substance abuse prevention, communicable disease control, elder abuse prevention, informal/caregiver support initiatives and dental programs. A planning process has been initiated to harmonize these programs and services which vary across the City.

Chronic Disease Prevention:

Public health works in partnership with organizations, government bodies and community representatives towards the prevention and early detection of certain chronic diseases such as cancer, heart disease, stroke, diabetes and osteoporosis. Community programs include the promotion of healthy public policies such as the municipal environmental tobacco smoke by-law, social marketing to increase awareness of chronic disease risk factors and community/group education to promote healthy lifestyle behaviours. Healthy lifestyle initiatives include the promotion of healthy eating for seniors, tobacco-free living and active living programs such as Walk-a-mall and the Home Support Exercise Program for housebound frail seniors.

Injury Prevention:

Public health collaborates with other health care providers and community groups to support policies to prevent motor vehicle and fall related injuries. Initiatives for seniors focus on the prevention of falls. These initiatives include the development of injury prevention coalitions, and community wide education campaigns and events.

Substance Abuse Prevention:

Public health works with community agencies and groups to support policies and educate the public about low-risk drinking, illicit and non-medical use of drugs. Initiatives for seniors focus on the prevention of misuse of medication and alcohol.

Communicable Disease Control:

Public health programs and services for seniors include:

- controlling outbreaks and following up in institutions such as long-term care facilities or hospitals where an outbreak has occurred and seniors are most vulnerable;

- conducting education related to outbreak prevention such as food-handling techniques and infection control for staff in institutions; and

- organizing the "Big Shot Challenge Campaign," a program aimed at increasing the number of institutions participating in the flu immunization program.

Elder Abuse Prevention:

Public health works with health care providers, community agencies and groups to support policies and educate the public about elder abuse. Initiatives include:

- the development of and active participation on elder abuse coalitions/networks; and

- public education including the production and distribution of newsletters about elder abuse and group education events.

It is noteworthy that seniors mentioned elder abuse in the consultations. Seniors, like most people, do not generally talk about abuse. When this issue was raised there was a general nodding of agreement from others in the room. Abuse is a concern across the seniors' community.

Seniors who are isolated from the broader community and do not know their rights are those who are most vulnerable to abuse. Seniors again expressed concern about the lack of personal contact with the reduction and, in some former municipalities, cancellation of Public Health Nurse home visiting program, and cutbacks in services provided by Community Care Access Centre (CCACs).

Informal/Caregiver Initiatives:

Public health works with health care providers, community agencies and groups to educate caregivers and to promote informal community support networks and caregiver support groups.

Dental Programs and Services:

Currently dental programs for seniors vary significantly across the City. Programs that are offered in some of the former municipalities include dental screening for seniors, oral health education for seniors' groups and caregivers in nursing homes, and training for nursing home staff in the cleaning and labelling of dentures. The most extensive dental treatment program for seniors is in the former City of Toronto where dental treatment for seniors is provided in five community-based dental clinics as well as in 34 nursing homes. A public health dental report and presentations made at the January 1999 Board of Health meeting stated that about 75 percent of seniors with their own teeth were likely to visit their dentist over the course of the year. Dental health planners believe that seniors living in institutions have worse oral health than seniors living independently. The report also stated that the elderly were far more likely to visit their physician than their dentist and that their greatest dental needs are for periodontal work, dentures and restorative care. It can be anticipated that as the Baby Boomer population ages with their own teeth the need for restorative care may supersede the need for denture work. The report to the Board of Health outlined various options for the harmonization of dental services across the new City for low income seniors (as defined by Statistics Canada) who are living on their own and for those seniors who live in institutions. City Council has approved funding of $800,000.00 to extend dental treatment to targeted groups, including seniors, in existing clinics for the remainder of 1999. A City Task Force has been assembled to review options for future delivery of dental care in Toronto.

Frail Elderly:

Frail, non-receptive older adults are those who are isolated, and without supports. They may be reclusive or have underlying mental health problems or substance abuse issues. They have little insight into their diminishing capacity and are likely to refuse support services initially.

Seniors in the consultations requested increases in home visits by public health nurses. Public health home visiting to seniors has been reduced/eliminated with the establishment of Community Care Access Centres by the Ministry of Health, Long-Term Care Division. Community Care Access Centres, as previously stated, have a mandate to arrange for community-based in-home services for eligible clients. The recent adoption of new eligibility criteria has resulted in the frail elderly no longer receiving services which they previously received and which were expected to replace the comprehensive health assessments, education, counselling/advocacy and resource linkage previously provided by Public Health home visits.

Service providers in 1997/1998 identified programs and services to address the needs of the frail, non-receptive elderly as a concern.

Representatives of public health and the Community Care Access Centres (CCACs) initiated a Task Force, including community representatives and seniors, which has developed the template of a community-wide response system for the frail, non-receptive older adult in the new City of Toronto. This report, (Appendix II: Summary of Toronto Task Force for the Frail Non-Receptive Older Adult) which includes a funding request from the Ministry of Health, was presented and approved at the January 1999 Board of Health meeting.

Recommendations - (5.2) Public Health:

The Seniors' Task Force recommends that:

(10) City Council continue to support and fund local public health programs and services for seniors (including chronic disease and injury prevention, substance abuse prevention, communicable disease control, elder abuse prevention, informal/caregiver support initiatives and dental programs).

(11) Toronto Public Health work with Community Care Access Centres and other agencies to address the needs of the 'at risk' frail elderly.

(12) Toronto Public Health continue to work with community agencies and groups to advocate for policies and practices which ensure equal access to health care and an equitable distribution of resources and services for seniors.

(6) Housing:

"Seniors need a range of affordable housing choices, co-ops, shared, group living and apartments."

Housing concerns, like health concerns, are common to the population as a whole. Several themes emerged during the consultations.

- seniors living in their own homes were concerned about property taxes and fees for service;

- seniors living in public housing were concerned about privatization, security and maintenance; and

- seniors who may be leaving their homes were concerned about affordability of rental units and being able to stay within their community.

"Will I have to move from my house, when and where?"

Seniors are predominantly homeowners. The number of senior households owning homes has steadily increased over the last decade between 1986-1996 with approximately 39,000 more senior homeowners (aged 65+). This amounts to a marginal increase in percentage share from 59 percent in 1986 to 60 percent in 1996. Some movement by seniors into condominiums has occurred, primarily in response to seniors requiring lower maintenance housing. Seniors, mostly aged 70+, purchased approximately 60 percent of the condominiums built in the late 1980s.

Although there has been a relatively small increase in senior apartment dwellers, it is estimated that the percentage of Toronto's seniors that rent will significantly rise over the next decade. Today's life-long middle-aged Toronto renters will raise the tenant share of Toronto's senior population strongly within a decade from now.

"There is not enough low and middle-income housing available with rent controls."

Rent Increases and the Supply of Affordable Housing:

"It is difficult to find appropriate housing anymore."

Over the last 15 years, the average real cost of renting rose as rents tended to increase faster than inflation. During 1991-1996, about one-fifth of the conventional private rental sector in the City (approximately 58,000 units) moved from the low-rent end to the middle-rent range due to rents rising faster than inflation. (Low-end is defined as under $500.00 for a bachelor, $600.00 for a one-bedroom, $700.00 for a two-bedroom, $800.00 for a three-bedroom apartment.) Although an annual average of 1,300 social housing units and 2,000-3,000 apartments were added to the supply of affordable housing stock, this addition far from replaced the loss of 11,000 affordable housing units per year.

Rent as a Share of Income:

"Rents keep going up, pensions stay the same."

Rent costs in excess of 30 percent of income are usually considered a reflection of affordability problems. 1996 Statistics Canada data on shelter costs for households headed by seniors (65+) in the City of Toronto showed that 31.7 percent of all seniors paid 30 percent or more for shelter costs and 10.8 percent paid at least 50 percent of their income on shelter. The situation is more critical for single seniors with 48.5 percent and 16.3 percent, respectively.

For senior homeowners, the comparable figures were 16.9 percent and 5.4 percent. Approximately 58 percent of senior tenants, on the other hand, paid 30 percent or more while 20 percent paid at least 50 percent of their income for shelter. By comparison, approximately 40 percent of senior tenants were identified as having unaffordable rents in 1986.

"Bring back rent control!"

Vacancies and Rent Control:

Vacancy rates continue to be low at approximately 1 percent since 1994; around 2.5 to 3 percent is generally considered to be healthy. In low vacancy markets, market forces tend to push up rents. Those who find themselves in unaffordable housing situations have limited options in improving their situation. This is exacerbated by the Tenant Protection Act.

The Tenant Protection Act (TPA), legislated in July 1998, is presumed to provide continuing rent control for tenants who remain in their current rental accommodation. In fact, landlords have a number of avenues to increase rental costs, regardless of tenure. Landlords can increase rents to a maximum guideline (currently 3 percent) for tenants in place; increase by an unrestricted amount when units are turned over to new tenants; transfer the cost of capital repairs through increased rents; apply for rent increases due to extraordinary costs incurred, such as increased property taxes or utility costs.

Anecdotal information has confirmed some tenants are facing 7-12 percent increases in rent since the enactment of the TPA.

Since the passage of the Tenant Protection Act, average market rents have increased. The average rent in 1997 of $751.00 has increased 7 percent in 1998 to $804.00. As this is only a reflection of six months, and given that markets continue to be tight, the 1999 increase is expected to be even higher.

A recent report released by the Ontario Non-Profit Housing Association and the Co-operative Housing Federation of Canada, "Where's Home? A Picture of Housing Needs in Ontario," revealed that rent increases over the last ten years has outpaced inflation. Toronto has experienced rent increases of 13 percent over 1994-98, while inflation has increased by 7 percent for that same period. This has significant implications for all tenants. Considering that many seniors live on fixed incomes (pension rates indexed to inflation rates), rent control is seen as an important issue in Toronto.

"Access to housing needs to be improved - the waiting lists are too long."

Waiting for Affordable Housing:

With the increase in affordability problems, waiting lists for subsidized housing have more than tripled since 1988. According to the Toronto Social Housing Connections' waiting list, approximately 49,000 households are currently on the waiting list for social housing (including about 7,000 in subsidized housing requesting a transfer to another subsidized unit). Eighteen percent (8,800) of those 49,000 households are seniors. This figure has actually dropped from 28 percent in 1988. Seniors have fared better than other households: families with dependent children (regardless of age of head of household) regained their share of the waiting list to 1988 levels at 53 percent, while all single people (regardless of age) have significantly increased their share from 18 percent in 1988 to 29 percent in 1998.

A significant growth in senior tenants is anticipated in the decade starting 2001, mostly in the private rental housing market. This has implications for widespread affordability for the City's senior population in the near future. No new social housing has been built in the recent past and the private sector has not been able to respond to the growing demand for affordable housing. This has been primarily due to the cost of construction and ongoing operations that has rendered the development of affordable housing financially impossible and focused any development in the higher-rent unit market.

In July 1998, the City approved and initiated a strategy for affordable housing to support private developers and community-based agencies to develop affordable housing. The need for such a strategy was reinforced within the report of the Mayor's Homelessness Action Task Force, "Taking Responsibility for Homelessness: An Action Plan for the City of Toronto." Critical to this action plan is the increased supply of affordable housing.

Consistently, seniors across the City of Toronto voiced their concerns over the affordability of housing in the City. Fewer and fewer low and middle-income housing options have become available. With a growing proportion of seniors in unaffordable living conditions, any expansion in affordable housing will need to reflect a fair share of units that target seniors.

"There is a lack of accessible housing. Many of the buildings seniors live in are not adapted to meet the needs of seniors."

Accessible Housing:

Some seniors voiced their concern about the inability of housing providers and themselves as homeowners, to upgrade their physical surroundings to keep pace with their changing physical needs. As the population ages, physical limitations impede the healthy functioning and physical security of seniors. This includes not only attending to mobility limitations but to the less evident limitations such as the loss of hearing. Some participants in the senior consultations brought attention to the need for the installation of appropriate technical devices, such as flashing doorbells to act as alarm signals, in case of fire for people with hearing impairments.

With the provincial direction to enable people to "age in place," the aging tenant population is presenting challenges to housing providers. The Ontario Non-Profit Housing Association (ONPHA), in acknowledgement of this issue, has included aging and accessibility as a component of their conference in November 1999. In the private sector, the Millennium Housing Corporation is reviewing gaps in seniors' housing and issues related to housing a senior population.

Tenants of the Toronto Housing Company have formed an Anti-Ableism Committee comprised of tenants, the community and funders. Toronto Housing Company staff provide support to the Committee. The Anti-Ableism Committee has developed an action plan to address ability concerns within the Housing Company buildings. These include working with architects and designers experienced in working with people with disabilities to develop standards for regeneration, retrofit and renovation. A Trillium Foundation grant has enabled the Committee to conduct an accessibility audit of its buildings. One of the conditions of this grant is for the information to be made available to other housing provider organizations. This audit could act as an impetus for other housing providers to undertake a similar inventory of their buildings to better meet their tenants' needs.

Disability activists have argued that with an aging population, the need for accessible housing will significantly increase as more seniors who acquire disabilities are added to the already two million adult Canadians with disabilities. Clearly, accessible housing is a growing issue both in terms of retrofitting existing buildings and ensuring new housing developments adequately incorporate universal adaptable design features.

There is some opportunity to further facilitate action on this issue. ONPHA has established a Toronto local network of social housing providers and some community service agencies in response to social housing devolution. This may be the appropriate vehicle to initiate discussion on accessible housing needs of an aging population. Key participants in such a discussion must include the Toronto Housing Company, the Co-op Housing Federation of Toronto, ONPHA and the Metro Toronto Housing Authority.

"We need help to stay in our homes. We need low-priced contractors to make our homes liveable in our senior years."

Housing Improvement Program:

Many seniors said that it is getting harder to remain home, if home has not adapted to aging seniors' needs. The cost of house repairs and modifications to enable them to maintain their homes were seen increasingly as unaffordable, especially on fixed incomes.

Some community-based seniors' organizations link seniors to volunteers or low-cost workers to do home repairs. The City also provides support through its Housing Improvement Program in the Shelter, Housing and Support Division of Community and Neighbourhood Services.

The Housing Improvement Program unit administers the federally funded Residential Rehabilitation Assistance Program (RRAP). The program provides financial assistance to low and modest income homeowners in the former City of Toronto to bring their properties up to the standards required by the City's Municipal Code and to assist homeowners in making necessary modifications which will make homes more suitable to meet their physical limitations.

In 1997, approximately 39 loans amounting to $317,000.00 were approved for general home repairs under the homeowners' portion of RRAP. Two out of every three applicants were over 65 years of age. Under the disabled portion of RRAP, $70,000.00 went to approximately eight loans to make home modifications for people with disabilities. Discussions are currently underway with Canada Mortgage and Housing Corporation with respect to delivering the RRAP program for the new City of Toronto.

Property Taxes:

Property taxes continue to be a major issue for seniors as they are a large portion of their yearly expenses. In many cases, seniors have had to sell their home of 30 years or more because they could not afford the property taxes.

Property taxes, especially in 1998, created a great deal of confusion and stress as many could not understand the tax bill and were hit with increases. Seniors want to know what happened. How were the new assessments calculated? Did we get our decrease as promised? How can seniors lessen the burden of the increase? What exactly are we paying for?

Recommendations - (6) Housing:

Vacancies and Rent Control:

The Seniors' Task Force recommends that:

(13) The City urge the Province of Ontario to amend the Tenant Protection Act to restore rent control.

Waiting for Affordable Rental Housing:

The Seniors' Task Force recommends that:

(14) The City, as part of its affordable housing strategy, encourage a fair share of affordable housing units be developed within the City to target seniors.

(15) The City urge the provincial and federal governments to ensure the housing needs of seniors are included in any new housing developments, recognizing that a solution to the affordable housing crisis in Toronto must involve all levels of government.

Accessible Housing:

The Seniors' Task Force recommends that:

(16) The City of Toronto approach the Ontario Non-Profit Housing Association to facilitate discussions on accessible housing needs in Toronto, through its local Toronto network. The Toronto Housing Company, Co-op Housing Federation of Toronto and the Metro Toronto Housing Authority should participate in these discussions so that a mutual exchange of learning and experience occurs between City-operated and community-based housing providers.

Housing Improvement Program:

The Seniors' Task Force recommends that:

(17) The City continue to negotiate with Canada Mortgage and Housing Corporation to expand the City's administration of the federal Residential Rehabilitation Assistance Program across the new City of Toronto.

Property Taxes:

The Seniors' Task Force recommends that:

(18) The City of Toronto conduct public information sessions for seniors in the community explaining the details of the new Property Tax System, how to read the new bill, where the money is going, and how the assessment worked.

(7) Public Transportation:

"Seniors need public transportation that meets our needs. We need to get to the activities, events and programs that help keep us well both physically and mentally. We want to be involved in the life of the City."

The subject of public transportation was raised consistently at every consultation held by the Seniors' Task Force. Seniors felt the service was vital to their lives and indeed their health and well-being. They identified several issues, however, that could make the service more "senior-friendly" and possibly increase ridership among seniors.

During 1999, the United Nations International Year of Older Person, it is especially timely that the City focus on seniors' public transportation needs. The City's population is aging and the need for accessible, senior-friendly transportation will be a necessity for both the transit needs of the rider and the economic need of the provider.

Seniors and the TTC:

"This service (TTC) is far from perfect, a lot needs to be changed, but I hate to complain because it is the only way I can get around."

On a typical day 32,000 seniors use the regular TTC service. This figure represents 11 percent of the senior population. Seniors use the service at off-peak times and ridership in this sector will increase 25 percent by 2011.

A typical senior rider makes 84 percent of her trips on the TTC for personal, medical, shopping, work or school purposes.

The population using conventional transit services with extreme difficulty is expected to increase at about 1.1 percent to 2 percent per year (two to four times faster than the overall population)

The population requiring "special transit" services is expected to increase at about 1.7 percent (three times faster than the overall population). (Transit Accessibility Needs Study, Metropolitan Council Advisory Committee on Accessible Transit, October 1997, Metropolitan Council)

Isolation and poverty among seniors are problematic to health and wellness. This report has presented income levels as at or below the poverty line for female seniors 75+. Currently, 46,331 seniors in the City of Toronto receive funds through the GAINS supplement program. It is not known how many of those people can or do use public transportation.

Operations:

In the consultations, many seniors said they feel insecure about asking for a seat. The "courtesy seating" system is little more than a sign. All the responsibility for getting a seat falls to the rider. The program should include information that people may have hidden disabilities.

Many seniors spoke to us about difficulty reading the TTC information in a number of formats. Seniors who do not speak or read English have a particularly difficult time and expressed concerns about loss of independence and embarrassment asking a family member to travel with them. The TTC advises that information in languages other than English is provided through its language line and that directional signage in the system has been recently updated to include graphics/pictographs to assist users who read languages other than English, visually impaired and people with low literacy.

Seniors expressed concern that staff does not recognize that seniors need more time to get on and off buses and streetcars. They commented that some drivers are impatient with the slower pace of seniors. They also commented that drivers start to move their vehicles before seniors have found a safe and secure spot on the vehicle, increasing the risk of a damaging fall. The TTC advises that training for staff is provided.

Seniors expressed fear about "getting stuck" in a subway station when escalators are broken. The effort to make more stations accessible with the provision of both escalators and elevators will offer a choice. While this upgrading is on going, appropriate signage is needed.

Announcements in the subway system are often impossible to hear for those whose hearing is excellent. For the 42 percent of seniors whose hearing is impaired, it is impossible. Louder, clearer announcements will benefit the whole ridership.

Often seniors need to sit when waiting for a bus especially if they must walk any distance to reach the bus stop. The provision of benches will make it easier for seniors to use the regular system.

Accessibility:

The October 1997 report from the Metropolitan Council Advisory Committee contained a Transit Accessibility Needs Study. This study estimated the number of current and future Metro residents who have or may have difficulty using conventional TTC services and those who are unable to use such services. This study was used to help Metro and the TTC assess overall transit accessibility needs and assist Council and staff in identifying and evaluating service and policy options including eligibility criteria for specialized and alternative public transportation services.

In response to individual citizens, advocacy groups, the TTC Advisory Committee on Accessible Transportation and the Metropolitan Council Advisory Committee on Accessible Transit, the TTC has committed to making the system more accessible starting in 1998-2003. The following work will be done in 28 stations (see schedule).

- power sliding doors;

- escalators;

- edge warning tiles;

- higher visibility signage;

- stair nosing;

- elevators;

- wayfinding tiles;

- accessible fare gates;

- railing and hand hold markings ;

- improved lighting;

- braille at designated waiting areas; and

- accessible washrooms (three stations).

Currently, 26 bus routes are accessible. By 2003-4, this network will expand to 62 routes. By the end of 1999, there will be 235 accessible buses with the total fleet size reaching 534 vehicles by 2003. The elevator network will continue to expand with 28 stations accessible by 2003.

Community Bus Service:

The community bus service is a fixed route, curb to curb service. Currently four routes operate. The TTC has indicated that further expansion of the community bus service cannot be justified economically. This service operates for both Wheel Trans registrants and non-registrants.

Seniors expressed support for community bus services and said they work very well for routes near seniors' homes that link the home to shopping and medical services. Seniors suggested that this service would work even better if communities were involved in identification and planning of routes.

Community agencies that serve seniors could be a great partner in provision of space, advertising of review meetings and the provision of multilingual service contacts.

Wheel Trans:

Wheel Trans is a special transit service for persons who require accessible transit vehicles as established by eligibility criteria based on a person's physical functional mobility limitations. Approximately 15,000 people are registered for this service. Currently the rate of increase in demand for this service is greater than the increase in funding.

In 1996 over 24,000 people were registered as eligible users of Wheel Trans. Under the new 60 point criteria, 11,300 reapplied and 13,000 did not reapply. Many of the users who did not reapply had been inactive for sometime, had passed away or moved. Some may not have reapplied because they felt that they would not qualify under the new criteria.

For instance, the current Wheel Trans application questions applicants on how they deal with stairs inside the home, outside the home (i.e., to the yard or driveway) and in the broader community away from home. A maximum of 10 points is given if the applicant cannot use stairs at all. Aging seniors who can no longer use the regular TTC system may be able to use stairs inside the home without assistance by methods that they could not use in the broader community. For instance, seniors may take a long, very slow time going up stairs or go up the stairs sitting down. The stairs to the yard or driveway may just be a few, from a front porch or side door. Negotiating a flight of 20 or more stairs in a TTC station is quite different. If the applicant can negotiate stairs inside and outside the house or apartment but not stairs in the wider community they can only get 10 points from this section. A minimum of 60 points is necessary to access Wheel Trans.

Seniors expressed concern about the criteria currently used to access the Wheel Trans system. The criteria do not service many seniors who are aging and do not use any assisted devises to get around. People who are frail, have hearing or breathing difficulties, people with arthritis or people who just aging and slowing down do not qualify. These are the seniors who cannot walk long distances to the bus stop, stand for long periods of time or wait in difficult weather either hot or cold. There should be a way that these problems of aging can be recognized as criteria for use to access the curb to curb system.

Of the 11,300 who did reapply to Wheel Trans under the new criteria, 9,900 did qualify. Of those who did not qualify in the 1997 study:

- 80 percent are seniors;

- 77 percent are female; and

- 53 percent are female, 75 ears of age or older.

Of those scoring between 50-60 points:

- 83 percent are seniors;

- 81 percent are female; and

- 62 percent are female 75 years of age or older.

Of those scoring less than 60 points using a mobility aid:

- 73 percent use a cane; and

- 18 percent use a walker

To sum up, females 75 and older are among the largest group denied access to Wheel Trans. The group represents the highest percentage of the senior population. This group also is profiled as:

- widowed;

- living alone, in rented accommodation;

- with incomes at or below the poverty line (The income for the majority of single seniors is between $10,000.00 and $15,000.00. It has been estimated that these lower-income seniors are primarily widows who have no Canada Pension Plan or employer pension incomes.);

- with no driving licence or car;

- living to an older age relative to men; and

- experiencing more disabling conditions.

The most common seniors' disabilities are those affecting mobility (74 percent), agility (65 percent), hearing (42 percent), seeing (27 percent) and speaking (9 percent). (Ontario Community Support Association/Ontario Ministry of Health - Through Other Eyes.)

As well, the ability of many seniors to remember, learn, and be cognitively alert declines with age so that even the knowledge and mastery of once familiar routes fades. The result is that more seniors wish door to door transit services but can only qualify if they also meet the physical criteria. Though many of the current improvements planned in accessibility will benefit seniors, others will continue to need the specialized services.

Zone service provides door to door service by dedicated Wheel Trans buses supplemented by accessible and sedan taxis for those trips with both pick-ups and drop-offs within defined geographical areas. Zone service customers are given a 30-minute pickup window when they call to book their ride; they do not need to call the rideline to confirm their ride. Currently three zone routes are operating with another three planned for 1999.

Seniors appreciate the Wheel Trans service. For many, it is the only way they can get around the City. We heard concerns expressed about long waits, poor scheduling and insensitive staff. The Seniors' Task Force heard from Wheel Trans that staff was addressing these issues and that the quality of service has improved with approximately 95 percent of trips being on time. They also advise that weather conditions, last minutes cancellations/no shows or vehicle breakdowns impact scheduling and the availability of trips. Over the next five years, Wheel Trans is replacing the aging Orion 11 with 144 new buses. Three additional taxi services have been added to the pool of taxi contractors to meet 1999 trip demands.

Community Transportation Action Program:

Five ministries at the Province of Ontario participate in the Community Transportation Action Program (CTAP). The purpose of this program is to provide transitional assistance to communities wishing to restructure and co-ordinate their local transportation services. Through the support program, CTAP will provide limited seed funding to encourage communities to develop local solutions and find better ways of using the range of transportation resources that already exist. The funding is used to test local proposals and to demonstrate practical and innovation cost management strategies. The intention is to facilitate change and the co-ordination of existing services across sectors, not to create a new transportation program.

The start up funding for any one community is up to a maximum of $50,000.00. The kinds of support that this can cover are the cost of a consultant, facilitator or a technical expert to work with different sectors in the community to implement a co-ordinated system of services.

Several communities in Toronto have received funding and are running transportation programs. One example is North Toronto Ride - Community Transportation in North Toronto. The program co-ordinates vehicles from five agencies to provide transportation, mainly to senior citizens. An e-mail system has been set up so each agency has access to the transportation schedules and can book rides. This prevents vehicles coming back from trips empty and duplication of trips to the same area at about the same time. The drivers are about 50 percent volunteers and 50 percent paid. The riders pay for the ride and the service picks them up at their home and takes them right into the building where their appointment is located. The demand for rides is far greater than the supply. This program serves many of those seniors who did not meet the criteria for Wheel Trans and those who cannot use the traditional system. The community used the funding to hire a technical expert to set up the computer e-mail system.

The second part of the program is in partnership with the TTC. North Toronto Ride will have access to the TTC scheduling computer software. These are time-limited programs and at this point can run for 10 months. Valuable partnerships have been established, however, and opportunities exist to look for other revenue sources such as advertising, donations and ticket sales to long-term care facilities.

Another current project being organized by the Rexdale Community Health Centre provides transportation which is needed by the community, is culturally appropriate and sensitive to the needs of seniors. Drivers take the client directly to the office where the appointment is scheduled not just to the curb of the building. This is especially helpful to seniors who have physical or cognitive impairments.

The provincial C-TAP program is currently planned to operate until September 1999.

Recommendations - (7) Public Transportation:

Fares:

The Seniors' Task Force recommends that:

(19) The Toronto Transit Commission continue the discounted seniors' fare.

(20) The TTC develop mechanisms which allow for reduced rates for seniors during off-peak times. One of these should be the development of a seniors' day pass which would be valid during off peak times and available for purchase at stations and community outlets.

(21) The TTC recognize that low-income seniors have difficulty having enough money to purchase transit fares even at a discounted seniors' rate. It is recommended that appropriate City staff explore the possibility of a transit subsidy for those seniors receiving the Provincial GAINS (Guaranteed Annual Income Supplement) and that staff approach the provincial government with a proposal.

Operations:

The Seniors' Task Force recommends that:

(22) The TTC change the current "courtesy seating" system to "designated seating" with the additional phrase "Be prepared to give up your seat." The current "elderly and disabled" signage can still be used. The program be supported by the drivers and a marketing program using the International Year of Older Persons theme and logo.

(23) Signage throughout the system be improved and include signs, brochures, and schedules with larger print, information in languages other than English, and international graphic signage. Information on improvements should be communicated to seniors' organizations, particularly ethno-racial groups and Seniors' Centres.

(24) Training for TTC staff on seniors' special needs be introduced to enhance sensitivity and improve customer service. An effective course would facilitate staff understanding about what it is like for a senior to use the regular system and what they can expect to encounter.

(25) Notification be posted in subway stations to advise passengers that escalators and/or elevators are out of service. If seniors can only exit the station using these services, they need to know before they exit to avoid paying an additional fare to travel to a station which they can exit.

(26) The sound system be upgraded to make it useful for seniors and others.

(27) The TTC and the Works Department install more benches at bus stops and shelters. Locations should be identified with the assistance of the Seniors' Assembly.

(28) The TTC develop an accessibility map which would plot out trips between stations that are accessible and link them with accessible bus routes.

Wheel Trans:

The Seniors' Task Force recommends that:

(29) A geriatrician be added to the Wheel Trans review panel to assess the needs of aging seniors who do not need mobility devices except for canes.

(30) The ability to challenge the decision of the Wheel Trans review panel be addressed. Many seniors are unclear about the criteria and their rights. They have a fear about speaking out and many do not speak English easily. The review panel should offer community locations, perhaps at seniors' centres, community or recreation centres. The panel should be prepared to provide services in languages other than English, with notices that reflect that service.

Community Buses:

The Seniors' Task Force recommends that:

(31) Community bus routes be expanded and that TTC staff work with the community to develop, support and promote these routes.

Community Transportation Action Program:

The Seniors' Task Force recommends that:

(32) The City champion the Community Transportation Action Program that is vital to the transportation needs of a number of sectors and promotes efficient use of community agency vehicles.

(8) City Services and Supports:

"Services to seniors should be a value, a principle by which the City operates."

Seniors attending the consultation meetings wanted the City of Toronto to be conscious of the needs of seniors when making decisions that would affect their ability to access City services and facilities. Services delivered by local government and through senior centres and agencies are important, and seniors expressed concern about possible loss of service due to amalgamation. They feel they have worked and contributed immensely to the City we now have today and are not willing to compromise what they have fought long and hard for.

For example:

- Seniors prefer talking to a real person when calling the City and find Voice Mail very confusing and impersonal. Voice Mail does not always provide the information or direction the caller is looking for.

- When attending public meetings, seniors find it difficult to hear speakers without microphones, and may miss vital input.

- Although many improvements have been made in physical access to buildings and transportation, many seniors believe that more can be done. Minimum requirements are not always appropriate.

Parks and Recreation:

Senior citizens generally have more time for recreation and leisure activities than any other age group. They devote an average of almost an hour and a half each day to active leisure pursuits such as sports, socializing and hobbies. It is imperative, for their general physical health and emotional well-being, that they are provided with ample opportunity to participate in activities of their choice.

Toronto Parks and Recreation delivers 54,000 programs to 1.1 million participants of all ages. The department supports 6,000 community groups and 200,000 trained volunteers who provide a wide range of recreation programs and services. There are 97 community centres, 90 indoor pools and 60 arenas/indoor rinks. Parks and Recreation organizes more than 3,000 special events throughout the year.

There are 2,500 recreation programs offered to seniors with 121,000 registrants. The Parks and Recreation Department currently uses a variety of methods to deliver recreation programs and services to seniors in the community recognizing the importance recreation plays in the prevention of illness and social isolation. The City operates 14 senior centres which are also the home and sometimes meeting space to hundreds of senior volunteer groups which offer many programs. Examples include sports clubs and leagues, senior games, camera, card, garden, stamp clubs plus a number of ethno-racial and cultural groups. A growing number of centres offer a congregate dining program. Although recreation services were delivered differently throughout the City of Toronto, each was successful in achieving the goals of the community. The one major similarity in all the delivery systems was the constant input and involvement from the senior users. In every former municipality, the recreation programs were based on the needs of that particular neighbourhood, community centre or seniors centre.

The fear of seniors across the City is that the amalgamation of recreation services will change the current delivery of programs that have been developed by and for seniors in their own communities. Seniors want to be involved in deciding the types of programs that work best for them. Seniors are proud of their contributions and do not want to lose that opportunity to participate.

Currently recreation services partner with a number of different City departments/divisions, community service providers, agencies and the private sector. Some examples include: Board of Education, Library, Police, Homes for the Aged, Toronto Housing, Meals on Wheels, CCACs, Volunteer Centres of Toronto, Senior Link, VON, P.O.I.N.T, local financial institutions, private nursing homes, and Older Adult Centre Association of Ontario.

Staff members, both full and part time, are knowledgeable and experienced in delivering service for seniors. Staff is also skilled at working with neighbourhoods to develop recreation services in partnership with the community. As these centres become community meeting places, staff also does a great deal of referral and information networking with and for seniors.

Recreation staff in partnership with other organizations facilitates many special events:

- In Scarborough during "Seniors Month" (June), a Scarborough Seniors' Showcase is held. Parks and Recreation partners with over 20 community agencies and groups including the Scarborough Town Centre. This two-day event consists of an Art Gallery, Community Support Service Information, a Craft Booth, Raffle, Tea Garden, Gardening Information and demonstration of line dancing, social dancing and fitness. This event attracts thousands of seniors annually.

- In North York Parks and Recreation partnered with the Tamil Seniors Association, Public Health, Provincial and Federal governments to present a weekend conference for seniors. Presenters spoke on health, social and community support issues. Over 100 seniors from many cultural communities attended this conference.

- In Etobicoke, Parks and Recreation hosted the Falls Prevention Coalition First Anniversary. The celebration consists of Interactive Displays, Safety Aids, Falls Assessment, Outdated Medication Clean-up, Line Dancing, Exercise, Medication Safety and a Barbecue. This event has partnered Public Health, Etobicoke General Hospital, The Red Cross, Toronto Housing, Toronto Ambulance and retail stores catering to the needs of seniors. The event was held as a kick-off to Seniors Month and over 200 seniors attended.

- East York Parks and Recreation in 1997 partnered with the Toronto Police Service, community agencies, Royal Canadian Legion, financial institutions, local media and The Ministry of Consumer and Commercial Relations to produce "Your Fraud Alert Calendar". This 16-month calendar gives seniors information about the many types of fraud that exist. It gives tips on how to recognize fraud and what to do about it. Ten thousand copies were distributed to seniors in East York.

- At Nathan Phillips Square, June was marked by "Seniors on the Square." This event featured 20 information tables staffed by seniors' organizations, a big band concert and entertainment from a number of talented seniors groups and individuals.

- The three seniors' centres in York deliver all the recreation programs to seniors. In addition, seniors enjoy annual health fairs, intergenerational breakfast and mentoring programs, community safety programs, health and legal clinics and multicultural festivities. Recently, staff from the Sunnybrook Health Science Centre held a lecture on pedestrian safety for seniors.

These types of programs offer the activities that help meet seniors' need to stay healthy and be contributing citizens in the life of the City.

Sidewalk and Traffic Safety:

Sidewalks are the only means of transportation for many seniors. In the consultations, seniors expressed strong concern about sidewalk and pedestrian safety issues. Specific concerns include rough and uneven sidewalks, curbs, driveways and curb cuts as well as the inconsistency of snow removal from region to region. Seniors need to be able to walk safely on a sidewalk that is free from ice, snow, holes, sandwich signs, bicycles, skateboards and roller bladers. A senior falling or being hit by a skateboard or a bicycle can mean many days or weeks in bed, which lead to other health related problems. "Falls among the elderly have shown that over $980 million in direct cost is spent on treatment of falls among the elderly. It is estimated that about 40 percent of falls leading to hospitalization are the result of hip fractures, and that this will increase dramatically from 23,375 cases in 1993 to over 88,000 cases by the year 2041 as the Canadian population ages…In 1995 there were over 468,000 falls among the elderly, amounting to almost $1 billion in costs or about $2,100.00 per fall (Canada wide figure). (The Economic Burden of Unintentional Injury in Canada 1998 - Smartrisk in partnership with Health Canada and Ministry of Health (Ontario).)

Seniors across the City identified difficulty in crossing multi-laned intersections in the time allowed by the pedestrian crossing light. Some seniors expressed a lack of understanding about the newer signals that flash.

Fire Safety:

The Fire Department has identified that adults over the age of 60 account for 36 percent of the total fire deaths in the City. Seniors' issues should be included in all fire safety booklets. The "Older and Wiser" program is very welcome and needs to be promoted.

Personal Safety:

The Toronto Police Service 1998 Environmental Scan states that for those 65 years of age and older the rate of victimisation has remained relatively steady for the past eight years, increasing slightly from 1.8 per 1,000 population over 65 to 2.1 per 1,000 population over the age of 65.

Issues of personal safety and crime were lower on this priority list than other safety issues, such as safe sidewalks, traffic and pedestrian safety, elder abuse and protection from fraud.

In terms of personal safety, seniors supported recreation programs for youth as a positive way to feel safe. Some seniors expressed fear of groups of youth. Some seniors feel threatened by some panhandlers and are supportive of initiatives to help the homeless and those living in poverty. Some women felt unsafe on the TTC in the evening.

Fraud:

The Toronto Police Service 1998 Environmental Scan indicates that "Financial victimisation can create serious problems for the aged…elderly persons who no longer work cannot recoup their economic losses. Victims may then become dependent on family members, which can cause stress within the family, or seniors could become dependent on ...public programs. Indicators of financial abuse can include: unusual activity in a bank account, new acquaintances of the elderly expressing a desire to live with them, loss of amenities and/or utilities, new signees or unusual activity on credit cards and/or suspicious signatures on document (source - Coker J. and Little, B. Investing in the Future: Protecting the Elderly from Financial Abuse. FBI Law Enforcement Bulletin 66 (12), December 1997.)

Anti-Fraud community initiatives have been popular. The East York Community Task Force to Combat Fraud Against Seniors has delivered 20,000 "Scams Against Seniors" brochures door to door; they have produced and distributed 10,000 copies of "Your Fraud Alert Calendar," a sixteen-month calendar warning seniors of a wide variety of frauds and scams. The Volunteer Centre of Toronto also delivers the excellent Scotiabank Fraud Awareness Program, "The ABCs of Fraud." Twenty senior volunteers provide a one-hour presentation to seniors' groups providing information and tips on identifying and preventing consumer fraud victimization.

Education:

In the consultations, seniors throughout the City of Toronto expressed an interest in life-long learning opportunities. Access to education, training programs and classes are necessary for quality of life and healthy relationships. A number of seniors had concerns that the changes to Board of Education courses could result in fewer programs and higher fees. Although procedures differed from municipality to municipality, it is estimated that 25,000 seniors are enrolled in day and evening continuing education courses. Twelve thousand of those are in the former City of Toronto which offers a broad curriculum. The costs have risen over the last few years and are different for day and evening courses. Seniors also expressed support for courses/programs that were geared to seniors, particularly literacy, computer literacy and English as a second language courses. The courses are conducted throughout the City in community centres, seniors' homes and public schools.

According to the Toronto Star newspaper 1998, under the Province's new educational funding model, allotment per adult student is $2,777.00, in contrast to the $7,000.00 per student which was spent by Toronto. This change in funding could result in the loss of approximately 600 teaching positions and a least 4,000 reduced spots for students.

The Toronto Adult Student Association (TASA) is a non-profit student organization founded in 1998. One of the primary goals of TASA is the development and maintenance of adult education programs. TASA endorses the continuing support of adult education including special programs for seniors as it perceives life long learning is vital for the maintenance of the well-being of seniors.

A report presented at the public meeting of the Toronto District School Board on May 12, 1999, on Adult and Continuing Education recommended that:

- programs be nine weeks in length;

- all participants pay a fee of $1.75 per hour;

- fees be waived for any individual on a disability pension; and

- "seniors" be defined as 60 years of age or older.

This reported was deferred for further analysis on:

- identification of potential impact on service levels;

- reduced access to programs for current users because of reduction of hours and increased user fees; and

- job loss.

Community Grants:

Funds provided by the City have helped support the community services sector in Toronto to meet local community needs. Municipal funding complements the funding provided by the Province. Together, these levels of government have addressed a variety of identified needs and problems.

The City of Toronto:

The City of Toronto's Community Service Grants Program (CSPG) is a combination of ten grants programs provided by the seven former municipalities as the primary means of support for community-based social service agencies.

The objectives of the Community Service Grants Program are to:

- support the City's strategic directions through a planned and proactive use of resources available to the CSGP, in partnership with communities;

- provide funding for the development of community supports which are effective in improving social prospects of diverse communities;

- support organizations which promote access to services and resources for diverse ethno-racial and Aboriginal communities;

- ensure organizations receiving community service grants are accountable to the City for the funding they receive and to the communities they serve; and

- foster the development of mutually beneficial partnerships and collaborations among communities, between service providers, and with governments.

The City provides approximately $3.4 million through the CSGP to 93 seniors' organizations across Toronto for seniors' agencies to support programs such as congregate dining, friendly visiting and wellness education. This is from a grant stream that allocated approximately $12 million in 1998.

The Community-based Social Service Sector:

Changes in both federal and provincial policy have adversely affected the capacity of the community-based sector to respond to needs. The United Way's 1997 report "Metro Toronto: A Community at Risk" noted that funding cuts to community-based agencies have resulted in a loss of $14 million in government funding to 140 United Way member social service agencies in 1996.

Although community-based seniors' services have fared relatively well during the time of cuts, both the United Way report and the 1996 community agency survey, "Profile of a Changing World," identified certain areas of the sector particularly affected by funding changes. These include programs targeting seniors from vulnerable communities such as low-income individuals, ethno-cultural groups, people with disabilities and immigrants and refugees.

The findings from these reports and the needs identified in the consultation process with seniors suggest that while the City should be applauded for its role in providing services to seniors through its funding, a more strategic approach to funding is required to ensure that the needs of the most vulnerable seniors across the City of Toronto are met.

Funding:

The far-reaching changes that have occurred to social service funding have created insecurity about the stability of services for seniors. Seniors were concerned that funding levels be maintained and that services to meet emerging needs amongst seniors were not being developed.

Community Supports:

The breakdown or absence of the extended family system, as well as cultural, linguistic and physical barriers to accessing services, mean that the reality for many seniors, as described during the consultations, is a life of poverty and social isolation. Seniors echoed the sentiment that community-based services such as in-home support services and social and recreational programs play a crucial part in enhancing the lives of many seniors. The importance of social programs was a sentiment echoed across the City and isolation was identified as a potential cause of many emotional and health related problems for seniors.

Seniors articulated a need for increased facilities and programs and for more recognition of the needs of frail often-housebound seniors.

Access and Equity:

Demographic data show that the City has an increasingly diverse population of seniors. Seniors across the City from different ethno-specific communities voiced the need for services that are culturally specific both in language and in content.

Seniors felt that services should be financially accessible to all, and named differences in user fees as an example of a barrier to accessibility.

"Seniors' agencies should remain accessible and be affordable. Seniors' agencies are very important to the future of seniors' healthy lives."

Recommendations - (8) City Services and Supports:

The Seniors' Task Force recommends that:

(33) All public and community meetings sponsored by the City provide for seniors' full participation to include:

- information that can be read easily, e.g., adequate font size, clear language;

- a public address system to ensure all can hear the speakers; and

- accessible buildings.

Parks and Recreation:

The Seniors' Task Force recommends that:

(34) Parks and Recreation services and programs which value seniors be supported and developed to meet the needs of the growing seniors' population. Programs for seniors create a balanced program in each community centre.

(35) Parks and Recreation continue to evaluate the impact of user fees on access and participation in seniors' programs.

(36) Parks and Recreation staff develop a broad range of recreation and leisure opportunities that accommodate variances in interest, culture and level of ability to participate, and that seniors are involved and consulted in this process.

Sidewalk and Traffic Safety:

The Seniors' Task Force recommends that:

(37) Works and Emergency Services continue to make regular formal inspection of sidewalks and curbs and that repairs to hazardous conditions be a priority.

(38) Works and Emergency Services develop a well-publicized reporting system that enables members of the public to report dangerous or hazardous sidewalk or curb conditions.

(39) All sidewalk snow and ice clearing by-laws be rigorously enforced.

(40) The Seniors' Assembly work with the Task Force on Community Safety, City Cycling Committee and the Pedestrian Committee on safer sidewalk strategies.

(41) The Seniors' Assembly work with the Task Force on Community Safety, the Pedestrian Committee and Transportation Services on appropriate timing for multi-laned intersection pedestrian crossings.

Fire Safety:

The Seniors' Task Force recommends that:

(42) The Fire Department promote the "Older and Wiser" program through public service announcements.

(43) The Fire Department promote a program to "train the trainer" through a wide range of seniors' organizations, especially groups in the ethno-racial community so that awareness can be promoted in languages other than English.

Personal Safety:

The Seniors' Task Force recommends that:

(44) The Seniors' Assembly work with members of the Task Force on Community Safety on common issues and any brochures, campaigns or advertisements include seniors' issues.

(45) The membership of the Task Force on Community Safety include seniors.

Fraud:

The Seniors' Task Force recommends that:

(46) City Council recognize the importance of anti-fraud community initiatives, such as The East York Community Task Force to Combat Fraud Against Seniors and the ABC's of Fraud program.

(47) Public service announcements be routinely developed on the latest fraud/scam, with encouragement to report incidents to police along with a list of community agency programs to contact. These should be announced by the Mayor and/or the Chief of Police and carried on television, radio and in community and City newspapers.

Education:

The Seniors' Task Force recommends that:

(48) City Council support affordable access to life long learning.

(49) Information on literacy programs for seniors at the Toronto Public Library for seniors be distributed to community and seniors' organizations.

Community Grants:

The Seniors' Task Force recommends that:

(50) The City of Toronto's Community Service Program Grants staff re-examine supports to community-based seniors' services and target appropriate funding to vulnerable, at risk groups within seniors' communities.

(51) Prevention and awareness of elder abuse be an important criteria in awarding the Breaking the Cycle of Violence grants.

(9) Burial Ground:

At a meeting held at the Native Canadian Centre, the participants identified the need for an Aboriginal burial ground to be established in the urban area in the City. They explained that there is no such place where Aboriginal people living in the City can be buried and have a site that honours the traditions of the community. It was stated that people living in the City may have left the reserve many years ago and no longer have close connections with their band members. It is also very expensive and sometimes impossible to be buried on a home reserve.

Recommendation - (9) Burial Ground:

The Seniors' Task Force recommends that:

(52) Staff from the Aboriginal Office, Access and Equity meet with appropriate members of the Aboriginal community to develop a process to acquire a site for an Aboriginal burial ground and that the appropriate City staff should be requested to provide any necessary expertise.

(10) International Year of Older Persons 1999:

The United Nations has designated 1999 as the International Year of Older Persons with the theme "Toward a society for all ages." It is timely that the Seniors' Task Force final report will be on the City Council agenda in this international year. This report, which outlines recommendations to address issues and priorities raised by seniors living in the new City, will become part of the legacy for City Council, staff and seniors to working together to make the new City of Toronto a society for all ages.

One of the tasks of the Seniors' Task Force was to establish a role for the City of Toronto in the International Year of Older Persons - IYOP. Seniors who attended the public consultations and members of the Task Force decided that it was important that a major legacy project be identified and started during 1999. Two initiatives reflect this thinking: the final report of the Task Force and the improvements in street signage.

Seniors were asked for their ideas and suggestions for recognizing and celebrating IYOP in the new City. The following suggestions for IYOP came from the community consultations:

- implement solutions for issues identified by seniors in 1999;

- develop intergenerational programs or meetings;

- work with community centres to organize events across the City;

- profile seniors' accomplishments at the CNE;

- encourage and welcome all seniors to participate in the Native Elders Conference held at the Native Canadian Centre each spring;

- highlight seniors' sports;

- hold line dancing and square dancing competitions;

- develop a tree dedication program to honour senior volunteers; and

- commission a statue reflecting a senior passing along wisdom to children.

The celebration events contain a listing of some City-wide events that we have been able to identify.

Seniors' Task Force:

The establishment of the Seniors' Task Force to identify issues and priorities for seniors in the City of Toronto has resulted in a broad public consultation and the production of this report which recommends an on-going initiative, the creation of a Seniors' Assembly.

This document should supply a blueprint for action on recommendations identified by seniors.

Street Signage Program:

Transportation Services has made funding available ($250,000.00) for the first stage of an improved street signage project, the installation of large, easy to read street signs on arterial roads. The Seniors' Task Force requested this pilot project as a first step in improving all signalized intersections in the City. Drivers can easily read these signs as they approach an intersection. They are visible at night, because of the reflecting material used. The design has been approved by the Task Force in conjunction with a knowledgeable expert in this area. We are pleased that eventually 1,823 intersections should receive this new signage. Although the project is the suggestion of the Seniors' Task Force, the signage improvements will benefit the general population. If the Olympics or any other international events are held in the City, this project will make it much easier for visitors to get around the City.

Global Conference on Aging:

Eight seniors from the Seniors' Task Force will represent Toronto at the Fourth Global Conference on Aging, the only official United Nations conference to be held in Canada in 1999. This conference will be held in Montreal in September 1999. It is expected that the delegates will report their findings to the Seniors' Assembly.

IYOP Logo:

The logo for the International Year of Older Persons will be planted in parks and carpet beds in the various areas of the City. Two existing carpet beds which will be used are located at Yonge and Lawrence and at Bloor Street West and the Kingsway. Other areas in City parks are being explored that will accommodate plantings to mark this year.

Events:

The International Year of Older Persons was launched on October 1, 1998, in Nathan Phillips Square. Mayor Mel Lastman, Minister Cam Jackson, Councillor Anne Johnston and Lois Neely, the Ontario representative to the Federal IYOP Committee, along with other Councillors on the Seniors' Task Force enjoyed great entertainment supplied by seniors groups. On the stage activities included line dancing and fitness. Demonstrations on the square included Tai Chi, bocce, and lawn bowling. A celebration 1999 IYOP cake was cut and shared with all in attendance under the International Year of Older Persons flag.

International Year of Older Persons was celebrated at Winterfest February 13 and 14, 1999, with a visit from Don Herron, one of the IYOP Celebrity Chairs. Information tables and big bands entertained many seniors who attended. There was dancing inside and activities for all outside at Mel Lastman Square.

June 1999 brought many activities all over Toronto. June was Seniors' Month and many groups celebrated with special events. On June 23, 1999, Seniors Month celebrations at Nathan Phillips square included "swinging seniors" and a farmers market. Special events are planned by Housing, Homes for the Aged, Library Services, Special Events and Parks and Recreation. Most of the City's recreation and senior centres will celebrate the International Year of Older Person events highlighting the theme "Towards a society for all ages."

In September 1999, Public Health held a conference on falls. "Falls among the elderly have shown that over $980 million in direct cost is spent on treatment of falls among the elderly. It is estimated that about 40 percent of falls leading to hospitalization are the result of hip fractures, and that this will increase dramatically from 23,375 cases in 1993 to over 88,000 cases by the year 2041 as the Canadian population ages…In 1995 there were over 468,000 falls among the elderly, amounting to almost $1 billion in costs or about $2100 per fall (Canada wide figure). (The Economic Burden of Unintentional Injury in Canada 1998 - Smartrisk in partnership with Health Canada and Ministry of Health (Ontario).)

Recommendations - (10) IYOP:

The Seniors' Task Force recommends that:

(53) City Council continue its support and fund the improved street signage program, and that funding be allocated each year until completion.

(54) City Council encourage property owners to put well-lit numerical addresses on the buildings, offices and homes on their property. In the development of the improved street signage program, it was noted that many buildings do not display their numerical address.

(11) Seniors' Assembly:

"We need a voice, some voices who can advocate for seniors, we need grey power."

Seniors said they wanted to have input into local government policy decisions that affect their lives and how services are delivered to them. Any group representing seniors in Toronto should reflect the cultural and ethno-racial diversity of the City.

"Seniors from ethnic minorities have no voice right now and our concerns are not being addressed."

During the public consultations, the subject of an on-going public participation model for seniors was discussed. Former municipalities had many different approaches on how seniors related to local government. During this time of great change, seniors through the consultations and on the Task Force felt that some direct support for a citizen participation model would be necessary. The model proposed allows for a Seniors' Assembly to act as a vehicle for sharing and receiving information. It would not, however, be the only group recognized by local government as a voice for seniors' issues.

"Who represents seniors, who will listen, who will we contact?"

There is support for a person to be a "Seniors' Advocate," someone who would speak for seniors' issues, ensure the involvement of seniors on issues of importance to them and to the City, and encourage a dialogue.

Role of the Assembly:

- Inform senior residents across the City of City-specific issues that impact on seniors.

- Advise Seniors' Advocate on seniors' issues in the community.

- Develop a seniors' action plan that includes a mechanism for reporting out on the status of seniors in the City of Toronto.

Responsibilities of the Members:

- Build on work being done in the community.

- Attend meetings and forums to act as a resource on seniors' issues.

- Help identify initiatives within the community.

- Share ideas within the broad community.

- Participate and link with established seniors' coalitions/networks across the new City.

- Facilitate public forums or meetings to promote public awareness and participation.

- Be responsive to the community, through requests for presentations, meetings and regular discussion of current activities.

- Be responsible for an ongoing newsletter for seniors in the City.

Responsibilities of the City:

- Appointment of a Seniors' Advocate from City Council.

- Staff co-ordinator - linkages to City services/supports through Social Development and Administration, Community and Neighbourhood Services.

- Support and participate in a Seniors' Summit.

Suggested Membership:

Individuals:

Seniors age 65 and up who:

- reflect the diversity of the population;

- reflect the geographic areas of the City;

- have experience working in group;

- have a keen interest and knowledge of issues affecting seniors; and

- have community connections and can reflect ones own view and those of the community.

Agencies:

Be a member of an agency serving seniors.

Recommendation - (11) Seniors' Assembly:

The Seniors' Task Force recommends that:

(55) City Council adopt the model described as the "Seniors' Assembly" and appoint a Seniors' Advocate for the City.

"On behalf of the seniors who attended the consultation meetings, we would like to thank you for allowing us to voice our concerns and issues with the City of Toronto. Seniors were so delighted to have been asked to voice an opinion in a public forum such as the one that was conducted."

(A copy of each of the Appendices I-VII of the Final Report of the Seniors' Task Force was forwarded to all Members of Council with the agenda of the Community Services Committee for its meeting on October 7, 1999, and a copy thereof is on file in the office of the City Clerk.)

The Community Services Committee reports, for the information of Council, also having had before it during consideration of the foregoing matter communications from the following:

- (September 16, 1999) from Ms. Mary Ellen Glover, Executive Director, Ontario Association of Residents' Councils, expressing concern that none of the recommendations deal with the improvement of the quality of life of seniors who live in long-term care facilities;

- (September 22, 1999) from Mr. Alex Ginou suggesting that the recommendations under Sidewalk and Traffic Safety be amended by adding the following Recommendation No. 37(b):

"That on any City street that has housing a sidewalk be constructed."; and

- (October 6, 1999) from representatives of the Ethno-Cultural Seniors Advocacy Project, Rexdale Women's Centre, expressing support with respect to the efforts and recommendations of the Seniors' Task Force; and outlining their particular areas of support.

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

- Ms. Eileen Smith, Footprints Affordable Housing Inc.;

- Mr. Terry Fagan, Executive Director, Millennium Community Building Association;

- Ms. Beverly McClelland, Toronto Seniors' Coalition;

- Ms. Rosemary Duff, and submitted a brief in regard thereto; and

- Councillor Anne Johnston, Chair, Seniors' Task Force.

(City Council on October 26 and 27, 1999, amended this Clause by:

(1) amending Recommendation No. (1) of the Community Services Committee to provide that Councillor Tom Jakobek also be a member of the team which will meet with the Hospital Boards;

(2) deleting Recommendation No. (3) of the Community Services Committee, viz.:

"(3) if the shelter system is operating above 90 percent by December 1, 1999, the decision to close the Fort York Armoury be revisited by the Community Services Committee at its meeting on December 1, 1999."; and

(3) adding thereto the following:

"It is further recommended that:

(a) City Council express its gratitude to the federal government for use of the Fort York Armoury as a shelter and appeal to the federal government to allow the City to continue using the Fort York Armoury shelter until January 15, 2000, in order to provide sufficient time to build temporary replacement shelter spaces immediately, and, in the event the federal government denies the City's request, the City cease to use the Fort York Armoury as a shelter as of December 15, 1999; and

(b) having regard that the City has a 97 percent occupancy rate in shelters for single men and youth, the Commissioner of Community and Neighbourhood Services be requested to:

(i) review all municipal buildings, including those occupied by agencies, boards and commissions, for locations for emergency shelters and report on the results of the negotiations related thereto to the next meeting of the Community Services Committee, such negotiations and report to also address the feasibility of utilizing the Guild Inn and any of the Civic Centres as emergency shelters;

(ii) immediately negotiate with the Interim General Manager, Exhibition Place, on how to utilize existing empty buildings in Exhibition Place as emergency shelters and include the results of such negotiations in the report requested in Recommendation No. (3)(b)(i); and

(iii) expedite her research and report on alternative forms of shelter services to the Community Services Committee as soon as possible.")

The Community Services Committee recommends to Council that:

(1) Councillors who sit on the Boards of various hospitals in Toronto, and other interested Councillors, together with appropriate staff (as designated by the Commissioner of Community and Neighbourhood Services) form a team to meet with the Hospital Boards regarding their discharge policies and develop a protocol to ensure the appropriate placement of health-compromised individuals prior to them being discharged from hospitals;

(2) between now and the scheduled closure of the Fort York Armoury in December 1999, and in order to alleviate crowding in other shelters, extra cots be added at the Armoury and other shelter locations when there is over 90 percent occupancy in Toronto's shelter system; and

(3) if the shelter system is operating above 90 percent by December 1, 1999, the decision to close the Fort York Armoury be revisited by the Community Services Committee at its meeting on December 1, 1999.

The Community Services Committee reports, for the information of Council, having:

(a) expressed its support for the efforts made by staff of the Community and Neighbourhood Services Department and agencies to create the shelter spaces required for this winter;

(b) requested the Commissioner of Community and Neighbourhood Services, in conjunction with the Commissioner of Works and Emergency Services and the City Solicitor, to develop a protocol to provide for the Mayor to enact the Emergency Plan if and when the City of Toronto finds itself in the position of being unable to provide shelter for those who need it, and report thereon to the Community Services Committee; and

(c) requested the Commissioner of Community and Neighbourhood Services to:

(i) report to the Community Services Committee on the possibility of enacting the Emergency Plan should circumstances change;

(ii) continue to pursue other opportunities to create additional shelter spaces in excess of the 860 opened, or anticipated to be opened by December 1999, in order to provide a cushion for shelter space to accommodate potential unanticipated needs this winter, and to report thereon to the Advisory Committee for New Emergency Shelter Sites in October 1999;

(iii) ascertain from some of the larger municipalities in Canada their experiences, trends and numbers with respect to homelessness in their jurisdictions, and report thereon to the Community Services Committee; and

(iv) provide monthly updates to the Community Services Committee on the status of the shelter system.

The Community Services Committee submits the following communication (September 23, 1999) from Councillor Jack Layton, Co-Chair, Advisory Committee on Homeless and Socially Isolated Persons:

At its September 22, 1999, meeting, the Advisory Committee on Homeless and Socially Isolated Persons, adopted the following motion to be forwarded to the Community Services Committee for action.

"It is recommended that the Community Services Committee and members of Council ask the Mayor to invoke the emergency by-law and thereby enact the emergency plan in order to develop an appropriate plan of action to immediately address the critical shortfall of emergency shelter."

The Advisory Committee has consistently heard from staff in the Shelter, Housing and Support Division that there is a significant shortage of beds in the emergency shelter system; a problem that is only expected to get worse this winter. Despite the best efforts of Community and Neighbourhood Services to add more beds to the system, it seems that few new hostels have been approved. Even with the addition of the new hostels and the Out of the Cold beds there will not be enough hostel beds to meet the expected demand.

In April of this year, Council adopted a policy objective to maintain the monthly occupancy level of the emergency shelter system for adults and youth at no more than 90 percent. It is now reported that the adult system is operating at 100 percent capacity.

Given this reality, the Advisory Committee asks the Community Services Committee and City Council to urge the Mayor to enact the emergency by-law to provide immediate relief to deal with this crisis.

The Community Services Committee reports, for the information of Council, also having had before it during consideration of the foregoing matter, a copy of a report submitted to the Advisory Committee on Homeless and Socially Isolated Persons by staff of the Community and Neighbourhood Services Department respecting Emergency Planning in the City of Toronto.

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

- Ms. Kira Heineck, Toronto Disaster Relief Committee, and submitted a brief in regard thereto;

- Ms. Linda Torney, President, Toronto and York Region Labour Council, and submitted a brief in regard thereto;

- Ms. Kathy Hardill, Regent Park Community Health Centre;

- Councillor Jack Layton, Co-Chair, Advisory Committee on Homeless and Socially Isolated Persons, and submitted a list of the hostels and any vacant spaces for the evening of October 6, 1999;

- Ms. Sarah Shartal, and submitted a brief in regard thereto; and

- Ms. Barbara Craig, Street Health, and submitted a brief in regard thereto.

(City Council on October 26 and 27, 1999, adopted this Clause, without amendment.)

The Community Services Committee recommends the adoption of the following report (September 21, 1999) from the Commissioner of Community and Neighbourhood Services:

Purpose:

This report proposes the mandate and membership selection process for an Aboriginal Homelessness Steering Committee, as recommended in the Mayor's Homelessness Action Task Force report.

Funding Sources, Financial Implications and Impact Statement:

There are no immediate financial implications for the City.

Recommendations:

It is recommended that:

(1) the Commissioner of Community and Neighbourhood Services be authorized to establish an Aboriginal Homelessness Steering Committee to advise the City on the implementation of the Mayor's Homelessness Action Task Force recommendations pertaining to Aboriginal homelessness; and

(2) the Aboriginal Homelessness Steering Committee be established for a two-year period, based on the Terms of Reference and membership selection process set out in this report, with annual reports to the City.

Executive Summary:

Aboriginal people make up a significant proportion of people who are homeless, or at risk of homelessness, in Toronto. This fact has been substantiated in the Mayor's Homelessness Action Task Force report, the Royal Commission on Aboriginal Peoples, and numerous reports from social service agencies in the City. A strategy is required which specifically addresses shelter, housing and support needs of the Aboriginal population in the City.

Jurisdictional responsibility for Aboriginal people has historically rested with the Federal Government (on reserve, status Indians) and with the Province (for those living off reserve.) The growth in the urban Aboriginal population, however, has resulted in municipalities having to take responsibility for many Aboriginal issues, particularly in the area of social services. In addition, the Aboriginal community shares in the responsibility for the well-being of urban Aboriginals, and there are now 16 Aboriginal-led social service agencies and non-profit housing providers in the City.

The proposed Aboriginal Homelessness Steering Committee would include representatives from all levels of government and the Aboriginal community. It would provide a forum where the Aboriginal specific recommendations in the Mayor's Homelessness Action Task Force can be advanced, and an appropriate strategy for urban Aboriginal people can be developed. The Committee would be advisory in nature and report annually to the City.

Council Reference/Background/History:

City Council endorsed, in principle, the general directions outlined in the Mayor's Homelessness Action Task Force final report, and requested that the Commissioner of Community and Neighbourhood Services report back on initiatives for homeless Aboriginal people (Clause No. 2 of Report No. 5 of the Strategic Policies and Priorities Committee, March 2, 3, and 4, 1999).

The Task Force specifically recommended that an Aboriginal Homelessness Steering Committee be established to "provide on-going advice on an implementation plan to prevent and reduce homelessness and monitor and evaluate the results." Other Task Force recommendations specific to the Aboriginal population are for new supportive housing, a clinical detox unit, a healing lodge and other services which promote prevention and self-help. (For a complete list of these recommendations see Appendix No. 1.)

City Council also requested that the Federal Government be encouraged to participate in the development of a culturally appropriate homeless strategy for the City of Toronto (Notice of Motion by Councillors Pantalone and Korwin-Kuczynski, seconded by Mayor Lastman, adopted by City Council on May 11 and 12, 1999). Staff are engaged in discussions with Human Resource Development Canada about a Federal representative to sit as an ex-officio member of the Aboriginal Homelessness Steering Committee. A representative from the Provincial Government will be requested as well.

Comments and/or Discussion and/or Justification:

Aboriginal people represent about 1 percent of the general population in Toronto. The Mayor's Homelessness Action Task Force estimates that 4,000 people or 15 percent of all homeless people are Aboriginal. The Royal Commission on Aboriginal Peoples research on urban poverty gives rise to a conservative estimate of 8,000 Aboriginal households at risk of homelessness in Toronto. Problems of urban Aboriginal poverty are often linked with addictions, abuse, mental illness, and lack of training and education.

The extent and complexity of Aboriginal homelessness demands a specialized response that requires leadership and input from the Aboriginal community, the City and senior levels of government. The Mayor's Task Force has recommended that an Aboriginal Homelessness Steering Committee be established to provide one forum where collaboration and leadership are encouraged.

The proposed Terms of Reference for the Aboriginal Homelessness Steering Committee has been developed in consultation with Aboriginal community members (see Appendix No. 2). The Committee would advise the City on an Aboriginal specific strategy, monitor progress on the strategy and seek out potential resources related to strategy implementation. The Committee would have a two-year mandate, and report to City Council annually.

The Aboriginal Homelessness Steering Committee members would be selected from applications received in response to a general mailing to community members. Members would be appointed by the Commissioner of Community and Neighbourhood Services. The Steering Committee would be comprised of seven representatives from the Aboriginal community. The assistance of technical advisors from Aboriginal social services, and representatives from all levels of government would be solicited as well. City representatives from the Mayor's office, Community and Neighbourhood Services Department and the City's Access and Equity Centre will provide staff resources for the work of the Committee.

Conclusions:

Aboriginal people are over-represented in the homeless and at risk populations in the City. Shelters, housing and social services which are culturally sensitive, and managed by Aboriginal people have demonstrated the importance of collaboration among Aboriginal people and all levels of government in addressing the service needs of this population.

The proposed Aboriginal Homelessness Steering Committee, as recommended by the Mayor's Homelessness Action Task Force, would provide an appropriate forum for collaboration on an Aboriginal homeless strategy as well as a means to make progress on the Task Force's specific recommendations for new services for Aboriginal people.

Contact Name:

Joanne Campbell, Tel: 392-7885/Fax: 392-0548

Appendix No. 1

Mayor's Homelessness Action Task Force

Aboriginal Specific Recommendations

(#24 to #33)

Establish a new Aboriginal shelter by expanding and strengthening Council Fire's operations so that it can operate its shelter year round.

The federal government should carry responsibility for funding housing and supports to the Aboriginal homeless population in partnership with the provincial government.

A supportive housing pilot project should be established in a suburban area of the City specifically for the Aboriginal population in Toronto. The capital costs should be covered by the federal government. Support services should be attached to appropriate Aboriginal-specific service providers. This project should establish formal linkages to the healing lodge recommended below.

The Li'l Beavers/Eagles prevention program for Aboriginal children and youth, operated by Native Friendship Centres, should be reinstated by the Province. The federal government should establish an Urban Multi-Purpose Aboriginal Youth Centre in Toronto in co-operation with the Native Canadian Centre of Toronto, Council Fire, and other Aboriginal agencies.

The Facilitator for Action on Homelessness should, as one of his or her special projects, create an Aboriginal Steering Committee to provide ongoing advice on an implementation plan to prevent and reduce Aboriginal homelessness and monitor and evaluate the results.

An Aboriginal clinical detox centre, funded by the Ministry of Health, should be established, building upon the efforts of Anishnawbe Health and Pedehbun Lodge.

Establish a rural-based healing lodge near Toronto to provide opportunities for healing and self-development of the Aboriginal homeless population in Toronto. This model should be similar to existing Aboriginal healing lodges in Ontario but with a focus on the homeless population.

A focused strategy should be established to increase training and job opportunities for Aboriginal youth based on transitional housing models in which residents work to upgrade their skills and prepare for independent living. It should be led by Native Child and Family Services in collaboration with Nishnawbe Homes and the Native Canadian Centre of Toronto and other youth service providers.

Expand the Biindgd Breakfast Club model.

Appendix No. 2

Toronto Aboriginal Homelessness Steering Committee

3^rd Draft

Terms of Reference

(September 8, 1999)

Purpose:

To facilitate and monitor the implementation of recommendations of the Mayor's Homelessness Action Task Force to reduce Aboriginal homelessness in Toronto.

Objectives:

The Committee will:

(a) Provide advice to the City and the Aboriginal community on ways to co-ordinate a strategy to reduce homelessness among Aboriginal people in Toronto.

(b) Establish a process to monitor and evaluate strategy implementation.

(c) Assist in resolving disputes related to strategy implementation.

(d) Ensure accountability for strategy implementation to the community and all levels of government.

(e) Ensure continuity in strategy implementation.

(f) Search out and identify potential resources related to strategy implementation.

Composition of Committee:

Membership:

The Committee will be composed of seven members to be selected by the City from nominations by the Aboriginal community. A youth representative (under 25 years of age) and a homeless representative will be among those members selected. Representation from women will be ensured.

The Committee will select a chairperson from among its number.

The Committee will be supported by technical advisors from all levels of government, who will attend meetings in an ex-officio capacity. Technical advisors from Aboriginal social service agencies which have direct interest in strategy implementation will also participate in Committee work.

Membership Selection Criteria:

Committee members must be Aboriginal and will have a working knowledge of issues and problems related to Aboriginal homelessness in Toronto.

Committee members will possess skills and/or knowledge related to addressing homelessness issues.

Committee members may include members of Board of Directors from social service agencies but not staff from agencies which provide services related to strategy implementation. Staff members may be technical advisors.

Committee members shall be willing to carry out Committee work on a voluntary basis.

Committee members shall be willing to adhere to the City's conflict of interest guidelines for committees.

Procedures for Selection:

The City will request that members of the Aboriginal community submit written nominations for Committee members and technical advisors. Nominations will be reviewed and Committee members and advisors will be appointed by the City.

The City will appoint staff to support the Committee. A representative from the Mayor's office will also participate. Technical advisors from the provincial and federal governments will be sought.

City Council will make final decisions regarding the mandate and membership of the Aboriginal Steering Committee.

Term of Service:

Committee members shall serve for a two-year term at which time an evaluation of the Committee will be undertaken. Committee Terms of Reference will be reviewed and revised, if necessary, at that time.

Authority:

The Committee is advisory in nature. It has no authority to commit the City or any party to specific courses of actions, or to initiate activities on its own.

The Committee will be responsible for identifying potential resources. It will have the authority to lobby or otherwise contact groups which may provide resources to addressing Aboriginal homelessness in Toronto.

The Committee members will not speak on behalf of the City or any Aboriginal agency unless they are specifically asked to do so in writing.

Accountability:

The Committee shall be accountable to the Aboriginal community, its service delivery agencies and the City of Toronto through regular written reports, the development of an annual work plan, and other means as determined by the Committee.

The Committee will present a yearly report to the City, as well as interim reports as requested. Once final, the yearly report will be circulated within the Aboriginal community.

Committee members will individually and as a collective endeavour maintain good communications with the City of Toronto and the Aboriginal community and its agencies. The Committee will constantly seek input from all concerned and in particular the Aboriginal agencies which have responsibility for implementing components of the strategy.

The Committee at its first meeting and yearly thereafter will develop a work plan to be distributed to all concerned.

(City Council on October 26 and 27, 1999, amended this Clause by adding thereto the following:

"It is further recommended that the City's Homelessness Report Card be prepared in consultation with, and co-sponsored by, the Advisory Committee on Homeless and Socially-Isolated Persons.")

The Community Services Committee recommends the adoption of the following report (September 23, 1999) from the Commissioner of Community and Neighbourhood Services:

Purpose:

To outline the proposed framework for the City of Toronto's Homelessness Report Card as directed by City Council in its response to the Mayor's Homelessness Action Task Force report.

Funding Sources, Financial Implications and Impact Statement:

There are no financial implications arising from this report.

Recommendations:

It is recommended that:

(1) the framework for the City's Homelessness Report Card as outlined in Appendix A be approved; and

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

Council Reference/Background/History:

As part of the response to the Mayor's Homelessness Action Task Force report last Spring, City Council directed the Chief Administrative Officer to produce an annual report card on homelessness for presentation directly to Council. The report card is to document the state of homelessness in Toronto and to outline action taken by the each level of government to alleviate the problem.

The Commissioner of Community and Neighbourhood Services was directed to submit a proposed framework for the report card to the Community Services Committee in the Fall. This report responds to that request.

Comments and/or Discussion and/or Justification:

Why is a Homelessness Report Card important for the City?

Based on its actions to date, it is clear that the City of Toronto recognizes the serious nature of homelessness in Toronto and is committed to finding solutions to this growing problem. Since the release of the Mayor's Homelessness Task Force report in January 1999, Council has dealt with the major policy and financial issues directed at the City. Most importantly, City Council has answered the call for strong leadership including calling on other levels of government to take action. The City now has a clear action plan, informed in large part by the recommendations of the Task Force, that articulates the municipality's role in reducing homelessness. The Report Card is an important piece of that action plan and serves several functions.

As an evaluative tool, the Report Card is a vehicle to assess the state of homelessness in Toronto. The information gathered will help determine if the problem is getting better or worse, and why. Most importantly, it will allow us to monitor the success of homeless and housing initiatives undertaken by the City and to identify areas that require further action. In this way the Report Card will enable Council and the community to evaluate the City's progress in meeting its goals with respect to alleviating homelessness. The Report Card will also be used to monitor the progress of provincial and federal initiatives to reduce homelessness and highlight key issues for future action.

As a service planning tool, the Report Card will help develop and refine programs and services that are delivered and funded by the City. In the future, the Report Card will be informed by municipal social planning initiatives such as the Social Development Strategy.

Finally, as an educational tool, the Report Card can be used to help build public awareness and understanding of the issue of homelessness both locally and at the national level.

Timing of the Report Card:

The original recommendation from Council called for a semi-annual Report Card. However, an annual Report Card is recommended as the most feasible option in terms of the availability of data required to produce the report card. The first Report Card is scheduled for release in January 2000. This date provides a meaningful marker for an update and progress report as it falls one year after the release of the Mayor's Homelessness Action Task Force report.

Process for Developing the Report Card:

As homelessness is an issue that cuts across many of the City's departments, an interdepartmental consultation was held this summer on the development of the Report Card. A smaller working group was then formed to begin to scope out the framework for the Report Card. This working group will continue to oversee the development of the Report Card.

The working group will liaise with the newly formed Homelessness Interdepartmental Implementation Committee that has been set up to oversee the rollout of the City's broader action plan on homelessness. This will ensure ongoing interdepartmental collaboration as the development of the Report Card progresses.

Structure of the Report Card:

The proposed structure of the Report Card is derived from the Mayor's Homelessness Action Task Force report as it provides a comprehensive frame of the issue. Appendix A contains a more detailed description of the Report Card framework, however, a summary of the key elements is as follows:

(I) Socio-Economic Context:

A brief analysis of the broad socio-economic factors that contribute to homelessness (poverty, labour market restructuring, the lack of affordable housing, addictions and mental health) including any impacts of public policy and program decisions with respect to these factors. This section will reinforce the role of all levels of government in alleviating homelessness.

(II) Profile of Homelessness:

An update on the profile of the homeless population that includes people who are homeless and those who are at risk of homelessness.

(III) Key Indicators of Homelessness:

A profile of key indicators related to the causes of homelessness. Is the rate and depth of poverty in Toronto increasing or decreasing? Are people finding affordable housing? What is the rate of new affordable housing development? Has the vacancy rate increased?

(IV) Report on City Initiatives:

An update on the progress of City homeless and housing initiatives. How are we doing? Are we beginning to see the results of these efforts? Have we taken action in all areas directed by Council? What needs further action? This section will also give a brief analysis of the service trends, demands and gaps in the community-based service sector from a City perspective.

(V) Report on Provincial and Federal Initiatives:

An update on the progress of provincial and federal homeless and housing initiatives as well as to highlight key issues for future action.

Data Collection:

Indicators for the Report Card are being developed by an interdepartmental staff group as described above. A wide range of data sources will be used including governmental, community-based and institutional data. Input on the development of indicators will be sought by the community and institutional sources contributing data for the Report Card.

The content of the Report Card is chiefly dependent upon the availability of data. Much of the data that will be used is collected annually while other data, such as census data, is only produced every five years. As a result, there are limitations on the amount of new information available for the first Report Card. With respect to updates on City homeless and housing initiatives, as many of these initiatives have only recently begun, information may be preliminary.

Key criteria for choosing the indicators include data that contributes to a comprehensive profile of the homeless population and data that is available in a comparable form on an ongoing basis. This allows the indicators to be monitored and compared in future report cards. This ongoing collection of data on the wide range of indicators that relate to homelessness contributes to the development of a comprehensive information database for the City that is useful for a broad range of policy, program and research initiatives.

The Homelessness Report Card is meant to be developmental in nature; the scope and focus will evolve and change over time to reflect and respond to current issues related to homelessness.

Evaluation of the Report Card:

In order to determine if the Report Card is an effective tool to monitor the state of homelessness and the progress of public initiatives, it is recommended that a formal evaluation be done following the release. The evaluation would seek broad input from municipal and community stakeholders to determine the success of the Report Card in meeting its goals and to generate ideas on how the content and structure can be improved. The evaluation would also be used to determine the best mechanism for including community voices in future report cards. As a result, the evaluation process will help the Report Card to stay meaningful, relevant and adaptable to the changing social environment.

Conclusions:

The City has committed to produce an annual Report Card on Homelessness to monitor the state of homelessness in Toronto and to report on the progress of municipal, provincial and federal homeless and housing initiatives. The first Report Card is scheduled for release in January 2000, one year after the release of the Mayor's Homelessness Action Task Force report. In order to proceed with the development of the Report Card, it is recommended that the framework proposed in Appendix A of this report be adopted by Council.

Contact Name:

Joanne Campbell, Tel: 392-7885/Fax: 392-0548

Framework for the Homelessness Report Card:

(I) Socio-Economic Context:

The section will give a brief overview of the socio-economic factors that contribute to homelessness. The intent is to illustrate the complexity of the issue and to highlight the need for governments to address the systemic causes of homelessness if any real progress is to be made. The discussion will focus on the determinants of homelessness (poverty, labour market restructuring, lack of affordable housing, mental illness and addictions). Any impacts of policy and program decisions by each level of government with respect to these determinants will also be highlighted. These may include, for example, the impact of vacancy decontrol under the Tenant Protection Act, welfare reform and the continued ripple effect of the withdrawal from social housing by senior levels of government.

(II) Profile of Homelessness:

This section will update information on who is homeless or at risk of homelessness in the City. It will build on the profile described by the Task Force, augmented by new data where available. Information presented would include demographics of hostel users (families, youth, couples, singles, Aboriginal people, newcomers and refugees) and patterns of hostel usage (short term emergency versus chronic users). Some new data will be available to inform this section, in particular hostels data for 1997 and 1998. To increase our knowledge of the at risk population, further data will be collected in areas such as social housing waiting lists.

(III) Key Indicators of Homelessness:

This section will profile key indicators related to the causes of homelessness in order to track and monitor these factors. The Report Card working group is currently developing indicators for the first Report Card. The intention is to start with a few key indicators determined for the most part by the availability of new data. The Report Card is meant to be developmental in nature, therefore, additional indicators will be added in subsequent years. A wide range of data sources will be used including governmental, community-based and institutional data. Examples of the types of indicators that will be developed include the following:

(a) Poverty: Rate and depth of poverty. Use of food banks.

(b) Labour Market Restructuring: Unemployment rates. Changes in labour market structure.

(c) Lack of Affordable Housing: Rate of affordability. Rate of economic evictions. New affordable housing starts. Vacancy rates. Loss of housing stock. Applications for demolition of affordable housing stock.

(d) Health, Mental Health and Addictions: Incidence of mental illness among homeless. Discharges from Psychiatric institutions directly into hostels. Demand for supportive housing. New supportive housing development.

(IV) What Has the City of Toronto Done to Alleviate Homelessness?

This section will highlight the key City achievements in responding to the homeless crisis. Progress will be measured against the six components of the City's homelessness action plan as follows:

(1) To reduce poverty: Given that income support is a federal and provincial responsibility, the City is limited in its ability to reduce poverty. However, we can help indirectly by providing resources to help people find and keep their housing as well as to encourage new affordable housing development.

(2) To create new and preserve existing affordable and supportive housing.

(3) To shift services away from emergency response to prevention.

(4) To adopt a service planning approach that holistically addresses the different needs of the different sub-populations (singles/families/youth).

(5) To address the health and mental health needs of people who are homeless.

(6) To ensure all levels of government work together to address homelessness.

The Report Card will include narrative accounts from people who are homeless or are at risk of homelessness to get their feedback on the real impact of these initiatives on people who are homeless. In addition, any City issues or actions that are still outstanding will need to be identified.

Finally, this section will provide a preliminary analysis of the service trends, demands and gaps in the community-based service sector from a City perspective. This sector represents the front-line system of response and as such is a rich source of information. Information will be gathered, primarily through municipal grants applications, to identify emerging trends and issues facing this sector. This is an area that needs further development in future Report Cards.

(V) What has the Province Done to Alleviate Homelessness?

This section will give a brief progress report on provincial homeless and housing initiatives. An analysis of the provincial strategy will assess how and where resources are being invested.

Progress in responding to the recommendations of the Mayor's Homelessness Action Task Force will be measured against the areas where the Province has primary jurisdiction including income assistance, supportive housing, affordable housing, mental health and health. Areas that have not been addressed will be highlighted.

(VI) What has the Federal Government Done to Alleviate Homelessness?

This section will give a brief progress report on federal homeless and housing initiatives. A brief analysis of the federal strategy will assess how and where resources are being invested. If details on the federal homelessness and housing strategy via Minister Bradshaw are available in time they will be included in the Report Card.

Progress in responding to the recommendations of the Mayor's Homelessness Action Task Force will be measured against the areas where the Federal Government has primary jurisdiction including affordable housing, Aboriginal people and immigrants and refugees. Areas that have not been addressed will be highlighted.

(City Council on October 26 and 27, 1999, adopted this Clause, without amendment.)

The Community Services Committee recommends the adoption of the report dated September 3, 1999, from the Commissioner of Community and Neighbourhood Services.

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

(a) conduct a review of the 416 Drop-In Centre (Friends of Shopping Bag Ladies) prior to consideration of any future grants funding for the agency, such review to give particular attention to the male clientele currently being served by the Centre; and to report thereon to the Community Services Committee in three months' time; and

(b) meet with both representatives of the 416 Drop-In Centre and the Ward Councillors prior to the report being submitted to the Community Services Committee.

The Community Services Committee submits the following report (September 3, 1999) from the Commissioner of Community and Neighbourhood Services:

Purpose:

This report provides an update of the actions taken by Friends of Shopping Bag Ladies in response to the funding conditions placed on the agency through the 1998 Community Services Grants Program.

Funding Sources, Financial Implications and Impact Statement:

N/A

Recommendations:

It is recommended that:

(1) the outstanding amount of $24,224.00 be released to Friends of Shopping Bag Ladies; and

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

Council Reference/Background/History:

The Friends of Shopping Bag Ladies (416 Drop-In Centre) is located in the Dundas and Sherbourne Street area. The agency provides a daily drop-in for homeless, transient and socially isolated women. The agency provides a range of programs and services which include shower and laundry facilities, clothing, food depot, breakfast and a hot lunch, crisis intervention, a full medical clinic, trustee support, recreation activities, and housing search supports.

On August 13 and 14, 1997, the former Metropolitan Council adopted the Human Services Committee Report No. 10, Clause No. 4, recommending that the Friends of Shopping Bag Ladies develop and immediately implement a plan to redirect male clients to more appropriate service providers and that a property audit of the agency be conducted. This recommendation resulted in the E.S.F. allocation to this agency of $8,000.00 being held pending the completion of the property audit. On November 7, 1997, staff reported to the Human Services Committee that the property audit was complete and recommended that the $8,000.00 be released. The issue of male clients was still unresolved at this time. In November of 1997, the agency informed staff that the agency mission statement had been changed to include the following sentence "to provide limited support to those men unable to access traditional male services". The agency was advised by staff that this change in mandate could influence future funding recommendations.

During the 1998 allocation process, the agency advised staff of efforts to comply with the condition. Staff were informed that the agency had moved over half of the men to other services, but had not fully met the condition placed by the former Metropolitan Council on August 1997 to redirect all male clients to more appropriate services.

The 1998 Community Services grant of $24,224.00 was held pending the agency developing a system to refer male clients to other service providers. The 1998 condition required the agency to meet regularly with other agencies providing services to homeless men and develop a system which documents the process of referral and when service is accessed or denied.

Comments and/or Discussion and/or Justification:

During 1998, the agency provided a report in response to the conditions of the grant. At that time the agency informed staff that on average 7-10 men use trustee, medical clinic and psychiatric supports at the drop-in. These 7-10 men are not permitted to access the drop-in program, they are supervised at all times and while at the agency their movements are restricted to the Executive Director's office on the second floor, the medical clinic on the third floor and the bench in the hallway at the entrance of the agency. The agency also confirmed that when responding to new referrals of men, their first approach has been to find suitable services at other programs; however, if the client cannot be accommodated elsewhere due to the vulnerable status of the individual, they offer supports through the medical clinic and trustee supports.

In past meetings other agencies have indicated that they had referred men to the agency because of the need for a "hands on" model of care. Agencies also spoke to the need for supports for homeless trans-gendered individuals in particular.

During 1998, the agency provided a letter from the Good Shepherd Ministries, commenting that they are ill equipped to meet the needs of the fragile and vulnerable men currently accessing the Friends of Shopping Bag Ladies. Letters of support from Street Health Community Nursing Foundation and Dr. Hayding, the physician working at the agency, were also included.

The agency continues to urge the City to establish a separate program based on the model of the Friends of Shopping Bag Ladies targeted for vulnerable men. The proposed model would provide a holistic, hands on approach to care, which can respond to the unique issues of each individual. This approach would consider all of the clients' issues such as substance abuse, and mental health, the need for and compliance to care, gender identification, housing search support; the provision of meals and showers; the dispensing of medication and the need for trustee services.

The conditions on the agency have come as a response to concerns expressed by the local residents group and issues raised by the former Metro Community Services Committee over the last three years. Over this time the agency has been required to participate in mediation discussions with the residents group, as well as undergo a property audit. The agency has complied in both aspects. The agency has stated that the needs of women continue to be the primary priority of the agency and meeting these needs has not been compromised by the medical/psychiatric care provided for this group of 7-10 men.

The agency has consistently argued that these men, many of whom face multiple issues, such as dual diagnosis of both substance abuse and mental health and some who are cross-gender, cannot access appropriate hands on support elsewhere. The agency has articulated that efforts have been made to refer these men to other agencies; however, for the 7-10 men still using the medical clinic and trustee services, no alternative can be found. Letters from the agency documenting these efforts are attached to this report.

Conclusions:

This report recommends that the 1998 Community Services grant in the amount of $24,224.00 be released to the agency based on the attached submission from the agency which includes written confirmation from other drop-in programs in the downtown area stating that they cannot accept male clients of the Friends of Shopping Bag Ladies.

Contact Name:

Manjit Jheeta; Tel: 392-8684/Fax: 392-8684

e-mail: mjheeta@metrodesk.metrotor.on.ca

(A copy of each of the communications referred to in the foregoing report was forwarded to all Members of Council with the agenda of the Community Services Committee for its meeting on October 7, 1999, and a copy thereof is on file in the office of the City Clerk.)

The Community Services Committee reports, for the information of Council, also having had before it during consideration of the foregoing matter communications from the following urging that the funds to the 416 Drop-In Centre (Friends of Shopping Bag Ladies) continue to be withheld until such time as the conditions of the grant have been met:

- (October 4, 1999) from Mr. Don Purvis, Chair, Seaton Ontario Berkeley Residents Association Inc. (SOBRA);

- (October 6, 1999) from Mr. Graham Orwin;

- (October 6, 1999) from Ms. Vanessa Magness and Ms. Iris Magness;

- (October 6, 199) from Ms. Gerri Orwin; and

- (October 6, 1999) from Ms. Colleen Watson.

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

- Ms. Kelley McKinnon, Chair, Board of Directors, Friends of Shopping Bag Ladies; and Ms. Lynn Hemlow, Assistant Executive Director, 416 Drop-In Centre, and submitted a brief in regard thereto;

- Mr. Cameron Atkison, 51 Division Community Police Liaison Committee, and submitted a brief and communication in regard thereto;

- Councillor Pam McConnell, Don River; and

- Ms. Alison Kemper, Executive Director, 519 Church Street.

(City Council on October 26 and 27, 1999, adopted this Clause, without amendment.)

The Community Services Committee recommends the adoption of the following report (September 20, 1999) from the Commissioner of Community and Neighbourhood Services:

Purpose:

This report outlines the staff review of six community agency appeals under the Homeless Support Services Fund and recommends three projects for $183,000.00 in funding. The report also outlines the process for the second Proposal Call for the City of Toronto Homeless Initiatives Fund.

Funding Sources, Financial Implications, and Impact Statement:

Funds are available in the City of Toronto Homeless Initiatives Fund (CT-HIF). The CT-HIF includes a 1999/2000 allocation of $4.724 million to the City of Toronto from the Province as well as an allocation of $881,100.00 from the City in the 1999 Approved Budget for the Consolidated Grants Program.

Recommendations:

It is recommended that:

(1) Council approve funding in the amount of $128,000.00 from the City of Toronto Homeless Initiatives Fund to the Fred Victor Centre for the operation of a Drop-in program for homeless women;

(2) Council approve funding in the amount of $25,000.00 from the City of Toronto Homeless Initiatives Fund to the Syme Woolner Neighbourhood and Family Centre for the provision of a day time drop-in program for homeless people;

(3) Council approve funding in the amount of $30,000.00 from the City of Toronto Homeless Initiatives Fund to The Massey Centre for Women for the provision of supports to homeless or potentially homeless young parents with no fixed address;

(4) authority be delegated to the Commissioner of Community and Neighbourhood Services to allocate funding to projects selected from the City of Toronto Homeless Initiatives Fund second Proposal Call as outlined in this report; and

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

Council Reference/Background History:

The Community Services Committee on September 9, 1999, had before it a report from the Commissioner of Community and Neighbourhood Services respecting funding for homeless services. The Committee recommended to Council the adoption of the report and referred the appeals from the following agencies to the Commissioner of Community and Neighbourhood Services for further review and report thereon to the next Community Services Committee:

Fred Victor Centre (Grant Item 13);

Friends of the Shopping Bag Ladies (Grant Item 14);

Massey Centre for Women (Grant Item 20);

Mens Sana (Families for Schizophrenics) (Grant Item 21);

Street Haven-at-the-Crossroads (Grant Item 43); and

Syme-Woolner Neighbourhood and Family Centre (Grant Item 45).

This report outlines the staff review of the appeals to the Committee from the Homeless Support Services Fund and recommends funding for three projects which were not funded through the HSSF due to the limited amount of funding available.

The report also outlines the timetable, priority setting process and issues related to the second Proposal Call for the CT-HIF and recommends delegation of the authority to allocate funds for projects selected through a Proposal Call to the Commissioner of Community and Neighbourhood Services.

Comments and/or Discussion and/or Justification:

(1) Appeals:

Staff have reviewed the applications to the HSSF from the agencies noted above. The following is an outline of the services offered from each agency, a review of their appeal, and a recommendation.

Fred Victor Centre - (Grant Item No. 13):

The agency provides a range of supports for people who are homeless including a 38-bed hostel, a restaurant providing affordable meals, social recreation programs, skill development and literacy classes, computer club, employment centre and a number of drop-in programs. The agency has requested support for the women's day drop-in located at the Adelaide Women's Resource Centre. The drop-in provides a necessary service to homeless women and operates in collaboration with the range of services provided from this site.

Comments:

During the appeals the organization reiterated the need for a year round drop-in program at the Adelaide Resource Centre. The drop-in which received a small amount of winter specific funding during 1998 has become a core program at the centre providing support to women who participate in specific programs or access health care services or simply need a safe supportive environment. The operations of the drop-in are supported by the City's Hostel Services which provides free rent for the drop-in at the Adelaide Resources Centre, phone service, and food for drop-in participants.

The program is recommended for $128,000.00 to support the delivery of a year round drop-in program for homeless women at the Adelaide Women's Resource Centre.

Friends of Shopping Bag Ladies - (Grant Item No. 14):

The agency provides a daily drop-in for homeless, transient and socially-isolated women across the City of Toronto. Services include shower and laundry facilities, clothing, food depot, breakfast and a hot lunch, a voluntary trusteeship program, crisis intervention, health services, recreation activities, and housing supports. The agency has requested $58,000.00 for a case manager to work as part of the drop-in program.

Comments:

In 1998, Council approved that the Community Services grant of $24,224.00 to this agency be held pending the agency developing a system to refer male clients to other service providers. The 1998 condition required the agency to meet regularly with other agencies providing services to homeless men and develop a system which documents the process of referral and when service is accessed or denied. These conditions, as well as the 1999 HSSF appeal, will be addressed through the report titled "Friends of Shopping Bag Ladies" which is also before Committee at the October meeting. This report provides an update of the actions taken by Friends of Shopping Bag Ladies in response to the funding conditions placed on the agency. The agency cannot be recommended for new funds until it can be demonstrated that the agency has met the outstanding conditions.

Massey Centre for Women - (Grant Item No. 20):

The agency provides a residential facility, day care, educational upgrading courses, a community counselling program and drop-in centre for young single mothers in the City of Toronto. The community program provides a clothing exchange, social support, crafts, recreational activities, health and life skills counselling, child management program, and a weekly supper club. The program focusses on high risk single mothers and their babies, and aims to reduce the incidence of homelessness, child abuse, relationship abuse and poverty. The program goal is to help young families stabilize housing and access community supports.

Comments:

The agency is recommended for a grant of $30,000.00 for the provision of supports to homeless or potentially homeless young parents with no fixed address. This will be a priority area for this target group in the second CT-HIF Proposal Call. The agency will be required to submit revised program information.

Mens Sana (Families for Schizophrenics) - (Grant Item No. 21):

This agency serves residents of the former City of North York and the surrounding areas. It provides services to persons with schizophrenia and their families. The agency provides services to assist their clients to cope with their condition and live independently in the community. It also promotes tolerance and understanding for this condition among the general public. This agency operates a residence as well as day programs at a drop-in centre.

Comments:

The agency request did not meet the HSSF criteria. The agency is encouraged to review the second CT-HIF Proposal Call and submit a proposal that meets the priorities and funding criteria specified in the RFP.

Street Haven-at-the-Crossroads - (Grant Item No. 43):

The agency has been providing services to homeless women for the past 32 years. Services include a day and evening shelter, residential homes for women with psychiatric disabilities, supportive housing and outreach for women with addictions.

Comments:

Funding conditions were placed on the agency through the 1998 Community Services Grants Program. The agency was advised at that time that future funding will be conditional on the development of a membership and Board recruitment strategy which includes a review of the agency's by-laws, an analysis of the community to which the agency is accountable, the development of membership targets which ensure accountability to this community and an implementation plan. This strategy must be integrated with the agency's anti-discrimination and access policy. Staff support was also offered to assist the agency in meeting this condition. The agency has not provided documentation to demonstrate that it has met this condition.. Further, applications from the agency both to the 1999 Homeless Support Services Fund and the CT-HIF have been incomplete. Future proposals from the agency to the CT-HIF will be reviewed once these outstanding conditions have been met.

Syme Woolner Neighbourhood and Family Centre - (Grant Item No. 45):

The agency provides a range of services including family resource centre programs, programs for school aged children and community (summer day camp, after school, reading clubs, breakfast/lunch program), women's and family support programs, drug awareness/education and community and economic development programs. The agency has requested funds to support the drop-in program for homeless people or those at risk of homelessness. The drop-in has received winter specific funding from the City during 1997 and 1998. The agency hopes to enhance the program to make it available year round.

Comments:

The agency requested $68,564.00 and was recommended for $33,987.00 through the 1999 HSSF. The agency has expanded its drop-in program to serve increasing numbers of homeless and at-risk people in an under-serviced area. These services meet the criteria for the CT-HIF and the agency is recommended for a further $25,000.00 to assist in the provision of the year round day time drop-in program for homeless and at-risk people.

(2) CT-HIF Second Proposal Call:

Staff are now in the process of establishing funding priorities for the second and final CT-HIF Proposal Call. Funding available for this RFP is approximately $2 million. The process involves identifying gaps in current services to homeless people and following up on outstanding recommendations of the Mayor's Homelessness Action Task Force. Staff have been consulting with community groups, staff from the Community and Neighbourhood Services Department, other Departments, other levels of government, and other funders to develop new ideas, avoid duplication, and establish strategies for joint funding initiatives.

An example of a joint funding initiative currently in the planning stages is a Community Economic Development strategy for homeless people that our staff have been working on. Plans are underway to develop this initiative jointly with Human Resources Development Canada, the Ministry of Community and Social Services, and the United Way. Such collaborative initiatives will allow us to lever additional funds and provide comprehensive support to community groups working with homeless people on employment and business initiatives. Staff will be reporting on this initiative in more detail once plans are finalized.

This is the final Proposal Call in 1999 for the CT-HIF and there are more needs in the community than can be met through this funding initiative. Staff are developing a Proposal Call which will address the key priorities identified during the consultation process. In addition, staff are working with other levels of government and the United Way to lever additional funding for projects so that comprehensive strategies can be developed.

Feedback from community groups during the initial RFP process was that groups had difficulty developing proposals within the tight time lines. Community groups have asked that they have at least six weeks to respond to an RFP and that assistance be given to groups in the under-served communities so that they have the necessary information to develop applications for funding.

In order to organize the Proposal Call process that targets funding to high priority areas, allows for collaboration with other funders, and ensures that community groups have sufficient time to develop good proposals, a minimum of ten weeks is required from the date of this meeting. Based on this timing, recommendations for project funding would be ready by December 13, 1999. The next meeting of the Community Services Committee would be January 13, 2000, as there is a six-week period between meetings over the Christmas season. Council approval could not be sought until its next meeting on February 1.

Because the Council and Committee schedules would delay approvals until February 2000, it is recommended that authority be delegated to the Commissioner of Community and Neighbourhood Services to allocate funding to projects selected through the CT-HIF Proposal Call. This would allow the following timetable to be met:

Request for Proposals No. 2 Issued October 15, 1999

Deadline for Submissions November 26, 1999

Selection of Projects November 29 - December 10, 1999

Projects Approved December 17, 1999

Report to Community Services

Committee and Appeals January 13, 2000

Projects would then be approved before the new year, giving community agencies the time to hire staff and get projects up and running in the winter months. Funds will also be set aside for appeals and a process established for groups to present their case to Committee in January 2000.

Evaluation Process for the CT-HIF:

The Province has allowed the City to use funds available from the 1998/1999 CT-HIF to support the development of a more formalized evaluation system for CT-HIF projects as well as the program as a whole. A consultant, selected through an RFP process, will be hired in November to design and test out a system which will help staff determine the effectiveness of the program in meeting its objectives of helping people move from the streets to shelter, from shelters to more permanent forms of housing, and in preventing homelessness.

Staff are, however, already working with the first 25 CT-HIF projects selected with 1998/1999 funding. As outlined in the report to Committee "City of Toronto Homeless Initiatives Fund Evaluation Approach" (March 4, 1999), groups have submitted comprehensive work plans for each project which include service targets. An interim report detailing the work undertaken by these projects and initial outcomes was submitted to Committee on June 23, 1999. A final report will be submitted to Committee early in January. Projects selected in 1999/2000 will provide interim reports in mid-year 2000.

Conclusion:

This report recommends $183,000.00 in funding for three projects which will provide needed services to homeless people starting this fall. In addition to the projects selected through the second CT-HIF Proposal Call, there are a range of winter specific program enhancements included in the Homeless Support Services Fund, 51 new projects recommended for funding under the City of Toronto Homeless Initiatives Fund that will begin in the fall of 1999 as well as United Way "Winter Relief" winter-specific grants which are currently in the middle of its allocations process. City staff have worked closely with the United Way to determine priorities and allocate funding for these three funding programs.

In 2000, funding for homeless services will be administered in the context of a consolidated program as outlined in the Funding For Homeless Services report to the September Community Services Committee meeting. A timetable will be established to bring the funding cycle including priority setting, Proposal Calls, project selection, evaluation, and Council reports in line with the reporting schedule established by The Province and the City's budget cycle. The priority in 2000 will be to streamline the program, measure outcomes, and evaluate this new range of projects funded through the consolidated CT-HIF to ensure ongoing support for successful projects that are most needed by homeless people. City staff will be working closely with the community-based agencies involved in these projects to ensure that they operate effectively and collaborate with projects doing similar work.

Contact Names:

Joanne Campbell, Tel: 392-7885/Fax: 392-0548

Chris Brillinger, Tel: 392-8608/Fax: 392-8492

(City Council on October 26 and 27, 1999, adopted this Clause, without amendment.)

The Community Services Committee recommends the adoption of the following report (September 23, 1999) from the Commissioner of Community and Neighbourhood Services:

Purpose:

To request approval for Food Related Capital Grant requests.

Funding Sources, Financial Implications and Impact Statement:

An amount of $100,000.00 has been set aside within the approved 1999 Consolidated Grants Budget for this program. First round allocations totalling $39,000.00 were approved by Council at its meeting held on July 6, 7 and 8, 1999. An amount of $61,000.00 is available for allocation.

Recommendations:

It is recommended that:

(1) STOP 103 be allocated funding up to $11,000.00; and

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

Council Reference/Background/History:

At the Budget Committee meeting of April 6, 7 and 8, 1999, it was directed that "$100,000.00 be earmarked in the Consolidated Grants Budget for the express purpose of providing capital funding, on a one-time only basis, for the purchase of refrigerators, ovens, etc., on an emergency basis for volunteers providing food to the homeless, the said funding to be at the sole discretion of the Commissioner of Community and Neighbourhood Services." This direction was approved by Council as part of the 1999 approved Operating Budget. On June 9, 1999, Council approved the report, titled "Allocation Criteria for a Food Related Capital Grants Program," (Strategic Policies and Priorities Committee, Clause No. 15, Report No. 10) which established the guidelines for the administration of the Food Related Capital Grants funding.

Comments and/or Discussion and/or Justification:

Ten applications for Food Related Capital Grants have been received by staff since the first round of allocations in June 1999. Four of these were requests for $1,000.00, or less, and have been approved under the Council delegation of grant making authority as defined in the report titled "Allocation Criteria for a Food Related Capital Grants Program." Four requests were for amounts greater than $1,000.00, and the remaining two requests were incomplete.

The allocation criteria for this program included an administrative guideline that a minimum of $50,000.00, or half of the fund, be reserved for grants of $1,000.00 or less. To date there have only been four requests for allocations of $1,000.00 or less, while six of the requests have been for amounts between $5,000.00 and $30,000.00. At this time there is $11,000.00 available for requests in excess of $1,000.00. Consistent with the "first come, first served" approach of the fund, STOP 103 was the third request received and is, therefore, recommended for funding of $11,000.00. If there is no significant take up on the $1,000.00 or less grants over the next month, staff will reconsider the guideline of reserving $50,000.00 for small grants and make the appropriate recommendations to the Community Services Committee in November 1999.

STOP 103:

STOP 103 provides a range of services and supports for socially isolated, low income residents of the Davenport West area of Toronto. The agency has requested $11,000.00 to assist in the capital costs associated with renovations and new equipment for the kitchen facility. This resource will be utilized for a range of programs including: a cooking class, a food reclamation project that uses leftover food from the food bank, a community garden and Healthy Beginnings, a perinatal nutrition and support drop-in. The agency application form was complete and provided the required information in detail.

Conclusions:

An allocation of $11,000.00 to STOP 103 is recommended. Staff will review the administrative guideline of reserving $50,000.00 of the Food Related Capital Fund for allocations of $1,000.00 or less. A final report with recommendations regarding the disposition of the remaining funding will be submitted to the Community Services Committee in November 1999.

Contact Name:

Chris Brillinger

Tel: 392-8608

(City Council on October 26 and 27, 1999, adopted this Clause, without amendment.)

The Community Services Committee recommends the adoption of the following report (September 21, 1999) from the Commissioner of Community and Neighbourhood Services:

Purpose:

This report describes the key features of the Provincial enhancements to job placement services provided under the Employment Placement (EP) component of Ontario Works (OW). Toronto Social Services' (TSS) proposed model for delivering these enhanced services is then discussed. The report also briefly provides a current picture of who is required to participate in the OW program, and the types of activities that these clients are engaged in.

Financial Implications:

The mandatory changes to the Employment Placement stream of OW announced by the Province will be cost shared on an 80/20 Provincial/Municipal basis. TSS's year 2000 budget submission incorporates costs associated with delivering enhanced EP.

Recommendations:

It is recommended that:

(1) City Council endorse the proposed model for delivering Enhanced Job Placement services in Toronto, as outlined in section II of this report; and

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

Background:

On December 17, 1998, the Minister of Community and Social Services (MCSS) announced an enhancement to the existing EP program whereby private sector employers would be paid to provide on-the-job training to social assistance recipients. Drawing on information available at the time, an initial report dated December 31, 1998, describing the basic elements of this new program feature, was forwarded to the Community Services Committee in January 1999. In order to provide delivery agents with further details about these mandatory changes to the EP program, the Ministry released implementation guidelines for Enhanced Job Placement (EJP) services in April 1999.

Implementation of EJP was initially undertaken in four selected delivery sites across the Province (Sudbury, Muskoka, Halton and Hamilton). In the remaining delivery sites, including the City of Toronto, proposals to implement EJP must be forwarded to the MCSS Toronto Area Office. Program implementation will commence in late 1999. Service targets and performance requirements for this new program feature will be integrated into the City's OW Business Plan, and into contracts with agencies and organizations providing job placement services for the City.

This report will provide an overview of TSS's approach to implementing Enhanced Job Placement in Toronto, and the anticipated benefits to clients and employers that will accrue from the implementation of this new program feature. The report will also provide an update on the numbers of clients participating in the OW program in Toronto, and the types of activities they are participating in. This information establishes the context within which TSS continues to refine and improve the design and delivery of services available to clients under the OW program.

Discussion:

(I) An Overview of OW Participants:

Under OW, all adults in receipt of benefits, including spouses and adult dependants, potentially have participation requirements. These individuals must be involved in one or more activities that will lead to employment in the shortest time possible, or that will increase their skills and aptitudes. Activities include a wide range of skills development courses, structured job search programs, and employment or community placements.

Recent changes in the overall caseload profile, which were analyzed in a recent report to the Community Services Committee, dated August 23, 1999, clearly influence who is available to participate in OW program activities. The overall length of stay has increased, especially for families with children, which now comprise a majority of adults in receipt of assistance. There is also an emerging long term caseload, comprised primarily of families with children, notably single parent families.

Who Can Participate in OW Activities:

As per Provincial policies, all families with children under four years of age, people over 65 years, those who are ill, temporarily disabled or caring for ill dependants, homeless people, and others with valid reasons may have their participation requirements deferred or exempted.

There are also significant numbers of individuals engaged in activities consistent with the aims of the OW program, which subsequently restricts their ability to participate in any additional OW program options. Two such groups are students (the vast majority of whom are completing high school) and individuals who are already working and have employment earnings, but who still qualify for assistance due to their low incomes. In fact, the proportion of cases with earnings has climbed steadily over the past four years, increasing from 12 percent in 1995 to 18 percent currently. Another relatively small number of individuals or families receive benefits for only short periods; either because they are waiting to obtain other government benefits for which they are eligible (e.g., Employment Insurance), or because they require assistance on an emergency basis only.

As a result of these factors, at any given time, the actual number of people who are available to participate in new activities is much smaller than the total number of adults enrolled in the OW program.

From an operational perspective, there are a number of other issues that must be considered when assessing whether clients can be successfully referred to skills development courses or to placements in employment or in community agencies. These are described briefly below:

(1) For many families with children, the ability to participate in OW activities is determined by the availability of appropriate supports, notably child care. In June 1999, there were approximately 12,000 families with children between the ages of four to ten years of age who were not in receipt of subsidized child care, and who were not receiving any other child care supports through OW. Without access to adequate and reliable child care, this sizable group will be at best able to be involved in OW in a limited capacity. Currently, Provincial funding under OW in the amount of $13.9 million, supports provision of child care to just over 2,000 children whose families are participating in program activities.

(2) The constant turnover of cases also affects the rate at which clients can be referred to different activities, or placed in jobs or community placements. In June, over 5,300 cases left OW, while 5,400 cases became eligible for benefits. While both groups participate in OW activities, particularly clients leaving the program, this ongoing dynamism means there are sizable numbers of clients flowing through the system at all times.

(3) About 15 percent of cases remain on assistance for less than four months. As the recently released KPMG report "Ontario Works in Toronto: An Operational Review" recognized, it is counterproductive to involve clients who are highly employable, and who should be assisted to return to work as soon as possible, in activities which will keep them on assistance for longer periods. There are a limited number of activities that will facilitate rather than hinder rapid entry into the workforce for these clients. Similarly, it will not be productive to invest significant resources in clients who are waiting to receive other government benefits.

(4) At any given time, substantial numbers of clients are actively involved in one of the OW program streams, or have been referred to specific courses or placement opportunities. Table 1 provides data on the number of clients who have been referred to, or have participated in, the Employment Support (ES), Employment Placement (EP) or Community Participation (CP) streams in 1999. Since in many cases an individual involved in one activity cannot feasibly participate in another, the majority of clients in ES, EP or CP are not available to participate in other activities.

(5) Perhaps most importantly, it is critical that clients are referred to services or directed to activities that are appropriate given their skill and education levels, as well as their previous work experience, and that will most effectively assist them obtain and sustain employment.

Thus, while there may be a sizable number of clients available at any one time to participate in OW activities, there is a much more limited number whose best interests are served by taking specific training courses, or who are sufficiently employment ready to be successfully placed in jobs through the EP program stream. It is also apparent that a growing number of participants, notably families with children, have become increasingly detached from the labour market. As a result, there is greater pressure on the Division to more effectively target both staff time and supports based on client need, such that the right services are available to the right clients at the right time.

It is within this context that TSS is developing its approach to delivering Enhanced Job Placement services in Toronto.

(II) Delivering Enhanced Job Placement in Toronto:

The Current EP Stream:

Through the EP stream, "job-ready" social assistance recipients are placed into unsubsidized, competitive employment positions. In Toronto, TSS has contracted with 19 agencies in 25 locations to deliver the job placement function of EP. In 1999, the gross budget for EP is $6.0 million.

Under the current EP service delivery model, TSS is responsible for co-ordinating client referrals to job placement agencies, ongoing case management, data capture, reporting, problem resolution and monitoring of agency contracts. Once referred, participants are screened by agencies. If accepted, the agency provides instruction to clients on basic job search techniques, develops participant job search plans, provides access to resources to support job search efforts, markets participants to employers, matches participants to jobs, and monitors participant activities.

In 1999, over 4,700 clients have been referred to EP agencies. Thirty percent of these referrals have been accepted by job placement agencies, with approximately 850 clients placed in jobs.

Enhanced Job Placement:

The basic enhancement to EP announced by the Province is the financial incentive that can be made available to private, public and not-for-profit employers who hire OW clients and agree to provide formal job related training. This employer subsidy is intended to offset employers' hiring and on-the-job-training costs. Additional incentives for employers include:

(1) hiring assistance and screening and matching services, provided either by the delivery agent or by an employment placement agency;

(2) human resource support services to assist participants in the workplace;

(3) Workplace Safety Insurance Benefit (WSIB) coverage;

(4) provision of Employment Related Expenses; and

(5) co-ordination with other federal and provincial programs.

Employers who hire OW participants can be provided with these financial and associated incentives for a maximum of six months, with the expectation that the participant will remain employed after the end of the six-month period. An alternative funding model for enhanced job placement has been introduced by the Province which gives the Division greater flexibility, both in terms of designing and delivering effective job placement services and providing financial incentives to employers. Details are provided in section (c) and below.

Both the financial incentive and placement service components of Enhanced Job Placement are cost-shared on a 80 Provincial/20 Municipal basis, and will be funded out of the Division's year 2000 EP envelope, which equals $6.3 million gross.

Overall, the City supports the Province's direction, and believes the enhancements made to the EP stream will enable the Division to more effectively assist less job ready clients to obtain and retain employment.

Delivery Framework:

Reflecting Provincial aims, TSS's objectives for Enhanced Job Placement are to:

(1) place Ontario Works participants into employment as quickly as possible;

(2) develop and foster long term sustainable employment for Ontario Works participants;

(3) address employment skill development through training;

(4) generate reductions in Ontario Works financial expenditures; and

(5) allow greater flexibility for service delivery and funding.

The following section briefly describes the key elements of TSS's approach to delivering Enhanced Job Placement services.

(a) Client Target Group:

Currently under EP, OW participants who are most job ready are referred to agencies providing job placement services. However, given rapid changes to caseload composition, these agencies have observed that even those clients who are seen to be job ready increasingly face significant barriers to establishing and maintaining employment in Toronto's competitive labour market. For this reason, the Enhanced Job Placement option will be targeted primarily at clients who were unsuccessful in finding employment through the regular Employment Placement (EP) program. Where it will improve the likelihood that these less job ready clients will obtain employment, a financial incentive will be offered to employers. This incentive can also be used to help certain participants with specific barriers secure employment (i.e., the hearing impaired). Job ready participants will continue to be placed into employment opportunities without the use of a financial incentive.

(b) Service Delivery Model:

Job placement services will be delivered in two ways. The Division will work with the 19 EP agencies currently providing job placement services, and expand their responsibilities to include delivery of the Enhanced Job Placement option. By adapting the existing delivery model, caseworkers can continue to focus on client assessment, referral, and case management functions. Agencies will continue to complete job readiness assessments for all referred clients, and use their expertise to provide job search supports, and screen and match participants to suitable employment opportunities. They will now have the flexibility to determine whether an employer requires a financial incentive to secure the client's employment. Agencies will also assume the new responsibilities of negotiating placement contracts with employers, monitoring employers to ensure contract compliance, developing training plans (in conjunction with clients and the employer), and marketing EJP to employers.

In the fall, TSS will hold an information session for the 19 agencies currently providing job placement services under EP, as well as the 24 agencies which provide training services under the Skill Development Option (SDO) but are not involved in EP. All of these agencies will have the opportunity to indicate their interest in delivering Enhanced Job Placement. Depending on the take up rate among current agencies and the available budget, in early 2000, TSS may approach a broader range of community agencies and organizations to explore their interest in becoming EJP delivery agents.

Complementing this approach, local Social Services offices will also initiate and develop projects, in conjunction with employers and community based agencies, which respond to the specific employment needs of participants and/or employers.

(c) Funding Model:

As part of the changes to EP, the Province has provided additional flexibility to fund job placement services on a fee-per-placement basis. TSS's proposed funding model represents an improvement for current EP agencies, which will now be paid a flat fee for each job placement. The maximum average fee per placement that can be paid to agencies under Provincial guidelines is $1,800.00. TSS will also be paid a minimal amount on a fee-per-placement basis to defray its costs. All fees are paid in arrears, and are paid based on the achievement of specific milestones (based on the length of time the client remains employed) established by Provincial guidelines.

(d) Payments to Employers:

As noted previously, financial incentives can be provided to employers to subsidize training costs associated with hiring less job ready OW participants. Payments to employers cannot exceed $4,000.00 for a six-month job placement. However, according to Provincial guidelines, the average level of incentive payments to employers should not exceed $2,000.00 except where higher payments will enable the delivery agent to respond to unique opportunities.

Payments will be structured to encourage employers to assist those clients who face additional barriers in the labour market, and who may require more intensive training supports. Fees will be paid in instalments, and on the achievement of specific milestones. When a financial incentive is provided, employers must provide training to the client. Where an employer engages a recognized third party to provide training to a client, an additional financial incentive of up to $500.00 is available to the employer.

(e) Program Administration:

In order to ensure efficient and effective program delivery, and to minimize financial risks to the City and agencies, TSS will be responsible for:

(1) management of both agency and employer contracts;

(2) payment to placement agencies and employers;

(3) management of the problem resolution process; and

(4) ongoing program administration.

Job Placement agencies will negotiate placement contracts with employers on behalf of TSS. TSS will provide final approval of all contracts. Similarly, where a financial incentive is provided, a job placement training plan will be completed by the agency during contract negotiation with the employer, with final approval provided by TSS. Agencies will be responsible for monitoring the employer and participant's status during the six months of initial employment. TSS will ensure contract compliance in all aspects of delivery.

Outcomes will be tracked through a central Divisional data base. Information will also be collected from clients and employers as a means of assessing the effectiveness of the EJP delivery model.

(III) Implementation:

Upon submission of its Business Proposal to MCSS, the Division will prepare for program implementation in late 1999. To obtain input into the design of the Division's EJP delivery framework, to date TSS has consulted with the Ministry, other OW delivery sites and selected staff. During the development phase, TSS will consult further with a wide range of program providers (e.g., Human Resources Development Canada, Ministry of Colleges University and Training), business organizations, other corporate departments (e.g., Economic Development), and agencies currently under contract with TSS.

The Division will also work with key groups, notably employers, to promote services provided to OW clients under the Enhanced Job Placement model. Extensive efforts will also be made to inform staff and clients about EJP services. Agencies will dedicate time to approaching organizations and a range of employer contacts to promote and develop placement opportunities.

Conclusion:

Currently, OW offers a variety of employment services and supports to clients. Subsidizing employers to provide on the job training, particularly for certain clients that may face barriers obtaining employment in Toronto's competitive labour market, is an important addition to this service continuum. The City supports the Province's direction, and believes the enhancements made to the EP stream will enable the Division to more effectively assist less job ready clients to obtain and retain employment.

Contact Name:

Heather MacVicar; General Manager, Tel: 392-8952

1. Statistics are based on data up to and including July 1999.

2. Enrolment increase reflects changing case mix (increasing proportion of dependent adults).

(City Council on October 26 and 27, 1999, adopted this Clause, without amendment.)

The Community Services Committee recommends the adoption of the recommendation of the Children and Youth Action Committee embodied in the communication dated September 23, 1999, from the City Clerk.

The Community Services Committee reports, for the information of Council, having:

(a) received Recommendation No. (1) contained in the communication (undated) from Councillor Olivia Chow, Child and Youth Advocate; and

(b) referred to the Policy and Finance Committee for consideration the following recommendations contained in the aforementioned communication from Councillor Chow:

"(2) that the City of Toronto reiterate its support for the federal firearms control legislation, and that this support be communicated to the Federal Justice Minister and the Solicitor General of Canada, and to the Federation of Canadian Municipalities (FCM);

(3) that staff complete the survey regarding the establishment of a Local Crime Prevention Council and explore federal funding sources in support of Council's work on safe community initiatives; and

(4) that various existing policies and initiatives on prostitution be collected and sent to the December board meeting of FCM for discussion."

The Community Services Committee submits the following communication (September 23, 1999) from the City Clerk:

Recommendations:

The Children and Youth Action Committee recommended to the Community Services Committee that it be authorized to:

(1) sponsor a round table discussion to invite a response from the community on the National Children's Agenda; and

(2) invite Federal Members of Parliament to the round table discussion to enable them to hear the community's response;

and noted that funds in an approximate amount of $1,500.00 are available for this purpose in the Children and Youth Action Committee's 1999 Operating Budget.

Background:

The Children and Youth Action Committee on September 21, 1999, gave consideration to the following verbal updates from Committee members in connection with a federal strategy on a commitment to children:

- Ms. Jane Mercer on the Federal Liaison Sub-Group;

- Ms. Fiona Nelson on a meeting with her local Member of Parliament; and

- Trustee Elizabeth Boyd on a meeting with the Member of Parliament for Rosedale.

In connection with this item, Councillor Chow provided a verbal update on the following initiatives:

- unveiling of a clock by the Mayor to monitor the elimination of child poverty;

- a postcard campaign to reduce child poverty;

- a motion passed at the FCM Conference in support of investing in children;

- a pilot project on the seamless day; and

- promotion of "the best return is investing in children" by economists of the Toronto Stock Exchange.

Ms. Fiona Nelson advised the Committee of a round table discussion on Children's Issues to be held on Thursday, September 23, 1999, from 7:00 p.m. to 9:00 p.m. at the Hillcrest Community Centre Gymnasium.

The Committee discussed the need for round table discussions and community feedback in connection with the development of a National Children's Agenda.

The Community Services Committee reports, for the information of Council, also having had before it a communication (undated) from Councillor Olivia Chow, Child and Youth Advocate, reporting on the recent Board meeting of the Federation of Canadian Municipalities and the issues of concern to the City of Toronto; and recommending that:

(1) the FCM Budget submission to the Federal government be received for information;

(2) the City of Toronto reiterate its support for the federal firearms control legislation, and that this support be communicated to the Federal Justice Minister and the Solicitor General of Canada, and to the Federation of Canadian Municipalities (FCM);

(3) staff complete the survey regarding the establishment of a Local Crime Prevention Council and explore federal funding sources in support of Council's work on safe community initiatives; and

(4) various existing policies and initiatives on prostitution be collected and sent to the December board meeting of FCM for discussion.

(City Council on October 26 and 27, 1999, adopted this Clause, without amendment.)

The Community Services Committee recommends the adoption of the following report (September 13, 1999) from the City Solicitor:

Purpose:

The purpose of this report is to obtain authority to commence legal action to recover the arrears of accommodation costs owed by D.M.

Funding Sources, Financial Implications and Impact Statement:

The amount of the arrears at this time is $33,165.92.

Recommendation:

It is recommended that authority be granted to commence court action against D.M., J.O. and M.L., to appeal any decision where warranted, to discontinue or settle any such claim or action where it is concluded that it is reasonable to do so, and to execute any documents in furtherance thereof.

Council Reference/Background/History:

N/A

Comments and/or Discussion and/or Justification:

On December 30, 1993, D.M. was admitted to Bendale Acres Home for the Aged and remains a resident as of this date.

J.O. executed an agreement to pay for D.M.'s maintenance costs. J.O. failed to make the payments required by the agreement and, as a result, arrears began to accumulate. In March, 1997, J.O. executed Minutes of Settlement whereby she agreed to repay the arrears outstanding at that time. The Minutes of Settlement were also executed by M.L., who is D.M.'s attorney pursuant to a valid Power of Attorney. J.O. and M.L. have failed to make the payments required by the Minutes of Settlement and the original admission agreement. The outstanding arrears, as of July 1, 1999, are $33,165.92.

The General Manager of the Homes for the Aged Division has referred this delinquent account to the Legal Services Division for collection as all other means to satisfy the arrears have failed.

The Commissioner of Community Services concurs in this report.

Conclusions:

Based on J.O. and M.L.'s history of non-payment of D.M.'s accommodation costs, it appears that legal action will be required to recover the outstanding arrears.

Contact Name:

Shirley Mathi, Tel: 392-2989

(City Council on October 26 and 27, 1999, adopted this Clause, without amendment.)

The Community Services Committee recommends the adoption of the recommendation of the Advisory Committee on Homes for the Aged embodied in the following communication (September 17, 1999) from the City Clerk:

The Advisory Committee on Homes for the Aged on September 17, 1999, had before it a report (August 31, 1999) from the General Manager, Homes for the Aged, recommending that the Community Services Committee be requested to support in principle the Homes for the Aged Division's strategic direction to establish annual and planned giving programs to enhance fundraising activities.

Members of the Advisory Committee offered the following suggestions with respect to the proposed annual and planned giving programs:

- that the program be introduced through Family Committees in the Homes;

- that donors be recognized by way of a plaque or other means; and

- that the pamphlet include a box to provide for the option to donate to the Home or Volunteers.

The Advisory Committee:

(1) recommended to the Community Services Committee the adoption of the aforementioned report; and

(2) directed that the suggestions noted be forwarded to the General Manager, Homes for the Aged, for consideration.

Purpose:

To receive approval in principle to develop annual and planned giving programs.

Impact Statement:

The introduction of these programs will increase the potential level of giving to the various Homes for the Aged.

Recommendation:

It is recommended that this report be forwarded to the Community Services Committee for its support in principle of the Homes for the Aged Division's strategic direction to establish annual and planned giving programs to enhance fundraising activities.

Council Reference/Background/History:

Prior to the amalgamation of the City of Toronto, the former Metropolitan Council approved a Management Plan for the Homes for the Aged Division. This Plan outlined strategies that could be undertaken to improve the cost-efficiency and/or effectiveness of the Homes for the Aged, as well as four potential strategic directions. One of these directions focused on the feasibility of increasing the donor base and fundraising initiatives to support resident activities and upgrade resident amenity space. The Division is looking for additional sources of funds through new partnerships and further linkages to the community. This report outlines one initiative in this regard.

Comments:

For the past several years, the Homes for the Aged Division has realized some minor success in generating donations/gifts from residents, their families/friends, corporations and foundations. This has been accomplished through various initiatives, such as Home-sponsored events, In-Memoriam donations and the annual Nissan Toronto Challenge. An objective of the Division is to take a more organized and formal approach to fundraising through the possible development of annual and planned giving programs. A recent example of this approach was the successful "Night of Knights" event held on January 9, 1999, in support of Cummer Lodge. Another component of this approach is the intention of the Homes for the Aged Division to introduce a "Giving Opportunities" brochure in each of the 10 Homes for the Aged. The introduction of this brochure will increase the potential level of giving to the various Homes by increasing awareness with potential donors of the need for their support and the various opportunities and methods of making a gift.

Studies have shown that the greatest source of contributions come from individuals (over 75 percent), with the remainder supplied by corporations and foundations. The Division provides care and services to over 2,600 residents of the Homes and another 2,000 clients of the Division's community-based services (Adult Day Centres, Homemakers and Nurses Services and the Supportive Housing Program). The Division sends out a "Your Opinion Counts" survey to residents and their families on a regular basis. The results of this survey have consistently shown a very high degree of satisfaction for the care and services provided.

The purpose of the "Giving Opportunities" brochure is to increase the awareness level of residents, clients, their families/friends of:

(1) the need for their support;

(2) the many different reasons or occasions to give; and

(3) the various methods for giving.

The brochure provides a brief description for gifts of cash, securities and tangible property, bequests in wills and life insurance. A brochure would be scripted for each Home. The draft attached to the report has been developed for Albion Lodge. The brochures would be available in prominent locations in each Home and distributed on a periodic basis.

The content of the "Giving Opportunities" brochure has been developed in consultation with the City's Legal Services and Finance Department.

Conclusion:

An objective of the Homes for the Aged Division is to enhance fundraising activities through the development of annual and planned giving programs. One initiative to support this objective is the introduction of a "Giving Opportunities" brochure, which will increase the level of awareness with potential donors of the need for their support and the potential level of giving.

Contact Name:

John Garnett,

Manager, Fundraising and Volunteer Programs

Tel: 392-8489/Fax: 392-4180

E-mail: john_garnett@toronto.ca

(A copy of the draft brochure referred to in the foregoing report was forwarded to all Members of Council with the agenda of the Community Services Committee for its meeting on October 7, 1999, and a copy thereof is on file in the office of the City Clerk.)

(City Council on October 26 and 27, 1999, received this Clause, for information.)

(a) Response to the Provincial Operational Review of Toronto's Implementation of Ontario Works and Child Care Fee Subsidy Program.

The Community Services Committee reports having:

(A) recommended to the Policy and Finance Committee, and Council:

(1) the adoption of the report dated September 22, 1999, from the Commissioner of Community and Neighbourhood Services, subject to amending Recommendation No. (1) to provide that the following Recommendation No. 47, headed "Directly Provided Child Care: Creating an Arm's Length Agency", contained in the KPMG report on Ontario Works, not be supported until a further review of such recommendation has been undertaken by the Commissioner of Community and Neighbourhood Services and a report submitted thereon to the Community Services Committee:

"Recommendation No. 47

The City of Toronto should renew efforts to make its directly operated child care service an arm's length agency of the City. If the City is successful in establishing this new arrangement, it should avail itself of the opportunity to invite centres of excellence involved in the treatment of children at risk to participate in the governance and programme development of directly operated child care services. Should the Province devolve the licensing of child care to municipalities, it should not do so with the City of Toronto until the City has taken steps to eliminate the potential for conflict of interest in its provision of child care, by the means above or otherwise.";

(2) the City of Toronto seek provincial cost-shared funding to pay actual costs of licensed child care centres and additional child care providers; and

(3) in the event that the provincial cost-shared funding is not forthcoming, the City of Toronto continue to pay its share of the actual costs, and that the necessary funding be included in the year 2000 Operating Budget; and

(B) requested the Commissioner of Community and Neighbourhood Services Committee to:

(1) provide the Community Services Committee with a comprehensive report concerning all pressures facing child care services in Toronto, and that such report include:

(a) the capital funding crisis;

(b) impact of school closures; and

(c) implementation of Ontario Works and the Learning, Earning and Parenting Program;

(2) explore the feasibility of providing subsidies to fill the 2000 vacant child care spaces, and sending the bill to the Province; and

(3) do everything possible to find replacement child care locations when school closures occur:

(i) (September 22, 1999) from the Commissioner of Community and Neighbourhood Services providing an update on the Provincial Operational Review of Toronto's implementation of Ontario Works and Child Care Fee Subsidy Programs and the Final Report prepared by the consulting firm KPMG, on behalf of the Ministry of Community and Social Services; and recommending that:

(1) City Council support in principle the recommendations contained in the consultant's Final Report that will contribute to the improvement of the Ontario Works program, and the child care required to support it, in Toronto;

(2) based on Provincial endorsement of the directions contained in the Operational Review, and Provincial cost-sharing commitments, the Commissioner of Community and Neighbourhood Services provide City Council, in future reports:

(i) with further details about those recommendations that have funding or service delivery implications for the City; and

(ii) with an implementation plan, developed in conjunction with Provincial officials, outlining steps that will be taken to implement those recommendations requiring joint City and Provincial action;

(3) with respect to Social Services, the Department evaluate and report back on the recommendations from the Operational Review which may be implemented immediately by the City within the current provincial legislation and the existing Council policies;

(4) with respect to child care, the Department evaluate and report back on the recommendations from the Operational Review which may be implemented immediately by the City within the current provincial legislation and the existing Council policies; and

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

(ii) (undated) Synopsis of the KPMG review of Ontario Works submitted by Councillor Olivia Chow.

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

- Mr. Andy Mitchell, Community Social Planning Council of Toronto;

- Ms. Jane Mercer, Toronto Coalition for Better Child Care, and submitted a brief in regard thereto; and

- Ms. Anne Dubas, President, and Mr. Tim Maguire, Canadian Union of Public Employees, Local 79, and submitted a brief in regard thereto.

(Councillor Pantalone, at the Council meeting on October 26 and 27, 1999, declared his interest in the foregoing Item, in that one of his children is registered in a day care centre which has a purchase of service agreement with the City of Toronto.)

(b) Lifting of Barring Policies in Hostels.

The Community Services Committee reports having referred the following communication to the Commissioner of Community and Neighbourhood Services for a report thereon to the next meeting of the Community Services Committee, to be held on November 4, 1999; and further directed that this matter be considered as the first item of business on the agenda and those interested in appearing before the Committee be advised accordingly:

(September 23, 1999) from Councillor Jack Layton, Co-Chair, Advisory Committee on Homeless and Socially Isolated Persons, advising that the Advisory Committee on September 22, 1999, recommended that the Shelter, Housing and Support Division of Community and Neighbourhood Services institute a policy directing emergency shelters in Toronto to lift all barring practices except in cases involving physical violence.

(c) Dental Care for Homeless People.

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

(September 23, 1999) from Councillor Jack Layton, Co-Chair, Advisory Committee on Homeless and Socially Isolated Persons, advising that the Advisory Committee on September 22, 1999, recommended that the City of Toronto develop a program to provide for the dental needs of people who are homeless; and that this program provide assistance for the range of dental care needs required, not limited to emergency care.

(d) Update on the Emergency Shelter System.

The Community Services Committee reports having received the following presentation:

Overhead slide presentation by Mr. John Jagt, Director of Hostel Services, providing an update on the emergency shelter system.

(e) Mandate and Budget Allocation for the Mayor's Homeless Initiative Reserve Fund.

The Community Services Committee reports having recommended to the Policy and Finance Committee the adoption of the following report (September 23, 1999) from the Commissioner of Community and Neighbourhood Services, subject to amending the mandate to provide that City-initiated initiatives also be eligible for funding from the Mayor's Homeless Initiative Reserve Fund:

(September 23, 1999) from the Commissioner of Community and Neighbourhood Services proposing a mandate and budget allocation for the Mayor's Homeless Initiative Reserve Fund; and recommending that:

(1) (a) the Chief Financial Officer and Treasurer be authorized to create a Mayor's Homeless Initiative Reserve Fund, in accordance with Recommendation No. 16 in the approved 1999 Operating Budget for the Shelter, Housing and Support Program;

(b) Council approve an initial amount of up to $5 million to be transferred to the Mayor's Homeless Initiative Reserve Fund in 1999, from the 1999 provincial Housing Download savings within the Shelter, Housing and Support Division's 1999 Operating Budget, contingent on the realization of such savings; and

(c) the Commissioner of Community and Neighbourhood Services report to Council for approval of any further transfers into the Mayor's Homeless Initiative Reserve Fund that the Commissioner deems necessary;

(2) the following mandate be approved for the Mayor's Homeless Initiative Reserve Fund:

(i) to help stabilize the housing of homeless people or those in identified high-risk groups, by providing one-time capital support to suitable projects that have short timeframes to completion;

(ii) to combine with federal capital funding, in the event that federal housing or homelessness capital funding announced within the timeframe of fiscal 1999/2000 requires a City contribution;

(iii) the Commissioner of Community and Neighbourhood Services report to Council on all expenditures from the Mayor's Homeless Initiative Reserve Fund on a regular periodic basis; and

(iv) such funding to be administered by the Commissioner of Community and Neighbourhood Services, in consultation with the Chief Financial Officer and Treasurer, in accordance with the Process for Project Development and Funding Approval set out in this report, including Council approval being required for each specific allocation from the fund in excess of $25,000.00;

(3) the Commissioner of Community and Neighbourhood Services and the Chief Financial Officer and Treasurer report back at the appropriate time with updated information on 1999 underspending in the Provincial Housing Download; and

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

(f) Status Report on the Proposed Add-A-Suite Incentive Program.

The Community Services Committee reports having received the following report:

(September 22, 1999) from the Commissioner of Community and Neighbourhood Services providing an update on the proposed Add-a-Suite Incentive Program; noting that the delayed timeline in regard to possible Federal contributions and the OMB hearing leads to the conclusion that the Add-a-Suite program be deferred at this time; and recommending that the report be received.

(g) Kipling Acres - Accreditation Award.

The Community Services Committee reports having received the following communication, and having extended its congratulations to the staff and volunteers at Kipling Acres:

(September 17, 1999) from the City Clerk advising that the Advisory Committee on Homes for the Aged on September 17, 1999, had before it a report (August 25, 1999) from the General Manager, Homes for the Aged, advising that the accreditation survey for Kipling Acres by the Canadian Council on Health Services Accreditation was carried out from June 15-18, 1999; attaching a copy of the survey report; and recommending that:

(1) this report be forwarded to the Community Services Committee for its information; and

(2) congratulations be extended to the staff and volunteers at Kipling Acres acknowledging their significant achievement;

and that the Advisory Committee directed that the aforementioned report be forwarded to the Community Services Committee for information.

(h) Lakeshore Lodge - Accreditation Award.

The Community Services Committee reports having received the following communication, and having extended its congratulations to the staff and volunteers at Lakeshore Lodge:

(September 17, 1999) from the City Clerk advising that the Advisory Committee on Homes for the Aged on September 17, 1999, had before it a report (August 27, 1999) from the General Manager, Homes for the Aged, advising that the accreditation survey for Lakeshore Lodge by the Canadian Council on Health Services Accreditation was carried out from June 20-22, 1999; attaching a copy of the survey report; and recommending that:

(1) this report be forwarded to the Community Services Committee for its information; and

(2) congratulations be extended to the staff and volunteers at Lakeshore Lodge acknowledging their significant achievement;

and that the Advisory Committee directed that the aforementioned report be forwarded to the Community Services Committee for information.

(i) Toronto Ambulance Services to the Greater Toronto Airport Authority Property.

The Community Services Committee reports having deferred consideration of the following report and motions until the meeting of the Community Services Committee to be held on December 1, 1999, in order to allow time for further negotiation with the Regional Municipality of Peel:

Motion by Councillor Gardner

"That Recommendation No. (1) be amended by deleting the date 'June 30, 2000', and inserting in lieu thereof the date and words 'January 1, 2001, or prior to that date.' "; and

Motion by Councillor Walker

"That the following options Nos. (3) and (4) be adopted:

'(3) Council direct the General Manager, Toronto Ambulance, through the Commissioner of Works and Emergency Services, to obtain full funding for the services described in option No. (2) from the Regional Municipality of Peel or the Greater Toronto Airport Authority, or both, notwithstanding the parties' original positions on the issue. Failing this, the Commissioner report back to Council for further instructions.

(4) Council advise the Regional Municipality of Peel that Toronto Ambulance will discontinue the provision of routine day-to-day emergency and non-emergency services to the GTAA effective June 30, 2000. This long-lead notice will permit the Region of Peel and the Ministry of Health to develop an appropriate plan for integrating the GTAA lands into its plans for service to the balance of the Region.' ":

(September 22, 1999) from the Commissioner of Works and Emergency Services and General Manager, Toronto Ambulance, recommending that:

(1) City Council advise the Regional Municipality of Peel that Toronto Ambulance will discontinue the provision of routine day-to-day emergency and non-emergency services to the Greater Toronto Airport Authority (GTAA) effective June 30, 2000, while maintaining Toronto Ambulance's lead role in disaster and mass casualty services on the GTAA site; and

(2) the appropriate City officials be given the authority to give effect thereto.

(j) Toronto Ambulance Marine EMS Rescue Program.

The Community Services Committee reports having received the following joint report:

(September 22, 1999) from the Commissioner of Works and Emergency Services and General Manager, Toronto Ambulance, providing an update on the Toronto Ambulance Marine EMS Rescue Program pilot project which was established in co-operation with the Toronto Police Service Marine Unit; and recommending that the report be received for information.

(k) Acquisition of Replacement Ambulances.

The Community Services Committee reports having received the following joint report:

(September 22, 1999) from the Commissioner of Works and Emergency Services and General Manager, Toronto Ambulance, advising that a response has been received from the Ministry of Health and Long-Term Care responding to a recommendation contained in Clause No. 3 of Report No. 2 of the Community Services Committee, headed "Acquisition of Replacement Ambulances", adopted, as amended, by City Council on July 27, 28, 29 and 30, 1999, with respect to exploring alternative fuel other than diesel fuel; noting that the Ministry will work with Toronto Ambulance in examining the potential application of non-diesel engines for ambulance vehicles in future, but that the replacement ambulances for the 1999 budget year will be diesel powered; and recommending that the report be received for information.

(l) Continuing Evaluation of the Ambulance Act of Ontario - Response to Outstanding Items.

The Community Services Committee reports having received the following report:

(August 31, 1999) from the Commissioner of Works and Emergency Services providing an update with respect to Minute No. 1.2 of the Emergency and Protective Services Committee from January 12, 1999, on the possibility of billing hospitals for the administration of the paperwork provided by Toronto Ambulance and the new Ambulance Act of Ontario and its Regulations as they relate to the issue of co-payments; advising that correspondence has been received from the Ministry of Health and Long-Term Care reaffirming that currently the legislation restricts the charging of fees for ambulance service to hospitals that either send or receive a patient by ambulance in the form of a co-payment of $45.00 charged to the patient by the hospital; indicating that there is no Provincial initiative currently underway to make changes to either the Ambulance or the Health Insurance Act relating to land ambulance payment or fees; and recommending that the report be received for information.

(m) Toronto Fire Services - 1998 Annual Report.

The Community Services Committee reports having received the following joint report:

(September 23, 1999) from the Commissioner of Works and Emergency Services and the Fire Chief submitting, for information, the Toronto Fire Services 1998 Annual Report.

(n) Learning, Earning and Parenting (LEAP) Program.

The Community Services Committee reports having recommended to the Policy and Finance Committee:

(1) the adoption of the following report (September 30, 1999) from the Commissioner of Community and Neighbourhood Services respecting the Learning, Earning and Parenting (LEAP) Program; and

(2) that the provincial Ministry of Community and Social Services be advised that the City of Toronto will not implement the LEAP Program until such time as an adequate response has been received from the Province of Ontario through discussions of the KPMG recommendations on the implementation of Ontario Works, and the impact on child care services:

(September 30, 1999) from the Commissioner of Community and Neighbourhood Services respecting the Learning, Earning and Parenting (LEAP) Program, a mandatory Provincial program that will be delivered by municipalities under the Employment Supports (ES) component of Ontario Works; and recommending that:

(1) City Council endorse the proposed direction for delivering LEAP in Toronto;

(2) funds for LEAP be included in the year 2000 budget requests of Toronto Social Services and Children's Services in the amounts of $1.89 million gross/$378,000.00 net and $4.00 million gross/$800,000.00 net respectively; and

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

Respectfully submitted,

BRAD DUGUID

Chair

Toronto, October 7, 1999

(Report No. 4 of The Community Services Committee, including an addition thereto, was adopted, as amended, by City Council on October 26 and 27, 1999.)