August 28, 1998

To:Board of Health

From:Dr. Sheela V. Basrur, Medical Officer of Health

Subject:AIDS and Drug Abuse Prevention Grants Review

Purpose:

To inform the Board of Health about the process and outcome of the review of the AIDS and Drug Abuse Prevention (DAPP) grants programs.

Source of Funds:

Not applicable.

Recommendations:

(1)That the Board of Health endorse the findings from the community consultations on the operation of the AIDS and Drug Abuse Prevention (DAPP) Grants programs;

(2)That the Board of Health forward this report to the Municipal Grants Review Committee;

(3)That the Board of Health recommend that the Municipal Grants Review Committee consider levelling up other municipal grants programs, using the principles endorsed by the Board of Health in Investing in Public Health (Board of Health, March 24, 1998).

Background:

At its meeting on March 4, 5, 6 through Clause No. 15, Report No. 3 of the Strategic Policies and Priorities Committee, City Council established a Municipal Grants Review Committee to oversee the development of a Municipal Grants Policy. Councillors Johnston and Jones were appointed to the Committee from the Board of Health. A Grants Managers Workgroup was also established to review procedures and consult with the community. Public Health staff participated on the Workgroup and initiated a review of the procedures of the AIDS and DAPP grants programs, including community consultations. Preliminary findings were reported to Municipal Grants Review Committee on July 27, 1998 and the final report will be considered by the Committee on September 28. This report is an opportunity for members of the Board of Health to review the findings of the public health consultations and to forward recommendations to the Municipal Grants Review Committee.

Comments:

Community consultations were held with key stakeholders of the AIDS and DAPP grants programs, regarding procedures, principles, and priorities. A background paper on each program was distributed to funded groups and agencies, and participation was encouraged at consultation meetings and through comments directly to staff. The AIDS and DAPP Review Panels, in consultation with staff, facilitated separate consultations attended by representatives from funded groups and agencies, staff from health districts in Toronto without similar grants programs, and staff from similar provincial and federal funding programs. The review panel co-chairs -- Councillor Rae (AIDS); Councillors Bussin and Korwin-Kuczynski (DAPP) -- facilitated discussions. Forty-five participants attended the AIDS consultation and 57 attended the DAPP consultation.

Key Practices/Issues Reviewed:

The background papers and consultation agendas for the AIDS and DAPP consultations varied somewhat, depending on the issues confronting each program. Overall, the common issues addressed relate to:

a) eligibility, application, assessment, approval and appeal procedures;

b) staffing, reports and administration procedures;

c) principles guiding the grants programs; and

d) priorities and level of funding for each grant program.

Findings:

In general, participants in the consultation meetings indicated a high level of support for the procedures, principles, and priorities of the AIDS and DAPP grants programs, while identifying the need to expand the programs throughout the new City.

In summary, participants suggested the following:

a)Eligibility, application, assessment, approval and appeal procedures:

i) More time should be allowed between issuing applications and the application deadline;

ii)Review panels, made up of City Councillors/Board of Health members and informed citizens, should retain lead roles in both the review and appeal process, with appeals being made before the appropriate review panel; and, in the case of AIDS Prevention, it is important to continue involvement of people living with HIV or AIDS.

b)Staffing, reports and administration:

i) Current staffing levels should be maintained to ensure the type of contact and relationship between agencies and staff that has occurred to date; i.e., staff involvement in development of projects/groups, application development, reporting and on-going support;

ii)Staff should maintain site visits and twice-yearly written reports; staff should clarify with funded projects how reports are utilized in monitoring and assessing project activities;

iii)Staff should explore mechanisms to provide funding of more than one year's duration and how to support core/sustaining funding in addition to project funding. This exploration could occur in the Municipal Grants Managers Workgroup.

Another key challenge facing the AIDS Prevention grants program is an historic accounting practice that relies on program approvals in one fiscal year to authorize spending, which is split between two fiscal years. Public Health staff are working with staff in various other service areas to develop proposals to resolve this situation.

c) Principles:

i) Public Health grants build community capacity for local initiatives in areas of strategic importance. Public Health grants approval, appeals, management and delivery should remain within the Public Health Division, with the Board of Health having program authority (See also (a) above, regarding review panels).

d) Priorities:

i) No significant changes in priorities were suggested;

ii)Public Health should consider mechanisms to open access to grants to groups in other parts of the new City, how to balance funding of City-wide projects and service organizations, with local neighbourhood/district projects; and balancing projects targeted to at risk and high need populations, with projects targeted to general need populations;

iii)Levelling up for both Public Health grants programs was strongly supported by consultation participants, using the formulas outlined in "Investing in Public Health" (Board of Health, March 24, 1998). At the June 23, 1998 Board of Health meeting, the Board recommended that the two community-based funding programs be expanded across the new City of Toronto with appropriate funding, and that this needs-based expansion be reflected in the 1999 budget. At the July8, 1998 Toronto City Council meeting, City Council adopted this recommendation.

Additional rationalization issues confronting the AIDS Prevention grants program relate to increasing consistency in management of grants and AIDS, sexual health and STD contracted services; and finalizing policy and mechanisms related to currently separate service area funding programs. In order to increase administrative efficiency, funds will be transferred from the AIDS Grant budget to the contracted services budget for those agencies receiving on-going funding. For the same reason, additional funds are tentatively anticipated from the current Metro Community Services Grants budget to support those community groups receiving Metro grants for AIDS-related activities.

Conclusions:

The community consultations on the principles, priorities, and procedures were largely supportive of AIDS and DAPP grants programs. The Interim Report from the Municipal Grants Review Committee leans towards de-centralized grants programs in Toronto, using the model of the two public health grants programs. Up levelling of the grants programs should be considered in the 1999 budget cycle of the Board of Health, following formulas in "Investing in Public Health". A report describing operational details for the AIDS and DAPP grants programs in 1999 will be forwarded to the Board of Health in November.

Contact Names:

Michael Fay, Coordinator, Drug Abuse Prevention Program

Tel: 392-0807

Fax:392-0635

email:mfay@city.toronto.on.ca

Connie Clement, Manager, Sexual Health

Tel:392-7451

Fax:3921483

email:cclement@city.toronto.on.ca

Dr. Sheela V. Basrur

Medical Officer of Health