putting people first: 10-year housing &...

Literature Review: 10-Year Housing & Homelessness Plan

DISTRICT OF NIPISSING SOCIAL SERVICES ADMINISTRATION BOARD

Putting People First: 10-year Housing & Homelessness Plan.

Nipissing District Review of Housing and Homelessness

Literature in Nipissing District. Sub Report #1

Project Research Team

February 25, 2013

This report is one of a series which taken together, form the 10-year Housing and Homelessness Plan for Nipissing District.

EXECUTIVE SUMMARY


i

In 2010 the provincial government released its long term affordable housing strategy, Building

Foundations: Building Futures. A key component of the long term affordable housing strategy is the

Strong Communities through Affordable Housing Act, 2011. This legislation replaces the Social Housing

Reform Act, 2000, with the Housing Services Act (HSA), 2011. Central to the HSA is the requirement that

Service Managers prepare local housing and homelessness plans while addressing matters of provincial

interest.

The report opens with a preamble which includes background information, the purpose of the review

and the report production. The literature review was a systematic, qualitative review of housing and

homelessness literature in Nipissing District and its municipalities and areas. The review was part of

assessing the housing and homelessness landscape in Nipissing District for the 10-year Housing and

Homelessness Plan, and was carried out by three researchers (working part time on the project) over a

three month period from November 2012 to February 2013.

The first section of the report describes the review’s methodology, including the research questions

posed for the review; the search and screening particulars; the document management system and

review tools; and the methodology for analyzing and assessing the quality of the literature. The

limitations and challenges of the review – as well as the benefits and opportunities – are also discussed

in this section. The project’s researchers performed an initial search for relevant literature and

transferred the literature into SharePoint where it could be centrally accessed and managed. After

screening the documents for how well they assessed the project’s research questions, 70 local

documents were carried forward for review (none of the literature had been formally published -see

types of documents below). Each document was systematically reviewed by two researchers using a

standardized reporting tool that had been developed for the project. The tool captured the document’s

characteristics and the researcher’s review notes, and also facilitated the assessment of the quality of

the literature. In order to synthesize the findings and results of the 70 documents, the researchers

carried out a four-step analysis process. This process included an independent, qualitative data analysis

by each researcher; a group qualitative analysis and thematic roll-up of the data; a quantitative analysis

of effect sizes and literature quality; and conclusions based on the researcher’s interpretation of the

data. Through this aggregative approach and meta-summary of the data, the results and findings from

the literature were combined to produce themes and sub-themes of the housing and homelessness

issues in Nipissing District.

The first section of the report also discusses some of the limitations and challenges of the literature

review. These include not having any set industry standards or procedures to follow for conducting a

systematic, qualitative review of local community literature (unlike a more conventional scholarly

review), and the difficulties in finding the grey literature and assessing the quality of that literature. The

benefits of the literature review are also discussed and these include increasing the validity of the 10-

year housing and homelessness plan by providing another data source with which to triangulate data,

and not having to start the plan from scratch.

The second section of the report talks about the characteristics of the documents reviewed. This

includes the types and categories of the documents, the geographical area covered by the documents,

EXECUTIVE SUMMARY


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and the time frame. A little over half (54%) the documents were in the form of local reports and studies,

with the remainder being symposia proceedings, Discussion Papers, Community Plans and government

submissions. Two-thirds of the documents were specific to housing issues while a smaller number (14%)

were related to homelessness. One-fifth of the documents covered both housing and homelessness. In

terms of geographical coverage, a large number of the documents covered Nipissing District or North

Bay (57% and 28.5% respectively), or both (12.8%). This illustrates the lack of literature on housing and

/or homelessness in the district’s remaining municipalities and areas. Although the documents spanned

a period of nearly 30 years, the majority of them were produced since 2000. The researchers also

assessed the quality of the literature and the results are also presented in the second section of the

report. Overall, the literature was of reasonable quality although there was variation in the individual

quality components, as well as between the researchers on their measurement of quality.

The results and findings of the literature are presented in the third section of the report. At the thematic

level, 15 themes and 43 sub-themes emerged from the local literature and these are shown graphically

on the following page. Figure 1 is derived from the notes of the researchers and it graphically

summarizes the abundance of literature and data reviewed. Conceptually, the graphic is showing the 15

major themes that were prevalent across the housing and homelessness literature, and the connection

between some of the themes and their respective sub-themes. Although the graphic gives equal

weighting to the themes and subthemes, their frequency of occurrence was calculated in order to

determine the effect size, i.e. the extent to which the themes and subthemes were present across the

literature.

Housing and /or homelessness needs and gaps were described in 97% of the literature, with the lack of

acceptable and affordable housing being a dominant sub-theme. The need for more supportive and

supported housing was mentioned in two-thirds of the literature, and more shelter beds was also a

reoccurring need in one-quarter of the literature. It can be noted from Figure 1 that the evidence also

points to the need for more long term care facilities, senior’s housing, transitional housing, apartments

and rental units, retirement homes, and halfway-houses. In describing the district’s housing need, the

literature often referenced indicators such as the social housing waiting list, core housing need, poor

housing condition, and North Bay’s relatively low rental vacancy rates and high rents.

Common gaps throughout the literature were the lack of housing support services, including both,

supports for the general population as well as those specific to people with mental illness. A gender-

equality gap was also noted in 14% of the literature that had the “needs /gap” theme, mainly as it

applies to the lack of core support services –such as emergency shelters for men - in areas outside of

North Bay. The lack of adequate discharge planning for people released from hospitals or correctional

facilities was also a gap noted in 11% of this body of literature.

EXECUTIVE SUMMARY


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Housing & Homelessness in

Nipissing District

Government

Policy /

Legislation

Needs /Gaps

Future Need:

Targets /

Demand

Funding /

Resources

Collaboration

Communication

Stigma

Cause

Success /

Best Practice

Geography

Aboriginal

Demographics

Socioeconomics

Data /Knowledge

Affordable housing

Support services

Waiting list

Vacancy rates

Core Housing Need

Housing condition

Supportive /Supported housing

Shelter beds

Long Term Care (LTC)

Rent increases /high rent

Mental health services

Seniors housing supply

Transportation

Transition housing

Gender equality

Alternate Level Care (ALC)

Apartments /Rental units

Discharge planning

Retirement homes

Halfway house

One-bedroom apartments

Aging population

Social assistance caseload

Population stagnancy

Singles

Youth population decline

Aboriginal population

Household growth

Mental illness population

Youth

Immigrant population

Low Income Cutoff (LICO)

Education

Labour Force /Employment

Social Determinants of Health

Housing tenure

Local economy

Income

Labour Force & Education

Inter-agency collaboration

No Wrong Door

Systems thinking / Holistic approach

Theme

Sub-theme

Housing and Homelessness Themes and Sub-Themes Emerging from the Literature

Seniors with mental illness

Legend:Indicators of

Progress /

Problems

Figure 1 Housing and Homelessness Themes and Sub-themes Emerging from the Literature1

1 Conceptual map adapted from Saini, M., & Shlonsky, A. (2012). Systematic Synthesis of Qualitative Research. New York: Oxford University Press

EXECUTIVE SUMMARY


Over half the literature reviewed described local socioeconomics and demographics. On the

socioeconomic front, the relatively low incomes in Nipissing District were mentioned in nearly two-

thirds of this literature. The district’s relatively low education levels, high unemployment rates, and low

labour force participation, were other sub-themes that surfaced in one-quarter of the documents with

the socioeconomic theme. These sub-themes were often referenced in the context of their association

with one another, and as underlying reasons for the need for more affordable housing. The social

determinants of health was also a common sub-theme across 20% of the socioeconomic literature,

particularly in reference to the relationship between income, food and housing, and the health

disparities that exist between Nipissing District and Ontario.

In terms of demographics, nearly three quarters of the demographic literature mentioned the district’s

aging population in terms of the impact this will have on the heath care and housing systems. Other

demographic groups were also discussed in this body of literature with reference to the lack – or

inaccessibility – of acceptable housing. These groups include social assistance recipients, singles,

Aboriginals, people with mental illness, and youth. The district’s population was also a common theme

in one-third of the demographic literature, and was often presented in terms of minimal growth or

stagnancy, and the linkage with the local economy. Countering the stagnant population is household

growth which was a subtheme in 15% of the literature. The local immigrant population (in terms of

finding acceptable housing) and a declining youth population were also common in approximately one-

fifth of this body of literature.

The lack of funding and resources echoed across half the literature reviewed. Often this pertained to the

lack of sustainable funding for core services such as shelters and housing crisis prevention, or for more

dependable funding to support housing and homelessness planning and projects. The overall decrease

in federal and provincial funding for housing in the mid-90s was also noted in the literature, as was

Ontario’s budget cuts to housing programs in the late 90s and more recently, 2012 /2013. Other

common issues noted across the literature are the lack of capital funding for new housing (such as

supportive or transitional), the lack of funding for housing support services, and the lack of resources for

more staff to deliver the range of housing services needed, or for initiatives such as increasing public

awareness and education about housing and homelessness (see also “Communications”).

Collaboration was a theme evident in 44% of the literature reviewed. Inter-agency collaboration was a

dominant sub-theme within the majority (85%) of this body of literature. This sub-theme mainly speaks

to the need to break down silos and coordinate a system of supports across a range of health and social

services organizations. Community service organizations are serving many of the same clients, and there

is a need to further collaborate around service planning and delivery. Closely related to the above was

the sub-theme of taking a holistic approach which appeared in one-fifth of this literature reviewed. The

literature described this approach as looking to serve the needs of the individual as a whole rather than

the needs in isolation. By extension, housing and homelessness issues are not isolated and span across

many different areas including food security, physical and mental health, employment, income, and

education. Currently, there is no comprehensive service system in the district that is able to assess and

meet all the needs of a given individual or population. The No Wrong Door was mentioned in 31% of the

EXECUTIVE SUMMARY


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literature (where ‘collaboration’ was a theme) as one positive step towards collaboration in Nipissing

District.

Communications, geography, government policy /legislation and data /knowledge were themes present

in 20% to 35% of the literature. In terms of communications, increased public awareness and education

around housing and homelessness is needed to build public support and facilitate advocacy, fundraising,

and policy change. Service organizations and providers also need to do a better job of promoting their

programs and services to citizens, as well as to each other. Geographically speaking, the evidence shows

that there are varying needs across Nipissing District, right down to the neighborhood level in the larger

cities such as North Bay. From the service provider’s and rural citizen’s perspectives, delivering and

accessing services is difficult due to the transportation issues associated with the large area. Rural

strategies are needed to address housing and homelessness issues close to home.

The impact of government policy /legislation on housing and homelessness was cited in 21% of the

literature. The literature mainly talks about the federal and provincial withdrawal of housing programs

in the 1990s and the subsequent change in the housing role of municipalities (see also “Causes”). The

literature also acknowledges the progress made with the reinvestment into housing by the federal and

provincial governments in 2005, and some of the local municipal policies that have encouraged the

development of affordable housing.

Data /knowledge was an underlying theme in 20% of the literature, mainly with regards to the lack of

hard data and evidence around the district’s homeless and ‘at-risk’ population (particularly youth). The

extent and depth of homelessness in cities such as North Bay – and the district – are not generally

known. The poor sharing of data with the mental health system was also cited as a problem, as was

housing providers not always having timely, accessible information from the Nipissing District Housing

Registry regarding social housing applications.

Cause was a theme that surfaced in one-fifth of the local literature. In terms of the cause of

homelessness, there are many interrelated variables – including some of the themes presented thus far-

that contribute to homelessness, the risk of homelessness, or the need for affordable housing. Some of

these are well known and include low income, low education levels, unemployment, or any combination

of these. The literature often identified the lack of affordable (acceptable) housing as a primary cause of

homelessness. Other causes of homelessness based on the evidence presented include family

/relationship break-down (which includes abuse and safety concerns), transience, substance use, mental

and/or physical illness and being discharged from custody. In terms of youth homelessness -or being ‘at

risk’ of homelessness - drugs and alcohol were cited as primary determinants in addition to low income

and unemployment mentioned above. Other causes of youth homelessness include mental health issues

of parents, physical violence and abuse at home, and generally difficult lives. Aside from homelessness,

the literature also points to other causalities within the housing system. For example, the negative affect

that the lack of supportive housing is having by creating backlogs in the long term care facilities which in

turn fills up acute care beds with ALC (Alternate Level Care) patients, at the North Bay Regional Health

Centre.

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Stigma was also cited as a local problem in one out of every five documents reviewed. The literature

describes local stigma as not only that for people who are homeless, but also the discrimination,

attitudes and beliefs about people who are at-risk of becoming homeless, people with mental illness,

people on social assistance, youth, people who live in social housing, and Aboriginals. NIMBY-ism (“not

in my backyard”) was also cited as a problem in some of this literature.

On a brighter side, 10% of the literature talked about success and best practices. The Futures program at

the Crisis Centre North Bay was acknowledged for its structured program that teaches youth the

necessary skills needed to succeed in the real world. LIPI (Low Income People Involvement of Nipissing)

was also mentioned for its important role in providing support for homeless and at-risk youth. Other

programs mentioned were YES employment services which are very present in the community, and

some of the alternative education programs offered by local high schools. No Wrong Door – a local

initiative – was also mentioned as a success /best practice on the collaboration front, and the protocols

between DNSSAB and the Crisis Centre North Bay are recognized as preventing absolute homelessness,

i.e. people living on the street.

The literature also spoke of some of the successes in increasing the affordable housing supply. Nipissing

District was one of the few areas in the province to have full program take-up of the Canada-Ontario

Affordable Housing Program (AHP) and as a result, over 220 new affordable housing units have been

built in Nipissing District since 2005. This represents the first new affordable housing in the area since

1993. Homeownership opportunities for lower-income families have also increased through the local

HOAP (Homeownership Affordability Partnership) and Habitat for Humanity programs.

Along the lines of best practices, the literature noted successful youth residential programs in Sault Ste.

Marie and Greater Sudbury. Additionally, there are successful supportive housing models for seniors in

the United Kingdom. Other communities have had success in repurposing old schools for seniors

housing.

An underlying Aboriginal theme was present in 7% of the literature. The literature mainly talked about

the stigma associated with Aboriginals as they try and find affordable housing. In one example, the

North Bay Indian Friendship Centre has difficulty finding housing for the Aboriginal community, because

of stigma, racism, etc., and many individuals are forced to leave the community. Aboriginal people often

face discrimination in finding housing, with some landlords unwilling to rent to a person who is (or

appears to be) Aboriginal. The local evidence also points to an overrepresentation of Aboriginals in

emergency shelters and core housing need in North Bay.

Indicators of housing progress /problems surfaced in a small (5%) percentage of the literature. The

indicators were presented within the context of needing to quantitatively measure the state of housing

and /or homelessness - or related variables – in order to gauge housing outcomes (progress or not). The

indicators are listed below:

Core housing need

Shelter to income ratio

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Social assistance housing gap

Renter affordability gap

Rental housing construction

Vacancy rates

Housing stock/inventory

Official plan status

Housing and population growth rates

Per capita number of households with incomes less than 20,000 annually

Social assistance rates per capita

Authors note: It’s interesting to note that although the above indicators were explicitly stated in this

group of literature, they were implicitly referred to or used, throughout most of the literature reviewed.

The final theme, future need: targets /demand was also captured in a relatively small (5%) percentage of

the literature. However, the data is powerful in that it provides hard evidence around housing supply

and demand for the future. Based on a 2008 forecast, Nipissing District requires 158 affordable housing

units annually, to 2016 (both rental and homeownership). In a separate forecast, the district will require

two and a half times the number of long term care (LTC) beds and supportive housing by 2031. Given

the ‘status quo’ scenario, this translates into approximately 227 supportive housing units and 1,900 LTC

beds by 2031. However, under the more cost effective ‘diversion’ scenario (whereby individuals are

diverted from LTC into supportive housing) the district would need approximately 1,500 supportive

housing units by 2031, and only 650 LTC beds. The demand for retirement beds /suites will also increase

significantly - more than doubling from 412 beds to 920 in 2031.

Turning to the end of the report, section four presents the researcher’s conclusions based on their

interpretation of the evidence and data reviewed. The researchers conclude that a great deal is already

known about housing and homelessness in Nipissing District, and the community has been looking at –

and working on – housing and homelessness issues for a very long time now. This is evident by the

many thematic issues described earlier in the report, and the 268 formal housing and homelessness-

related recommendations that are in the literature (and which are included in the appendix for

reference).

Through the review of literature, it also became apparent to the researchers that the same trends and

issues have been occurring in Nipissing District throughout the years. These are systemic in nature and

include: relatively low incomes; high unemployment; low workforce participation; low educational

achievement; rising rents; low vacancy rates; a lack of affordable housing supply; food insecurity; poor

mental health; a shortage of government housing funding; stigma; and a large number of local citizens in

core housing need. Based on the past data – and barring any significant changes or interventions - it is

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probable that these systemic trends and issues will continue through the life of the 10-year housing and

homelessness plan. This presents a new context and reality for developing the plan and in forming

expectations for what the plan can deliver and achieve.

Closely related to the above, the researchers indicate that many of the needs, gaps and concerns related

to housing and homelessness in Nipissing District have existed for at least one generation. An example is

given whereby two different authors writing two different reports almost 30 years apart, make similar

statements concerning the poor housing condition in Nipissing District relative to the province. In

another example, the project researchers describe how the need for supportive housing in the district

has been talked about for over 10 years, with little action taken. This is despite an abundance of

evidence supporting the housing claim, and the cost rationale which says it would be better to house an

ALC (Alternate Level Care) patient in a supportive housing bed for under $100 /day then in a hospital

acute-care bed for $800 /day.

The literature review has confirmed many of the ‘knowns’ about what is needed. The question now in

developing the local 10-year housing and homelessness plan is not so much what are the housing needs

or problems in Nipissing District but rather, how can we solve the housing needs and problems in

Nipissing District, given the current barriers, fiscal and systemic included.

Switching over to a more positive note, the project researchers feel that the development of the 10-year

housing and homelessness plan offers a renewed opportunity to confront the housing and homelessness

issues through a framework that takes a coordinated, systematic approach towards assessing and acting

on the data. Viewed through the lens of the 10-year plan, the community stakeholders and leaders have

a new opportunity to rally around the evidence and start systematically prioritizing the needs, and

evaluating what can be done within the confine of current resources.

Finally, this section concludes by acknowledging that the literature review has produced a large body of

empirical evidence which can be acted upon starting now. Community stakeholders and project

planners can begin to develop the 10-year housing and homelessness plan’s objectives, targets, and

implementation /action plan, based on the literature review’s preliminary evidence and findings.

TABLE OF CONTENTS


EXECUTIVE SUMMARY ........................................................................................................................ I LIST OF FIGURES AND TABLES ....................................................................................................................1 BACKGROUND .......................................................................................................................................2 PREAMBLE .........................................................................................................................................2 PURPOSE OF LITERATURE REVIEW ..............................................................................................................2 TIME FRAME .........................................................................................................................................3 REPORT PRODUCTION .............................................................................................................................3 1.0 DESCRIPTION ...................................................................................................................................4 I METHODOLOGY ...............................................................................................................................4 1.1 RESEARCH QUESTIONS .......................................................................................................................4 1.2 SEARCH STRATEGY ............................................................................................................................4

1.2.1 DATE OF LITERATURE ............................................................................................................................. 4 1.2.2 SEARCH TERMS ..................................................................................................................................... 5 1.2.3 DATABASES /SOURCES ........................................................................................................................... 5 1.2.4 SEARCH RESULTS .................................................................................................................................. 6

1.3 DOCUMENT MANAGEMENT AND REVIEW TOOLS ......................................................................................6 1.4 SCREENING ......................................................................................................................................6 1.5 QUALITY ASSESSMENT .......................................................................................................................8 1.6 DATA ANALYSIS ................................................................................................................................9

1.6.1 INDEPENDENT DATA ANALYSIS .............................................................................................................. 10 1.6.2 GROUP DATA ANALYSIS ....................................................................................................................... 10 1.6.3 EFFECT SIZES, THEME DESCRIPTION, AND QUALITY ASSESSMENT ................................................................ 11 1.6.4 CONCLUSIONS ANALYSIS ...................................................................................................................... 11

1.7 LIMITATIONS/CHALLENGES ............................................................................................................... 11 1.7.1 CONDUCTING A LOCAL, QUALITATIVE REVIEW ......................................................................................... 11 1.7.2 FINDING LITERATURE ........................................................................................................................... 12 1.7.3 QUALITY ASSESSMENT ......................................................................................................................... 12 1.7.4 STATISTICAL OR PRACTICAL SIGNIFICANCE?.............................................................................................. 12

1.8 BENEFITS /OPPORTUNITIES ............................................................................................................... 13 1.8.1 INCREASED VALIDITY ........................................................................................................................... 13 1.8.2 NOT STARTING FROM SCRATCH ............................................................................................................. 13

2.0 DOCUMENT CHARACTERISTICS ........................................................................................................... 14 II. DOCUMENT CHARACTERISTICS ..................................................................................................... 14

2.0.1 DOCUMENT TYPE ................................................................................................................................ 14 2.0.2 DOCUMENT HOUSING CATEGORY .......................................................................................................... 14 2.0.3 GEOGRAPHICAL AREA COVERED ............................................................................................................ 14 2.0.4 PERIOD OF DOCUMENTS ...................................................................................................................... 15

2.1 QUALITY OF DOCUMENTS ................................................................................................................. 15 2.1.1 INTERRATER RELIABILITY....................................................................................................................... 17 2.1.2 QUALITY OF DOCUMENTS SUMMARY ..................................................................................................... 19

3.0 THEMES ....................................................................................................................................... 20 III. RESULTS AND FINDINGS .............................................................................................................. 20

3.0.1 NEEDS AND GAPS ............................................................................................................................... 21 3.0.1.1 Affordable Housing ................................................................................................................. 21 3.0.1.2 Support Systems (Non-Mental Health) ................................................................................... 25 3.0.1.3 Waiting Lists ............................................................................................................................ 26 3.0.1.4 Vacancy Rates ......................................................................................................................... 27 3.0.1.5 Core Housing Need ................................................................................................................. 27

TABLE OF CONTENTS


3.0.1.6 Housing Condition (Adequacy) ............................................................................................... 27 3.0.1.7 Supportive/Supported Housing .............................................................................................. 28 3.0.1.8 Shelter Beds ............................................................................................................................ 29 3.0.1.9 Long Term Care ....................................................................................................................... 29 3.0.1.10 Rent Increases/ High Rent .................................................................................................... 30 3.0.1.11 Mental Health/ Mental Health Supports .............................................................................. 31 3.0.1.12 Seniors Housing Supply ......................................................................................................... 32 3.0.1.13 Transportation ...................................................................................................................... 33 3.0.1.14 Transition Housing ................................................................................................................ 33 3.0.1.15 Gender Equality .................................................................................................................... 33 3.0.1.16 Alternate Level of Care (ALC) ................................................................................................ 34 3.0.1.17 One Bedroom Apartments/Units .......................................................................................... 35 3.0.1.18 Rental Units / Apartments .................................................................................................... 35 3.0.1.19 Discharge Planning ................................................................................................................ 36 3.0.1.20 Retirement Homes ................................................................................................................ 37 3.0.1.21 Halfway House ...................................................................................................................... 37

3.0.2 SOCIOECONOMICS ............................................................................................................................... 37 3.0.2.1 Income (Low Income/ Low Income Cut Off) ........................................................................... 37 3.0.2.2 Education ................................................................................................................................ 38 3.0.2.3 Labour Force/ Employment .................................................................................................... 38 3.0.2.4 Social Determinants of Health ................................................................................................ 39 3.0.2.5 Labour Force Interaction with Education ............................................................................... 39 3.0.2.6 Housing Tenure (Renters versus Owners) .............................................................................. 40 3.0.2.7 Local Economy ........................................................................................................................ 40 3.0.2.8 Income (Seniors) ..................................................................................................................... 40

3.0.3 DEMOGRAPHICS ................................................................................................................................. 41 3.0.3.1 Aging Population ..................................................................................................................... 41 3.0.3.2 Social Assistance Caseload ...................................................................................................... 41 3.0.3.3 Population Stagnancy ............................................................................................................. 42 3.0.3.4 Singles ..................................................................................................................................... 42 3.0.3.5 Youth Population Decline ....................................................................................................... 42 3.0.3.6 Immigrant Population ............................................................................................................. 42 3.0.3.7 Aboriginal Population ............................................................................................................. 43 3.0.3.8 Household Growth .................................................................................................................. 43 3.0.3.9 Mental Health Population ....................................................................................................... 43 3.0.3.10 Youth ..................................................................................................................................... 43 3.0.3.11 Seniors with Mental Illness ................................................................................................... 44

3.0.4 FUNDING/ RESOURCES ........................................................................................................................ 44 3.0.5 COLLABORATION ................................................................................................................................. 46

3.0.5.1 Inter-agency Collaboration ..................................................................................................... 46 3.0.5.2 No Wrong Door ....................................................................................................................... 47 3.0.5.3 System’s Thinking/ Holistic Approach..................................................................................... 47

3.0.6 COMMUNICATIONS ............................................................................................................................... 0 3.0.7 GEOGRAPHY ...................................................................................................................................... 48 3.0.8 GOVERNMENT POLICY/ LEGISLATION ..................................................................................................... 49 3.0.9 DATA/ KNOWLEDGE ............................................................................................................................ 49 3.0.10 CAUSES ........................................................................................................................................... 50 3.0.11 STIGMA ........................................................................................................................................... 51

TABLE OF CONTENTS


3.0.12 SUCCESS /BEST PRACTICES ................................................................................................................. 51 3.0.13 ABORIGINAL/ FIRST NATIONS .............................................................................................................. 52 3.0.14 INDICATORS OF PROGRESS/PROBLEMS ................................................................................................. 53 3.0.15 FUTURE NEEDS/ TARGETS/ DEMANDS .................................................................................................. 53

3.1 RECOMMENDATIONS EMERGING FROM THE LITERATURE .......................................................................... 55 4.0 CONCLUSIONS ................................................................................................................................ 57 IV. CONCLUSIONS ............................................................................................................................. 57 APPENDIX A: LIST OF RECOMMENDATIONS FROM LITERATURE REVIEW ............................................................. 59 REFERENCE LIST OF LITERATURE REVIEWED ................................................................................................. 83 BIBLIOGRAPHY .................................................................................................................................... 88

LIST OF FIGURES AND TABLES


1

Figure 1 Housing and Homelessness Themes and Sub-Themes Emerging from the Literature .................. iii Figure 2 Literature Review Schema .............................................................................................................. 7 Figure 3 Data and Analysis Process ............................................................................................................. 10 Table 1 Type of Document .......................................................................................................................... 14 Table 2 Housing Category ........................................................................................................................... 14 Table 3 Geographical Area Covered............................................................................................................ 14 Table 4 Period of Document ....................................................................................................................... 15 Table 5 Quality Checklist ............................................................................................................................. 16 Table 6 Quality of Report and Percent of Agreement between Researchers ............................................ 18 Table 7 Major Themes ................................................................................................................................ 20 Table 8 Needs and Gaps Sub Themes ......................................................................................................... 21 Table 9 Socioeconomics Sub Themes ......................................................................................................... 37 Table 10 Demographic Sub Themes............................................................................................................ 41 Table 11 Collaboration Sub Themes ........................................................................................................... 46

PREAMBLE


2

Background In 2010 the provincial government released its long term affordable housing strategy, Building

Foundations: Building Futures. A key component of the long term affordable housing strategy is the

Strong Communities through Affordable Housing Act, 2011. This legislation replaces the Social Housing

Reform Act, 2000, with the Housing Services Act (HSA), 2011. The main purpose of the HSA is to “provide

for community based planning and delivery of housing and homelessness services with general

provincial oversight and policy direction” and “provide flexibility for Service Managers and housing

providers while retaining requirements with respect to housing programs that predate this Act, and

housing projects that are subject to those programs” (Bill 140, Legislative Assembly of Ontario). Central

to the HSA is the requirement that Service Managers prepare local housing and homelessness plans

while addressing matters of provincial interest.

In view of the above, the District of Nipissing Social Services Administration Board (DNSSAB) has started

to develop a 10-year housing and homelessness plan for Nipissing District. The plan will also serve as a

five-year update of the Nipissing District Housing Needs, Supply & Affordability Study (2008) which

empirically revealed gaps in each area of the housing continuum and the subsequent need for more

acceptable housing in Nipissing District. The plan’s development centres around four research objectives

which include assessing the housing and homelessness landscape in Nipissing District, assessing the

district’s current and future housing needs, and developing an implementation plan. The implementation

plan will include strategies and tactics for addressing the housing gaps and needs in the district, and take

DNSSAB a step further towards realizing its vision of enhancing opportunities for citizen success.

Purpose of Literature Review Developing the 10-year housing and homelessness plan has started with an assessment of the district’s

housing and homelessness landscape. Conducting a literature review is an important part of this

assessment because it looks at the district’s housing and homelessness picture through the lens of an

existing body of empirical knowledge and evidence. Specifically, the results of the literature review will:

Capture what has already been said and done. Before embarking on the development of a 10-

year housing and homelessness plan for Nipissing District, it is important to look at the work

that has been done in the area of local housing and homelessness, and describe current

knowledge in this area.

Set the stage, and guide further development of the 10-year housing and homelessness plan.

The results of the literature review will help to direct – or redirect as the case may be – the

focus and emphasis of the plan’s development. For example, where there is already

documented empirical evidence of local housing or homelessness need, the planning emphasis

may turn more towards developing strategies and taking action for meeting that need – or

prioritizing the need in terms of funding and investment – rather than conducting more

research into the need. Conversely, the literature review may reveal gaps in data and

knowledge where more research or analysis is needed around a particular housing and/or

homelessness issue. Additionally, the results of the review will help to shape other areas of the

PREAMBLE


3

10-year housing and homelessness plan – such as the community consultations and focus

groups – by influencing the design of these sessions (objectives, types of questions, workshops,

etc.). The review’s conclusions may also impact the plan’s development.

Avoid “recreating the wheel” and “stakeholder fatigue”. Developing a housing and

homelessness plan in isolation of existing evidence is ineffective and not a good use of planning

resources. Having conducted the literature review, the researchers will be able to avoid

duplication and repeating what is already known to be true about local housing and

homelessness. Rather, the researchers – in consultation with the community and project

stakeholders - will take the existing evidence (given no change and continued relevancy) and

build it into the 10-year housing and homelessness plan. This will also help to avoid stakeholder

fatigue which occurs when the researchers go out in the community and ask stakeholders the

same types of questions, or discuss the same issues, which have been asked and discussed

many times before (and often resulting in little or no action).

Time Frame The literature review was conducted over a period of three months, between November 2012 and

February 2013. This period covered the entire project, including developing the review’s methodology,

framework, and tools; collecting and analyzing the literature and data; summarizing the results; and

drawing conclusions.

Report Production Members of the 10-year housing and homelessness plan research team conducted the literature review

and co-authored the report. The members of the research team are:

Kelly Clarke, Project Assistant Emma Langdon, Data Coordinator David Plumstead, Research Analyst

I. METHODOLOGY


1.0 Description As stated in the research design for the 10-year Housing and Homelessness Plan, the literature review is

a systematic review of housing and homelessness literature in Nipissing District and the district’s

municipalities and areas. The review identifies, evaluates, and descriptively synthesizes, the existing

housing and homelessness literature relevant to Nipissing District and its municipalities and areas. Given

the local nature of the review, the literature reviewed was grey (unpublished) literature and consisted of

reports, proceedings, community plans, discussion papers, government submissions, and local studies. 2

Given that the local housing and homelessness literature is grey and does not lend itself to statistical

review methodology such as meta-analysis, the literature review is a descriptive, qualitative one.

Specifically, the review takes an aggregative approach which combines the findings across the literature

through a meta-summary of the data.

1.1 Research Questions The research questions for the literature review were pre-determined by three of the research

objectives for the 10-year Housing and Homelessness Plan, as outlined in the plan’s research design.

The questions are as follows:

What is the housing and homelessness landscape in Nipissing District?

What are the current housing needs in Nipissing District?

What are the future housing needs in Nipissing District?

These questions guided the review and formed the main screening criteria for the literature (see

“screening”).

1.2 Search Strategy

1.2.1 Date of Literature

In terms of the literature reviewed, there were no limits or restrictions placed on the publication date -

the literature could be dated at any point in time. As the purpose of the review is to inform the

development of the 10-year Housing and Homelessness plan, any relevant literature that met the search

and screening criteria was considered to be valuable.

2 Grey literature generally refers to literature that has not been formally published (for example, in scientific

journals) or peer reviewed. The literature includes government reports, technical and research reports, policy documents, conference proceedings, dissertations, etc. As noted in the American Psychological Association’s (APA) Publication Manual, Sixth Edition, grey literature “can serve a valuable supplementary role to formal publication, including additional resources, details, research methods and experimental techniques” (p. 205).

I. METHODOLOGY


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1.2.2 Search Terms

The search for literature was a practical one intended to gather the greatest amount of literature

possible, on housing and homelessness in Nipissing District, and /or any of its municipalities and /or

areas. The terms used for the search included “housing” and /or “homelessness” and /or “Nipissing

District”; “Bonfield”; “Calvin”; “Chisholm”; “East Ferris”; “Mattawa”; “Mattawan”; Nipissing First

Nation”; “Nipissing 10”; “Nipissing North”; “Nipissing South”; “North Bay”; “ “Papineau-Cameron”;

“South Algonquin”; “Temagami”; “Temagami First Nation”; “Bear Island”; “West Nipissing”. Generally,

any literature from the prescribed data sources (below) that mentioned housing and/or homelessness in

Nipissing District and /or any of the municipalities and areas was accepted for initial review. The search

did not include content such as newspaper headlines or articles, presentations, program descriptions,

DVDs, meeting minutes, government communications /memos, Terms of References, etc..

The project researchers also asked others to perform a literature review within their respective work

files and organizations. These included members of the Nipissing Homelessness and Housing

Partnership, DNSSAB staff in the housing and social services department, and each municipality. While

guidelines for performing a systematic search were provided to these external parties, the actual search

terms and methodology they used are unknown.

1.2.3 Databases /Sources

All the databases/sources searched are identified below; this list is in alphabetical order and includes

databases/sources that yielded few or no results.

Academic One File (database)

Academic Search Premier (database)

Canadian Periodicals Quarterly (database)

Canadian Points of View (database)

District of Nipissing Social Services Administration Board, internal files

General web search (Google)

Google Scholar (database)

Nipissing District Homelessness & Housing Partnership (via email request for literature)

Nipissing District Municipalities (via letter requesting literature)

Ontario Government Documents (database)

Scholars Portal Journals (database)

Sociological Abstracts (database)

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Social Services Abstracts (database)

1.2.4 Search Results

The initial search produced 100 documents for review, none of which had been formally published.

Rather, the literature was in the form of community plans, government submissions, local studies and

reports, discussion papers, and conference / consultation (symposia) proceedings. The documents

ranged in size from one page to over 300 pages and covered a period of nearly 30 years, from 1984 to

2013.

1.3 Document Management and Review Tools SharePoint is being used by the research team to manage the large volume of information and data

associated with the 10-year housing and homelessness plan. SharePoint facilitates a central point of

access to the plan’s data and allows the researchers to work with multiple documents and data sets at

the same time. The literature review documents were transferred into SharePoint which gave the

researchers common access to the literature and a central platform to work from.

Each document was reviewed independently by two researchers using a standard reporting tool (see

below for an explanation). In some cases, the respective researchers were the authors of the documents

being reviewed. In these cases, the other two researchers reviewed the document (i.e., a researcher did

not review a document that he or she had written). This increased the objectivity of the review and

helped to eliminate any bias that might be present.

To facilitate the literature review process, a reporting tool and tracking sheet were developed. The

reporting tool was a standard report form which the researchers created to record their review notes.

The tool was also used to capture key document statistics such as the type of document reviewed, the

author, date, geographical scope and the quality of the document. The reporting tool standardized the

review process and helped to ensure that the researchers were consistent in their approach. The

researchers also created an Excel tracking sheet which enabled them to monitor the progress of

reviewing the 100 documents. At any given time, the researchers knew which document had been

reviewed by whom and which documents were completed (i.e. had been reviewed twice) or

outstanding.

1.4 Screening After the reporting and tracking tools were in place and the documents were uploaded to SharePoint,

they were screened for relevance to the study and review. The criteria used to determine whether or

not the respective documents would be included in the review were how well they assessed the

research questions. For example, if a document did not assess the housing and/or homelessness

landscape in Nipissing District or mention current and /or future housing needs in the district, it was

discarded from the review. Additionally, any duplicated documents were discarded (some of the

documents were the same but they had different file names). Each document was screened by two

I. METHODOLOGY


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researchers so there needed to be agreement before a document was discarded. At the end of the

screening process, 30 documents had been discarded leaving 70 for review3. Some of these remaining

documents however were part of a reoccurring series (there were 15 documents representing three

series) and the series of documents were reviewed using one reporting tool. This resulted in 58 review

reports (see figure 2). 4

Figure 2 Literature Review Schema

# excluded: 30

# documents reviewed: 70

# review reports: 58

Screening

Type of

document

Reports (22);

Symposia Proceedings (12);

Community Plans (6);

Discussion Papers (8);

Gov’t Submissions (6);

Local Studies (16)

Databases searched: 13

Document

characteristics

Quality

assessment

Data extraction

Meta-summary

Total documents: 100

Findings; Results;

Conclusions

3 Note: the Bibliography contains a list of all documents, including the literature that was not included by the

researchers and other scholarly sources. The Reference List of Literature Reviewed contains only the literature that was included. 4 Saini, M., & Shlonsky, A. (2012). Systematic Synthesis of Qualitative Research. New York: Oxford University Press

Figure 1 adapted from Systematic Synthesis of

Qualitative Research

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1.5 Quality Assessment In an academic setting, judging the quality of literature is an essential part of a literature review process.

This quality assessment judges literature on indicators such as the literature’s framework, the study

setting and design, data collection methods, analysis and findings5. While not all quality indicators may

be applicable to all literature, in general, the higher number of indicators a literature document has, the

better its “quality”.

That being said, for literature reviews such as this one where the focus is on local, grey literature,

academic (quality) standards are often not the primary consideration. Despite not necessarily being of

‘quality literature’ by academic standards, the local literature is valuable for the development of a 10-

year housing and homelessness plan because it describes current, local knowledge which includes

community insights and needs.

Additionally, assessing the quality of documents in a qualitative review can be challenging due to the

absence of generally accepted principles and procedures. As noted by Saini and Shlonsky “there remains

no consensus on an actual tool to guide decision making in the process of establishing quality”.6 This is

echoed by Fink who states “because few studies are perfect or even nearly perfect, reviewers are

typically on their own in deciding which criteria to apply and whether the quality of the data in a body of

literature is acceptable”.7

Having said the above, performing some sort of quality assessment of the local literature is integral to

conducting a sound, systematic review. Otherwise, the literature review becomes more of a subjective

one which can result in findings and conclusions that are less accurate.

As part of the reporting tool, the researchers developed the following quality checklist. The checklist has

eight, equally weighted questions that were considered to be a good cross-section of the quality and

rigor of the literature and data reviewed: 8

5 Saini, & Shlonsky, 2012.

6 Saini, & Shlonsky. 2012. (p. 113).

7 Fink, A. (2010). Conducting Research Literature Reviews: From the Internet to Paper (3rd ed.). Los Angeles: Sage

Publications Inc. (p. 170). 8 The eight questions were adapted from Saini & Shlonsky, 2012. (pp. 169-173).

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Q Does the Document Yes No Unsure N/A

1 Clearly state a research question /purpose?

2 Use a qualitative, quantitative or mixed approach appropriate to answer the research questions?

3 Is the setting of the study appropriate and specific?

4 Adequately describe the methods for data collection?

5 Consider ethical issues (e.g. informed consent, privacy, confidentiality)?

6 Is the process of data analysis presented with sufficient detail and depth to provide insight and meaning?

7 Do findings or recommendations emerge from the experiences/data /subjective interpretations of the sample?

8 Were stakeholders involved in the project?

Upon completion of reviewing a document, the researcher would go through the quality checklist and

answer each question. It should be noted that none of the local literature was discarded from the

review due to a poor quality rating. This may have eliminated data that is relevant and useful to the

development of a local 10-year housing and homelessness plan.9 Rather, in keeping with a systematic

review, the project researchers assessed quality to determine the ‘general quality’ of the literature as it

relates to supporting the findings and conclusions. Overall, the local literature reviewed was of

reasonable quality (see “quality of documents”).

1.6 Data Analysis Given the qualitative and descriptive nature of the literature review, the researchers took an

aggregative approach to analyzing the data. Specifically, a meta-summary of the literature was

performed which aggregated common themes and sub-themes across the 70 documents. The effect size

was determined by calculating the frequency of the themes across the literature. Sub-themes also

emerged during the analysis and their effect sizes and frequencies were also calculated. Through this

process of analysis, the housing and homelessness data was quantified at a thematic level.

The researchers also took an interpretive approach in forming their conclusions at the end of the review.

Each researcher drew their own conclusions based on their analysis and interpretation of the data.

Unlike the aggregative approach which quantifies the data and attempts to use the same interpretation

and language as found in the original documents, the interpretive approach builds upon the previous

analysis and provides a new, descriptive interpretation of how the data is connected and interacts. This

approach can include integrating themes or creating new ones, connecting the dots between themes, or

providing new explanations or meaning of the data.

9 For example, while a government submission document may not score particularly well on the quality checklist, it

is very useful because it states what the needs are and/or the recommendations being put forward, and the advocacy efforts to date.

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Below is a diagram showing the four steps in the data analysis process, followed by a brief description of

each step.

Figure 3 Data and Analysis Process

Step 1. Independent Data

Analysis:

- Data extraction

- Thematic analysis

Step 2. Group Data Analysis:

- Aggregate data

- Thematic analysis and discussion

- Counts: document characteristics;

themes; sub-themes

Step 3. Effect Sizes,

Theme Description,

Quality Assessment:

- Summary statistics

- Frequency of occurrence of

themes and sub-themes

- Theme and sub-theme description

- Quality checklist summary

Step 4. Conclusions:

- Interpretive analysis

1.6.1 Independent Data Analysis

The first step of analysis required the researchers to systematically work their way through the

documents, reading and reviewing each one (as stated previously, there were two reviews done on each

document). During this step the researchers used the reporting tool and extracted data which included

the document characteristics (author, date, type, category, etc.) and major findings. Taking a thematic

approach, the researchers then organized the findings under themes which emerged as they worked

through the document.

It’s interesting to note that approximately two-thirds of the way through this step, the researchers felt

they were reading the same thing over and over again and the analysis was producing similar data. This

represented the point of saturation whereby at the thematic level, the literature and data was not

revealing anything new about housing or homelessness in Nipissing District. Saturation is a good

indicator that the number of documents represents a sufficient sample size and the documents are

representative of the existing local housing and homelessness literature.

1.6.2 Group Data Analysis

The second step in the process was a group data analysis whereby the three researchers combined their

individual analyses and results to form new themes and sub-themes. During this step of analysis, the

researchers came together for a day to discuss their notes and findings and aggregate the data. Each

brought copies of their reports (the standard reporting tool) for the documents they had reviewed. Each

document was then discussed by the two researchers who had reviewed it while the third researcher

took notes on flip charts and joined in the discussion. In some cases the themes identified in the first

step of analysis (above) were common and these were carried forward and recorded. In other cases,

new themes and sub-themes emerged as the data was aggregated and interpreted collectively by the

three researchers. This was an iterative, emergent process as the data was discussed throughout the day

in terms of definitions, themes, and what the data was saying. During the analysis, the researchers kept

count of the document characteristics (type, geographical area, etc.) and the occurrences of the themes

and sub-themes so that the effect sizes could be calculated afterwards. In this manner, the aggregated

I. METHODOLOGY


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housing and homelessness data from the 70 documents could be quantified and common themes

identified. In most cases, there was agreement between the two researchers on their interpretation of

the respective documents. Most differences occurred in how the researchers had classified the type of

document or whether or not the data represented a theme or sub-theme. But generally it was perceived

that there was a high degree of interrater reliability, i.e. the researchers were in agreement and had

derived similar themes from the data.10

1.6.3 Effect Sizes, Theme Description, and Quality Assessment

The third step involved calculating the summary statistics of the document characteristics and the effect

sizes, and describing the themes. After the group data analysis, the flipchart notes and counts were

transferred into Excel where the summary statistics of the documents and the effect sizes could be

calculated. The effect sizes were calculated by dividing the number of occurrences of a given theme by

the number of review reports (note: as mentioned previously, the number of review reports is smaller

than the number of documents reviewed because some of the documents were part of a series and

were reviewed as one report). The themes and sub-themes were then described based on the

researcher’s notes from the reporting tools. In describing the themes, the researchers tried to stay with

the same language and meaning as presented in the original documents by the authors. However, the

researchers provided additional context and meaning in describing some of the themes where

necessary.

1.6.4 Conclusions Analysis

After the previous steps of analysis described above, the researchers were in a position to draw their

own conclusions based on their interpretation of the data. This provided an opportunity for the

researchers to step back and take a look at the big data picture, and put into their own words, the

meaning of the housing and homelessness s literature.

1.7 Limitations/Challenges

1.7.1 Conducting a Local, Qualitative Review

Unlike a traditional scholarly review of formally published literature such as scientific journals, there are

no set guidelines or procedures for conducting a systematic, qualitative review of local, grey literature.

This becomes particularly evident when trying to conduct a systematic search for local studies or

evaluate the quality of the data across a diverse set of community documents. However – like the

scholarly review – the local review needs to be as rigorous as possible in order to produce accurate

findings and results, and draw sound conclusions from the data.

10

Measuring the agreement between the two researchers can be done through various statistical methods. However, this would add in another layer of analysis, and was beyond the scope of this review due to project time constraints.

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With no clear roadmap to follow – and being the first local literature review of its kind in the area of

housing and homelessness – this review was challenging to design and implement. To help overcome

the challenges, Saini’s and Shlonsky’s Systematic Synthesis of Qualitative Research proved a valuable

reference guide and resource for the local review. The housing and homelessness plan researchers were

also able to draw from their academic experience with literature reviews, and tailor that experience to

the local situation.

1.7.2 Finding Literature

As mentioned previously, trying to conduct a systematic search to find local grey literature on housing

and homelessness proved to be difficult. Unlike a review of published studies, there were no public and

private bibliographic databases or libraries which conveniently housed all the literature. There was also

no way to determine how much relevant literature was in the community or where it was located. In the

end, most of the literature came from community organizations and groups, and government agencies.

Fortunately, the search produced a large number of local documents which revealed a great deal of

information and data about housing and homelessness in Nipissing District.

1.7.3 Quality Assessment

As discussed in section 1.5, adhering to strict academic quality standards for a community focused

literature review, was difficult – and impractical. If rigorous quality control indicators were utilized, very

few pieces of local literature would be acceptable and thus limit the scope of the review.

Quality literature in a community setting is not the same as quality literature in an academic setting.

The latter often focuses on peer-review processes, strict research design, ethical considerations and

stringent data collection processes and analysis. On the other hand, during the literature review, it

became apparent, that quality community – grey – literature, occurs when the community

(stakeholders) are involved in the design, analysis and outcomes; the authenticity of experience.

Despite not meeting rigorous academic standards for quality, the information gathered from the grey

literature provides historical and contextual information about the community’s experiences with

housing and homelessness.

1.7.4 Statistical or Practical Significance?

The literature review as conducted faced certain challenges and limitations that should be discussed

further. The implication of practical versus statistical (academic) significance plays a central role when

conducting a review of literature on a specific topic. Documents deemed to be statistical or academic

are often those published in an academic journal and frequently involve statistical analysis conducted on

the data gathered. That said discounting documents that do not meet the requirements to be

considered academic may result in a disregard of important information not captured in academic

research. For example, it has been suggested that there is a publication bias in some academic journals

I. METHODOLOGY


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in that they frequently do not publish studies that fail to show significant findings11. Therefore, despite

the fact that a lot of the documents reviewed in this literature review were of the qualitative nature and

therefore did not involve statistical analysis, a lot of key themes and trends arouse from the

documentation that may have been missed if they had been dismissed. Additionally, due to the fact that

limited statistical/academic research is available on housing and homelessness specific to Nipissing

District this review of literature and findings may direct future academic research.

1.8 Benefits /Opportunities

1.8.1 Increased Validity

The literature review provides another valuable source of data with which to triangulate the 10-year

housing and homelessness plan data. This increases the validity of the study and its findings,

conclusions, and recommendations.

1.8.2 Not Starting From Scratch

In keeping with one of the project’s values of not recreating the wheel, the remaining research

objectives for the 10-year housing and homelessness plan will be completed with the review’s findings

in mind. There is no benefit to conducting further research about something that is already well known

and this will avoid duplication and repetition. Invariably, the literature review will save work and time

further on in the plan’s development process because the community stakeholders and project planners

are not starting from scratch.

11

Ferguson, C. J., & Heene, M. (2012). A vast graveyard of undead theories: Publication bias and psychological science’s aversion to the null.

Perspectives on Psychological Science, 7(6), 555-561. doi:10.1177/1745691612459059

II. DOCUMENT CHARACTERISTICS


14

2.0 Document Characteristics The following tables characterize the documents, by document type, housing category, geographical

area covered and the period of the document.

2.0.1 Document Type

As Figure 1 indicated, there were 70 documents reviewed (as noted earlier, 15 of these documents were

part of a series and were combined into one review – thus there were 58 review reports). The

documents were categorized into one of six types as listed in Table 1 below:

Table 1 Type of Document The largest number of documents reviewed were reports

(n=22 or 31%) followed by local study (n=16 or 23%) and

symposia proceedings (n=12 or 17%).

In categorizing the type of document, there were some

overlaps between reports, discussion papers and local

studies. At times, when the analysts had categorized a

document differently, a subjective decision was made as to

the type of document it was.

2.0.2 Document Housing Category

The documents reviewed fell into one of three categories: housing, homelessness, or housing and

homelessness. The table below shows the breakdown:

Table 2 Housing Category The majority of the documents (66%) covered housing

while 20% covered housing and homelessness. The

remaining 14% covered homelessness.

2.0.3 Geographical Area Covered

The researchers categorized the documents by the geographical area the document related to. Table 3

shows the number of documents by area of geography.

Table 3 Geographical Area Covered When a document was written about a geography

level larger (or higher) than Nipissing District, it was

cited as a Nipissing article. These documents were

often for health regions such as the North East Local

Health Integration Network (LHIN).

Most documents (n=40 or 57%) referenced the entire District of Nipissing, 20 articles (29%) referenced

Type of Document Number

Report 22

Local Study 16

Symposia Proceeding 12

Discussion Paper 8

Community Plan 6

Government Submission 6

Total 70

Category Number

Housing 46

Housing and Homelessness 14

Homelessness 10

Total 70

Area Covered Number

Nipissing District 40

North Bay 20

Nipissing District and North Bay 9

Other 1

Total 70



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only North Bay, nine articles (13%) referenced all of Nipissing District and North Bay specifically, and one

article was for another municipality (Temagami). This indicates that there has not been much written

about housing or homelessness in the district’s remaining municipalities and areas.

2.0.4 Period of Documents

The documents were also characterized by the period the document was published or created. Table 4

illustrates the date range of documents reviewed.

Table 4 Period of Document The earliest document was published in 1984 and the most

recent document was published in 2013. Approximately

72% of the documents were published since 2005; 41% of

these were published between 2005 and 2009 while the

other 31% were published between 2010 and 2013.

Of the remaining documents, 16% were published in the

early half of 2000’s and 6% (n=4) were published in 1999 or

earlier. It should be noted that only one article was published before 1998, the other articles were

published in 1998 or 1999. A further 6% of documents had no known date.

2.1 Quality of Documents As mentioned earlier in the report, each researcher performed a subjective evaluation of the quality of

the documents they reviewed by means of a quality checklist in the reporting tool. As each document

was reviewed by two researchers, there were two independent quality assessments for each document.

For each document reviewed, the respective researchers went through the checklist and answered the

questions with one of four possible answers: “yes”, “no”, “unsure” and “N/A” (not applicable).

Table 5 on the following page shows the results of the quality assessment of the literature. The results

for each question were calculated by adding the totals for each of the four answers for that question by

both researchers, and dividing those by the total number of answers for the question (each researcher

completed 58 quality checklists so there were 116 answers for each question).

Period of Document Number

1984-1999 4

2000-2004 11

2005-2009 29

2010-2013 (present) 22

No date/ date unknown 4

Total 70



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Table 5 Quality Checklist

On average, 55.4% of the quality questions across the documents scored a “yes” and this percentage

increases to 68% when the “not applicable” is removed from the calculation (some of the questions are

not applicable to some of the documents). Overall, this indicates literature of a reasonable quality. As

noted from the table however, the quality of literature varies, depending upon the area being

measured. The following summarizes the table further by question:

On average, close to three-quarters of the literature reviewed was of high quality (scoring a “yes”) in

terms of stating a clear research question or purpose, and taking a qualitative or quantitative approach

to addressing that question or purpose (questions 1 and 2). The setting of the respective documents

(question 3) speaks to their contextual elements and this quality indicator also scored high in

approximately two-thirds of the documents.

Generally in literature of high quality, the findings and/or recommendations should emerge from the

data and evidence presented, and this was the case in two-thirds of the local documents reviewed

(question 7). This number increases to nearly 80% when the “not applicable” is accounted for (some

documents such as community plans may not present recommendations or findings). For nearly one in

five documents however, either the findings and /or recommendations were not supported by the data

or it was unclear if this was the case.

Involving stakeholders in some form or other is important for many local studies or community planning.

In approximately half of the documents reviewed, stakeholders had been involved in the study (question

8) although this number increases to 64% when the “not applicable” is accounted for (some studies –

particularly quantitative ones – may not involve stakeholders). In approximately one quarter of the

documents however, it was unclear as to whether stakeholders had been involved in the study or not.

Q Does the document: Yes %

No %

Unsure %

N/A %

Total %

1 Clearly state a research question/purpose? 73.3 12.9 5.2 8.6 100

2 Use a qualitative, quantitative or mixed approach appropriate to answer the research questions?

71.6 5.2 12.9 10.3 100

3 Is the setting of the study appropriate and specific? 68.1 1.7 14.7 15.5 100

4 Adequately describe the methods for data collection? 46.6 31.9 6.0 15.5 100

5 Consider ethical issues (e.g. informed consent, privacy, confidentiality)?

6.9 1.7 41.4 50.0 100

6 Is the process of data analysis presented with sufficient detail and depth to provide insight and meaning?

57.8 16.4 12.1 13.8 100

7 Do findings or recommendations emerge from the experiences/data/ subjective interpretations of the sample?

66.4 3.4 14.7 15.5 100

8 Were stakeholders involved in the project? 52.6 2.6 26.7 18.1 100

Total 55.4 9.5 16.7 18.4 100

Total with “N/A” removed 67.9 11.6 20.5 / 100



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In over half the literature reviewed, the data analysis was sufficient to provide insight and meaning, and

this number increased to 67% when the ‘non applicable’ literature was removed. However, in the

remaining cases (28.5%) the analysis did not provide a clear meaning of the underlying data or it was

unclear.

The documents were of weaker quality in describing their data collection methodology (question 4) with

less than half scoring a high quality rating in this area. While this quality indicator was not applicable to

some of the documents, there was still a relatively large percentage (38%) of the cases that did not

describe their methodology or the methodology was unclear.

Most of the documents had poor quality in terms of conformance to research ethics (question 5). While

ethics considerations were not applicable in half the cases, the researchers were unsure if ethics had

been considered in another 41% of the cases.

2.1.1 Interrater Reliability

As mentioned above, there were two quality checklists completed for each document by any two of the

three researchers. Thus, when evaluating the overall quality of literature, it is also important to look at

the extent of agreement between the researchers on their measure of quality. There are various

statistical methods that can be used to check the consistency and level of agreement between the

researchers. For the purpose of this study, the percentage of agreement is used because of its simplicity

and adequacy for the project.12

The percentage of agreement is calculated by taking the number of times the two researchers agreed on

the quality questions and dividing that by the total number of questions. For example, there were 58

review reports (or reporting tools) completed for the 70 documents reviewed, and each review report

had a quality checklist consisting of eight questions with four possible answers each (see Table 5) – thus

in total, there were 464 quality questions (with four possible answers). The total percentage of

agreement is the sum of the number of times that the two researchers agreed on their answers for each

of the eight questions in the 58 checklists, divided by the total number of questions – in this case 464. In

this manner, the percentage of agreement can be calculated at any level of the data, including the

aggregated total, any sub-group level, or by quality component (i.e. for each question).

In terms of the overall results, there was agreement between any two of the researchers on their

assessment of the literature’s quality, 62.7% of the time. General industry guidelines suggest that this is

12

The percentage of agreement does not take into account the agreement between the researchers that could occur by chance alone. For example, each question on the quality checklist represents a 4 x 4 table with 16 possible combinations of answers (of which four could be in agreement) so there is a 0.25 theoretical probability that the two researchers will choose the same answer by chance over a repeated number of assessments. For a more robust measurement of agreement between the researchers, this probability of chance could be accounted for using other statistical methods. However, there is not enough time in the project to do the additional analysis required by these other methodologies (or the software which would speed the analysis up). Additionally, the researchers feel that the percent of agreement is sufficient for the overall quality assessment of the local literature because it provides a general indication of the extent to which there is agreement.



18

substantial agreement between the researchers. However, while the agreement is reasonably strong

overall, it starts to weaken at lower levels of the data. For example, Table 6 below shows the percentage

of agreement between the researchers for three sub-groups of quality. The groups are based on the

number of questions that both researchers answered “Yes” to on the quality checklist:

Table 6 Quality of Report and Percent of Agreement between Researchers

Quality of literature

# questions on checklist where both researchers answered “yes”

# quality checklists

Percentage of agreement

High 7 or more “Yes” 9 91.7

Medium 5 or 6 “Yes” 20 75.0

Low 4 or less “Yes” 29 45.3

Total 8 questions 58 62.7

It can be noted that in 15.5% (9) of the cases, the literature reviewed was of high quality as both

researchers answered “yes” to seven or more of the questions and their percentage of agreement was

over 90%. Most of this literature was found to be in the form of local studies. Another 35.5% of the

literature is considered to be of medium quality, with both researchers answering “yes” to five or six of

the questions and the percentage of agreement between the researchers still high at 75%.

However, the remaining literature (50%) is considered low quality with both researchers answering

“yes” to four or less of the questions. The percentage of agreement between the researchers for this

group of literature was also low (below 50%) which indicates that their measure of quality varied

significantly and was inconsistent. Reviewing the document characteristics of this group helps to provide

an explanation for the low quality. Most of these documents were government submissions, community

plans, symposia proceedings, or Discussion Papers, which don’t necessarily lend themselves to the type

of quality demanded in a literature review. For example, a government submission often needs to be

direct and to the point – it won’t go into detail around research methodology. Also, in discussing these

quality assessment results afterwards, some researcher bias became evident. For example, in some

cases a researcher was familiar with the community planning process specified in the documents and

assessed the quality with that additional knowledge in mind (biased). The other researcher assessing the

same document however was not familiar with the community planning process and assessed the

quality based on what was in the document (unbiased). In cases like these the quality assessments could

vary widely. Another common example of the inconsistency in quality assessment for this group of

literature had to do with the “N/A” answer. There were many cases where a researcher felt that certain

questions were not applicable to a given document – most of the time this was the unbiased researcher

(above). The other researcher however – in most cases the biased one – thought otherwise (based on

the additional knowledge they had about the document) and answered the questions differently.

The above are good examples of some of the difficulties that were encountered in trying to assess the

quality of the local, unpublished literature, as mentioned elsewhere in the report. It should also be

noted that apart from developing the quality assessment checklist - and prior to conducting the quality

assessment of the literature – the researchers did not discuss their approach to answering the quality

questions or the definitions of the quality components, etc. Spending more time in this area may have



19

increased the percentage of agreement between them, especially for the literature that ended up in the

‘low quality’ group.

2.1.2 Quality of Documents Summary

In summarizing the above sections, the local documents were of reasonable quality overall, with 68% of

them scoring a “Yes” on the quality questions across the documents (this is with the removal of the

documents which the quality questions did not apply to). However, there was variation in the quality of

the literature at the component level. The literature was of highest quality in stating a clear research

question or purpose, and describing the approach taken to address that question or purpose. The

literature was of lowest quality in the area of ethics and in stating the methodology for data collection.

The three project researchers conducted the quality assessment on a rotating basis with two of them

each completing a quality checklist for the respective documents at any given time. Overall, the

researchers agreed on their measurement of quality 62.7% of the time which is considered to be

substantial. Half the literature was of medium-to-high quality with both researchers answering “Yes” on

five or more of the quality questions, and their percentage of agreement being 75% or higher. The other

half of the documents were of low quality with both researchers answering “yes” to four or less of the

questions and their percentage of agreement below 50%. In order to find the reason for this

inconsistency between the researchers, the data was analyzed further and it became evident that most

of these documents were government submissions, community plans, symposia proceedings, or

Discussion Papers (most of the documents in the higher quality literature were local studies or reports).

These types of documents don’t necessarily lend themselves to the high quality standards demanded in

a literature review and as a result, the researchers started to diverge on how they interpreted the

quality of these documents. Researcher bias also surfaced during the quality assessment of this group of

documents which contributed to the inconsistency and low percentage of agreement between the

researchers.

In closing, the researchers feel that based on their method of assessing quality, the local literature they

reviewed is of overall reasonable quality.

III. RESULTS AND FINDINGS


20

3.0 Themes The researchers, during the group analysis, categorized the major themes in the documents. There

were 15 major themes and 43 sub themes. Table 7 lists the major themes, in descending order.

Reviews often had more than one theme, thus, the frequency sum is greater than the 58 review reports.

The percentage is based on the total number of review reports (58).

Table 7 Major Themes Almost all the documents (97%) had

needs and/or gaps as a major

theme. There were 21 sub-themes

within needs and/or gaps and these

are discussed below in section

3.0.1.

Socioeconomics and demographics

were the second and third most

popular themes (67% 59%

respectively). These themes also

had a number of sub themes which

are also discussed below (sections

3.0.2 and sections 3.0.3

respectively).

Half the documents discussed funding or resources, 44% discussed collaboration and 21% discussed

communications. Documents which discussed collaboration have sub themes and are discussed below

under collaboration in section 3.0.5. Approximately one-fifth of documents discussed geography,

government policy or legislation, data or knowledge, the cause(s) of homelessness or housing need and

the stigma of homelessness/ housing need. Ten percent of the review reports described successes or

best practices, 7% discussed Aboriginal or First Nations peoples, 5% discussed indicators of problems or

progress and 5% discussed future needs, targets or demands.

The next sections will describe the major and sub themes. However, it is important to remember that

no theme exists in isolation. For example, the need for increased or core funding (major theme), is

often one of the key factors in the specific needs and gaps (another major theme). As well, an aging

demographic (demographic sub theme) is putting pressure on the senior housing supply, including long

term care, alternative level of care, retirement homes and supportive/supported housing (needs /gaps

sub themes). These are just two of the many examples of how the themes and sub themes interact.

The information in the sections that follow are drawn from the literature reviewed, relevant background

information was added as necessary by the researchers. Please see Reference List of Literature

Reviewed for a complete list of literature used in this review.

Major Theme Frequency %

Needs/Gaps 56 97%

Socioeconomics 39 67%

Demographics 34 59%

Funding/ Resources 29 50%

Collaboration 26 44%

Communications 21 36%

Geography 13 22%

Government policy/ Legislation 13 22%

Data/ Knowledge 12 21%

Cause(s) 11 19%

Stigma 11 19%

Success/ Best practices 6 10%

Aboriginal/ First Nations 4 7%

Indicators of progress/ problems 3 5%

Future needs/ targets/ demands 3 5%



21

3.0.1 Needs and Gaps

There were 21 sub-themes identified under needs and gaps in the literature. These sub themes are

listed in descending order in table 8 below. As was the case for identified major themes, reviews often

had more than one sub theme, thus the frequency sum is greater than the 56 review reports.

One central theme was related to acceptable housing and core housing need. According to the Canada

Mortgage and Housing Corporation (CMHC), acceptable housing is housing that is of adequate condition

(housing that is not in need of major repair), suitable size (enough bedrooms and size for the makeup of

residents) and affordable (costs less than 30% of gross income). When a household does not meet one

or more of these standards they are in ‘core housing need’. Affordable housing and housing condition

(indicated in the table by a *) are two components of acceptable housing and core housing need (also

indicated by a *).

Table 8 Needs and Gaps Sub Themes 3.0.1.1 Affordable Housing

Affordable housing was cited as a

need/gap by almost three-quarters

of all review reports. Affordable

housing is a component of

acceptable housing and is closely

related to core housing need (see

section 3.0.1.5 below) and housing

condition or adequacy (section

3.0.1.6).

Housing that is not affordable is

defined by the CMHC as

households that spend greater than

30% of their gross income on rent

and utilities or mortgage (principal

and interest), property taxes and

utilities. In one of the local studies,

an annual income of $30,000 was

set as the affordable housing

threshold for local households (i.e.

depending on family composition

and size, many households with incomes less than this would find themselves in unaffordable housing

based on local average rents and utility costs).

Needs and Gaps Sub Theme Frequency %

Affordable housing* 41 73%

Support systems (non-mental health) 30 54%

Waiting lists 21 38%

Vacancy rates 19 34%

Core housing need* 19 34%

Housing condition (adequacy)* 18 32%

Supportive/supported housing 18 32%

Shelter beds 14 25%

Long term care 12 21%

Rent increases/ high rent 12 21%

Mental health/ mental health supports 11 20%

Senior housing supply 11 20%

Transportation 10 18%

Transition housing 8 14%

Gender equality 8 14%

Alternate level of care (ALC) 8 14%

One bedroom apartments/units 7 13%

Apartments / Rental units 7 13%

Discharge planning 6 11%

Retirement homes 3 5%

Halfway house 3 5%

Total Needs and Gaps Review Reports 56



22

In 1981, 4500 households were in housing need in terms of affordability; in 2006, 9100

households spent more than 30% of gross annual income on housing.

Nipissing District Housing Needs, Supply and Affordability Study (2008)

The number of residents in Nipissing District who

require affordable housing has increased since 1981.

In 1995, 48% of tenants (renters) spent 30% or more of

their income on rent and 23% spent 50% or more of

their income on rent13. In that same year, 130

scheduled social housing units were cancelled.

By 2006 (the latest data available) 27% of the district’s

households spent 30% or more of their income on housing14. This percentage has remained relatively

steady since 1981; however, in absolute terms the number of households who spent more than 30% of

their income on housing has doubled. In 198115, 4500 households were in need of affordable housing;

in 2006, 9100 households were in need of affordable housing (i.e. they were spending more than 30% of

gross income on housing).

The affordability gap depends on the municipality – rent is often less expensive in the rural parts of the

district. In West Nipissing and Mattawa, 56% of renters pay more than 30% of their income on rent –

the Ontario average is 42%, and in Chisholm it is 18%16. North Bay’s housing costs (based on median

monthly payments) are higher than other northern communities such as Sault Ste. Marie and Timmins.

The literature often mentioned that there is

a huge gap between a single individual’s

household income and rent. Seventy

percent of singles that are supported by the

Ontario Disability Support Program (ODSP)

spend between 53-63% of their income on

housing; this is higher than non-disabled

singles in Nipissing. The shelter allowance

for social assistance recipients is not

enough to cover the average one bedroom

rent in the district17. As 65% of the social

assistance case load are singles and the fact

that singles are the fastest growing household in the district, this group is most in need of affordable

housing. Non-singles spend between 30%-42% or more on housing.

All citizens require affordable housing and there is a shortage of affordable housing in every

demographic category. Although North Bay has created affordable housing units in the last decade, it is

13

O’Brien Davis, 2001 14

Plumstead, 2010 15

Note: in 1981 the affordability threshold was 25% of gross income but in 2006 it was 30%. 16

District of Nipissing Social Services Administration Board (DNSSAB), 2008b 17

DNSSAB, 2006

A man on ODSP says, “My shelter allowance on ODSP is $447. You cannot rent decent housing. I put up with

cockroaches. I get about $1000 dollars a month. Well, $447 for housing, $600 for food. It’s not fair to have to take food money to pay rent. A one bedroom at market

rent in North Bay costs $600. I am not asking for a mansion. Do I pay the rent or do I eat? It’s not fair to have to take money from basic necessities. I don’t get to go to the grocery store. I don’t like to go to the soup kitchen. I feel less of a person to go to the soup kitchen

and food banks. There just is not enough money.”

Living the Story: Local Experiences of Poverty and Ideas for Change (2010)



23

Nipissing District is not only faced with the current affordable housing shortage… but also the prospect of the situation not improving, or

even worsening.


not enough to meet the demand. Currently the demand for social and affordable housing exceeds the

current or available supply.

The literature stated that the lack of affordable housing and the low availability of housing for workers is

a barrier to decent employment and a strong workforce. In addition, the significant social assistance

caseloads and the significant percentage of working poor/low income earners increase the demand for

affordable housing. Without start-up funds, such as

first and last month’s rent, many individuals find

housing difficult to attain. High rents result in

difficulty paying for other essentials such as food.

Youth who want or need to remove themselves

from their current living situation (such as an

unhealthy relationship with parents or guardians,

because they are couch surfing etc.) are unable to find safe affordable housing.

The increase in students at Nipissing University and Canadore College also affects the availability of

affordable housing as students require affordable, quality, housing. Since 2000, student enrolment has

double at the university and approximately 85% of the students come from outside North Bay. This has

implications on housing stock and availability in a market with one of the lowest vacancy rates in the

province.

There is also a need for the creation of affordable housing that meets the needs of citizens who require

special assistance; including accessible and supportive housing, especially for seniors and people with

physical or mental disabilities. Further, there is a lack

of funding available to modify units for tenants with

special needs or to retrofit units for the future

projected needs.

Affordable housing is also important for new

immigrants to North Bay. In a survey of newcomers

(immigrants) to Canada who have decided to settle in North Bay, 26% felt that housing is not affordable

and some indicated the required repairs were not affordable18. Of those surveyed, 14% were unhappy

or very unhappy with their current housing situation. This is important as any projected increase in

population will be the result of in-migration.

There is lack of government incentives to develop, build and create affordable housing (see funding,

section 3.0.4), and the creation of new programs will not solve this issue. Rent supplements are one

program that works well to allow individuals to retain affordable housing. Many citizens receive rent

supplements in order to afford housing, but more are needed.

18

Welch, 2007

Vision: Provide [acceptable] housing for all socio-economic levels that are well mixed

and not clustered

The Report from the Sustainable Community Advisory Committee (2006)



24

The current social housing landscape has many different providers with many different mandates.

Social housing agencies/landlords (and private landlords) find it difficult to balance an individual’s rights

within a unit with the rights of all individuals in the buildings, and by extension help maintain

accommodation for all residents. Social housing agencies are also finding that buildings have a lack of

space and storage space for the tenants and are forced to comply and update buildings with building

code and legislative changes, which are often expensive. Many citizens also prefer to be in social

housing because of sub-standard units in the private market. There are also questions about the future

of social housing as contracts begin to expire in 2013.

The creation of affordable housing needs to be sustainable and consider the environmental, economic

and the social or cultural needs of the community. Individuals, from all income levels, often want the

same ‘things’ when they look at housing, including quiet, clean neighbourhoods that are good for

children and they are concerned about the cost of housing, community safety and community

cleanliness.19

Furthermore, there needs to be a balance to housing development with one vision for the future being

to provide housing for all income levels. Upscale housing developments are not affordable for all

citizens; therefore there is a need to produce affordable housing for everyone rather than only high-end

housing. Housing prices (in North Bay) are comparable to communities in southern Ontario; yet the

median incomes of citizens in North Bay and Nipissing are lower.

Different municipalities need to place different emphasis on the type of affordable housing needed. For

example, Temagami, South Algonquin and Mattawa have a relatively high proportion of seniors in their

population, thus they need to place priority on senior’s housing. Moreover, Nipissing First Nation’s

senior’s population has quintupled in the past twenty years; however, it is also one of the youngest

population centres. Bonfield and Chisholm have a high percentage of children and youth and a lower

percentage of seniors, thus priority will need to be placed on affordable housing for working

households. North Bay and West Nipissing have a high percentage of youth and seniors, thus affordable

housing needs to be created for all age groups and

household types.

Private developers and landlords need to be

encouraged to maintain and create appropriate

affordable stock. Literature stated that in setting

targets it is important to create targets for a range

of incomes as approximately 40% of households

have incomes less than the $30,000 affordability threshold. There needs to be affordable housing for

renters with incomes of less than $30,000 annually and affordable housing targets for home ownership

with incomes between $30,000 and $45,000 annually20.

19

TWP Consulting Inc. Management Consultants, 1999 20

DNSSAB, 2008b

The municipality [North Bay] needs to provide incentive and leadership in the housing market – create housing development within the city:

each house transaction puts approximately $30K into the local economy.

Nipissing District Needs, Supply and Affordability Study (2008)



25

Developers are seeing an increased demand for one and two bedroom houses (which is similar to the

demand for one bedroom rental apartments in section 3.0.1.17). Recent housing starts have been for

semi-detached or detached housing (which is often the more expensive end of the market) or high end

market homes; very few affordable entry-level homes are being built. Land development costs are high;

it can cost $50,000 before a hole is dug. There is unused capacity (for land development), but

development regulation or legislation prohibits it. However, the supply side of the equation is slightly

distorted as a single North Bay developer has market dominance21 and owns many lots within the city.

What is required to create affordable housing options for home owners is municipal leadership.

Housing is currently being built outside North Bay (and the district) on demand because of more

affordable lots.

3.0.1.2 Support Systems (Non-Mental Health)

The need for and the importance of non-mental health support systems for vulnerable, at-risk or

homeless citizens was cited in more than half of the review reports (54%). High risk clients are hard to

reach and accessing the right service at the right time is limited or difficult. Strengthening local supports

can help reduce poverty and are needed to help individuals maintain housing.

In general there is a need for increased resources (human and financial) and capacity across the district,

including physicians, personal support workers and assisted living services. The need for increased

funding and resources is discussed in section 3.0.4.

The literature reported there is sometimes a lack of access to appropriate and timely core support

services. As such, some citizens look for alternative support services (outside of the core housing and

homelessness sector) such as churches and food security programs (food banks, soup kitchens, school

meal programs etc.). There is also a need to respond to some of the housing needs in rural communities

where access or transportation to support services is limited or difficult. Individuals who live in rural

communities do not receive all the services they need within their communities (also see geography,

section 3.0.7).

In literature from 1999, landlords indicated interest in action planning and taking part in discussions

regarding housing. More recent literature has shown local landlords have expressed concerns about

responding to their tenant’s problems – the landlord is unable to help or get help for some tenants.

Landlords feel that they are becoming social workers, by supporting tenants to remain in housing.

Landlords articulated that they do not have the ability, training, or knowledge to support tenants in

units. While there are many supports systems to assist individuals in finding appropriate housing, many

tenants are left without support to maintain housing once they are placed in a unit. For example,

tenants with serious mental illnesses often need reassurance and help once they are placed in a unit,

which landlords are sometimes left to do in the absence of supports.

Another segment of the population who require support services are youth. There are few community

organizations that have a mandate to deal with vulnerable youth; many agencies with multiple

21

C. N. Watson and Associates Ltd., 2009



26

mandates often mean youth fall through the cracks. For example, there are no street-level outreach

workers in Nipissing to help the homeless or at-risk youth. In addition there is a lack of addiction

services, social supports, recreation opportunities and life skills training for youth. Youth sometimes

require flexible alternative education and employment training programs which is difficult to access.

Another example in a lack of support services occurs when a youth finds themself homeless; there is no

one to talk to other than suicide prevention.

3.0.1.3 Waiting Lists

Waiting lists for housing was discussed by 38% of review reports. There is a long waiting list for social

and supportive housing in the district and across the province. Singles represent the biggest area of

need and are the most difficult to house due to the lack of one bedroom units. The average wait time

for a one bedroom unit is four years; a supportive housing unit is ten years. Couples without children

and singles have the longest waiting time for social housing: these are also the fasting growing groups in

the district. In 2011, seniors represented 23.5% of the social housing waiting list22. Social housing wait

lists could be reduced if private landlords had affordable rental housing.

Approximately one-quarter of individuals on the

social housing waiting list are ODSP clients23.

Individuals who have intellectual disabilities are

waiting for appropriate housing on other waiting

lists such as wait lists for group homes. There is a

three to five year wait for appropriate social

housing, a five to ten year wait for group homes

and a three to five year wait for independent living

units with supports. As such, there are many

individuals with disabilities who do not apply for the waiting list for housing because they believe it is

futile.

Local surveys also produced other data related to the social housing waiting list. For example, one

survey from 2009 showed 87% of Ontario Works (OW) applicants (who were not in social housing)24 had

not applied for social housing but 21% indicated they intended to apply to the social housing wait list25,

thereby increasing the demand for social housing. Another survey indicated 93% of the waiting list

applicants were very satisfied with the level of service they received26, but the location of the registry

office was not central and the hours were limited, which made accessing registry services difficult.

22

DNSSAB, 2011a 23

DNSSAB, 2006 24

6% of citizens indicated they were living in social housing 25

DNSSAB, 2009b 26

Clarke & Belanger, 2012

Couples without children and singles currently have the longest waiting time on the social

housing waiting list: couples without children are waiting for over 5 years for housing while

singles are waiting for 1.5 years …couples without children and singles are also the

fastest growing household types in the District




27

In Nipissing, the housing conditions reflect a lower standard

of living than the provincial averages

A Demographic Profile of Nipissing District with Social Indicators. (1984)

3.0.1.4 Vacancy Rates

Vacancy rate was a sub theme in 34% of the literature with needs/gaps. It should be noted that almost

all the documents discussed vacancy rates as it relates to North Bay. (Note: vacancy rate information is

published semi-annually by the CMHC for only North Bay and West Nipissing in Nipissing District).

North Bay has consistently had one of the lowest vacancy rates in the province, with a vacancy rate

often below 1%.27 North Bay’s vacancy rate has been below the 3% equilibrium for 12 of the 19 years

prior to 200828. Higher vacancy rates allow more choice for, and keep rents at a reasonable level for

residents with lower incomes. Without an increase in the rental housing stock, the rental market will

continue to get tighter.

3.0.1.5 Core Housing Need

As defined by the CMHC, core housing need occurs when households fall below one or more of the

standards of affordability, adequacy or suitability, and they need to spend more than 30% of their gross

annual income to pay the median rent of alternative housing that meets all three standards. Thus, core

housing need is closely linked to affordable housing (see above, section 3.0.1.1) and housing condition

(section 3.0.1.6). Core housing need was a need/gap in 34% of the review reports (34%). Between 1991

and 2001, 15% of the North Bay CA’s households were below at least one of the housing standards of

affordability, adequacy or suitability. As there is an inherent relationship between income and

affordability, core housing need is more likely to affect renters (see section 3.0.2.6). In absolute terms,

renters account for half the households in North Bay and their incomes are approximately half that of

homeowners. However, renters are five times more likely to be in core housing need.29

In 2006, 3800 North Bay households were in core housing need and three-quarters of these (2900) were

renters.30 . The majority of those in core housing need are singles or lone-parents, with one quarter

being youth and a further one quarter being seniors. Aboriginals represent 8% of those who are in core

housing need. Of the echo boom population31, 60% spend more than 30% of their income on rent and

boomers represent 33% of households in core housing need. Individuals on ODSP and who pay market

rent are in core housing need as the shelter allowance allocated is not enough for market-rent housing.

3.0.1.6 Housing Condition (Adequacy)

Housing condition (or adequacy) alludes to housing that is in

need of major repair. It, along with affordable and suitable

housing, are components of acceptable housing. Thirty-two

percent of the review reports referred to housing condition.

Efforts have been made to educate and, provide funding and

27

An ideal vacancy rate is 3% 28

DNSSAB, 2008b 29

DNSSAB, 2008b 30

DNSSAB, 2011a 31

The echo boom generation are generally born between 1981-1997 and are the children of the baby boomers



28

support for landlords who have housing that is in need of major repair, however, there is still an

abundance of sub-standard housing in the community. In addition, the social housing stock is aging,

while the costs for maintaining housing are rising, producing limited reserves for major repairs.

Part of the concern with housing condition alluded to by the literature is the age of the current housing

stock. Only 3% of the district’s households live in housing built since 2001; in Ontario 9% of households

live in housing built since 2001, and in Canada the percentage

is 8.532. The current housing stock (especially with regards to

social housing) is older and therefore will likely be in need (or

is in need) of major repair. Nipissing District has a larger

percentage of older housing stock compared to the province.

Ten percent of the housing stock is in need of repair33 in

addition to the poor housing condition rate being 1.5 times

higher than the rate of Ontario34. In many municipalities the need for major repair is two times the

provincial rate with Mattawa, South Algonquin and Temagami having the highest percentage of older

housing stock; and Nipissing First Nation, East Ferris and Calvin having the lowest percentage.

3.0.1.7 Supportive/Supported Housing

Although similar, supported and supportive housing are distinct yet related parts of the housing

continuum. Supported housing is required by seniors and/or people with mental illness and/or people

with physical disabilities. This type of housing provides support services within the community – people

can live independently in their own homes and the support services are delivered to them. Supportive

housing is also required by seniors and/or people with mental illness and/or people with physical

disabilities. However, support services are provided for people who cannot live independently in the

community with housing and services integrated (such as a group home). Supportive housing is

sometimes difficult to build and create because of NIMBY-ism (not in my back yard).

The need for more supportive/supported housing was discussed in 32% of this literature. The literature

stated that supports need to be in place before someone is housed in order to reduce the chance of

losing accommodation. Supported housing (community care) is delivered by community partners such

as PHARA and the North East Community Care Centre (NECCAC), but there is a capacity/human resource

issue for serving citizens who are in need of support within their own home. In addition, some support

services are not accessible to people throughout the district.

Currently, there is a lack of supportive housing in Mattawa and West Nipissing – most supportive

housing units are located in North Bay. Youth and seniors often fall through the cracks and are difficult

to house in supportive or supported units. Diverting seniors from long term care to supported housing

will also save money, including the cost of creating additional long term care spaces (see long term care,

section 3.0.1.9 and alternate level of care, section 3.0.1.16). There are long wait lists for those who

32

DNSSAB, 2008b 33

Plumstead, Bowes, & Burns, 2009 34

Plumstead, 2010

The incidence of poor housing condition in Nipissing District is

approximately one and a half times that of Ontario.

Nipissing District: A Socioeconomic Profile & Report. (2010)



29

require supported housing, which creates back logs in alternate level of care beds at the hospital and

long term care beds.

There is a lack of funding for supportive and supported housing. Repeated studies have maintained the

need for more supportive housing, but even when new housing is started and completed it is not

enough to meet the need. For example, the government has not met benchmarks for adequate

supported/supportive housing in the district35. Many people receive rental supplements to maintain

housing; however, there is no supplement or funding for rent/housing supports.

3.0.1.8 Shelter Beds

The need for more shelter beds or enhancing shelter services was discussed in 25% of the literature

review reports, dating back to 1999. In 1997-1998, half of shelter admissions were readmissions, often

caused by people with mental health concerns, addictions or the transient population. Women would

move between shelters if they were unable to find housing, or return to an abusive relationship36. This

period also saw an increase in youth and older adults using shelters, and an increase in the number of

children accompanying a caregiver to the shelter.

There are no designated shelters or specific support services for youth in the district and there is a

general lack of safe beds. Youth who are in rural and outlying areas of the district must access service

from the more urban areas such as North Bay. Another group which has specific needs which may not

be met in the shelter system is individuals with serious mental health issues. Many people who are

using the shelters have mental health concerns; however, it is difficult to quantify the number of

individuals with mental health concerns and/or who are on ODSP because of current reporting methods.

Emergency shelters have often been over capacity. In 2011-2012, the Crisis Centre North Bay was at or

over capacity 27%37 of the time. The average occupancy rate was 81%. Youth and Aboriginal people

were overrepresented in the admission statistics. Families who are at shelters often spend an extended

time at the shelter as it is difficult to find affordable three bedroom units.

During the Nipissing District Housing Needs, Supply and Affordability Study completed in 2008, the

Nipissing Transition House had 13 beds, but needed to serve 21 clients. The Ojibway Family Resource

Centre was unable to serve 149 women and the Sturgeon Falls Family Resource Centre had a waiting list

for emergency beds.

3.0.1.9 Long Term Care

Long term care is closely linked to alternative level of care (3.0.1.16), seniors housing supply (3.0.1.12)

and retirement homes (3.0.1.20). Long term care was cited in 21% review reports. Long term care is

supportive housing often for seniors, whose needs cannot be met within the community. There is a

consensus in the literature that more long term care beds are needed.

35

DNSSAB, 2006 36

TWP Consulting Inc. Management Consultants, 1999 37

Langdon, 2012



30

Residents in long term care often need on-going

nursing and or/health supports. Long term care

facilities require adequate human and physical

resources for all patients in the facility, such as

individuals who have severe dementia and serious

behavioural issues. For example there is a need

for specialized psychiatric registered and practical

nurses and the funding for training or creating

secure areas/facilities is inadequate. This is a

serious concern as 60% of seniors in long term care have mental health concerns, compared to 15% of

seniors in the community38 (see seniors with a mental illness, section 3.0.3.11 for more information).

Without adequate resources, some patients are unable to move from a hospital setting to a long term

care facility, thus increasing the cost to the hospital health care system and contributing to the

alternative level of care crisis.

Section 3.0.15 describes some of the needs of the long term care system; there were 250 individuals

waiting for a long term care bed in 2008. Many of the individuals waiting for long term care beds and in

long term care facilities could have their needs met in supported housing or affordable retirement

housing. Not having affordable or appropriate housing options available creates additional pressure on

the district’s long term care homes.

3.0.1.10 Rent Increases/ High Rent

Twenty-one percent of the literature with needs /gaps discussed rent increases and/or high rent as a

sub theme. Average monthly rents, and housing costs, are rising. Average rent in North Bay has been

climbing since 2000 and almost half the renters in the

district are spending over 30% of their income on rent.

Between 2004 and 2009, rents in North Bay increased at a

rate greater than inflation. Additionally, the average rent

for a two bedroom apartment increased at a rate greater

than inflation between 1999 and 2009. The rental increase

in 2009-2010 was 4.1%; one of the highest increases in the province39.

The literature reported that there is a large gap between social assistance incomes (OW & ODSP) and

rent. Based on social assistance shelter rates and average market rents, gaps range from between $260

and $460 depending on the source of income assistance (ODSP or OW), the size of family and bedrooms

needed.

38

Philbin Wilkinson, 2006 39

Ontario Non-Profit Housing Association, 1999, 2000, 2001, 2002, 2005, 2006, 2007, 2009, 2010, 2011

The absence of retirement and supportive housing units in the area have created additional

pressure in the area’s long-term care homes which has also contributed to the lack of beds for

more complex clients.

Older Adults Living with Mental Illness: Achieving a More Responsive System in the District of Nipissing and Northern

Sections of North East Parry Sound (2006)

The need for affordable rental housing in Nipissing District is also the highest

in Northern Ontario.

Nipissing District Housing, Needs and

Affordability Study (2008)



31

3.0.1.11 Mental Health/ Mental Health Supports

The gap between the supply and demand for mental health care and mental health supports is wide,

and there is a shortage of services for people with emotional or mental health concerns. Demand for

specialized and appropriate support services and treatment are high; including employment, crisis

intervention and help to secure and maintain housing. This need for mental health support services and

the discussion of the high rates of significant mental illnesses within Nipissing District was cited in 20%

of this body of literature. Problems associated with a lack of appropriate services and supports were

made worse with the closure of the North Bay Psychiatric Hospital.

Mental health care and supports at the community level is fragmented. There are services available in

the community for individuals who have a serious mental

illness, such as schizophrenia or bi-polar disorder, from

organizations like the CMHA or NMHHSS. However, these are

insufficient services to deal with individuals in the community

who have milder forms of mental illness such as depression.

There are a lack of addiction services and mental health

counselling and the links between mental health and addictions

services need improvement. Youth in crisis face long waiting lists for and a lack of access to mental

health counselling. Citizens in rural areas of the district need mental health supports and services close

to home as accessing appropriate services can be difficult. The literature described the need for

improved system integration for people with mental illness and their families.

The literature discussed the lack of therapeutic counselling programs for clients with mental health

concerns. This is compounded by the high ODSP rate in the district – half of ODSP clients have a serious

mental illness. When a serious mental illness impacts maintaining and retaining housing, landlords have

indicated they become social workers – they (and tenants) require mental health support systems.

Landlords do not have the training or knowledge to support

individuals with serious mental illness and feel some of the

best tenants are those who have caseworkers.

There is a disjointed array of services due to funding silos.

The services provided to clients are established by different

funding formulas, different databases and different ways of

classifying patients. The agencies have their own administrative structures, mandates, assessments,

admission and discharge protocols, treatment and discharge practices, varying levels of medical supplies

and equipment and different service delivery models. In addition, placement options for patients with

complex medical and mental health issues are limited as their needs exceed the available resources in

the system.

Housing support services are inadequate to meet the needs of

the population with mental illness…they are ‘underhoused and

underserved’.

The Face of Homelessness (1999)

The ODSP tenants through the Association for Community Living

tend to be some of the best clients – these tenants have Caseworkers.

Nipissing District Housing Needs, Supply and Affordability (2008)



32

3.0.1.12 Seniors Housing Supply

The supply of seniors housing was a sub theme in one fifth of the literature with needs /gaps. The

increasing demographic of seniors is having broad implications on the seniors housing supply from

alternate level of care to long term care and supported housing to retirement housing, increasing the

need for community planning. In addition, many seniors are unaware of their housing or residential

options. Seniors are living longer and spending a greater proportion of their lives after 65 in ill health,

therefore the acute and long term needs of seniors will only increase.

According to one piece of literature, there are two forms of seniors; “active adults” and “dependant

retirees”. These two forms have implications for the type and need for seniors housing. Active adults

are often empty nesters who are approximately 55-65 years of age. They often have a greater

disposable income than dependant retirees. Active adults often look for specific residential

communities. In contrast, dependant retirees have low to moderate fixed incomes and are 65 and

older.

Some segments of the senior’s population have unique needs for housing, for example, widowed and

single senior women often lack the financial resources to

find acceptable housing. There has also been an increase

in migrant seniors, which suggests a strong demand for

specific housing development and housing such as

retirement living, assistive living and nursing homes.

Housing options developed for seniors need to be

affordable for those of ‘modest’ means.

There is inadequate housing stock for seniors including acceptable (affordable) housing. The proportion

of seniors spending more than 30% of their income on housing increases with age. Some seniors live in

housing that is in poor condition: a higher percentage of seniors compared to non-seniors live in housing

in poor condition. The literature described how some seniors may need accessible units, community

support to maintain their home because of health reasons (such as light housekeeping, meal services)

and supported housing.

Seniors who are owners often have different needs than seniors who are renters. Many seniors who

own their own home have had long term tenure in their homes and often no longer have a mortgage.

The needs of seniors who are owners include affordability, accessibility, the desire to be close to

amenities, less maintenance (or help with maintenance) and the desire to move to an apartment in the

future (often because of housing maintenance or becoming older). On the other hand, seniors who are

renters described wanting more space and modified units. In the coming years, this distinction will

become important as there will be major transitions from senior citizen homeowners to renters,

triggered by the inability (or desire) to maintain a home.

There is a lack of housing between independent living and long term care. The need for additional

supportive housing options for seniors will exist for the next 25 years. This will occur as seniors grow

The provision of an adequate supply of supportive housing can significantly reduce the need for more expensive

long-term care facilities while providing a highly preferred living environment.

North East Local Health Integration Unit Aging at Home Strategy (2008)



33

older and an increased number require community support and/or indicate they have accessibility

concerns (such as housing modifications).

The municipalities of Temagami, South Algonquin and Mattawa have a high senior population, thus,

senior’s housing supply will need to be a priority. While there was not much literature pertaining to

rural areas in the review, a small number of studies do provide insight into rural housing needs. For

example, a seniors housing survey in Temagami revealed that most seniors recognize they will

eventually need to move from their homes, but are not sure where they will go, or where they can move

to. Many of them would prefer to move into an apartment and were already on a waiting list for the

seniors housing in Temagami. Most of the respondents felt there was a shortage of seniors housing in

Temagami.

3.0.1.13 Transportation

Almost one-fifth of this literature (18%) discussed the sub theme of affordable transportation to access

services, in particular transportation in the rural areas. Residents who live in rural areas have limited or

no access to public transit. Owning a car becomes a necessity for accessing social services, health

services, education and gaining and maintaining employment. Transportation is particularly important

for seniors, those who have physical disabilities or persons with a serious mental illness, to access the

supports they need to maintain housing.

3.0.1.14 Transition Housing

There is no transition housing in the district. The need for transitional housing was discussed in 14% of

the review reports. Transitional housing is a safe, secure living environment where people can receive

assistance, counselling and/or treatment for substance abuse or mental illness. To prepare for

independent living, transitional housing occupants practice ‘life skills’ and it is used for a short period of

time. Transitional housing is longer than (emergency) shelter housing but shorter than supportive

housing, which is permanent. Transitional housing is an important part of the housing continuum as it

helps citizens gain the skills necessary to access and maintain permanent housing.

As was stated in the introduction to this section, there is no transition housing in the district, however

there are a number of programs that offer supports as people transition to, or retain, independent

living. Through the period covered by the literature, the programs have included: transitional support

workers, community supports programs from the CMHA and Community Living North Bay housing

allowance, rent-geared-to-income program and the rent bank.

3.0.1.15 Gender Equality

Gender equality was cited in 14% of the review reports. The literature stated that a balance between

male and female core support services is required in the district. For example, Nipissing District

currently has one shelter that will accept youth and adult males; youth and adult males who require

shelter support services must travel to North Bay to access the shelter. Therefore, it was recognized

that there needs to be an increase in emergency shelter options for males. There are also fewer options

at halfway houses to support males compared to females released from correctional facilities.



34

When planning support services, it is important to remember gender differences when it comes to

aging. The life expectancy for women over the age of 70 is greater than that of men. Therefore, there is

and will be more women in the senior population than men. There also exists a wage gap; women earn

less than men, which affects affordable housing options. On a positive note, however, the literature

indicates that the gap in labour force participation is narrowing as males and females are almost equally

represented in the district’s labour force.40

3.0.1.16 Alternate Level of Care (ALC)

Eight review reports (14%) discussed alternate level of care concerns. Alternate level of care (ALC)

describes patients who are occupying a bed in a hospital (or long term care facility), but have needs that

are best meet outside of the hospital (or long term care) setting, such as in a long term care facility,

supportive or supported housing. Thus, ALC is linked to long term care (3.0.1.9), seniors housing supply

(3.0.1.12) and retirement homes (3.0.1.20).

When an ALC patient occupies a bed in a hospital and cannot be moved to a more appropriate setting,

hospitals become full, elective surgeries may be cancelled and emergency room delays occur (as

patients who are admitted to the hospital do not have a bed to go to). The inability to move to a more

appropriate setting is due to the lack of alternative level of care in the community, lack of (appropriate)

long term care beds/facilities and lack of supportive housing. The problem is compounded by the fact

that it is difficult to ensure individuals are placed in the right facility at the right time.

The North East Local Health Integration Network (NELHIN) described the ALC pressure (in Northeastern

Ontario) as one of the highest in the province41. In 2009, the NELHIN cites ALC as its number one

priority. A five point action plan was created to reduce ALC pressure and included supported and

supportive housing for seniors. A $19 million, three year, aging at home strategy was created in 2009.

In 1998, 13% of the total beds at the North Bay General

Hospital (now the North Bay Regional Health Centre)

were occupied by ALC patients; if these patients were

moved to appropriate facilities, 28 beds could have

been saved for non-ALC patients42. Between October

2002 and September 2003 an average of 25% of all

beds occupied at the North Bay General Hospital were

occupied by ALC patients. This included paediatric,

neonatal intensive care and intensive care units –

approximately 27-35% of all ALC patients required hospitalization43. In 2003-2004 the cost to the system

was $523,00044.

40

Plumstead, 2010 41

North East Local Health Integration Network, 2009, Winter 42

Health Services Restructuring Commission, 1998 43

Near North Community Care Access Centre Committee, 2004

In 2006 the cost of an ALC bed was approximately $846 a day; the cost of long

term care was $134 day and the cost of supporting an individual in their own home

was $75-$85 day.

Older Adults Living with Mental Illness: Achieving a More Responsive System in the District of Nipissing

and Northern Sections of North East Parry Sound (2006)



35

The district’s hospitals are often used as convalescent care after a patient leaves hospital from larger

centres such as Ottawa and Toronto. The literature stated that building capacity to serve these patients

can include creating step-down facilities for convalescent care: this is often the least expensive option

and can be created in long term care facilities. Fifty percent of ALC patients are waiting for long term

care beds and 25% are waiting for convalescent beds or another type of bed (for example,

rehabilitation)45. However, between 32% and 69% of ALC patients who are waiting for a long term care

bed could have their needs met better in a supportive housing setting.

There is an astonishing cost difference between ALC care, long term care and supported housing. In

2006, the cost of an ALC bed was the most expensive option, at approximately $846 day. The cost to

support an individual in their home was approximately $75-$85 a day; long term care is approximately

$134 day.

There are some patients who occupy ALC beds who are particularly difficult to place. Seniors with

serious mental health concerns are difficult to place due to lack of resources (human), appropriate

training, and suitable facilities (including secure units; see long term care, section 3.0.1.9).

There are some ALC patients occupying beds in long term care facilities. The care these patients are

receiving is not congruent with the services offered in long term care facilities and they would be served

best in affordable retirement homes or in a community care setting (supported housing), however there

is a lack of affordable and supportive housing available. Approximately 16% of long term care patients

would be served best in another care environment46. ALC patients in long term care facilities cause

further problems as the long term care facilities then cannot accommodate the ALC patients from

hospitals.

3.0.1.17 One Bedroom Apartments/Units

With the changing demographics (aging population (3.0.3.1) and increasing singles (3.0.3.4) there is a

need for more one bedroom units. This need was described in 13% of the literature review reports. In

particular there is a need for accessible one-bedroom units because of the increasing senior

demographic. The literature did suggest that although there is currently a need for apartment/units for

families (three or more bedrooms), in the future that demand will decrease and the need for one

bedroom units will increase beyond what it is currently.

3.0.1.18 Rental Units / Apartments

The general lack of available rental units was discussed in 13% of the literature with needs /gaps. The

lack of rental units is associated with vacancy rates (3.0.1.4). In the early 1990s rental housing

construction completions in Ontario accounted for approximately 25% of the market. After housing

programs were cancelled in 1993, rental construction starts fell to 10% of total completions by 1997.

44

Philbin Wilkinson, 2006 45

North Bay and District Hospital, n.d. 46

Philbin Wilkinson, 2006



36

Since 2002, rental construction completions have averaged 5-7% of all total starts, with the exception of

2009 which was 10%.

Nipissing District has less per capita (purpose built) rental stock than the province. Many renters rent

units in the secondary rental market (units that are not purpose built rentals). In North Bay, the average

rental production completion between 2006 and 2010 was 37 units per year (20% of all construction

completions), but there was virtually no rental construction in the ten years previous (1996-2006).

However, despite the completions, North Bay actually

lost 359 private apartment rental units between 2005-

2010 due to demolitions and condominium

conversions.47

There is a high cost to become and remain a private

market landlord as some landlords are just breaking

even. Apartments do not have the same return on

investment and low-end market rents are not attractive

to developers or landlords. There is a need to repair older stock and look into converting and/or

repurposing older buildings to increase rental stock.

The housing market is volatile and there are high multi-residential tax rates in some municipalities,

which is a barrier to increasing the rental housing stock. The literature described how landlords feel the

quality of tenants have changed; they often have to carry out repairs to units after a tenant leaves,

which further increases the costs to landlords. These cost increases are often passed on to tenants in

the form of increased rent. Both tenants and landlords cite problems with the Residential Tenancies

Act48.

3.0.1.19 Discharge Planning

The lack of adequate discharge planning when citizens are released from hospitals or correctional

facilities was cited as a need/ gap in 11% of this literature. Inadequate discharge planning often can lead

to the individuals ending up in shelters upon release. There is a lack of a coordinated planning for youth

who are leaving custody or detention to reintegrate and transition into the community. When seniors

are discharged from the hospital there is a gap in support services for them (e.g. supported housing).

The hospital restructuring and mental health reform (specifically the closure of North Bay Psychiatric

Hospital) have not improved discharge or transitional planning for patients with serious mental illness.

When an individual is released back to the community, better communication needs to occur between

the discharging organization (such as the hospital or the detoxification centre) and support agencies

(such as the North Bay Crisis Centre, Low Income People Involvement of Nipissing (LIPI), CMHA and

OW/ODSP). Individuals are often released on a Friday, in order to free up beds, and the individual has no

place to go and no supports in place.

47

Ontario Non-Profit Housing Association, 1999, 2000, 2001, 2002, 2005, 2006, 2007, 2009, 2010, 48

DNSSAB, 2008b

In North Bay, the average rental production between 2006-2010 was 37 units per year…despite the completions,

North Bay actually lost 359 units between 2005-2010 due to demolitions and

condominium conversions.

Where’s Home (series) (1999-2000)



37

3.0.1.20 Retirement Homes

Retirement homes for seniors were described as a need or gap in 5% of this body of literature. As has

been mentioned previously, retirement homes are a component of senior housing need, and therefore

are closely linked to long term care (3.0.1.9); senior’s housing supply (3.0.1.12) and alternative level of

care (3.0.1.16). The literature stated that it is important to maintain affordability for seniors who

choose to live in a retirement residence. There is also a need to increase the awareness of housing and

residential options for senior as an increasing number of seniors can afford to live in retirement homes.

3.0.1.21 Halfway House

There are no halfway houses for males who are released from custody, which impacts appropriate

discharge planning and supports services. This gap was discussed in 5% of review reports.

3.0.2 Socioeconomics

Thirty-nine reviews identified nine sub themes under socioeconomics. These sub themes are listed in

table 9, in descending order. Reviews may have identified multiple sub themes, thus the frequency is

greater than 39.

Table 9 Socioeconomics Sub Themes 3.0.2.1 Income (Low

Income/ Low Income Cut

Off)

Income or the low income cut

off was a sub theme in 82% of

the literature that described

socioeconomics. The low

income cut off (LICO) by the

Statistics Canada definition, are

income levels at which families

or individuals spend 20% more than average of their income on food, shelter and clothing. The

literature described how there needs to be structural changes to the current system in order for all

individuals to achieve liveable incomes.

Nipissing District has a median income that is well below the median income of Ontario and, as

discussed earlier with affordable housing, lower incomes make

accessing and maintaining housing more difficult. Many young

adults have high student debt and many individuals have little

to no financial security, often living pay cheque to pay cheque.

Nipissing also has a higher percentage of income coming from

government transfers than the Ontario average. This is further

compounded by low social assistance rates, which makes the

population vulnerable, creates income disparity and threatens the health status of individuals (see social

determinants of health, section 3.0.2.4).

Socioeconomic Sub Theme Frequency %

Income (Low income/Low Income Cut Off) 32 82%

Education 15 38%

Labour force/ Employment 14 36%

Social determinants of health 12 31%

Labour force interaction with education 10 26%

Housing tenure (renters versus owners) 5 13%

Local economy 3 8%

Income (Seniors) 1 3%

Total Socioeconomic Review Reports 39 /

A larger percentage of children per capita (under the age of 5) are

living under the low income cut off compared to the province

Nipissing District: A Socioeconomic Profile and Report (2010)



38

The district’s median income is between $4,000 and $14,000 below Ontario, depending on the family

household type. In 2006, a relatively large share (20%) of Nipissing households had incomes below

$20,000.49 Nipissing District also has a higher percentage of people living below the LICO compared to

Ontario and in some of the district’s municipalities, such as Mattawa, the difference between the

percentage of people living below the LICO and the province is even more marked. North Bay’s LICO is

higher than other northern municipalities such as Sault Ste. Marie and Timmins.

Although when 2006 is compared 1985, there are fewer total individuals living under the LICO. In 2006

there was a higher prevalence of low income individuals (singles) and children under the age of five

living under the LICO compared to 1985. In addition, a larger percentage of children per capita (under

the age of five) are living under the LICO compared to the province. The literature showed that a

greater number of people who live below the LICO are on social assistance.

3.0.2.2 Education

Thirty-eight percent of the socioeconomic literature discussed education. Nipissing District has a higher

percentage of people without a high school education and a smaller percentage of people with a

university degree compared to Ontario. The district also has larger percentages of people with college or

apprenticeships and trades compared to Ontario. Compared to Nipissing District, North Bay has a higher

percentage of people ages 15 years and older with less than a high school education.

Of the district’s population ages 15 years and older, 27% do not have a high school diploma, and over

half the OW caseload has not completed high school. Alternative and/or flexible education is needed to

meet the needs of citizens, in order for them to access better employment opportunities.

3.0.2.3 Labour Force/ Employment

The labour force was cited as a theme in 36% of the socioeconomic literature. Participation and

employment rates in Nipissing are much lower compared to Ontario. Transportation was cited as a

barrier to employment in rural areas. In some of the district’s rural areas, unemployment rates are four-

times that of the province. Youth unemployment is high and youth often have low earnings, which

make finding acceptable housing difficult, and contributes to the youth population decline (section

3.03.5).

Job stability can be challenging in the district as many jobs are temporary, contract, and/or part-time in

nature, with little or no benefits. In general, better paying jobs with more public and private sector

employment opportunities are needed within the district, which will help retain youth in the workforce

and lower the dependence on social assistance. Recent changes to the federal employment insurance

program (EI) have resulted in less access to benefits for seasonal and part-time workers.

On a related matter, it is interesting to note that in a local OW survey, close to half the respondents who

were not eligible for EI had housing and childcare needs. For those whose EI had run out, the majority

(82%) had housing and childcare needs. Meanwhile, none of the respondents who lost their job within

49

Plumstead D., Bowes C., & Burns K. 2009



39

the last 30 days had housing or childcare needs50. This shows the linkage between the provincial and

federal assistance programs, and between employment and housing.

There has been a recent shift in the employment base moving from the primary and industrial sectors

(in North Bay) to knowledge based business and professional services. Many individuals require job

skills training in order to gain employment in these new fields.

The literature also discussed population dependency. For example, Nipissing’s dependency ratio is 48.

That is to say, there are 48 dependants (children and seniors) per 100 supporters (core wage earners). In

comparison, Ontario’s dependency ratio is 44.551. Chisholm has the lowest dependency ratio in the

district, South Algonquin’s is 50 and Mattawa has the highest at 57.

3.0.2.4 Social Determinants of Health

The social determinants of health, include (but are not limited to) food security, income security,

housing, education and employment. These factors influence a citizen’s health and well-being. Many of

these factors have been described as themes during this literature review. The social determinants of

health were cited in 31% of the literature. There are strong correlations between shelter, income and

food bank use – lower income is a barrier to affordable housing, and when housing is not affordable

there is less income for food. Individuals then resort to using food security programs such as food banks

and soup kitchens.

Nipissing District has poorer overall health compared to Ontario. The health region has a higher

mortality rate ration compared to Ontario. Between 1991 and 2001, North Bay’s mortality rates were

higher than the province across most age groups The incidence of overweight or obesity is significantly

higher in the local health region than in Ontario - two-thirds of the population (ages 18 years +) in the

local health region report being either overweight or obese. The health region also has a hospitalization

rate 1.7 times higher than Ontario52and a significantly lower number of residents reporting having a

family doctor.

3.0.2.5 Labour Force Interaction with Education

The interaction between education and the labour force was a theme in 26% of the socioeconomic

literature. Nipissing District has lower education rates and higher unemployment than the provincial

median, which has a direct relationship to housing and the economy. Lower incomes combined with

rising rent or housing costs make acceptable housing more difficult for lower and some middle income

individuals. The literature stated that in 2006, those without a certificate, diploma or degree in Nipissing

District (13%) had twice the unemployment rate of those with a university certificate, diploma or degree

(6%)53.

50

DNSSAB, 2009b 51

DNSSAB, 2008b 52

Poverty Reduction Working Group, 2009, 2010, 2011 53

Plumstead, Bowes, & Burns, 2009



40

3.0.2.6 Housing Tenure (Renters versus Owners)

Housing tenure (whether an individual owns or rents the housing they live in) was cited in 13% of the

review reports as a theme. The district’s population centres (North Bay, Mattawa and Sturgeon Falls)

have the largest per-capita number of renters in the district. Nipissing District also has a larger per

capita share of renters compared to the province.

Between 1991 and 2001 there was a trend of increasing homeownership and decreasing renters,

however, while home ownership rates have increased in the province since 2001, home ownership rates

have stayed steady in the district. In 2006, the district’s households were comprised of 67.5% owners

and 32.5% renters.54

Renters are more likely than owners to spend more than 30% of their income on housing. Forty-seven

percent of renters spend greater than 30% of their gross income on housing compared to 17% of

owners. The average income of renters is half that of owners income, and due to this, certain groups

are more likely to be affected by affordability including; seniors, singles, lone-parents (females) and

Aboriginals.

3.0.2.7 Local Economy

The local economy was in a recession during 2008 as part of the worldwide recession. The deteriorating

financial situation (for business and individuals) was cited in 8% of the literature review reports.

Economic problems, even if global in origin, affect the district’s income and employment levels.

3.0.2.8 Income (Seniors)

The income of seniors was cited in three percent of the review reports. A survey of seniors suggested

that many seniors have government income as their primary source of income (such as OAS and CPP),

followed by private/corporate pension plans and retirement savings (such as RRIFs and investments).

The income of seniors has implications on the ability to afford housing.

54

Plumstead, Bowes, & Burns, 2009



41

3.0.3 Demographics

Thirty-four reviews identified 11 sub themes under demographics. These sub themes are listed in table

10, in descending order. Reviews may have identified multiple sub themes, thus the frequency is

greater than 34.

Table 10 Demographic Sub Themes

3.0.3.1 Aging Population

Of the review reports that

described demographics, 71%

described the trend of an aging

population.

The population is aging at a

faster rate in Nipissing District

than in Ontario. As the baby

boomers age55 and become

seniors, there will be distinct

pressures on the health care

and housing systems. The most dramatic increase in seniors will be those over the age of 75. In 2009,

the population in the area covered by the North East LHIN consisted of 16.5% aged 65 or older. This

percentage is expected to increase by 78% by 203456.

The aging population puts pressure on many different aspects of the human services system, including

emergency medical services, changing housing need and employment structure/supply. The urban

areas of Mattawa and West Nipissing, and rural areas of Temagami and South Algonquin have the

highest per capita rates of seniors in the district. Temagami and West Nipissing have the highest rates

of aging. These trends will have impacts of service needs for the municipalities.

3.0.3.2 Social Assistance Caseload

The per-capita social assistance caseload in Nipissing District for ODSP and OW is higher than the

provincial average. This sub theme was noted by 38% of the demographic literature. Moreover,

Nipissing District has one of the largest ODSP caseloads in the province (twice as many people per capita

compared to the provincial average) and many of the ODSP clients have a serious mental illness, which

presents unique housing challenges.

Citizens who access social assistance often have multiple needs in addition to income, including housing

and childcare needs. Accessing affordable housing can therefore be more problematic due to these

compounding needs.

55

The baby boomers are born between 1946 and 1965. The baby boomers started turning 65 in 2011. 56

SHS Consulting, 2008, 2009

Demographic Sub Theme Frequency %

Aging population 24 71%

Social assistance caseload 13 38%

Population stagnancy 11 32%

Singles 9 26%

Youth population decline 7 21%

Immigrant population 6 18%

Aboriginal population 6 18%

Household growth 5 15%

Mental illness population 4 12%

Youth 2 6%

Seniors with mental illness 1 3%

Demographic Review Reports 34 /



42

3.0.3.3 Population Stagnancy

Thirty-two percent of review reports (32%) indicated that Nipissing District has minimal, modest or

stagnant population growth. This has been a historical trend in the district and is not expected to change

in the future. The literature indicates that the natural population increase (more births versus deaths)

will actually become negative (more deaths than births) and any population increase will come from net

migration.

3.0.3.4 Singles

Approximately one-quarter of the literature describing demographics cited the increasing number of

singles in the district as a sub theme. The district has significantly fewer families with children and more

single households per capita than the provincial average. Therefore, the increase in singles impacts the

increase in the number of households (see 3.0.3.8 below) and the need for more single bedroom rental

units (3.0.1.18).

Since 1980, the number of single households has increased 36% while the population has increased 6%.

The trend of increasing single households is also linked to incomes (section 3.0.2.1) as in general, the

single households in the district also tend to have the lowest incomes. In particular, Mattawa has the

highest percentage of single households in the district and the lowest median income. Lower average

incomes influences the affordability of a home.

3.0.3.5 Youth Population Decline

One-fifth of the demographic literature discussed the population decline in youth. The population

decline in youth can be attributed to a decrease in fertility rates, an aging demographic, youth leaving

the district for education or employment opportunities, among other things. Section 3.0.3.10 also

discusses youth as a demographic sub theme as it contributes to the youth population decline.

3.0.3.6 Immigrant Population

The small immigrant population in Nipissing was discussed 18% of the review reports. Five percent of

Nipissing’s population are immigrants; comparatively 28.3% of Ontario’s population are immigrants.

Despite the relatively small population of newcomers to Canada, there have been increases to the

overall newcomer population in Nipissing (20%) and North Bay (18%) between 2001 and 2006. In a

survey looking at the needs of newcomers to the area, a majority of immigrants (84.3%) felt that finding

good housing was an important or very important part of the immigration process57. Many of these

immigrants also indicated that it was difficult to find housing information outside of North Bay.

As was previously mentioned, in section 3.0.3.2, the future population growth for Nipissing District will

need to come from net migration as population change from natural increase will be negative.

57

Welch, 2007



43

3.0.3.7 Aboriginal Population

Eighteen percent of the review reports discussed the relatively high Aboriginal population in Nipissing

District compared to Ontario. Approximately 8.5% of Nipissing District’s population is Aboriginal

compared to approximately 2% in Ontario. The Aboriginal population, in particular youth, is expected to

increase despite the district’s modest or stagnant growth in the general population, and the general

decrease in youth. The Aboriginal population has a younger median age than the district. The

Aboriginal/ First Nation population’s needs as it relates to housing and services are discussed in section

3.0.13 below.

3.0.3.8 Household Growth

The increase in the number of households was described as a theme 15% of this literature. The

percentage increase in the number of households is exceeding population growth. Thus, households are

increasing and the size of the households is becoming smaller resulting in more single households (see

above section 3.0.3.4). The increase in the number of households in the district has been a trend since

1980 and it is expected to continue until at least 2031 as the echo generation begin to form households.

Some of the greatest growth in household type has been in singles and couples without children.

Couples with children, as a household type, have been decreasing. Thus households are becoming

smaller (for example, there are fewer households with four or more persons in Nipissing District, than

there were in 1986).

3.0.3.9 Mental Health Population

Nipissing has a higher-than-average number of people with serious mental illnesses compared to the

province. This was discussed in 12% of the review reports. The ODSP rate in the district is 2.5 times

higher than the provincial average and the ODSP caseload has a relatively high rate of serious mental

illnesses. The high percentage of citizens in the district who are affected by a serious mental illness has

implications for maintaining and finding acceptable housing with appropriate supports.

3.0.3.10 Youth

Six percent of the review reports discussed the theme of youth. Youth homelessness has been

identified as a serious issue (in one study, more than 90% of the stakeholders consulted identified youth

homelessness as a serious issue). Youth are not usually ‘homeless on the street’; they often have no

permanent place to stay and are couch-surfing. This causes the problem of youth homelessness to be

hidden.

The need for a drop-in centre for homeless and at-risk youth has been identified by the community as

being important, as has gaining a better understanding of the needs of youth in order to serve them

better. There are often gaps in the programs and services available to youth due to age requirements,

the need for trusteeship etc.

Youth are often unsure of where to turn for community services other than those they already receive.

A youth survey indicated that while they are aware of where to access health care, financial services and



44

information, youth often have a lack of knowledge of where and what other resources may be available

to them.

In order to access social assistance benefits, youth who are 16 or 17 years old must have a trustee.

Many youth, especially those who have left the family home, are unable or unwilling to find an adult

they trust to act as a trustee. Youth sometimes struggle with the expectations put on them in order to

access services such as OW and the Futures program (Crisis Centre North Bay) and even with support

programs, such as Futures or the HIT program at LIPI, youth cannot, or do not want to, access the

services.

Youth are particularly vulnerable to a lack of housing because of a lack of education and work

experience (which is needed to get a job). They have little financial resources and are often unsure on

how to manage personal finances. The district’s youth unemployment rate (2006) is 17% which is twice

that of the general population. There is significant youth out-migration and youth often leave the area

for employment and education opportunities.

3.0.3.11 Seniors with Mental Illness

In conjunction with the projected increase in the seniors population, older adults living with mental

illness is expected to increase by 54.5% from 2001-202158. This will lead to an unprecedented demand

for services to address the needs of older adults living with mental illness. Mental health concerns for

seniors include dementia, delirium, depression and alcoholism. As it stands currently, there are

significant service gaps for older adults with mental illness and the current system is stretched beyond

its limit, especially outside the hospital system. There are gaps along the continuum of services,

including at the general hospitals, in schedule 1 beds, for speciality services, at long term care homes,

for community health services, accessing long term community services, and for psychogeriatric

resource consultants. In each sector resources are inadequate.

3.0.4 Funding/ Resources

Half of the literature reviewed discussed funding as a major theme. In Nipissing District essential social

resources are being stretched beyond capacity without adequate financial or other resources. Funding

levels have been decreasing for many years. Funding levels are often too low to do what is expected – or

mandated – for clients. The cancellation of the Community

Start-up and Maintenance Benefit (CSUMB) and the capping of

discretionary benefits will limit the ability of OW to meet the

needs of citizens in receipt of social assistance with expenses

related to establishing a residence, rental and utility arrears

and moving expenses.

Funding needs to be sustainable in order to maintain core services such as emergency shelters, shelter-

to-home-transition services, housing crisis prevention services and emergency food services. Service

58

Philbin Wilkinson, 2006

Limited or no new resources will be available from the government

for the foreseeable future.

Homelessness in Nipissing District: One Step Forward (2000)



45

providers need more financial and human resources to deliver the range of services required. The

literature described that the current funding situation is like a band-aid that does not fix the problem(s).

As such, there is competition among providers for scarce funding dollars.

For example, much of the funding to support citizens who are homeless or at –risk comes from the

federal government in two or three year cycles (it is not sustainable). Therefore it is hard to plan and

coordinate programs and services at or between agencies. The funding is available for one-time projects

and programming; the lack of ongoing, sustainable funding creates on-going challenges for service

providers. As such, many of the agencies working with people in poverty are without core funding and

compete with each other for special project funding.

Very few agencies have designated budgets to specifically

serve homeless youth, which make services specific for

youth difficult to find and access. Long term care facilities

lack the funding for increasing health needs of older adults with serious mental illnesses and funding for

this group is often delivered in silos. Most health agencies have inadequate travel allowances in their

budgets to effectively service rural areas.

It was discussed in the literature how municipalities such as North Bay felt that social housing

developments should continue to be funded and administered by the federal and provincial

governments; as such the City of North Bay would not make financial contributions to social housing

projects. The city would, however – on a project by project basis – facilitate (within its responsibilities

and powers and where resources allow) housing developments or programs funded by the provincial

/federal governments in conjunction with the DNSSAB.

Funding levels and program guidelines (for housing programs from federal and provincial governments)

that are sometimes received need to be flexible and reflective of geographical differences in terms of

land, construction, and site preparation costs in Northern Ontario. Funding also needs to be equitable,

for example, there was no allocation in northern Ontario for Affordable Housing Program (AHP)

supportive housing. As provincial funding is often population-based it does not take into account areas

such as Nipissing District, where the per-capita need is higher than average.

There is a lack of capital funding to build supportive and transitional housing, which have been identified

as a concern in the district. There is a lack of capital funding for affordable senior’s housing. The current

funding for support services cannot keep pace with the growing senior population (as was discussed

above).

Mental health funding is determined on an annual basis and there was also a belief in the literature that

mental health services are seriously under-funded. The community needs to advocate for additional

support dollars for clientele. Because of high rents in the community, people (who are already

vulnerable or at high-risk) are forced into substandard and unsafe housing.

The lack of funding was also apparent in 1999 when the provincial government decreased or cut funding

for programs and services. For example, social assistance rates were cut in 1995 by 21.6%; and the

We are headed into a time of significant funding cuts…

Nipissing Human Services Summit Report (2012)



46

[The] community works well in a collaborative way but we are still stuck in our mandated silos… [youth] is one issue where we have to think outside the box

Summary Report: Needs Analysis of Homeless and At-Risk Youth in the Nipissing District (2009)

shelter allowance did not reflect ‘real’ market rents which meant a high percentage of tenants were

paying more than 30% of their income on rent. The effect of these decisions remains today as many

renters are in core housing need and shelter allowance often does not reflect market rents.

The low vacancy rate in the district, combined with high rents and the addition of a strong housing

market result in an increase in people who require services from services providers and an increased

pressure to assist people with low incomes.

For many organizations, as funding is not sustainable, planning and coordinating services is difficult.

Staff and volunteers are more difficult to recruit and retain and there is a lack of resources to build

community awareness about homelessness and affordable housing need. The literature described how

a greater focus needs to be placed on prevention.

3.0.5 Collaboration

Collaboration was identified as a major theme in 44% of the literature (26 literature review reports). In

turn, there were three sub themes identified which are listed in table 11, in descending order of

occurrence. Reviews may have identified multiple sub themes, thus the frequency is greater than 26.

Table 11 Collaboration Sub Themes

3.0.5.1 Inter-agency Collaboration

Inter-agency collaboration (or the breaking down of silos) was cited by 85% of this literature. The

literature ascertained that better coordination needs to occur with a range of appropriate and

accessible health and social (human) services organizations to assist at risk and vulnerable citizens.

These services need to be coordinated in a way to

support the needs of citizens (and their families) who

find themselves in a circumstance when and where

assistance is needed. In essence there needs to be a

system of supports from the current ‘non-system’. For

example, for some segments of the population, such as

homeless or at-risk youth, there is no standard intake

process or common definition of a ‘vulnerable youth’ or person.

People in need of homelessness services are being assessed many times by different agencies,

independently. This system does not promote comprehensive service planning or individual plans to

move the clients along a continuum of services. Partnerships can create appropriate strategies to aid

collaboration, however, while there are formal and informal networks of agencies within the

community, there are some agencies that have been left out of the loop in dealing with homelessness

Collaboration Sub Theme Frequency %

Inter-agency collaboration 22 85%

No Wrong Door 8 31%

System's thinking/ holistic approach 5 19%

Collaboration Review Reports 26 /



47

issues or do not see the need to participate in meetings. There is a need to interact with these agencies

on a regular basis in order to ensure they are aware of all the services available in the community.

Many agencies are serving the same clients but they do not know which services are being duplicated or

the most effective way to coordinate services. As such, the system needs to integrate service planning

and coordination with greater coordination of services among housing service providers, stronger

presence from agencies such as the Community Care Access Centre, and collaboration with funding to

meet the community needs. The increased complexity of the system for both agencies and citizens has

resulted in longer intake processes, longer wait times and slow and poorly timed funding approvals.

The DNSSAB needs to be a lead in the breaking down of silos for all service providers. In addition, the

Nipissing District Housing Registry (NDHR) needs better linkages with the range of services, direct and

indirect, offered by the DNSSAB. There have been some steps in the coordination of services, for

example DNSSAB, LIPI and the Crisis Centre North Bay have developed strong partnerships to service

people along the entire continuum. Other agencies have strong case management programs that link

with LIPI and Crisis Centre North Bay staff. Other ideas presented in the literature included the co-

location of some agencies, a one stop centre for homelessness services, which would eliminate clients

going to various locations to acquire services. Nevertheless, collaboration can go beyond the boundaries

of Nipissing District and include collaborating with other district social services administration boards in

Northern Ontario.

3.0.5.2 No Wrong Door

One positive step towards collaboration in Nipissing District has been No Wrong Door. No Wrong Door

is a system process that occurs if an individual in crisis needs assistance from multiple service providers.

Instead of the individual going to multiple, separate, service providers, the service providers come

together in a case conference to assist the individual. In essence, whichever ‘door’ the individual goes

through first to seek service is the correct door to access services. No Wrong Door was discussed in

almost one-third of the literature that spoke to collaboration.

There has been success with the No Wrong Door model and it has been illustrated as a best practice in

the province. However, there is a need to create a sustainable approach to the management of the

process, including Board level buy-in from the partners. There is also a need to create resource manuals

and share appropriate information and data across multiple agencies and create an online, or virtual, No

Wrong Door system.

3.0.5.3 System’s Thinking/ Holistic Approach

There is a need to create and develop a holistic approach for support services. This approach looks

beyond the specific needs of an individual in isolation and looks to meet the needs of the individual as a

whole. This type of system’s thinking/ holistic approach was described in 19% of the literature that had

collaboration as a theme. This is because housing and homelessness needs are not isolated; they are

also related to other areas such as food security, physical and mental health, employment, budgeting,

independent living skills and supports to live independently.



48

There is no comprehensive service that is able to assess and meet the needs of the entire at-risk

population. Instead, there are some targeted support programs for specific demographic groups. This

causes gaps in the continuum of services. Service providers need to look at the entire continuum of

services, across all agencies and service providers, and not focus solely at what is in their respective

mandates.

3.0.6 Communications

The need for better communication about services to citizens in

need of service, service providers and the community, was

described as a theme in one-third of this literature. Often times

the literature described that there appeared to be a lack of

knowledge or appreciation of services within the community.

The community at large (“the public”) needs to be made more

aware of the extent of homelessness within Nipissing District and the community needs to be enlisted

for support, advocacy, fundraising and policy change.

Providers in the community, including physicians, teachers, and support workers need more education

about the homeless youth population and how to best address their needs. Agencies who serve the

youth population often do a poor job promoting the services they have available. Regular liaisons and

networking will help improve services for homeless people. Often, individual community agencies are

not aware of all the supports and services being offered in North Bay and the district, and are therefore

unable to build the full range of appropriate services into each client’s service plan.

There is a need to educate the public on the extent of homelessness in the district. Some issues are

invisible to the public – homelessness in Nipissing District is not visible on the street, therefore there is a

perception that it is not an issue in the community. There is also a lack of public education around social

assistance and living on social assistance, which increases the stigmas surrounding social assistance

recipients. The literature stated that there needs to be a housing and homelessness communication and

marketing strategy.

3.0.7 Geography

Nipissing District is large, more than 17,000 square kilometres; 22% of review reports alluded to

geography as a theme. There are varying needs across the district’s municipalities and areas, right down

to individual neighbourhoods in the larger centres. The district has a large rural area and generally,

housing costs are less expensive in these locations. However, this is offset in high transportation costs.

As transportation is a necessity for the rural/outlying parts of the district, without it accessing services

(such as employment, support and crisis services) and gainful employment in rural areas is difficult.

There are also few accessible apartment buildings for seniors in rural areas.

For service providers, providing service to all areas in the district can be challenging. The large

catchment area and low population density means service provision and access to timely interventions

Homelessness is not visible on the street…there is a public perception

that it is not an issue in the community.

Community Plan (2007)



49

and supports are a challenge – 85% of the district’s area covers 10% of the district’s population. Rural

strategies are needed to address housing and homeless issues close to home.

3.0.8 Government Policy/ Legislation

Government (federal, provincial and municipal) legislation and regulation affects the ability to create

and maintain housing and services, in particular for citizens who are vulnerable. The different legislation

and regulation often cause gaps in social policy. The impact of government policy and legislation was a

major theme in 22% of the literature reviewed.

Although progress has been made in creating new affordable housing units because of government

assistance, there is a lack of government incentives (from all levels) to build or create affordable

housing. The municipal role in the provision of social housing has changed significantly since the 1970s

and 1980s. The federal government cancelled housing programs in 1993 and the provincial government

cancelled housing programs in 1995. Limited funding through programs has resulted in some gains in

affordable housing, but the programs and funding are not long-term or sustainable. Social housing

services are not a specific area of jurisdiction for municipal governments under the Municipal Act, 2001,

which leads to a disjointed array of social housing programs.

In the most recent Official Plan, the City of North Bay has included policies that support the

development of affordable rental and homeownership opportunities. For example, the conversion and

renovation of older dwellings and other buildings into multiple dwelling units for the rental market (in

the residential intensification area) is encouraged. There are also policies to promote condo

conversions: where the selling price of units is below the average resale housing price. The literature

suggested the federal and provincial governments should give a higher funding priority to affordable

home ownership housing programs.

3.0.9 Data/ Knowledge

The need for information, data and knowledge gathering for the homeless or at-risk population was

cited in approximately one-fifth of the literature. There is often a lack of information and data related to

at risk populations, and identifying and engaging at-risk or vulnerable populations is not easy,

particularly when it comes to youth. The extent and depth of homelessness in North Bay and the

District is not generally known as there is a lack of hard data. With adequate data/knowledge,

community capacity can be assessed and common knowledge and data about people who are homeless

/at risk can be shared. The literature suggested consolidating data gathering to enhance knowledge

through programs such as Homeless Individuals and Families Information System (HIFIS).

Quantifiable information and data has helped shape the policy environment, such as the development

of a response team and Ministry of Municipal Affairs and Housing (MMAH) funding. Without

quantifiable and accessible information and data, community awareness is difficult and accessing some

funding opportunities may be missed.



50

There has been extensive research conducted on housing needs in the district (for example Nipissing

District Housing Needs, Supply and Affordability Study); these needs are known but the extent to which

the needs and recommendations have been acted upon is not as clear.

3.0.10 Causes

Many of the themes discussed have a direct relationship to the causes of homelessness, the risks for

homelessness or the need for affordable housing. Causes were directly discussed in 19% of the

literature review reports. These causes include some themes that have already been discussed such as

lower than average incomes in the district (section 3.0.2.1), higher than average number of households

above affordability threshold (section 3.0.1.1) and relatively low vacancy rates (3.0.1.4). Historically,

during the 1990s, there was a 21.6% cut to welfare (OW) in 1995 and the termination of social housing

programs (federal in 1993; provincial in 1995) which housing problems are also attributed to.

The lack of affordable housing was often identified as a key cause of homelessness or as a risk of

homelessness. In addition, self-sufficiency and stability is weakened through a lack of affordable

housing. Due to low wages, paying for food and rent is often difficult (section 3.0.2.4). Lower education

attainment also contributes to lower wages – half of the district’s OW clients do not have a high school

education (section 3.0.2.2). This results in low wages and the continuation of the cycle of poverty. For

many individuals the lack of appropriate and timely supports is a key factor in evictions.

The supply of privately owned rental housing in North Bay has decreased due to the lack of building

activity for new apartments (section 3.0.1.8). The lack of building activity for new apartments was

caused by the withdrawal of government funding for social housing and construction which in turn was

a result of the LSR (Local Services Realignment) and federal deficit reduction measures in the mid-90s.

Another cause of homelessness cited by the literature is when an individual (usually female) has a family

break-down (often with children) and needs to find new alternative housing arrangements. Problems in

finding affordable housing result in longer time in shelters as there is no transitional housing (see

sections 3.0.1.8 and 3.0.1.14).

Many individuals with low income or housing problems have experienced the problems for multiple

family generations and it has become a natural progression in the family. There is also a ‘welfare wall’,

individuals stay on OW because they make the same – or less- while employed (for example there is

often no dental or health benefits) and they are ‘better off’ on social assistance.

Youth who are homeless or at risk have often had difficult family lives, including experiencing sexual or

physical abuse and parents with mental health issues or addictions. These youth often have addictions

to drugs or alcohol. Some youth have behavioural issues and may be in conflict with the law. Other

youth, and some adults, have a lack of life management skills, which has been noted as a cause of

homelessness (section 3.0.3.10).

The relatively large ODSP caseload with mental illness results in increased need for supportive housing

and mental health supports (see sections 3.0.1.11 and 3.0.1.7). The lack of community mental health

programs and services puts pressure on the hospital by admitting mentally ill people for crisis, family



51

respite, and general care. Literature from 1999 identified the closing of the North Bay Psychiatric

Hospital as having great impacts on the district. The concern at the time was that the support services

and housing for this client population were already inadequate and this would become worse without

further community services put in place before the hospital closes59.

The lack of supportive housing is adding to the backlogs in the long term care facilities and is also

contributing to the shortage of acute-care beds in the North Bay hospital and the alternative level of

care crisis (see sections 3.0.1.9 and 3.0.1.16), which in turn contributes to the hospital’s deficit.

In 2011-2012, the top three reasons for admission to the Crisis Centre North Bay were a

family/relationship breakdown (including abuse and safety concerns), the need for housing, and

transience. In a period prevalence homelessness study that took place in North Bay in July 2011, the top

three reasons for homelessness were systematic in nature: unemployment, inadequate/not qualifying

for social assistance and affordable housing60. Other reasons included domestic violence or family

issues, substance use, mental or physical illness, and discharged from custody

3.0.11 Stigma

The major theme of stigma surfaced in in close to one-fifth of the literature reviewed. Stigma not only

includes the stigma of being homeless, but the discrimination, attitudes and beliefs about people who

are homeless, at-risk of homelessness, people with mental illness, people on social assistance, youth,

people who live in social-housing, and racism against Aboriginal people.

People who are on social assistance, people with mental illness and youth often have difficulty renting

accommodation as landlords are unwilling to rent to marginalized populations. By creating more

inclusive communities (in participation and engagement) and creating more opportunities for

marginalized populations by removing barriers, attitudes can be changed towards the populations

affected by stigma, discrimination and racism. Often, ‘not in my back yard’ (NIMBY-ism) creates ghetto-

ization in some neighbourhoods; collaboration and education can help.

3.0.12 Success /Best Practices

Ten percent of the literature reviewed described some of the best practices in Nipissing; the community

needs to identify the success as well as the needs. The following lists some of the successes and best

practices in Nipissing District and elsewhere.

The Futures Program (Crisis Centre North Bay) is a structured program that teaches youth the necessary

skills needed to succeed in the real world. LIPI provides great support for homeless and at-risk youth,

but often lack resources and staffing to target services for the youth population. YES employment

services are very present in the community and some local high schools offer alternative education

programs. There are successful youth residential programs in Sault Ste. Marie and Greater Sudbury.

59

TWP Consulting Inc. (1999) 60

Kauppi, Pallard, & King, 2013



52

Nipissing District was one of the few areas in the province to have full program take-up on the Canada-

Ontario AHP and built new housing. Through AHP and DOOR (Delivering Opportunities for Ontario

Renters), over 220 new affordable housing units have been built in the district since 2005. This was the

first new local housing built since 1993. The Federal –Provincial AHP allocation for Nipissing District was

approximately $13 million by December 2009. The DNSSAB contributed through municipal partners

approximately $3 million. Additional municipal contributions were made through the use of planning

tools and local planning capacity. The City of North Bay sold surplus land for affordable housing – both

rental and ownership.

In terms of homeownership, community partners such as HOAP (Homeownership Affordability

Partnership) are successfully helping low income families achieve homeownership. In addition, Habitat

for Humanity is also helping local low income families with homeownership.

A Nipissing initiative, No Wrong Door, has been successful for collaboration among many agencies (see

section 3.0.5.2)

The literature described how there is one OW Case Manager assigned to work with all clients who are

admitted to emergency shelters within the district. OW is developing a new set of protocols to ensure

that OW recipients have full access to all of the services available to help them move out of the shelters

into more permanent housing. The DNSSAB and the Crisis Centre North Bay have developed protocols

to provide emergency shelter to everyone who meets admission criteria which helps to prevent

absolute homelessness (people living on street). There is also an overflow plan to assist individuals and

families when the shelter is at full capacity

In the United Kingdom there are successful supportive housing models for seniors. Other communities

have had success in repurposing old schools for seniors housing.

There has been some success in advocating for affordable housing; however there is still a lack of public

awareness around the need for affordable housing in the district. There has also been some success in

educating landlords on services available (such as rent bank) and how the services can benefit them,

however, more education is needed.

3.0.13 Aboriginal/ First Nations

The Aboriginal and First Nation communities were discussed in 7% of the review reports. The North Bay

Indian Friendship Centre has difficulty finding housing for the Aboriginal community, because of stigma,

racism, etc., and many individuals are forced to leave the community. Aboriginal people often face

discrimination in finding housing, with some landlords unwilling to rent to a person who is (or appears to

be) Aboriginal. Given the relatively large Aboriginal population, the district’s agencies need to ensure

this population receives culturally appropriate and sensitive services.



53

Aboriginals are overrepresented in the ‘system’, such as admissions to shelters, and accessing services

for individuals who are homeless or at-risk and core housing need. Fifty percent of Aboriginal

households in North Bay are in core housing need61.

3.0.14 Indicators of Progress/Problems

Five percent of the literature presented housing indicators that are useful for measuring the state of

housing – these are listed below. Many of these are statistical indicators that describe outcomes or

progress with regards to acceptable housing and homelessness.

Core housing need

Shelter to income ratio

Social assistance housing gap

Renter affordability gap

Rental housing construction

Vacancy rates

Housing stock/inventory

Official plan status

Housing and population growth rates

Per capita number of households with incomes less than 20,000 annually

Social assistance rates per capita

3.0.15 Future Needs/ Targets/ Demands

The projected future needs, targets or housing demands was a theme in 5% of the literature and they

are listed below. It can be noted from the data that the demand for housing along the continuum is

expected to increase.

Nipissing will require 158 affordable units a year to 2016 (from 2008); 49 for owners and 109

for renters62.

o This equates to 70 units for those with incomes under $20,000; 39 units for those with

incomes between $20,000 and $30,000, and 49 units for those with incomes greater

than $30,000.

61

DNSSAB, 2008b 62

DNSSAB, 2008b



54

In 2008, the following needs/gaps were identified along the housing continuum. These can also

be thought of as demand for housing62:

o 16 shelter beds (gap) o 0 transitional beds (need) o 143 supportive/supported housing units (gap) o 1325 social housing units (gap) o 60 apartments (gap) o 2590 renters in core housing need (need) o 1390 renters in poor housing condition (need) o 49 entry level homes (gap) o 1050 owners in core housing need (need) o 2010 owners in poor housing condition (need) o 250 waiting for long term care (gap)

Nipissing District needs 1600 affordable housing units over the next 10 years.

North Bay requires 72 affordable rental units produced annually over the next 10 years (as of

2008).

o There will be an increased demand on rental market as boomers age (i.e. older age

groups, 70 years and older).

o Annual household growth in North Bay is forecast at approximately 149 households

/year (2006-2031).

o North Bay will require on average, 100 new housing units annually to maintain a stable

population over the forecast period (2006-2031).

o Housing occupancy levels in North Bay are expected to decrease (2001-2031).

Forecasted population growth in North Bay is minimal at around 0.3% annually to 2021, and

then 0.25% through to 2031. Any growth will be driven by net migration.

Independent living units should be 70% of the total independent and residential care housing

spaces. This includes supported mental health housing spaces and supportive housing with a

variety of housing options but with an emphasis on supportive apartments.

Related to the above, Residential care spaces should move closer to 30% of the total

independent and residential care housing spaces, as more independent living spaces become

available.

Aging at home will become a future trend.

Nipissing District will require 2.5 times the number of long term care beds and supportive

housing by 2031.



55

The need for supportive housing (the status-quo) will increase 64.5% by 2031, from 131 units in

2008 to 227 units by 203163.

o However, if individuals are diverted

from long term care to supportive

housing (the more cost effective

scenario), 879 units were needed in

2008 which equates to 1479 units in

203164.

The need for long term care beds will increase

by 59% by 2031; from 1196 beds in 2011 to 1898 beds in 2031

o However, if individuals were diverted to supportive housing from long term care, 407

units were needed in 2011 and 647 units in 2031.

The need for retirement bed/suites will increase from 412 beds/suites in 2011 to 920

beds/suites in 2031.

The need for convalescent beds will increase from 8 beds in 2011 to 14 by 2031.

The need residential hospice beds will increase from 5 in 2011 to 9 in 2031.

Although the demographics and future need points to needing more single units (i.e. singles are

increasing and families with children are decreasing) there is still a need for more affordable

housing for families with children (specifically 2-bedroom units).

3.1 Recommendations Emerging from the Literature During the literature review process, the researchers gathered relevant recommendations from the

various documents (of those reviewed, 26 made formal recommendations). Appendix A lists the 268

recommendations made in alphabetical order by document title and author, starting with the earliest

publication.

Note: No priorities have been assigned to the list; this is simply an accumulated presentation of

recommendations made to date and they are specific and/or relevant to housing and/or homelessness.

It should be noted that recommendations from the literature, in the research team’s opinion were not

specific to housing or homelessness, were not included. Items in bold indicate recommendations that

have been made to the government through submissions.

63

SHS Consulting, 2009a, 2009b 64

Note, this is based on a medium diversion scenario. High diversion scenario would require more supportive housing units. A low-diversion scenario would require fewer supportive housing beds, but would still be more than the status quo

In 2006 the cost of an ALC bed was approximately $846 a day; the cost of long

term care was $134 day and the cost of supporting an individual in their own home

was $75-$85 day.

Older Adults Living with Mental Illness: Achieving a More Responsive System in the District of Nipissing

and Northern Sections of North East Parry Sound (2006)



56

While no analysis has been completed on the recommendations from the literature, it is interesting to

note that many recommendations share a similar purpose and/or theme and are reflective of the

themes discussed in this report. An analysis of the recommendations (such as those that have been

competed or acted upon) will be completed further on in the development of the 10 year housing and

homelessness plan for Nipissing District.

IV. CONCLUSIONS


57

4.0 Conclusions The literature review has revealed that a great deal is already known about housing and homelessness

in Nipissing District. It has also revealed that the community has been looking at – and working on –

housing and homelessness issues for a very long time. Underlying this premise are the many thematic

issues described earlier in the report, and the formal housing and homelessness-related

recommendations that came out of the literature – all 268 of them (which are included in the appendix

for reference). These recommendations span a period of 15 years and offer the perspective of many

different authors, groups, committees, researchers, housing consumers, service providers, etc. on what

is needed to address affordable housing and homelessness in Nipissing District. Although a current

analysis of the recommendations has not been done at this point (in terms of relevancy, feasibility,

action, etc.), they underline the existing knowledge and work that has been done in the area of local

housing and homelessness to date.

It became apparent throughout the review of available housing and homelessness literature that the

same trends and issues have been occurring throughout the years in Nipissing District and do not seem

to be going away. Thus many of these are systemic in nature and include: relatively low incomes; high

unemployment; low workforce participation; low educational achievement; rising rents; low vacancy

rates; a lack of affordable housing supply; food insecurity; poor mental health; stigma; a shortage of

government housing funding; and a large number of local citizens in core housing need. Some of these

systemic variables can be considered a cause of homelessness or of living in unacceptable housing, while

others can be considered a negative outcome of something else. In any case, the past data suggests that

barring any significant socioeconomic change or intervention, these systemic trends and issues will be

around for some time to come, including during the life of the 10-year housing and homelessness plan.

This presents a new context and reality for developing the plan and in forming expectations for what the

plan can deliver and achieve.

Closely related to the above, the review indicates that many of the needs, gaps and concerns as it

relates to housing and homelessness in Nipissing District have existed for at least one generation. A

good example of this is where two different authors writing two different reports almost 30 years apart,

made similar statements concerning the poor housing condition in Nipissing District relative to the

province. This is somewhat profound and, not to be too cynical, leads one to believe that either the

problem of poor housing condition is unsolvable, or it hasn’t been acted upon yet (and in all probability

won’t be for another 30 years), or tried solutions are not working. In yet another example, the

community has been talking about the need for supportive housing for over 10 years now. Even when

the evidence abounds and the cost rationale is there (why are we spending $800 a day for an ALC bed at

the hospital when that same patient could be in a supportive housing bed for under $100 /day?) there

has been little action on the supportive housing front. It is difficult not to become cynical during a

community planning process when issues are identified multiple times and in many cases are left

unresolved.

The literature review has confirmed many of the ‘knowns’ about what is needed. In addition to the

examples above, the need for more affordable housing, increased supports for citizens with a serious

IV. CONCLUSIONS


58

mental illness and preparing for the increasing needs of the senior population are well known in the

community (the impact on local housing need by the aging seniors’ population is well documented).

These concerns have been cited multiple times in the literature – and these concerns are going to

continue in the future. The question now in developing the local 10-year housing and homelessness plan

is not so much what are the housing needs or problems in Nipissing District but rather, how can we solve

the housing needs and problems in Nipissing District, given the current barriers, fiscal and systemic

included.

Switching over to a more positive note, the development of the 10-year housing and homelessness plan

offers a renewed opportunity to confront these issues through a framework that takes a coordinated,

systematic approach towards assessing and acting on the data. The purpose of the 10-year housing and

homelessness plan is to affect achievable and real acceptable housing for the citizens of Nipissing

District and to create a seamless system of supports. Viewed through this lens, the community

stakeholders and leaders have a new opportunity to rally around the evidence and start systematically

prioritizing the needs, and evaluating what can be done within the confine of current resources. The

literature review has also described some of the housing and homelessness best practices and

achievements that have occurred in Nipissing District, and taking these into consideration will be helpful

for creating the action plan and achieving the 10-year housing and homelessness plan’s goals and

objectives.

The literature review has produced a large body of empirical evidence which can be acted upon starting

now. The community stakeholders and project planners do not have to wait until the end of the

research process before developing the 10-year housing and homelessness plan’s objectives, targets,

and implementation /action plan. Rather, community stakeholders and planners can begin to develop

the implementation framework and action plan based on the literature review’s preliminary evidence

and findings. Completing the 10-year housing and homelessness plan’s remaining research objectives

will also serve to inform the implementation plan as it is being developed, either confirming the

literature review results and/or presenting any new evidence or data to be incorporated into the plan.

APPENDIX A


59

Appendix A: List of Recommendations from Literature Review The following lists all 268 recommendations made in chronological order by date of document

publication with earlier publications listed first. Note: as mentioned earlier, no priorities have been

assigned to the list; this is simply an accumulated presentation of recommendations made to date.

Items in bold indicate recommendations that have been made to government in submissions.

The Face of Homelessness in Nipissing District

(TWP Consulting Inc. Management Consultants, 1999)

1. Recommendations for Action Planning – the following criteria should be used to develop the Action Plan:

a. District-Wide Plan: Homelessness is a district issue, requiring a collective response. Affordable housing and support services should be accessible /available throughout the areas of the district.

b. Integrated System: Strategies to address homelessness must form a coherent plan, and services should be delivered through an integrated, accessible system.

c. Adequate Housing: Adequate housing, available to and appropriate for the poorest of all citizens, must be central to the plan.

d. Prevention: Strategies that prevent people from losing their housing is key to addressing homelessness.

e. Cost-effectiveness: The overall goal of the plan to prevent /reduce homelessness is to invest in strategies and programs that have the most impact.

f. Responsiveness: Solutions must be flexible and respond to the needs of the diverse homeless.

g. Participation: Homeless people and community stakeholders must participate in the planning, development, and evaluation of programs and services.

h. Respect: Respect for the dignity and capabilities of homeless people is essential to the success of the plan.

i. Continuity: Strategies should build on existing best practices and experience in the field. 2. Recommendations (to the Initiatives Against Homelessness Committee):

a. That a forum facilitated by the committee be provided for consideration of this report b. That the objectives of that forum be to establish responsibility for homelessness and to

commit to a planning process. c. That private sector be involved in the process d. That strategies address –but not be limited to – the service and housing needs of the

most “at risk” population groups identified in the report (xxx) e. That strategies for the mentally ill be left to the Task Force at this time, and that the role

of the Committee be to monitor and respond. f. That strategies be built around existing available resources as much as possible. g. That a mechanism be established that ensures that the plan will be implemented,

monitored, evaluated and accountable. Various government and stakeholder groups, including the homeless and formerly homeless people, service providers, and business representatives will participate in whatever mechanism is established.

APPENDIX A


60

Homelessness in Nipissing District: One Step Forward

(North Bay and Area Social Planning Council, 2000)

3. Convert at least one empty government-owned building from each level of government (federal/provincial/municipal) into low-income affordable housing units that meet the different needs of the at-risk population.

4. Develop Single Room Occupancy (SRO) option for housing with supports to house singles who are currently falling between the housing and shelter cracks, including those living in unsafe houses.

5. Facilitate the development of a shared accommodation registry and related support services to make it easier for seniors and others to retain decent housing

6. Develop rooming house standards and rating system similar to Habitat Services Incorporated in Toronto.

7. Convert existing vacant, to be moved or demolished houses into rent-geared-to-income units. Committee must review a similar model located in Peterborough - Peterborough Community Housing Development Corporation.

8. Recommend a group, sponsored by the North Bay and Area Social Planning Council, to advocate, speak on behalf of, and be a united voice for those who are at risk of becoming homeless. The group will act as a funnel between the at-risk population and the world.

9. Develop a proposal for a leading advocate, to be reviewed at the municipal level, which will outline all resources that are needed (including financial and human), a timeline to follow, and the plan to accomplish this goal.

10. Explore similar models that will help to identify the most feasible progressive policies and public awareness strategies to follow.

11. Establish a mobile housing help service for individuals who are homeless or at risk of losing their housing. The service would be available to help tenants make negotiations with landlords, to intervene on the tenants' behalf should they be unable to make rent payments and to provide referrals for decent, available and affordable accommodation for people on a limited budget. Life skills training such as budgeting workshops or tenant information will be provided. The service would be available to anybody.

12. Develop a housing committee to “watchdog”, audit policies and monitor progress of various homeless prevention projects.

a. This committee should have the power to make recommendations and prepare resolutions at provincial and municipal levels of government.

b. There should be representation from all three levels of government, financial institutions, the Housing Network, university and colleges, landlords, churches and other community representatives as well as consumer liaisons.

c. Responsibilities shall include: I. Facilitating effective networking and community partnering,

II. Monitoring and making recommendations for policy changes and/or enforcement. 13. Build a pool of human and monetary resources to be available for projects that will assist in

ensuring that low to moderate income earners will find housing if they have none, and keep their housing if they are on the fringe of losing housing.

a. Develop a working group or task force that will work together to pool human and monetary resources together and investigate models of similar assistance programs.

b. Establish a Rent Bank (lending service) that can be accessed by tenants, for rent purposes only, should they be unable to make rent payments for one reason or another.

APPENDIX A


61

The Time for Change is Now: Building a Sustainable System of Care for People with Mental Illness and

their Families in the Northeast Region (Northeast Mental Health Implementation Task Force, 2002)

14. The MOHLTC [Ministry of Health and Long Term Care] should update its ten-year benchmark (2002/2003) for housing spaces including a review of the assumptions used in developing the current benchmark.

15. The MOHLTC should establish an information system that will capture, on an annual basis, the actual housing needs of people with mental illness as well as an inventory of the housing and supports capacity (including new developments) and demands/waiting lists. This inventory will be used to support planning and resource allocation across the region including the local integrated agencies.

16. The Ministry of Community, Families and Children’s Services review the ODSP and OW so that: a. The ODSP/OW shelter allowance component be increased to allow a person to rent an

existing housing unit (includes rent and essential utilities). b. The shelter allowance portion of the income maintenance program be indexed to the

market rents and housing costs in different cities and will, therefore, vary from city to city. Note: These measures would remove the need to deliver administratively complex and expensive programs, such as rent supplement, to essentially address an income problem. The rent supplement program provides a supplement to a landlord so it is tied to a unit of housing, not the individual in need.

c. That ODSP policies and procedures that restrict access to this income support program for people who have mental health problems and particularly for those who are homeless, be revised. The requirements for medical information are cumbersome and need to be reexamined.

d. That a procedure be found to address the problem of people losing their housing due to loss of income support program when a person leaves their permanent housing for a specific reason (e.g., hospitalization, incarceration, abuse, other treatment, etc.).

17. As part of a multi-year plan, the funding and business model for mental health housing for the Northeast should take into account the immediate need for housing for inpatients at the NBPH [North Bay Public Hospital] who are awaiting transfer to the community (including planned bed reductions). (Note: The HSRC [Health Services Restructuring Commission] estimated that a bed closure affects 4-8 patients per bed; i.e., the number of persons with mental illness who regularly use these mental health beds.).

18. The MOHLTC’s Five Point Development Strategy for new mental health housing includes community development, head lease/rent supplements, effective use of current supportive housing stock, purchase/renovation of current stock, and residential care, where appropriate. This strategy should be expanded into a funding and business model for the Northeast that includes the full participation of both the private and public sectors in the development of new housing including the building of new stock in areas with low vacancy rates (e.g., less than 3%) through:

a. Capital and incentives provided by the government for non-profit and other partnerships as well as for families (e.g., tax rebates or exemptions, incentives to rebuild/renovate the family home to accommodate the needs of the person with severe mental illness, etc).

b. Private builder providing stock with units available to MOHLTC funded community-based mental health agency via a head lease arrangement to pay market rent.

19. Additional independent living housing arrangements must be developed across the Northeast to bring the percentage of independent living housing arrangements closer to the preferred

APPENDIX A


62

70%. This includes supported mental health housing spaces (i.e., long-term housing with delinked support) and supportive housing with a variety of housing options but with an emphasis on supportive apartments.

20. As more independent living spaces become available, the number of residential care spaces (HSC [Housing Services Corporation] and Domiciliary Hostels) should be reduced to move closer to the preferred 30% of the total of independent and residential care housing spaces.

21. The MOHLTC North Region establish a Northeast Mental Health Housing Workgroup to undertake a five-year review of best practices and research as well as to establish an ongoing evaluation of current and proposed housing and supports. The Northeast approach will reflect a flexible approach that is responsive to changes and the ever-changing needs of people and community conditions. The routine evaluation will utilize an accountability framework that includes the tracking of funds and measuring of outcomes with respect to housing and supports along the continuum of care.

22. A special housing model in the Northeast will offer a range of housing options to residents. Due to some of the challenges in Northern rural areas (e.g., lack of critical mass, staffing and transportation issues), respite and crisis beds should be co-located with the high support housing to meet local needs.

23. The development of the proposed HPSN (HSC and Domiciliary Hostels) program will be formally recognized within the reformed Northeast regional mental health system. HPSN will be affiliated with the integrated agency in their area and individual residents will have access to the full range of supports and service available through the integrated agency. Standards for HPSN will be in line with the recovery approach. Over time, the administration for these homes could be transferred to the Northeast Mental Health Centre.

24. Each person should have access to individual treatment and supports if needed (ACT [Assertive Community Treatment] teams, case management, community support workers, psychosocial rehabilitation, employment/day activity, CCAC home care, etc.). It is the responsibility of the integrated mental health agency to be the access point for supportive housing to support consumer choice, improve efficiency, reduce barriers, etc. The following are the functions of the one stop access point:

a. Hold an accessible, up-to-date inventory of housing resources dedicated for people with SMI [serious mental illness].

b. Link with the municipal housing registries as well as with services that help people find housing and with other supportive housing groups.

c. Through a collaborative approach involving consumers and existing engaged providers, help determine appropriate housing and supports using standardized assessment and risk management tools which match needs with the housing, treatment and supports continuum options.

d. Follow through to ensure that a person gets into housing of choice. e. Hold the waiting list based upon highest needs rather than chronological “first come,

first served” as well as other waiting lists based on subsequent assessments to facilitate movement and allow people to move on to more appropriate housing options as their needs change. Coordination with other waiting lists (such as those for municipal social housing which are chronological) will be needed.

f. Provide a process to resolve cases in which there is a disagreement as to the admission of a resident to a facility (this will include the reference to conflict resolution clauses in service agreements with housing providers and to system conflict resolution mechanisms.).

APPENDIX A


63

25. That each integrated mental health agency, through its housing team, develop direct linkages with private landlords to advocate for more accessible housing, develop supportive strategies so more people with mental illness are welcomed and foster creative community approaches to housing.

26. That mechanisms for linkages to support services and crisis management be developed for landlords and others.

27. People with severe mental illness have access to a wide range of professional home care and home support services delivered in a flexible and appropriate manner as identified by the individual whatever their living arrangements.

28. The eligibility criteria for CCACs should include people with a primary or secondary diagnoses of psychiatric illnesses.

29. That the need for reduced caseloads for home support services due to the complexity of needs of individuals be recognized and funded accordingly.

30. Ongoing education and training in caregiving issues related to those with severe mental illness should be available to professional and paraprofessional staff as well as volunteers. This training would place emphasis on the principles of psychosocial rehabilitation and the recovery model and address issues related to safety, stigma, crisis, etc.

31. That additional funding be provided for home support services to increase access for people with severe mental illness.

32. That home support services formalize and expand collaborative inter-agency approaches to planning and delivering of services, including protocol development and shared care planning.

33. Community Support Services – Additional community support services are required to help individuals age in place. These additional resources will range from Meals on Wheels programs to personal support services. The Long-Term Care Annual District Service Plans provide documentation about these services including unmet needs and gaps.

34. Specialized Units within Long-Term Care Facilities and Chronic Care Units – The MOHLTC should immediately begin: Analysis of utilization data and profiles of persons with disruptive behaviours who no longer require highly specialized treatment (yet cannot be managed in a long-term care facility or chronic care unit) in order to establish benchmarks for staffing resources for specialized units within long-term care facilities and chronic care units, Identification of the structural modifications required for these facilities to accommodate these persons’ needs followed by detailed cost estimates, Identification of potential sites for these units across the Northeast Region, and Implementation planning for these beds.

SCPI 2nd Round Summary of Meeting

(Supporting Community Partnerships Initiatives, 2003)

35. More housing. 36. Coordinated inter-service Case Management model. 37. More coordination and collaboration among agencies, etc. 38. More seamless and accessible continuum of care and affordable housing. 39. Cultural sensitivity training to service provider / staff. 40. Timely interventions that allow for creative responses and client ownership and control. 41. Sharing information about clients. 42. Access to income when you don’t have an address. 43. Trusteeship program. 44. In-Home services (Basic).

APPENDIX A


64

Building a Spectrum of Health Care Options in Nipissing and Northern Sections of North East Parry Sound

(Near North Community Care Access Centre Committee, 2004)

45. Promote the use of trial placements with enhanced support from mental health institutions. 46. Increase the short-stay bed utilization of this region. 47. Ensure maximum integration and collaboration of Nurse Practitioner services across care

settings so that we support individuals in the most cost effective care setting. 48. In-Home Services: Expand corporate sponsorship to provide funding for client purchases of

medical equipment and home renovations. 49. Work with municipalities to promote understanding of the need for affordable housing/living

arrangements for a rapidly aging population. 50. Encourage the MOHLTC to review and modify the funding formulas and CMI [Case Mix Index]

formulas to be more congruent to system capacity issues and sociodemographics in Northern Ontario.

51. Establish the capacity for Capital Grant Funding for Long-Term Care Facilities. Provide funding to retrofit/renovate existing long-term care facilities enabling structural changes to accommodate specific client needs.

52. Consider establishing new care settings in the community for individuals requiring residential care (i.e. secure units, forensics, staffing at a RN, RPN, Personal Support Worker level). This may involve building new settings or enhancements to existing Long-Term Care Facility settings.

53. Long Term Care Facilities: Expand the number of RNs, RPNs, and Personal Support Workers in long-term care facilities to support medically complex individuals in long-term care facilities rather than in hospitals.

54. Long Term Care Facilities: Consider use of isolation units to accommodate admissions of patients with infectious diseases (i.e. SARS, FRI).

55. Long Term Care Facilities: Consider methods to increase flexibility for transitional care, i.e. quick access/admissions to long-term care facilities from hospitals (methods to handle male: female beds, private : semi-private).

56. Long Term Care Facilities: Increase short-stay utilization for respite care and convalescent/rehabilitation stages of recovery (rather than staying in hospital).

57. In-Home Services of NNCCAC: Expand funding for respite, personal support, and rehabilitation therapies (occupational therapy, physiotherapy, speech-language pathology) for adult patients to support patients in their home setting.

58. PHARA Outreach Services: Expand funding for PHARA Outreach Services to support patients in their home setting.

59. Expand supportive housing options, particularly in West Nipissing and Mattawa regions. Note: Defined as 24-hour onsite personal support in adapted housing units similar to 280 Oakwood Complex in North Bay.

APPENDIX A


65

Community Services Review, Based on the Ontario Disability Support Program (ODSP) Client Population

(District of Nipissing Social Services Administration Board, 2006)

60. Ministry of Community and Social Services (MCSS): That the Ministry further explore the need for trustee programs within the District, and work with the relative community organizations to develop adequate, sustainable programs & services to meet the needs of clients (note: MCSS action is in progress).

61. MCSS: Increase ODSP incomes, based upon an index of average household expenditures (LICO or market basket measure). Alternatively, make changes to the Shelter Maximum which better reflects the national components of core housing need (affordability, suitability & adequacy), and provide a food allowance in addition to Basic Needs.

62. MCSS: Review the current ODSP Shelter Maximums, With the view of making the shelter maximums more reflective of the local housing markets. Also, to align the shelter maximums to the national components of core housing need (affordability, suitability and adequacy), and With the view of considering a different scale for clients who are not able to access social housing or any affordable housing programs, and who are paying market rent. The initial focus should be on single clients as this is where the largest affordability gaps are (for example, the shelter maximum for one person is $427 /mo. and yet the average rent for a 1-bdrm. apartment in Ontario’s 11 CMA’s is $774 /mo.).

63. Ministry of Health & Long Term Care (MOHLTC): That the Ministry of Health and Long Term Care review their benchmarks for housing supports in Nipissing District. These benchmarks should consider not only population, but actual prevalence, which takes into account Nipissing District’s large ODSP caseload, and that based upon this review, a plan is developed and implemented that will establish adequate supported /supportive housing capacity in Nipissing District.

64. DNSSAB & MCSS: Streamline the existing shelter reporting format, so that specific information is captured (such as user profile), beyond that which is needed for policy conformance and reports. This will facilitate effective planning for programs and services, as well as provide measurements for the monitoring of program effectiveness (results).

65. MCSS, MMAH, MOHLTC: That the Ministries review the present Strong Communities Rent Supplement Program funding allocations for Nipissing District, with the view of reducing the waiting lists …. This should include providing support-services funding that matches the rent-subsidy funding.

66. MCSS: That the Ministry enhances its Homelessness services and increases the Community Homelessness Prevention Program (CHPP, previously PHIF), specifically the Housing Guarantee Program and the Community Housing Transitional Support Worker program.

67. MCSS: Increase the basic needs benefit by an amount that will decrease the clients’ food-to-income ratios to that of the District’s median, or approximately 10% of income. Calculations would probably show that this approaches the Low Income Cutoff Levels. OR Create a food allowance which would be added to the basic needs and shelter allowance. This allowance would be indexed to the local nutritious food basket (published annually by Ontario’s Public Health Units) and would change as the family moves through its life cycle. The food allowance could be calculated through a weighted index, and could either be administered as a separate benefit or added into basic needs.

68. MOHLTC: It is recommended that funding be secured for a Coordinators position for the Food Security Advocacy Group. With this staff position, the organization could move forward on many of the local food issues and work towards establishing a Food Charter for Nipissing District.

APPENDIX A


66

69. MCSS: Provide resources to a lead agency for the development and implementation of a Community Transportation Program. The program would utilize a staff and volunteer network of drivers, and would be evaluated on its effectiveness in meeting client needs, as well as specific performance measures. OR Expand an existing service such as Para-Taxi to be more inclusive (i.e., move beyond just the physical disability aspect) and handle larger volumes of clients during the times of greatest need. This service would also be extended into West Nipissing.

70. North East LHIN: Under the LHIN’s mandate to plan, integrate and fund local health services: a. That the LHIN identifies the resources necessary to implement a community service

integration model in Nipissing District, when developing its Integrated Health Service Plan with input from the community;

71. MOHLTC /North East LHIN: In partnership with the mental health service community, create a Gateway to Services for mental health services in Nipissing District. This would provide a central point of access for information, referrals, treatment and prevention.

Nipissing District: A Socioeconomic Profile & Report

(Plumstead, 2006)

72. In the short-term, it is recommended that DNSSAB educate Government Ministries on Nipissing District’s position through the use of this report and presentations. Also on behalf of Nipissing District, DNSSAB should seek additional funding for the respective areas of social assistance, housing, children’s services and health. This funding will be used within the community to enhance present programs and bridge gaps, to meet the immediate needs of low income families.

73. In the short-term, it is recommended that DNSSAB take the initial lead in raising awareness of the District’s disparity gap with municipal leaders, Government officials and community partners. This will include sharing this report where appropriate, making presentations and meeting with senior-level administrators.

74. Working on permanent solutions that will reverse the District’s negative trends and reduce the disparities is a long-term value proposition. As such, once committed, DNSSAB and others will need to expend significant resources for planning and implementation. It is recommended that DNSSAB first establish a Task Force or Committee comprised of municipal representation and other strategic community partners, to evaluate the present environment for this type of planning, and to determine the next steps.

75. The first step in being able to improve something is being able to measure it, and this initial report serves to create a type of socioeconomic scorecard or Nipissing District. It is recommended that DNSSAB maintain, update and improve this report where possible, and share the results with Governments and community partners (above). In the future, this will become increasingly important for providing feedback and measuring progress.

Older Adults Living with Mental Illness: Achieving a More Responsive Service System in the District of

Nipissing and the Northern Section of Northeast Parry Sound (Philbin Wilkinson, 2006)

76. A formal Older Adults/Mental Health Committee, led by a dedicated planner from the Northeast Local Health Integration Network, should be established immediately with formal linkages with other planning groups such as the local Dementia Networks and the Nipissing

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Addiction and Mental Health System Group. This committee should have representatives from various professional disciplines.

a. Develop an implementation plan based on this proposal, including outcome measures, patient satisfaction and ongoing monitoring and evaluation to ensure that the local system’s supply of services continues to meet the projected service demands and growing needs of this client population with attention to the area’s significant First Nations and Francophone cultural groups; this plan would also place emphasis on strategies that would foster health promotion and prevention services.

b. Lead the development of an integrated care pathway to ensure timely access to both community support and health services.

c. Implement the use of a common risk assessment tool by each service sector to ensure client safety and the triage of clients to the safest, most appropriate service.

d. Monitor the supply and demand of resources to make adjustments as gaps, issues and policies evolve over time in order to sustain the system.

e. Review the current inventory of community support services with the objective of identifying areas of collaboration to optimize the efficiency of those existing resources.

f. Develop service agreements to establish guidelines for admission and access to services. g. Develop transition/discharge planning.

77. The Older Adults Mental Health Committee will undertake a comprehensive annual assessment of the training needs of primary care physicians, mental health and long-term care service providers while taking into account the P.I.E.C.E.S. training. This should be followed by the development of an integrated training plan for all sectors led by the Northeast Mental Health Centre including a review of the roles and responsibilities of the different providers that offer education in order to reduce any duplication. This can be accomplished by transferring the supervision of the existing Psychogeriatric Resource Consultants (PRC) to the Regional Seniors Mental Health Program.

78. The Northeast Mental Health Centre, in collaboration with the appropriate local agencies, should immediately begin to define the roles and responsibilities and administrative structure of the district/regional senior’s program as part of the Tier 2 divestment transfer. Funding is required to create a local program with distinct district-based resources for the NNCCAC area in order to provide in-home assessments and treatment recommendations by psychiatrists and clinicians that have historically provided outreach to this area as part of their regional mandate. As is recommended in the Ken White Report…, this will require a 1.0 FTE clinician with distinct NNCCAC district responsibilities. Additional funding is required to ensure this clinician is supported by a multidisciplinary team (i.e., occupational therapy, psychiatry, psychology, social work). This enhancement will allow the clinician to dedicate up to 30 per cent of his/her time to capacity building as supported by the Clarke Benchmarks.

79. Intensive Clinical Services providing ongoing management and support would be required to maintain the older adults living with mental illness in the community. This could include 2-3 visits per week per client by trained Registered Practical Nurses and/or Personal Support Workers to ensure functional well being. Case Managers from the Rapid Response Team would oversee the Clinical staff.

80. Resources are required to enhance the capacity of mental health community programs, including but not limited to Assertive Community Treatment (ACT) teams and intensive case management, to ensure ongoing management post 65 years of age. This will allow this client population to age in place without transition to new service providers.

81. Additional funding is required to increase/subsidize the number of accessible, 24 hour, supportive housing units that include home help and caregiver support, geared to income and

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affordable retirement homes. These options can reduce institutionalization and reduce the significant number of residents that are presently in long-term care homes and interim beds that require a light level of care.

82. The Rapid Response Seniors Assessment Team could fulfill the role of crisis outreach for long-term care homes in order to avoid the unnecessary and costly displacement of residents to acute care facilities.

83. Given the lack of resources that long-term care homes have to respond to the complex behavioural, cognitive, and psychiatric issues of residents, it is essential that the current classification system and funding formula be revised by the Ministry of Health and Long-Term Care to allow staff to provide safe and effective care for this client population. This particular recommendation is consistent with Recommendation No. 26 of the Inquest Touching the Death of Ezz-El Dine El-Boubi and Pedro Lopez.

84. In addition, regulations must be reassessed for the provision of high intensity funding to provide for the ongoing needs of the clients. With long-term care homes becoming placement options for this client population, new funding is required to increase the supply of safe and effective special care units in each long-term care home in the NNCCAC area. New units and/or structural modifications will require new funding. Costing estimates are provided in the proposal highlights (Appendix H) prepared by the Au Chateau Home for the Aged. This would include the addition of interim secure beds to serve this population as long-range plans are developed for the district.

85. As previously communicated by the NNCCAC to the Ministry of Health and Long-Term Care in September 2005 … residents of each long-term care home should have access to a full range of mental health and behavioural services, including psychiatrists, psychologists, nurse practitioners, registered nurses, registered practical nurses and personal support workers specialized in mental health and behaviour management. As such, funding is required to provide psychiatric nursing positions in long-term care homes. This additional resource would facilitate the placement of clients requiring dementia care and behavioural management in long-term care homes. Budget and dedicated time for P.I.E.C.E.S. trained in-house resource staff to provide ongoing education and support to their colleagues is required.

86. The structure of adult day programs should be reviewed to ensure affordability, relevancy and client focus. These will help ensure that older adults with mental illness have the option of accessing ongoing specialized support while avoiding hospitalization or admission to a long-term care home. This should include respite programming at night for clients who do not sleep and exhaust caregivers.

87. General hospitals in the NNCCAC area should increase their capacity to appropriately respond to the assessment and treatment planning needs of seniors with mental illness. Funding is required to provide ongoing education and support of staff in the emergency departments of each general hospital and the area’s Crisis Intervention program thus helping to reduce the number of unnecessary and costly admissions and, the length of stay in hospital. Agreements would be required to be made with community partners to provide 24/7 Crisis Intervention services for Seniors in West Nipissing and Mattawa where programs operate for limited hours. Use of a standardized risk assessment tool will allow for systemic consistency when evaluating client needs.

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Community Plan Assessment Phase II: Framework, Nipissing District

(District of Nipissing Social Services Administration Board, 2007a)

88. Implementation of HIFIS; Improve data management of homelessness services within community.

89. Support agency networks to work with other sectors to achieve common goals and provide better service to clients

a. Enhance and expand inter-service coordination and referral to include Child and Family Services, agencies providing services for youth at risk/youth in detention /custody, and agencies working with aboriginal and visible minority populations; cultural sensitivity awareness.

90. Develop a coordinated inter-service Case Management Model to increase “In-home” support services to the repetitive homeless, youth and aboriginal populations.

91. Further develop community awareness of homelessness; Further develop a common vision and community ownership of homelessness issues and solutions; expand private partnerships and sponsoring of special projects.

Temagami Senior Citizens Housing Survey

(Plumstead, 2007)

92. Hold a community session with the Temagami seniors population, to present the survey

findings back to them, while also confirming the data and acquiring any additional information

that may be needed.

93. Based on the above, confirm the feasibility of additional seniors housing in Temagami, based

on scenario’s of 10, 15 and 20+ additional units. This would include looking at the various

types of housing for seniors (retirement homes, apartments, etc.).

94. As a general guideline, ensure that “affordable housing” is a part of the formal, municipal

planning structure. In this capacity, it will remain on the radar screen and the housing needs of

Temagami’s general population will be considered, as they evolve.

Housing in Nipissing Communities, Building the Foundations: Executive Summary

(District of Nipissing Social Services Administration Board, 2008a)

95. Need for the development of a comprehensive strategy/plan of action to be through broad consultation with all stakeholders and all levels of government produced.

96. Integration of a district wide official plan with emphasis on municipal leadership on housing initiatives.

97. Better public/private partnerships. 98. Develop methods of better integrating human, physical and financial resources. 99. Overall internal and external communications need to be improved (i.e., within our

community and with the various levels of government). 100. Jettison silo thinking. 101. Require a better balancing of competing issues all of which have a direct effect on housing. 102. The time is now for innovative thinking to address our housing issues. 103. Current funding models are ineffective and need to be replaced with a continuum-based

approach.

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104. Best practices from other jurisdictions should be customized to meet local needs.

Nipissing District Housing Needs, Supply & Affordability Study

(District of Nipissing Social Services Administration Board, 2008b)

105. Establish a Housing Task Force or ad hoc Housing Committee to follow-up with recommendations in this report, as well as look at other housing strategies and solutions that could be implemented in Nipissing’s communities.

106. Schedule presentations to municipal councils of their unique data for their community, key findings and recommendations.

107. Convene an initial meeting, or series of meetings, with Realtors, Private Contractors, Municipal Planners, emergency shelters, supportive housing, social housing, seniors housing, legal clinic and public and private landlords.

108. Conduct a follow-up study specific to the housing needs of Nipissing District’s urban Aboriginal population.

109. That the urban areas of North Bay, Mattawa and West Nipissing consider incorporating quantified affordable housing targets into their new Official Plans (note: Mattawa currently has a target of 25% affordable housing in their OP from 1980 – whether this is carried forward into the new plan or a revised target is set, would depend upon their updated data and information).

110. That the urban areas of North Bay, Mattawa and West Nipissing consider adopting housing development policies that will facilitate the development of affordable housing.

111. That Nipissing District’s other municipalities also consider the use of quantified affordable housing targets in their new Official Plans, based upon the level of demonstrated need within their communities.

112. That the DNSSAB initiate discussions with municipalities on developing a framework to determine communication protocols, establish roles/responsibilities and, integrative linkages at the District and municipal level on affordable and social housing.

113. That the DNSSAB offer presentations of the Housing Needs Study (DVD/slide-show) to “key sectors” such as, education, health, social, employment, etc…to promote education/awareness/communication on housing in Nipissing.

114. That DNSSAB and the province acknowledge the above affordable housing targets and also incorporate them into their planning and budgets.

115. Meet with the ministries /funders semi-annually to review the housing needs of Nipissing District.

116. Recommend that MCSS increase ODSP & OW incomes, based upon an index of average household expenditures (LICO or market basket measure). Alternatively, make changes to the Shelter allowance which better reflects the local housing markets.

117. Recommend that MCSS review the current ODSP & OW shelter allowances with the view of making the shelter maximums more reflective of local housing markets. This would include indexing them to average market rents (as published by CMHC) and average vacancy rates.

118. Recommend that MCSS, MOHLTC and MMAH review the present Strong Communities Rent Supplement Program with the view to: i) Providing support-services funding that matches the rent- supplement funding. ii) Revising the funding calculation so that the RGI income tables are replaced with social assistance, maximum shelter allowances.

119. Call on the federal government for the development of a National Housing Strategy in support of the Federation of Canadian Municipalities (Sustaining the Momentum, 2008), the

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Association of Municipalities of Ontario (AMO News Release, April 2008) and the Toronto Summit, 2007.

120. Examine and revise rent-setting policies for social assistance recipients living in social housing; Where appropriate, reinvest to modernize and preserve existing social housing, including energy efficient upgrades; Where neighborhood or property regeneration is more logical, ensure that existing policies do not impede regeneration or redevelopment solutions.

Poverty Reduction in Nipissing District: Perspectives and Priorities

(Provincial Consultation Working Group of Nipissing District, 2008)

121. The PCWG recommends the federal government, with the support from the provincial government, develop a National Housing Strategy.

122. Align social assistance shelter allowances with the cost of local market rents by indexing allowances to average rents as published bi-annually by the Canadian Mortgage and Housing Corporation (CMHC).

123. Social assistance incomes are not reflective of actual household expenditures. The PCWG recommends indexing social assistance incomes to reflect the minimum acceptable income for Ontarians to enable them to purchase basic needs (i.e. food, shelter, clothing).

124. Coordinate funding initiatives more effectively to support a more integrated system of services. A detailed analysis of ministry programs, services and initiatives will reveal areas of duplication and overlap, as well as areas where there are gaps.

125. Develop criteria and a funding formula for community-based poverty action planning and provide further funding to communities to implement top priorities that support better integration and coordination efforts.

126. Provide increased and sustained annual funding for an Emergency Energy Fund. 127. Improve transportation infrastructure for low-income households. One way of doing this is by

contributing funding to programs that are being operated by non-profit organizations and/or volunteers, and which are meeting transportation needs with success.

128. Recognizing the disproportionately large percentage of income that is spent on food by social assistance recipients, the PCWG recommends introducing a food allowance alongside the basic needs and shelter allowance.

129. Develop a policy regarding surplus public buildings such as schools and hospitals to provide these facilities as community resources first, to meet needs for affordable housing, long-term care facilities or other community service initiatives, including a funding strategy for necessary retrofits.

The Standing Committee on Finance and Economic Affairs, Pre-Budget Consultations: Sudbury, ON

(Poverty Reduction Working Group, 2008)

130. Reducing the number of people in core housing need will take time and will involve both supply & demand-sided solutions, like those we have just mentioned. Again, on the demand side, this includes enhancing shelter allowances, rent supplements, etc. On the supply side this includes stimulating housing through construction, conversions and preservation. We ask the government to consider this mix of housing solutions in the 2009 budget.

131. Past reports out of Nipissing District have called on the provincial government to review the shelter allowances with the view of making the shelter maximums more reflective of local housing markets. We think the 2009 budget provides the opportunity to do this. This may

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include indexing the allowances to average market rents and average vacancy rates (as published by CMHC) or alternatively, increasing OW & ODSP incomes, based upon an index of average household expenditures (market basket measure) or relative income measure (LICO or LIM).

132. The 2009 budget offers an opportunity to look at introducing rental assistance to low-income, working households. This assistance could be in the form of a portable shelter allowance for those facing relatively high STIRs (shelter-to-income ratio). As with social assistance shelter allowances (mentioned next) these portable allowances should be reflective of local rental markets (i.e., indexed).

133. The local research indicates that the private sector rental business is unattractive due to the current tax and regulatory environment – we think that this budget cycle is a good time to review the present federal and provincial tax polices (as they relate to rental development) and rent regulations.

134. Thus the lack of supportive housing in the community is having a negative impact on hospitals – not only on their level of patient care but also on their operating budgets. This is also straight economics: should we be housing some people (ALC patients)1 in the very-expensive-to-operate acute hospital beds when they could be housed in the less-expensive-to-operate LTC beds, or supportive housing!? Again, we would like to stress the importance of having the next budget provide increased investment for supportive housing in our communities.

135. The District needs more supportive housing funding which should include both the shelter and the supportive services funding components – we also need to see this taken into consideration in the 2009 budget.

136. We ask the government to include much-needed transitional housing dollars for Nipissing District, in the budget.

137. We realize that the issue of ageing housing stock is on the radar of senior governments but we re-emphasize the importance of making additional investment into the preservation of the existing housing stock – we would also like to see this addressed in the next budget.

138. Canada–Ontario Affordable Housing Program: We are also very concerned that there has been no firm commitment regarding the extension of this program, either at the provincial or federal levels. We would like to see this addressed in the 2009 budget.

Nipissing District Homelessness Partnership Priority Issues Workplan

(Nipissing District Homelessness Partnership, 2009-2011)

139. Ensure sustainable funding for core homelessness services using funds from existing sources where available, and where necessary, identify new sources.

a. Define and Identify core homelessness services and current funding gaps. b. Present a report focusing on the success and benefit to the community of the service

delivery model and collaborative approach practiced by core service providers in Nipissing, as well as the funding issues, to potential funders and the public.

140. Implement a communications and networking strategy to increase public awareness of the issues identified and work undertaken by the NDHP.

a. Create a rotating schedule for NDHP meetings for 2009-2010, hosted by different member agencies.

b. Hold a networking event to engage current members and other agencies that participated with “No Wrong Door.”

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c. Reduce the stigma attached to people who experience homelessness or being at risk of homelessness by promoting greater awareness of issues that contribute to these conditions.

d. Follow up on responses to networking event. 141. Improve/Enhance/Build on the work done in the No Wrong Door and Homeless and At-Risk

Youth Projects, to ensure that these remain high on the NDPH priority list, and that momentum that has been built is sustained.

a. Enhance, expand and use No Wrong Door Effectively. 142. Take action on recommendations from Homeless and At-Risk Needs Analysis report

a. Design and carry out a Youth Outreach Project to connect homeless and at-risk youth with services, support provider linkages with the No Wrong Door service delivery approach, and to help the Partnership gather data to better understand the needs and demographics of the target population.

143. Develop a common knowledge /database about people who experience homelessness or risk of homelessness in Nipissing District, and the services they are accessing.

a. Pilot the Homeless Individuals and families Information System [HIFIS] amongst core service providers.

144. Ensure that all people in Nipissing District who require emergency shelter beds can access them when they need them.

a. Develop short-term solution to “fix” current bed shortage. b. Develop longer-term strategy.

Ontario’s Long-Term Affordable Housing Strategy: Provincial Housing Consultation Submission (District of Nipissing Social Services Administration Board, 2009a)

145. The provincial and national governments need to play the role of funders of housing, with the funds being allocated through a housing plan that is set within their respective authoritative and legislative frameworks. This funding needs to be firmly entrenched in annual block-type or base funding, as opposed to the random bilateral agreements (such as AHP) currently being experienced.

146. The municipal governments in turn should be the implementers of housing and they use the federal and provincial funds to address the housing needs within their communities. Where evidence exists of local housing needs, the municipalities should have flexibility in using the funding to meet these needs. The municipalities also add additional resources through their local planning tools and capacity, and their local expertise in implementing projects and programs at the community level.

147. If Ontario’s long-term housing strategy is going to be successfully formulated and implemented, it needs to address the concerns of the private housing industry also.

148. Sufficient Administration funding should be provided within the AHP allocations to cover the full cycle of program and project development, delivery (including legal costs), and ongoing monitoring.

149. The provincial government should deliver the replacements for the housing units it will take out of the market, or has created additional demand for, due to project work in other sectors which may inadvertently, reduce affordable housing supply. In other words, if one arm of the provincial government takes this housing out of circulation another arm should provide equivalent housing somewhere else.

150. There should be a bias towards renovation over new build where there are high vacancy rates or surplus buildings suitable for conversion/renovation.

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151. The Province of Ontario should ensure that there is effective coordination and increased allocation of support service funding to meet the needs of clients living in supported housing. Each physical unit of supported housing in Ontario (i.e. the bricks and mortar – new or existing), should be accompanied by a service unit of supported housing (i.e. the bundle of support services required by the client who lives in the housing). One without the other is proving to be very ineffective.

152. Address the disparity between the housing subsidy formulas and processes used by the Ministry of Municipal Affairs and Housing, and the Ministry of Health, as the disparity leads to inequities in how many individuals may be housed for the same amount of funds. The Ministry of Health and Long Term Care uses a flexible process for its Mental Health Housing which results in the housing provider using the funds to house as many individuals as possible. On the other hand, the Ministry of Municipal Affairs and Housing (MMAH) uses only the Rent Geared to Income (RGI) formula for its supplement system. This means the MMAH housing provider will almost always pay larger portions of supplement than those paid by the MOHLTC housing providers.

153. The S.H.R.A. needs to be made more responsive to the needs of low income tenants, who can lose the housing under it for reasons relating to income without an effective appeal mechanism.

154. The management of social housing could be improved if funding were made available for community development workers.

155. The district’s current AHP activity needs to be sustained for the next six years. 156. In areas (such as Nipissing District) where there has been a successful uptake of the AHP

Housing Allowances, the province could look at increasing program allocations. 157. The ministry should focus on addressing the demand for housing. 158. If Building Fire Codes are all that is standing in the way of basement apartments and legality,

there is a way of preserving this affordable housing that is revenue neutral, in the longer run. Low interest loans could be provided for the construction of an extra exit or adequate fire barriers, secured by a mortgage registered against title to the property in question. Like the successful federal home renovation tax credit program, this would create jobs too.

159. A public education campaign is needed that will educate the public around the importance of affordable housing and the crucial role it plays in the community. These campaigns need to be rolled out at the local (district or county) level, throughout the province. The province’s long-term housing strategy needs to incorporate an effective communication strategy that can be implemented at the local level.

160. Convene a Cabinet Minister Housing Table similar to that of the G-North Table for the Growth Plan for Northern Ontario. A Minister’s Table would provide the horizontal policy and program decision-making that Ontario’s long-term housing strategy now requires.

Rural Ontario Municipal Association Briefing: Meeting with Minister Watson

(District of Nipissing Social Services Administration Board, 2009c)

161. Nipissing’s AHP allocation of $2.2 million represented less than half-a-percent of the $600 Million available! We now have the data and evidence showing that we need more than the 0.5% - we hope your ministry looks at our business case, before the next round of funding.

162. We need capital dollars for supportive housing, four [sic] our seniors population and those with mental illness – this will also help to eliminate the inappropriate use of hospital beds and

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lessen the negative impact of reduced beds at the North Bay Psychiatric Hospital. We can not be excluded from supportive housing dollars like in the previous round of AHP.

163. We have construction-ready, housing projects that are ready to go. 164. We need approximately 160 units annually, through to 2016 – we ask that you consider these

targets when making your decisions regarding program funding, for Nipissing District.

Summary Report: Needs Analysis of Homeless and At-Risk Youth in the Nipissing District

(Paquette, 2009)

165. That the Nipissing Homeless Partnership advocate for regulatory changes to Social Assistance which support the needs of local Homeless and At-Risk youth (providing access to social assistance for 16-17 year olds who do not have a trustee).

166. That the Nipissing Homelessness Partnership examines the roles and requirements involved in assuming the role of trustee, determine the annual community need and explore options for establishing a dedicated interagency pool of trustees to assist 16-17 year olds applying for social assistance in Nipissing.

167. That a Community Housing Support Worker should be hired which would be dedicated to the Youth Homeless and At-Risk population. This position would support youth in securing suitable housing, negotiating rental agreements and paying monthly rent on their behalf.

168. Given that there is currently no transitional housing available for youth in North Bay and surrounding communities that the Nipissing Homelessness Partnership continue to advocate for new transitional housing models/units which address the needs of the hard-to-serve youth population. (This population would include individuals with serious mental health and/or addictions problems, or who may be in conflict with the law) who may not qualify for other residential programs in the community.

169. That the Nipissing Homelessness Partnership continue to support local efforts to expand the range of affordable housing in the Nipissing District. To this end, the NHP could provide existing planning groups with data on the needs of the homeless youth and low-income populations in the community and continue to advocate for additional support from all three levels of government.

170. That the Nipissing Homelessness Partnership explore viable opportunities to expand the range of residential programs for youth in the catchment area. Any new programs should build on the success of the Futures Residential Program in North Bay which has been identified as a best-practice model by local providers who have expressed the need to expand its program capacity for District youth.

171. That the Nipissing Homelessness Partnership work closely with West Nipissing, Mattawa and surrounding communities to share information and ensure a consistent planning process is in place to address the shelter needs of homeless youth in each of these respective jurisdictions.

172. That designated Outreach Worker(s) be hired to provide street-level liaison with homeless and at-risk youth in North Bay. These workers could provide initial counseling and support, access to emergency shelter, and information and navigational support for accessing required support services in the community. * A key role of this worker would be collecting statistics on hard-to-serve youth and establishing a client database (of homeless individuals) to support interagency service planning and advocacy.

173. That the Nipissing Homelessness Partnership work with existing youth initiatives such as the North Bay Youth Action Team to explore opportunities for establishing a drop-in centre for

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youth. This drop-in centre would provide valuable information and referral, crisis counseling as well as individual and group peer support.

174. That the Nipissing Homelessness Partnership coordinate planning with local mental health service providers to provide immediate (on-demand) mental health counseling services to homeless and at-risk youth who find themselves in crisis.

175. That the Nipissing Homelessness Partnership work closely with Municipal representatives to establish additional social, recreational and volunteer opportunities for at-risk youth within the community.

176. That a more consistent and proactive planning process be put in place (with out-of-district custody/detention facilities) to support positive reintegration/transition of local youth. It is also recommended that the mandates of local service providers involved in undertaking discharge planning and providing after-care support for youth in custody be reviewed to ensure that processes/procedures and resources are being used effectively.

177. That the Nipissing Homeless Partnership initiate a planning process with the local business community to establish a Youth Mentorship Program in North Bay. This program would provide at-risk youth with valuable employment experience and skills training to support job readiness and independent living.

178. That the Nipissing Homelessness Partnership continue to work closely with local school boards and educational institutions to develop flexible alternative education programs for at-risk youth which support individualized learning and effective transition to the local workplace.

179. That the Nipissing Homelessness Partnership support the establishment of a single consolidated client database as well as a single intake process to support coordinated service delivery to clients. This should build upon the No Wrong Door pilot project currently being led by LIPI.

180. That Youth Homelessness remain a planning priority for the Nipissing Homelessness Partnership and that a process to monitor the on-going status of youth homelessness in Nipissing be implemented within the community.

181. That the Nipissing Homeless Partnership advocate as a coalition of agencies for increased funding and human resources to continue the important work of the group in developing a “system of support” for the homeless in Nipissing.

182. That the Nipissing Homelessness Partnership develop a targeted communications and public awareness strategy to inform both the public and providers about the issue of youth homelessness in North Bay and surrounding communities. This strategy should aim to reduce the stigma for youth and to inform the broader community that homelessness is most often not a choice but an unfortunate reality for youth.

183. That available services for homeless and at-risk youth including locations and contact numbers be marketed throughout the catchment area so that local youth know where they can access help if they need it.

Blueprint on Social Development Planning Capacity in North Bay/Nipissing (Draft)

(Social Planning Network of Ontario, 2010)

184. Develop a short educational brochure on social and economic development planning, highlighting a first action initiative on the social and economic needs of a strong and stable workforce.

185. Use the brochure to engage community, civic, and private sector leaders in a discussion on social and economic development planning and the strong workforce priority.

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Community Entity Update

(District of Nipissing Social Services Administration Board, 2010)

186. Enhance, expand and use No Wrong Door Effectively a. Obtain board level buy-in from No Wrong Door partner agencies b. Increase the number of agencies who buy in to the NWD approach c. Create online version of the NWD Resource Manual d. Convene a learning session with community case scenarios to re-engage agencies

participating in NWD e. Create and implement a sustainable approach to managing and coordinating the NWD

model. 187. Design and carry out a Youth Outreach Project to connect homeless and at-risk youth with

services, support provider linkages with the No Wrong Door service delivery approach, and to help the Partnership gather data to better understand the needs and demographics of the target population

a. Direct and coordinate Youth Outreach Worker’s activities, and provide required support to the incumbent to achieve targeted project outcomes

b. Review progress monthly c. Review outcomes achieved at end of the project and determine future directions.

188. Pilot the Homeless Individuals and families Information System [HIFIS] amongst core service providers

a. Obtain up-to-date information on the HIFIS system, requirements, costs and support available from Government of Canada and other sources

b. Develop implementation plan with Crisis Centre, LIPI, Salvation Army, and others interested in participating in pilot

c. Commence pilot. 189. Follow up on participant input from November, 2009 NDHP-hosted interagency networking

event a. Invite North Bay Building Department and North Bay Fire Department to present to the

Table regarding 1) regulations affecting boarding homes and other residential facilities 2) reporting and follow up process

b. Explore ways to promote improved housing benefits for low-income households c. Develop recommendations re homelessness and increased affordable housing to inform

municipal planning d. Monitor opportunities for NDHP and larger community to provide input into a national

housing strategy e. Assess community capacity building on results of the Core Homelessness Services

Survey. f. Partner with the Social Planning Council and Poverty Reduction Working Group of

Nipissing who have the capacity to provide public education and increase community awareness (common goals).

190. Develop a report/presentation focusing on the success and benefit to the community of the service delivery model and collaborative approach practiced by core service providers in Nipissing, as well as the funding issues, targeted to potential funders and the public.

191. Develop a validated common knowledge /database about people who experience homelessness or risk of homelessness in Nipissing District, and the services they are accessing.

192. Implement a communications and networking strategy to increase public awareness of the issues identified and work undertaken by the NDHP

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a. Reduce the stigma attached to people who experience homelessness or being at risk of homelessness by promoting greater awareness of issues that contribute to these conditions

b. Create material for publication through various media geared to dispel commonly-held misconceptions and misinformation.

Living the Story: Local Experiences of Poverty and Ideas for Change

(Poverty Reduction Working Group Nipissing & North Bay and Area Social Planning Council, 2010)

193. Indexing social assistance basic needs allowances to local food costs through the public health unit’s Nutritious Food Basket data, or providing a Healthy Food Supplement for all social assistance recipients.

194. Indexing social assistance shelter allowances to local housing costs. 195. Creating more affordable housing. 196. Guaranteeing core funding for core services that assist people with low incomes.

Letter to Dwight Duncan, Minister of Finance: 2011 Pre-Budget Consultation

(Pilon & Carew, 2011)

197. Social assistance rates do not enable recipients to afford both adequate housing and nutritious food; we urge an increase in current levels of Social Assistance. We call on the government to increase social assistance rates by $100 per month for all adults.

198. In 2010 in Nipissing District, the waiting List for social housing was approximately 1000 people. Throughout Ontario more than 140,000 households were on the municipal waiting lists for assisted housing. We urge the government to have a funded infrastructure plan to ensure community based affordable housing is available. And we call for a new Ontario Housing Benefit that help low income tenants pay the rent.

Nipissing Housing and Homelessness Services: Discussion Paper

(Malette, Barraclough, & Belanger, 2011)

199. Create a senior’s housing needs report having regard to demographic change and senior’s financial ability to meet their housing needs.

200. Review of social housing mandate and rent-geared-to-income target plans. 201. Commit to the development of the 10-Year Housing and Homelessness Plans to assess local

municipal housing and homelessness needs as part of the Provinces LTAHS subject to availability of resources.

202. Preparing a regular District-wide Housing/Homelessness Report as resources permit. 203. Intense collaboration, coordination/leadership and participation in local, northern and

provincial working groups such as Provincial Long-Term Affordable Housing Strategy, Nipissing District Homelessness Partnership and Pan-Northern initiatives through NOSDA and advocate for unmet District housing needs.

204. Continue to raise issues with the Province and Federal government and keep DNSSAB board members informed and aware of these issues.

APPENDIX A


79

205. Continue the leadership role of Homelessness Partnering Strategy (HPS) Community Entity through means such as chairing the Nipissing District Homelessness Partnership and facilitating community planning and administer funds allocated to planning priorities.

206. Implementing the Homelessness Individual and Families Information System (HIFIS). 207. Review programs and unit targeting plans of housing provider mandates including Nipissing

District Housing Corporation. 208. Review of Coordinated Access and Waiting List System. 209. Program review of DNSSAB Affordable Housing Delivery Plan (2007). 210. Sponsoring Community Education Opportunities to raise awareness of homelessness issues

facing Nipissing. 211. Educating communities and developing strategies to facilitate new affordable rental and

ownership housing “NIMBY”. 212. Sponsoring/Coordinating new Affordable Housing Activities/Initiatives.

Reaching Out: Strategic Planning Consultation Forums

(District of Nipissing Social Services Administration Board, 2011b)

213. Rural strategy that addresses homelessness close to home. 214. Encourage and support landlords to get involved in creating and maintaining appropriate

stock. 215. Existing supports need to be balanced between male and female. 216. Consider transportation solutions – may open up new opportunities for stock. 217. Need to accommodate ability for people to move on. 218. Use of the hospitals. 219. Multi generational housing.

Youth Outreach Project: Activities, Findings and Recommendations (Summary Report)

(Lair, 2011)

220. Through the implementation of a Youth Transitional Support Worker, in conjunction with adjustments made to existing services, the ability for youth to secure assistance during their times of need would be greatly enhanced. This would limit the instances of family breakdown as well as the risk of youth homelessness. By utilizing my contacts with youth and their experiences as a foundation for these conclusions, it is evident that transitional supports would directly benefit a young person’s ability to succeed and overcome adverse circumstances. A transitional support worker would be required to be much more mobile than many of our existing programs, as youth often require a more intensive support network. The worker would need to be highly skilled, professional, and able to relate to youth as well as have some training in behaviour management and Cognitive Behavioural Training. Furthermore, the implementation of a Trusteeship program in conjunction with the Youth Transitional Support Worker role would be imperative to its overall success.

APPENDIX A


80

Homelessness in North Bay

(Kauppi, Pallard, & King, 2013)

221. Provide sufficient funding to agencies serving homeless people to ensure that adequate staffing is available to meet the needs of clients.

222. Develop new public housing initiatives (i.e., the creation of subsidized housing units). 223. Provide more community-based services to people with mental illness in order to prevent

periodic or chronic homelessness. 224. Provide sustainable funding for shelters and beds for homeless people to ensure that there

are adequate numbers of shelter beds available. 225. Enhance existing resources and services in the areas of greatest need: housing and income

security; counselling; health care, mental health services, and dental care; life skills; employment services; transportation; and addictions.

226. Educate landlords in order to reduce discrimination against key groups (e.g., people with mental illness, battered women, and Aboriginal people) and ensure that adequate supports are available to help people stay housed (including support for landlords).

227. Have peer navigators in the community to assist homeless people navigate services. 228. Provide resources to shelters and soup kitchens to enable the provision of comprehensive

services and to work with individual clients in order to coordinate services. Taylor Gaubatz (2001) has outlined the requirements of comprehensive housing and service programs for homeless people. These include the provision of clean, safe housing, professional counselling, housing support services, medical care and mental health services, income support, literacy and job skills training, job placement, education, day care and respite care, and drug and alcohol treatment. Income supports should include increases in Ontario Works and Ontario Disabilities Support Program. Employment supports must enable marginalized people to be hired.

229. Extend the length of time that clients may stay in shelters to provide sufficient time for homeless people to become connected to services and housing support systems.

230. Given the primacy of domestic violence and other family issues as causes of homelessness, especially for women, provide more funding support for services to address trauma.

231. Develop strategies for ensuring that Aboriginal people moving to urban communities can be connected to varied services.

232. Take steps to address racism as a cause of homelessness to ensure that Aboriginal people can obtain rental housing and gain access to services.

233. Increase funding for outreach and prevention programs to address domestic violence and abuse among all age groups, including seniors.

234. Ensure educational system meets the needs of all students. 235. Develop standards around food security to ensure that near homeless and absolutely

homeless people have access to nutritious food supplies. For example, the needs for food security are not met when clients can only access food banks once per month and when homeless people are not permitted to use the food banks due to a requirement to produce proof of residence.

236. Work with Aboriginal communities to develop strategies for supporting Aboriginals who move from their First Nation communities into urban centres. Culturally appropriate services must be developed to assist with basic needs, education, and employment.

237. Establish standards for emergency shelters (e.g., in an evaluation tool) to ensure that homeless people are not exposed to further stress from over-crowding in shelters or overly rigid shelter regulations.

APPENDIX A


81

238. Conduct a series of community forums to ensure that service providers and other community partners have opportunities to meet, exchange information about needs and local services, and resolve conflicting program requirements. For example, Ontario Works and Children’s Aid Society have conflicting policies for women who are attempting to regain custody of their children (i.e., OW benefits are often provided for a single person while the CAS may require women to demonstrate that they can provide adequate food and shelter for their children).

239. Develop programs so that they address trauma and reduce further exposure to abuse and violence on the streets.

240. Develop materials to educate service providers and the general public about the complex individual and structural causes of homelessness, including the high prevalence of victimization and trauma among homeless people.

241. Sustain local working relationships between the university, local planning bodies, and local agencies to ensure that there is an ongoing process for the collection of data on people who are homeless.

242. Provide or enhance moving allowances. 243. Develop local, provincial, and national initiatives to address the structural problems of lack of

access to education, unemployment, lack of jobs, and low wages for vulnerable groups. 244. Develop training materials documenting effective strategies for working with the most

marginalized groups of people (e.g., people with addictions and serious mental illness) and ensure that these groups are not barred from access to services.

245. Develop linguistically and culturally appropriate emergency services for Aboriginal people. 246. Redesign the system of emergency services to reflect the characteristics of the homeless

populations using them (e.g., more women, children, Aboriginal people). 247. Work with the various levels of government so that they recognize the medium-sized urban

centres that are destination points for people leaving small, rural, and remote communities in search of work or services. Enhance the emergency service systems to deal with the needs of those who become homeless as a result of relocation.

Alternative Level of Care: Beyond Beds

(North Bay and District Hospital, n.d.)

248. Capital and Operating dollars for at least 148 supportive housing units. 249. Subsidy for retirement homes. 250. Additional LTC beds. 251. Funding for community support services including homemaking, home repair, meal

preparation, transportation, shopping and accompaniment to appointments. 252. Additional special LTC beds funded to care for those with mental illness, behavioural issues

and dementia. 253. Hospice for the care of end of life patients. 254. Public education to plan for aging versus dealing with a crisis situation in golden years. 255. Deregulating the community and LTC systems to allow for more flexible use of respite, short

stay and convalescent care beds. 256. Report recommends a provincial action group be struck to delve further into the issue and

develop long-term, cost-effective and sustainable solutions. 257. NE Local Health Integrated Network (LHIN) has declared ALC a priority and has convened an

ALC Task Force as well as sponsored an ALC Summit to seek solutions. 258. Reduce financial barriers to accessing retirement homes.

APPENDIX A


82

259. Create capacity for full spectrum of community supports (home care, supportive care, supportive housing, improved addictions and mental health services).

260. Improved respite care and supports for family members who choose to care for elderly or infirm people in their homes.

Consultation with Stakeholders: Homeless and At-risk Youth, n.d.

261. More Futures Programs. Programs where youth can live in a group setting and have structured activities, schooling, life skills. These programs are critical because we are sending youth into a society with no budgeting skills, and a lack of life skills. Additionally, some youth have serious addiction and mental health issues that have not been dealt with.

262. Develop the concept and build a Transitional Home with structured programs including life skills training dedicated to youth, the Crisis Centre should be the lead for this new service.

263. Build a new shelter that would provide 24/7 programs to help youth stay off the streets and address why they are homeless. This shelter would be the first step towards a transitional housing program and then to an affordable housing opportunity.

264. An additional dedicated Housing in Trusteeship Worker would be very beneficial in supporting the needs of homeless and at-risk youth in the community.

265. North Bay should consult with similar residential programs for youth such as Say Cedar in Sudbury and the Peter House in Sault Ste. Marie to work towards creating a similar residential facility for youth in Nipissing.

266. Youth need a safe, reliable place together, stay and play. North Bay requires a much needed shelter.

267. Community Outreach Workers (street level) should be hired to interact with youth on the streets and support them in coordinating access to services and programs which can address their primary needs. Once stabilized, these youth will have a better chance to successfully reintegrate into the community.

268. The community should also explore viable opportunities for expanding the pool of safe beds for youth in crisis who require short-term accommodation.

REFERENCE LIST OF LITERATURE REVIEWED


83

Reference List of Literature Reviewed

Associations of Municipalities of Ontario. (2004). Regions Affordable Housing Workshop.

C. N. Watson and Associates Ltd. (2006). City of North Bay Population, Household and Employment Forecast, 2001-2031: Final Report.

Children’s Services Advisory Committee Nipissing. (1984). A Demographic Profile of Nipissing District with Social Indicators.

Clarke, K., & Belanger, T. (2012). Coordinated Access Review Summary & Recommendations. District of Nipissing Social Services Administration Board, Resolution No. 2012-034.

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District of Nipissing Social Services Administration Board. (2008b). Nipissing District Housing Needs, Supply & Affordability Study.

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Lair, L. (2011). Youth Outreach Project: Activities, Findings and Recommendations (Summary Report). Nipissing Homelessness Partnership Committee.

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85

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Ontario Non-Profit Housing Association & Co-operative Housing Federation of Canada. (2005). Where’s Home? 2004 Update.

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86

Ontario Non-Profit Housing Association & Co-operative Housing Federation of Canada. (2011). Where’s Home?

Paquette, D. (2009). Summary Report: Needs Analysis of Homeless and At-Risk Youth in the Nipissing District. Summit Consulting.

Philbin Wilkinson, H. (2006). Older Adults Living with Mental Illness: Achieving a More Responsive Service System in the District of Nipissing and the Northern Section of Northeast Parry Sound. Nipissing District: Interim Strategies Mental Health Working Group.

Pilon, N., & Carew, W. (2011, February 15). [Letter to Dwight Duncan, Minister of Finance] 2011 Pre-Budget Consultation. North Bay and Area Social Planning Council.

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