Adapting ACT to Deliver Housing First: A Service Provider’s Perspective Pam Nir, Senior Manager, Cota, Toronto

ACT/ICM Teams Assertive Community Treatment (ACT): Multi-disciplinary team with wrap-around services Services and crisis coverage are available 24/7 Staff to client ratio of 1:10 Intensive Case Management Teams (ICM): Case managers have individual case loads Outreach and coordination with other services Extended evening and weekend hours Staff to client ratio of 1:16 2

ACT Eligibility Criteria 3

Catchment Area 4

HF: 6 Core Principles (Pathways to Housing) 1.Immediate access to housing with no housing readiness requirements 2.Consumer choice and self-determination 3.Individualized, client-driven and recovery-oriented supports 4.Separation of housing and services 5.Harm reduction 6.Community integration 5

Client Engagement Activities Housing is the primary objective. Other work can occur simultaneously but achieving housing is first objective ACT and ICM provide services and support in all aspects of choosing, getting and keeping housing Clinical teams assist clients to maintain independent housing Housing stability seen as crucial to the Recovery process 6

Clinical and Support Services Clinical services as homelessness prevention Eviction from housing is not discharge from clinical services Clinical services continue through housing loss, or relocations, in and out of hospital or jail ACT and ICM are community-based and can flexibly follow clients 7

Evictions and Rehousing 8

Guests Aggressive Behaviours Illegal Activity Unit Takeovers (guests) Tenancy Issues 9

When Clients Want to Move 10

Housing First Helpful Hint #1 11

Housing First Helpful Hint #2 12

Housing First Helpful Hint #3 13

Housing First Helpful Hint #4 14

Thank you! Pam Nir 15

Thank you! Pam Nir 16