A Homeless Prevention System for London Housing First November - - PowerPoint PPT Presentation

A Homeless Prevention System for London Housing First

November 24, 2014

Relevant Aligned Plans

Our Planning Approach Homeless Prevention and Housing Solutions

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Homeless Prevention System for London

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Vision

The Vision The City of London’s Homeless Prevention System is a coordinated and integrated individual and family centred housing stability approach that is outcome focused and designed to address, reduce and prevent homelessness in London.

Principles Homeless Prevention System

Homelessness is a Solvable Problem

Housing First or Housing with Support Approach

Individuals and Family Centred A Harm Reduction Approach Community Engaged

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Principles…cont’d

Partnership Based London Driven Neighbourhood Based Inclusive Fiscally Responsible Outcome Focused

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• Securing

Housing

Securing Housing

• Housing

with Support

Housing with Support

• Housing

Stability

Housing Stability

• Emergency

Shelter Diversion

Shelter Diversion

Homeless Prevention System for London

Strategy – Competency – Capacity

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Outcomes

Two primary outcomes guide the efforts and form the basis for the indicators of success

• Individuals and families experiencing

homelessness obtain and retain housing.

• Individuals and families at risk of

homelessness remain housed.

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Housing First

A housing and service intervention that provides immediate access to permanent housing and support services and is based on a philosophy of client choice. Participants are not required to participate in psychiatric treatment or attain a period of sobriety in

• rder to obtain housing.

Frequent use of acute care services

Jail Shelter Hospital/ Detox Streets

Institutional Circuit

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Street/shelter/hosp /jail Community Placement Transitional Housing Permanent housing Ongoing, flexible support Harm Reduction

Housing First Model

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In three years what percentage of funding should be allocated in each of the four areas of focus?

Shelter 20% Securing Housing 33% Housing with Support 29% Housing Stability 18%

Summary of 5 Working Groups from the forum held December 5, 2012

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CHPI spending by category across Ontario 2013-2014

20 40 60

Housing Stability Bank

The Housing Stability Bank offers financial assistance to low income Londoners to obtain and retain their housing and for those at risk of homelessness to remain housed.

Introduced in April 2013 and operated by The Salvation Army Centre of Hope

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London CAReS

London CAReS is a highly collaborative community-based Housing First service aimed at improving the housing and health

• utcomes
• f

individuals experiencing homelessness.

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London CAReS – Housing First Intervention

• Street outreach services operate 24hrs a day to

support individuals to move from the street into their home.

• Housing Stability workers provide intensive in-home

case management to support individuals in their transition into a new home, neighborhood and community.

• Housing Selection workers identify private market

landlords and property groups and support landlords 24/7.

• Syringe recovery includes maintaining the stationary

needle bins.

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Case Example:

• Residing on the streets and in ‘crash

beds’ for almost 15 years

• High consumption of non-beverage

alcohol

• Outdoors all day most days, including

during extreme weather

• Frequent injuries related to falls from

substance use or victim of violence

• Daily contact with Emergency Services
• Most frequent visitor to the

emergency dept. – 259 in one year

• Housing

with Support

London CAReS

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Outcome: Housing Stability

Since being housed with support in November, 2013

• 0 days in emergency shelters
• 2 visits to Hospital Emergency Rooms
• 0 occurrences resulting in police contact and hours

in holding cells

• Accessing routine community-based health services
• Increased satisfaction in housing

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Diversion from entering shelter Rapid housing from shelter

Emergency Shelter Services

Reduced pressures on emergency shelter use

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Centralized intake Shelter Specialization Housing support

Coordinated Intake

Emergency shelters are beginning to develop the plan for a coordinated intake for emergency shelters – for launch late 2015/2016

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Integrated data base for all

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To be successful with coordinated intake we need to track unique individuals through all funded agencies

Court to Homes – Order to Reside

The purpose of the Court Order to Reside Pilot Project is to focus on a subset of homeless individuals who are before the courts, eligible to be released into the community to await their trial, and agree to participate in the “Order to Reside” Pilot Project.

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Partners and Collaboration

This collaborative pilot project involves a number

• f key services working together to achieve a goal
• f a rapid housing plan with support, for

individuals placed on a Judicial Interim Order with a condition to reside (02R) at The Salvation Army Centre of Hope. The Salvation Army Court Services will identify and refer individuals to St. Leonard’s Community Services who will complete a housing/charge/risk assessment and implement the rapid housing plan with support for the individual.

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Community Plan Regarding Street Involved Sex Workers

Hard to Stop….Harder to Stay Stopped

Community Plan Regarding Street Involved Youth and Youth Experiencing Homelessness We are starting with completing a comprehensive review of research and promising practices

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NATIONAL VETERANS PROJECT:

Addressing Homelessness Among Canadian Forces Veterans

Cheryl Forchuk RN PhD, Professor/Scientist, Faculty of Health Sciences, Arthur Labatt Family School of Nursing, Western University/Lawson Health Research Institute; Jan Richardson, MBA, Manager Homeless Prevention, City of London, Adjunct Faculty, Faculty of Health Sciences, Labatt Family School of Nursing, Western University

BACKGROUND

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“it t takes 9 90% of the worry tha hat you ha have a abo bout whe here you’re g going to b be e every morning…so w without t that wor

• rry, n

now y you

• u can

conc ncent ntrate on “ n “I’m a an n addi ddict” m myself and y d you can c concentrate on t trying to c clean u n up p and nd g get y your life b back t together because you’re no not conc ncent ntrating ng

• n
• n t

trying to s

• survive ou
• ut

there all ll the t time”

November 24, 2014

BACKGROUND

• The majority of research on homelessness among

veterans originates from the USA

• Little is known regarding meaningful interventions that

would address homelessness among Canadian veterans however, some inferences can be drawn from the UK literature (Milroy, 2009) – where contextual experiences

• f homelessness among veterans have noted similarities
• Further validation and exploration of housing

interventions and other potential solutions to addressing homelessness among veterans within the Canadian context is needed

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KEY PRINCIPLES:

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BASED ON THE WORK OF MILROY (2009) AND RAY AND FORCHUK (2011), SEVERAL KEY PRINCIPLES WERE DEVELOPED FOR ADDRESSING HOMELESSNESS AMONGST CANADIAN VETERANS:

peer support (by vets for vets) provision of services that are separate from the general shelter population emphasis on promoting self-respect providing structure during the day addressing alcoholism issues/addiction providing a transition process to housing

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PROJECT SUMMARY/OBJECTIVES

• The Canadian Model for Housing and Support for Homeless Veterans was a

two year pilot project

• Local community agencies who work with homeless and/or veteran

populations collaborated with federal partners including HRSDC, Veterans Affairs Canada (VAC), and the Operational Stress Injury Social Support (OSISS) Program to provide housing and related supports to 56 veterans who were homeless or at imminent risk of becoming homeless across 4 Canadian cities: Victoria, Calgary, Toronto, London

• Each site adhered to key principles and used different strategies to enact in
• rder to evaluate their utility in practice and to evaluate the usefulness of

the different implementation strategies

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PROJECT OVERVIEW

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OVERVIEW OF THE FOUR HOUSING FIRST PROVIDERS

LOCATION CAPACITY STAFFING HOUSING MODEL HOUSING & SUPPORTS PEER SUPPORT CALGARY 15 On site 24/7 1 bedroom units in one building owned and

• perated by site

Combined roles of landlord and program Informal LONDON 10 7 day daily support plus 24/7 on call Scattered site: private sector rental apartments private landlord and supports by program OSSIS TORONTO 20 weekday support plus 24/7 on call 2 bedroom units in one building owned and

• perated by site

Combined roles of landlord and program Mental Health Peer Support VICTORIA 11 Weekday volunteer support - no staff Shared accommodations in

• ne building and some

private sector Combined role of landlord and program Veterans/ OSSIS

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London

Outcomes

• London CAReS has provided housing with

support to 13 unique Veterans in dispersed private sector housing.

• Recreation and leisure worker assists Veterans to

to develop interests and hobbies and help integration with their local neighbourhoods.

• One Veteran completed employment

readiness training and moved to take up full time employment in Toronto.

• Three female Veterans have been supported,
• ne with a child.

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RESULTS

HOUSING INSTABILITY AND RISK FOLLOWING RELEASE FROM CF MILITARY SERVICE Years since release from CF: 24.8 years (SD 13.6) Time since first episode of homelessness: 9.8 years (SD 10.5) Nights homeless in the year prior to enrollment: 160.2 nights (SD 137.9) Total time spent homeless: 5.8 years (SD 6.8) Total number of undesirable moves (past 5 years): 5.7 (SD 6.0)

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OUTCOMES

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RESULTS

DESCRIPTIVE ANALYSIS (N=63)

Average Age : 52.8 years (SD 9.8)

Sex/Gender: Female: 5 (7.9%) Male: 58 (92.1%) Highest Level of Education: College/University: 21 (33.9%) High School: 29 (46.8%) Grade School: 12 (19.4%) Single/Never Married: 25 (39.7%) Separated/Divorced: 33 (52.4%) Widowed: 3 (4.8%) Married/Common Law: 1 (1.6%)

Years served in the Canadian Forces (CF): 8.1 years (SD 8.8) Deployed Overseas: 21 (39.7%) (Afghanistan, Aleutian Islands, Bosnia, Cyprus, Egypt, Israel, France, Germany, Korea, Kosovo, Middle east, North/South Atlantic & Adriatic Sea, Norway, Persian Gulf, Saudi Arabia, Sierra Leone, Somalia, South Africa, Spain, United States, the former Yugoslavia) Duration of deployment: 26.4 months (SD 29.7)

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RESULTS

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RESULTS

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RESULTS

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FOCUS GROUP EXCERPTS

OPTIONS FOR FUTURE PROGRAMS “I would love t

to see this p project expand t to [inc nclude bo both h single le-cluster and] scattered s

• site. I

I kno now tha hat w we k kno now transition

• n doe
• esn’t w

wor

• rk, but I t

thi hink nk tha hat t the here are a a c coupl ple guys he here w who ho m might ht do be better in n [an a alternate] m model…. …..[i [it’s] ] not

• t one

ne s site f fits a all ba basically I I thi hink nk you ne need bo both… h….I t thi hink nk a lot o

• f t

them found out t that they s stabilized well h here, b but now feel l like t they are r really s stunted” “…there cou

• uld b

be a a m mix [ [of

• f hou
• using op
• ption
• ns], I wou
• uld say

cause t there a are c certain participants that w would benefit m more [from] ha having ng t the he po possibi bility o

• f c

communa nal living ng and nd t the he possibility o

• f a

a p private sector”

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FOCUS GROUP EXCERPTS

“I t think they’ve g got a n new found r d respect in some ways f for themselves, generally…[the veterans d demonstrate a] willingness to s step f forward d vulnerably t towards professions and s d stuff t they w wouldn dn’t have n norm rmally done in t their h homeless situation. T That t they only would’ve gone to a a do doctor if it’s an e

• emergency. Now, t

they’re quite willing to go t to t their do doctor’s o

• ffice, e

even though they’re smelling ng of b booze, and nd s stuff like tha hat. You k know, they’ll rise t to t the occasion and d get t themselves there a and s d stuff, s

• so. I’ve seen that’s b

been s significant.”

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FOCUS GROUP EXCERPTS

PEER SUPPORT “…you k kno now t w the he pe peer suppo pport workers ha have be been t n tremend ndous in n doing ng c communi nity mappi pping

• ng. So he

helpi ping ng t the hem t to l locate r resources tha hat a are availabl ble to [ [the he v veterans ns] in t n the he c communi

• nity. And

nd s so, s some

• f t

the [ e [co community y dev evel elopmen ent o

• rien

ented ed] a act ctivities es they a ey are e doing ng…you kno now, t the hey ha have a a walking ng club. The hey a are going ng out a and nd pa participa pating ng in o n oppo pportuni nities t tha hat a are allowi wing ng the hem t to e expl plore thei eir co community y in a a v ver ery y hea ealthy y way.” “… … it’s up t p to e each i h ind ndividual whe whethe her or no not t the hey w want nt tha hat peer eer suppo pport … I I n needed it, s so t

• therefor
• re I t

took

• ok advantage of
• f i

it . . I It t took

• ok

me e awhi while to actually get t there b but finally I I g got t to t the p point w where

• k
• kay I

I need eeded ed it a and I I need eeded ed t that s sen ense e of s stru ruct cture, e, sen ense e of pu purpo pose t tha hat you

• u kind

nd o

• f l

lost whe when n you l left t the he m military.”

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FOCUS GROUP EXCERPTS

OUTCOMES

“in our experience of housing support and harm reduction approach works, and you pair that up with an agency that promotes…an intensive case management model as opposed to a brokerage model” “[ “[The he veterans ns] are a a f func nctioni ning ng pa part of t the he c communi nity … they h have a a p place [ [and] people do c care ab about them a and they care ab about other … r …the hey’re ho house pr proud so to spe peak w whi hich I h I thi hink nk is r remarkabl ble for a bu bunc nch h of pe peopl ple w who ho m might ht

• the

herwise be be t trans nsient nt.”

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FOCUS GROUP EXCERPTS

OPTIONS FOR FUTURE PROGRAMS “I would l love e to s see t ee this p project ect ex expand to [inc nclude bo both s h sing ngle-cl cluster er and] s sca catter ered ed site.

• e. I

I kno now t w tha hat w we k kno now t w trans nsition n doesn’ n’t work, but I I thi hink nk t tha hat t the here are a a c coupl ple g guys he here who who might ht do be better i in n [an n altern ernate] e] m model el…. …..[it’s ’s] n not one ne s site f fits a all ba basically I I thi hink nk you ne need bo both… h….I t I thi hink nk a a l lot o

• f t

the hem f found nd out t tha hat t the hey s stabi bilized well he here, bu but now f feel eel l like t e they a ey are e rea eally y stunted ed” “…ther ere e co could b be a e a m mix [ [of h housing o

• ptions], I would s

say ca y cause t e ther ere e are e certain pa n participa pant nts t tha hat w would be bene nefit m more [ [from] ha having ng t the he po possibi bility

• f c

communa nal l living ng and nd the he po possibi bility of a a pr private sector”

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REFERENCES

• 1. Milroy, H. (2009). From Welfare to well-being: Turning things around among

homeless Veterans. In Mancini, J. A., Roberto, K. A., (Eds.), Pathways of human

development: Explorations of change, (pp. 327-346). Maryland: Lexington Books.

• 2. Ray, S. L. & Forchuk, C. (2011) The Experience of homelessness among Canadian

Forces and allied forces Veterans (Research Report submitted to HRSDC Canada).

• 3. Endicott, J. et al. (1993). Quality of life enjoyment and satisfaction questionnaire: A

new measure. Psychopharmacology Bulletin, 29, 321-326.

• 4. Gaetz, S. (2012). The real cost of homelessness: Can we save money by doing the

right thing? Toronto, ON: Canadian Homelessness Research Network Press. Retrieved from: www.thehomelesshub.ca

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CONTACT INFORMATION

JAN RICHARDSON Manager, Homeless Prevention, City of London jrichardson@london.ca 519-661-2500 ext. 5228

• DR. CHERYL FORCHUK

Western University/Lawson Health Research Institute cforchuk@uwo.ca 519-685-8500 ext. 77034

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Thank you for your efforts to address, reduce and prevent homelessness Enjoy your day!