July 12, 1999
To:Board of Health
From:Dr. Sheela V. Basrur, Medical Officer of Health
Subject:Impact on Public Health of Implementing the Report of the Task Force on Community Safety
Purpose:
This report outlines the impact on Public Health of implementing recommendations emerging from
the report entitled "Toronto. My City. A Safe City. A Community Safety Strategy for Toronto."
Financial Implications:
The full financial impact of implementing the recommendation to establish a Substance Abuse Sub-committee of the Board
of Health and to administer the Youth Mentoring program within Public Health's operating budget is still to be determined.
It is envisioned that costs will be absorbed within the Division for the 1999 fiscal year although additional resources may
be required during the 2000 budget cycle.
Recommendations:
It is recommended that:
(1) The Board of Health implement the recommendation to establish a Substance Abuse Sub-committee of the Board of
Health according to the proposed membership and terms of reference outlined in Appendix B.
(2)The Board of Health support the transfer of the Youth Mentoring program from the Healthy City Office to Toronto
Public Health, effective September 1, 1999, with a view that the Medical Officer of Health investigate sources of funding
beyond the 1999 fiscal year; and
(3) The Board of Health forward this report to the Community Services Committee via the Children's Action Committee.
Background:
On March 2, 1999, City Council adopted the recommendations contained in the February 1999, report from the Task Force
on Community Safety, entitled "Toronto. My City. A Safe City. A Community Safety Strategy for the City of Toronto".
The report directs the Chief Administrative Officer to report to the Policy and Finance Committee on recommendations
requiring funding beyond the approved Departmental budgets but does not identify any sources of funding for specific
divisions to implement the recommendations.
The Task Force's recommendations are in the areas of community mobilization, tougher by-law enforcement and
addressing the root causes of crime. They are therefore multi-faceted and span a number of City divisions. Some
recommendations require that Public Health take a lead role while others place Public Health in a partnership role with
other divisions and community agencies. A full synopsis of the recommendations are listed in Appendix A.
Comments:
The following recommendations (see Appendix A) identify Public Health as the lead:
- Substance Abuse Sub-committee of the Board of Health: (Recommendation #9)
The report recommends that the Toronto Board of Health appoint a substance abuse sub-committee to deal with the
community impact of illicit drugs and other harmful substances.
Prior to amalgamation, Boards of Health in the former cities had committees and/or task forces that addressed the issue of
substance abuse. The former City of Toronto had a Mayor's Task Force on Drugs, a Board of Health Sub-committee on
Substance Abuse and an Alcohol Advisory Committee. North York had a Mayor's Advisory Committee on Substance
Abuse Prevention while Scarborough had the Special Committee on Alcohol and Drug Abuse. The new City's Special
Committee to review the Final Report of the Toronto Transition Team (The "Miller Committee"), recommended that the
Board of Health establish a body to address substance abuse issues and their effects on communities and neighbourhoods
across the new city. This recommendation was put on hold pending the report from the Task Force on Community Safety.
The Task Force's recommendation is important given the continued popularity of drug use among youth and adults.
However, special attention also needs to be given to alcohol consumption, since alcohol is still the drug of choice for both
youth and adults. This is demonstrated by the fact that 80% of Torontonians consume alcohol and there has been a
significant increase in the number of youth and adults who report consumption of five or more drinks on one occasion. The
resulting risks lead to increased injuries, impaired driving, violence, as well as physical and emotional consequences for the
individual.
It is therefore timely that the Board of Health strike a Substance Abuse Sub-committee with special attention being given
to addressing both drug and alcohol issues as they impact on local communities (see Appendix B for proposed terms of
reference and membership).
For 1999, it is proposed that Public Health provide some staff support to the Sub-committee to augment the City Clerk's
support functions. During the 2000 budget cycle, the Board of Health must assess the mandate and anticipated workplan of
the Sub-committee to determine the resource implications for Public Health in supporting this.
- Coordination of Substance Abuse Policies in Schools: (Recommendation #14)
The report recommends that Public Health work with Boards of Education, police and appropriate agencies such as the
Centre for Addiction and Mental Health to co-ordinate efforts to combat substance abuse in schools.
It should be noted that all the Public Health units in the former municipalities worked in partnership with local school
boards in co-ordinating substance abuse policies. More specifically, both school and community partnerships focussed on
education, prevention, assessment, referral and grants programs.
With amalgamation, there are many opportunities for former linkages to be strengthened and new partnerships to be
created. To this end, Toronto Public Health will continue to partner with the Boards of Education, Toronto Police Services,
the Centre for Addiction and Mental Health, youth treatment agencies and the appropriate community agencies.
Toronto Public Health will also partner with Boards of Education in response to the new Ontario Physical and Health
Education Curriculum which outlines specific expectations for the prevention of substance abuse among students in grades
1 through 10. Public Health will provide some resources, expertise and advice in effective drug prevention programming.
- Youth Mentoring: (Recommendation #16)
The report proposes that the one-on-one school based Youth Mentoring program be expanded City wide and that Public
Health administer the program which is currently housed in the Healthy City Office.
In 1996, the former City of Toronto undertook a unique in-school Youth Mentoring program in partnership with the
Toronto Rotary club and the police for students identified as in need of a caring, one-on-one relationship with an adult. The
intent of the program is tutorial enhancement and assist children to improve their study skills. The program was initiated in
two inner city schools, staffed by carefully screened and trained employees of the former City of Toronto, each of whom
met with a designated child weekly during the lunch hour.
Mentoring programs have been shown to be successful in increasing self-esteem and discouraging school drop-out. The
current 30% drop-out rate in Toronto, and the growing number of children living in poverty who are at extremely high risk
for school drop-out, underscore the need for such programs. Furthermore, with volunteer staffing, the program is extremely
cost-effective.
An evaluation of the program was conducted by Public Health staff. It indicated a high degree of success and enthusiasm
for the program by the students, teachers and mentors. The strong, positive relationships established have been meaningful
for both the child and adult mentor.
Public Health is committed to this program and is willing to administer it for 1999. However, this will require reallocation
of resources to enable staff to co-ordinate the program. It may be necessary to seek other sources of funding to enable it to
continue in 2000. This issue will be raised with the Children's Action Committee.
- Improving Parenting Supports: (Recommendation #15)
The report recommends that Public Health work with Community and Services Committee, Children's Services, school
boards, police, senior levels of government and appropriate community agencies to develop a list of parenting supports and
to identify priorities and gaps in service. The need to find potential funding sources to expand the service is also
mentioned.
Toronto Public Health's Healthy Babies, Healthy Children program has an established network of health and social service
providers and has developed an inventory of over 500 programs and services for children and families. The Network has
also identified some gaps in service. Public Health will continue to work with this network to address these gaps, identify
resource priorities and find potential alternative sources of funding.
- Youth Employment/Job Skills and Community Safety: (Recommendation #19)
The report recommends that the City of Toronto continue to support and expand youth employment initiatives that
combine job readiness and job creation with community safety enhancement. Such initiatives include the Graffiti
Transformation, Ambassador Program, and Youth Job Corps Programs.
Public Health will continue to be proactive in developing both internal and external partnerships to create job opportunities
geared to youth. Of notable importance is Public Health's innovative Ambassador Partnership to prevent school drop-out
for at risk youth which is currently in its tenth year. The program is being evaluated to ensure its continued effectiveness,
as well as to ascertain other funding sources to enable the program to continue to be relevant for youth at risk.
The following recommendations require Public Health to continue working with other City divisions and/or community
partnerships:
(6)Coordination of Child and Youth Violence Prevention Across the City: (Recommendation #13)
This recommendation suggests a multi-sectoral approach to children and youth violence prevention across the city, both in
co-ordinating anti-violence resources and in the development of a case management referral protocol. Toronto Public
Health sees violence as a public health issue and has played a pivotal role in violence prevention through case management
activities, educational sessions, consultation, and resource development both in the schools and community.
The following highlights some of Public Health's innovative programming in the area of violence prevention.
The Healthy Babies, Healthy Children program, a joint Ministry of Health/Ministry of Community and Social Services
prevention and early intervention program, promotes optimal physical, cognitive, communicative, and psycho-social
development in children who are at risk. The program objectives are to support children who are at risk, increase parenting
ability in high risk families, and increase the proportion of high risk children achieving appropriate developmental
milestones.
A collaborative and creative program with a focus on violence awareness and prevention is the "Kids Have Stress"
program which was jointly developed by Public Health, Toronto District School Board and other community partners.
Public Health has been pivotal in establishing a protocol for homeless and street-involved youth with a consortium of
community based service providers. The intent of the protocol is "to ensure the best interests, protection and well-being of,
and to improve access to services by homeless and runaway youth under sixteen years of age who refuse to involve
themselves with traditional services or for whom such services may be inappropriate".
Public Health has also been instrumental in the establishment of "The Drug Treatment Court" which is a collaborative
effort between the Centre for Addiction and Mental Health, the Criminal Justice System, the Toronto Police Services, the
Healthy City Office, Toronto Public Health and various community-based agencies. The objective of the Drug Treatment
Court is to reduce the number of crimes committed to support drug dependency, and to connect people to the range of
community services available to deal with the related social, health and economic needs of addicted individuals.
7. Drug Abuse Prevention Community Grants Program: (Recommendation #10)
Public Health will continue to administer the program. The Grant Review Committee has allocated additional annualized
dollars to increase the Drug Abuse Prevention Program from $500,000 to $626,100 to enable the program to be delivered
across the city.
8. Additional Recommendations:
Other recommendations where Public Health is specifically named i.e. "A Safety Audit in Every Neighbourhood" (#1);
"Problem Properties" (#5); "Promoting and Awarding Excellence" (#26); "Community Safety Grants" (#27); "Staff and
Community Leaders Working for a Safer City" (#28). These will require staff from Public Health to work collaboratively
with other City divisions and/or community partners on implementation. No immediate financial impact is anticipated
since these activities will be considered as part of the respective staff's work assignment. Depending on the outcome of
these initiatives, there may be resource implications for continued Public Health involvement in the future.
9. Recommendations Where Public Health is Not Specifically Mentioned:
Recommendations such as "Putting Pedestrians First" (#3); "Provision of Quality Recreation to Children, Youth and
Families at Risk" (#17); "Self-Defense Classes" (#18) may have implications for Public Health, but do not require
immediate allocation of resources. Staff will monitor the implementation of these and will provide input and support where
necessary.
Conclusion:
This report outlines the financial implications for Public Health in implementing the recommendations of the Task Force
on Community Safety. Many of the recommendations are central to Public Health's mandate and can be done within the
current staff complement. However, others require reallocation of resources and should therefore be monitored and
evaluated to determine whether ongoing involvement is possible without additional resources. Public Health will continue
to work collaboratively with other divisions within the Corporation as well as community partners to ensure
implementation of these recommendations.
Contact Name:
Liz JanzenConnie Clement
Regional DirectorDirector
Tel:392-7458Public Health Planning & Policy
Fax:392-0713Tel:392-7463
Fax:392-0713
Dr. Sheela V. Basrur
Medical Officer of Health
Appendix A
(as per "Toronto. My City. A Safe City. A Community Safety Strategy for Toronto" Report)
1."Strengthening Neighbourhoods" - Community Mobilization
