October 14, 2020

Current Context

  • Toronto has the largest shelter system in Canada.
  • 75 shelter/respite sites sheltering approximately 7,000 people every night, including the almost 3,000 people already sheltered in hotel/family settings prior to the pandemic
  • 11 locations are operated by the City and 64 programs are operated by community non-profit agencies
  • The City has implemented an inter-governmental and sectoral response to COVID-19 involving the city, provincial/federal government, provincial healthcare sector, and community non-profit
  • Phased approach to prioritize actions based on impact analysis
  • Tiered approach has been able to respond to each stage of the pandemic
  • Primary goal is to save lives and make sure the health care system does not become overwhelmed
  • Toronto Public Health is regularly updating the status of COVID-19 cases in the shelter and 24-hour respite site system.

Three-Tier Response

Tier 1: Prevention

  • Maintain and enhance strong Infection Prevention and Control measures
    • Provide ongoing updated guidance, training and resources to all providers, including regular webinars with the sector
    • Following all provincial public health recommendations
    • Provided funding ($6.1 million) to all shelters, 24 hour respite sites, and drop ins for IPAC, Personal Protective Equipment (PPE), and wage increases
    • Directly distributed PPE supplies to providers from our own limited supply
    • City is currently distributing more than 100,000 pieces of PPE to the homelessness sector for use by staff per week.
    • Advocate to the federal and provincial governments to prioritize access to PPE for frontline shelter workers
    • A Toronto Shelter Directive was issued requiring use of masks and face coverings for all frontline shelter and outreach workers as well as clients
  • Physical distancing in the shelter system
    • Provided guidance on maintaining physical distancing:
      • Adding visual cues throughout buildings, including in common staff spaces to assist clients and staff in maintaining physical distancing
      • Staggering meal times and/or providing meals to rooms, where possible
      • Staggering or limiting use of common areas
    • For those who were not, we have focused on reducing their capacity and relocating people to other sites
    • All shelters are now meeting physical distancing requirements
    • A Toronto Shelter Directive was issued confirming that all sites are required to maintain physical distancing to meet current public health guidance for shelter settings during the pandemic.
  • New temporary facilities opened
    • Since March 2020, we have opened more than 40 temporary facilities for physical distancing in our shelter system and provide spaces for people to move indoors from encampments.
    • This includes:
      • 2,600 spaces created in at least 27 temporary shelter and hotel programs for physical distancing
      • At 19 hotels that are operational for physical distancing and for isolation/recovery
      • More than 2,000 people moved into housing through the Rapid Access to Housing Initiative, housing allowances, and rent-geared-to income housing
      • Over 900 people moved from encampments into safe indoor spaces in shelters and hotel programs
    • Working with Inner City Heath Associates (ICHA) and our health sector partners to identify those at greatest risk to move first (Risk Stratification)
    • Staff will continue to monitor and expand sites as needed
    • Outreach and encampments
      • Opened City-operated facilities with showers, washrooms, and drinking water for individuals experiencing homelessness.
      • Enhancing street outreach response strategies for COVID-19:
        • Focus on safety of encampments
        • Increase cleaning and garbage removal
        • Active screening for symptoms, referral to testing and isolation
        • Provide information on physical distancing strategies for encampments
        • Provide hygiene kits and information to prevent transmission
      • Access to safe indoor spaces through temporary respite programs, hotel spaces and housing options with supports
    • Launched the new Interim Housing Program to move clients sleeping outdoors into interim housing located in a vacant apartment building with up to 130 units that were leased from a local developer. The program closed on August 28, 2020 and all clients have been relocated to other temporary programs located across Toronto or moved to permanent housing

Tier 2: Mitigation

  • Screening and testing for COVID-19
    • Standard screening processes using Toronto Public Health guidelines at all points of entry by phone or in person
    • Active ongoing screening and monitoring of clients and staff at all sites, using a Screening Tool for Homeless Service Settings
    • Transportation for clients provided directly to assessment centres for testing
    • More than 790 clients transported for assessment
    • Advocated to prioritize testing in shelter and respite settings.
    • SSHA and Toronto Public Health have partnered with the health care sector and continue to implement mobile testing at shelter locations as part of outbreak management strategies. We are following all provincial public health testing guidance for congregate settings.
    • Over 4,900 individual tests have been administered through 98 mobile testing sessions.
  • Isolation programs
    • Created a dedicated isolation program with appropriate health supports for people identified through screening and assessment processes that are waiting for test results. Program was the first program of its kind in Canada.
    • More than 774 clients have been provided space for isolation with medical supports
    • Isolation program available for people who are close contacts of confirmed cases and require isolation for 14 days
  • Isolation hotel site for people who have traveled in past 14 days was available in the first weeks of the pandemic. Demand has now decreased due to federal policy on border closure

Tier 3: Recovery

  • Recovery programs
  • As of April 16, 2020, the first recovery new program was activated and can support up to 200 people. On May 8, a second recovery program at another downtown located was activated for up to 250 people. The two recovery/isolation programs have since been consolidated.
  • To date, more than 450 clients have been provided isolation space to recover
  • Innovative collaborate program model, with integrated health, harm reduction and peer supports
  • Provides isolation space for those not sick enough to be in hospital, to reduce pressure on the acute care system and prevent the transmission of the virus within the shelter system
  • Rapid rehousing
    • Rapid rehousing to prioritize those in shelter for access to vacant Toronto Community Housing units
    • Referred through Coordinated Access and provided supports
    • Fully furnished units, in partnership with Furniture Bank
  • Leveraging investments for permanent housing
    • Unprecedented expansion of services presents an opportunity to leverage investments
    • To secure these properties through purchase or long term lease to secure for future affordable and supportive housing
    • City will be advocating for future stimulus funding from federal and provincial governments
    • Move quickly to take advantage of this opportunity to advance longer terms solutions to homelessness
  • Ensuring housing stability

Communication & Partnership

Built on a foundation of strong communication and partnership:

  • Working closely with our sector networks to implement response
    • Toronto Shelter Network, Toronto Drop in Network and Toronto Alliance to End Homelessness
  • Hosting regular webinars in partnership with Toronto Public Health
  • Partnerships with health care sector through Inner City Health Associates, Inner City Family Health Team, University Health Network and the Toronto Centre Local Health Integration Network (LHIN)
  • City Community Response Table meets daily and includes representation from more than 30 agencies across Toronto and 11 City divisions
  • United Way partnership to coordinate supports across all neighbourhood organizations and agencies