1. A study of HF programs Jeannette Waegemakers Schiff, PhD Faculty of Social Work, University of Calgary

2. Do different Housing First approaches have similar results in providing stable housing?

3. Housing First programs are supportive housing programs with additional features: tolerance for substance use permanent tenancy supports tailored to individual need clinical services NOT part of housing services Housing first programs typically provided by organization with a health care umbrella promote a “model of care” Have a clinical focus

4. Do Supportive “housing first” programs with different organizational structures deliver similar services? Do they have similar or different outcomes in housing retention? Are clients of these programs essentially similar or different? When client profiles are similar, are there organizational characteristics that can explain differences in outcomes?

5. based on the HF program model Pathways to Housing - Edmonton The Alex Pathways - Calgary At Home/Chez Soi (MHCC national study) based on HF philosophy Houselink, Toronto Mainstay, Toronto

6. Varied across programs and cities in the various studies All participants have a serious and persistent mental illness All receive income and housing entitlements Many have co-occurring alcohol and substance use problems All clients had a history of homelessness

7. Housing first programs: 2 year averages Pathways Edmonton 72% Pathways Calgary 72% AHCS 66% - 72% Toronto Supportive Housing providers 5 yr. averages Houselink 94% Mainstay 94.5%

8. Pathways and AHCS programs operate from a professional/clinical service delivery model – the professionals establish, organize and provide the services Houselink and Mainstay operate from a radically different organizational structure: The program acts in a dual capacity – as landlord and as providing support services. Consumers are tenants, not clients, and participate in organizational governance. Program encourages development of intentional communities. Multiple agency activities are designed for development and enhancement of living and social skills.

9. Organizational structure, mission, philosophy and culture are essential to establishment of a positive support services and housing environment ACT or ICM teams are not essential for Housing First success Scatter-site is not a determinant of housing stability: choice is. Housing supports are essential to housing tenure Eviction prevention as a policy and an organizational value is tantamount The “hard to house” may be kept more stably housed when the landlord is the services provider.