2017 Toronto Urban Health Fund Allocations and Review Process

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1 REPORT FOR ACTION HL20.6 and Review Process Date: May 29, 2017 To: Board of Health From: Chair, 2017 Toronto Urban Health Fund Review Panel Wards: All SUMMARY This report outlines the Toronto Urban Health Fund (TUHF) funding priorities, review process, and funding recommendations for Board of Health approval. The TUHF Review Panel is recommending the allocation of $308,792 for six one-year projects; and $2,497,328 for 40 three-year projects that focus on HIV Prevention, Harm Reduction and/or Child and Youth Resiliency to be used between July 1, 2017 and June 30, It should be noted that funding for the three-year projects (i.e., funding for 2018 and 2019) will require City Council's approval through the 2018 and 2019 Operating Budgets. RECOMMENDATIONS The Board of Health direct the Medical Officer of Health to: 1. Allocate $308,792 for six one-year projects; and $2,497,328 for 40 three-year projects, for a total of $2,806,120 in 2017 as recommended by the 2017 TUHF Review Panel, and as outlined in Appendix B and Appendix C of this report; and 2. Execute funding agreements with the approved applicants. FINANCIAL IMPACT Funding for the 2017 allocation is included in the approved 2017 approved Operating Budget for Toronto Public Health (TPH). The Deputy City Manager and Chief Financial Officer have reviewed this report and agrees with the financial impact information. Page 1 of 6

2 DECISION HISTORY Since 2012, the Board of Health has executed reports recommending funding of HIV Prevention, Harm Reduction and Child and Youth Resiliency initiatives. The most recent was May 30, At its meeting on May 30, 2016, the Board of Health approved 16 one-year projects and 33 projects to receive three-year funding from July 1, 2016 to June 30, At its meeting on July 4, 2016, the Board of Health approved the changes to the Toronto Urban Health Fund (TUHF) target populations and funding objectives. At its meeting on January 23rd, 2017, the Board of Health appointed 16 members and 3 alternate members to serve on the 2017 TUHF Review Panel. At its meeting on March 30, 2017, the Board of Health approved the Toronto Overdose Action Plan: Prevention & Response which includes a commitment from TUHF to prioritize funding and support for community services for overdose prevention and response, and other harm reduction initiatives. COMMENTS HIV/AIDS prevention as well as the prevention of illicit substance misuse (including harm reduction strategies) is mandated by the Ministry of Health and Long-Term Care through the Ontario Public Health Standards (2015) under the Health Promotion and Protection Act (HPPA). The TUHF supports TPH in meeting the OPHS, as the mandate of the TUHF is to build individual and community capacity that will support local HIV prevention, harm reduction, and child and youth resiliency initiatives. Due to cultural language barriers, stigma and discrimination, and distrust of government organizations, people at risk of acquiring HIV, people who use illicit substances, and/or those who are at-risk of engaging in high-risk behaviors, are often amongst those least likely to access preventive public health services. Community agencies providing HIV prevention, harm reduction, and child and youth resiliency programming in Toronto are uniquely positioned to provide accessible, relevant, and timely services to these marginalized and vulnerable populations. TUHF Funding Criteria and Priorities Toronto Urban Health Fund provides opportunities for time-limited one-year and threeyear project funding to community groups. Funded projects must address the needs of TUHF priority populations through resiliency building, organizational capacity building, Page 2 of 6

3 community capacity building and health promotion strategies including: creating supportive environments, strengthening community action, re-orienting health services, and developing personal skills. Funding criteria and priorities are outlined in Appendix A. The objective of the one-year funding is to fund innovative interventions that address emerging or short-term public health issues or to conduct needs assessment to increase understanding of the health and programming needs of high risk populations. The objective of the three-year funding is to fund demonstration projects based on effective interventions and community-based best practices that are flexible and responsive to long-term trends. Further consideration is given to projects servicing high-needs geographic areas, such as: City-designated Neighbourhood Improvement Areas or neighbourhoods with a high incidence of HIV or Hepatitis C; harm reduction projects that are working with populations involved in injection drug use to address overdose prevention; and applications from organizations that primarily serve First Nations, Métis, or Inuit groups are encouraged given historical funding gaps. Emphasis is also placed on reducing the duplication of services by other community agencies, funders, and TPH. To address the alarming rates of overdoses due to opiate and fentanyl use among drug users in Toronto, TUHF is providing additional funding to harm reduction projects to support building the capacity of harm reduction project staff and peers to address overdoses. Thirteen projects are recommended for additional funding to support workers and peers to attend overdose prevention training that will be facilitated by TPH s The Works at the commencement of their projects. In 2017, 14 staff and 52 peers will be trained in overdose prevention. The training and funding will be sustained in subsequent years with an additional 52 peers and 58 peers being trained in 2018 and Community Outreach, Request for Proposals and Support 2017 Project Solicitation Process Toronto Urban Health Fund request for proposal involves a two-phase process. First phase includes potential applicants submitting a Letter of Intent (LOI). These were independently reviewed and ranked in accordance to the TUHF project criteria noted above. Those organizations (70) whose LOI achieved a mark of 50% or higher were then invited to submit official proposal(s) in February To support applicants, staff hosted seven orientation sessions/loi writing workshops and five proposal writing workshops to 70 applicants. In addition, 17 TPH staff provided consultation and individualized support to 66 projects to build applicant capacity in program planning and proposal development. Review Process The review process occurred in two stages with staff conducting an initial review of applications followed by independent reviews by TUHF Review Panel members. Page 3 of 6

4 Proposal assignments were matched according to the reviewers knowledge, expertise and experience with the priority population groups and declared conflict of interest. In addition, a standard assessment tool was used to assess merit based on the following established criteria: 1) evidence informed/based approaches; 2) project development process; 3) target population reach; 4) intervention addresses needs and population risks; and 5) cost effectiveness. The review process also considered the distribution of funding across the three funding streams, priority populations, and geographic needs. Summary of Recommendations Preliminary funding recommendations included 41 projects at $2,569,636. As such, a total of $236,484 remained available for successful appeals. On May 23, 2017, the TUHF Review Panel considered appeals by 13 applicants (submitting written deputations requesting $717,924.39). The TUHF Review Panel considered all submissions and based on the information presented, recommend funding six additional projects, for a total of 46 projects (six one-year projects and 40 three-year projects). Table 1 provides a summary of the distribution of funding to TUHF target populations. Table 1: 2017 TUHF Target Population Funding Distribution Population HIV Prevention Harm Reduction Child and Youth Resiliency Total $ Proportion of $ Injection drug users $- $561,845 $- $561,845 20% Men who have sex with men $367,865 $- $122,108 $489,973 17% Youth $- $- $353,707 $353,707 13% Indigenous $- $113,257 $169,401 $282,658 10% African Caribbean Black $148,833 $81,764 $- $230,597 8% People who use drugs $- $166,819 $42,532 $209,351 7% Street-Involved $- $89,201 $115,571 $204,772 7% Sex Work $163,259 $- $- $163,259 6% Sex Partners $124,286 $- $- $124,286 4% People Living with HIV/AIDS $67,786 $- $- $67,786 2% Trans $61,156 $- $- $61,156 2% Prison $- $56,730 $- $56,730 2% Total $933,185 $1,069,616 $803,319 $2,806, % Page 4 of 6

5 Funding Oversight and Management To ensure appropriate financial management and oversight of the TUHF, all organizations applying for funding are required to submit an audited financial statement. This is to ensure compliance with City of Toronto Grants Policy. Projects were not recommended for funding if the organization: 1) demonstrated risk according to the City of Toronto Risk Management Framework; or 2) did not have reasonable unrestricted reserves. Budget item requests were also reviewed for consistency with the project objectives and work plan provided in the funding application; and budget item requests were assessed based on the budget guidelines included in the application package. Funding for both one and three-year projects in 2017 are funded through the approved 2017 TPH operating budget. Funding for the three-year projects would be conditionally approved by the Board of Health and subject to City Council approval in 2018 and again in 2019 through the budget process. It should be noted that three-year funded projects receive two instalments of funding per year. Should the organization not meet the conditions of the Funding Agreement at any point, TPH will discontinue the funding. Project Monitoring Funded projects are bound by the terms and conditions outlined in their Funding Agreement. Material changes to the budget and nature of the contracted activities for which funding has been approved require prior written approval by TPH staff. Project monitoring is conducted by TPH staff through site visits, consultations, and face-to-face, phone and communications with the funded organization. Toronto Public Health staff also observe workshops, presentations, and community events, and assess resources developed by funded agencies. Organizations must complete all contracted services to qualify for future funding. Both one- and three-year projects are required to submit interim and year-end progress and financial reports in each year of funding. CONTACT Nicole Welch Herbert Co Director, Healthy Communities Supervisor, Toronto Urban Health Fund Toronto Public Health Toronto Public Health Tel: Tel: SIGNATURE Shine Chung Chair, 2017 Toronto Urban Health Fund Review Panel Page 5 of 6

6 ATTACHMENTS Appendix A: TUHF Priority Populations Funding Objectives Appendix B: 2017 TUHF Funding Allocation Recommendations for One Year Projects ( ) and Three-Year projects ( ) Appendix C: Recommended activities for each project recommended for funding Page 6 of 6

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