September 28/04 Report
Meeting of the combined "Public Health and Community Services Committee"
9:35 am to 12:30 pm

Attending

• Members: Merulla (chair), McHattie, Morelli, Jackson, Whitehead, Bruckler, Mitchell, McCarthy (left before vote on golf course)
• Non-members: Kelly (in and out until 11:10); Ferguson (in at 11:00 for discussion about golf course/ski hill)
• Staff: E. Richardson, D. Elliott, B. Hall, W. Fenwick (could be other, but I didn't know who they were)
• Press: Spectator (McGuiness, Dreschel); CHML (Mann); K-Lite (reporter); CHTV (reporter & camera); Brabant (reporter)
• CATCH (Janet, Linda H., Jenny S.)

Contents:

• Letter from Artistic Productions (Joel Starkman)
• Health and Homelessness Study/Report: Health Needs and Assessment
• Website Public Report for Long-Term Care Facilities
• Golf Courses/Ski Hill Operations Report
• Implementation of Provincial Rent Bank Program in Hamilton Report
• User Fees for Sexual Health Clinic Medications
• Dental Clinics
• Recently Arrived Somali Refugees in Hamilton

Agenda:

No additions or deletions. The Golf Courses/Ski Hill presentation was moved to the end of the agenda.
http://www.hamilton.ca/clerk/agendas-minutes-reports/
public-health-com-serv/2004/Sept28/Agenda%2004-003doc.pdf

NOTE : Summaries are from my own notes and quotes are paraphrased. (My tape recorder wouldn't work; Janet taped some of the meeting, about 2 hours worth.) - Linda Hall

6.1 Public Delegation - Joel Starkman (of Artistic Productions) & Marv Caplan - 2005 Arts and Tourism Project, "Opening Doors."

Request: Council supports this project by allowing city logo to be used on the brochure, and allowing Public Works staff (e.g., Ed Suszinki - sp.?) to work with this group to identify possible sites for the doors in Hamilton. No financial commitment from the City.

• Project involves soliciting local businesses, organizations, groups or individuals to sponsor a "funkily decorated" door, created by local artists, which will be displayed for a 6 month period during 2005
• Purpose: (a) promote Hamilton, a la Toronto's successful " Moose Project"; (b) give local artists recognition, exposure
• Costs: $3000/door (some of this $ goes to the artists as an honorarium; brochure doesn't specify what happens to the rest of the $)
• Charity auction, Thanksgiving 2005 (live and on internet) ends project; moneys from this auction go to charities designated by businesses that supported this project

McHattie/McCarthy - moved and carried.

7.1 Health and Homelessness Report: Health Needs Assessment . - presented by Prof. Helen Thomas

Request: Presented for information; asks that staff be directed to review the report and report back to PH & CS Committee within 3 months with a plan to address recommendations, including the creation of an Implementation Task Force.

• study was funded through the Fed. Government, 2002 - Supporting Communities Partnership Initiative Re: National Homelessness ;
• contract awarded to McMaster School of Nursing, lead by Helen Thomas, D. Semogas, J. Gordon
• final report submitted in April 2004
• is one of the most comprehensive, local municipal studies done to date, involving 16 local agencies; report is very readable, 45 pages in length.

Findings and Proposed Actions :

(a) An easy, accessible system needs to be put into place to assure that the homeless get money to which they are entitled; e.g., ODSP process long and cumbersome;

(b) Affordable housing is a priority, since it has a serious negative effect on people's health; a number of studies have linked poor health to inadequate or sub-standard housing.

(c) Stable, long-term funding is needed for programs to assist homeless youth;

(d) Multi-sector strategies are needed to address the needs of children of the homeless;

(e) Many homeless people are hungry and not getting adequate nutrition;

(f) A local Harm Reduction Program is being investigated to address substance abuse;

(g) More mobile, publicly funded preventative dental care is needed;

(h) More staff will likely be needed to improve coordination of mental health services;

(i) Continuity of care needs to be improved for those with physical and/or mental problems, pregnant women and children. Beds in the community for those who have been discharged from hospital and professional staff to care for the patients need to be available;

(j) Strategies need to be developed to ensure that those who are homeless receive and retain Ontario Health Cards and Dental Cards;

(k) An Implementation Task Force to coordinate all of these efforts should be set up. The Task Force should be lead by the Hamilton Dept. of Public Health and Comm. Services, and include representatives for the various health services (e.g., hospitals, public health centres etc.), other essential community services (e.g., housing, food, financial aid, access to health cards), Ministries of Health and Long Term Care, and Community and Social Services

Discussion:

Bruckler - Re: Leadership? Have you made this presentation to higher levels of gov't?

Thomas: Not yet. How local communities implement their programs is important.

Merulla: How are we doing compared to other communities?

Thomas: Hard to answer. Few studies have been done. Toronto did a one-year follow up on the homeless after they were removed from the "tent city." Found they were still in their "new" homes and that their health was improved.

Merulla: Are alcohol and mental health problems more prevalent in this group?

Thomas: Alcohol was a factor in only a small % of this group; mental health problems are more prevalent.

McHattie: Excellent report. There is a need to allocate more money for affordable housing. Which comes first, homelessness or mental health problems?

Thomas: Hard to know. In Toronto, large institutions (99 Queen St. W.) were closed, but the second phase of setting up group homes did not get organised. The problem goes both ways.

Mitchell: The better we do, the better we need to do. We need stats to find out the numbers of needy coming from outside Hamilton to access our services. (He thinks there are many - source: CHAN) We need to work with the Province and other cities to address this issue, and get support.

Morelli: The real challenge is not to collect info' but to find a strategic response to this. (Mitchell's comment?, the overall situation?)

He questioned whether affordable housing was really the problem. Said that many lacked the ability to seek housing bec. of deep rooted health issues.

Thomas: Agreed, that is the case some of the time.

Whitehead: The level of burden is not equally shared among municipalities. What impact have changes to the Mental Health Act had? (Had to clarify that he was referring to "civil liberties".)

Thomas: Don't know if they correlate.

Whitehead: But there seem to be more of these types of homeless people on the streets.

Thomas: There are many more homeless who are NOT mentally ill, about 75%. And they could benefit from the changes we make in housing support.

Whitehead: Hamilton has been second to none in services. How are we doing?

Thomas: The size of Hamilton makes our services workable, but we have still have a 'patchwork' system of assisting the homeless.

Whitehead: Are our costs increasing because people are coming from outside Hamilton to access our good services? How can we find out?

Thomas: There is no evidence that they are coming from other cities. There are Prov. funds to explore this over the next 3 years.

Merulla calls for the motion to receive the report.

McCarthy/Kelly - moved and carried.

7.2 Website Public Report for Long Term Care Facilities - presented by B. Hall

Request: Council contact Minister of Long Term Health and Long term Care requesting they revise their proposed Public Reporting Website on Long-Term Care Facilities so that information regarding inspection, complaints and steps to comply at Macassa and Wentworth Lodge is accurate and more understandable for the public. The main concerns centred around some wrong information on the site (e.g., wrong number of citations issued, incorrect telephone number and fax numbers) and that no context was being provided to enable the public to grasp what the information really means. To provide this context, City staff recommended that the Ministry create links on the website so that the public can view the actual compliance reports and corrective action plans. . *** B. Hall advised Council that The Ministry had agreed by Sept. 17 th , to make some of the changes, including the hyperlinks requested.

The website is to be up and running by October 9th at www.ltcfacilities.net/homeview/facdeficiencies.asp

Discussion:

Kelly: Comparison to other facilities?

Hall: On par with most homes. Don't have specific data.

Bruckler: This is crucial for choices. How does Ministry respond to repeat complaints?

Hall: They visit, and if the facility is not dealing with the issues, they impose sanctions. On the third offence, they issue the compliance order under the Homes for Aged and Rest Homes Act, so they can start to take legal action.

Whitehead: How does the Ministry deal with many complaints against organizations that run multiple facilities?

Hall: The Ministry focuses on the individual facilities.

Motion to receive report, carried.

7.3 Information Session Re : An Overview of Health Protection Programs and Public Services presented by Dr. E. Richardson, Medical Officer of Health

• No written report was provided.
• Dr. Richardson outlined the programs, which are mandated by the Ministry, and gave some statistics regarding the City's compliance rates. Apparently there has been no feedback from the Ministry, so Hamilton is trying to monitor its own compliance rates.
• Some of the 11 mandated programs include:
  • West Nile Virus & Rabies
  • Food Safety
  • Tobacco Control and Health Hazards
  • Safe Water and Health hazards
  • School and Community Immunization
  • STD and Sexual Health
  • Infectious Disease Control
• Dr. Richardson spoke about opportunities such as partnering, a surveillance unit (?) and technology to keep data base current
• "Public protection is cornerstone of public health and it needs to be delivered at today's speed."

Discussion:

McHattie: West Nile Virus - How do you "remediate" a site?

Hall: Eliminate standing water sites; largest projects were Bow Valley & working with a developer to eliminate mosquitoes at a retention pond. Over 139 H. of land treated this year.

McHattie: asked about chemicals used in treatments.

Hall: Products used are licensed and okayed by the Ministry.

McCarthy/Kelly motion to receive report, carried.

Discussion Items

8.1 Implementation of provincial Rent Bank Program in Hamilton

• $428,000, one time deal
• intended to assist those who are 2+ months behind in rent

Whitehead: Concerned that the 10% designated for staff to administer the program is adequate.

Staff(? ): It is the minimum required. City will consider delivering program through community agency: will put out tenders.

Whitehead: Concerned that it is a one time deal.

Staff: Ministry is proposing a similar program for utilities.

Whitehead: Would like to see all of these programs encompassed into 1 administrative area so they will not be handles piecemeal.

8.2 User Fees for Sexual Health Clinic Medications

• Council approve user fees for four different medications provided in public health run sexual health clinics
• no significant discussion

8.3 Dental Clinics

McHattie: What are we doing for dental services for the homeless?

Staff: Cuts were proposed but after an initial audit report, staff realized $130,000 in savings would not happen. Upper Ottawa Clinic and North Hamilton Community Health Centre were supposed to close but this was reconsidered. A dental audit will be looking at streamlining the service. Rotating clinics might be the best method.

8.4 Recently Arrived Somali in Hamilton

Staff wants Council to respond to ministry of Citizenship and Immigration to support designation of Hamilton as a reception centre to receive funding to support integration and settlement costs for immigrants, and request that the ministry extend federal sponsorship given the difficult experience and extreme problems faced by these families.

• 210 Somali government sponsored refugees have arrived in Hamilton since the summer of 2003
• Hamilton is a termed a "secondary migration" location, and unlike Toronto and Vancouver who are deemed "points of entry" and receive additional funding, Hamilton does Not receive any additional funding
• $580.00 per month (single rate) from Fed. Gov't for one year
• no municipal supplement
• financial assistance ends after one year and refugees are eligible for social assistance

McCarthy: Concerned that this is only ½ of the money required to meet their basic needs

Merulla: Is there a quick link between arrival time and starting to work?

Staff: No, the Somali have severe recovery issues; coming from camps where they have been marginalized, experienced harassment etc.

Whitehead: Hamilton is the 3 rd largest intake centre in Canada behind Toronto and Vancouver, but we get no extra funds like the other two cities. Federal Gov't is not contributing enough. Long term problems associated with post-traumatic stress, physical disabilities, mental health, women and health issues will be the result. Who will "cover" the cost to fix these?

Staff: The intention of the report is to advocate on behalf of these immigrants and approach other groups to provide additional support. Fairness in partnering is needed. Tax payers will be responsible with no commitment from the Federal Gov't. Cost to City would be @ $180,000 annually after fed. Funding ends.

Merulla: move to cuts discussion at this point, says the money debate is too small to warrant more discussion.

McHattie: Would like to see a motion some time soon to ask that Hamilton be identified as a major centre and receive proper funding.

Asked how the proportion of visible minorities plays out at City Hall.

No answer.

7.3 Golf Courses/ Ski Hill Operations Bill Fenwick

Staff came to Council asking for permission to proceed with Option 3, which would advertise a RFP for a Public/Private Partnership for the management and operation of one or both of municipal golf courses. They also asked that an evaluation team be set up to evaluate the proposals and compare them to the option of the City continuing to run and manage the operation.

After discussion, the recommendation was modified to include options 2, 3 and 4 and it was agreed that the label, Public/Private would be removed from the RFP. McHattie, Bruckler and Whitehead volunteered to be on the evaluation committee.

• Option 1, outright sale of the municipal golf courses ( McCarthy's preference)
• Option 2, public/private partnership
• Option 3, public/private partnership (Hamilton Conservation Authority)
• Option 4, municipal golf courses continue to be operated by the city
• Option 5, sale of a portion of golf course lands, put reserves back into remaining assets
• Courses would continue to operate through 2005 (for financial stability); would come back to Council to ask for direction for the 2006 season

Morelli: Agree, prepared to move on public/private recomm.

McHattie: Not enough financial info' is available in the report. Asks questions about profits over the last 10 years and how they were used. Did we meet budget? Where did any surpluses go? Upset that these numbers are not readily available and asked to see a complete financial report as soon as possible.

• Rob Gatto had success at Chedoke this year
• Program need stabilizing not RFPs
• City's history with RFPs is bad, could open ourselves to more lawsuits
• Likes Option 4, and wants to include a 5 year plan

McCarthy: What would the properties sell for? Does the recommendation include an option for the Conservation Authority to bid? We're not in the golf course business. I would have no problem selling them, but would support the recommendation to see what opportunities exist.

Whitehead: Can we encourage an internal bid to see whether it is possible for the City to carry on operations/

Fenwick: We wouldn't bid on something ewe already run.

Merulla: Do we have the luxury of time?

Fenwick: Direct us to do that if you want.

Bruckler: Value in structuring the RFP so the Conservation Authority can bid. Can support the cost comparison language in the bid to note we will compare competitors before decision is made. Need to include mention of ski hill in the RFP.

Amendment from Whitehead/Jackson to include a staff bid.

Ammendment from Bruckler to remove Public/Private, and include ski hill

Staff (after checking): Any corporation can apply.

Ferguson: With the amendments, and Options 2,3, and 4 applying, does this still leave open the option (#5) to sell 1 of the 2, 18-hole golf courses at Chedoke?

Fenwick: It is not part of options 2,3, or 4, but that doesn't precluded it in the future.

Mitchell: Mentions that the 8 golf course owners in his ward are paying taxes which are going to subsidize city golf courses under the present situation. He supports option 3. and volunteers to sit on the evaluation committee.

Jackson: Glad that any notion of selling the assets is off the table. Public/private partnerships are flourishing. Supports the recommendation to see whether we can be more efficient in a partnering deal. Content with recommendation and amendments.

McHattie: Is this the same process as in 1999? What happened? The state of flux continues? Back then we lost golfers because of raised fees. Staff are wondering about their future.

Morelli: Things were terminated (in 1999) because Council did not have the heart to proceed.

Merulla: The wording of the RFP is vital. We all need to be involved.

Whitehead: Do we have the cost figures for the City to make a bid?

Fenwick: The golf course reserve will be needed to put in a bid.

Tolis: If staff is asked to put in a formal bid, we will hire an outside consultant to remove staff. It would cost about $30,000 to $40,000 from the reserves.

All in favour as amended: Carried.