Implementing Housing First

Dec 4, 2013 OMSSA Conference 2013

Dr. Abe OudshoornArthur Labatt Family School of Nursing

History of Homelessness• Pre-1977: transience and skid row• “Report on Skid Row” – City of Toronto

Planning Division, 1977

1977-1987

• Homelessness as a real problem in developed nations

• To 1985: 136,334 social housing units developed

• UN 1987 – International Year of Shelter for the Homeless

A Reaction• Food Banks Canada – 1989• 400 shelters developed across Canada by

1990 (including domestic violence shelters)• The charitable impulse

Current Situation

• 1,086 shelters; 28,495 shelter beds• 146,726 unique individuals accessed shelter• 5,263,182 shelter bed nights

The PressureWelfare Benefits

(1992 Dollars* )

$ 0

$200

$400

$600

$800

$1000

$1200

$1400

J an-35 J an-40 J an-45 J an-50 J an-55 J an-60 J an-65 J an-70 J an-75 J an-80 J an-85 J an-90 J an-95 J an-00 J an-05

Month

Mo

nth

ly W

elf

are

Be

ne

fit

($)

Single person Sole support parent with one child

* Deflated using C anada C PI

The Pressure

The Pressure

2007 2008 2009 2010 2011 2012 20130

50000

100000

150000

200000

250000

300000

350000

400000

450000

Foodbank Users per Month - Ontario

Foodbank Users per Month - Ontario

Ontario’s Affordable Housing Policy Vision

1. Demonstrating outcomes2. Housing First3. Collaboration with non-profit and private

market4. Integration with other services5. Priority populations6. Environmental sustainability

Housing First

• All things held equal…

Policy Issues

• Orders to reside

Policy Issues

• Hospital discharge to shelter

Policy Issues

• Rent supplement, direct to landlord

Fiscal Issue

Therefore…

• Where is the housing?

Housing First in Action

Existing Model

New Model• London CAReS• A municipal commitment• Flexibility• Monitoring outcomes• Outreach partnered with housing stability

20

Current Housing Status*as of August 31st, 2013

85%

Shelter 2

4%

Tenuously

Housed

36%

Incarcerated 12%

Residential Treatment/Hospital 2

4% Housed 46Shelter 2Tenuously Housed 3Incarcerated 1Residential Treatment/Hospital 2

21

Participant #8

Jun-12

Jul-1

2

Aug-12

Sep-12

Oct-12

Nov-12

Dec-12

Jan-13

Feb-13

02468

101214161820

# of Emergency Room Visits

# of Emergency Room Visits

Fiscal Impact

• $800 per ED visit• $335 per street arrest• $255 per night in prison• $75 per night in shelter

source: HomelessHub

Elucidating Outcomes

• Hours of service, number of contacts, satisfaction with service

Vs• Housing result, fiscal impact, health and QoL

outcomes

Managing Ending

Questions

Contact

aoudsho@uwo.ca

@abeoudshoorn