Meeting Crisis with Opportunity - Reimagining Toronto's Shelter System - FULL RESEARCH REPORT
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FULL RESEARCH REPORT Meeting Crisis with Opportunity Reimagining Toronto’s Shelter System The Impact of COVID-19 on Toronto’s 24 Hour Emergency Homelessness System June 2021
Acknowledgements
This report was made possible thanks to the contributions of hundreds of shelter users, shelter service
providers and other key stakeholders who donated their time, experience and expert knowledge.
First, TSN and Dixon Hall would like We would like to thank the individuals We are also grateful for the insight
to thank the 230+ shelter users who who shared their time and expert provided during consultations
completed surveys. From their generous knowledge regarding the direct and held with the following:
contributions, we gained valuable insight indirect impacts that the pandemic has ■ Researchers from the MAP Centre for
into their experiences with homelessness, had on the emergency shelter system:
Urban Health Solutions (The Covenant
the impact that the pandemic has had ■ Abigail Bond, Executive Director, Study), Covenant House Youth
on them, their ideas about changes that
Housing Secretariat Shelter, and Unity Health Toronto
could be made to the shelter system ■ Emily Martyn, Community Development ■ TSN Women’s Sector Table and
to improve their access to housing and
Officer, Social Development Financial TSN Men’s Sector Table
suggestions for improving access to
and Administration - Tower and ■ Emily Martyn, Community Development
housing in Toronto more generally.
Neighbourhood Revitalization (SDFA) Officer, City of Toronto - Tower and
■ Gord Tanner, Director of Neighbourhood Revitalization
In addition, our thanks to the many shelter
Homelessness Initiatives and
staff who participated in focus groups or
Prevention Services, SSHA Lastly, we would like to thank our funders
surveys for the study, as well as those who ■ Laural Raine, Director of Service at SDFA and Dixon Hall, the project trustee.
helped with coordinating or conducting
Planning and Integrity, SSHA
service user engagement in the midst ■ Shaun Hopkins, Manager, The Photo credits
of the second and third waves of the
Works, Toronto Public Health
COVID-19 pandemic. The Meeting Crisis ■ Cover: iStock.com/FilippoBacci
■ Terry Pariseau, Coordinated Access
with Opportunity study could not have ■ Page 12: iStock.com/PhilAugustavo
Engagement Coordinator, Toronto
been conducted without their support. ■ Page 16: PNW Production from Pexels
Alliance to End Homelessness (TAEH)
The participating organizations include: ■ Page 30: Sean Benesh on Unsplash
■ Valesa Faria, Director, ■ Page 45: iStock.com/wilpunt
■ COSTI Housing Secretariat ■ Page 55: Priscilla Du Preez on Unsplash
■ Christie Ossington ■ Page 62: iStock.com/
Neighbourhood Centre We would like to thank Community
Highwaystarz-Photography
■ Christie Refugee Welcome Centre Animators, Althea Galloway, Bridget ■ Page 80: Berkay Gumustekin
■ City of Toronto – Birkdale Residence, Babirye and Shoeb Ahmed. Their
on Unsplash
Women’s Residence, Robertson House, assistance and dedication to this project
Scarborough Village, Roehampton were vital to its successful completion.
Report design by Green Living Enterprises
Hotel and Streets to Homes Much gratitude to the TSN family, Soha
■ Dixon Hall Neighbourhood Services Mohammed (TSN Coordinator), Shafeeq
Meeting Crisis with Opportunity
■ Eva’s Initiative for Homeless Youth Armstrong (Welcome Home Project
was written by:
■ Fred Victor Centre Coordinator) and Gabriela Russek (Pipeline
■ Good Shepherd Ministries Project Coordinator) who were always ■ Sonja Nerad (Executive Director,
■ Homes First Society ready and willing to roll up their sleeves Toronto Shelter Network);
■ Horizons for Youth and jump in at a moment's notice to ■ Haiat Iman (Research Coordinator,
■ Kennedy House assist with this project. Thanks to Caitlin Toronto Shelter Network);
■ Red Door Family Shelter Thompson (Research Analyst, Salvation ■ Carmelle Wolfson (Community
■ The Salvation Army Army), who supported quantitative data Researcher, Toronto Shelter Network);
■ Sistering analysis. Special thanks to the members ■ Tanzil Islam (Data Coordinator,
■ Sojourn House of the Meeting Crisis with Opportunity Dixon Hall).
■ St-Felix Centre Advisory Committee: Colin Bains
■ Street Haven at the Crossroads (Executive Assistant Director, Salvation
■ Turning Point Youth Services Army); David Reycraft (Director, Dixon
■ Warden Woods Community Centre Hall); Deborah Gardner (Executive
■ YMCA of Greater Toronto Director, Streets Haven); Keith Hambly
■ YWCA (Chief Executive Officer, Fred Victor); and
Kirk McMahon (Senior Manager, Good
Shepherd) for their support and guidance.
FULL RESEARCH REPORT | Meeting Crisis With Opportunity: Reimagining Toronto’s Shelter System 2
Executive Summary
Vulnerable populations, including people experiencing homelessness, have been hard
hit during the COVID-19 pandemic1. In Toronto, a rapid emergency response to protect
homeless populations was undertaken, resulting in a significant restructuring of the
24-hour emergency homelessness system (shelter system). In order to document the
impact of this transformation, the Toronto Shelter Network (TSN), in partnership with
Dixon Hall Neighbourhood Services (Dixon Hall) embarked on a six-month exploratory
study called “Meeting Crisis with Opportunity: Reimagining Toronto’s Shelter System”.
TSN is an umbrella organization that is This report identifies findings and highlights
composed of approximately 35 member considerations that can improve the delivery
organizations that together operate more of housing and homelessness services
than 100 emergency shelter, respite, 24-hour and supports for people in Toronto, build
drop-in and COVID-19 response programs2. capacity and infrastructure for future waves
TSN believes that housing is a human right of COVID-19 and other emergencies and
and envisions a City where everyone has a inform the permanent transition of the
home that enables them to live with dignity. shelter system into one that is people-
centered and housing-focused.
Meeting Crisis with Opportunity was
funded by the Social Development, Finance Methodology
and Administration (SDFA) department
at the City of Toronto. The study aimed Meeting Crisis with Opportunity was conducted
to achieve the following objectives: using mixed research methodologies as follows:
■ To better understand the impact of ■ A review of grey literature.
COVID-19 on the shelter system. ■ A survey of 239 current service users
■ To describe the experiences of shelter at shelters, respites, 24-hour drop-
users (clients)3 since the onset of COVID-19, ins, and COVID-19 hotels across the
and to better understand the impact the City. People from diverse populations
pandemic has had on diverse populations including Black and Indigenous, families,
using Toronto’s shelter system, including LGBTQ2S+, men, refugees, women and
those who moved into hotels and those who youth were included in the sample.
remained in legacy4 shelters and respites. ■ Three focus group sessions with 56
■ To develop recommendations that will help managers, front-line staff and shelter
guide homelessness service providers and housing help workers/counsellors, as well
decision makers to develop sound and as an online survey of four managers.
actionable short- and long-term strategies for ■ Interviews with seven stakeholders
improving emergency homelessness services. bringing expertise in homelessness and
housing policy and operations, public
health and community engagement.
1 The terms “COVID-19 pandemic”, “COVID-19”, the “pandemic” are used interchangeably throughout the report.
2 As part of the COVID-19 response, The City of Toronto has leased approximately 25 hotels providing more than
3,000 spaces for physical distancing and for people to move indoors from encampments.
3 The terms “shelter user”, “client” and “resident” are used interchangeably throughout the report.
4 The term “legacy” is used to refer to shelter programs that are not located in hotels, but does not refer to respites or 24-hour drop-ins.
FULL RESEARCH REPORT | Meeting Crisis With Opportunity: Reimagining Toronto’s Shelter System 3
Executive Summary (continued)
Challenged at the outset with a very short Service User Survey Results
project timeframe, the research team’s efforts
Survey participants reported having both
were further complicated by constant outbreaks
positive and negative experiences with the
of the COVID-19 virus at various shelters and
shelter system during COVID-19. In general,
resulting lockdown measures, service delivery
shelter users felt well supported by shelter
priorities and research fatigue. Thanks to
staff during the pandemic and reported
the cooperation and willing participation of
satisfaction with infection control measures
shelter users and service providers, the project
undertaken by shelters. Without doubt,
was completed on time and as planned.
hotel clients appreciated the increased
privacy and safety available to them.
Findings
Review of the Literature At the same time, restrictive rules, mask wearing
and program reductions were difficult for many of
Existing literature describes how the lack of those surveyed. The survey findings indicate that
sustained investment in housing and social policy COVID-19 and the related changes implemented
by federal and provincial levels of government in the shelter system have had a differential
has contributed to the current homelessness impact on different populations. They highlight
crisis in Toronto. Systemic inequities, propelled strengths and deficits of the shelter system
in large part by anti-Indigenous and anti-Black and the lack of supports available outside of
racism, have made particular populations shelters for many communities. Notably, hotel
vulnerable to homelessness. The COVID-19 program users and Black survey participants
pandemic has amplified inequities for diverse reported a lack of access to housing supports.
socio-demographic groups that experience For Black shelter users, this may be attributed
intersecting barriers, and which comprise to both systemic racism and bias within the
shelter using populations in Toronto, including shelter system and on the part of landlords.
Indigenous peoples, women, LGBTQ2S+ In addition, childcare has been eliminated for
people, families, Black people, refugees, youth many families, youth have been challenged to
and men, as well as some of the pathways secure employment supports and women need
into homelessness for these populations. gender-informed harm reduction services.
The literature shows that there is a unique policy Shelter users made many suggestions for
moment to leverage. The City has committed improving homelessness services and for
to a vision of ending chronic homelessness ending homelessness in Toronto, with most
with the HousingTO Action Plan, the Province respondents advocating for robust housing
of Ontario is working towards a vision of supports to be embedded across the shelter
ending chronic homelessness by 2025 and the system and improved access and pathways
Government of Canada has committed to ending to affordable and supportive housing.
all chronic homelessness in Canada by 2028.
FULL RESEARCH REPORT | Meeting Crisis With Opportunity: Reimagining Toronto’s Shelter System 4
Executive Summary (continued)
Service Provider Focus Group Results Considerations for the
Management and front-line staff described Shelter System
the challenges and the successes that they
experienced during the pandemic. They spoke Human Resources and Sustainability
of facing significant human resources and This study has shown that a number of
financial pressures and raised questions about changes need to be made to ensure that
organizational and system-wide sustainability. shelters are equipped to mitigate and/
They expressed significant concern about or handle emergency situations.
the health, mental health and safety of staff ■ It is essential that individual shelters, and
and shelter users, and about increased rates the shelter system as a whole, have a) the
of overdose. They also highlighted the loss capacity to adequately recruit, retain and
of programming supports for clients, their compensate their staff, b) resources to
increased social isolation and disruptions to create workplaces that prevent burnout and
their social networks and sense of community. compassion fatigue and foster wellness, and
c) a strategy to quickly skill up the workforce
On the other hand, they discussed positive to respond continuously to changing
experiences, such as the ease of transitioning demographics in the system or shifts in need.
shelter users into private accommodations at the ■ It is important to have staff – permanent
hotel programs and into permanent housing as and relief – who have the knowledge,
a result of rapid housing initiatives introduced skills, experience and resources to address
during the pandemic. They also described many challenges that may be amplified during
strengthened partnerships, most notably with emergencies and to work effectively
the health sector. Service provider accounts with populations who are particularly
help to paint a picture of the direct and indirect vulnerable during times of crisis.
ways in which the pandemic has both tested ■ To help stabilize shelter service providers,
and helped shelter users, service providers the Shelter Support and Housing
and the shelter system as a whole. Their Administration (SSHA) and other City
testimonies highlight the resilience of service divisions can deepen their work with
providers, their commitment to ensuring the shelter providers to transition the shelter
well-being of shelter users and their continued system to embody a more robust housing
efforts to find permanent housing solutions delivery focus. Immediate opportunities for
for shelter users during these trying times. enhanced collaboration include the roll out
of the coordinated access system and the
conversion of emergency homelessness
programs into supportive housing.
FULL RESEARCH REPORT | Meeting Crisis With Opportunity: Reimagining Toronto’s Shelter System 5
Executive Summary (continued)
Program and Service Delivery ■ Shelter service providers should build
staff knowledge and skills, and/or invest
The pandemic disrupted program and service
in additional housing workers, in order to
delivery across the shelter system. Enforced
strengthen, reshape or introduce services
masking and social distancing coupled with
and programs explicitly focused on preparing
service/program reduction and closures, and
clients to achieve optimal housing outcomes.
the lack of access to friends, family, other ■ Funding agreements with SSHA
shelter users, shelter staff and community
should appropriately resource and
service providers contributed to the rise in
hold accountable shelter service
mental health and substance use related
providers for housing outcomes.
crises across the sector. At the same time, a
most incredible outcome during this pandemic
Human Rights Focused, Inclusive and
has been the range of partnerships forged
or strengthened across various sectors.
Equitable Shelter Models
Further, feedback from shelter users and The pandemic triggered a system-wide
staff indicates that there is an opportunity shift from congregate to individual rooms, a
for housing to be a stronger and more change that enables people to live with more
fundamental feature of shelter programming. privacy and provides a sustainable solution
■ There is a need to embed programming for protecting people in the face of future
that promotes wellbeing and fosters both health emergencies. At the same time, there
belonging and community into the shelter are valid concerns to address regarding
model, so that during emergencies and health, wellbeing and safety, particularly
times of crisis there is capacity to prevent for shelters users who are most at risk.
social isolation and promote mental health.
■ Tables that are working on the development Despite the complexity of the emerging
of referral and service pathways between shelter hotel program, there is a need for
health services (primary care, harm reduction these dignified settings and an opportunity,
and mental health) and the shelters as communities and services begin to
should hasten their efforts and should be stabilize, to perpetuate and elaborate on
resourced adequately so that all shelter these programs for unique communities
users, regardless of where they are in (i.e., LGBTQ2S+, Black , Indigenous, etc.).
the shelter system, can receive equitable
access to the services that they require. It is The study findings also indicate that shelter
time to double efforts at assuring ongoing service models and built forms/physical structure
access to and sustainability of health care, can be improved to better address the unique
harm reduction and mental health/case needs of distinct shelter using populations and
management resources within the shelter to foster inclusive and welcoming communities.
system coupled with follow up supports
that lead to successful housing outcomes.
FULL RESEARCH REPORT | Meeting Crisis With Opportunity: Reimagining Toronto’s Shelter System 6
Executive Summary (continued)
■ SSHA, the Housing Secretariat and shelter ■ Shelter users should inform policy and
service providers can work together program development as an important step
more intentionally to ensure that human towards greater inclusiveness. Shelter service
rights principles are consistently and providers can play an important role in helping
equitably applied across all facilities to put forward effective models for doing so.
that comprise the shelter system.
■ Shelter service providers should continue From Shelter to Housing
to engage with funders, policy makers and
Overwhelmingly, feedback from shelter
health system partners to strengthen the
users and service providers emphasized the
foundation established during the pandemic
utmost importance of increasing the supply of
to ensure that a robust and comprehensive
affordable and deeply affordable housing stock
range of services (e.g., housing, primary
across the City. They stressed the need for a
care, mental health, harm reduction,
range of housing options that meet people’s
addiction, employment, etc.) are consistently
diverse mental and physical health and harm
embedded across the shelter system so
reduction needs, and which support their
ensure equitable access for all shelter users.
education and employment goals. Inevitably,
■ The shelter system must continue to evolve
they also identified the need for robust social
to ensure that a range of options are available
and housing policies that entail sustainable
for diverse and emerging populations.
long-term financial investment from municipal,
» First and foremost, SSHA and Indigenous
provincial and federal levels of government,
partners can continue to advance
as well as the private sector. These findings
accountability statements and action
suggest that shelter providers can leverage
items identified in the Meeting in the
the unique moment afforded by the COVID-19
Middle Strategy to meaningfully address
pandemic and work collectively towards the
Indigenous homelessness in Toronto.
common goal of ending homelessness by:
» SSHA and the shelter system should also
continue to work with Black leadership, ■ Engaging with SSHA and the
within the shelter system and other Black Housing Secretariat to help inform
serving organizations, to implement decisions about the future of the
the recommendations of the COVID-19 shelter system and the acquisition/
Interim Shelter Recovery Strategy, which repurposing of shelters for housing.
call for a distinct approach to serve Black ■ Ensuring that learnings from other
people experiencing homelessness jurisdictions are leveraged, particularly in
wherein the reality of anti-Black racism future decisions regarding hotel programs.
is recognized and addressed. ■ Participating in collaborative and cross-
■ There should be an intersectional approach sectoral initiatives for increasing the
to all shelter system planning whereby availability of supportive housing stock, such
the unique experiences and backgrounds as the Supportive Housing Growth Plan.
of diverse shelter users (families, ■ Advocating for rent subsidies, such
LGBTQ2S+, refugees, youth, women, as the new Canada-Ontario Housing
etc.) are prioritized and accounted for. Benefit (COHB), more portable rent
FULL RESEARCH REPORT | Meeting Crisis With Opportunity: Reimagining Toronto’s Shelter System 7Executive Summary (continued)
subsidies and rent controls. shelter users and service providers.
■ Developing a strategy for engaging ■ Engagement with Indigenous shelter
with the City, housing developers service providers and Indigenous
and landlords to create more (deeply) researchers to support their efforts to
affordable and supportive housing. document the differential impact of
■ Advocating for improvements to the minimum the pandemic on Indigenous shelter
wage, Ontario Disability Support Program and users and service providers.
Ontario Works Program, and for alternative ■ A study of the feasibility of converting shelter
models for guaranteeing people a living wage. programs (i.e., legacy shelters and hotel
programs) into permanent supportive or
Future Areas of Research transitional housing for clients and defining
the requirements for ensuring inclusive and
and Research to Action welcoming environments for diverse people.
Meeting Crisis with Opportunity provides a ■ A study to explore opportunities for
snapshot of the shelter system at an important integrating peer-based programming (i.e., with
point in time. The findings and considerations the expansion of harm reduction) and creating
presented should offer guidance on policies, good work opportunities for people with
procedures and future areas of research. lived experience across the shelter system.
With more time and resources, the following
areas deserve further exploration:
■ Further comparative analysis of Meeting
Crisis with Opportunity data to better
describe the unique experiences for diverse
socio-demographic populations of shelter
users and for people using different shelter
programs (i.e., hotels, legacy shelters).
■ A study to better understand the impact
of the pandemic on Black shelter users,
who comprise more than 40% of all
shelter users, and the intersection of the
pandemic experience with anti-Black
racism and the unique experiences of
diverse Black populations, including
women, youth and LGBTQ2S+.
■ A study to evaluate the long term impact
of the pandemic for people using different
shelter programs and on the health and
mental health outcomes for diverse
FULL RESEARCH REPORT | Meeting Crisis With Opportunity: Reimagining Toronto’s Shelter System 8Executive Summary (continued)
Conclusion
People experiencing homelessness have been hard hit during these past
three waves of the pandemic – communities have been disrupted, people
have become increasingly isolated, mental health challenges have been
exacerbated and more lives than ever have been lost to overdose.
The impact on service providers, who throughout the pandemic have shown
remarkable commitment and resilience, has been significant. Despite daunting
workplace circumstances and the risks posed to their health and their families’
health, service providers rose to the challenge and enabled the shelter system to
remain operational throughout the pandemic. The majority of shelter users and
service providers see a silver lining, namely the increase in the number of people
that have been housed this past year, the introduction of the hotel program and the
overall success of measures taken to prevent the spread of COVID-19 in shelters.
Sixteen months into the pandemic, it is time to turn our attention to the future of the
shelter system. The TSN and Dixon Hall share this report to foster reflection, ongoing
inquiry and change. Data from other jurisdictions shows that homeless individuals
with even short stays in shelter hotel programs have greater successes once they
transition to other forms of permanent housing. This is just one of many findings and
considerations highlighted in Meeting Crisis with Opportunity which inspire hope
and can help move us toward the eradication of chronic homelessness in our city.
Finally, shelter users best understand what is required to improve their housing
outcomes and can best articulate the needs of diverse populations using the shelter
system. As a next step, shelter users, as well as shelter providers and decision makers,
will be re-engaged to identify priority recommendations and actions so that this study
FULL RESEARCH REPORT | Meeting Crisis With Opportunity: Reimagining Toronto’s Shelter System 9Table of Contents
Acknowledgements. . . . . . . . . . . . . 2 5. Service Provider Perspectives . . 46
Executive Summary. . . . . . . . . . . . . 3 5.1 About the Service Provider Focus Groups
Methodology 5.2 Human Resources
Findings 5.3 Access to Financial Resources and PPE
Considerations for the Shelter System 5.4 Services and Programs
Future Areas of Research and Research to Action 5.5 The Hotel Program
Conclusion 5.6 Housing
5.7 Partnerships
1. Introduction. . . . . . . . . . . . . . . . . . . 11
5.8 Conclusion
1.1 About TSN and Funding Partners
6. Considerations for the Shelter
2. Methodology . . . . . . . . . . . . . . . . . . 13
System . . . . . . . . . . . . . . . . . . . . . . . 56
2.1 Data Collection
6.1 Human Resources
2.2 Data Analysis
6.2 Program and Service Delivery
2.3 Challenges and Limitations
6.3 Safe, Inclusive and Equitable Shelter Models
3. Homeless in Toronto: 6.4 From Shelter to Housing
An Overview. . . . . . . . . . . . . . . . . . .17 6.5 Future Areas of Research and Research to Action
3.1 The Shelter System
7. Conclusion . . . . . . . . . . . . . . . . . . . . 63
3.2 The Current Policy Landscape
3.3 A Year into the Pandemic Appendix A. . . . . . . . . . . . . . . . . . . . 64
3.4 Homelessness among Diverse Populations TSN Member Agencies
3.5 Conclusion Appendix B. . . . . . . . . . . . . . . . . . . . 65
4. Shelter User Perspectives. . . . . . 31 Advisory Committee Terms of Reference
4.1 About the Shelter User Survey Questionnaire Appendix C. . . . . . . . . . . . . . . . . . . . 68
4.2 Survey Participant Profile Key Stakeholder Interview Participants
4.3 Overall Experience of Homelessness Appendix D. . . . . . . . . . . . . . . . . . . . 69
4.4 Positive Impacts List of Service Provider Focus Group Participants
4.5 Negative Impacts
Appendix E. . . . . . . . . . . . . . . . . . . . 70
4.6 Program Changes & Impacts
List of Participating Organizations
4.7 Impact on Shelter Users by Population in Shelter User Survey
4.8 Shelter User Recommendations
Appendix F. . . . . . . . . . . . . . . . . . . . 71
4.9. Conclusion
Shelter User Survey Sample
Works Cited . . . . . . . . . . . . . . . . . . . 74
FULL RESEARCH REPORT | Meeting Crisis With Opportunity: Reimagining Toronto’s Shelter System 101. Introduction
More than a year has passed since the onset of the COVID-19 pandemic,
and what a year it has been. The pandemic has had a profound impact on
Toronto’s society, with rippling effects that surely will be felt for generations
to come. Aside from the spread of the virus, which has claimed the lives of so
many, the on again, off again lockdowns and stay at home orders disrupted
families, separated communities and decimated countless businesses.
The pandemic exposed and exacerbated ■ To better understand the impact of
significant social and health inequities COVID-19 on the shelter system.
across Canada. Data has shown that people ■ To describe the experiences of shelter
who experience homelessness and other users since the onset of COVID-19, and
marginalized groups are those who most feel to better understand the impact that the
the impact of the pandemic. In Toronto, a rapid pandemic has had on diverse populations
emergency response to protect homeless using Toronto’s shelter system, including
populations using shelters5 was undertaken, those who moved into hotels and those that
resulting in a significant restructuring of the remained in legacy shelters and respites.
shelter system. Whereas in March 2020, ■ To develop recommendations that will help
35 organizations were operating shelter guide homelessness service providers and
programs at approximately 65 different sites, decision makers to develop sound and
by May 2021 these same 35 organizations actionable short and long-term strategies for
were operating programs at more than improving emergency homelessness services.
140 sites. For more than a year, 24-hour
emergency homelessness providers have This report identifies recommendations
stepped up, ever adapting their operations that can improve the delivery of housing
to better serve and protect shelter users. and homelessness services and supports
for people in Toronto, build capacity and
In order to document the impact of this infrastructure for future waves of COVID-19 and
transformation, the TSN in partnership other emergencies and inform the permanent
with Dixon Hall, embarked on a six-month transition of the shelter system into one that
exploratory study called “Meeting Crisis is people-centered and housing focused.
with Opportunity: Reimagining Toronto’s
Shelter System”. The study was designed
with the following objectives in mind:
5 The term “shelter” is an overarching term used throughout this report in reference to 24-hour emergency homelessness services,
commonly including shelter, transitional shelter, respite, 24-hour drop-in and COVID-19 response (hotel) programs.
FULL RESEARCH REPORT | Meeting Crisis With Opportunity: Reimagining Toronto’s Shelter System 11Introduction (continued)
1.1 About TSN and collaborative planning, research and advocacy.
TSN believes that housing is a human right
Funding Partners and envisions a City where everyone has a
TSN is an umbrella organization made up of home that enables them to live with dignity.
approximately 35 member organizations that Dixon Hall, a TSN member agency, was the
together operate more than 100 emergency trustee organization for Meeting Crisis with
shelter, respite, 24-hour drop-in and Opportunity, and the study was funded by
COVID-19 response programs. Please see the City’s SDFA Department. This project
Appendix A for a list of TSN member agencies. is aligned with TSN’s vision as well as its
TSN champions the best housing outcomes strategic priority of collaborating on research,
for people experiencing homelessness by policy and advocacy initiatives and the
enhancing the collective capacity of diverse development of alternative housing strategies
homelessness service providers in Toronto that expand housing options for member
through knowledge sharing and learning, organizations and the clients they serve.
FULL RESEARCH REPORT | Meeting Crisis With Opportunity: Reimagining Toronto’s Shelter System 122. Methodology
Meeting Crisis with Opportunity is an exploratory study that was
conducted using mixed research methodologies. The overarching
research questions identified for the study included:
■ What are the demographics of people Literature Scan
using different emergency homelessness
For insights into the COVID-19 context, a review
programs (shelters, respites and hotels)?
of grey literature was conducted. The review
■ How has COVID-19 impacted (positive,
focused on the following: homelessness; the
negative, neutral) people’s health and
housing and homelessness policy landscape;
wellbeing, access to services, employment/
health and homelessness; COVID-19 related
education, and social interactions / contact
changes to and impacts on the shelter system;
with friends, family, or other loved ones?
unique needs of populations known to be
■ What is the differential impact of COVID-19
using shelter services6 (Black, Indigenous,
on different populations of shelter clients?
LGBTQ2S+, Youth, Single Adult Women,
■ What has worked and not worked well in terms
Single Adult Men, Families, and Refugees)
of the shelter system’s response to COVID-19?
and their experiences during the pandemic.
■ What factors have contributed to
success for people using different
shelter programs during COVID-19? Shelter User Surveys
To understand how the pandemic has impacted
Over the course of six months, between shelter users, 239 current clients were surveyed
November 2020 and April 2021, staff members at shelters, respites, 24-hour drop-ins, and
from TSN and Dixon Hall worked together to COVID-19 hotels across Toronto. Service users at
collect and analyze data and then author this both city-run and community/purchase of service
report. The research team was guided by the organizations of diverse size and geographic
Project Advisory Committee, formed at the location were surveyed. See Appendix C for
outset to provide input on the study questions the list of clients’ shelter sites. As the study
and methodology and to illuminate the study is focused on the impact of the pandemic on
findings and considerations for the shelter diverse populations, surveys were conducted
system as identified by the research team. with men, women, youth, families, refugees, as
See Appendix B for Advisory Committee well as members of the LGBTQ2S+, Black and
Terms of Reference. Indigenous communities. The surveys helped
capture their unique stories, provide insights into
2.1 Data Collection the challenges and successes they experienced,
and identify factors that have contributed to
The task of collecting data was split into both positive as well as negative outcomes in
four parts: literature scan, shelter user their lives. The survey was pilot tested with ten
surveys, service provider focus groups clients in advance of being administered broadly.
and key stakeholder interviews.
6 The Toronto Street Needs Assessment (2018) was referenced to identify the main shelter using populations.
FULL RESEARCH REPORT | Meeting Crisis With Opportunity: Reimagining Toronto’s Shelter System 132. Methodology (continued)
Sampling Strategy Service Provider Focus Groups
To ensure that there was adequate To help understand how the pandemic impacted
representation of different populations in service providers, 56 staff members from across
the study, a stratified sampling method was the shelter system were invited to participate in
used. However, due to limitations imposed a series of focus group discussions. However,
by the pandemic and the transient nature of due to the outbreaks and the demands of
the shelter using population, a convenience adapting to a constant and rapidly changing
sample approach was used to engage clients at environment, we were only able to engage
participating shelter organizations. Accordingly, 70% of our target. Over the course of three
the proportion of the survey participants from days, 56 managers, front-line staff and shelter
each socio-demographic group is not precisely housing help workers/counsellors participated
representative of the entire population currently in focus group sessions. To ensure adequate
using the shelter system. However, the stories representation of shelters from across the
highlight their unique characteristics and system, digital questionnaires were subsequently
experiences; give voice to some of the most sent to managers at organizations that did not
vulnerable members of society and emphasize attend the sessions. This exercise brought
the need for immediate and targeted action. the total to 60 service provider participants.
Focus group discussions, held over Zoom with
Collecting the Data these field experts, provided insights into the
challenges they have faced in serving shelter
At the beginning of the data collection period,
users during the pandemic. A discussion
the surveys were conducted in person by
guide, composed of standard questions
Community Animators and the Community
as well as a series of questions tailored for
Researcher. However, when shelters started
each of the three staff groups, was used by
to experience outbreaks and the City issued
facilitators. All discussions were recorded and
stay at home orders alternative strategies were
later transcribed for analysis, along with the
implemented. Service providers volunteered
questionnaire responses received by email.
to administer the surveys with clients and
shelter users were able to complete the
surveys independently, either by hand-to-paper
Key Stakeholder Interviews
or digitally. Further, if clients had access to To gain insights and expert knowledge on the
technological devices such as phones or laptops, impacts of the pandemic on the homelessness
Community Animators were available to interview sector from perspectives outside the shelter
them digitally. All shelter user survey data was network, seven interviews were conducted with
entered into a Survey Monkey template for key stakeholders. Decision makers and subject
analysis with the help of a data entry specialist. matter experts in the housing and homelessness
policy and operations, public health, community
Prior to completing the survey, all shelter engagement and service delivery planning
users read or reviewed and signed off on participated in these interviews. Unsuccessful
a consent form, and also were offered $30 attempts were made to engage representatives
honorariums for their time. The compensation from the primary care and mental health
was delivered to them in the form of gift cards sectors. These perspectives would have added
from stores of the service providers’ choosing.
FULL RESEARCH REPORT | Meeting Crisis With Opportunity: Reimagining Toronto’s Shelter System 142. Methodology (continued)
tremendous value to this report. All interviews Further complicating the study were the
were recorded and later transcribed for analysis. constant outbreaks of the COVID-19 virus at
Please see Appendix D for the participant list. various shelters and the lockdown measures
imposed by the City. This meant, for example,
2.2 Data Analysis that the research team could not administer
client surveys in person as had originally
A data analysis team was created to review been planned and a course correction was
the primary and secondary data collected. required to ensure participation targets
Results from the shelter user surveys were met through alternative means.
yielded predominantly quantitative data,
which was entered into a Survey Monkey Lack of time and funding also affected the
template. To compare experiences of different researchers’ ability to recruit and support study
subpopulations, responses were cross tabulated participants, as well as deliver and collect
and populated into an excel spreadsheet for documents to and from sites across the City.
analysis. A thematic analysis was conducted Shelter users have limited access to financial
of the transcripts produced from the service and material resources and opportunities.
provider focus groups and key stakeholder Additional support could have been provided
interviews. Subsequently, both quantitative in the form of training and funding for
and qualitative data were compared to technology or transportation, which would
information garnered from the literature scan. have avoided reinforcing marginalization and
The data analysis team carefully reviewed may have created a more efficient process.
all the documents for ideas and patterns
that emerged repeatedly and discussed the As stated, service providers were faced with
similarities and differences in their findings multiple and competing priorities, thereby limiting
to identify key themes for this report. the time available to participate in this study.
The research team also found that research
2.3 Challenges and fatigue was being experienced by service
Limitations providers and shelter users. Due to the unique
nature of the pandemic, researchers in different
sectors have been scrambling to understand
The short time frame was a key challenge to the impacts on the City's most vulnerable
undertaking such a large and complex endeavor. populations and develop effective solutions to
As this was an exploratory study, with additional meet their needs during these trying times. As a
time the research team may have conducted result, shelter providers and shelter users have
qualitative interviews or focus groups with both been inundated with requests to participate in
shelter users and service providers prior to studies and information collection activities.
collecting quantitative data via the shelter user
survey to collect more detailed information. Nonetheless, thanks to the cooperation
and willing participation of shelter users
Lack of time also limited the research and service providers it was possible to
team's ability to undertake a successfully complete this project and provide
comprehensive comparative analysis a compelling set of recommendations.
of the data for diverse populations.
FULL RESEARCH REPORT | Meeting Crisis With Opportunity: Reimagining Toronto’s Shelter System 15Highlights from the Literature Review In this section we briefly describe the homelessness landscape, including the environment internal to and surrounding the shelter system pre-COVID-19 and since the onset of the pandemic. In some instances, the focus group discussions with service providers are referenced to supplement the literature. FULL RESEARCH REPORT | Meeting Crisis With Opportunity: Reimagining Toronto’s Shelter System 16
3. Homeless in Toronto:
An Overview
By the 1990’s, the Central Mortgage and Housing Corporation (CMHC)7,
created to lead the nation’s housing programs in 1946, had supported
some 650,000 social housing homes in Canada. Beginning in the 1990s,
the federal government withdrew its funding and transferred responsibility
for administering affordable/social housing to the provinces.8
The dismantling of the social housing supply system; the majority exited the system within
program meant that provinces and municipalities three months. A smaller group of approximately
had to bear the indirect costs of inadequate 5,000 people (22%) are chronically homeless
housing and homelessness (Hulchanski, 2003). and stay in the shelter system for six months or
more (City of Toronto/United Way, 2020). Once
In Ontario, between 1985 and 1995 the Province fairly homogenous and comprised primarily of
played a significant role in adding to its social single men, this population is very diverse and
housing stock and assisting with housing needs includes many women, youth, LGBTQ2S+ people
in other ways (such as raising social assistance and newcomers/refugees (Gaetz et al., 2016).
benefits and the minimum wage). By 2001, the
Province was downloading responsibility for 3.1 The Shelter System
social housing to the municipalities (Toronto
Board of Trade, 2003). Since then, provincial Although the COVID-19 pandemic is not the
governments have rescinded subsidies for first health outbreak in the shelter system –
the construction of social housing, refused there have been group A Streptococcus and
to assist in capital costs and eliminated rent Tuberculosis (TB) outbreaks over the years
controls (City of Toronto, 2020). As a result, (Crowe, 2019) – none has been as severe as
Toronto has been in the challenging position the current global pandemic. Shelter service
of funding social housing construction with providers, with guidance from SSHA and Toronto
costs exceeding the scope of its tax base. Low Public Health (TPH), were quick to respond
vacancy rates and an aging and insufficient to the pandemic, implementing emergency
rental inventory have further stressed availability measures and adapting their operations
in the low and medium cost rental markets. and service delivery procedures to protect
All this has led to a significant increase in the shelter users and staff against worsening
number of people experiencing homelessness. COVID-19 pandemic conditions. Some of
the most significant changes undertaken
As of 2016, the estimated number of Canadians since March 2020 are described below:
who experienced homelessness was 35,000 per ■ Over the course of four months during the
night and 235,000 over the course of the year. spring and summer of 2020 more than 3,000
It is estimated that in Toronto, approximately shelter clients were relocated from shelters to
10,000 people experience homelessness9 COVID-19 response programs, mainly hotels.
each night (Fred Victor, Nov 2020). In 2019, There was continued relocation of homeless
26,000 different people used Toronto’s shelter people, mainly from encampments, into hotels
7 In 1979 the Central Mortgage and Housing Corporation changed its name to the Canada Mortgage and Housing Corporation.
8 Until the 1990’s the federal government was the primary funder of social housing in Canada.
9 According to the Homeless Hub, homelessness is defined as a state “being without stable, safe, permanent,
appropriate housing, or the immediate prospect, means and ability of acquiring it.”
FULL RESEARCH REPORT | Meeting Crisis With Opportunity: Reimagining Toronto’s Shelter System 173. Homeless in Toronto: An Overview (continued)
during the 2nd and 3rd waves in 2020/21. 3.1.1. The Opioid Crisis
■ More than 1,570 clients were housed between
While this study examines the impact of the
March 2020 and August 2020 (City of Toronto/
COVID-19 pandemic on homeless populations
United Way, 2020), a 50% increase over
in Toronto’s shelters, it must be noted that
the same period during the previous year.
at the same time a parallel opioid crisis has
■ The City leased space in 25 hotels,
ravaged the shelter system. Since March
including two hotels to operate two
2020, there has been a 48% increase in
COVID-19 isolation and recovery
opioid-related deaths in Toronto’s shelters.
programs (City of Toronto, Oct 2020).
The opioid crisis can be attributed to the
■ To curb the rising rate of infection across the
increasing toxicity of the unregulated drug
shelter system, particularly during the 2nd
supply, but the COVID-19 pandemic has
and 3rd waves, shelter providers implemented
exacerbated the crisis in the following ways:
numerous guidelines and directives,
including but not limited to the following: ■ More people consuming drugs alone
» the provision and mandatory use due to physical distancing.
of Personal Protective Equipment ■ Some shelter users have been moved
(PPE) for staff and shelter users to programs in areas of the City that
(e.g. masks, shields, gloves; are new to them, which means they
» mandatory completion of screening may be purchasing their supply from
assessment tools for COVID-19 symptoms; dealers that are not familiar to them.
» restriction of outside visitors ■ The City has opened more hotel spaces,
from entering facilities; which afford privacy, but can be isolating.
» daily temperature checks for ■ Health-funded harm reduction services (i.e.
shelter users and staff; detox, withdrawal and mental health facilities)
» increased cleaning of facilities; reducing their service hours and capacity
» transportation and relocation of during the first wave of the pandemic.
clients testing positive and their close
contacts back and forth from shelter to 3.2 The Current Policy
»
isolation and recovery programs, and
cancellation of all non-essential programs
Landscape
and gatherings. 3.2.1 Federal
In 2019, Canada legally recognized housing as
By and large the shelter system has remained a human right through the National Housing
operational throughout the pandemic. Strategy Act (Morrison, 2019; Legislative
However, conversations with shelter managers Services Branch, 2021). In 2017, the federal
confirm that numerous program sites have government committed to the National Housing
experienced reduced capacity due to Strategy (NHS), a ten-year plan investing $55
outbreaks and some have temporarily been billion to build stronger communities and help
closed to implement new requirements, re- Canadians across the country access safe,
opening at a later date with increased physical affordable homes, prioritizing communities
distancing and other measures in place. facing distinct housing barriers such as the
FULL RESEARCH REPORT | Meeting Crisis With Opportunity: Reimagining Toronto’s Shelter System 183. Homeless in Toronto: An Overview (continued)
LGBTQ2S+ community, homeless women, renovate and purchase facilities to create longer-
women and children fleeing family violence, term housing solutions and to add to rent banks
seniors, Indigenous peoples, people with and support plans in preparation for potential
disabilities, mental health and addictions future outbreaks or emergencies (Ministry of
challenges, veterans and young adults. The Municipal Affairs and Housing, Dec 2020).
strategy aims to cut chronic homelessness in
half, remove 530,000 families from housing need 3.2.3 Municipal
and invest in the construction of up to 125,000
In its HousingTO 2020 -2030 Action Plan, the
new affordable homes (NHS, n.d.). During
City of Toronto laid out an ambitious agenda for
COVID-19, CMHC introduced initiatives as part of
supporting people to access housing over the
the NHS, including the Rapid Housing Initiative
next 10 years, from homelessness to rental and
to create 3,000 new permanent affordable
ownership housing to long-term care for seniors.
housing units for vulnerable populations and
With the onset of the pandemic, the City’s focus
the Rental Construction Financial Incentive,
on affordable housing was intensified. The
which provides low-cost loans to encourage the
COVID-19 Housing and Homelessness Recovery
construction of sustainable rental apartments.
Response Plan was developed to create 3,000
permanent, affordable homes within the next 24
3.2.2 Provincial months for vulnerable and marginalized residents
The Province’s homelessness programs centre and requests that the federal and provincial
on the commitment to end chronic homelessness governments fast-track and expand initiatives
by the end of 2025. In 2018, the Ontario under the National Housing Strategy and other
government signed a bilateral agreement with existing federal and provincial funding programs.
the federal government to provide a Housing
Benefit, investing $1.4 billion to help low-income The Mayor’s Housing Action Team was
renters afford housing (Municipal Affairs and established to create a diverse set of affordable
Housing, 2019). Since the beginning of the and market rental housing opportunities. The
COVID-19 pandemic, the Ontario government COVID-19 Interim Shelter Recovery Strategy
has twice put a temporary halt to evictions of and Implementation Plan put forward immediate
formal rent arrangements and passed legislation priorities in the context of the pandemic and
to freeze rents at the 2020 levels (Hale, 2020; will provide guidance to SSHA and other
Ministry of Municipal Affairs and Housing, City divisions. This strategy recommended
March 2020). Changes made to the Residential enhanced capacity across the shelter system;
Tenancies Act include a new requirement that cross sectoral collaboration to handle
landlords work a repayment plan with tenants health care needs and future outbreaks; the
before filing for eviction for non-payment of rent opening of new facilities that offer dignified
(Ministry of Municipal Affairs and Housing, 2021). emergency shelter; investment in long-
In 2020, $120 million in funding was allocated to term deeply affordable housing, and distinct
help municipalities and Indigenous partners help actions for addressing Black and Indigenous
vulnerable individuals secure and keep housing homelessness (City of Toronto, 2020a).
during the pandemic. This funding was intended
to protect homeless shelter staff and residents,
FULL RESEARCH REPORT | Meeting Crisis With Opportunity: Reimagining Toronto’s Shelter System 193. Homeless in Toronto: An Overview (continued)
In 2018, in response to the increased demand
for shelters in neighbourhoods across the City,
3.3 A Year into the Pandemic
SSHA introduced changes to processes for 3.3.1 Shelter Utilization
identifying new shelter locations as well as During the month of January 2020, prior to the
community engagement and neighbourhood start of the pandemic, approximately 11,322
integration processes. These have led to the people used overnight emergency homelessness
development of Community Liaison Committees services in Toronto; 901, or 9%, were new
(CLCs) in neighbourhoods where new shelter identified shelter users; 35% had either been
programs, especially hotel programs, opened homeless for six months or more that year, or had
during COVID-19. SSHA has also been “overnight stays over the past three years with a
moving forward with best practice design cumulative duration of at least 546 nights” (Gaetz
guidelines and the implementation of a new et al., 2014; City of Toronto, 2021c)10. During
housing focused shelter model, integrating the month of January 2021, 10 months into the
a housing first approach with client-centered pandemic, 8,835 people used the shelter system;
case management (City of Toronto, 2018). To 647, or 8%, were newly identified users and 45%
this end, SSHA has also been advancing the were chronic shelter users. Between January
Coordinated Access System to streamline the 2020 and January 2021, there was an increase
process for people experiencing homelessness in the percentage of men, transgender people,
to access the housing and support seniors and chronically homeless people, and a
services needed to permanently end their decrease in the percentage of women, families
homelessness and ensure system adjustments and refugees using shelters (City of Toronto,
are data-informed and evidence-based. 2021c) (Figure 1)11. Evidence suggests that job
and income loss and the closure of the borders
Finally, SSHA is in the midst of completing to refugees12 may be contributing factors
a new Five Year Service Plan, which will to some of the changes in the populations
identify specific actions that SSHA needs to relying on emergency shelter services.
take to achieve the directions and outcomes
in the HousingTO2020-2030 Action Plan.
10 This aligns with the federal definition of “chronic homelessness” (Gaetz et al., 2014).
11 Information regarding Black and Indigenous shelter users is not currently available through City of Toronto data.
12 Female headed refugee families made up significant proportion of those using family shelters pre-pandemic.
FULL RESEARCH REPORT | Meeting Crisis With Opportunity: Reimagining Toronto’s Shelter System 203. Homeless in Toronto: An Overview (continued)
Figure 1: Shelter use by demographic in January 2020 and January 2021
(Toronto Shelter System Flow Data)
Jan 2020 Jan 2021
70%
60% 64%
61%
50%
40%
38%
30% 34%
30%
28%
20%
16%
10% 12% 13%
2% 10%
1%
0%
Men Women Transgender Youth Families Refugees
People (16-24)
According to Toronto Shelter System Flow people were living in encampments at the
Data, 2,757 fewer people used emergency time. The City put the estimate at closer to 400.
homelessness services in January 2021 Finally, many asylum seekers have not been able
compared to January 2020, or before the to enter Canada as a result of COVID-19 border
pandemic began (City of Toronto, 2021c). There closures, which has led to a significant decline in
are several factors that may be contributing to the number of refugees using the shelter system.
this discrepancy. First, for a period of time the
number of spaces in shelters was reduced as 3.3.2 Shelter and Health Systems
physical distancing measures were introduced at Collaboration
the onset of the pandemic. Second, each time an
It has long been recognized that homeless
outbreak occurs at a shelter that shelter is closed
people face significant health-care challenges,
to new intakes, resulting in overall reduction in
including equitable access, experiences and
system capacity that fluctuates depending on
outcomes. A survey undertaken by the TSN in
the number of outbreaks that are occurring at
2018 found that clients were not receiving the
any one time. Third, throughout the pandemic
same level of health services from shelter to
many people experiencing homelessness have
shelter. Health service availability in any given
chosen to stay outside rather than in shelters
shelter was largely relationship driven, and while
due to fear of acquiring COVID-19. In December
some shelters provided a range of primary care
2020, a CBC News report noted that, according
and mental health services, others had very little
to some homelessness advocates, up to 1,000
available to offer their clients. It has also long
FULL RESEARCH REPORT | Meeting Crisis With Opportunity: Reimagining Toronto’s Shelter System 213. Homeless in Toronto: An Overview (continued)
been recognized that a coordinated approach helped shelter service providers to adapt to
between health and shelter services providers the plethora of pandemic related changes
is needed to support the provision of health and services implemented over the past year
services that are user-centered, accessible, across the shelter system, most notably:
comprehensive, coordinated and sustainable for ■ Infection Prevention and Control (IPAC)
shelter users, while in the shelters and after they from TPH, Unity Health and other
have moved into permanent housing. In 2018, hospitals helped shelters manage
a framework for coordinated health services and minimize risks of outbreaks.
was developed by SSHA, the Toronto Central ■ The Inner City Health Associates (ICHA),
Local Health Integration Network (TCLHIN) instrumental in identifying and supporting
and Central East Local Health Integration shelters to protect clients at highest risk for
Network (CELHIN). However, the transition to COVID-19 infection, has been a key player
a new provincial government in 2018 stalled in bringing COVID-19 testing across the
the implementation of the framework. system and has provided various health-
related services and supports to shelter
The onset of the COVID-19 pandemic, coupled users (e.g., primary care, grief counselling).
with the worsening opioid crisis, particularly ■ Isolation and recovery sites have
in many of the social distancing sites (hotels), been operationalized by ICHA
accelerated collaborative problem solving together with Parkdale Queen West
between the health and shelter systems. Community Health Centre.
“
■ Harm reduction services and programs
July marked the highest cluster have been implemented across COVID-19
hotels by TPH, Parkdale Queen West
of overdose fatalities since TPH and other health service providers.
began tracking data three years ■ Mental health case management, harm
ago.” reduction and primary care referral pathways
City of Toronto, 2020a are being put in place to ensure equitable
access across the shelter system.
■ Mental health case management teams
The Toronto Region Homelessness COVID-19 were made available to hotel clients
Working Group and the Health Services through interdisciplinary teams of staff
Framework Steering Committee were formed from numerous organizations.
to address COVID-19 needs for homeless
■ ICHA, numerous Ontario Health Teams (OHTs),
populations and to revitalize and move forward including hospitals and community health
the health services framework (City of Toronto/ centres (e.g., Unity Health, University Health
United Way, 2020). Three streams of work Network, Women’s College Hospital, South
were added to the framework, with primary Riverdale Community Health Centre) have
health care, mental health/case management been working to deliver vaccination clinics
and harm reduction coordinating tables on-site at shelters and at community clinics.
established. Partnerships with the health sector
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