by Alannah McBride and Randall Bartlett<\/p>\n\n\n\n
On June 11, 2018, the federal government announced its redesigned homeless program, Reaching Home<\/em>. While details remain scant, Reaching Home<\/em> leaves the impression that the government is prepared to take a number of bold and promising steps forward but is willing to risk progress with one big step backwards. <\/p>\n\n\n\n In its abandonment of the Housing First requirement and lack of firm commitment to end chronic homelessness in Canada (i.e., a weaker commitment to a achieve a 50% reduction), Reaching Home<\/em> leaves open the door for federal funding to be diverted toward homelessness interventions that are neither evidence-based nor best practice. Indeed, without binding incentives for communities to follow a data-driven, performance-based approach to reaching the federal government\u2019s less-than-ambitious target of reducing chronic homelessness by 50% over the next decade, taxpayers, communities, and homeless people could be made worse off as a result of Reaching Home<\/em>.<\/p>\n\n\n\n The purpose of this note is to highlight practical risks related to the elimination of the requirement for a Housing First investment target. Reaching Home<\/em> officially begins on April 1, 2019. It is our hope that the government will re affirm its commitment to a Housing First allocation as was recommended in the May 2018 Final Report of the Advisory Committee on Homelessness.<\/p>\n\n\n\n The Homelessness Partnering Strategy elevated Canada to a global stage<\/u><\/em><\/p>\n\n\n\n Reaching Home<\/em> replaces the Homelessness Partnering Strategy (HPS), which was introduced by the former federal Conservative government in Budget 2013. Under the HPS, federal funding for homelessness initiatives largely became focused on what\u2019s known as Housing First \u2013 a highly effective evidence-based intervention which places chronically homeless people in homes with the supports they need. The HPS was also highly prescriptive, requiring that 65% of the funding going toward \u2018Designated Communities\u2019 (municipalities that received funding under the HPS) be used for Housing First.<\/p>\n\n\n\n The design of the HPS was based on the outcomes of the At Home\/Chez Soi project<\/a> \u2013 the largest Housing First<\/a> controlled trial in the world to date \u2013 which the federal government first announced funding for in 2008. Its results were nothing short of miraculous, housing previously chronically and episodically homeless people with serious mental illness in their own homes with the needed level of supports. Surveys showed formerly homeless people not only remained housed for longer and in better conditions relative to the treatment-as-usual approach (e.g. shelters and transitional housing), but that their quality of life and mental health outcomes improved as well. And as an added bonus, it turns out that Housing First is also better for taxpayers as program costs were offset with reductions in health care, social service use, and implication in the justice system. As a result of these monumental outcomes, Housing First became the primary intervention for homelessness funded by the federal government beginning in 2014.<\/p>\n\n\n\n And these outstanding results weren\u2019t just isolated to federal government programs. The outcomes of the At Home\/Chez Soi project mirror many of the positive results already observed at that time in Alberta, where Housing First had been mandated by the province for its seven largest cities starting in 2008. In all of Alberta\u2019s urban centers, homelessness fell steadily, ultimately leading to an end to chronic homelessness in Medicine Hat. Meanwhile, larger centers, like Edmonton, on the same path. Contrast this with Ontario, where there is a more laissez-faire approach to combatting homelessness, and where Housing First was endorsed but without firm commitments from the provincial government. This approach in Ontario, which mirrors that now taken by Reaching Home<\/em> has seen none of the same successes that Alberta has experienced. Indeed, the track records of Ontario\u2019s largest cities \u2013 Toronto and Ottawa \u2013 are not good.<\/p>\n\n\n\n In 2018, the HPS subsequently underwent an internal evaluation<\/a> by Employment and Social Development Canada (ESDC) (note that the Institute of Fiscal Studies and Democracy (IFSD) attempted to work with ESDC on undertaking an external evaluation to determine the drivers of Housing First success in Canada, but after some initial enthusiasm our correspondence was subsequently ignored). According to ESDC\u2019s evaluation of the HPS, \u201cThe Housing First approach is associated with a host of positive outcomes, such as increased housing stability, cost effectiveness, improved community functioning and quality of life. The overall program design contributes to improving access for Canadians struggling with homelessness.\u201d Further, \u201cKey findings from the evaluation indicate that within the resources available and through extensive partnering, the Homelessness Partnering Strategy is addressing some of the highest priority needs of the homeless in Canada. The program\u2019s primary focus on the chronic and episodic homeless aligns with those who are the heaviest users of the emergency shelter system\u2026 The program\u2019s design addresses many of the contributing factors to homelessness and areas of specific need, including supporting approaches to addressing systemic and societal barriers to housing, provision of housing supports, and accessing health and social services within communities.\u201d<\/p>\n\n\n\n The ESDC evaluation also came with some recommendations on how the HPS could be improved upon. These include:<\/p>\n\n\n\n 1) Increase flexibility under Housing First to enable the provision of Housing First interventions to a greater proportion of the homeless population beyond the episodically and chronically homeless.<\/p>\n\n\n\n 2) Further promote the participation of diverse groups on Community Advisory Boards, such as the private sector, police and correction services, landlord associations and individuals with lived experience\/experiential knowledge of homelessness.<\/p>\n\n\n\n 3) Review reporting requirements in order to reduce the burden on communities to gather the necessary information to monitor and measure performance.<\/p>\n\n\n\n At no time did the ESDC evaluation recommend abandoning the Housing-First requirement for the HPS. These recommendations instead spoke to the need for greater inclusion of diverse groups in consultations, the flexibility to include in Housing First homeless people before their homelessness becomes chronic, and a reduced burden of reporting by communities.<\/p>\n\n\n\n Housing First has many enemies at home<\/u><\/em><\/p>\n\n\n\n But not everyone in Canada was happy with the HPS or with its mandated funding of Housing First programs starting in 2014. The lack of consultations and the rigidity of the program requirements left some municipalities and service providers feeling sore. It also left traditional service providers scrambling to adapt to this new paradigm in supporting the homeless. Their services would have to revolve around giving homeless people a home first as opposed to maintaining them in homelessness until they \u2018earn\u2019 the privilege of having one, a practice can be described as \u201ctreatment first focused on facilitating housing readiness\u201d.<\/p>\n\n\n\n Given its incredible success relative to treatment as usual, Housing First has been widely recognized as among the most effective evidence-based interventions to end chronic homelessness. Indeed, Housing First has been, at the very least, mentioned<\/em> in every federal budget since 2013. It is also now a favoured approach in the United States and in most countries in Western Europe.<\/p>\n\n\n\n This made Budget 2018 the first budget in five years to deviate from endorsing this evidence-based approach. Instead, Budget 2018 reiterated the federal government\u2019s announcement in the National Housing Strategy (NHS) that the HPS would be replaced with a redesigned homelessness program starting in April 2019. The NHS similarly omitted any mention of Housing First. Budget 2018 also put a focus on homeless shelters \u2013 a less effective model of reducing homelessness than Housing First, as it manages homelessness as opposed to solving it. The language in Budget 2018 is problematic as well. To quote the budget, \u201chousing in shelters doesn\u2019t just provide a safe place to sleep, it saves lives.\u201d This is a strange way to describe shelters as interviews with people experiencing homelessness demonstrate that people using shelters broadly find them to be unsafe<\/a>, among having other negative qualities.<\/p>\n\n\n\n As it turns out, the omission of Housing First and endorsement of emergency shelters in the NHS and Budget 2018 as a means of mitigating homelessness was no accident. It instead foreshadowed the end of federal government support for the requirement to deliver Housing First programs, as had been the case under the HPS.<\/p>\n\n\n\n Recommendations of the Advisory Committee on Homelessness<\/u><\/em><\/p>\n\n\n\n Despite the success of the HPS and Housing First, the federal government first announced that it was redesigning its homeless program in November 2017 along with the NHS. As part of this process, the Government of Canada planned to consult broadly with stakeholders as well as its Advisory Committee on Homelessness (the Committee). The Committee, made up of prominent homelessness experts from around the country, was given the mandate \u201cto support the redesign of Employment and Social Development Canada\u2019s Homelessness Partnering Strategy (HPS) after 2018-19.\u201d<\/p>\n\n\n\n In May 2018, the Committee released the Final Report<\/a> . The Committee\u2019s Final Report contained 12 recommendations for the redesign of the HPS, as well as further sub-recommendations which subsumed the recommendations made by ESDC in its evaluation of the HPS.<\/p>\n\n\n\n More specifically, the Final Report supports a rights-based approach and points out the various aspects of the current HPS that violate this. This section of the report extensively cites Leilani Farha, the UN Special Rapporteur on the Right to Housing, and explores what the Responsibility to Assist protocol entails. An important recommendation of the report is to amend the goal of a 50% reduction in chronic shelters users and replace it with a goal to eliminate chronic homelessness as this would be better aligned with a rights-based approach. An important note made by the Committee is the discriminatory nature of the current target, since women are less frequent users of shelters due to safety concerns and the risk of losing their children to child and youth services. Therefore, the goal of a 50% reduction in chronic shelter users is likely to exclude outreach to many women.<\/p>\n\n\n\n The Committee also supported the Housing First model for the federal program. They agreed with the current requirement that 65% of funding must go toward Housing First activities and suggest the maintenance of this requirement. Although the Committee supports Housing First, they suggest that the redesigned program should act to reduce the barriers to the adaptation of the Housing First model. This will help the program to better meet local conditions. Increased flexibility can be useful for communities to better suit their local needs. However, maintaining fidelity of the Housing First model is crucial to its success in reducing and, eventually, eliminating homelessness. The Committee also recommended the development of criteria which would allow Designated Communities in the redesigned homelessness program to reallocate investment for Housing First to other areas such as homelessness prevention.<\/p>\n\n\n\n Unfortunately, much of this has turned out to be mute, as the federal government has decided to ignore these recommendations. Specifically, the federal government has demonstrated no intention of amending the goal of reducing chronic homelessness by 50% over the next decade to be more ambitious and inclusive. It has also backed away from any requirement for Housing First at all. <\/p>\n\n\n\n Reaching Home <\/u><\/em><\/p>\n\n\n\n Not requiring adherence to evidence-based interventions like Housing First, on the part of communities is a clear failing of Reaching Home. Instead, tossing around the usual buzzwords like \u2018innovation\u2019 takes priority once again over tried and tested interventions that are proven to work.<\/p>\n\n\n\n The Backgrounder: Reaching Home <\/em>makes clear that the goal of giving communities more flexibility with federal resources was a higher priority than a \u2018requirement on allocation\u201d for Housing First<\/p>\n\n\n\n \u201cWhile Housing First remains the model supported by the Government of Canada, and an effective tool to reduce homelessness, we chose to give communities more flexibility in how they use their funding to meet local needs\u201d<\/em><\/p>\n\n\n\n As noted, there are some positives to come out of Reaching Home. Specifically, the strategy will receive more resources and will be expanded to include more communities without reducing funding to the existing Designated Communities. It promises to \u201cwork with communities to develop and deliver data-driven system plans with clear outcomes\u2026<\/em>\u201d tied to the federal government\u2019s less-than-ambitious goal of halving the number of chronically homeless shelter users over the next decade. Indeed, most provinces and large municipalities already have more ambitious targets.<\/p>\n\n\n\n Reaching Home will \u201calso provide communities with the tools they need to deliver systems plans, coordinated access to services, and better local data.\u201d This is a good thing, and arguably a weakness of the very narrowly focused HPS, as it\u2019s difficult to drive good outcomes if you don\u2019t have good data.<\/p>\n\n\n\n However, there is a great deal of antagonism toward evidence-based interventions, and particularly Housing First, on the part of some municipalities and service providers. As such, increased flexibility is likely to just mean greater resources funneled toward traditional treatment as usual in some jurisdictions that have proven to be ineffective in ending chronic homelessness for a majority of individuals as opposed to long-term, evidence-based solutions and best practices.<\/p>\n\n\n\n Indeed, the IFSD\u2019s in depth analysis of the City of Ottawa\u2019s homelessness interventions<\/a> revealed that the Housing First programs were, by and large, funded through the HPS. However, these programs had poorer outcomes for individuals relative to recognized outcome benchmarks for these programs in published studies and, according to the City<\/a> itself, would show a high level of fidelity \u00a0to the evidence-based Housing First model (a fidelity assessment examines the adherence of a Housing First to the Pathways Housing First<\/a> model). A focus on expanding offerings and resources dedicated to treatment as usual was then further reinforced in a policy paper<\/a> written by the City of Ottawa\u2019s Deputy Mayor and the Mayor\u2019s Special Liaison on Housing and Homelessness with recommendations that included building new shelters. Taken together, the increased flexibility under Reaching Home is very likely to lead to even more dismal outcomes in the City of Ottawa. But it isn\u2019t just Ottawa when evidence-based interventions to support homeless people are in short supply. Take the homelessness crisis that occurred in the winter of 2018 in the City of Toronto and called for as many as 1,500 more permanent emergency shelter beds<\/a>. This suggests that increased flexibility in federal funding is likely to drive more Band-Aid interventions for homelessness over long-term solutions in Canada\u2019s largest city as well. With both of these cities completely adrift when it comes to meeting the provincial goal of eliminating chronic homelessness by 2025, it\u2019s difficult to see how a movement away from evidenced-based interventions on the part of the federal government will support better outcomes.<\/p>\n\n\n\n Further, the requirement that \u201ccommunities participating in Reaching Home will work toward a 50% reduction in chronic homelessness over the next 10 years<\/em>\u201d also conflicts with the federal government\u2019s stated objective of a rights-based approach to housing. This approach should force governments to view people experiencing homelessness as rights-holders when it comes to housing, which ensures that no one is left behind. But given the targets for reducing homelessness in Reaching Home and the NHS are quite literally \u2018half measures\u2019, the federal government does not appear to have fully embraced a rights-based approach.<\/p>\n\n\n\n This view is further supported by the work of Leilani Farha in the United Nations 2018 annual report<\/a> of the Special Rapporteur on the Right to Housing, and was also explored at a symposium on ending homelessness<\/a> hosted by the IFSD. The Final Report of the Committee calls this reduction goal into question as well. Not only would the realization of this goal be an underachievement, it will still leave too many Canadians without a home. \u00a0\u00a0<\/p>\n\n\n\n Conclusion<\/u><\/em><\/p>\n\n\n\n When it comes to tackling homelessness, Canadians deserve a solid plan evidence-based interventions are utilized to their full potential. This will ensure that the intended outcomes are reached and that tax dollars are well spent, making everyone better off. If the federal government is committed to a rights-based approach, the initiatives and funding must be grounded in evidence and ensure accountability and transparency, something presently lacking in Reaching Home<\/em>.<\/p>\n\n\n\n But one thing is clear from the Reaching Home proposal: the federal government is backing away from an evidence-based model for tackling homelessness in its abandonment of Housing First. Clearly, shelters have a role in what should be a wrap-around system, but they should not be the primary approach for the prevention and reduction of chronic or episodic homelessness. The shelter model should be a supportive aspect of a grander plan, one that embraces Housing First.<\/p>\n\n\n\n Fortunately, these issues can be rectified quickly, and all it involves is a requirement for evidence-based interventions and greater accountability in how resources are being used. The federal government still has time to take the recommendations of the Committee to heart and implement many of their evidence-based recommendations grounded in best practice, including the requirement for Housing First.<\/p>\n\n\n\n Without thoughtful alterations to Reaching Home<\/em>, the federal government\u2019s redesigned homelessness plan is unlikely to see the desired reductions in chronic homelessness. This is because it won\u2019t target its root causes and it won\u2019t implement evidence-based policies such as Housing First. This plan is not giving Canadians a place to call home. Instead, it is removing the key pillar that has held up the strategy for years.<\/p>\n","protected":false},"excerpt":{"rendered":" On June 11, 2018, the federal government announced its redesigned homeless program, Reaching Home<\/em>. While details remain scant, Reaching Home<\/em> leaves the impression that the government is prepared to take a number of bold and promising steps forward but is willing to risk progress with one big step backwards. <\/p>\n\n