Report to/Rapport au:

Health, Recreation and Social Services Committee/

Comité de la santé, des loisirs et des services sociaux

and Council/et au Conseil

3 February 2004 / le 3 février 2004

Submitted by/Soumis par: Chair, Health and Social Services Advisory Committee/

Présidente, Comité consultatif sur la santé et les services sociaux

Contact/Personne-ressource: Rosemary Nelson

Committee Coordinator / Coordonnatrice du comité

580-2424, ext/poste 21624, Rosemary.Nelson@ottawa.ca

Ref N°: ACS2004-CCV-HSS-0001

SUBJECT: COMMUNITY FORUM ON PROPOSED CITY OF OTTAWA PROGRAM SPENDING CUTS

OBJET: RÉUNION COMMUNAUTAIRE SUR LES COMPRESSIONS DES DÉPENSES DE PROGRAMMES PROPOSÉES DE LA VILLE D’OTTAWA

REPORT RECOMMENDATIONS

That the Health, Recreation and Social Services Committee receive this report and the recommendation contained herein as the position of the Health and Social Services Advisory Committee on the 2004 Budget and that this report rise to Council for information on 24 March 2004.

RECOMMANDATIONS DU RAPPORT

Que le Comité de la santé, des loisirs et des services sociaux prenne connaissance du rapport mentionné ainsi que de la présente recommandation quant à la position du Comité consultatif sur la santé et les services sociaux relativement au budget 2004 et que ledit rapport soit présenté au Conseil municipal à titre d’information le 24 mars 2004.

BACKGROUND

As part of its 2004 workplan, the Health and Social Services Advisory Committee (HSSAC) proposed to hold a public forum to receive presentations from various groups providing social and health services in the City, backed up with data regarding the consequences of the possible cuts. The end result would be to develop/approve a set of principles that could be recommended to Council prior to developing the draft budget.

DISCUSSION

On 27 January 2004, the Advisory Committee conducted a Community Forum on Proposed City of Ottawa Program Spending Cuts. About 60 members of the public participated in addition to members of the HSSAC. Dr. Robert Cushman, the Medical Officer of Health, opened the forum discussing the social determinants of health. He noted that poverty is the major determinant of health and that is particularly important in the case of children. The City cannot afford child poverty because it leads to poor health (e.g., heart disease) and to crime, both of which end up costing society. Either we invest in our children now or we pay for the consequences later. However, cuts in budgets over the past ten years have resulted in reduced health care and social services which have contributed to increasing levels of child poverty.

City Council recently endorsed the Toronto Charter on the Social Determinants of Health and hence the City and its Council are presumably committed to improving these social determinants in our community.

Representatives of 19 health and social agencies in Ottawa, ranging from the Jewish Family Services, through the Community Health and Resource Centres Coalition and the Good Day Workshop to the Centretown Churches Social Action Committee, made presentations to HSSAC. A complete list of speakers and their presentations (where provided) are appended at Attachment 1. The main message from these groups was the need to preserve the fabric of our community and our quality of life. After 10 years of holding the line on taxes, we are now paying the price in terms of deterioration in the quality of life in Ottawa. Social groups are collectively calling for leadership on the part of City Council to provide adequate resources to preserve and improve the vital services that are provided by these groups and by the City directly.

A number of speakers pointed out quite cogently that the continuing cuts in programs and services by the City is totally inconsistent with the Ottawa’s 20/20 vision. One group noted that “…Ottawa 20/20, in which much public effort was expended in establishing a comprehensive and caring approach to developing an inclusive, vibrant city, are being ignored. Much of the public input to these initiatives came from the very groups that are now being threatened and put on the defensive by the universal program review process. The divisive nature of the program review process is the antithesis of the vision for Ottawa 20/20."

The Coalition of Community Health and Resource Centres asked HSSAC to share the following key messages with Council:

· The need to ensure that we continue to provide services that support the most vulnerable populations in our community;

· The need to ensure that service cuts at the city level does not result in other losses for the city; and

· The need to ensure that decisions that are made today lead to an investment in our community.

The Coalition also noted the need to be mindful of the vulnerability of the charitable/volunteer sector as identified in the recently released Canadian Policy Research Networks study. It is only through investment in these organizations that communities can ensure that services will continue to be available.

Some groups noted that service reductions undermine the feeling of security in the community and these cuts further victimize the most vulnerable in our city such as children, those with disabilities, citizens from visible minority groups and the elderly. Related to this is the loss of the sense of independence that these services provide to our most vulnerable residents. A young woman with Multiple Sclerosis poignantly described the importance of the weekly housekeeping service that she receives thereby providing her parents with a respite from providing care to her. A young single mother received support from the Youth Programs at the South East Ottawa Centre for a Healthy Community that allowed her to obtain a decent paying job with the federal government and move off of social assistance.

Participants at the Good Day Workshop, who range in age from 19-65 and were experiencing substance abuse and mental illness, would remain in isolation if they did not have the opportunity to go to the Bronson Centre to repair old furniture. This organization, which through teaching retail and furniture repair/refinishing skills and encouraging and building a sense of community rather than isolation with adult homeless men, has helped many individuals move to paid employment.

The Ottawa Food Bank provides 36,000 residents with food each month, 40% of whom are children. Demand for food has increased by 12% in the past year and more and more working poor are showing up at the food banks.

These are just a few examples of the many critical services being delivered by these groups to the citizens of Ottawa.

Another important point made by a number of groups is that often the funding that they receive from the City allows them to lever funding from other levels of government. Cutting the grants to these groups will mean loss of federal and provincial government support. Moreover, the City’s funding allows them to lever volunteer support from members of the community for their programs. However, core base funding is required in all such partnerships and leveraging efforts. Diana Davis of the Ottawa Women’s Training and Employment Network noted that even with little funding, huge time and effort is required in networking, building momentum, and fostering relationships built on trust. These relationships are threatened if core funding is taken away.

Ottawa is the capital of this country. As an advisory committee, we would not like to leave the impression to those across Canada and from other countries that we do not care about our most vulnerable residents. Leadership from City Council is the key.

The following Motion was subsequently adopted:

Whereas it is recognized that long term cost-effective community benefits result from health and social services programs;

Whereas these programs and services permit the leverage of both volunteer and financial resources and contribute to improved community health and well being which in turn leads to lower treatment and other social and economic costs, as well as higher societal productivity in the future;

Whereas the Health and Social Services Advisory Committee has endorsed the vision of the City of Ottawa that emerged from the Ottawa 20/20 process, and believes that cuts to these services and programs will take the City in a diametrically opposite direction to the vision set out in Ottawa 20/20;

And whereas City Council has endorsed the Toronto Charter on the Social Determinants of Health;

Therefore Be It Resolved that this report be circulated to the Health, Recreation and Social Services Committee summarizing and consolidating the presentations from the community received at its “Community Forum on Proposed City Of Ottawa Program Spending Cuts” held on 27 January 2004;

And that the Health, Recreation and Social Services Committee recommend to Council that there be no cuts to health and social programs and services in the 2004 budget;

And further that the Health, Recreation and Social Services Committee and Council continue in subsequent years’ budgets to support and enhance the delivery of services that support and improve the social determinants of health in Ottawa;

And further, given that many other services and programs delivered by the City to the citizens of Ottawa are equally critical to community health and well being, the Health and Social Services Advisory Committee recommends a 9.7% tax increase, if it is necessary, to maintain all of the City’s programs and services at their current funding levels;

And further, that the Health, Recreation and Social Services Committee recommend to Council that a program of relief be established by the City for those whose well being would be threatened by increased property taxes.

CONSULTATION

As detailed in the report, the HSSAC conducted a public forum to receive presentations from agencies and organizations that provide social services to the community. An extract of the Draft Minute of the Forum of 27 January 2004 is appended as Attachment 2.

PEOPLE SERVICES DEPARTMENTAL COMMENT

City staff endorse the determinants of health in principle and recognize the contribution of these factors to overall health and vitality in the community.

FINANCIAL IMPLICATIONS

In December 2003 City staff were directed by Council to prepare a zero-tax increase budget. Staff have endeavoured to prepare a budget that both meets Council’s direction and provides a clear picture of the impact on the community of the implementation of specific budget reductions.

As of 3 February 2004, the financial implications on the approval of the recommendations cannot be determined. The People Services Draft Budget will be tabled with Council on 11 February at which time the implication of the recommendations can be determined.

SUPPORTING DOCUMENTATION

Attachment 1 - List of speakers and presentations submitted (Distributed Separately)

Attachment 2 - Extract of Draft Minutes, HSSAC 27 January 2004

DISPOSITION

The Coordinator will forward the report to Council.

Attachment 2

1. COMMUNITY FORUM ON PROPOSED CITY OF OTTAWA PROGRAM SPENDING CUTS / FORUM COMMUNAUTAIRE SUR LES RÉDUCTIONS DE

DÉPENSES PROPOSÉES DANS LES PROGRAMMES DE LA VILLE D’OTTAWA

The Chair of the Health and Service Delivery Sub-committee, Member Brian Jonah, explained that the purpose of the forum is to receive feedback from agencies that provide health and social service to residents in regards to the anticipated budget shortfall in 2004 and the impact of the recommendations contained in the Universal Program Review (UPR). Following the public input, a position/recommendation would be brought forward to the Health, Recreation and Social Services Committee and Council for consideration.

Dr. Robert Cushman, Medical Officer of Health spoke briefly about the social determinants of health. The more salient comments noted were as follows:

- poverty is the most important determinant of health because diseases are more predominant amongst those within that population;

- a disproportionate amount of low birth weight babies is concentrated amongst the poor;

- tobacco use is concentrated amongst the poor;

- the #1 determinant of an inability to get a good start in life is housing; affordable housing is not easily accessible;

- there are a number of sub factors to poverty that affect health, including: isolation, unemployment, inadequate housing and poor education; the actual term ‘poverty’ should be challenged because its statistical definition (according to Statistics Canada) does not fully address many of these other issues which are equally if not more important;

- too much service is concentrated in the institutions and not enough in the community and there is an over-emphasis on cure and not enough emphasis on care;

- between 40% and 50% of the provincial budget is spent on health care and there are opportunity costs that are lost when it comes to education, training, housing and social services;

- the City cannot afford poverty and if these issues are not dealt with up front, the City and its residents, end up paying for them down the road;

In closing, Dr. Cushman advised that it is not only about the quality of life in the community, but investing in the community and ensuring inexpensive but effective preventative services are available at the community level that will affect the health of the community in the long term.

The following delegations were received:

Mark Zarecki, Executive Director, Jewish Family Services emphasized that Council must be cognisant of the fact that a lot of time, money and energy were spent creating a Vision for the city and that same vision is now facing destruction given the anticipated cuts to the budget. He made note of the fact that several decades ago, the province reduced the number of medical doctors entering medical school and the impact of that decision has been felt in the community because it is very difficult to find a family physician. The direct consequence of that is that emergency rooms in hospitals are overloaded and while the original move by the province might have been a cost-saving measure, the actual cost to society is greater. He went on to explain that he sees the impact of this on his clients who do not have the capacity to live at home and should be in nursing homes, but the Community Care Access Centre, which is supposed to take care of them, has limited resources and has been cutting back. These people live very isolated lives and while municipal funding has helped to some extent, that will probably be lost if there is a major cut. A copy of his presentation is held on file.

Terry Gilhen, Disabled Persons Community Resources advised that the DPCR provides community services and support to persons with disabilities and their families and service providers. A survey distributed by a community coalition of individuals and agencies (including the DPCR) that are interested in the quality of life for persons who are disabled revealed the following:

· of the 1033 respondents, 52% were living on $15,000 or less a year (the services provided by the City with regards to health services would therefore be very helpful for those individuals);

· 70% required homemaking services, which is often beyond their means to pay for;

· concern was expressed about access to the public transit system not always being available to the disabled due to poor sidewalk clearing/maintenance and the lack of trained operators to assist those individuals using the system;

· 3 of 5 respondents had barriers to participating in recreational/social activities because of cost and transportation difficulties.

Mr. Gilhen recognized that while it has been slow, some progress has been made in recent years to addressing those barriers and it would be unfortunate for the City to stop investing, as proposed in some of the various reduction scenarios. He would rather pay more taxes to ensure the availability of those services. His written submission dated 27 January is held on file.

Cathy Jordan, A/Executive Director, Western Ottawa Community Resource Centre introduced Carolyn Andrew, Board Member, Lowertown Community Resource Centre. They were speaking on behalf of the 14 community health and resource centres that provide health and social services across the City. The proposed reductions in the UPR and the impact on the 2004 budget will mean significant cuts to programs and services in the community. She highlighted the following key messages:

1. The need to ensure that we continue to provide services that support the most vulnerable populations in our community, i.e. those living in poverty as defined by the Medical Officer of Health.

2. The need to ensure that service cuts at the municipal level does not result in other losses for the city.

3. The need to ensure that decisions made today lead to an investment in our community and not further losses tomorrow.

Ms. Jordan read from a letter submitted by one of their clients in which concern was expressed about the impact to them and their support services with the proposed cuts.

Carolyn Andrews noted the need to be mindful of the vulnerability of the charitable/volunteer sector as identified in the recently released Canadian Policy Research Networks study. She emphasized that it is only through investment in these organizations that communities can ensure services will continue to be available. A copy of their presentation is held on file.

Father Stewart Murray, West Carleton Social Services Committee stated that the proposed reductions in the UPR would have a significant impact on their community, especially on the senior and youth populations. He noted that they have one of four rural health nurses serving their community and that individual has been an integral part of promoting healthy living for all ages in the community as well as being an important contact and link in accessing health information and programs. Therefore, the proposal to reduce resources in the public health nurse area would be of great concern to them. Father Murray went on to state that local arenas and community centres are an important part of the rural neighbourhoods and are a focus of community activities including sports, senior and community events. Any further reductions in program funding will mean less money being able to go to support people who are in need. In addition, any reduction in support of the programs delivered through the West Ottawa Community Resource Centre would affect a large number of areas in the community including seniors, family and youth. Father Murray concluded by stating the lack of affordable housing, homeless people living on the street, overcrowded shelters, line up at food banks, youth crime and violence, are difficulties and deficiencies that point to the people who have the responsibility and the power to make the community a safe and equitable place to live and invest in.

Krystal Gervais-Yelle, South East Ottawa Centre for a Healthy Community (Youth Programs) spoke about her experience as a single mother of two small children living on social assistance. Her involvement with Better Beginnings Better Futures and the Southeast Ottawa Community Centre has helped her to change things in her life and to overcome some of the many hardships she and her family face. She now has a full-time job with the Federal government and has moved beyond the label of “young single woman living on social assistance”. She continues to use the services offered by the Centre and hoped the City would continue to support such important community programs. A copy of her presentation is held on file.

Trudy Sutton, Executive Director of Housing Help and Denise Vallely of the Youth Services Bureau of Ottawa spoke on behalf of 87 agencies and 9 networks that form a continuum of services within the Popcorn Group and the Alliance to End Homelessness and the thousands of children, youth, families and single people who receive services from one or several of these agencies being represented. Some of the comments contained in their joint presentation responded to the principles detailed in the Ottawa 20/2. These were highlighted as follows:

- community intervention and prevention programs have a proven return on investment and a reduction in these services has a fiscal impact in other areas through a significant increase in demand for emergency services, use of shelters, health care, mental health services, crisis intervention and street outreach;

- a reduction in services impacts the quality of life in all sectors but significantly for visible minorities, seniors and those with special needs where community isolation is augmented as barriers to successful integration to the Ottawa community increase;

- the maintenance of support to the Networks’ agencies is necessary for the City to continue showing national leadership around standards for quality of life for all of its citizens;

- the agencies within their Network are connected provincially and nationally with standards for quality of service and best practices; thus, their strength lies in being able to apply these standards to support innovative, creative development of initiatives best designed to address the very needs of the people accessing their services;

- a reduction in services:

· creates an increased sense of hopelessness in those at risk, increases the potential for loss of life from illness, poor quality life and suicide;

· means that marginalized youth are less successful in achieving reintegration in the community;

· increases victimization of the most vulnerable and those least able to cope, the poor, the marginalized, those already in distress;

· impacts the quality of life denying basic necessities to more children and youth;

· equals an increase in numbers of homeless youth, men, women and increases the need for additional shelters, food banks, health services and emergency services;

In closing, Ms. Vallely stated that reduced access to necessary programs means more people on the street, an increase in behavioural problems, people feeling abandoned, isolated, frustrated, alienated and not valued. A copy of their joint presentation is held on file.

Nubia Cermeño, Mujer Sana, Communidad Sana/Healthy Women, Healthy Communities stated that they have a cost-effective proposal to meet some of the public needs of the Hispanic and the ethno linguistic minority communities. They propose the employment of Lay Health Promoters, which would involve leaders in these particular communities promoting and participating in research to provide information and support for breast and cervical cancer screening and aid in the evaluation of the program. Their organization acts as a bridge between Isolatic, Hispanic women and publicly funded health promoters and ensure that services are available to all women. One Lay Health promoter may reach the community rather than a public health team of 2 or 3 people including an interpreter, noting that currently, no organization offers social, health and community service in Spanish. She indicated that spending cuts could easily lead to an increase in access barriers due to reduced budget funding for culture interpretation for service providers. She encouraged the committee to consider this model, which would empower the Hispanic and ethno linguistic minority communities to decrease barriers to public health access. A copy of her detailed presentation is held on file.

Laurie Cucheran-Morris, Multiple Sclerosis Society of Canada, Ottawa Chapter spoke in particular to the expected impact of spending cuts on clients. She briefly illustrated what many of her clients have to deal with on a day-to-day basis, emphasizing that the nature of this disease is such that the majority of clients experience severe fatigue resulting in a dramatic reduction in energy levels. There is also physical deterioration resulting in severe mobility impairment, paralysis, lack of balance, speech challenges, vision loss and the ongoing risk of injury from lack of tactile sensation. A copy of her presentation is held on file.

Mary-Ellen Coughlan spoke as a person living with multiple sclerosis who relies on many of the services the city offers to help her live an independent life. In particular, she appreciates the three hours of homemaking service she receives each week, noting it allows her parents, with whom she lives, some freedom from looking after her. She stated that if this service is cut, she would have to pay somebody herself and on the limited income she receives from Ontario Disability Support Program (ODSP), this would increase the level of poverty in which she already lives. She implored the City to look at the long-term effects of these impacts.

Sister Marilyn McGrath and Sister Maureen Mckeown, Good Day Workshop stated that they welcome those who are unemployable because of problems related to addiction, homelessness and mental or physical disabilities, and teach them to repair and refinish furniture. Participants include men, women and visible minorities ranging in ages from 19 to 65. In conjunction with social workers, the Good Day Workshop helps participants to find suitable accommodation and to help them go back to school or find good paying jobs. Over the past five years, over 200 people have been safe and sober when working at the Workshop. Should these programs not be supported, participants will have no safe working place to use their skills to be of service in the community. Some will gradually drift back into drop-in centres, negative friendships, food lines and homelessness. Others will remain isolated, depression will deepen and mental illness will increase until hospitalization is needed again. A copy of their written presentation is held on file.

Ann Braden, Causeway Work Centre advised that the Centre serves the mentally ill, the homeless and those with fetal alcohol spectrum disorder and their main function is to provide basic training and to find employment for them. They receive $93,000 from the City for core funding, under the Development Innovation and Partnership program and that allows them to apply for further grants. The repercussions of cutting the core funding, which is time limited, are quite monumental and worth more than that funding allocation. They support a 9.7% tax increase in order to maintain existing programs.

Heather Tkalec, Centretown Churches Social Action Committee advised that they currently support the Centretown Emergency Food Centre and the Centretown Employment Support Program. She maintained that health and social service funding should not be viewed in isolated silos such as public health apart from housing or community services apart from employment support because research has proven that these are interrelated and contribute to a healthy, stable and thriving community. Also, social inequities have a direct impact on health and it is the responsibility of service providers to consider these social determinants of health in a more comprehensive way and not as isolated services that can be cut or enhanced without having impacts elsewhere.

She added that the current budget consultation process only serves to pit social advocacy groups and service providers against another. Public input sought during the Official Plan and Ottawa 20/20 helped to establish a comprehensive and caring approach to developing an inclusive vibrant city and yet, much of the public input to those initiatives was derived from the very groups that are now being threatened and put on the defensive by the UPR. If caring for people is insufficient reason, the social determinants of health would indicate that the City should properly fund these aspects of the community out of self-interest. She emphasized that the City would ultimately save money by investing in basic services that result in more people being able to contribute to social and economic life.

Jenny Gullen, West End Legal Services Ottawa explained that budget cuts only serve to lessen the ability of the City to leverage resources of other levels of government. Their service assists individuals on Ontario Works (OW) who are applying for benefits with the ODSP. The services previously offered by the City’s OW staff, i.e., assistance and monitoring of applications for ODSP, filing internal review requests from negative decisions and assisting with the transfer of files from the OW Office to the Disability Adjudication Unit, greatly increased the ability of their clinic staff to continue to efficiently provide legal support when such intervention is essential to a favourable outcome to the client. However, they have learned that there has been a change regarding the discretion of OW staff to make home visits to disabled clients, and, as a result, there will no longer be home visits. Without home visits, it is highly unlikely that many people in the community would not have the capacity to make an initial application for the OSDP, thus remaining dependent upon the lower OW income. She stressed that these individuals are among the most vulnerable in the community and the reinstatement of home visits will serve to benefit many of them, while also allowing the City to retain it’s OW Resources for those who have no other avenues for income support. A copy of her presentation is held on file.

Helen Smith, Interfaith Network Reaching Out to Isolated Seniors stated that isolated seniors suffer from loneliness, declining functional ability and limited social support. As a result, they be invisible in the community and are often not recognized until a crisis occurs. Their Network consists of representatives from a variety of faiths, whose aim is to encourage faith communities and their work with isolated seniors. The public health department has assisted in these efforts to survey the work of faith of communities with seniors and in writing and distributing a report on this survey. They currently have a pilot project underway to study senior service providers and to reach out to the isolated seniors of the target area. She emphasized that no cuts should be made in this area. A copy of her written presentation is held on file.

Gordon Pearson, Ottawa Food Bank stated that of the 36,000 people served by the Food Bank at any given month, approximately 40% are children and the impact of cutting City funding would worsen the hunger problem in Ottawa by decreasing the Food Bank’s ability to provide food and baby supplies to those in need. Another concern is the impact reduced funding would have on the 100 agencies across the region, which have food programs, many of which rely heavily on municipal funding. He stressed that with the increasing number of hungry in the city, it has been difficult for the Food Bank to meet the demand with changes in the demographics and the types of people that are using the services. The Food Bank does have a reserve fund and an emergency food purchase fund that was equivalent to about 3 or 4 months of food. However, increased demand on their services has depleted these funds and in discussions with City staff, it is hoped those funds can be replenished back to safer levels. Mr. Pearson stressed that grant cuts would not make their job any easier and he was prepared to pay additional taxes to maintain the kinds of services that make this city the kind of city it is. A copy of his written presentation is held on file.

Jodie Golden and Lee-Anne Lee, representing J F Norwood House advised that this is a residential program of the Elizabeth Fry Society of Ottawa. Their organization is a cost-effective resource whose mandate is to provide services and support to women of all ages involved in the criminal justice system. They indicated that J F Norwood House is a transitional supportive residence for a combined population of women, i.e., homeless, victims of violence, etc and women who are integrating to their home communities from both federal and provincial institutions. Any spending cuts would have huge impacts on this population because there would be fewer opportunities to address some of the systemic barriers that women fact within the criminal justice system. Transitional housing creates opportunities for them to develop the strategies and skills necessary for them to live independently within the community. If such opportunities are not created, the Society will continue to be faced with numbers to house and supervise women at J F Norwood House under the conditions set out by the criminal justice system.

Tracy Davidson, Centre 507 – Day Programs advised that St-Luc’s Lunch Club, the Well, St-Joe’s Women Centre, Centre 454, Centre 507, the Caldwell Family Centre and the Shepard’s of Good Hope serve the most marginalized individuals in the community. They offer a link to other services and work together to allow and support a quality of life, health and safety to members of the community. Their programs offer safe places, day shelters and welcoming environments, which offer nourishment, personal needs and social support. In addition, they provide platforms for the delivery of other services such as outreach nurses from community health centres and a space where people can connect with other supports within the community. The day programs already struggle to provide these services and any further cuts will negatively affect services. However, she did not want day programs preserved at the expense of other services.

Ken Love, Board Chair, Centre 507 stated that the centre serves 160 people a day (37,000/year). He explained that they serve people who cannot effectively use other city services. In terms of providing the services, they receive thousands of volunteer hours every year and this alone saves thousands of dollars. In addition, the centre provides day-to-day emotional support for people who are unable to visit with their social worker or psychologist every day and this saves the City and the Province on considerable health costs, keeping individuals in their rooming house instead of overnight shelters. He was not in favour of any cuts to these services and in fact suggested more funding should be provided.

Diana Davis, Regional Coordinating Committee to End Violence Against Women indicated that they are dedicated to promoting accessible and effective services in Ottawa for female victims of violence and their children. They are a cross-sectoral membership made up of community-based organizations. The main functions of the coalition are to:

· share information on local initiatives and government policies pertaining to violence against women;

· identify gaps in services and facilitate integrated solutions based upon shared values and common understanding of the causes of violence against women;

· engage in public education through the development of resource materials and to support and promote research;

· identify areas of potential collaboration and avoid duplication of efforts.

Ms. Davis emphasized that it took years to build up relationships of trust and that the work cannot afford to be thrown away. While they would not like to see cuts to the coalition, at the same time they realize that all of the peers, their agencies, their work and the services that they do, are the network of services which members rely upon in order to help women to extricate themselves and their children from situations of violence and to establish themselves as independent and contributing members of society.

Member Brown put forward the following Motion:

That the HSSAC circulate a report to members of Council summarizing and consolidating the presentations from the community received at the meeting of 27 January 2004;

Further, that HSSAC recommend to the HRSS Committee and Council that there be no cuts to health and social services programs and services this year;

And further, that HSSAC endorse the vision of Ottawa that emerged from the Ottawa 20/20 process, and express its concerns that cuts to services and programs will take the city in a diametrically opposite direction to the vision set out in Ottawa 20/20;

And further that HSSAC recommend that the HRSS and Council continue in the 2004 and subsequent years’ budgets to support and enhance the delivery of services that support and improve the social determinants of health in Ottawa in recognition of the community benefits and long-term cost effectiveness that result from such programs and services, recognizing their ability to lever both volunteer and financial resources and that these programs contributes to improved community health and well-being which in turn leads to lower treatment and other social and economic costs as well as to higher societal productivity in the future.

Member Jonah suggested the Motion go one step further by recommending a tax increase. He recalled this position was supported by many of those who spoke out during the budget consultation sessions. Member Brown agreed to amend his Motion to include such a statement, especially if it meant maintaining a strong vision of Ottawa and the fact it was a recurring statement voiced this evening. It was noted that the city is paying the price for undermining the funding of these important programs these past 10 years by not increasing taxes.

While she agreed that a tax increase is necessary, Member Muldoon was reluctant to suggest a specific percentage because of the impact it would have on the poor.

In response to the above comments, Member Brown proposed the following amendment:

And further that HSSAC recognizes that the many other services and programs delivered by the City to the community are equally critical to community health and well-being and endorses a _% tax increase to maintain programs and services at full funding levels.

Member Chaplin suggested any recommendation should be limited to that area in which the committee has a mandate and not to make any comment about other programs or budgetary expenditures. He proposed that the original Motion be amended simply to state that the committee would support the necessary tax increase required to meet current obligations under the health and social services envelope.

Conversely, other members believed that limiting the committee to what sometimes can be a narrow definition (the determinants of health) and not include other aspects of that definition, such as transportation and the funding in those areas, only constrains the message the committee might wish to convey.

Member Brown understood the messages conveyed about the issue of taxes, but maintained that it is more a matter of what is fair. Therefore, he proposed the following additional amendment to take into consideration the above-noted concerns:

That the committee recommends to HRSS and Council that a program of relief be established for those whose well being is threatened by increased property taxes.

Member Jonah recognized that the mandate of this committee is health and social services; however, since many of the services offered by the City are linked, he believed what the committee should convey to Council is that the City deserves the services it is currently getting and any reduction in funding will negatively affect the quality of life in the community. Therefore, the committee should be explicit about the level of cut it is willing to support.

Vice Chair Faucher supported a tax increase of 9.7%, noting that since there has not been a tax increase in over a decade, recommending the maximum increase is simply ensuring maintaining existing services and programs.

Member Brown suggested that his previous amendment be changed to address both concerns regarding whether or not to put in a percentage, to read as follows:

And further that HSSAC recognizes that the many other services and programs delivered by the City to the community are equally critical to community health and well-being and supports a 9.7% tax increase if that is necessary to maintain programs and services at full funding levels.

He also proposed the following additional amendment:

Further, that HSS recommends that a program of relief be established for those whose well being is threatened by increased property taxes.

The committee agreed to support the foregoing Motion and the amendments at this time, for finalizing by Chair Chisholm and Member Jonah at a later date. It would then be circulated to committee members. *

* The final recommendation appears in the report of the Health and Social Services Advisory Committee report to the Health, Recreation and Social Services Committee on 19 February 2004 (ACS2004-CCV-HSS-0001 refers).