© 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.

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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.

Streets to Homes

Victoria BRITISH COLUMBIA

Fiona Scott

Key Messages

• Shows how a program from a large city can be adapted and replicated in a smaller community.

• Provides options for providing housing in a tight housing market including a unique Private-Public Housing Initiative.

• Focuses on episodic and chronically homeless individuals with a mental health and/or addictions issue.

In Victoria, British Columbia, one of Canada’s most expensive cities, high rents and low vacancy rates means homelessness is a critical issue for the city. In 2007, a Mayor’s Task Force was established to explore improving how some of the city’s social problems were addressed. The report, Breaking the Cycle of Mental Illness, Addictions and Homelessness, identified an annual expenditure of $76 million on over 200 organizations addressing the needs of individuals experiencing homelessness and/or mental health and addiction challenges. At least $62 million in additional funding was spent on additional services, such as policing, jails, hospital services and emergency shelters (Mayor’s Task Force, 2007). Despite this spending, many needs remained unmet.

Breaking the Cycle established a plan to address the disparity between spending and outcome, mandating that

“[t]he outcome of the work will be the identification and costing of options for a comprehensive, integrated, client-centered model to support those most vulnerable to homelessness, inadequate housing, poverty, mental illness and addictions, along with recommended next steps for implementation” (Mayor’s Task Force, 2007:4).

In 2008, resulting from Breaking the Cycle’s recommendations, the Greater Victoria Coalition to End Homelessness was formed. The Coalition is a community-based partnership of local service providers, non-profit organizations, all levels of government, businesses and post-secondary and faith communities. The Coalition’s goal is to end homelessness in the Capital Region by 2018.

The Coalition brought together different partners and jurisdictions to create an integrated and coordinated service delivery model addressing chronic homelessness in Victoria. The Coalition also wanted to complement significant investments already made in the region, such as Assertive Community Treatment (ACT), the Victoria Integrated Community Outreach Team (VICOT), the Ministry of Social Development’s Homelessness Intervention Project (HIP) and other non-profit programming in the sector.

When exploring how other jurisdictions across Canada were organizing to end homelessness, the Coalition found Toronto’s Streets to Home program. Established in 2005, the program was having great success in housing people and supporting them in remaining housed. Based on Toronto’s example, the Coalition initiated the Greater Victoria Streets to Homes (S2H) Program pilot project in April 2010. While Pacifica Housing has taken over administrative responsibility for S2H it is essentially the same program with minor changes and innovations as the program evolves.

This case study presents an analysis of Victoria’s S2H Housing First program. The study focuses on the underlying principles of the program, the process of building support for the initiative, planning and implementation challenges and evidence of success. The case study concludes with the central findings learned from this Housing First program.

GETTING STARTED: FRAMING THE ISSUE

Housing First, as a concept, had been operating in Victoria on a small scale since the early 1990s. Pacifica Housing had operated low-barrier, harm reduction-based supportive housing programs in four buildings beginning in 1988 with Medewiwin, a project of The Victoria Street Community Association (Pacifica took over management in 1999). They added Waterview in 2008, Clover Place in 2010 and Camas Gardens in 2011. The idea of providing housing plus supports to address homelessness was not a new approach in Victoria, however it had not been implemented on a large scale as the main intervention format.

The Mayor’s Task Force Report Breaking the Cycle (2007) demonstrated the need to change the status quo of service delivery to people experiencing homelessness, mental health and/or addiction challenges. At the same time, there was growing frustration around the number of people cycling in and out of the shelter system. The community wanted change for its citizens experiencing homelessness.

It was clear to those planning and delivering services in Victoria that Housing First would be an integral part of solving homelessness in Victoria. Because there was no capital funding available to provide new housing, the Coalition team knew that rent supplements delivered through the program were essential to providing housing. Pacifica Housing’s experience with managing private market landlord relationships also informed the city’s programs.

Increasing support for the Housing First model required involving multiple sectors of the community in education outreach and dialogue. Frontline service workers from a variety of housing-related organizations were brought together to learn about the program and its goals and to participate in community discussions. The team also held sessions with landlords that asked for their involvement and shared with them how the Housing First model would work in Victoria. The success of Housing First programs in other areas, including New York, validated investment in Victoria’s program.

The shortage of affordable, next-step housing was another factor framing Victoria’s Housing First approach. Supportive housing providers and stakeholders were aware that some people living in supported housing no longer needed intensive supports. However, because of the lack of affordable, next-step market housing clients would remain in supportive housing unnecessarily. Implementing the Housing First model with flexible program delivery would allow those no longer needing supportive housing to move into market housing and free up spaces for those who needing support.

Improved access to affordable market housing was facilitated by the Rental Owners and Managers Society of BC (ROMs). Based on Pacifica Housing’s programs that provided support to both the landlord and resident, ROMs saw an existing and successful Housing First model that they could support.

MOVING FORWARD: PLANNING

Learn From Other Housing First Programs…

One of the Coalition’s first steps in developing city-wide Housing First in Victoria was looking at the models other communities had used to effectively reduce homelessness amongst vulnerable populations. In 2009, research and stakeholder discussions revealed a variety of programs active in a number of jurisdictions across North America. Toronto’s Streets to Homes program had impressive outcomes in terms of reducing homelessness and was an excellent example of using strong private market partnerships to access housing for clients.

…But Adapt to the Local Context

Toronto’s Streets to Homes program was chosen as Victoria’s Housing First model because it offered a Canadian program functioning in a political climate similar to Victoria. However, despite these similarities there were a number of differences that emerged from the context of program planning and implementation. The planning team knew that the housing markets in Victoria and Toronto were different: there were far more housing options and housing stock at lower rent levels in Toronto. Housing people in Victoria was going to present a challenge and would require building a relationship with an organization that could provide funding for rent supplements. The team partnered with BC Housing to cover these costs.

Attracting Landlords and Housing Providers

In order to secure housing for their clients, Housing First providers in Victoria had to build relationships with local landlords and housing providers. They had learned that landlords, as business-owners, were hesitant to accept clients who had been living on the streets. Landlords wanted to know that Housing First would benefit them and not just the client. Staff also discovered that rather than trying to convince landlords to support Housing First for the good of the community, landlords needed to hear that the initiative would not present a significant risk to them.

S2H staff conducted outreach with landlords by finding buildings, talking to landlords and learning about their common frustrations. Often landlords cited problem tenants as a barrier to participating in a Housing First program. To overcome this barrier, staff worked alongside clients and landlords to develop good relationships and ensure that supports were in place to remedy any potential negative situations.

THE STREETS TO HOME HOUSING FIRST MODEL IN VICTORIA1

The S2H program enables clients to find private market housing and provides rent subsidies and supports to maintain housing. S2H is based on the following principles, in line with those outlined in the A Framework for Housing First (Gaetz, 2013):

• Housing is a right and everyone is ready to be housed regardless of his or her circumstances and behaviours;

• Clients are not required to abstain from drugs/alcohol in order to be housed; and

• Clients need unique supports in order to stabilize and progress after being housed.

Target Population

S2H targets individuals who are experiencing chronic homelessness and who face barriers to stable housing including affordability, mental health and/or substance use challenges. To qualify for S2H, potential tenants must:

• Have experienced homelessness for at least 12 months in the past two years.

• Have an observable mental health or substance-use challenge.

• Accept the supports and terms of the program.

A network of agencies works together to address a client’s range of needs including:

• Help finding permanent private market housing;

• Providing a rent subsidy of up to $300;

• Assistance in building capacity to meet and sustain housing needs;

• Support and training in building capacity to navigate complex systems and self-advocate in order to meet personal needs;

• Case planning, community referrals and direct support services to address mental and physical health and/or substance use challenges;

• Assistance with obtaining new or increased benefits and subsidies;

• Access to support and training to increase skills including financial literacy, budgeting, general life skills and employability skills;

• Support in accessing recreational and social activities; and

• Assistance in finding meaningful ways to strengthen social inclusion.

Intake Process

In June 2012, the Greater Victoria Centralized Access to Supported Housing (CASH) was implemented. CASH is a centralized intake system that includes all supportive housing providers in Victoria, including non-Housing First programs. CASH is an administrative hub which can be accessed through most community service providers including hospitals, shelters, food banks health clinics, detox facilities and outreach programs.

The CASH system was developed in response to the identification of an administrative barrier to supportive housing in Victoria. Before centralization, clients applied directly to each of the housing providers in the city, completing a number of forms for each provider. Over eight months the intake criteria, assessment, infrastructure and funding were developed to create a centralized hub where anyone working with someone or directly experiencing barriers to stable housing could complete a single application and access the most appropriate housing, depending on vacancies, through the city’s various supportive housing providers including Housing First providers.

The S2H Frontline Service Worker Group (comprised of representatives from the Victoria Cool Aid Shelter, the Salvation Army and other partner agencies) meets weekly to review S2H referrals from CASH. The committee makes recommendations based on the applications and availability of housing.

Staffing

Follow up Support Workers (5)

Each client is assigned a Follow-up Support Worker (FSW), who works closely with the S2H Landlord Liaison and client to identify and secure a suitable and appropriate private market unit. FSWs also support clients in maintaining their housing by assisting in areas such as budgeting, apartment maintenance and facilitating access to community support. Two FSWs are funded and employed by the Victoria Native Friendship Centre (VNCF) while the other three are employed by Pacifica Housing.

Program Coordinator

The S2H Program Coordinator is responsible for areas such as financial management, program monitoring, data collection and reporting, policy development and program evaluation. This position is part of Pacifica Housing and reports to Pacifica’s Director of Support Services. The Service Integration Committee of the Coalition provides high level oversight for the program.

Landlord Liaison

The Landlord Liaison is an employee of Pacifica Housing who works to identify and build relationships with potential landlords in order to increase access to housing for participants. The Landlord Liaison also works with landlords to address any problems that arise.

MAKING IT HAPPEN: IMPLEMENTATION

The S2H program was based on Toronto’s successful Housing First model. However, the different housing and socio-economic situation in Victoria, including a low vacancy rate and lack of affordable private market rentals, meant that program adaptations were needed to address these challenges.

Extremely Low Vacancy Rate

Victoria generally experiences a very low vacancy rate (ranging between 0.5%-2.5% observed between 2005-2011) (Crewson, 2011). Although there is always tenant turnover, with rates so low in Victoria finding suitable housing can be a slow process.

Lack of Affordable Private Market Rentals

In response to high market demand, rental prices have risen beyond what is affordable for people living in poverty. The result is a significant lack of options for people who are experiencing homelessness or at risk. Greater Victoria, in contrast to many other cities, also has few other housing options such as Single Room Occupancy (SRO) hotels. This is in part because of the municipality’s closure of a number of poorly maintained, low-rent buildings. The Toronto S2H program also had the advantage of accessing public housing stock that included rent-geared-to-income social housing.

One Solution: the Private-Public Housing Initiative (PPHI)

In response to the challenges of finding affordable housing, the Victoria Private-Public Housing Initiative (PPHI) was created as an alternative way of accessing housing. The initiative is a partnership between the ROMs of BC and S2H. The partnership works to increase housing stock by moving people no longer needing intensive supports out of supportive housing, into private market housing. This in turn opens up spaces in supportive housing for those currently in need. S2H facilitates a smooth transition by providing the resources for less intensive supports and subsidies. Involving landlords in housing people with a greater level of stability meant that landlords were less concerned about the potential risks. This initiative increased the number of housing units available while improving relations between housing organizations and landlords. Al Kemp, CEO of ROMs BC, stated that:

“This pilot project was not only a success in that its result was ‘creating’ 15 units of subsidized social housing, but also it demonstrated that a private-public partnership can cause effective change in our community. I sincerely hope the creating of these 15 units and the successful housing of 15 people in private sector accommodation will serve as a bellwether for continuing this partnership” (Crewson, 2011:14).

Maintaining Landlord Relationships and Mitigating Risks

Private landlords are often understandably concerned about the risks associated with housing people experiencing a variety of challenges. The S2H program helps to mitigate many of these risks. For example, once a client is housed the rent payment goes directly from the S2H administration at Pacifica Housing to the landlord, eliminating the risk of nonpayment. Another common concern from landlords was the potential for property damage. S2H staff have found that Housing First must have the financial resources available to pay for any damage repair. Another important aspect is dedicating a staff member to working with landlords to build trusting relationships, just as they would with clients, and to deal with issues as they arise. For landlords the reassurance of knowing they can call a dedicated staff member to address their concerns is essential to building a long-term and trusting relationship with S2H. The Landlord Liaison and FSW manage the majority of S2H tenancy issues. Clients are also empowered to take on progressively more responsibility.

Landlords in Victoria had also been exposed to a number of different housing programs at work in Victoria. On some occasions when S2H staff called landlords to inquire about availability, landlords would report issues with a previous tenant from the S2H program. Further conversations would reveal that the tenant was from a non-S2H program. This points to the potential for further collaboration amongst service providers who work with landlords in the private market.

The relationship-building aspect of partnering with landlords was crucial in Victoria’s S2H program development. The team has secured 20 landlords with 50 buildings who are willing to work with S2H to access and maintain housing for clients. All 20 landlords have been retained since the beginning of the program.

High Support Need

Given Housing First’s focus on the most vulnerable citizens, clients in the program can experience significant social and behavioural challenges. As Brad Crewson, S2H Coordinator explains

“…structural and systemic factors associated with homelessness in Greater Victoria, including lack of rental affordability, low minimum wage ($8 at the time of writing) and income assistance rates, limited substance use treatment resources and more, have resulted in a disproportionately large number of participants with a range of chronically unmet health and social needs” (Crewson, 2011:13).

People who have experienced long-term street involvement, substance use and/or mental health challenges can display disruptive behaviours. In Victoria, S2H staff found that some clients needed significantly more time to adjust to their new situation than others. Change is difficult for everyone. For those adjusting to a new manner of living, with new rules and responsibilities, it can be overwhelming and difficult to control emotions and behaviours. Some participants who were stable during their initial assessment became more aggressive or destructive after getting housing.

“The coping mechanisms that keep them alive on the street become deeply ingrained as they adapt to extreme demands. When they become housed, many of these stressors disappear and some participants show a tendency to react instinctively by acting out or resorting to behaviours that increase the levels of stress and crisis that are more familiar to them. While S2H was well aware of the potential for these behaviours, with only four FSWs2 who provided off-site support services, there was limited capacity to respond efficiently to the range of behaviours and needs of the participants” (Crewson, 2011:13).

Another potential problem is a participants’ capacity to manage guests. Many people who formerly experienced homelessness have broad social networks with others who are currently experiencing homelessness. When one person becomes housed they are sometimes pressured to assist their friends who are still experiencing homelessness. Parties, noise and overcrowding that result from this pressure can cause problems with neighbours. Having a staff member working with clients and landlords to deal with these issues has been essential to the success of the S2H program.

Adjust Staffing Models to Suit Needs

During the pilot project the existing S2H staffing model did not allow for the intensive levels of support sometimes required and needed adaptation. The pilot program’s staffing model included a Landlord Liaison, a Program Facilitator and a Program Coordinator. Not all of these roles were found to be necessary and were subsequently revised. In the revised model, the Program Coordinator took on some of the Facilitator’s tasks. Additionally, the number of FSWs was expanded to five based on increased rent subsidises and best practices regarding client-worker ratios.

Maximum Caseload

As the program grew and more subsidies became available, more staff were hired in order to maintain a client caseload of 24 people or less for each worker. The maximum caseload ensures that clients receive the support they need to obtain and maintain housing.

Remuneration

Salaries in the nonprofit sector are notoriously low, however S2H in Victoria understands that talented workers increase the effectiveness of the program and budgets for the necessary costs of attracting and retaining quality staff. S2H works to offer wages and incentives that attract high quality support workers who are experienced and knowledgeable.

Continuous Monitoring and Evaluation to Inform Program Adaptation

Successfully adapting programs to suit client needs was essential to improving S2H outcomes. Information collected and documented during the pilot project identified the challenges needing to be addressed and was used to inform the program going forward. Staff continue to refine and adapt best practices, integrating recommendations learned in program delivery, as well as from program evaluations.

Need for Collaboration and Integration of Services

There is a strong belief in Victoria that ending homelessness requires a community effort; it cannot be done without the support of Victoria’s major players in the homelessness, health and social care sectors. The S2H program was initiated by the Coalition and is currently administered by Pacifica Housing, but relies on other agencies’ contributions to the program’s success.

Central Partnerships that Enable Housing First in Victoria

S2H is a partnership and collaboration between the Coalition and a variety of organizations. Since the coalition’s mandate did not include direct service delivery an agency was chosen that had existing administrative infrastructure (payroll, physical office space, communications, accounting etc.) to administer the program on behalf of the community. While Pacifica Housing and VNFC provide the structure, pay for staff etc. all partners identify as part of the S2H team. Each plays a key role as outlined below:

• BC Housing provides funding for S2H rent subsidies.

• Victoria Cool Aid Society, Our Place Society and The Salvation Army provides shelter and transitional housing services, as well as referrals. They also send representatives to the Frontline Service Worker Group that is responsible for S2H intake decisions.

• Pacifica Housing provides the administrative infrastructure for Victoria’s S2H program as well as employing the Program Coordinator, Landlord Liaison and 3 FSWs.

• Victoria Native Friendship Centre employs two of S2H’s five support workers who have access to additional agency expertise, particularly regarding Aboriginal issues.

• Vancouver Island Health Authority has provided a ‘one-time-only’ operations grant.

• The Ministry of Social Development provides staff support, information access and policy provisions that facilitate service provision for S2H clients.

• The United Way of Greater Victoria provides the majority of the operational funding for the Victoria S2H program.

EVIDENCE OF EFFECTIVENESS

An evaluation of S2H was conducted in the summer of 2011 with the support of the Community Social Planning Council. The evaluation’s goal was to provide evidence of S2H’s effectiveness by documenting both individual outcomes of participants, as well as system-level changes relevant to addressing homelessness amongst people with multiple barriers to housing in Greater Victoria. A subsequent internal evaluation in 2012 provided updated data on outcomes for all clients since the program began.

From the beginning of the program (August 2010) until December 2012:

• 130 participants have been housed; and

• 63 of the 86 (73%) participants who were housed, prior to and including Jan 1st 2012, are known to be housed (clients who have left the program may still be adequately housed but S2H is unable to confirm their housing status).

Of the 35 housed participants who have exited the program since it began:

• 13 were transitioned to supported housing or a higher level of support;

• 4 left for other housing opportunities before completion;

• 7 completed the program (attained stable housing and income);

• 6 exited due to non-compliance;

• 3 with whereabouts unknown; and

• 2 are deceased.

Surveys were also administered to clients about their perceptions of the program and its impact on their lives. Responses included:

• 36 of 57 (63%) of those participants responding to the survey reported increased access to mental health and addictions support;

• 22 of 95 (23%) of current participants received some kind of new employment income in addition to their existing benefits and subsidies;

• 26 of 95 (27%) of current participants are involved in volunteer activities; and

• 39 of 95 (41%) of current participants are involved in pre-employment training, employment training or educational upgrading.

Sustainability

Greater Victoria’s S2H model has evolved into a cost-effective, efficient alternative for people experiencing homelessness and multiple barriers to accessing stable, affordable housing. The cost of running the program is approximately $7,000 per participant, per year; much less than the costs of operating purpose-built supported housing.

Funding

At the end of the two-year pilot project, S2H received three year funding from the United Way of Greater Victoria, as well as grants from BC Housing, The City of Victoria, The Victoria Foundation and the Coalition. In January 2012 S2H transitioned into a permanent program and ongoing administrative responsibility moved to one of its community partners, Pacifica Housing. The core service delivery model remains the same; changes were noted in the ‘making it happen’ section.

Sustaining the program will rely on maintaining the momentum of the program’s success and effectiveness within the community and amongst stakeholders. Securing diverse sources of funding is also necessary to achieving long-term sustainability.

The Importance of Knowledge Mobilization in Sustaining S2H

Raising awareness about the success of the program is integral to its sustainability. It is essential that knowledge of Victoria’s successful Housing First program be spread amongst community members, funders and broader Canadian society. Leaders from within the community are taking the opportunity to speak, for example at a recent BC Non-Profit Housing Association Conference, with other groups and communities about Housing First and Victoria’s S2H program. S2H staff feel that as people hear about successful Housing First programs occurring in different communities overall support for S2H, both in Victoria and elsewhere, will inevitably grow.

Diverse Multi-source Funding

Programs reliant on one or two funding sources are at risk of program instability if one funder decides to remove their financial support. Having multiple and diverse sources of funding in Victoria has also proven to be a form of leverage; multiple funders demonstrates that organizations are already supporting the program, which in turn encourages others to do the same.

KEY LEARNINGS

A Home is Foundational

Regardless of the level of support a person receives in the community, until they have a their own home it is very difficult, and sometimes impossible, for a person to focus on other needs such as finding a job or maintaining sobriety. Having a home promotes stability, health and social inclusion. If homeless reduction programs in Victoria are going to be successful, providing housing is essential.

Context Matters

Every community is unique. What makes Housing First a viable option is its adaptability to a specific community’s needs and its capacity to address existing service gaps. Although Victoria’s S2H program is based on Toronto’s model, adaptations were made in response to Victoria’s particular rental market. As long as a program is based on the core Housing First principles, the specific supports and activities that are offered can be modified to suit the needs of the clients and the community.

The Importance of Rent Supplements

The Victoria S2H program provides participants with a maximum $300 monthly rent supplement. Without the supplement staff feel they would be far more restricted in terms of where people could be housed, that it would take longer to find housing and that fewer people would be able to access housing.

Early in 2013, BC Housing planned on gradually eliminating the rent subsidies through attrition, however the rental market in Victoria remained too expensive for many of its citizens to afford. The community rallied together and convinced the funder to renew their commitment to funding. Rent subsidies was clearly an aspect of the program that all stakeholders felt was important for the success of the program.

Public Education

The data on homelessness in Canada indicates that anyone can experience homelessness. Many people experiencing homelessness have faced significant difficulties in their lives that have resulted in homelessness; some have lost their jobs, been the victim of a fire or other tragedies. Traditional methods of managing homelessness are not working because they consistently lack a key aspect: housing. People experiencing homelessness need a home and they need support in finding and maintaining that home.

Education that works to break down the stereotypes around homelessness and helps the public understand the realities of homelessness is an essential component of Housing First. As communities come to understand the philosophy of Housing First and see the evidence of success among Housing First programs, both locally and nationally, their capacity and propensity to support these programs will increase.

REFERENCES

Crewson, B. (2012). Greater Victoria Streets to Homes Program Evaluation and Report. Pacifica Housing.

Brad Crewson, B., Moreno, A., Thompson, D., Kerr-Southin, M. (2011). Streets to Homes Pilot Project Evaluation.

Mayor’s Task Force on Breaking the Cycle of Mental Illness, Addictions and Homelessness. (2007). Breaking the Cycle of Mental Illness, Addictions and Homelessness. Retrieved from http://www.victoria.ca/EN/main/city/mayor-council-committees/task-forces/homelessness.html

ENDNOTES

1. The description of Victoria’s Streets to Home program is adapted from a document entitled Streets to Homes Pilot Program Evaluation (2011).

2. During the pilot there were four FSWs, but this was increased to five.