© 2013 Canadian Homelessness Research Network

ISBN 978-1-55014-637-0

Gaetz, Stephen; Scott, Fiona; & Gulliver, Tanya (Eds.), Housing First in Canada: Supporting Communities to End Homelessness. Toronto: Canadian Homelessness Research Network Press.

Hosted by the Homeless Hub

http://www.homelesshub.ca/housingfirstcanada

Canadian Homelessness Research Network Press

6th Floor, Kaneff Tower

4700 Keele Street

Toronto, ON M3J 1P3

thehub@edu.yorku.ca

www.homelesshub.ca

Cover and Interior Design: Stephanie Vasko

This book is protected under a Creative Commons license that allows you to share, copy, distribute, and transmit the work for non-commercial purposes, provided you attribute it to the original source.

The editors wish to acknowledge the work of Sarah Jean Harrison and KC Santo who provided excellent copy-editing services. We would also like to thank the key informants who contributed to the development of each case study: Tim Richter, Katrina Milaney & Alina Turner (Calgary – Calgary Homeless Foundation), Kim Wirth/Katie Davies (Infinity Project), Brad Crewson (Victoria), Amanda DiFalco (Hamilton), John Sharpe & Timothy Ross (Fredericton), Amelia Ridgway (Vancouver), Wally Czech (Lethbridge) and Susan McGee & Alex Abboud (Edmonton).

The Canadian Homelessness Research Network (CHRN) acknowledges with thanks the financial support of the Government of Canada’s Homelessness Partnering Strategy (Employment and Social Development Canada) and the Social Sciences and Humanities Research Council of Canada. The analysis and interpretations contained in the chapters are those of individual contributors and do not necessarily represent the views of the financial contributors of the CHRN. The views expressed in this book are those of the Canadian Homelessness Research Network and do not necessarily reflect the views of the Government of Canada.

Community Action Group on Homelessness

Fredericton NEW BRUNSWICK

Fiona Scott

Key Messages

• This is a case study of a developing systems response to Housing First thus providing a glimpse of a very different stage of development.

• Smaller and more rural city than many of the other case studies profiled.

• Includes information about how different groups are responding to the same issue within the city.

Fredericton is a small city in New Brunswick on Canada’s east coast with a population of 125,000 in the Greater Fredericton Area. The city has the highest average cost of rental accommodation in the province and the lowest vacancy rates (CAGH, 2012).

In 2012 there were 262 individuals who accessed the City’s shelter system (Ross, Personal Communication, 2013). Between 2008 and 2012, there was a 40% drop in shelter use in Fredericton from 432 individuals in 2008 (Ross, 2013), despite declining rental vacancy and increasing rents. This marks the fifth consecutive year that shelter utilization has decreased. One factor in the reduction of shelter usage is the work being done by outreach social workers and the community on Housing Loss prevention, which has reduced the return rate to shelters of previous residents.

However, guidelines provided by the Wellesley Institute’s report, Precarious Housing in Canada (2010), mean that as many as 1,300 people could be considered part of the hidden homeless population in Fredericton.

The Province’s housing strategy report, entitled Hope is a Home, as well as the accompanying homelessness framework (Government of New Brunswick, 2010) in 2009-2010, resulted in a number of changes to the way homelessness was addressed that contributed to the decrease in shelter use. Strategies outlined in the report included: an increase in the creation of new affordable housing, the creation of a supportive housing network, a focus on ‘organized’ departures, and a move towards a Housing First systems approach. The publication of Overcoming Poverty Together: The New Brunswick Economic and Social Inclusion Plan, set a significant goal that could further contribute to success in Fredericton. This plan states that “by 2015, New Brunswick will have reduced income poverty by 25% and deep income poverty by 50%, and will have made significant progress in achieving sustained economic and social inclusion” (Government of New Brunswick, 2009).

Despite the decline in shelter use, the problem of homelessness is not going away just yet. Several indicators suggest hidden homelessness continues to rise, including1:

• There are few housing options for individuals with addiction issues or other complex needs (for example, Fredericton only has dry shelters and lacks sufficient harm reduction service models).

• There is increasing demand for access to Chrysalis House, a transitional housing program for female youth.

• There are no emergency shelter options for male youth in Fredericton.

• There is increasing demand for the food bank and community kitchen as food insecurity increases.

• Housing insecurity is on the rise. More people are at risk of homelessness due to precarious housing situations (for example, paying more than 30% of their income towards the rental cost of a unit).

Traditional services for people experiencing homelessness in Fredericton, much like the rest of the country, were originally focused on supporting people with other issues, including mental health and addictions, before providing housing. The success of other Housing First programs in Canada, with Moncton, New Brunswick, as one of the pilot sites of the At Home/Chez Soi project, has helped to increase awareness and support for the model. As a guiding philosophy, Housing First is emerging as the motto of the organizations addressing homelessness in Fredericton.

Overall, reducing and preventing homelessness in Fredericton will depend on a number of significant factors, including a continued investment in affordable housing and the provincial housing and homelessness frameworks (which include a Housing First approach). To date, the Province’s Poverty Reduction Strategy has reformed New Brunswick’s income supports and social assistance policy which has contributed to the declining numbers.

There are multiple groups working on the development of the Housing First model in Fredericton including the Supportive Network (SUN), a group of front-line service providers and government partners, as well as the Community Action Group on Homelessness (CAGH), a network of frontline service providers, government liaisons, and community leaders, who are working to address homelessness. CAGH was born out of the National Homelessness Initiative’s Supporting Community Partnership Initiatives (SCPI), renamed the Homelessness Partnering Strategy (HPS) as of 2007. These two groups have allowed for systems planning and visioning towards ending homelessness in Fredericton. CAGH believes one of the fundamental principles of ending homelessness is “a system built around Housing First works best” (CAGH, 2012:3).

Although a Housing First systems approach has been adopted in Fredericton, the planning and implementation of Housing First programs vary; some are in the planning stages and others in early years of operation. In late June 2013, CAGH convened a large-scale systems planning table to revise the mission, vision and objectives of the model, and to develop a multi-year plan to end homelessness, based on a coordinated system of care that utilizes both prevention and Housing First strategies. CAGH plans to have completed the development of this new approach by the fall of 2014.

One of the most important tools of development for this plan has been community engagement and education. The housing and homelessness sectors are on-board in terms of Housing First implementation. An ongoing dialogue about the Housing First framework has been significant in fostering support and funding for the important changes to the housing and homelessness system of care within the city.

The success of the John Howard Society’s permanent supportive housing program, created in 2010, and the work of the Supportive Network are both strong indicators of how Housing First strategies can impact the issue of homelessness in Fredericton.

The purpose of this study is to provide an overview of CAGH’s experience with planning new Housing First strategies, as well as some of the barriers they anticipate and how they plan to address them.

GETTING STARTED: FRAMING THE ISSUE

The growth of other Housing First program models and demonstrated effectiveness, in Canada and internationally, highlight the humanitarian and moral arguments for providing people with housing; housing is a basic human right, a right everyone deserves. The evidence increasingly indicates without a home, it is often much more difficult for people to address other issues contributing to their circumstances. Stakeholders and communities alike are beginning to see the cost benefits of providing housing, particularly in relation to health.

In his column entitled ‘Poverty Matters’ in the Fredericton Daily Gleaner, Brian Duplessis, former Executive Director of the United Way/Centraide of Central New Brunswick wrote:

"When we know that providing emergency service to a homeless person can run as high as $100,000 per year, and we also know that following the Housing First approach can reduce that to as little as $14,000 per year, why aren’t we rushing to implement it?"

Based on the province’s homelessness framework and housing policy, several initiatives in the city moved towards a different approach to homelessness, an approach that resembled the philosophy of Housing First. For example, in the summer of 2010, the 'Supportive Network' was established by community partners in an effort to support people forced to use the shelter system as long term housing into permanent affordable housing. The network includes a cross section of workers from social organizations including social workers, outreach staff, mental health and addiction help providers, income support institutions, occupational therapists and staff from long-term care facilities. Since early 2010, 52 people who were living in shelters or were at-risk of becoming homeless were provided with affordable housing and ongoing support (John Sharpe, Personal Communication, 2013). In addition, as part of the framework, shelters were given additional resources to help individuals achieve ‘organized departures’, rather than evictions. An ‘organized departure’ means helping people find housing and providing them with the supports they need to get out of homelessness.

The two other big components of the community plan believed to have made a significant reduction in shelter use, are:

1) An investment in housing-focused outreach services that connects individuals with access to housing as soon as possible, helping them gain an income and access to community supports. Since 2010 this service has been successfully developed and operated by Partners for Youth Inc. (P4Y). This program includes three full-time registered social workers who connect with clients in the emergency shelter system, the soup kitchen and various community based locations. One social worker provides support to clients once they are housed. The other two work as a triage system (one working with clients under 36 years of age, the other with clients above 36 years of age) to help move people out of the shelter system very quickly. Ongoing supports and connections to partner agencies are provided once housing has been established. Funding for this approach is provided by the Federal Homelessness Partnering Strategy and the Provincial Department of Social Development. The partnership with the Fredericton Homeless Shelters and the provincial government has been significant in terms of communications and the sharing of resources. This partnership has been a key component to the overall success of outreach services in the community.

2) There was a lack of permanent supportive housing (PSH) in the area which created a gap in services. In October 2010, the John Howard Society opened the doors of a new 12 unit affordable housing program that was based on the philosophy of Housing First.

Data was collected with people upon entry to the program, as well as one year later. The data showed a significant reduction in: emergency health use (from 136 nights in hospital to 17), justice system interactions (from 465 to 30) and stays in detoxification units (from 98 to 12). These results suggest a significant cost savings in other social services as a result of providing housing and support (Ross, 2012).

Over the last few years CAGH has leveraged an unprecedented level of support in ending homelessness. One of the events that contributed to this change was a tragic rooming house fire in 2012 in which 26 people lost their homes. Key partners in the housing sector pulled together to house them in 55 days. Given this success, community members and organizations realized if it could be done for those 26 people, it could be done for others.

“What a difference there was between finding suitable accommodations for all 26 within 55 days and the grim stories of homelessness we were dealing with such a short time ago one man in his 50s in the homeless shelter for 19 years; several others in the shelter for five to seven years. The capacity to respond to the aftermath of the fire evolved out of the collaborative work done to reduce the use of the shelters by 30% – work by members of the Community Action Group on Homelessness (CAGH), local churches and other volunteers. We know it’s possible to end homelessness, not just manage it as we have for the last few decades” (Brian Duplessis, Former Executive Director, United Way/Centraide of Central New Brunswick).

After the fire, CAGH began an awareness campaign which culminated in a public engagement fundraiser. In March 2013, the fundraiser, a community discussion, entitled Let’s Get Frank About Homelessness, was held. The event featured keynote speaker Frank McKenna, former premier of New Brunswick, and a panel that included Tim Richter, then Director of the Calgary Homeless Foundation (CHF). The proceeds went towards affordable supportive housing in Fredericton, which included a pledge of $100,000 by Frank McKenna that helped to leverage corporate sponsorships.

Since then, more people have begun to embrace the Housing First philosophy. The more people who understand the program and its potential, the easier it will be to make it a successful program. Community engagement will therefore continue to be an important part of planning Housing First services in Fredericton.

MOVING FORWARD: PLANNING

Agencies within the City of Fredericton are at a mixed stage in the development and enhancement of a city-wide Housing First philosophy. The next steps and potential challenges have been identified to include:

Agreement and Understanding of the Housing First Model

There appears to be explicit agreement among all homelessness sector and housing organization that Housing First is the right approach to solving homelessness in Fredericton. Expanding this to other areas including health, education, emergency response, corrections and the general community will involve more dialogue and education to increase understanding of Housing First and its principles. CAGH has strengthened the network and community understanding about a plan to end homelessness in Fredericton and will leverage this network to access the required support and resources. The work will be guided by templates for ending homelessness developed by the CHF and the Canadian Alliance to End Homelessness (CAEH). These include four strategies (one being Housing First) and 10 essential elements of Plans to End Homelessness (for more information see Calgary’s 10 Year Plan to End Homelessness and the CAEH’s planning framework A Plan, Not A Dream).

Coordinated Entry

In recent years, there have been increased communication and referrals between sectors. While there is not a coordinated system of care to address homelessness in Fredericton in terms of a common intake or assessment program, partners are working together to share information. Each new client to a shelter must contact a social worker (provided through Partners for Youth) within 48 hours of arrival in the shelter. When a hospital or jail makes a referral to a shelter, they also provide information to Partners for Youth about the new, incoming client.

A database or comprehensive coordinated entry system – in other words developing one centralized point of access to all programs in the community that are working to address homelessness – will be an essential next step. Also known as coordinated intake or assessment, coordinated entry means everyone seeking assistance with housing completes the same assessment process, enabling service providers to match the level of housing and supports to an individual’s need. CAGH continues to work to bring the key players together, and will seek expert consultation on the development of coordinated entry. Some members of the Supportive Network use HIFIS, an information management system to collect data on clients but it isn’t a pure coordinated entry intake. Social Workers gather ‘tombstone information’ (e.g. name, age, gender, date of birth) as well as information about education, employment history, addictions, mental health etc. Partners for Youth and shelter staff work with each client to establish weekly short and long term goals as part of the exit plan from the shelter system and recovery plan.

Consumer Choice and Developing Landlord Relationships

The principle of consumer choice is currently difficult to achieve based on the housing available in Fredericton. Increasing access to different types of housing, in different locations, will require a concerted effort to develop relationships with landlords. Social workers have built several successful partnerships with landlords. The limited numbers of landlords within the city means that a new building may still be run by a known landlord, although the property manager/superintendent may be different. CAGH intends to consult with other Housing First programs and experts to create a plan to successfully recruit willing new landlords and maintain tenancies with them in order to fulfill this principle.

Poverty and Barriers to Increasing Income

Providing people with housing will not necessarily address some of the underlying issues that contribute to homelessness, such as low income and poverty. As a small city, access to income and employment opportunities continue to be serious issues in Fredericton (CAGH, 2012). While there are also fewer opportunities for training and education, particularly for people experiencing low-income vulnerabilities, an increasing number of a training and education programs have been developed in recent years.

Low literacy levels also contribute to unemployment in Fredericton and throughout the province. Among the adult population in New Brunswick, more than half have “literacy skills that are considered to be below the level that enables them to function adequately at home, at work and in their communities, and to deal with the demands of a knowledge-based economy” (Government of New Brunswick, 2009:5).

Food security is a significant problem for many families in Fredericton, indicating the lack of buying power and prevalence of low income and poverty in the city. Recent research found food security is a problem across the province with New Brunswick having the third highest level of food insecurity in Canada (25%) (Tarasuk et al., 2011).

In order to support some people in maintaining their housing, there will need to be increased opportunities to develop skills, access training, education and more employment opportunities will be necessary.

Data and Technology

CAGH is keen to develop systems to monitor and evaluate the effectiveness of the Housing First approach in reducing homelessness in Fredericton. There are currently no solid data systems in place to accurately measure the outcomes of housing interventions. HIFIS and the ad-hoc data systems used by outreach social workers and SUN track some data but not all. The network plans to identify the key indicators that will be used to measure the outcomes of the program in the fall of 2013, and plans to bring in experts to implement a data monitoring system, such as the Service Prioritization Decision Assistance Tool (SPDAT) currently being used in other jurisdictions.

The SPDAT was originally developed for Housing First programs to prioritize who needed to be served next. It is a tool that assesses 15 different aspects of a person’s needs, including mental health and wellness, substance abuse, history of housing and homelessness, interaction with emergency services, self-care and daily living skills, and managing of tenancies.

Expert Advice

CAGH is aware of the extensive expertise already available in terms of planning and implementing Housing First systems and plans to make use of expert advice from across the country. The Canadian Homelessness Research Network (CHRN) has already been a valuable resource for knowledge mobilization tools and resources that will help with planning and implementation. The team feels like they don’t need to reinvent the wheel and can build on existing programs and practices from across Canada. The work being done by SUN has been replicated in Moncton and further plans are to replicate the approach in other regions as well.

To date, CAGH has brought Brigitte Witowski, Executive Director of Toronto’s Mainstay Housing, to Fredericton to talk about their programs and to learn about the supportive housing aspect of Housing First and the strategic partnerships required to sustain these programs. Tim Richter from CAEH has travelled twice to Fredericton to provide training and public awareness. Additionally, CAGH has participated in the Canadian Housing and Renewal Association’s Homelessness Learning Network for two years. This has enabled them to develop pan-Canadian connections to people with experience and expertise in this work.

Community Engagement

Community and stakeholder support is crucial for building and sustaining a Housing First program. In order to leverage more involvement and buy-in from community members, CAGH will be developing a community engagement process. The team will consult with other Housing First program providers and experts to develop an effective plan.

Accessing Funding for Rent Supplements

As in most other communities there is a lack of affordable housing in Fredericton, and many people face significant challenges in paying their rent. The average rental price in the housing market rose from $730 in 2010 to $747 in 2011. The City’s wait list for affordable housing also continues to rise: from 800 in 2010 to 982 in 2011 (CAGH, 2012).

Results from successful Housing First programs, including the initial results of the Mental Health Commission of Canada’s At Home/Chez Soi project, identify rent supplements as an essential component of Housing First. CAGH is also aware of the importance of rent supplements in order for people to access affordable housing. The rent supplements must be portable, or in other words, applicable to a range of housing options. Accessing funding for rent supplements is one of the key priorities for CAGH in planning their Housing First model.

Balancing Prevention and a Change in Service Delivery

Any kind of change can be difficult, particularly a significant change in the way an entire system functions. A Housing First approach is a major change from managing homelessness to reducing, and ideally preventing, it. In order to put significant and multiple resources into a new approach, existing services need to continue to evolve to address changes in programming required by a Housing First approach. In Fredericton, CAGH is conscious of this struggle to balance prevention strategies with an effective response to chronic homelessness. The team is currently trying to figure out how to go through that change process without sacrificing other effective interventions.

Strengths of the Approach in Fredericton

The advantage of planning and implementing a new system response to homelessness in Fredericton is the size of the community. Although a smaller city lacks big city resources, there is potential for a more cohesive network. Currently all of the major players in the homelessness system of care are at the systems planning table – outreach services, emergency shelters, social development agencies, housing providers, and mental health and addiction services are becoming more coordinated in a formalized way.

THE HOUSING FIRST MODEL IN FREDERICTON

The Housing First Model in Fredericton will be based on the following core principles, in line with the Canadian Homelessness Research Network’s A Framework for Housing First (Gaetz, 2013):

1) Immediate or rapid access to housing, with supports to maintain it.

2) Consumer choice and self-determination.

3) Not conditional on sobriety.

4) Community inclusion.

As with most other Housing First programs, the initial focus will be on supporting people experiencing chronic homelessness as a starting point. The goal will be: if someone accesses a system of care that responds to homelessness, this person will not be without support and/or housing, or will not stay in shelters or sleep on the streets, for more than 14-21 days. This figure will guide the analysis of the effectiveness of the new response to homelessness.

NEXT STEPS: IMPLEMENTING AND SUSTAINING HOUSING FIRST IN FREDERICTON

Although the development of the Housing First systems model and programming is in the early stages in Fredericton, success of the SUN program shows that Housing First can work in Fredericton. SUN reports a 93.5% housing success rate after 6 months of occupancy (Sharpe, 2013). CAGH is confident the recent renewal of the federal government’s HPS five-year plan, as well as Fredericton’s commitment to affordable housing, will help continue the momentum to implement effective interventions that will change the focus from managing to solving homelessness.

The heightened level of awareness of the problem of homelessness in Fredericton, and effective solutions, will ideally lead to more capital being leveraged from charitable markets, allowing the development and implementation of more Housing First programs.

The CAGH team believes all the resources are available to implement a coherent and coordinated systems approach that will effectively reduce and eventually eliminate homelessness in Fredericton.

REFERENCES

Community Action Group on Homelessness. (2010). Experiencing Homelessness: The 3rd Report Card on Homelessness in New Brunswick. Retrieved from http://www.cagh.ca.

Community Action Group on Homelessness (2012). Experiencing Homelessness: The 4th Report Card on Homelessness in New Brunswick. Retrieved from http://www.cagh.ca.

Duplessis, Brian. (2013). McKenna gets frank about homelessness. Fredericton Daily Gleaner. March 7th 2013. Retrieved from http://www.cagh.ca.

Government of New Brunswick. (2009). Working Together for Adult Literacy: An Adult Literacy Strategy for New Brunswick. Retrieved from www.gnb.ca.

Government of New Brunswick. Economic and Social Inclusion Corporation. (2009 ). Overcoming Poverty Together: The New Brunswick Economic and Social Inclusion Plan. Retrieved from http://www2.gnb.ca/content/dam/gnb/Departments/esic/pdf/Plan-e.pdf .

Government of New Brunswick. New Brunswick Housing Corporation, Department of Social Development. (2010). Hope is a Home: New Brunswick’s Housing Strategy. Retrieved from www.gnb.ca.

Ross, T. (2012). Homelessness in a big town, small city: Supportive housing network in Fredericton, NB. Retrieved from http://www.chra-achru.ca/media/content/SUN%20presentation%20-%20May%204%20-%20CHRA%20Tim%20Ross.pdf

Ross, T. (2013). Personal Communication.

Sharpe, J. (2013). Personal Communication.

Tarasuk, V., Mitchell, A., Dachner, N. Research to identify policy options to reduce food insecurity (PROOF). (2013). Household food insecurity in Canada 2011. Retrieved from http://nutritionalsciences.lamp.utoronto.ca/

ENDNOTES

1. Adapted from Experiencing Homelessness: the 3rd Report Card on Homelessness in New Brunswick. Fredericton Edition. http://intraspec.ca/CAGH_Fredericton_Report-Card-on-Homelessness.pdf