April 27/04 Report

Present: Merulla (chair), Morelli, McHattie, Collins, Horwath

first 15 minute (approx) of meeting are not included

Staff Presentation
7.1 Coordinated Access System for Social Housing HCS04029
first speaker, woman, : ..consultants that we secured to do a review of our waiting list system according to access for housing which is a requirement that the City of Hamilton has under the new social housing reform act, so they've done a fairly extensive review which resulted in the report and recommendations in front of you. So, I'm going to turn it over to you, Christie.Thank you

Christie: This will be a very brief presentation on our report. We'll just review for you the study background, purpose and objectives, our study process, which as Vicky mentioned, included quite a wide consultation ; the evaluation framework that we used and our recommendations on our refined model. Just a bit of background; the social housing reform act requires that service managers such as the City of Hamilton establish and maintain a common waiting list system to coordinate application and assessment processes for rent-geared -to-income applicants in municipally-administered housing. Currently, in the city of Hamilton, the Community Housing Access Network (or CHAN, as we refer to it) maintains a coordinated access system on a purchase-of-service basis with participating housing providers. So, overall, the reason we were hired and the purpose of the study was to determine the most appropriate system to deliver a coordinated system consistent with provincial requirements under the social housing reform act and its accompanying regulations. So we had some objectives that we also had to meet. We had to define a refined service model for coordinated access which meets legislative requirements and community needs. So the new legislation did set out some new requirements for the community . Secondly, we were to recommend appropriate accountability structures to ensure that service requirements are met and the city's accountability protected. Thirdly, we were to recommend approaches to resourcing the new coordinated access system and also to recommend options for enhancing applicant accessibility to the coordinated access system. So we've touched upon all of these within the report. We just wanted to give you an overview of our study process. As some of you may be aware, the city of Hamilton established work teams back in 2001 to help with the joint local transfer plan and other issues related to the transfer of social housing. The "access and eligibility" work teams did look at coordinated access between2001 and 2002 and did make some recommendations. The work teams' work and their recommendations were considered as part of our review.

As for the literature review, there's been a number of documents put out by the province, the city, the joint local transfer plan of the city, the city's social vision, as well as all the incorporation policy and procedures documents of CHAN were reviewed. We also conducted an environmental scan of practices by other service managers. There are 46 other service managers in Ontario. We selected 10 we felt were the most similar to Hamilton and interviewed them and reviewed their practices; vis a vis, coordinated access. We also undertook a broad consultation process which took place between August 2003 and roughly January of this year. We consulted with CHAN, the community housing registry, with housing providers in the area, community agencies in groups involved in social housing, applicants themselves. We had a focus group with applicants, as well, we reviewed a CHAN telephone survey on their services. We had meetings and discussions with city staff in public service, public health and social services. So we did do a wide consultation. We also sent out a broadcast to the 800 community agencies, asking them to participate in a survey. So we had about 100 responses to the survey on this issue.

We looked at 2 options that were considered for the delivery of the coordinated access system; first of all, a system governed and operated by the service manager, or secondly, a system governed by the service manager and operated by a third party selected through an RFP process.

A third option was suggested by the work team , and actually, this was the option that was put forward in their recommendation and that was..The third option was a coordinated access system governed and operated by housing providers. We didn't consider this option for 2 major reasons: first of all, the governance of the system itself must remain with the service manager, due to the requirements of the Social Housing Reform Act, you are accountable for the system. Secondly, your purchasing policies and practices require that services of this nature and cost be tendered through an RFP process.

We focused our evaluation on the 2 options and we looked at 4 criteria: quality of service to applicants, quality of service to housing providers, meeting service manager requirements, both legislative and your other visions and goals, and maximization of cost effectiveness. The results of our analysis did find a number of problems and concerns with the existing systems (the CHAN system). First of all, there was a mixed reaction among our stakeholders about the effectiveness of CHAN and its ability to equally represent the interests of all providers and applicants. There was also some concern about whether CHAN fully reflects the city's goals, objectives and values. The other piece of information in our analysis is most other service managers in Ontario ,about 90% of the others, deliver coordinated access in-house or through their local housing corporation. But despite that, we really felt that in our analysis, pretty well the system delivered by the third party (in this case would be CHAN), did score marginally higher when we looked at those 4 criteria, than a system that would be delivered by the city, based on our analysis. Given that, there was no real compelling reason to bring it in-house but really, the overriding factor for going through the RFP process is the deep and ongoing community commitment to the delivery of coordinated access for social housing in Hamilton. Hamilton was one of the first municipalities in Ontario to voluntarily set up a coordinated access system. You have dedicated volunteers and housing providers who want to see this system continue and on balance, we see a lot of positives in the existing system and with some refinement, we feel it could be a great system! So, our recommendation then is that the City of Hamilton proceed with the request for proposal for the delivery of a coordinated access system for social housing. So this would be the way that CHAN, your existing provider could then, they would be invited also to participate in the RFP and if successful, would continue to provide the service.

We had a series of other recommendations in the report, primarily to do with the refinement of the existing model. Overall, what we saw was a need for the city and the service provider to form more of a partnership than exists right now. We also felt there was a need to put in place an improved accountability structure. To begin with, there needs to be an arrangement between the two, including a framework structure. We have recommendations around how to enhance applicant accessibility and also, we're recommending establishing an advisory committee for the implementation of system and policy development. Thank you.

Chair (Merulla): Are there any questions from committee members? Are there any questions, comments? Councillor Morelli?

Morelli: I'm just looking at management and coordinating function..is that the focus? Is that what you're trying to accomplish?

Staff (Christie): The focus is to coordinate the management of the applications of the RGI applications. Does that answer the question?

Morelli : (the tape was slightly garbled at this point) ..Mr. Chairman...equality in that process..

Unknown speaker (presumably Staff: Through you, Mr. Chair,..there are some issues related to accessibility. There are some problems with, say, language barriers for individuals to access information in a timely way. There is a need to provide more sort of technological support, in terms of, you know, sort of more web-based support as well. Primarily it's related to access, clear communication, clear understanding, what their options are when they're looking for various types of housing. Having said that, the existing group has also, you know, recognized that there needs to be, you know, more energy and time resources put into this to make that happen.

Morelli: These are all functional things that you're talking about here(further mumbled reply..) I guess if we look at item 1a, could the city issue an application or file to participate in the request for proposal ....functional areas.

Staff: We technically could apply ourselves to manage this waiting list. In many areas across the province, they do. Having said that, because we've had such a strong community-based approach right now that overall, is running well, we're recommending that we put the RFP process through and encourage this community group and perhaps others, to apply.

Merulla: Councillor Horvath

Horvath: Mr. Chairman, just to clarify, we're sending this out to RFP and we are not at this point in a position to do an internal, in-house bid on the RFP?

Staff: My recommendation to you would be that we do not do an internal bid at this time. And further to that, Councillor Horvath, my understanding is that there is support to proceed with the first recommendation in terms of...

Horvath: I understand that, we'll get to that when we get to the recommendations, but at this point, speaking of what happens often in the public works area with regards to providing some opportunity for in-house bids to be put together..But if there's no desire to do that at this point, then can I ask then if the RFP's come in and they're not satisfactory, is that when we then look at the possibility of bringing it in-house?

Staff: Yes that's what we would do.

Horwath : Mr. Chairman, regarding the 2 recommendations as Vicky was indicating, I think item A is something that is fairly time-sensitive and we should probably move forward with that but my understanding from providers and various other participants in the process of this study and of the coordinated access, whatever that CCOHS group.., have indicated to me that they have some concerns around the details of the recommendations that have come out, indicated in item B. So, what I would like to do is move item A and table item B until the next public health and social services meeting, so that the participants and community have an opportunity to discuss with staff, some of their concerns.

Merulla: OKAY. Just a point of clarification that council directs staff to proceed with the request for proposal for coordinated access system for social housing according to the city and table B for .?.Councillor Horvath, seconded by Councillor McHattie; all in favour? CARRIED. Thank you.

Now, moving on to item 7.2 respecting capacity building for infectious disease control.Ms .?..Dr. Richardson.?(garbled)

Staff (?): This presentation is in follow-up to recommendations that were made after the SARS outbreak to look at enhancing the surveillance and outbreak response mechanisms within local health units. And, indeed, the ministry did provide 100% funding for a time, related to that, and then it anticipated become a 50-50 funded programme. We advocated for continued funding for that and that appears to now be in place. (undecipherable name) who is the programme manager who headed up our team to do the project implementation is going to present today the outcomes of that project. So I will just set her up and have her speak.

Project Manager: Thank you Mr.Chair and committee members, for the opportunity to show the outcomes of the surveillance and outbreak response project. The next few minutes, we'll go over the objectives and goals of the project, discuss the outcomes and deliverables, discuss the implementation of the outcomes and a bit about evaluation, and finally, mention our next step. So the SOR, or Surveillance and Outbreak Response, the project goals were to increase future capacity for outbreak response and to develop and implement an enhanced surveillance system.

Goal # 1 is : increase future capacity for outbreak response. The question of preparedness dominated this goal for us. The questions of "are we prepared if SARS returns to Ontario and/or Hamilton tomorrow, or if we had another large enteric outbreak such as E-coli in January, are we ready ?" We focused on what would be most useful to frontline staff to deliver an organized system in response. We developed a manual for outbreak response that will provide us with policies and procedures, steps of an outbreak investigation, roles and responsibilities of each member of the outbreak response team, and other relevant information to assist our staff and others in the department who may provide surge capacity. We worked on the development of an electronic information system which was borrowed from Thunder Bay but we tweaked it for Hamilton and we called it OCCMS, which is the Outbreak Case and Contact Management System. So we adapted it for Hamilton and it will be useful to us for case management of SARS, avian flu, or any severe respiratory illness case that could come through from our acute care hospitals. We have a User Guide which will be for frontline staff and the system has report capabilities. Along with this, we also developed some resource binders which contain all the provincial and federal guidelines, our local protocols for the investigation of persons with respiratory illness who meet case definitions. And that's for the respiratory outbreaks.

The next one is for enteric illness outbreaks and we developed a customized information system for frontline staff again and this particular system had GIS-system links, it has report-generation capabilities, and at present, our information technology staff person is tweaking our data base to make it more user-friendly for us to handle another outbreak such the enteric E-coli one which we had in January.

In order to build surge capacity within the health protection branch, we will be promoting and encouraging staff to take online, Health Canada skills enhancement courses and will provide in-house refresher courses on field investigation. Mentoring opportunities will also be made available to health protection branch staff. We hope to use a rotating system for staff within the branch and/or department through the infectious disease programme.

Goal#2: to develop, implement and enhance surveillance system. Globally, as you know, surveillance has become a priority, at all levels from the World health Organization, to Health Canada , provincially as well as locally. Some of our stakeholders, such as acute care hospitals, long term care facilities and our local physicians remind us that surveillance of diseases and other health threats, is a role for public health. This is supported also in the most recent Naylor and Walker-Kirby Report. The project team began by researching the literature about surveillance systems and what they could do and where they would be most beneficial. We considered our current resources and decided on what we think are the following practical systems.

We looked at our current reportable disease information system which is ..?.We looked at the current system and how we can enhance that to work better for us, in terms of report generation so that we can share with our community partners, such as acute care hospitals. We reinstated the pandemic influenza surveillance system which was started in 2000/2001 and we're working with CWH PIN and other health units within central west to get this up and running. And we're also working very closely with the acute care hospitals and we have implemented the most recent infection control standards for emergency rooms regarding the febrile respiratory illness and the ..surveillance system.

We looked at participating in a provincial syndromic surveillance pilot study, and at present, this is being looked at as a top priority by the Ministry of Health in long-term care. They are choosing pilot sites. Hamilton was hoping to be a pilot site but it is being coordinated, as we speak, out of Queen's University and we have to hear who the pilot sites are. But this is an interesting surveillance system where we look at the signs and symptoms that are presented in the emergency departments throughout the city, so that we will have an idea of what is being seen. We also are going to propose to join in Health Canada's pharmaceutical and drug monitoring pilot project and we are proposing a new model for a permanent surveillance team within our department.

Implementation and evaluation: presently we're re-organizing the programmes within our health protection branch to accommodate an increased surveillance activity. We are having ongoing collaboration with the epidemiology staff in the P3 branch, related to surveillance and enhancement. We are planning to do mock exercises to test the systems we have developed and will be implementing, and we're hoping to do an evaluation process in June, 2005.

So, next steps:

I think, and as you know as Dr. Richardson has mentioned the 100% funding for capacity building for infectious disease control has been extended .We will be recruiting staff. We're looking at innovative methods of surveillance, and new operational models. The project gave us an opportunity to improve our programmes and align our department with the federal and provincial public health reform strategies. I think we will be in a better position now for surveillance and epidemiological investigations, surge capacity, and we have the technical infrastructure for data collection, and I'm open to any questions.

Merulla: Are there any questions from committee members?

Comments? Councillor Horvath.

Horwath : So, Mr. Chairman, the funding is continuing from the province at 100%? Is that right? And what's the., is it another year,6 months, what's the length of the project?

Staff: the term that they used was "indefinitely". The province, as you know, with the recent SARS reports that have come out again, with Campbell and Walker's final report, is looking at developing an action plan which they hope to release in about 2 months time. So we're expecting some final decisions around these things from the budget discussions, and as well, from those action plans. They've told us that this funding will continue for the foreseeable future but I'm sure they're referencing that there may be some additions there. And so we're waiting for that sort of change before we do something terribly permanent around these issues.

Horwath: Thank you Mr. Chairman

Morelli: (question was garbled and cut off)

Staff : the province provided us with start-up funds to facilitate the hiring and some of the training objectives. I don't recall the dollar values of those originally but the ongoing staff costs were in the neighbourhood of about $400,000.00. The monies that were provided at the time were provided for a certain period of time which was not a full year; it was supposed to be from September until the end of March. They provided start-up costs and I don't remember the exact dollars; $392,000.00 I'm told were the start-up costs , 100% funding from the province and some $400,000.00 for ongoing staffing costs related to that. They based that on the level of hospital beds; it's been argued whether that was the most appropriate thing to base it on but then decided we should have 10 FTE's (?) related to the needs here in Hamilton.

Morelli: OK, so if I follow that, are you saying that 792 is sort of the..?

Staff: That's right, and those dollars worth have yet to be...Well, you have to ensure that you have spent them all; I don't think that we have spent every one of those dollars in relation to this project because of the difficulty of hiring staff on short-term contracts.

Morelli: What I'd like to know, Mr. Chairman, if you could just answer me, what's the amount of money you would assign to that cost centre that's associated with this programme?

Merulla: The full amount?

Morelli: the full amount, yeah, as we go.If you could give that to me , I'd just like to have that.

Merulla: Recognizing Councillor McHattie

McHattie: Through you Mr. Chair. There are other costs associated with SARS and West Nile that we have in our budget for this year. We just went through that stuff a couple of weeks back, or whenever it was, our last budget session that we dealt with that. Is your sense, given the reports that have been tabled at the provincial and national level, the Walker report and others you mention in here ..is there any sense yet as to whether they're going to come through with additional funding that will help offset some of our costs that we currently have in our 2004 budget? It's a bit of a guess at this point I understand but just any sense of that?

Staff: Through you, Mr Chairman, we had elected not to go forward with an enhancement around the surveillance and outbreak response, the infectious disease capacity, instead, we elected to lobby for 100% funds. So indeed those were not included in the 2004 budget and it's been indicated by the ministry that that funding will continue ongoing. So that's not actually offsetting anything within the budget but if new dollars that are available at 100%. From the standpoint of the West Nile virus itself, they have indicated some small amounts that weren't already assumed within the budget process in terms of testing and those sorts of things, that they are going to pay 100% for. But I'm talking in the tens of thousands of dollars range at this present time. Overall, from a systems perspective, there is within all of those reports recommendations of increased funding for public health and recommendations for increased provincial contributions to public health. But we don't know at this time until we get those action plans or until we get some budget announcements in the coming months what that investment, from the provincial perspective is going to be.

Horwath: Just in regards to some of the questions around the cost of the programme and the funding from the provincial government, is there also included, funding that covers off our administrative costs? So if the costs for the FT's to under take the study and ensure that the data is being collected and reported, but do we also have funding that's provided internally or to our administrative side, like 10% or 20% to be able to ensure..

Staff: Mr. Chairman, we did include within our staffing model for this, a manager position and some clerical staff to support that, and indeed, we should note that this project is not just out of the public health and community services department but we have IT support and support from elsewhere within the corporation that has all been funded by this project directly. Because of the short-term nature of it, we were looking more at the issue of 100% funding in the long-term, rather than looking at the administrative pieces per se, but we will be advocating again for that full cost recovery model in any programmes as we go forward.

Merulla: For all that, can I have a mover and a seconder? Moved by Horvath and seconded by Morelli - CARRIED

Moving on to item 7.3, respecting sexual health networking

Earlier on under consent items, I neglected to mention that Cameron .., the Hamilton. for action against tobacco, I presume he has left, but I did want to formally acknowledge him. I would like to now introduce Ms Theresa Hartnet and Ann Tyrrell. Ms Hartnet was until recently, an elementary school teacher with the Hamilton District Catholic School Board and she is the programme director in the office of Family Ministry, the Diocese of Hamilton and she has been the executive director of Birth Right for 16 years. Welcome.

Ann Tyrrell is a public health nurse with the school programme of the Healthy Lifestyles and Youth branch. Welcome.

Hartnet: Good morning. We wanted to come to you today to present a little bit about the Sexual Health Network , being that it was the council itself that actually implemented the existence of the network and we've been running for quite some time now and having some success, we do believe, and we want to update you on that success and what it is that we're doing. Just for the background information for you, the network was begun because we were and still are concerned about the fact that there was a high number of pregnancies and sexually transmitted diseases among our young people. In fact, Hamilton, unfortunately, has always been slightly above the provincial averages and the city wanted to look at how we could reduce those numbers, especially in the Hamilton area. So, they mandated that the public health would bring together community partners, people who dealt with adolescents in our community, and the group would come together and see how it was that we could in fact assist our adolescents in being more knowledgeable about their own sexuality and in helping to reduce the sexually transmitted diseases that they experience, and pregnancies. The mandate of the group was to look and see how we could do that. Initially when the group came together, there was a number of partners , probably about 50, who came together to discuss those issues, how are we going to do this, how would it be possible in this city, how do we tackle such a diverse problem in a diverse community? We had a lot of good discussions around how that would be done. The group set up their own mandate which was to encourage postponement of sexual activity, lessen the occurrence of risk behaviours, because we know that sexual activity is just one of the risk behaviours that youths undertake and we know that youths who are involved in one risk behaviour are usually involved in many. It was all connected. We wanted to promote self-esteem and decision-making because we know that also has a profound effect on risk behaviours. Most importantly we wanted to help parents and children talk together about this area because it was a belief of all present that it was the role of the family and parents to be involved in this area with their children. We went out to the community and asked, through focus groups with adolescents and pre-adolescents and their parents, do you want the city to do something about this? Are you interested in having some assistance through public health in dealing with this whole area of sexuality? The resounding answer was "yes, we are very interested". We found out from the young people, "we want to talk to our parents about this area". We found out from parents that they wanted to talk to their children but therein lies the great divide of how to get them together; parents were uncertain, they weren't sure they had the right information. Youth were not going to approach their parents but they wanted their parents to talk to them. We needed to respond to what the 2 groups asked for. The adolescents wanted to have good information in their school systems and the parents wanted to have good information to provide to them and they asked for assistance in doing that.

Through the network we came up with a slogan, and developed a campaign to assist us in promoting the message. The slogan was, "I'm worth the wait". We took the slogan back to the adolescent groups and asked them what it meant to them. We wanted it to be an empowering statement, a statement that they understood clearly that talked to them about their sexuality and we wanted to be sure that the message would be promoted.

The answer from the focus groups was that indeed it did speak to them on that level, so we proceeded with the programme of developing "I'm worth the wait".

I will show you the campaign..we didn't give you all a poster because we didn't think you'd need them, but we developed the poster...

(...Missing transcription...tape changed at this point)

Morelli: .especially amongst the churches where they're trying to get programmes developed for the kids or the youth. One of the mistakes that they're learning that they're making is that they have adults trying to run the programmes. They're finding when they let the kids run it they're getting more success. Are there more youths involved in this, or are there any plans to do that? I know you said you were going to have an assessment here originally, but has that been looked at?

Hartnet: We did originally have a number of older youths, in their twenties as part of the network who gave us input into this programme. The problem we've had , we've invited students on numerous occasions from the high schools to be part of the discussions, is their time commitments and getting them to be able to come to meetings and all those sorts of things. We did do the focus groups and will continue to do that so that we have input from adolescents. In terms of actually going out to do some work for the network, it's not anything we would be opposed to. We have had youth panels at both of our conferences so that parents could ask some questions and they could respond. They were well received and very well spoken and one of the comments that gave the biggest shock wave from one of the adolescents was the parents were very concerned about where are the drugs coming from that are in the schools. One of the students replied that they're coming from the childrens' homes and it was a surprise to the parents. The youth do have some valuable insights that we, as adults, don't always consider. We are using them to the capacity that we can. Would we like to use them more? Yes. It's not always easy but we definitely understand that they are the people we need to talk to to understand their needs.

Morelli: Do you have someone in the communications business who helps you develop this type of material?

Hartnet: We didn't actually have anyone who developed the book so we developed it ourselves, mostly Ann and I, and we vetted it through other people and ultimately we had people who work in public health look at it who are communications people, but the basic book was designed by us. We did use an art director for the set-up of the booklet and for the pictures in the booklet and the posters.

Morelli: It's well done, by the way ,and it is kind of interesting because you do use throughout it so it's kind of.....

Mr.Chairman, I want to join my colleagues in saluting the people responsible for ...

I can tell you the social health network has certainly done a great job in this area and it's kind of oppressive for me because it points to what I believe is a process that we need to constantly look at, and that's the definition of the signing of the objectives, and the strategies that address those objectives. Listening to you very closely, I see that you say you are going to have some assessment to follow, where you will go back through that loop again, in terms of the decision - making process. I really liked the focus in your presentation, referring to needs and wants. You mention parents were desperate; that's kind of an interesting comment for me, but again, it obviously reflects the fact that you've undertaken some feedback and the feedback is broad enough to make that comment. So for me it's very much a project which responds to all the things I think we need........(missing text)

Merulla: .....seconded by Morelli, all in favour? CARRIED

Moving on to the added items 7.4 verbal update respecting homemakers and nurses ...(garbled and unintelligible)...

Staff: Mr. Chair and committee members, I'll get started on the presentation because it looks as if we're having some technical difficulty with power..copies in front of you, so we'll work our way through that.

I'm providing you with a brief update around the cost of ....

I'll go through it quickly; I just wanted to make sure we had the context ...(missing sentences, etc)

As you know, the homemakers and nurses services programme provides financial assistance to eligible clients ....(end of tape - nothing more was picked up on tape)

Chair (not Merulla): Thank you. Councillor Morelli, then Councillor Horvath

Morelli: thank you staff for a good report. This is a topic that is obviously near and dear to all our hearts. I also salute your leadership, Mr Chairman, it came forward a lot earlier than it has in the past and certainly, your support, ...... (garbled)

..It attacks those who are most vulnerable; the elderly, the convalescing, the chronically disabled, and I think we need to make sure again that we focus on the fact that we don't create any unnecessary anxiety ,recognizing that it is a need that must be responded to. It's obvious that we are communicating more effectively with the province to make sure that this happens and happens in a fashion that doesn't bring unnecessary anxiety. I'm really pleased to see this report here today and I urge us to move forward enthusiastically with the communication plan. We can bring this message to those that aren't aware. We are going to allow the intake to expand , so I'm very pleased with the future action that is planned and I'm very pleased that we will move this thing along.

Horwath: I also want to thank and congratulate you for the work you have done on this particular issue. For too long these people in our community, mostly seniors, who are very vulnerable have been in the position of being a political football with regards to their homecare and that's just not right. Staff has done an admirable thing by recognizing that and putting an option in front of Council that although it's going to cost some money, also some sensitivity, some security around the system so these people don't continue to have their lives disrupted or anxiety produced by their homecare being threatened.

I do have a question, with regards to the possibility of the provincial government stepping in. Is that a matter of going back to the CCAC , funding it at appropriate levels and changing the eligibility requirements back to what they should be when we actually started to reduce our caseload because CCAC was taking it over? Is that what we're hearing from the province?

Staff: I don't think we're hearing anything quite that specific. What they said to us is that they're looking at it. The new minister is doing a review of the entire health care system, which would include the acute care, the public health system and the homecare piece of that as well. I think it's a review of the entire system, as I understand it. We don't know how that is going to end up and whether that means that the CCAC changes its guidelines, etc. The context of them asking us to hold out for a year is pending this larger review of the entire system.

Horwath: Am I mistaken then? We were in the process of handing our caseload over to the CCAC and that was going well until all the provincial funding cuts by the previous government and changes in eligibility requirements which put everybody back onto our system. There is a way to get at this quicker, at least in the interim, to take the burden off the city and put it where it belongs, with the provincial government . That is to go back to appropriate funding of the CCAC and appropriate guidelines to make sure these people's needs are covered off in the way it was prior to the Tory cuts. I don't understand why the government can't undertake those few small changes in the interim to give us the relief we need.

Merulla: ( garbled - spoke about eligibility criteria...)

Staff: I haven't heard this specifically, but I think what is going to involve part of the system review is a readjustment of funding or a re-alignment of some funding or adding new funding to the system, because it wouldn't be just our community. It would be a big funding issue and I don't know if that's part of their budget or how they're going...

Staff (Elizabeth): that's exactly the position we're taking, that there could be a simple way of moving forward within this community but we can't answer for what the province has in its mind in terms of strategy they want to take in reviewing the issue and whether they want to have a local or province-wide solution. My perception is they want a province-wide solution.

Merulla: Moved by Morelli and seconded by Horvath, all in favour?

You have before you, item 8.1.Moved by Morelli, seconded by McHattie, now we have a couple of options here, though, before we move it. We made a motion to approve the recommendation a) in the report, and two, approve the recommendation b) in the report and establish a selection committee or approve the following alternate recommendation before you, which I prefer. Is there any discussion?

OK, so moved by Morelli ,seconded by McHattie,all in favour? CARRIED

Now, item 8.2 we are tabling, Moved by Morelli, seconded by Horvath CARRIED

Item 8.3 - any discussion?

McHattie: Councillor Bruckler asked me to ask about funding approved on page 2 of 6 of your background. It talks about a motion passed on Feb.13, 2002 to provide $100,000.00 education programme, $25,000.00 for signage , and additional 20 to hire some FT's(?). he was just wondering about the relationship between that approval and the $51,000.00 we approved yesterday.

Merulla: We should actually be moving just the receipt of this particular recommendation, so the motion is to receive the report. So that was moved by Morelli and seconded by McHattie.

It should be noted that Councillor Horvath declared that she declared a conflict on that.

McHattie: Just to continue my question...on behalf of Councillor Bruckner, to understand the funding that's outlined in this paragraph as compared to the one we approved yesterday. He just wanted to know the relationship between the two.

Staff: We wanted you to know what the campaign that was planned for the dollars

Item 8.5:

McHattie : "Found this a fascinating report. It has a lot of interesting things to say about Hamilton and even though we've been contributing financially to lowering business taxes over the last couple of years, it's not immediately apparent in some of the quality of life indicators for Hamilton what kind of effect that's had on the City. In particular, it really shows it in larger trends across Canada, that the rich are getting richer and the poor are getting poorer, and it's evident in this report that's the case. I think this would have been additional information for our discussion the other day in budgets around the BTR and perhaps may come up tomorrow night when we have our council meeting. The other thing that stands out for me is the status of public transit and the walking and biking, the other modes of transportation. We're significantly behind the other Quality of Life Report System communities that are identified here. So that's a real wake-up call for us as well. In light of our sustainability interests that really speaks to where we are going. This is great stuff. It gives you the broad level trend analysis to see whether we're going in the right direction and I think it raises some real red flags for us in the city."

Horwath: question about how this report gets fed into any kind of policy discussion in a proactive way in the departments, or will it get filed and that will be the end of it. Priel: "very good question" . we'll feed some of this information into the GRIDS process. . it should actually form part of our environmental scan as we're bringing the bank into talk to us about the economic situation. As we do budgets . this should form a good part of the discussion in terms of triple bottom line and the other leg of the school, what's our current environment in terms of the social demographics and other of our communities. I'll take that under advisement."

Merulla (gives chair to Horwath): "In consider this to be new information under the BTR so I'm going to move that we attach this for budget discussions tomorrow and I'll move subtraction of a million dollars from the BTR, based on the new information before us, for consideration at budget tomorrow."

Horwath: "So that's moved by Merulla, seconded by Morelli that this be forwarded to budget discussions tomorrow with a recommendation from the committee for a further reduction of $1 million from the BTR as a result of this new information." Carried.

Morelli: "Following up on Brian's comments . and I salute Brian for asking that we look at sustainability aspects when we began the budget and refer to the Vision 2020 document. What I really think is important here is that somehow we get this document into a benchmark graphic chart form. Because it needs some qualititiative, you know the quantitative information is really good, but it needs some qualititative assessment as well. And I'm wondering through you, I don't want to lose sight of this, because it really sets the critieria. We're all driving for some sense of balance around here. We have our differences periodically, but I think we're all driving for what we perceive to be the right sense of balance, and given the environmental circumstance. . hope that we can give some sense of direction to staff where they can take this and get it into a form that will be somewhat enduring and perpetuating. And secondly it will be in a chart form which is somewhat in a format of an executive summary that everyone can have, because it really does focus and highlight some major issues, even the ones with respect to the modes of transportation, the use of the private vehicle, the walk and the biking behaviour of people, relative not just to Hamilton but to the rest of Canada. I think that some of those things need to be known or defined, but also there has to be some variability quotient that you right in given an understanding of the particular environment that we're involved in. So those qualititative issues have to be written in and arrive at an index which is really a little bit more accurate. . It's sort of a form of an econometric model ... I really think this is good stuff, but it's not going to be good enough if it just sits here and is not taken the next step."

McHattie: "This is important work. it can't just sit here at this committee. I'd like to move a motion that this report be forwarded to Mr. Rinaldo and the budget group . and to Strategic Planning and Budgets for consideration as they consider the 2005 budget process and how we are going about building sustainability ideas, quality of life indicators ideas, into that process. Councillor Morelli is quite right. This is critical to that and we had a brief discussion of it at the beginning of the 2004 budget discussions, but we're not at a point where we're able to successfully integrate that kind of thinking into our budget process. But we want to be there. So lets move forward in 2005 using this, as well as our own Vision 2020 sustainabilty indicators - both of those initiatives forwarded to Strategic Planning and Budgets for the 2005 budget process."

Moved by McHattie, seconded by Morelli. Carried.

Staff recommendation also adopted.