Creating New Supportive Housing Opportunities in Parkdale in Partnership with the University Health Network and United Way of Greater Toronto

Poverty not only prevents people from being able to maintain stable housing, it also leads to poor health outcomes, and places increased pressures on public health systems. Recognizing the complex link between poverty, health and social outcomes, and the need to take a systemic approach to improving the lives of residents across the city, the University Health Network (UHN), the United Way of Greater Toronto (UWGT) and the City of Toronto entered into a Memorandum of Understanding (MOU) to establish the Social Medicine Initiative in 2019. Through the pandemic, this MOU was central in establishing a number of COVID-19 hotel recovery sites with UHN and the City of Toronto for people experiencing homelessness alongside community partners including the Neighbourhood Group and Parkdale Queen West Community Health Centre. The partnership resulted in caring for over 1,300 patients and families, and it continues to inform a Social Medicine approach in improving the quality of care for marginalized patient populations. The Social Medicine Initiative (SMI) is a collaborative approach integrating health and social services to improve health outcomes for Toronto residents. The intent of SMI is to scale such integration and any upstream policy solutions such as housing for all or income supports to improve the wellbeing of our city's most disadvantaged patient populations. In order to prevent worsening health conditions, SMI is focused on a more proactive approach that improves access to services such as primary care, mental health, and harm reduction, while meaningfully addressing the social determinants such as poverty, food insecurity, social isolation and housing to improve population health. This report outlines a framework to activate a SMI housing partnership and create new permanent supportive housing in the Parkdale neighbourhood for structurally vulnerable and marginalized individuals, including people experiencing homelessness. It proposes a unique model to utilize land owned by UHN, and new affordable and supportive housing which coordinates resources to help establish a campus of care onsite. This innovative approach will see affordable housing integrated with health and social services. It will provide more housing opportunities for people who are currently being under-served by the health care system while experiencing homelessness and other challenges imposed by poverty. Furthermore, this approach will integrate medical care and community supports to provide solutions for permanent housing and the wraparound services residents need as evidenced through the partnership in the COVID-19 pandemic. The lands owned by UHN in Parkdale include the majority of the block bounded by King Street West, Close Avenue, Dunn Avenue and Springhurst Avenue. The properties include both institutional and house-form buildings and comprise of the EW Bickle Centre for Complex Continuing Care, the Sunflower House Child Care Centre fronting onto Dunn Avenue, and the existing Lakeside Long-term Care Centre. The properties also include three parcels that are currently vacant as well as a large parking lot. UHN has recently submitted a planning application to expand the Lakeside Long-Term Care Centre to include a new 6-storey addition with 192 beds which is scheduled for consideration by Toronto and East York Community Council and City Council in October, 2020 (Item No. TE19.1). The new long-term care beds will provide homes for elderly residents who are unable to live independently, and contribute to the continuum of housing and health model envisioned for the site. The application related to the Lakeside Long-term Care Centre was voluntarily revised by UHN to include the 17 institutional and house-form building properties within the block. City Planning is recommending approval of the re-zoning application that would allow for the expansion of the long-term care centre on condition that the rental tenure of all existing rental dwelling units be protected for a period of 49 years. Further signifying UHN's commitment to incorporate affordable and supportive housing as part of its health care model, UHN is in discussions with the City regarding a potential long-term lease to the City for the existing house-form buildings. As some of these properties are occupied, they will continue to be operated to provide affordable housing for existing residents until future redevelopment of the site. The City will select a non-profit organization to manage these homes. Subject to Council's approval of this report, staff will proceed with due diligence work related to the house-form properties and will report back to Council by the second quarter of 2021 with recommendations related to the proposed lease arrangement. Concurrently, staff will begin work with the UHN, UWGT, the local community (including existing UHN tenants) and the ward Councillor to plan for the future redevelopment within the block. A report will be presented to Council for consideration in the second quarter of 2021 with a plan to initiate the project, including the potential to add net new affordable rental housing on the vacant lots and large parking lot.

Avenue (the "House-form Properties") and report to the Planning and Housing Committee in the first quarter of 2021 with recommendations including proposed terms and conditions for the City of Toronto to enter into a long-term lease with University Health Network at below market rent in respect of the House-form Properties, and budget details in relation to the lease and operation of the properties. 2. City Council direct the Executive Director, Housing Secretariat and the Chief Planner and Executive Director, City Planning, in consultation with CreateTO, University Health Network, the ward Councillor and the local community, to begin a visioning and master planning exercise for a future redevelopment of the lands, including the potential to add modular housing on the vacant parcels as well as the large parking lot at 150 Dunn Avenue, as part of a shorter term plan, and report back to Council in the second quarter of 2021 with recommendations to activate the site and create new affordable and supportive housing opportunities. 3. City Council direct the Executive Director, Housing Secretariat and the Executive Director, Corporate Real Estate Management, in consultation with CreateTO and the Chief Planner and Executive Director, City Planning, to evaluate additional privately owned lands adjacent to or in proximity to the lands owned by University Health Network within the block for opportunities to create a more efficient redevelopment block, and report back to Council on potential to incorporate these additional properties as part of a larger assembly and redevelopment plan. 4. City Council authorize the Executive Director, Housing Secretariat to allocate up to $100,000 in funding, inclusive of HST and disbursements, from the Capital Revolving Reserve Fund (XR1058) for the purpose of completing the pre-development work, including the due diligence work and the visioning and master planning exercise referred to in Recommendations 1 and 2 above. 5. City Council approve an increase to the 2020 Approved Operating Budget for Shelter, Support and Housing Administration, in coordination with the Executive Director, Housing Secretariat, of up to $100,000 gross, $0 net funded from the Capital Revolving Reserve Fund for Affordable Housing (XR1058) to support pre-development activities related to the University Health Network-owned institutional and House-form Properties in Parkdale for the purposes of creating new affordable rental and supportive housing opportunities. 6. Council approve an exemption from the Donations to the City of Toronto For Community Benefits Policy to help advance a potential below fair market value lease to the City from University Health Network of lands located at 74 and 82 Dunn Avenue, 1, 3, 5, 7, 9, 11, 13, 15 and 17 Close Avenue, and 74 and 78 Springhurst Avenue for the purpose of affordable housing and report back as necessary to seek further direction in this regard.