1. FAMSAC - AN EMERGENCY FOOD SERVICE IN NEPEAN

Councillor M. McGoldrick-Larsen presented correspondence from FAMSAC, an emergency food service in Nepean, asking that staff review whether any assistance can be provided to this agency.

2. Ottawa-Carleton Community Houses

Councillor W. Byrne requested information on the Community House Coordinator’s position, the role/authority of Ottawa-Carleton Housing with regard to that position and the procedure related to the disbursement of funds.

1. SUPPORT FOR RESOLUTION - COMPREHENSIVE EARLY CHILDHOOD DEVELOPMENT SERVICE

- Coordinator, Community Services Committee report dated 10 Feb 00

The Committee heard from Ms. Rachel Besharah, President, CUPE Local 2204, the Child Care Workers of Eastern Ontario. She said the Local has been involved in the national child care campaign, Child Care Now, which calls on the federal government to provide strong leadership on the National Children’s Agenda by making the February 2000 a children’s budget. The request is for $2 billion dollars in federal spending and a multi-year commitment to fund an Early Childhood Development Services fund. Regional Council is being asked to endorse the resolution before it today.

Ms. Besharah continued by saying that, in May 1999, the federal, provincial and territorial governments signed the National Children’s Agenda, developing a shared vision. The agreement is the result of three years of negotiations which commit these governments to work together to better coordinate programs and services to children and youth. The agreement also outlines values and principles which should guide government efforts to improve the lives of children and to ensure all children are healthy, safe and secure, successful at learning and socially engaged. Local 2204, together with 25 national organizations, is working to hold governments to these commitments. It is calling on the federal government to use the principles outlined in the National Agenda, to work in tandem with provincial and territorial governments to develop a national strategy on early learning and care services based on principles that should include:

Ms. Besharah said the local network of child care services has been meeting with MPs and MPPs to put forward its vision of quality child care. Local 2204 is asking the federal and provincial politicians to look at Québec’s universal, five dollar a day child care and education system as an example of what is possible. Local 2204 requests that Regional Council send a strong message to the federal government by supporting its resolution, by standing with CUPE in support of a national system of early learning and care services that promotes high quality child care, the kind of care that best supports the healthy development of children.

Councillor A. Loney wanted to know if the Québec government’s program is strictly a non-profit program. Ms. Shellie Bird, Education Officer for Local 2204, replied that the goal is for the system to be non-profit, but currently, it is in a transition period and funding the for-profit sector. The Québec government’s hope is that, over the long term, the for-profit sector will voluntarily become non-profit programs. Ms. Bird added that the fact that Québec has implemented such a system is a good example of what is possible in terms of creating a comprehensive system. Councillor Loney asked if he could conclude that the child care community was prepared to have a program like Québec’s even though it is not totally non-profit in the beginning, to achieve universality. Ms. Bird replied that the goal is to have a non-profit system; how this is achieved will need to be discussed within the community.

Ms. Hightower pointed out that the federal government has long been promising a national child care program and now is the time to act on this promise. She spoke in support of the principles of a comprehensive early childhood development service, one that is not-for-profit and universally accessible. Ms. Hightower expressed the hope that the Region will support and adopt the Resolution and encourage the Province to work with other levels of government to ensure a National Children’s Agenda.

Councillor W. Byrne moved the Resolution outlined on p. 2 of the report. She said the point is well made that governments have to start working together towards a universal, non-profit child care system to benefit families and children. She recalled that the promise was first made in 1993, and was an indication of the importance of such an initiative. The Province of Québec has at least taken steps to move forward as opposed to waiting for the federal government to act. Councillor Byrne said it was timely to remind the Liberal government of its promise, of its obligation and of the community’s expectation to see that obligation met.

Moved by W. Byrne

REGULAR ITEMS

2. AMBULANCE HEALTH SERVICES UPDATE
- Co-ordinator, Community Services report dated 10 Feb 00

Ms. Joanne Yelle-Weatherall Director, Land Ambulance Services, presented the staff report. She began by providing background information on the provincial downloading of ambulance services to the Upper Tier Municipalities in 1998. At the time, the Province had indicated that the cost of ambulance service was $8 million, but the Region was billed $14 million in for 1998. In 1999, the Province announced a cost-sharing arrangement of 50/50 with the Region, and a delay in the transfer of the service to January 1, 2001. Ms. Yelle-Weatherall indicated that, from the outset, staff have consistently stated ambulance service is seriously under-funded and the real cost of providing a service to meet the needs of Ottawa-Carleton residents will be between $20 and 25 million per year.

Ms Yelle-Weatherall reiterated that the key is dispatch and, without it, there can be no performance-based system: the Region can only provide funds and hope for the best. She indicated that the Regional Chair, Bob Chiarelli, has written to the Province seven times, and there has still been no response. The latest deadline of a response by 15 February has come and gone. Ms. Yelle-Weatherall said staff remain optimistic that a decision is forthcoming, based on recommendations from the Joint Provincial AMO/MOH and Long Term Care (LTC) Land Ambulance Implementation Steering Committee (LAISC), but there is no indication of when and under what conditions. The next steps are for the LAISC recommendations to proceed to the AMO Board and to the Minister of Health and Long Term Care.

Ms. Yelle-Weatherall continued by saying that, in December 1999, Ministry of Health staff reported that legislated response times were not being met in over 100 communities in Ontario. Response times in Ottawa-Carleton are up to 50% longer than most other urban centres in the Province. She spoke about Regulation 501/97, Section 42, which may have a serious financial impact on the Region, since it decrees that response times for 1998 and beyond will be at the same level as those for 1996. Since urban centres in Ottawa-Carleton, such as Vanier and Ottawa, would get 50% funding for response times between 14 and 16 minutes, versus response times of approximately 10 minutes in other urban centres, the 1996 standard could constrain the Region’s efforts at improving pre-hospital care in Ottawa-Carleton. Ms. Yelle-Weatherall pointed out that the 1999 Ministry of Health and Long Term Care raw call data will be available in March, and staff anticipate response times will be worse, given the increase in calls and the fact that no additional service is being provided.

Ms. Yelle-Weatherall informed the Committee that the legislated requirement to select a service provider and inform the Ministry about the identity of the provider has been advanced to 01 September 2000 from 30 September 2000. In light of the fact that the issue of dispatch has not been resolved, and the shorter period of time for the new legislated deadline for Ministry notification, staff recommend the development of an in-house service for January 1, 2001. She said staff cannot explain why the Province is not forthcoming on the issue of dispatch. The Region has consistently indicated its willingness to take on ambulance services, and has demonstrated its intent in many ways, most recently by approving a capital transition budget of $3.6 million for 2000. These funds will be used to replace defibrillators and to purchase seven new ambulances and technology upgrades.

Ms. Yelle-Weatherall described the next steps in the process as follows:

The following interim measures that will be undertaken to address the current situation:

Ms. Yelle-Weatherall concluded her presentation by stating that, given the many unresolved issues, the advanced deadline for service delivery and future uncertainties, staff recommend that, subject to the resolution of certain labour relations issues, the Region directly assume ambulance service for a two year period, subject to review after that time.

The Committee Chair, A. Munter, asked whether any consideration has been given to following the lead of Hamilton-Wentworth and "early assume" ambulance services. Ms. Yelle-Weatherall replied that the system in Hamilton-Wentworth is a level of effort system; as well, many other issues would have to be taken into consideration. She added that staff might consider going in earlier if there were a positive response to the dispatch issue.

Councillor A. Loney posited there should be a number of ways to improve the current system by insisting on certain standards and providing more funding. The Medical Officer of Health, Dr. R. Cushman, said staff estimate it will cost between $4 to 6 million to salvage the existing system, however the specifics need to be worked out, as well as the 50/50 funding arrangement with the Province. He reiterated that, in order to provide a quality, performance-based system, dispatch is essential, however there are other efficiencies in the system. Dr. Cushman posited that having control of dispatch in a performance-based system would represent better return for investment. Councillor Loney wanted to know whether any consideration was given to developing two protocols for the RFP, i.e., one with dispatch and one without dispatch. Dr. Cushman reiterated that the goal has always been to have dispatch, and staff believe this is forthcoming. However, as the September deadline is fast approaching, and in light of many remaining uncertainties, staff recommend the service be taken in-house in the interim and re-evaluated after two years to determine whether or not to proceed with an RFP.

Councillor Loney asked why is was not possible to do an RFP for an ambulance system without dispatch. Ms. Yelle-Weatherall said staff’s position has always been that the Region shouldn’t be in the business if it doesn’t control dispatch and staff cannot be accountable to Council without having control over the system. There was never any consideration of an RFP for a level of effort service, as it would be extremely difficult to hold a provider accountable for performance if that provider didn’t have control over all the factors of production. Councillor Loney wondered if this meant that, if there is to be a lack of accountability, it should be in the public and not in the private sector. Dr. Cushman responded that staff may be coming back to Committee for periodic "transfusions", whereas a private sector operator runs the risk of under or over-bidding on the contract. In this instance, staff would have no control. Dr. Cushman indicated that, while he was not happy with presenting a single option, he believed it was the better of the two. Councillor Loney asked what would happen if the Region gave the ambulance service back to the Province. Dr. Cushman said the message would be that, while there is an adverse effect on the people of Ottawa-Carleton, ambulance service is a Ministry of Health responsibility: it should never have been downloaded to municipalities, the system is in disarray and the Province must "fix it". In the interim, the Region will pay 50% of the cost, but the responsibility lies with the Ministry.

Councillor H. Kreling said he wanted to understand why it was not possible to prepare an RFP with certain parameters, even if the result is not the preferred performance-based system and how improvements can be made internally without the performance measurement tools an RFP would provide. Ms. Yelle-Weatherall reiterated that, with staff running the system, there is direct accountability to Council, there are clear and specific corporate policies and levels of authority. In a private sector contract, the provider cannot be held as closely accountable for performance, and staff have legal advice to this effect. Ms. Yelle-Weatherall said that going to a level of effort system with a private operator has to be done through an RFP, since the legislation does not permit negotiation with a single private operator. Councillor Kreling asked whether any measurement tool exists. Dr. Cushman replied the standard tool is the response time. The factors of production are the problem. Staff maintain that, with an in-house system, the factors of production will be more fluid, and can be adjusted as the Region grinds along in its evolution to a high performance ambulance system. Dr. Cushman posited that putting the service in the hands of private operators would result in a loss of flexibility because of the lack of accountability. Councillor Kreling inquired whether staff have any indication of how many ambulances are needed in Ottawa-Carleton. Ms. Yelle-Weatherall replied that the paramedics are the ones who will make or break the system. Staff have had two years to gain expertise in performance-based systems and now feel confident they can run the system and make significant improvements.

Dr. Cushman indicated that, while staff do not have all the information they need, it is thought that a more rational deployment of vehicles and paramedics will improve the system. He added that, in the past two years, regional staff have gone through a dramatic learning curve, and their knowledge is as good as, if not better than, anyone in Ontario. Councillor Kreling said that, because the Committee is being asked to take in-house a service that could represent a $25 million expenditure, he would want to know how many paramedics and vehicles will be needed. Ms. Yelle-Weatherall informed the Committee that no one can respond to this question, because a detailed system design has yet to be done. Chair Munter wanted to clarify that the investments prior to January 1^st are an estimate, and that staff will report back to Committee and Council with a plan. Dr. Cushman, responding to a subsequent question from Chair Munter, indicated that the $20 to $25 million estimated cost of ambulance service was first presented to Committee and Council in May 1998.

Councillor D. Holmes pointed to the lack of co-operation from the Province so far, and she asked why staff believe the Province will agree to cost share any costs. Ms. Yelle-Weatherall responded by saying that, as a member of the joint Provincial AMO/MOH Committee, this matter has been the focus of a lot of discussion since response time figures were released. The provincial committee is dealing with the entire funding issue, and has been told by Minister E. Witmer’s parliamentary assistant that answers are forthcoming. There have been indications that the Ministry would entertain a plan from Ottawa-Carleton but no formal notification has been received.

Councillor Holmes asked why, with the advent of fire services and the current systems for police and other emergency services, there has been no movement towards creating a regional dispatch system. Ms. Yelle-Weatherall indicated this may be a long-term goal of the new City of Ottawa, as significant economies are to be gained in terms of overhead and equipment. This option was explored early in the process, but at this time, it cannot be set up, by law. Councillor Holmes wanted to know what would be the consequence of such an action.

Dr. Cushman replied there are three issues here:

Councillor C. Doucet said that the Province’s attitude has been frustrating to everyone. He spoke about knowing that something has to be done while being still unclear about the monetary implications. Dr. Cushman responded by saying staff have been analyzing the issue for two years, and are now recommending a less than perfect solution. The proposed infusion of funds will allow staff to look at some of the most salient problems and address those areas. By doing this, the Region will get better results and will better protect the people of Ottawa-Carleton.

At this point, Chair Munter read a Motion from Councillor A. Loney, calling for staff to proceed with an RFP for ambulance service, including dispatch.

The Committee heard from Mr. René Berthiaume, representing Rural/Metro Ontario. He began by saying the recommendations were not what was expected, and were disappointing to a company that has provided the best possible service, given the conditions under which it has to operate. Mr. Berthiaume indicated that, while he agreed there are a number of unresolved issues, he disagreed with the proposed solution. He posited it will take all possible options to arrive at the best service at the best cost in the future for Ottawa-Carleton. In addition, the proposed actions will drive away competition. Mr. Berthiaume expressed surprise at the fact that the City of Nepean, which has the best response time in the Region, does not appear on the chart at Annex A. Rural/Metro’s first priority is saving lives and the company’s culture is the reason its response times are faster. He said that adopting the recommendations will force the Region’s most effective ambulance operation to offer its services elsewhere. Mr. Berthiaume posited that the recommendations do not give the Region control over costs, rather they represent writing a blank cheque. In addition, history has shown that, once a service is taken inside, it does not come back out. He felt that, over the two-year period, all serious local competitors would probably be eliminated. Mr. Berthiaume said staff’s decision is not based on sound analysis, financial responsibility or proven performance, rather it is based on political expediency to allow a quick fix. This is not what the Region aimed for at the outset. He urged Committee members not to be put in a position where decisions are made under pressure. He pointed out that Rural/Metro Ontario has worked with the Region, it has shared all its information, provided all its data. Mr. Berthiaume asked that the Committee not approve the recommendations, but rather look at options where the Region would continue the process it started, that is, to provide the best possible ambulance service at the best price through competition. He suggested that, if the competition cannot be held at this time, it be held later: in the meantime, the Region can continue to contract with the existing operators. Mr. Berthiaume indicated Rural/Metro Ontario is ready to continue providing service, with the intention of competing once the Region has all the information it needs to go forward.

Chair Munter posed a number of questions with a view to clarifying Mr. Berthiaume’s presentation. The speaker reiterated that since it is not possible to go forward with an RFP for a performance-based system at this time, taking the service in-house will kill all options for a best service for best cost in the future. His suggestion is that the Committee look at keeping its options open by extending contracts with the existing providers and allowing the extra funding to be used to improve the service. Mr. Berthiaume said Rural/Metro would like to offer its service to the entire Region and is ready to cooperate with regional staff. Councillor Munter wanted to know whether extending the contract could be followed by an RFP. Mr. Berthiaume replied the Committee has the option of calling for an RFP for a level of effort service, however should this not be approved, the existing contracts can be extended to allow time to gather data in anticipation of the RFP. He expressed the belief there are contracts to control level of effort systems that have performance criteria and, while dispatch is under Ministry control, some improvements can be made through this approach, as well as through an in-house contract.

Councillor M. McGoldrick-Larsen asked whether Mr. Berthiaume’s company would respond to a call for proposals for a full service, with dispatch. He replied that, at this juncture, and with all the issues that have been brought forward, and in the absence of all the components to make a final decision, he could not say whether or not the company would respond. In response to a subsequent question from Councillor McGoldrick-Larsen, Mr. Berthiaume indicated he would be ready to compete in an RFP for a level of effort system, without dispatch at this time.

Neils Norgaard, a Paramedic, said it was no secret that response times are terrible. He pointed out there are five companies providing ambulance services in Ottawa-Carleton, and Rural/Metro Ontario is not solely responsible for response times in Nepean. That municipality is never without an ambulance as other providers cover-off when a vehicle is out on a call. Mr. Norgaard posited that lower response times have more to do with geography and infrastructure than with service.

Chair Munter sought a legal opinion as to whether or not the companies that qualified through the original Expressions of Interest (EOI) would need to re-qualify, given that there have been changes in ownership, structure and relationship to the original American owners. Mr. Geoff Cantello, Manager, Commercial Contract Law, Regional Legal Department, agreed that a great deal of time had elapsed since the original qualifying process. He said he felt that, at a minimum, there would need to be an evaluation of the participants and their financial and administrative structures at this time.

Councillor Holmes asked for a staff comment on Councillor Loney’s Motion. Ms. Yelle-Weatherall said staff are recommending what they feel is the best approach to bring relief to the system and to ensure taxpayers’ money is being spent appropriately. She added there are many risks involved; time is running out and staff have said all along that, in order to meet the September 30^th deadline, the RFP would need to be out now. Since the date of notification has been advanced by almost one month, there are additional concerns about timing. Councillor Holmes wanted to know whether staff have looked into the cost of setting up a regional dispatch.

Ms. Yelle-Weatherall replied this was done at a very high level. She added that there are very large capital and technology costs involved, in addition to space requirements to house the current dispatch staff of 20 to 25 people. Another reason staff are pushing so hard is because the Province has signed a contract to provide a new computer-aided dispatch system for Ottawa-Carleton and Kingston before the end of 2000. The Province has also indicated it will fund 100% of the operating and capital costs of the dispatch centre. Councillor Holmes pointed out the Region has just spent $6 million on a new police radio system, and surely the system is big enough to absorb fire and possibly ambulance services.

Councillor Doucet asked why the response time data for the City of Nepean does not appear on the chart at Annex A, as stated by Mr. Berthiaume. Ms. Yelle-Weatherall said the point she was trying to make was that most of the calls in Ottawa-Carleton occur within 300 square kilometers of the core, densely populated areas containing over 1000 persons per square kilometer. That is why the Village of Rockcliffe Park and the cities of Ottawa and Vanier are included and not the cities of Gloucester, Kanata and Nepean. Ms. Yelle-Weatherall said there was no intent whatsoever not to include the City of Nepean. She wanted to make it clear that dispatch controls response times in Ottawa-Carleton and, while the service providers are very good companies, they cannot take the credit for good response times. Ms Yelle-Weatherall so pointed out that all cities, including Nepean, appear on the easel chart displayed at the side of the room.

Councillor W. Byrne said there were three possible responders, including the Region, and one has indicated he would not be able to respond. She inquired whether staff have any indication whether the other company will be able to respond. Ms. Yelle-Weatherall replied that Canadian Medical Response has been very quiet over the last two years, however they have indicated they would proceed with submitting a bid, with the understanding that the service is provided with dispatch or not at all.

Councillor Loney asked how staff would have reacted had there been a positive response on dispatch by the February 15^th deadline. Ms. Yelle-Weatherall replied that the RFP is almost ready to go and needs only a short period for legal review. She added that staff would still not have the information on the number of ambulances needed, because this is not a tender, but an RFP, and it is for the provider to demonstrate its expertise and how it will match available resources to demand. Councillor Loney described the situation where proceeding with the RFP would have contributed to staff knowing what is needed for a performance-based system, including dispatch, and have an idea of the associated costs. In the event that the Province still hadn’t agreed to provide dispatch, the Committee’s decision would be whether to proceed without the Province’s authority or move forward. Ms. Yelle-Weatherall responded by saying staff do not believe this is the best use of resources, rather there need to be immediate improvements to the system for the future. She added that this position has worked for the last 22 months.

Councillor Loney clarified he was not disputing the need to move ahead with the "band-aid" approach suggested by staff. In the event the Province provides dispatch, capital will need to be injected since everything will need to be replaced. Dr. Cushman said the problem with proceeding with an RFP including dispatch, then having to take the better of the contenders in a level of effort system should dispatch not be granted is in the fact this process requires a lot of information and analysis which is not available. Staff are not moving forward with the optimal option, they are presenting the least worst option in an effort to address shortcomings in the system.

Councillor Loney posited that, sometime back, the Region passed the point where it could have reasonably gone out for an RFP. He asked why the Committee is only being informed of this today. Dr. Cushman reiterated that a lot of new information has only recently come to the fore. He said staff have been painting a bleak picture of the situation: the Committee and Council know that dispatch is the key and that the Province has not been forthcoming. Councillor Loney said he didn’t agree that the report could not have come to Committee earlier than today, even if part of the strategy was not to tip the Region’s hand to the Province in case dispatch is provided.

Speaking to his Motion, Councillor Loney said he did not believe that proceeding with the RFP, with dispatch, was as risky a thing to do as was stated. He pointed out that the City of Toronto had control of dispatch a long time ago, and this initially without subsidy from the Province. Councillor Loney asked why not take this course of action, given that there are back-up positions described in the report, i.e., declining to take over the service because of the absence of winning conditions to do so properly. The Councillor said he also felt the Region should move forward with its own dispatch, in light of all the difficulties this item has encountered over the last two years.

Councillor Byrne expressed her support for an in-house ambulance system and for moving ahead to address the crisis situation that exists. She pointed out that the Region has gone forward in other areas, such as social housing and since ambulance services will be a regional service, it should be improved sooner than later. Speaking to Councillor Loney’s Motion, Councillor Byrne said it seemed empty, as it calls for an RFP, with dispatch, when possibly only two companies, one of which is the Region, are prepared to respond. The second party hasn’t responded to the situation as it exists, leading to the possibility the Region will be the only one to respond.

The Regional Chair, Bob Chiarelli, said he shared Councillor Loney’s disappointment and concern. He recalled that the Council debate regarding the decision to go with an RFP was heated, and that he had supported the option at the time, since it was based on having control of dispatch. Chair Chiarelli informed the Committee his office indicated to representatives from Rural/Metro Ontario they would do everything they could to get the Province to move on the question of dispatch. He said everyone recognizes there is no accountability without dispatch, and that a private sector contractor cannot be held accountable without it.

Chair Chiarelli pointed out there are three levels of service; levels A, B and C. At the moment, the Region is at level C, with totally inadequate response times. Under the existing legislation, the Region cannot take over dispatch without provincial authority, but neither can it accept the pitiful level of ambulance response times in the community. It must do what is within its control to improve the service and move it to level B. Should the province come forward on dispatch, the service can quickly move from level B to level A. Chair Chiarelli continued by saying that choices have to be made, and while these may not be the best choices, they will "move the yardsticks" closer to what the community needs. He said he could not support Councillor Loney’s Motion, as he felt the only option, assuming the human resources conditions can be met, is to take the service in-house and improve it. In the interim, staff will continue to work on the issue of dispatch, while waiting for the Province to do for Ottawa-Carleton what it has done for Toronto.

Councillor Holmes said she was not optimistic that the Province will give the Region control over dispatch or provide adequate funding to support the ambulance service. She spoke in support of the staff recommendations, to at least begin to improve the service. She said that, should Councillor Loney’s Motion not be approved, she will move an amendment to Recommendation no. 5 to include the dispatch function in the detailed system plan. Councillor Holmes said Council needs to know what the costs are and how this will improve response times in order to make an informed decision. She reiterated that she did not see the Province resolving the problem anytime soon, and that it is time for the Region to get on with it.

Councillor Kreling posited that the way to move towards dispatch and to show the Province the Region intends to move towards this sooner rather than later is to approve the Loney Motion. He noted that, had staff received a positive response on dispatch within the deadlines, it would be moving towards the RFP. This is an indication that the Region has the ability to proceed. Commenting on the Region’s relationship with the Province, Councillor Kreling recalled a recent decision to assist individuals or groups with legal challenges to regulations pertaining to RRSPs and subsidized spaces. He felt that, if the Region is prepared to disagree with the Province on this issue, it can do likewise on the issue of ambulances and indicate it is going to proceed with an RFP, including dispatch.

Councillor McGoldrick-Larsen spoke in support of Councillor Loney’s Motion and she echoed Councillor Kreling’s comments regarding the subsidized space issue. She expressed grave concern with timing of the report’s release, suggesting that, in the future, staff provide a confidential draft to Committee, in advance of the presentation. Councillor McGoldrick-Larsen was also concerned about the recommendations and the next steps politically. Should the Committee support the recommendations and move forward to Council, the Transition Board could prevent the Region from doing so. She felt it was Regional Council’s responsibility to challenge the Province on this matter, not the Transition Board.

Councillor L. Davis described a recent personal experience where she waited four hours for a medical transfer. As a parent watching a child suffer while waiting for an ambulance, the waiting period is excruciating. There are many cases where people are not only dying, but being put through inordinately long waiting periods, and this is not acceptable. Councillor Davis said this cannot be allowed to continue by proceeding with an RFP where no company is in a position to make the infrastructure investment. Taking the service in-house will allow staff to monitor it, to identify the irregularities and to have all the information needed to go after the Province to address the deficiencies. Councillor Davis said she was horrified at the erosion of the health care system, at the delays in hospital emergency rooms; all that one sees is an increase in suffering. Those people are not present today, and speaking with one voice. The Region has the opportunity to changes the mistakes made in the past, and while this might be costly, it will help save and improve people’s lives.

Councillor Doucet said Council’s role is to defend the community, and the debate today centers around how best to defend it. He spoke in support of Councillor Holmes’ amendment to include dispatch in Recommendation 5. The Councillor expressed concern with Recommendation 2, positing it should not be approved, because the Province will not consider the health and welfare of Ottawa-Carleton as its first priority. This contention can be illustrated by the way the system has been funded to a lower level on a cost-shared basis. Councillor Doucet said he could not support Recommendation 2, as it sends a cop-out message.

Chair Munter called the Loney Motion, "preposterously un-doable", since the Region would have to go through the process of re-qualifying the bidders. The Committee has heard that one of the companies doesn’t want to bid on a system with dispatch without knowing whether it will have the opportunity to run it. Chair Munter said this means there may not be any bidders. This would have to be followed by spending $500,000 to design a system, having private bidders design a system, then coming back sometime in the Summer, still without dispatch. Chair Munter pointed out that the Region must submit a detailed operational plan to the Ministry of Health by September 3^rd for approval. The Region has run out of time. The Committee cannot do the interesting, academic, political pressure exercise of continuing an RFP that is without basis because it is contrary to provincial law. Chair Munter said the main reason he favours the report is that it responds to the community criticism about doing something to fix a bad system, as has been done in other UTMs such as Durham, York and Hamilton-Wentworth. The intent is to make investments as quickly as possible to get more vehicles on the road, more equipment, better training, to deal with emergency room overload in a better way and all this is great news. Chair Munter said Council should be excited and proud about this prospect, and he encouraged the Committee to support staff’s recommendations.

Councillor Loney expressed the hope that the appropriate amount of time and expertise will be allocated, should the service be brought in-house, to do it right and to ensure development funds are there. He pointed to Recommendation 5, and the allusion to the Transition Board, calling for the detailed information to be brought to Committee and Council.

Dr. Cushman responded by saying his understanding was that the Transition Board will set the year 2001 budget, and this is why the recommendation was worded in this fashion. He said it goes without saying that the Committee and Council will be involved.

The Committee then considered the following Motions:

Moved by A. Loney

That the RMOC issue a call for proposals for ambulance service, including dispatch.

LOST

NAYS: W. Byrne, B. Chiarelli, L. Davis, C. Doucet, D. Holmes, A. Munter 6

YEAS: H. Kreling, A. Loney, McGoldrick-Larsen 3

Moved by D. Holmes

CARRIED

At this juncture, the Committee moved In-Camera, pursuant to Section 11(1)(d) of the Procedures By-law, to discuss a matter concerning labour relations or employee negotiations.

The meeting resumed in open session with consideration of the staff report.

Moved by D. Holmes

3. ONTARIO HOUSING CORPORATION PROGRAM REVIEW INITIATIVES

- Special Advisor on Social Housing’s report dated 1 Feb 00

CARRIED

4. AFRICAN HERITAGE CENTRE -LANGUAGE, ART AND CULTURE
- Social Services Commissioner’s report dated 31 Jan 00

CARRIED

ADDITIONAL ITEM

5. CHILD CARE CAPITAL PROJECTS FOR 2000

Ms. Gayle Preston, Director, Children’s Services Directorate, presented the report. It recommends that approximately $400,000 be transferred from the Child Care Contingency fund to the Child Care Capital Reserve fund, as well as expenditures totaling $1.9 million to meet the capital requirements of a number of programs. Ms. Preston described the requests received and she drew Committee’s attention to the following changes required in Annex A;

Councillor M. McGoldrick-Larsen asked for additional information on the "wellness" concept, specifically, whether this is offered in other countries and what research is available. Ms. Preston indicated some programs are offered in the United States, and, if approval is received, the proponent will look to the federal government for funding. Councillor McGoldrick-Larsen asked if additional funds were available from other sources, since there are indications some of the delegations find the proposed 50% share is not sufficient. The Social Services Commissioner, D. Stewart, replied that there are no funds available from the Province for capital expenditures, nor are there federal funds to be accessed. He mentioned that the corporate Child Care Contingency Fund still has $1.7 million, and while this is an edge against operational issues, funds have been used in the past to pick up available subsidized spaces, mid-year, and to fund capital expenditures. Replying to a further question from Councillor McGoldrick-Larsen, Ms. Preston indicated that the French Catholic School Board has submitted a revised request in the amount of $662,900, representing $331,000 at 50% funding as opposed to $202,000. Commenting on the reason for this change, Ms. Preston said it appears that the Board has apportioned the total cost of the project, including land costs, to the child care program, as opposed to looking only at additional costs. She added that the other two Boards have not included the cost of the land in their submissions.

Commissioner Stewart spoke about new school construction being an excellent way to increase child care capacity through capital grants. However, should the Committee wish to entertain the cost of land as an additional cost, the Department will need to change the formula under which it has been operating with the Boards. These increased costs will reduce the amount of funding available, and staff will have to review the proposals received from the other Boards. Mr. Stewart called this the growth area in the next two years in terms of child care capital, and the Department will need to have clear policies on what expenditures it is prepared to consider and under what circumstance.

Councillor McGoldrick-Larsen said she felt that additional land required to build a child care centre and play space should be a permissible expenditure under the criteria. Commissioner Stewart replied that if the land requirement needs to be increased to accommodate a program, the Department would have to consider whether this represents the most economical way to increase child care capacity.

Councillor A. Loney asked whether staff anticipate any additional funds flowing into the Contingency Fund. Mr. Stewart replied that the 1999 books have not been closed, and that an additional $500,000 may be available from this source. Councillor Loney wanted to know whether the Province is likely to provide additional subsidized spaces in 2000. Mr. Stewart indicated this was unlikely to occur. Councillor Loney signified it was his intention to move that the requests be approved in principle, subject to review. He asked that all the presenters comment on how confident they are about operating without subsidy dollars. Ms. Preston said the majority of the programs are located outside the Greenbelt, and can attract full-fee payers. She added that a lot of parents want their children to be in a francophone environment. Councillor Loney wondered how non-full fee payers can afford to pay. Commissioner Stewart said another growth area for child care is the Ontario Works Program. There will soon be a cross-over point when that program will be unable to maintain all the children it currently has and the Province will have to act soon to address this problem.

Councillor H. Kreling asked how the per space cost gets evaluated in the review process. Commissioner Stewart said all programs are not the same. School-based programs have less infrastructure. In the case of the Kanata Research Park proposal, a family resource centre is part of the equation. Because of these variances, staff looked at the cost per square foot, but the Department does not have the capacity to do a detailed review of architectural drawings. Ms. Preston pointed out that, at one time, the Province was a major funder of the resource centres, but this is no longer the case. It is anticipated that centres will be developing capacity in the coming years and devote a fair amount of resources to family centres.

Councillor McGoldrick-Larsen sought clarification on why the Kanata Research Park family resource centre is recommended for funding under child care capital. Commissioner Stewart replied this is because there is no other funding source. There are currently 16 centres funded on a cost-shared basis of 80/20 with the Province, and staff predict there will be more requests in the future. Mr. Stewart added that this concept is very important in the early years, as it provides an opportunity for supportive parenting in a community or a neighbourhood and is part of healthy child development. Councillor McGoldrick-Larsen said she supported the concept, but she felt that, if this is going to be done, it should be clearly written into the policy so others can access funding.

At this juncture, the following delegations were heard:

Danielle Galipeau, representing le Regroupement des services de garde de langue française. Ms. Galipeau said the Regroupement has identified lacks in francophone programming in Gloucester and Nepean. For this reason, there is support for the Nepean South project, since this area has no french-language child care service and one is necessary in order to avoid the inevitable assimilation. Ms. Galipeau expressed concern about only 50% funding being provided, as this leaves the agencies with a need to fund-raise, and many lack the required skills to do this effectively. She pointed out that french-language services receive less funding than their anglophone counterparts, and she indicated that addressing this remains a priority for the Regroupement.

St-Louis, respectively. Ms. Perron provided information on the programs offered by la Coccinelle, a facility that serves 450 children and has no subsidized spaces. She pointed out that since there are only a few francophone programs in the area, there is demand and a waiting list. She briefly described the joint project with la Résidence St-Louis, a non-profit seniors’ long term care facility. Ms. Perron indicated that 50% funding compromises the project, and that the agency will have to fund-raise. The Trillium Foundation has already been approached, as well as schools, local businesses and the Ottawa Foundation, but the amounts that are levied are always small. Ms. Perron called the joint project an excellent example of a grass-roots movement and she requested the Committee approve funding for the project.

In reply to a question from Councillor McGoldrick-Larsen, Ms. Bertrand indicated that the Résidence St-Louis will help by charging very little for rent because it is very interested in seeing the project come to fruition.

Ms. Heins said that the opening of the centre in a few weeks represents a long-time goal of hers to link the business community and child care services. She pointed out that the Kanata Research Park will provide $2.7 million over the next 20 years to provide services so that employees don’t have to leave the campus, and a key component is the family resource centre. Ms. Heins said it is impossible to keep up with the growth in Kanata. The Research Park currently has 6,000 employees and that number is growing; additional child care services are required. The request presented was for 60% funding, but the Corporation will manage with the 50% offered by staff. Ms. Heins stressed the importance of setting an example for other corporate business parks in the Region.

Ms. Hiscott said the facility has the necessary budget to operate without subsidized spaces. She added that the proposal does not include funding for the family resource component and this will be employer-sponsored. Chair Munter pointed out this is the first time that the private sector and a corporate partner are investing such a large amount of money into a child care venture.

Elaine Murphy, a parent with two children, from Barrhaven, said a francophone centre is needed in that locale. The population is increasing, parents are ready to participate and the centre will be a good facility, with excellent resources.

Nancy Barrette, a parent with three children, from Nepean, spoke about the need for other services and resources. She posited that a child care centre is a good environment in which to learn a language before attending school. Parents are very enthusiastic, and many want to be involved; they are prepared to work hard. Ms. Barrette pointed out the centre will have a waiting list upon opening and it represents an excellent opportunity for the francophone community. Replying to a question from Councillor McGoldrick-Larsen, Ms. Barrette indicated that children now have to travel between 30 to 45 minutes to get to Ecole Laurier-Carrière or to Bridlewood.

Caroline Lajoie-Jempson, a parent with one child and another on the way, said it is hard to get french child care in Nepean, especially for infants. There are two anglophone centres and no bilingual services. She said the new facility will be well-attended, with 43 families ready to use it full-time and another 61 families requiring pre-school care. Ms. Lajoie-Jempson said the need is there, and the community has already undertaken some fundraising activities.

Madeleine Caron, adjointe au directeur d’éducation des écoles catholiques de langue française thanked staff from the Child Care Directorate for working collaboratively with the Board to put into place very progressive programs, among which is the Vanier project for "la petite enfance".

Marie Biron, President, Conseil des écoles catholiques de langue française, Longfields region. In the Fall of 1998, the Board began a massive reorganization of french language education throughout its territory, described as a "Little Belgium". Although painful in the short term, these decisions were taken to improve french language education in the longer term and to provide the community with what it wants in an minority environment. In the western part of Ottawa, the francophone community is widely spread out, and a school becomes the nucleus of that community. In the Fall, the Board announced the construction of the school at Longfields and it will open in the Fall of 2000. There were concerns about purchasing land that could accommodate both a school and a child care centre, and an interest on the part of the Board in increasing the number of early learning programs, as this these are an investment in the future. Mrs. Biron said the Board will not make money from the child care centre, as it will rent the space for a nominal consideration, and there are commitments to work towards building the facility.

Ron Larkin, speaking on behalf of the CECLFCE, indicated that the decision was taken to plan a facility that incorporates the shell of a child care centre, the idea being that the Board were unsuccessful at getting capital funding, the space would be converted into a classroom. Mr. Larkin referred to a brief sent to all Members of Council, providing new information on costs. He said that, while costs might seem high, they represent cost-recovery for the Board and can be defended.

The biggest cost element was land. Mr. Larkin posited that the Board can put together the facility with 50% funding of the actual costs submitted. With respect to whether or not the centre can operate, it can operate but it will be taxing for the operators and they will have to count on the assistance of the Board. It will be contributing $150,000 towards building the child care centre, and this will come from economy in the construction of the school. Once the school is built, the Board will assist with operating costs. Mr. Larkin concluded by saying there is some urgency on the Board’s part, the contract has gone to tender and the facility must be in place by September.

Chair Munter asked why it was not possible for the Board to make it work with 50% funding of the original figures in the report, as was the case at the Elizabeth Bruyère School in Bridlewood (total project cost $450,000). Mr Larkin replied that the difference was the land component; the cost for the Bridlewood project was between $75,000 and $80,000 per acre whereas the land for the Longfields project cost $157,500 per acre. Responding to further questions from Chair Munter, Ms. Preston indicated the cost difference relates primarily to land costs. The French Public Board submission is strictly for construction, it has not incorporated other costs. Mr. Larkin added that, while the Boards essentially receive the same amount of funding per pupil, bigger budgets provide more flexibility. Chair Munter wondered how the public board can do the same thing for half the amount of money. Mr. Larkin posited it might have to do with the type of facility proposed, its size and other factors. He reiterated that in the CECLFCE’s case, the submission represents cost recovery for that Board.

Councillor McGoldrick-Larsen, commenting on the issue of land costs, pointed out that the land was purchased three years ago, and costs have increased since then. She said she felt taxpayers should not have to pay twice for the same piece of land, as Nepean taxpayers did in 1970 and again in 2000. The Councillor said this won’t be an issue in the new City and she expressed the hope that the new Council can take a position for building community facilities to accommodate new growth areas with the land at no cost.

Terry McIver, the Children’s Place, began by complimenting representatives of the Kanata Research Park for their work with high tech companies. She made reference to the Children’s Place proposal to offer a licensed program for moderately ill children, indicating there is no doubt this will raise a lot of questions: the challenge will be to provide clear and concise responses to those questions. The dream of a wellness program began in 1996 put had to be put on hold. Two and one-half years ago, the Ministry of Community and Social Services was approached and it is committed to working on the program, along with the Regional Health Department. Ms. McIver said research indicates that European countries tend to provide generous parental leave to accommodate their children’s needs, and the United States is ahead of Canada in offering

moderately ill programs within a group environment. With respect to questions about actual costs, the original estimate was $2.5 million but, considering the critical funding issues facing regional staff, the Children’s Village was asked to phase in the project and has done so by purchasing a small building close to its facility. Ms. McIver said she believes the agency can do the job with $200,000 as opposed to $280,000 but it would appreciate getting more funding.

The new facility will deal with expansion and the release of congestion. The wellness program will offer a different service than its neighbours, negating potential conflicts. Ms. McIver pointed out that subsidy does not represent a difficult issue for the Children’s Place, but the hardship is the grant dollar. She noted that, with responsibility for 85 staff and 300 families, the program has to ensure its sustainability.

Ms. McIver read a written submission from Ms. Cathy Yach, representing the Child Care Council of Ottawa-Carleton. On behalf of the OCCOC, Ms. Yach urged Council to approve the staff report and the investment of capital funds in new child care facilities. The Region should also, when talking to the Province, indicate that more subsidized spaces are needed for children in child care, home care, nursery schools, Headstart programs and Special Needs programs. Waiting lists also need to be reduced.

At this point, Chair Munter presented Motions submitted by Councillors McGoldrick-Larsen and Loney. Speaking to his Motion, Councillor Loney suggested the fair way to deal with this issue is to provide additional funds and to direct staff to look carefully at the submissions to ensure the numbers are compatible. Councillor Loney said he did not want to be paying for land costs in one project and not in another and that common denominators are required in all submissions.

Councillor McGoldrick-Larsen thanked all the participants for their patience and for speaking on this issue. She said the individuals presenting today have input from residents asking for Committee to support them. Eighty-nine (89) petitions have been signed indicating the need for French language child care in Nepean and stating this would be a great asset to the francophone community in that community. Speaking to the viability of the program, Councillor McGoldrick-Larsen said the school will be built in Longfields, where there is a need for community facilities. There is currently one elementary school and one high school between Lonfields and Davidson Heights, for a population of approximately 15,000. Building another school means another community facility will be available and everything must be done to enhance that facility. Councillor McGoldrick-Larsen went on to say the child care operation will be a satellite to the one in Bridlewood: it will have one administration, be a not-for-profit centre, and benefit from fundraising and parent participation in the community. If the funds aren’t provided to make it viable an opportunity will have been missed. She asked that the Committee support her Motion for $330,000 for the South Nepean project. She pointed out that some of the projects include land costs while others don’t: the Children’s Place is buying another building, this is a land cost. She said she saw it as a matter of fairness that South Nepean should be able to factor in the land costs associated with the project. Speaking to the matter of capital funding for the City View child care, Councillor McGoldrick-Larsen expressed disappointment this project has not materialized, and expressed the hope the project will come to fruition in 2001.

Councillor Holmes said she was always very pleased to see new child care facilities being developed. She recalled earlier discussions about the funding formula, and being told by all the agencies they could not fund-raise 50% of their capital costs: the alternative was to negotiate long-term loans. Councillor Holmes said this report supports their contentions. She said she was delighted to see that additional funds are available, including funding from Regional Development Charges (RDCs) for child care. She expressed support for Councillor Loney’s Motion.

Councillor W. Byrne called herself a big supporter of child care centres in schools and in employment facilities since these are beneficial to all and should be supported as much as possible. She posed a number of questions to clarify issues around land costs. Commissioner Stewart said that, if staff were to agree to paid 50% of the cost of land, soil testing and other related activities, it would be the first time this is done to determine the amount of grants to centres. Those costs were not included in the French Public Board’s submission. Councillor Byrne said the process should be fair, and if one agency is allowed to claim land costs, all agencies should be allowed to do so.

Councillor McGoldrick-Larsen sought clarification as to when land costs are permitted and when they are not. She pointed out that, If a child care centre is located in a school, land costs are not permitted, but if it is located in another kind of facility, land costs are permitted. She added that a school board will have additional land requirements in order to include a child care centre. Commissioner Stewart indicated the Department has not said it would not honour land costs in capital grant requests for child care centres in schools. The fact is that, until now, it has not had such requests The Boards of Education have said they could build additional capacity on sights which they own, and this is the basis under which the Department thought it was negotiating with the two Boards: it was only at the eleventh hour that the new information was provided.

Commissioner Stewart pointed out that, if the real cost of the project includes land, because more land is needed to actually build a child care facility, Councillor McGoldrick-Larsen’s arguments are without reproach.

Chair Munter called the behaviour of the City of Nepean relative to raising the cost of land for school facilities outrageous. He said it was not fair that the school board be penalized for the avarice of the municipality in which it is located. He asked to be provided with additional information on land cost issues for both school boards and where these figures originate.

Moved by M. McGoldrick-Larsen

Resolved that, due to the revised project costs, funding for the CECLFCE be revised to $332,000.

NAYS: W. Byrne, C. Doucet, D. Holmes, A. Loney.....4

YEAS: M. McGoldrick-Larsen, A. Munter.....2

That an additional $400,000 be transferred from the Child Care Contingency Fund and that (Social Services Department) staff allocate this additional funding on a needs basis to the programs that require it.

CARRIED, as amended

NEXT MEETING

ADJOURNMENT

The meeting adjourned at 6:30 p.m.

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CHAIR CO-ORDINATOR