RESPONDING TO VULNERABLES

IN TORONTO

A SOCIALSOCIALSOCIAL ENTERPRISE RESPONSE

Richard Grotsch, Manager

Integrated pest Management

Toronto Community Housing

What would you do if:• You were 76 years old and living alone in the community?

• You had a severe infestation of bed bugs?

• You had no family or friends to help you?

• Your support services were threatening to cut you off because ofthe bed bugs?

• You had just enough money to pay your rent and no money to pay for a treatment?

• You were afraid that you would have to leave your unit to have it treated?

• You were afraid that you would have to throw out all your belongings if your unit was treated?

Social Impact of Bed Bugs

• Stigma and social isolation

• Anxiety and despair

• Stress and frustration

• Time and expense

• Loss of belongings

• Refusal of services (contractors, visiting homemakers and nurses)

• Embarrassment

Bed Bugs and Vulnerable Tenants

• Often these bedbug infestations go unreported, undiscovered for a long time for variety of reasons.

• This can result in Bed Bugs being left to happily reproduce every couple of weeks.

Resulting In MEGA Infestations

Toronto: Who Are The Most Vulnerable?• Individuals who have limited

income to prepare or treat units.

• Individuals whose physical health may limit their ability to prepare units – age, disability, health conditions.

• Individuals with mental health issues or addiction issues who may have difficulty recognizing the issue or organizing themselves to get help.

Vulnerable Clients• Majority of onsite bed bug investigations conducted by City of

Toronto staff will be to assist vulnerable clients

• Cases are likely extremely complicated and time-consuming

• Predominantly, other issues are involved, commonly mental health, physical disabilities

• Clients are often socially isolated from family friends, other tenants, community

• Clients often may not have any support from family, friends or community agencies

• Clients usually do not have resources to pay for cleaning, preparation services. Financial barriers are most common.

Action Plan May Include:• Temporary relocation of tenant.

• Recruiting of Family and Friends to assist in the process.

• Temporary relocation of pets

• Securing Funding (who pays?)

• Removal and disposal of excess items, clutter, waste, contaminated materials etc from the unit.

• Extreme cleaning and sanitizing of contaminated surfaces.

• Preparation for pest control

• Tenant Laundry

• Repair of structural deficiencies.

• Referral of Client to Long Term Supports

• Ensure timely removal of infested items excess from the property (may require additional garbage bins).

• Repair of structural deficiencies

Who Will Do The Work?

A Social Enterprise Response

Toronto’s Bug and Scrub Program

Bug and Scrub is a SPE modeled program that was created by the City of Toronto’s Seaton House. The program creates real employment opportunities for homeless individuals and assists them to overcome the barriers that restrict their ability to gain employment and reintegrate successfully back into their community. Bug and Scrub provides responsible, reliable, and cost effective assistance to members of the community to respond to growing numbers of bed bug infestations across the city of Toronto.

Bug and Scrub program works throughout the community providing comprehensive assistance to vulnerable individuals who are dealing with moderate to severe bed bug infestations. Along with bed bug infestations, the teams encounter a variety of different challenges including cockroach infestations, hoarding, clutter, and unsanitary conditions. Many of the clients in the community are dealing with a variety of social and medical issues and have little if any supports in place to assist them in living healthy and free of pests.

Toronto’s Bug and Scrub Program

Toronto’s Bug and Scrub Program• Designed to provide comprehensive assistance and support

to vulnerable citizens across the City of Toronto dealing with Bed Bug infestations.

• A triage process ensures that the most Vulnerable/ in need individuals receive supports from Bug and Scrub in a timely manor. Most units are assessed, funding achieved and completed within 2-3 weeks of request.

• Units triaged based on level of infestation, overall condition of unit, mental and/or physical health, existing supports (family and friends) and if children are present in these conditions.

• Have built strong working relationships with various agencies across the City to fast track referrals and supports can be provided to clients as part of a long term plan. .

Toronto’s Bug and Scrub Program

• Work in partnership with other city divisions as part of a city wide strategy and response to bed bugs through participating in TBBP.

• Develop partnership’s with housing providers to educate staff on issues related to bed bugs and accessing supports for their tenants.

Bug and Scrub Provided:• Removal of all infested belongings and furnishings where

disposal is necessary.

• Steam treatment of complete unit. Steam treatment of all furnishings deemed to have minimal infestation levels.

• Complete cleaning of kitchen and washrooms.

• Caulking of all baseboards and crevasses where infestation is evident.

• Hand washing of all walls, baseboards, and floors

• Collection and removal of all clothing and linens. Wash, dry, fold, bag and return to resident within 24 hours

• Follow up inspections within 14 days

Case StudyClient:• 76 yr old male living in Toronto Community Housing

• CPP and Old Age benefit recipient (Not funding eligible)

• Case identified through outside sources (TCHC rep. and Police)

• 90 % Hearing impaired and severe mobility issues due to infection of his feet

• No immediate supports (Community, Family or friends)

• Questionable competency to live on his own

• Client accepting of assistance

• Client hospitalized to treat for infection, 5 days allotted to treat this unit Courtesy of

City Of Toronto

Apartment Conditions• Severe infestation of bed bugs

• Live bed bugs all over bed

• Severe infestation of cockroaches throughout the apartment

• Human feces throughout bathroom on floor, bathtub, toilet

• Unsanitary conditions throughout apartment including decomposing food, dirty dishes etc.

• Cluttered with paper, cardboard boxes, food waste

Courtesy of

City Of Toronto

Bed Bugs Infesting Hallway

Roach Infested Phone Jack

Case StudyAction:• Public Health Inspector/Lead Specialist, Toronto Bed Bug

Project investigates report from Toronto Police and TCHC of an elderly man who lives alone who is unable to care for himself, with no supports and recently taken to hospital is living with severe infestation of bed bugs.

• Infestation confirmed, along with infestation of cockroaches, and conditions described previously.

• Lead specialist contacts Bug and Scrub to consult and obtain quote for required work.

• During consultation/investigation it is agreed it is unsafe for client to remain in these conditions, as it poses serious risks to the clients health.

• Client is removed by paramedics, returned to hospital. Lead specialist and representative of Bug and Scrub attend at hospital to provide pictures and emphasize the severity of situation. Courtesy of

City Of Toronto

Cast skins, Eggs, Fecal Matter and Bed Bugs Along Baseboard

Case StudyActions:

• Lead for Bug and Scrub contacts Housing Provider, describes situation and secures a new apartment in same building for client when they return from hospital.

• Full clean up of prior unit. Destroying, wrapping and removing of all infested and unsalvageable belongings.

• Preventative measures taken in new unit, (caulking and sealing, laundered clothing, sanitization of salvageable belongings and encasements on new bed).

• Sanitization of both units (new and old).

• Work along with TPH and housing provider to ensure long term supports for tenant on his return from hospital.

Courtesy of City Of Toronto

Case StudyOutcome

• After 5 days to treat both new and old unit, client returns with daily visits arranged with CCAC and psycho-geriatric outreach team.

• Client receives donation of Bed frame, new mattress, mattress encasement and bed bug proof pillow from Toronto Bed Bug Project.

• Items that were unsalvageable were replaced by donations from community partnerships and housing provider.

Courtesy of City Of Toronto

Successes• Bug and Scrub has a 90 % success rate.

• Since Bug and Scrub was created in 2008 they have assisted over 200 clients.

• The Bug and Scrub Supervisor, Lead Specialists of TBBP along with Public Health Inspectors have visited and inspected over 2000 residential units in 2009 who were dealing with bed bugs or related issues.

• Bug and Scrub Supervisor and Lead Specialists of TBBP have formed a structured team approach that has proven to be very successful in assisting vulnerable clients.

• Bug and Scrub has received international recognition for their socially minded and comprehensive approach to helping vulnerable clients.

• Bug and Scrub’s crew will extreme clean under any conditions, they understand mental illness, addictions and do not judge how one lives.

• Provide expertise/participate in TBBP pilot project planning andimplementation

Questions?

Richard Grotsch

Manager, Integrated Pest Management Community Health Unit

Toronto Community Housing 416-981-4054

Richard.Grotsch@torontohousing.ca