January 15, 1999

To:Board of Health

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

Subject:Harmonization of Food Access Grants

Purpose:

To respond to the Board of Health's request for information on restoring and funding Food Access Grants and appropriate staffing levels to deliver the grant program in 1999 and beyond.

Source of Funds:

No source of funds has been identified.

Recommendations:

It is recommended that the Board of Health select one of the following service options for food access grants and request Municipal Grants Review Committee to recommend the additional funding required within the 1999 budget approval process:

(1)Establish an optimal service level for city-wide Food Access Grants at a new cost of $1,000,000 in operating grants, and $500,000 for capital grants targeted outside the former Toronto with $152,370 for grants administration, for an additional cost of $550,790 in 1999 and $1,652,370 in 2000 and subsequent years; or

(2)Establish a partnership funding model for city-wide Food Access Grants as in Option A with the City of Toronto contributing $750,000 and seeking additional funding of $750,000 from community foundations (if additional funds cannot be secured, the program would operate at a reduced level based on the municipal funding portion of $750,000 and any matching funds which could be secured), with at an additional cost of $300,790 in 1999, and $902,370 in 2000 and subsequent years; or

(3)Do not re-establish a Food Access Grants program.

Background:

In March 24 1998 the Board of Health adopted the report "Improving Food Access in Toronto: A Report on the former City of Toronto Food Access Grants program 1996-98. The Board approved in principle the restoration of the Food Access Grants program in the 1999 grants cycle and requested the Medical Officer of Health to report back on how the program should be funded and administered.

Only a small number of programs are being brought forward for harmonization or expansion in the 1999 budget cycle. Food Access Grants is one of the programs prioritized for harmonization because it responds to the needs of Toronto's burgeoning homeless and low income population. Pursuant to direction received from City Council in November, the Chief Administrative Officer is preparing a city-wide report on service level harmonization to the Strategic Policies and Priorities Committee, which will be referred to local Community Councils and then to Standing Committees. That report will include the harmonizations options contained in this report.

Need:

Increasing hunger and limited ability to obtain a healthy diet compromises nutritional status and imposes emotional stress and stigma on vulnerable communities and individuals in Toronto. The need for strategies to decrease hunger and improve access to food across the city is demonstrated by the following data related to food access and health:

(a)Significant levels of poverty exist in Toronto. Data from the 1991 and 1996 census show the number of low income families increased in over 90% of Toronto census tracts and median incomes declined in each community council area. Over 27% of Toronto residents now have incomes below the Low-Income Cut-Off (LICO).

(b) Poverty and homelessness contribute to situations where people are unable to afford, store, prepare or obtain nutritionally adequate food or special diets for health problems.

(c)Nutritional problems in the population overall (too many calories from fat, less than the minimum required vegetable consumption) are even more pronounced among those experiencing poverty or homelessness (e.g. a 1998 study of women and children using Toronto food banks found inadequate intakes of iron, magnesium, Vitamin A, folate, protein, zinc and calcium - nutrients that affect prenatal and infant health and increase risk of chronic disease).

(d)Recent surveys of food bank users in Toronto document that families use coping strategies to stretch minimal resources (put off paying bills, give up telephone and other services, go without food, sell or pawn possessions) before resorting to food banks, and many experience hunger in spite of charitable food assistance.

(e)The number of people assisted by food banks in the GTA increased by 44% from October 1990 to October 1996 and, by late 1997 135,000 persons per month were served, of whom 39% were children.

(f)According to data from the Foodlink Hotline, the number of food access programs in each of the former municipalities ranges from a low of 20 to a high of 600. Agencies providing these programs, particularly those outside the former Toronto, identify a serious lack of resources to meet increasing demand for services, and could benefit, particularly, from capital funds to improve kitchen facilities.

(g)Using data from Daily Bread Foodbank User Profiles and experiences of agencies such as Foodshare, it is estimated than more than 100,000 people in Toronto could benefit from Food Access Grants. Current programs are only meeting about a quarter of the need.

Effective prevention:

Many of those requiring food assistance have incomes so low that major changes in income and employment support programs are required for effective prevention of hunger and poor diets. However, strategies that increase access to food and fund community facilities such as kitchens to support group nourishment programs have been shown to reduce hunger and improve nutrition.

Working with the community to improve access to nutritious, safe and affordable food is a requirement of the Ministry of Health's 1997 Mandatory Health Programs and Service Guidelines. Collaborative food access initiatives range from emergency relief to building community capacity to grow, obtain, and prepare food (e.g. Good Food Box programs; community gardens; community kitchens; food skills development programs; perinatal drop-ins; congregate meals; and community-based catering, delivery and food service businesses).

In 1995, the former Toronto City Council established a $2.4 million Food Access Grants program with funds from the Canada/Ontario Infrastructure Works Projects, the Parking Authority of Toronto, and from housing joint venture projects. Funds were allocated as follows:

(a)$500,000/year for two years for purchase-of-service contracts with organizations providing low-cost food to low-income people; and

(b)A one-time capital allocation of $1.4 million to expand existing food programs.

In total, 127 projects were funded. Approximately 20% of the grant money was allocated to emergency programs (e.g., Out of the Cold), 40% to perinatal and child nourishment programs, and 40% to food access programs serving adults and seniors, including community economic development projects. Grants have supported these programs primarily through provision of high quality food (emergency relief, as a component of effective programs, as a tool for skill development, reducing isolation, etc.) and by building the capacity of the organization to deliver effective programming (project and volunteer coordination, skill development, fundraising and capital improvements).

An evaluation in early 1998 revealed that with small amounts of money (most programs received less than $10,000) these programs:

(1)Increased access to nourishing, safe food;

(2)Improved nutritional quality of food;

(3)Developed new small businesses and jobs;

(4)Improved food selection and preparation skills;

(5)Increased community accessibility and reduced isolation;

(6)Improved facilities for food programs; and,

(7)Spawned additional programs above and beyond those funded by the grants.

Current service issues:

The former Toronto program was a two-year initiative (1996 and 1997) and was therefore not included in the new city's 1998 amalgamated budget. Some of the original funding supported the operation of programs into 1998. The Community Services Funds and the Housing Initiatives Fund have both provided limited funding for food programs at Drop-Ins and Out of the Cold programs in order the enhance the effectiveness of their programs. However, without Food Access Grants the 1100 existing food access projects in Toronto are anticipated to experience major service reductions and failures. It should be noted that the number of persons served by food banks has remained high despite pressures on service agencies that reduce food availability, food bank hours and that have resulted in the closure of nine agencies between 1996 and 1997.

Options for Program Re-establishment

Option A: Optimal Food Access Grants

This option establishes annual city-wide funding for operating grants of $1,000,000. This is a level double that of the program in the former Toronto. This will be a dilution from the amount distributed across the former Toronto in the past, resulting in unmet needs in that district but a response to growing needs in other parts of the city. Annual capital grants of $500,000 (equal to 36% of the total program in the former Toronto) would be targeted to areas of the city that did not benefit previously from Food Access Grants. The enhancement of community kitchen facilities in the former Toronto funded by the capital component of the former Food Access Grants program continue to be a resource to support food access programs in that area.

The Food Access Grants program will be modelled on the former program because the evaluation clearly showed its effectiveness in achieving substantial benefit and community impact. Based on the experience of the former Toronto program, we would anticipate at least 200 applications for projects covering the full range of effective food access programming described above. Assuming a similar pattern of grant disbursements, approximately 150 programs would be funded, serving the needs of an additional 20,000 - 40,000 people. The type of support is anticipated to be similar to that provided by the former Food Access Grants program with the largest share of funding going for food and staffing. Staffing provides for volunteer and project coordination and fundraising to enhance the long term sustainability of the food access projects.

Program staff perform functions essential to the success and accountability of grants programs (e.g. community consultation and development, assessing proposals, briefing and staffing review panels, appeals, monitoring projects, preparing reports, workshops and application formats, policy development). Accordingly, additional staff are identified as part of this service option.

Anticipated outcomes include: increased access to nourishing, safe food; improved nutritional quality of food offered by agencies; improved food selection and preparation skills for many program participants; reduced isolation for at-risk people; reduced food bank use by program participants; and self-reported improvements in health.

Option A achieves geographic equity in the distribution of food access strategies according to need, reduces hunger and poor nutrition, builds skills and capacities for sustainable community-based initiatives, potentially doubles the number of people benefiting from food access programs and meets legislated requirements to respond to local needs. While not dependent on partnership funding, these grants are likely to leverage additional community funds to further reduce the gap between needs and service access.

Option A requires an annualized budget of $1,652,370, $1,000,000 for operating grants city-wide, $500,000 for capital grants, and staffing at the level of 2.5 FTEs: 1 FTE community grants officers, 1 FTE nutritionist and 0.5 FTE clerical support at an annual cost of $152,370. Given current grants cycles, a limited grants program could be offered in 1999 at approximately 1/3 of the annualized cost. A year-long grants program would be operational by 2000.

Option B: Partnership Funding Model for Food Access Grants

This option establishes a partnership funding model for city-wide food access grants that achieves the target of $1.5 million on an annualized basis as in Option A but based on a funding partnership with community foundations. A successful partnership, yet to be secured, would see the City of Toronto contributing $750,000 and foundations providing additional funds of $750,000. The ability to use grants to leverage this amount of additional funding from community partners is unknown. If additional funds could not be secured to match the city contribution, the program would operate at lower levels with the $750,000 provided by the City of Toronto and any additional community funds which could be secured.

If a successful partnership is secured, this option provides funding for a broad range of food access projects across the city, as in Option A. If the program operates only with the City of Toronto contribution, grants would be targeted to projects focussing on the most vulnerable including the homeless, "at-risk" and "high risk" pregnant mothers and infants, and nutritionally-compromised seniors.

If fully funded, option B would reduce geographic inequities in access to services according to need, reduce hunger and poor nutrition, enhance skills and capacities and meet legislated requirements to respond to local needs. The impact of the program will depend on the extent to which matching funds can be secured. A reduced grant level meets a portion of local needs but leaves the majority of local needs unmet and results in continuing high pressure on food banks and lower quality diets for at-risk populations.

This option, with full partnership funding, requires staffing at the same level as Option A -- 2.5FTEs at an annual cost of $152,370. While the level of grants administration activity may be somewhat reduced in the early years as compared with Option A, it will be more than offset by efforts to secure partnership funding. Given current grants cycles, a limited grants program could be offered in 1999 at $500,000 (1/3 the annualized cost) with staffing costs of $50,790 in 1999 with the full grants program operational by 2000.

Option C:Do Not Re-establish a Food Access Grants Program

Most of the 1100 food access projects that exist in the City are in precarious financial situations. We anticipate that the absence of Food Access Grants will result in significant service reductions, the potential failure of many community programs, increased demand on food banks, and a lower quality diet and increased risk of ill health for many unserved populations. Over half of the projects funded by the former Food Access Grants are at risk of failing due to the absence of adequate funding.

If no Food Access Grants are provided, substantial identified local need will remain unmet, hunger and poor nutrition will continue to increase in Toronto, and geographic inequities and service gaps will remain.

Program Budget and Budget Options:

Table 1

Service Impact of Program Options and Budget

Table 2

Budget Impacts of Service Options for Food Access