Supporting Partnerships Between Health and Homelessness
Supporting Partnerships Between Health and Homelessness – Research shows that persons experiencing homelessness have a disproportionate amount of acute and chronic illness when compared to the general population, and encounter systemic barriers that may preclude them from seeking care and maintaining treatment adherence. Such complex health needs may act as a barrier to securing stable and sufficient shelter/housing, which can lead to a ‘revolving door’ of hospital admissions.
In order to gain a better understanding of the supports and mechanisms needed to enhance transitions from hospital to shelter/housing for persons experiencing homelessness, HSABC partnered with the SFU Gerontology Research Centre and Providence Health to complete a comprehensive two-year research and recommendations project called Supporting Partnerships between Health and Homelessness. This report outlines key findings and recommendations designed to help support successful transitions from hospital and increase the possibility of future partnerships between health and homelessness sectors.
In 2012, the Greater Vancouver Shelter Strategy (GVSS), now the Homelessness Services Association of BC (HSABC) created the Homeless Seniors Community of Practice in response to the increasing number of older people experiencing homelessness. The Community of Practice (CoP) utilizes a peer-based model to better enable front line service providers’ ability to meet the needs of this growing population. The increase in the number of seniors within the homeless population presents unique challenges with Canada’s aging population as well as for health, housing, and community services providers. The combination of research and consultation conducted by the CoP over the three year funding period, provides a basis for exploration of how to better address the needs of older adults facing homelessness in Greater Vancouver. The following documents provide information, recommendations, and resources to assist shelter and outreach providers in effectively supporting seniors who are accessing their services.
Sheltering Homeless Seniors (Mar 2016)(PDF) – This report provides recommendations from existing shelter operations that support seniors accessing shelter services. Recommendations for shelters serving seniors fall into three categories: design, operations and staffing considerations and are informed by the provision of choice, self-determination and the experience of safety and support in moving forward.
Health Supports for Shelters Serving Seniors (Mar 2016)(PDF) – As the number of older adults facing homelessness continues to grow, shelters commonly identify that seniors’ health needs create issues that dramatically impact their capacity to provide service. This needs assessment was conducted to clearly identify the physical health issues that most impact a shelter’s capacity to serve a senior and what types of support may be beneficial.
Housing First Considerations for Seniors (Feb 2016)(PDF) – There has been much practice and research demonstrating the effectiveness of Housing First targeted to the general homeless population. While this is important in establishing the benefits and impacts of the program, sub populations such as seniors have specific needs. Research indicates that changes associated with aging, combined with homelessness create a unique situation for seniors. This report informs adaptations for Housing First service delivery based on insights from interviews conducted with homeless seniors and shelter staff about their experiences with homelessness and needs in housing. Recommendations were developed to inform how Housing First service delivery may need to be modified to ensure that seniors needs are met under this operating paradigm.
Housing for Vulnerable Seniors (Jul 2015)(PDF) – The CoP developed a Housing Framework to guide the development of housing for seniors who have experienced homelessness with seven Preferred Practices for Housing Sites. To further strengthen the framework recommendations, a series of interviews were conducted with seniors experiencing homelessness. Seniors were asked about their accommodation needs as well as the factors that are associated with the ability to maintain housing. This report outlines these enhancements and makes a call for action to those involved in the creation of housing for vulnerable seniors.
Serving Homeless Seniors: Tools and Checklists (Nov 2014)(PDF) – Between December 2014 and January 2015 the Homeless Seniors Community of Practice conducted a series of surveys with seniors and staff in shelters. The focus of these surveys was to understand how to better serve vulnerable seniors in a residential setting (both housing and shelters). This toolkit was developed through research and consultation as a reference guide for staff seeking to improve services that support seniors.
Towards Aging In Place – Summary Report (Jun 2013) (PDF), Towards Aging in Place – Full Report(PDF) – The Homeless Seniors Community of Practice has identified key components and preferred practices for housing that includes older people (50+) who have experienced homelessness and/or have lived with chronic risk of homelessness. The primary purpose of these reports is to support decision making and to inform action toward ending homelessness among older people. The secondary purpose is to enhance the ability of shelter, outreach and transitional housing services to meet the needs of this population.
Sheltering Seniors Literature Review (Dec 2013)(PDF) – A review of existing literature was conducted to inform discussions about best practices for sheltering homeless seniors and moving them towards appropriate housing. This review follows the common themes presented in the readings, which break down the issues of homeless seniors in the following contexts: challenges and characteristics of homeless seniors; physical and mental health issues; and best practices.
Housing First is a recovery-oriented approach to homelessness that involves moving people who experience homelessness into independent and permanent housing as quickly as possible, with no preconditions, and then providing them with additional services and supports as needed. The underlying principle of Housing First is that people are more successful in moving forward with their lives if they are first housed (“Housing First in Canada: Supporting Communities to End Homelessness”, Stephen Gaetz, Fiona Scott, Tanya Gulliver ). GVSS, now HASBC first began conducting research and developing Housing First resources in response to feedback from shelter and outreach providers in Metro Vancouver identifying increasing pressure to conform to Housing First principles. As federal funding mandates continue to grow in support of Housing First related activities, it is imperative to build capacity within the sector ensuring that shelters and outreach providers are adequately equipped to respond to and engage with Housing First considerations. The following resources are designed to support organizations as they prepare to implement Housing First in consideration of unique operating and community contexts as well as sub populations served.
Evaluating the Housing First Approach in Metro Vancouver(PDF) – In March of 2017 GVSS, now HSABC partnered with the SFU Gerontology Research Centre to evaluate Housing First delivery in Metro Vancouver. This report presents findings from a literature review on best practices in Housing First, followed by a report on the strengths, weaknesses, opportunities, and threats to the delivery of Housing First in Metro Vancouver based on interviews and focus groups with stakeholders. Consultation with HPS-funded Housing First projects and other Housing First providers in the region support the highlighted recommendations to enhance Housing First delivery in Metro Vancouver.
Landlord Engagement Recommendations(PDF) – Across Canada there is a growing emphasis on providing access to housing for those experiencing homelessness as soon as suitable accommodation can be found. Integral to finding suitable accommodation is engaging landlords who are willing to rent to people who are experiencing homelessness. As a result, many efforts have been undertaken to understand how to engage landlords and in supporting tenants and landlords throughout the tenancy. This report synthesizes findings from a number of key works and projects that outline best practices for landlord engagement and eviction prevention from across the globe.
Examples of landlord engagement tools:
- Draft Landlord Introduction Letter(Word format)
- Draft Program Pamphlet (Word format)
- Draft Program Pamphlet (Publisher format)
Mapping Metro Vancouver to Support Housing First Implementation(PDF) – Housing First is a paradigm experiencing great impact and recognition across Canada. While it is recognized that sufficient access to support resources is essential for successful Housing First delivery, there is no formal documentation to describe and understand resource differences between and within communities in Metro Vancouver. Between March and June 2016, GVSS, now HSABC partnered with SFU Gerontology Research Centre and bc211 to conduct 13 community mapping workshops to gain a better understanding of varying levels of access to these types of support services. This report compiles findings from this research to help organizations understand how the service system functions in their specific communities and inform the implementation of a systems approach to delivering Housing First across Metro Vancouver.
GVSS Membership Response to Housing First(PDF) – Housing First executed well is nuanced by the circumstances and environment within which it is delivered, tailored to meet the needs of its intended service population, and operates within a system of interventions. This report seeks to inform on some of the nuances of the homelessness context within Metro Vancouver to encourage a Housing First implementation that considers unique operating circumstances.
Housing First for Shelters & Outreach Webinar(YouTube) – This presentations provides an overview of the five principles of Housing First and their potential relationship to service delivery in a shelter or outreach setting. It also reviews the key elements of case management and engagement within Housing First.
Implementation Tools(PDF) – This report outlines tools developed to support organizations in implementing Housing First programs, particularly in Metro Vancouver. Resources developed provide an overview of the key components of a case management approach from a Housing First perspective, prioritization tools to identify client eligibility, and the HIFIS tools related to specific data entry and reporting requirements of the Housing First funding provided under the Homelessness Partnering Strategy (HPS).