January 19, 2016 NAVNET-NLHHN Navigating Systems Workshop

 We are a community- led, multi-stakeholder Board founded in 2000, committed to ending homelessness.  We have a plan – not a dream – to achieve this.  As the only designated community in NL under Canada’s Homelessness Partnering Strategy (HPS), we’ve levered provincial, municipal, business & philanthropic investment with $21.8 million from HPS towards local solutions.

 We believe every person has a right to safe, appropriate housing and supports tailored to their strengths and needs.  To develop and implement an integrated, coordinated community plan to prevent, reduce and end homelessness.  As the ‘backbone’ for the Plan, our Board – in partnership with the City of St. John’s – is entrusted with resources from the Homelessness Partnering Strategy and others to translate this belief into meaningful, concerted action.

 In 1998, St. John’s joined municipalities across Canada calling for national action to address Canada’s growing homelessness.  In 1999, Canada announced the $119M/year Homelessness Partnering Strategy (HPS), to be delivered by 61 designated communities through Employment & Social Development Canada.  St. John’s is the only designated HPS community in NL.

 (HPS) Homelessness Partnering Strategy is recognized by UN Habitat as a best practice for addressing homelessness. ◦ Community Plans, plus resources, based on local priorities.

 Canada’s 10 big communities share 80% of HPS national funding.  51 other communities (including St. John’s) share 20%.  In Atlantic Canada: ◦ NS – Halifax, Sydney ◦ PE – Charlottetown, Summerside ◦ NB – Moncton, Saint John, Fredericton, Bathurst ◦ NL – St. John’s ◦ NL - Rural & Remote: Grand Falls-Windsor)

 237 supportive housing beds (163 units).  37 transitional housing beds (22 units).  63 emergency shelter units That’s 337 spaces to date  Plus a range of initiatives to engage partners, raise awareness, mobilize knowledge, and build capacity (including investments in the City’s housing action).

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 Under the HPS model, Community Entities are invited by the Community Advisory Board to administer the federal funds based on the CAB’s Community Plan priorities.  The Community Entity – or CE – enters into an agreement with Service Canada to perform this role in exchange for receiving up to 15% of the total HPS community allocation to offset administrative costs.  The City of St. John’s was a founding member of End Homelessness St. John’s & became its CE in 2012.

 Community Services Department manages the CE Agreement: ◦ Employs a contractual Community Development Worker with HPS funds. ◦ Provides in kind administration through its Non Profit Housing Manager.

Judy Tobin, Non Profit Housing Manager Bruce Pearce, Community Development Worker

 Starting January 2016, Andrew is our Local Coordinator for EHSJ’s Housing First System Coordination Framework initiative.  Part-time contract, and we intend to grow this to full-time in May 2016.

 Prior to consulting, Alina was the Vice President of Strategy for the Calgary Homeless Foundation where she led program investments of more than $35M annually, system planning and integration, the Homeless Management Information System, research and policy.

Dr. Stephen Gaetz

Communications & Fund Development CommunicationsFund Development 15 Rosalie Courage Patrick Martin

16 Community Planning Forum, May 2014 Housing First: Homelessness strategy headed in a new direction: The Telegram, May 28, 2014

1. End chronic and episodic homelessness. 2. Re-house and support homeless persons, and prevent homelessness for those at risk. 3. Reduce the average length of stay in emergency shelters. 4. Develop a coordinated homeless-serving system. 5. Enhance the integration of public systems to reduce discharging into homelessness. 6. Align resources and funding across diverse sectors to support the St. John’s Plan to End Homelessness. 17

Organize the homeless-serving system. Implement coordinated access & assessment. Develop discharge planning measures. 1. System Coordination Implement an integrated information system. Build partnerships with the research community. 2. Information & Research Support measures to increase housing affordability & reduce homelessness risk. Introduce & ramp up a range of Housing First programs. Tailor supports to meet the needs of diverse groups. Support the enhancement of service quality & impact. 3. Housing & Supports Develop the infrastructure necessary to implement the Plan. Coordinate funding to maximize impact. Champion an end to homelessness. 4. Leadership, Resources & Engagement Priorities in detail:

 St. John’s aims to be the 1 st Atlantic Canada community to end chronic & episodic homelessness – by  Once we’ve ended chronic homelessness, it will never return to our community.

2014 Establish a solid foundation 2015 Housing First ramp-up to end chronic & episodic homelessness 2016 Moving upstream: Homelessness prevention & rapid re-housing 2017 Maintain focus 2018 Focus on sustainability 20

 Guided by Housing First principles.  Meaningfully engaging our communities.  Through inclusion, collaboration & consensus.  Having each other’s back.  Leaving our hats at the door.  Learning & doing together.  Celebrating our milestones, acknowledging & overcoming our hurdles.  Assessing our progress, using ‘ground truth’.

Board System Coordination Information & Research Housing & Supports Leadership, Resources & Coordination Executive Community Entity (City) End Homelessness St. John’s Priority Teams

End Homelessness St. John’s – Meet our Board Shawn Skinner (Chair) To be recruited Rotary Club – St. John’s Northwest Elizabeth Davis, Co-chair, The Gathering Place Tammy Davis, Executive Director, United Way of NL Aisling Gogan, Coordinator, Poverty Reduction Strategy, Dept. of Seniors, Wellness & Social Development Adrice King, Acting Senior Development Officer, Service Canada (Ex-officio) Cynthia King, Director, Income & Social Supports, Dept. of Advanced Education & Skills Bruce Pearce, Community Development, End Homelessness St. John’s (Ex-officio) Sheldon Pollett, Executive Director, Choices for Youth Colleen Simms, Special Advisor to the Minister, Mental Health & Addictions, Department of Health & Community Services Gail Thornhill, Director of Supportive Housing, Stella’s Circle Gail Tobin, CEO, Iris Kirby House Judy Tobin, Manager, Non Profit Housing, Community Services Dept., City of St. John’s (Ex-officio) Madonna Walsh, Manager, Affordable Housing, NL Housing Jenny Wright, Executive Director, St. John’s Status of Women Council/Women’s Centre

A closer look

During 2012:  1,685 individuals required emergency shelter (this includes domestic violence shelters)  141 Individuals experienced unsheltered homelessness (people living on streets, in wooded areas, etc..)  3,743 individuals experienced hidden homelessness (temporarily living with friends or relatives)  An estimated total of 5,569 persons in NL experienced homelessness. 25

A breakdown of the 1,685 sheltered homeless estimate: 26 Region St. John’s854 Rural Avalon154 Burin124 Clarenville & Gander114 Grand Falls- Windsor34 Stephenville92 Corner Brook- St. Anthony 143 Labrador170 Total1,685

80% transitional ~ % episodic ~ % chronic ~40 St. John’s homeless population ~800 27

 A chronic shelter user is one that has stayed at shelters for more than 180 days in the past year.  An episodic shelter user is one who has three or more episodes of homelessness in the past year. A single stay or stays within 30 days of each other are considered an episode. (A new episode is counted when a user stays at a shelter after 30 days since their last stay at a shelter). Our Plan (including ICM) must start here and house 90% of these populations first – then we can shift our focus ‘upstream’.

 Chronic: Those who have either been continuously homeless for a year or more, or have had at least four episodes of homelessness in the past three years. In order to be considered chronically homeless, a person must have been sleeping in a place not meant for human habitation (e.g., living on the streets) and/or in an emergency homeless shelter.  Episodic: A person who is homeless for less than a year and has fewer than four episodes of homelessness in the past three years.  Transitional: A person who experiences homelessness for a short time and infrequently in their lifetime. Usually, this is a result of lack on income or housing affordability challenges. Most of these persons exit homeless with minimal or no intervention.

 61.5% males  38.5% females  17.7% families  9.2% youth  16  30% youth Data not available for:  Aboriginal or ethnic identity, migration, rough sleeping, those with No Fixed Address (institutions, hotels).  61.5% males  38.5% females  17.7% families  9.2% youth  16  30% youth Data not available for:  Aboriginal or ethnic identity, migration, rough sleeping, those with No Fixed Address (institutions, hotels). St. John’s shelter use 31

 Main reasons for service: ◦ Partner abuse, eviction, personal safety, lack of housing, family/relationship breakdown.  Contributing factors: ◦ Mental health issues, substance use, conflict with the law, lack of housing (eviction, unsafe, etc.), family/relationship breakdown.

 To better understand the homeless population, communities are doing Point-in-Time Counts.  St. John’s will conduct its first Count during Fall  EHSJ has also recruited the NL Statistics Agency in partnership with NL Housing & the NLHHN to develop data sharing & coordination.

 Commitment to evidence-based decision-making and planning, a “Homelessness Research Agenda” will be built into our community's approach to system planning.

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 The cost of intensive service use by just 12 individuals with complex needs in St. John’s (the chronic homeless, including people with addictions & mental illness): $1,345,000 in 6 months Eastern Health cost analysis

From managing homelessness, to ending it

 There’s strong alignment between our Community Plan to End Homelessness and: 1. Directions proposed in A Road Map for Ending Homelessness in Newfoundland and Labrador; and 2. Priorities raised in the NL’s Primary Health Strategy, the Poverty Reduction Strategy consultations, and the deliberations of the All Party Committee on Mental Health & Addictions.

 With regard to provincial government leadership – given that the issues and therefore solutions to homelessness cut across multiple government department policies & mandates, we recommend: NL’s plan to end homelessness be housed directly within central government – working in equal partnership with communities & service providers. 39

 Edmonton's homeless population decreased by 29.4%.  Wood Buffalo's (Fort McMurray) homeless population decreased by 43.7%.  Lethbridge's homeless population decreased by 58.7%.  Medicine Hat reported a 32% reduction in shelter use, and will become the 1 st Canadian community to end chronic homelessness in  This demonstrates the value of supporting community plans as part of a provincial plan. 40

Alberta's Human Services Department provides seven communities with $82.6 million annually through the Outreach Support Services Initiatives to implement local plans to end homelessness (this is new funding, not re- allocated). Alberta Health also provides $5 million from the Addiction & Mental Health Strategy to the ministry of Human Services. The 7 cities/organizations (akin to End Homelessness St. John’s) in turn provide the funds to homeless serving agencies in the seven cities. Funds are invested in community plan priorities which also address provincial outcomes. End Homelessness St. John’s seeks a similar coordinated funding partnership with the Government of Newfoundland & Labrador. 41

Ending chronic & episodic homelessness in St. John’s, NL

43 Navigators & Networks

A Partnership between Eastern Health, the Government and the Community. This team is working together to transform our systems response to those with “complex needs” in St. John’s from a fragmented, often band-aid response, to a coordinated and responsive model of service delivery. 44

 100% have maintained stable housing since  85% decrease in use of the Waterford Hospital Psychiatric Assessment Unit. Some examples:  Prior to NAVNET, a client spent 253 days at the Waterford Hospital in 1 year. Their hospital stays fell to 132 days during their 1st year with NAVNET. When housed with supports, their hospital stays dropped to 30 days the next year.  One client moved 13 times during the year prior to NAVNET. This fell to 2 moves following intake.  Rates of involvement with the justice system also fell 60% for NAVNET participants. Re-offences tended to be less serious crimes (i.e. mischief vs assault). 45

Stella’s Circle Community Support Program: 5 of 40 participants are engaged in NAVNET. Program evaluation: 73% reduction in average number of prison days. 39% reduction in hospital days. Brian Martin Housing Resource Centre: 129 individuals were assessed with moderate to high acuity (need & complexity). 51 were housed. 66% of these persons remain stably housed. 46

Choices for Youth 9 of 10 current clients have stable housing. The 10 th client is in a temporary living arrangement with support staff. One client transitioned from a mental health facility to semi-independent living, to independent living (with supports from Moving Forward) 73% of overall participants secured stable housing. 80% attended all medical, psychiatric, dental, optical, legal, school & counseling appointments (that’s 1,800 appointments). 76% of prescribed medication was distributed and/or consumed. 47 Moving Forward Program

A closer look

Higher Needs Permanent Supportive Housing (Assertive Community Treatment) Moderate Needs Intensive Case Management, Transitional Housing Lower Needs Prevention, Rapid Re-housing, Affordable Housing 49

Housing First Programs Intensive Case Management & Housing Supports Permanent Supportive Housing Assertive Community Treatment Prevention & Rapid Rehousing 50

EHSJ Programs: Client TypeTotal Estimated Individuals Served Intensive Case Management (Launching 2015, sustain to 2019) Chronically & episodically homeless 155 Permanent Supportive Housing (capital) ( ) Chronically homeless13 Prevention & Rapid Re-housing (Launching 2016, sustain to 2019) Transitionally homeless 300 (approximately 200 households) Total

Community Plan Investment Projections HPS Confirmed Contributions Needed Total Housing First System Coordination 1,099, ,198, Permanent Supportive Housing (Capital) 697, , ,500, Permanent Supportive Housing (Operations) 600, Intensive Case Management & Housing Supports 1,097, ,480, ,578, Rapid Re-housing/Prevention592, ,185, TOTAL $ 3,487, ,575, ,062,425,90 52 $4.596 million yet to be raised (approximately $1.15 million per year)

 We see our Community Plan as a prime opportunity to address shared priorities, build partnerships with all governments & sectors, and forge an integrated system to end homelessness.  Let’s open new doors together!

54 Contact: Bruce Pearce End Homelessness St. John's