Title: Coordinating Housing, Health and Social Supports in Manitoba to Address Homelessness
1Coordinating Housing, Health and Social Supports
in Manitoba to Address Homelessness
- Cross-Department Coordination Initiatives
- September 9, 2008
2Purpose of the Presentation
- Making the case for coordination
- Reducing homelessness through public,
not-for-profit and private sectors partnerships - Mandate of the Cross-Department Coordination
Initiatives (CDCI) - Update on current projects and outcomes of CDCI
activities
3Why a Housing Focus?
- Affordable housing issues
- High housing costs
- Decline in affordable housing stock
- Housing in a key determinant of health
- Limitation to income and rental supports
- Lack of appropriate housing with health and
social service supports - Increasingly visible homeless population
4Manitobans Increasingly at Risk of Homelessness
- Mental illness and/or substance use
- Physical disability or ill health
- Aboriginal descent
- Large families
- Single parents
- History of abuse/family violence
- History of institutionalization
- Poverty
- Lack of life skills
5Human Costs of Homelessness
- Those at-risk of housing insecurity and
homelessness have poor health outcomes - 2007 Street Health Report (Toronto)
- 20 X epilepsy
- 5 X heart disease
- 4 X have cancer
- 2 X diabetes
- 30 X Hepatitis C
- Emergency housing and current social housing
models have difficulty supporting
health/wellbeing
6Financial Cost of Homelessness
- Band-Aid solutions are expensive
- High cost emergency shelter 2X more costly than
social housing - Emergency and transitional housing used as
long-term housing, creates a backlog - High cost of evictions (Legal fees, Court
attendance, Rent arrears, Property refurbishment,
Unit turnovers)
7Financial Cost of Homelessness
- 35 of visits to emergency rooms in Canada are by
homeless people (CIHI) - 38 street people in Winnipeg cost the
emergency, health and justice systems millions of
dollars (Project Breakaway) - Over 16 month the 38 generated
- 570 IPDA calls
- 447 calls for service (e.g. medics)
- 49 arrests
- Multiple costs for ambulance, hospital and detox
services
8Current Situation
- Some efforts to coordinate policy and service
delivery in housing, health and social services - Dominant trend for systems to work in isolation
- More tenancies considered high risk
- Housing providers have conflicting roles
(property management versus addressing the needs
of complex tenancies)
9Benefits of Coordinating Housing, Health and
Social Services
- Development of range housing models and support
services - Cost saving to the justice and health systems
- Increase familiarity with services and supports
in other sectors - Integrated research, policy and planning among
various sectors - Policy development informed by front line
- Common understanding needs of at-risk populations
- Better ability to provide a wide range of
services - Full range of services housing and communities
safer - Expectation confirmed between housing and service
providers
10Challenges
- Perception that demand often exceeds available
resources - Challenge of pressing old systems into more
collaborative ones seems insurmountable - Turf protection
- Creation of mechanisms to coordinate services
- Contrasting mandates, responsibilities, cultures
- Health/social services view housing
finance/development as inaccessible and
profit-driven - Housing systems view human services as
inaccessible, imprecise, subjective, inconclusive
and beyond mandate
11Current Examples of Coordination
- Housing First
- Outreach Urban Health/ Partners In Community Care
- Program of Assertive Community Treatment (PACT)
- Community Wellness Initiative (CWI)
- Winnipeg Integrated Service (WIS)
- Cross-Department Coordination Initiatives (CDCI)
12Housing First
- Best practice approach
- Housing with wraparound case management services
- Key component of long-term housing and homeless
plans - Alternative to the emergency shelter response and
continuum of care model - Examples
- New Yorks Pathways to Housing
- Torontos Street to Homes Project
13Outreach Urban Health (OUHKelowna) BC
- Primary Health Care Centre that provides low
barrier access and full scope outreach services
to homeless individuals - Based on principles of primary health care
- Access to health care
- Health promotion (includes housing)
- Intersectoral collaboration
- Partners In Community Collaboration (PICC)
coordinated inter agency case management
includes housing providers - Formal agreements enable collaboration
- Over 60 reduction in Emergency Department visits
14Program of Assertive Community Treatment (PACT)
Manitoba
- Multi-disciplinary team of mental health
professionals, addiction specialists and
vocational rehabilitation specialists (2 teams in
Manitoba) - Low staff to client ratio, using a team approach
and shared caseloads - Services include medication management,
therapeutic counseling, substance use
intervention, primary health care, crisis
response 24/7 - Support with daily living activities such as
maintaining housing
15Community Wellness Initiative (CWI)
- Partnership between Winnipeg Regional Health
Authority (WHRA) and the Manitoba Housing
Authority (MHA) - CWI supports the overall mental health and
wellness of tenants, and to build stronger
communities - Community activities, presentations, workshops,
annual Health Fair build awareness of programs
and supports - Current CWI is located in 5 MHA sites
16Winnipeg Integrated Services (WIS)
- Developed in 2001, Winnipeg Regional Health
Authority (WRHA) and Manitoba Family Services and
Housing (FSH) - Integrated community-based health and social
service delivery model - Provides efficient, effective and holistic
services - Objective
- Improve access to services
- Improve efficiency
- Reduce duplication
- Simplify coordination
- Opportunities for Housing Providers to engage in
health/social services providers
17Housing for Seniors
- In October 2005, Central Government endorsed
Aging in Place to be used as a central principle
in the planning of all provincial government
housing and Long Term Care initiatives - The principles of Aging in Place addresses the
need for affordable option for housing with
supports, as alternative to premature personal
care home placement - The long Term Care strategy addresses the gap
between an individual living in their home and
Personal Care Homes - The strategy focuses on three community models of
support, Supports to Seniors in Group Living
(SSGL), Supportive Housing program and
Specialized Supports
18Supports to Seniors in Group Living (SSGL)
- Target Population
- Seniors in existing community congregate
settings. - Do not require 24-hour support and supervision
- Model
- Enhanced support services
- Health promotion
- Focus on Instrumental Activities of Daily Living
(IADLs) (telephone, banking, appointments) - Tenants pay their own rent
- Regional Health Authority funds services
19Supportive Housing
- Target Population
- Primarily cognitively impaired, frail elderly
- Require 24-hour support and supervision
- Model
- Community, congregate setting
- Personal support/supervision (24/7)
- Secure environment
- Resident responsible for rent and service package
- Service package includes meals, laundry and light
housekeeping - RHA funds care component
20Where Are We Now?
- Since the introduction of Aging in Place in
January 2006 - 2,760 units of Support to Seniors in Group Living
have been implemented - Over 358 units of Supportive Housing have been
developed - 83 spaces for Specialized Supports are active
21Cross-Department Coordination Initiatives (CDCI)
- June 2007 - Division of FSH and MHHL in
partnership with WHRA - Mandate to identify and review existing
housing-related policies, programs and services
that require coordination, and propose
enhancements or alternatives to improve policy
coordination and service delivery - Initial focus on housing and supports for the
homeless, seniors and individuals with mental
health issues
22(No Transcript)
23Work to Date
- Regional Forums with frontline FS, Housing, MHHL
and RHA staff - Key stakeholder consultations/interviews
- Inventory of existing housing, health and social
services - Review of government/community and
research/planning documents - Better coordination of funding allocation
opportunities (e.g. WHHI, MHCC, HPS, WPS, UAS) - Best practice re current housing, health and
social service policy, program and funding models - Continuation and implementation of existing
homeless, metal health and seniors housing
projects
24Next Steps
- Work with multi-sector stakeholders to promote
coordinated resource allocation - Assist in the development of strategy to end
homelessness - Support the Mental Health Commission of Canada
- Developing housing and support options for target
populations - Increase awareness of best practice in
coordinating housing, health and social services - Provide recommendations to government on
mechanisms to coordinate policy/program
development, funding allocation and service
delivery